临床护士肠内营养相关性腹泻知信行现状及影响因素分析

目的 了解临床护士肠内营养相关性腹泻的知信行现状并分析影响因素,为临床开展相关培训及管理提供参考。 方法 采用自制的一般资料问卷、知识考核问卷和汉化版的护士肠内营养相关性腹泻定义、态度和行为问卷,对1 444名临床护士进行调查。 结果 临床护士肠内营养相关性腹泻知信行得分分别为定义（21.97±2.94）分、态度（20.29±5.35）分、行为（33.17±5.11）分、知识（55.16±17.24）分。多元线性回归分析显示,工作年限、职务、职称、肠内营养护理频率、肠内营养专项培训次数是护士肠内营养相关性腹泻知信行的影响因素（均P＜0.05）。 结论 临床护士肠内营养相关性腹泻知信行水平均有提升空间,护理管理人员需结合护士个人特征,通过开展多模式培训提高其肠内营养相关性腹泻的知信行水平。     

银屑病患者皮肤保湿护理知信行现状及影响因素分析

目的 调查寻常型银屑病患者皮肤保湿护理认知、态度、行为现状,分析影响因素,为落实患者皮肤护理健康指导提供依据。 方法 采用自行设计的寻常型银屑病患者皮肤保湿护理知信行问卷,对283例银屑病患者进行调查。 结果 寻常型银屑病患者皮肤保湿护理知识维度得分为（10.20±3.22）分,得分率为72.86%;态度维度得分为（24.14±4.14）分,得分率为80.47%;行为维度得分为（17.63±5.36）分,得分率为70.52%。不同年龄、文化程度、病程患者的认知、态度或行为得分比较,差异有统计学意义（均P＜0.05）。 结论 寻常型银屑病患者皮肤保湿护理知信行水平处于中等偏上水平,其认知和行为水平需要提高。医护人员应结合患者年龄、学历、病程对患者皮肤保湿护理知识进行个性化指导,帮助形成正确的皮肤保湿护理行为,以缓解银屑病症状。     

银屑病患者皮肤保湿护理知信行现状及影响因素分析

目的 调查寻常型银屑病患者皮肤保湿护理认知、态度、行为现状,分析影响因素,为落实患者皮肤护理健康指导提供依据。 方法 采用自行设计的寻常型银屑病患者皮肤保湿护理知信行问卷,对283例银屑病患者进行调查。 结果 寻常型银屑病患者皮肤保湿护理知识维度得分为（10.20±3.22）分,得分率为72.86%;态度维度得分为（24.14±4.14）分,得分率为80.47%;行为维度得分为（17.63±5.36）分,得分率为70.52%。不同年龄、文化程度、病程患者的认知、态度或行为得分比较,差异有统计学意义（均P＜0.05）。 结论 寻常型银屑病患者皮肤保湿护理知信行水平处于中等偏上水平,其认知和行为水平需要提高。医护人员应结合患者年龄、学历、病程对患者皮肤保湿护理知识进行个性化指导,帮助形成正确的皮肤保湿护理行为,以缓解银屑病症状。     

急诊科医护人员过度氧疗知信行多中心调查及影响因素分析

目的 调查急诊科医护人员过度氧疗知信行现状,并探索其影响因素,旨在为临床开展氧疗相关培训、规范氧疗行为提供参考。 方法 采用急诊科医护人员过度氧疗知信行问卷,对全国10个省市20所二级及以上综合性医院的急诊科医护人员998人进行调查。 结果 急诊科医护人员过度氧疗知信行总分为（120.76±13.61）分,知识、态度、行为维度得分分别为（29.54±5.45）分、（41.60±4.44）分和（49.62±9.49）分。多元线性回归分析结果显示,急诊科医护人员过度氧疗知信行的主要影响因素为医院级别、近12个月内是否学习过相关文献、职业、是否参加过相关培训、职务等（均P＜0.05）。 结论 急诊科医护人员对过度氧疗知识、态度、行为水平均处于中等水平。医院管理者应针对影响因素对急诊科医护人员进行过度氧疗知识培训,改变氧疗观念,以规范临床用氧,提高氧疗质量。     

