老年急性心肌梗死PCI术后患者健康促进行为驱动力的质性研究

目的探讨老年急性心肌梗死(AMI)PCI术后患者出院后健康促进行为的驱动因素,为改善患者的健康行为提供依据。方法本研究采用质性研究中的现象学研究法。采用目的抽样法,选取2019年11月—2020年1月在广州某三级甲等医院AMI门诊复诊的12例老年AMI行PCI术后患者为研究对象。采用半结构访谈法对其进行深度访谈,并采用Colaizzi 7步分析法分析资料。结果共提炼2个主题:(1)内源性驱动力,包括积极的自我感知老化、家庭责任感知、对未来社会发展的期待、健康相关控制感4个亚主题;(2)外源性驱动力,包括社会支持系统、自然与社会医疗环境、长期的医疗经济费用3个亚主题。结论老年AMI行PCI术后患者健康促进行为的驱动力复杂多样,医护人员应根据老年患者的个性化特征,调动患者的内源性与外源性驱动力,促使其采取健康促进行为,养成良好的健康生活方式。     

动机性访谈在老年高血压病病人教育中的应用

[目的]探讨动机性访谈（MI）在老年高血压病病人教育中的应用。[方法]将86例老年高血压病病人随机分为观察组44例和对照组42例,观察组采用动机性访谈干预,对照组采用常规健康教育。干预前及干预后3个月、6个月分别评估病人的自我管理能力和监测血压。[结果]两组病人干预后血压均降低,但观察组血压控制及自我管理能力优于对照组。[结论]动机性访谈干预能可改善高血压病病人的生活方式,提高病人的自我管理能力,从而有效控制血压。     

NICU出院早产儿母亲的育儿困难与应对行为

[目的]了解新生儿重症监护病房(NICU)出院早产儿母亲育儿生活中的困难及应对行为。[方法]采用质性研究法,在早产儿出院后1周、1个月时分别利用面谈和电话访谈的方式对18名母亲进行深度访谈。[结果]母亲在早产儿出院后经历了困难的母乳喂养、哺乳不确定性的困惑、自我育儿能力低下的无措与自责、对早产儿常见症状的担心与不安、疲劳及育儿负担感、育儿信息所致的混乱等育儿困难及不安,母亲采取积极应对和消极逃避两种方式应对育儿过程中所遇到的困难。[结论]早产儿母亲在育儿过程中存在育儿困难,为提高早产儿母亲的育儿能力,探讨医院—社区—家庭一体化的连续性护理服务模式势在必行。     

综合社会支持对年轻宫颈癌放化疗病人生活质量的影响

[目的]探讨综合社会支持对年轻宫颈癌放化疗病人生活质量的影响。[方法]将86例病理确诊为宫颈癌的年龄40岁及以下病人分为观察组及对照组,对照组按常规的方法对病人进行健康教育,观察组病人在整个放化疗期及出院期间在常规的健康教育的基础上加上综合社会支持行为干预,并用社会支持评定量表(SSRS)和宫颈癌病人生命质量评价量(QLS-CCP)对病人进行问卷调查,两组病人均在放化疗前和放化疗结束后出院时进行1次综合社会支持调查,并在放化疗结束出院时和出院后3个月时生活质量问卷进行专门调查。[结果]观察组病人放化疗后综合社会支持评分、出院3个月后生活质量优于对照组。[结论]综合社会支持可以提高年轻宫颈癌病人的生活质量。     

奥马哈系统在老年COPD病人连续护理中的应用研究

[目的]观察奥马哈系统(Omaha System)在老年慢性阻塞性肺疾病(COPD)病人连续护理中的应用效果。[方法]采用自身前后对照的研究方法,选择2015年9月—2016年2月本院呼吸内科住院的老年COPD病人120例,运用Omaha System,由COPD管理小组成员主要负责研究对象的连续护理工作,观察老年COPD病人入院时、出院时、出院后3个月的环境、心理社会、生理和健康相关行为领域健康问题的认知-行为-状况的变化。[结果]老年COPD病人在环境、心理社会、生理和健康相关行为领域的10个主要健康问题的认知-行为-状态评分比较变化明显,出院时与入院时和出院后3个月与出院时比较,差异均有统计学意义(P0.05)。[结论]Omaha System可量化老年COPD病人连续护理效果,为连续护理实践和护理研究提供参考。     

老年脑卒中病人健康促进行为成因的质性研究

[目的]从病人角度出发,深入了解形成住院老年脑卒中病人健康促进行为的主要原因。[方法]运用质性研究现象学法,访谈了10例广州市某三级医院神经内科老年脑卒中的住院病人。[结果]应用NVivo 8软件进行资料分析,得出5个老年脑卒中病人健康促进行为成因的主题概念,分别是病人的求医欲望、疾病影响的程度、疾病结局的恐惧、信息获取的渠道以及病人的社会支持。[结论]根据健康促进行为的影响因素提供针对性的护理是建立健康促进行为的先决条件。     