ICU护士俯卧位通气知信行现状及影响因素分析

目的 探讨ICU护士俯卧位通气知信行现状及影响因素,为开展相关教学培训提供依据。方法 便利选取北京市5所综合医院209名ICU护士作为研究对象,自行设计ICU护士俯卧位通气知信行调查问卷进行调查。结果 共回收有效问卷190份,ICU护士对俯卧位通气知信行总分（148.75±23.64）分,知识维度得分（75.22±15.33）分,态度维度（37.20±4.59）分,行为维度（36.34±6.89）分;是否是带教老师、是否接受过俯卧位通气培训以及是否护理过俯卧位通气患者是俯卧位通气知信行评分的影响因素(均P<0.05)。结论 ICU护士对俯卧位通气的信念和行为较好,但知识层面有待提高。管理者应根据不同ICU护士的特征开展相应的俯卧位通气培训,以提高护士的知信行水平,促进俯卧位通气在ICU的有效应用。     

护理本科生课程思政知信行现状及影响因素分析

目的 了解护理本科生对护理专业课程思政知信行现状，并探讨其影响因素，为本科护理专业课程思政教学提供参考。 方法 采用自行编制的护理专业课程思政知信行问卷，对294名护理本科生进行调查。 结果 护理本科生对护理专业课程思政知信行总分为（91.10±10.40）分，其中知识、态度、行为得分分别为（23.71±3.17）、（28.81±4.02）和（38.57±5.06）分。多元线性回归分析显示，对护理专业的喜爱程度、参与相关课程思政教学情况及高校组织思政相关活动情况是护理本科生课程思政知信行的影响因素（均P＜0.05）。 结论 护理本科生对护理专业课程思政的知信行处于中等偏上水平，教学过程中应重点关注非自主选择护理专业、对护理专业喜爱程度低的护理本科生，调动护理本科生参与课程思政积极性，加强并优化课程思政建设的力度和形式，从而进一步提高护理本科生对护理专业课程思政的知信行水平。     

肿瘤化疗后患者居家跌倒预防知信行现状及影响因素研究

目的 了解肿瘤化疗后患者居家跌倒预防知信行现况及其影响因素,为构建肿瘤化疗后患者居家跌倒预防策略提供参考.方法 使用自行设计的居家跌倒预防知信行问卷,便利选取350例肿瘤化疗后患者进行调查.结果 肿瘤化疗后患者居家跌倒预防知信行总分(62.86±15.13)分,知识、信念及行为维度得分分别为(60.84±17.52)分、(74.10±16.48)分、(57.62±15.13)分.多元线性逐步回归分析显示,文化程度、已完成化疗疗程、家庭人均月收入、医疗付费方式、家庭关怀度及医护人员是否对居家患者定期进行跌倒预防随访是肿瘤化疗后患者居家跌倒预防知信行得分的影响因素(P<0.05,P<0.01).结论 肿瘤化疗后患者居家跌倒预防态度较为积极,但相关知识欠缺,行为总体较差.需着重进行居家跌倒危险因素及跌倒后应对技能方面的知识教育,同时加强定期随访服务.     

护理人员对住院患者自杀预防知信行的调查研究

目的 对护理人员住院患者自杀预防的知识、态度、行为水平进行现况调查,为开展护理人员 自杀预防学习提供参考.方法 采用自制护理人员对住院患者自杀预防知信行调查问卷,对445名护理人员进行调查.结果 护理人员对住院患者自杀预防的知识、态度、行为得分分别为(42.56±6.96)分、(30.02±4.31)分、(52.45±8.02)分,总分为(125.00±15.15)分.是否使用过心理评估量表、是否使用过自杀风险评估工具、是否参与患者自杀预防培训是护理人员 自杀预防知信行的主要影响因素(均P＜0.01).结论 护理人员对住院患者自杀预防知识态度行为总体呈中等偏上水平,管理者应当重视并针对护士开展自杀预防的培训学习.     