社会福利院老年人生活适应过程的质性研究

[目的]探讨老年人入住社会福利院后接受机构照护的生活适应问题及其影响因素。[方法]采用立意取样法选择泰安市某老年公寓14名老年居住者,采用质性研究中的扎根理论法,以深入访谈方式了解老年人入住后生活适应的心里历程,并对资料进行阅读、反思和编码分析。[结果]归纳出老年人入住社会福利院后的生活适应过程包括混乱期、熟悉适应期和稳定期3个阶段;自身人格特质和入住前的准备程度、护理人员的服务态度和护理服务内容以及家庭方面因素是影响老年人入住后适应的重要因素。[结论]通过协助老年人熟悉福利院环境、让老年人短暂回家、促进家属与老年人互动以及善用义工人力等措施可有效地缓解老年人入住福利院后的不良生活适应。     

健康管理模式在老年冠心病病人中的应用

[目的]探讨健康管理在老年冠心病病人中的应用效果。[方法]选取96例老年冠心病病人为研究对象,所有病人按健康管理模式实施护理干预,并分别于入院第3天及出院后2个月对病人进行健康商数评定及生活质量测评。[结果]出院后2个月,病人的健商测试评分及生活质量评分均高于入院第3天,差异有统计学意义(P0.01)。[结论]健康管理模式的实施可帮助冠心病病人建立规律、正确、科学的健康理念,促进健康恢复,提高生活质量。     

高龄老年病人出院1年内日常生活能力与抑郁状况的相关性分析

[目的]探讨高龄老年病人出院1年内日常生活能力与抑郁状况的相关性。[方法]随机选取某三级甲等医院高龄老年病人310例,分别于出院时、出院3个月及出院1年采用一般资料调查表、日常生活能力量表和老年抑郁量表进行问卷调查。[结果]随着出院时间的延长,高龄老年病人日常生活能力逐渐恢复,抑郁情绪逐渐减轻;在出院3个月和出院1年时,高龄老年病人的日常生活能力与抑郁呈负相关(P0.05)。[结论]应将医院的延续性护理和社区的卫生保健结合起来以提高出院的高龄老年病人的健康水平。     

压力管理对急性心肌梗死病人心理状况的影响

[目的]探讨压力管理对急性期、出院时和恢复期急性心肌梗死(AMI)病人心理状况的影响。[方法]采用便利抽样法在某三级甲等综合性医院CCU选取首次发生AMI病人326例,按时间段分为对照组156例和观察组170例,对两组病人均采用住院期AMI护理常规和出院后讲座活动,在此基础上对观察组病人采用压力管理干预,分住院期和出院后恢复期两阶段进行。使用综合医院焦虑/抑郁情绪测定表分别在病人住院急性期、出院恢复初期和出院3个月后恢复期进行测评。[结果]观察组病人焦虑和抑郁得分在住院急性期、出院恢复初期、恢复期有差异,且逐渐降低;对照组随着病程进展,焦虑和抑郁得分逐渐增高。观察组焦虑得分在出院恢复初期和恢复期都低于对照组;观察组抑郁得分在恢复期低于对照组,出院时没有差异。[结论]AMI病人在常规护理的基础上,压力管理能缓解其焦虑抑郁情绪。     

Setting a research agenda for interprofessional education and collaborative practice in the context of United States health system reform

Interprofessional education (IPE) and collaborative practice (CP) have been prolific areas of inquiry exploring research questions mostly concerned with local program and project assessment. The actual sphere of influence of this research has been limited. Often discussed separately, this article places IPE and CP in the same conceptual space. The interface of these form a nexus where new knowledge creation may be facilitated. Rigorous research on IPE in relation to CP that is relevant to and framed by health system reform in the U.S. is the ultimate research goal of the National Center for Interprofessional Practice and Education at the University of Minnesota. This paper describes the direction and scope for a focused and purposive IPECP research agenda linked to improvement in health outcomes, contextualized by health care reform in the U.S. that has provided a revitalizing energy for this area of inquiry. A research agenda articulates a focus, meaningful and robust questions, and a theory of change within which intervention outcomes are examined. Further, a research agenda identifies the practices the area of inquiry is interested in informing, and the types of study designs and analytic approaches amenable to carrying out the proposed work.     