知信行三级目标理论模式在乳腺癌患者健康教育中的应用

目的提高乳腺癌患者对疾病相关知识的认识,改善其健康信念,促进其健康行为。方法将180例乳腺癌择期手术患者随机分为观察组（80例）和对照组（100例）。对照组行常规健康教育;观察组运用＂知、信、行＂三级目标的理论模式进行健康教育,即进行疾病相关知识教育、健康信念的培养和健康行为的支持。术后15d对患者进行疾病知识、信念、行为及健康教育满意度调查。结果观察组知识、信念、行为及对健康教育的满意度显著高于对照组（P〈0.05,P〈0.01）。结论根据＂知、信、行＂三级目标的理论模式进行健康教育,可为患者提供相关知识,改善其信念,促进其健康行为。     

临床护士化疗药物外渗预防相关知识和行为的调查

目的 了解临床护士化疗药物外渗预防知识和行为现状,为临床开展相关培训及质控提供依据。 方法 采用自行设计的调查问卷,对肿瘤相关科室临床护士151人进行化疗药物外渗相关知识和行为调查。 结果 临床护士化疗药物外渗预防知识总得分为（12.56±2.38）分,得分率为66.10%;对“哪些化疗药物外渗风险高”的答题准确率最低,只有19.20%。行为总得分为（49.28±5.38）分,得分率为72.47%;“外周化疗者当日输液后三班持续交接穿刺部位情况”条目得分最低。 结论 临床护士化疗药物外渗预防知识储备不足,预防行为水平有待提升。护理管理者应系统梳理肿瘤专科工作核心内容,对知识掌握的薄弱环节（如风险评估、患者教育等）进行针对性培训,以提高临床护士化疗药物外渗预防知识水平,促进预防行为的改善。     

Effects of different preparations of propofol, diazepam, and etomidate on human neutrophils in vitro

BACKGROUND: Intravenous anaesthetics and sedatives can influence polymorphonuclear cell (PMN) functions. Some of the drugs for sedation and anaesthesia have been alternatively dissolved in lipid solutions containing medium (MCT) and/or long chain (LCT) triglycerides. The in vitro effects of two different diazepam (benzyl-alcohol, LCT/MCT), etomidate (propylene-glycol, LCT/MCT), and propofol (LCT, LCT/MCT) preparations on respiratory burst (RB) and phagocytosis of human PMNs were studied. METHODS: Diazepam (2, 20 microg ml(-1)), etomidate (0.5, 5 microg ml(-1)), and propofol (6, 60 microg ml(-1)) were investigated in clinical and 10-fold concentrations with flow cytometric assays. The RB was measured with the fluorescent dye rhodamine after induction with Escherichia coli or formyl-methionyl-leucylphenylalanine (FMLP) following priming with tumour necrosis factor alpha (TNF-alpha). Phagocytosis of PMNs was carried out in whole blood after incubation with fluorescein-labelled E. coli. RESULTS: LCT-propofol at 60 microg ml(-1) reduced the percentage of PMNs with RB activity after induction with E. coli (52.8+/-20.4) and TNF-alpha/FMLP (10.8+/-5.1)) as well as the percentage of phagocytosing PMNs (48.9+/-19.5) in contrast to LCT/MCT-propofol, which augmented all parameters (85.4+/-10.1, 50.3+/-12.7, 66.5+/-12.5). Also the higher concentrations of LCT/MCT-diluted etomidate and diazepam increased the percentage of RB positive PMNs compared to the alternative compositions. The percentage of phagocytosing PMNs was less reduced with 20 microg ml(-1) LCT/MCT-diazepam (85.2+/-6.9) than with the same concentration of benzyl-alcohol diluted diazepam (68.8+/-12.2) compared to the control. CONCLUSION: The in vitro effects of diazepam, etomidate, and propofol are dependent on the solvent applied. The tested LCT/MCT preparations reduce the inhibitory effects on the bacterial killing capacity of PMNs found after incubation with propyleneglycol, benzyl-alcohol, or LCT preparations, respectively.     

A Randomized, Double-Blind, Pharmacokinetic Study of Oral Maribavir with Tacrolimus in Stable Renal Transplant Recipients

Maribavir is being developed as a novel agent for the prevention or treatment of cytomegalovirus infections after stem cell and organ transplantation. This was a randomized, double-blind, placebo-controlled study designed to evaluate the potential pharmacokinetic interaction of concomitant administration of maribavir and tacrolimus. Twenty-five adult renal transplant recipients with stable renal function and stable dosing regimens of tacrolimus were randomized (20 maribavir 400 mg p.o. q12 h: 5 placebo). Tacrolimus whole blood concentration profiles were determined before and after 7 days of co-administration with maribavir. When co-administered with maribavir, tacrolimus mean C_max increased 38%, tacrolimus trough concentrations (12 h post-dose) increased 57% and tacrolimus AUC_(0-τ) increased 51%. Apparent oral clearance of tacrolimus decreased 34% and T_max was delayed by 0.5 h. There were no serious adverse events and no subject prematurely discontinued treatment. Because of the limited 7-day dosing course, the adverse event profile could not be adequately assessed. However, as seen with other maribavir studies, dysgeusia was common (90% of maribavir subjects and 20% of placebo subjects). In conclusion, co-administration of maribavir 400 mg twice daily increases exposure to tacrolimus. Routine therapeutic drug monitoring of tacrolimus blood concentrations should be included both at initiation and completion of maribavir treatment.     

Effect of pentosan, a novel cancer chemotherapeutic agent, on prostate cancer cell growth and motility.

Pentosan is a new chemotherapeutic drug which is currently in Phase I clinical trials. In our experimental systems, in vivo, pentosan inhibits the growth of the highly metastatic MAT-LyLu (MLL) Dunning R3327 prostate cancer cell line only at toxic doses and has no apparent effect on growth in vitro. The mechanism of tumor inhibition of this drug is unknown; however, in vitro, pentosan exhibits a potent inhibition of cell motility. Cell motility is essential for tumor cell metastasis and angiogenesis. By blocking cell motility, pentosan has the potential to inhibit both tumor growth and metastasis. We have characterized the mechanism of motility inhibition by pentosan and believe it alters cell-extracellular matrix interactions. The mechanism of motility inhibition by pentosan appears to be independent of cytoskeletal structural alterations, including changes in microfilament and microtubule networks. Pentosan acts through a different mechanism than suramin, a drug which inhibits motility through inhibition of growth factor effects. In vitro, pentosan alters cellular contacts with the extravascular matrix and inhibits cell motility. In vivo, pentosan prolongs survival of rats injected with MLL cells by 25%, but did not appear to decrease the rate of primary tumor growth or the number of metastatic lesions in the treated animals. These data suggest that, in vivo, pentosan acts through an as yet undefined mechanism.     

Burnout,coping and job satisfaction in service staff treating opioid addicts—from Athens to Zurich

The Treatment‐systems Research on European Addiction Treatment study (TREAT‐project) is a longitudinal multicenter study on predominantly opioid‐dependent patients and their health‐care system in six European cities. As part of the examination of the drug services, this study evaluates level of burnout, coping strategies, perceived self‐efficacy and job satisfaction among health‐care workers treating opioid addicts. Employees were recruited from organizations in Athens, London, Padua, Stockholm, Zurich and Essen. The Maslach burnout inventory, Brief COPE, general self‐efficacy questionnaire and a job satisfaction scale were filled in by about 383 drug service workers. One‐third of the staff suffer from severe burnout. London and Stockholm colleagues are significantly more burdened than Zurich personnel where job satisfaction is highest. No cross‐national differences could be detected concerning coping styles or level of perceived self‐efficacy. Burnout is positively correlated to passive coping strategies and negatively linked to self‐efficacy and job satisfaction. Males experience more depersonalization. Organizational features such as the entry‐threshold level of the institution or out‐ vs. inpatient setting are relevant for coping strategies and job satisfaction. These and other findings are discussed in relation to preliminary data from the TREAT‐project on characteristics of opioid addicted patients and other specific features of the drug treatment system. Copyright © 2009 John Wiley & Sons, Ltd.