A review of research related to blood transfusion in Canada, 2000-2002

The former National Blood Safety Council undertook a comprehensive review of blood transfusion research in Canada for the years 2000 through 2002. Data were acquired by direct contact with agencies which support such research and by searches of the relevant websites. Total grant support increased markedly over the 3-year period, from 4.1 million dollars to 18.5 million dollars. Publicly funded granting agencies, biopharmaceutical companies, the blood services and the province of Ontario were major supporters. Much smaller amounts were granted from charitable organizations. Clinical research attracted the majority of the funding, although a larger number of projects were basic science in nature. Most research was carried out in the provinces of Ontario, Québec and British Columbia. Although we have not assessed the productivity of blood-related research, it appears that substantial amounts of funding were allocated to these projects between 2000 and 2002. These data may provide a helpful perspective to investigators in transfusion medicine elsewhere, who may also be assessing the relative priority given to this field of research in their own countries.     

护理人员科研能力及科研成果产出现状

目的了解分析护理人员科研能力及科研成果产出关系及现状并提出对策。方法通过文献检索及探讨,分析目前护理人员科研能力及成果产出现状。结果护理人员医学检索及阅读能力较薄弱,科研意识和科研素质欠缺：护理论文发表数量及质量与学科发展仍不相称,基金论文发表率低。结论护理人员的科研水平及科研成果产出不理想,原因是多方面的,应采取对策改变这一现状。     

Research Fundamentals: II. Choosing and Defining a Research Question

Abstract. This is the second in a series of articles developed by members of the SAEM Research Committee to describe a stepwise approach to the research process. This series is aimed at junior academic emergency physicians (EPs), as well as nonacademic EPs with an interest in the research process. This article describes the development of a testable research hypothesis. While a multitude of sources provide interesting questions for consideration, choosing and refining the research question, so that it can be tested adequately and answered completely, are difficult tasks.     

Bridging the divide: a survey of nurses' opinions regarding barriers to, and facilitators of, research utilization in the practice setting

Background. Many researchers have explored the barriers to research uptake in order to overcome them and identify strategies to facilitate research utilization. However, the research–practice gap remains a persistent issue for the nursing profession. Aims and objectives. The aim of this study was to gain an understanding of perceived influences on nurses’ utilization of research, and explore what differences or commonalities exist between the findings of this research and those of studies that have been conducted in various countries during the past 10 years. Design. Nurses were surveyed to elicit their opinions regarding barriers to, and facilitators of, research utilization. The instrument comprised a 29‐item validated questionnaire, titled Barriers to Research Utilisation Scale (BARRIERS Scale), an eight‐item scale of facilitators, provision for respondents to record additional barriers and/or facilitators and a series of demographic questions. Method. The questionnaire was administered in 2001 to all nurses (n = 761) working at a major teaching hospital in Melbourne, Australia. A 45% response rate was achieved. Results. Greatest barriers to research utilization reported included time constraints, lack of awareness of available research literature, insufficient authority to change practice, inadequate skills in critical appraisal and lack of support for implementation of research findings. Greatest facilitators to research utilization reported included availability of more time to review and implement research findings, availability of more relevant research and colleague support. Conclusion. One of the most striking features of the findings of the present study is that perceptions of Australian nurses are remarkably consistent with reported perceptions of nurses in the US, UK and Northern Ireland during the past decade. Relevance to clinical practice. If the use of research evidence in practice results in better outcomes for our patients, this behoves us, as a profession, to address issues surrounding support for implementation of research findings, authority to change practice, time constraints and ability to critically appraise research with conviction and a sense of urgency.     

The struggle for methodological orthodoxy in nursing research: the case of mental health

This paper is not intended as an exhaustive review of contemporary mental health nursing research. Rather, the intention is to explore some of the competing arguments for different methodological approaches in social research, using mental health nursing as a case example. The paper questions the extent to which the artificially dichotomized debate over quantitative versus qualitative research impacts upon the working lives of practitioners, managers and policy makers. In particular, the paper traces the development of survey method, during this its centennial anniversary year. It also traces its subsequent decline, in favour of what will be referred to as the new methodological orthodoxy in nursing research. It is also interwoven with occasional accounts of personal experience, drawn from an international perspective. The paper calls for a reapproachement between different wings of methodological opinion, in deference to a publicly unified position for nursing research in which the achievement of quality becomes the over-arching concern.     

Collaboration in Emergency Medicine Research: A Consensus Statement

The role of collaboration in medical research and how it applies to emergency medicine (EM) research are discussed. The guidance of the Division of Health Sciences Policy of the Institute of Medicine is reviewed. Application of the principles of collaborative efforts and recognition of each individual's contribution are overviewed. Emergency physicians can and should be invaluable contributors to collaborative research. Collaborative research relationships, whether established at individual institutions or through national clinical trials, must be developed deliberately. The specialty of EM must make the necessary commitment of time and resources to ensure that these occur.