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91.
92.
Eriko Anzai RN MN Clint Douglas RN PhD Ann Bonner RN PhD 《Nursing & health sciences》2014,16(2):171-178
The purpose of this study was to describe Japanese hospital nurses' perceptions of the nursing practice environment and examine its association with nurse‐reported ability to provide quality nursing care, quality of patient care, and ward morale. A cross‐sectional survey design was used including 223 nurses working in 12 acute inpatient wards in a large Japanese teaching hospital. Nurses rated their work environment favorably overall using the Japanese version of the Practice Environment Scale of the Nursing Work Index. Subscale scores indicated high perceptions of physician relations and quality of nursing management, but lower scores for staffing and resources. Ward nurse managers generally rated the practice environment more positively than staff nurses except for staffing and resources. Regression analyses found the practice environment was a significant predictor of quality of patient care and ward morale, whereas perceived ability to provide quality nursing care was most strongly associated with years of clinical experience. These findings support interventions to improve the nursing practice environment, particularly staffing and resource adequacy, to enhance quality of care and ward morale in Japan. 相似文献
93.
94.
Berta Torres Alberto C Guardo Lorna Leal Agathe Leon Constanza Lucero Míriam J Alvarez-Martinez Miguel J Martinez Jordi Vila María Martínez-Rebollar Ana González-Cordón Josep M Gatell Montserrat Plana Felipe García 《Journal of the International AIDS Society》2014,17(1)
Introduction
Monotherapy with protease-inhibitors (MPI) may be an alternative to cART for HIV treatment. We assessed the impact of this strategy on immune activation, bacterial translocation and inflammation.Methods
We performed a cross-sectional study comparing patients on successful MPI (n=40) with patients on cART (n=20). Activation, senescence, exhaustion and differentiation stage in CD4+ and CD8+ T lymphocyte subsets, markers of monocyte activation, microbial translocation, inflammation, coagulation and low-level viremia were assessed.Results
CD4+ or CD8+ T lymphocyte subset parameters were not significantly different between both groups. Conversely, as compared with triple cART, MPI patients showed a higher proportion of activated monocytes (CD14+ CD16−CD163+ cells, p=0.031), soluble markers of monocyte activation (sCD14 p=0.004, sCD163 p=0.002), microbial translocation (lipopolysaccharide (LPS)-binding protein; LBP p=0.07), inflammation (IL-6 p=0.04) and low-level viremia (p=0.035). In a multivariate model, a higher level of CD14+ CD16−CD163+ cells and sCD14, and presence of very low-level viremia were independently associated with MPI. Monocyte activation was independently associated with markers of inflammation (IL-6, p=0.006), microbial translocation (LBP, p=0.01) and low-level viremia (p=0.01).Conclusions
Patients on MPI showed a higher level of monocyte activation than patients on standard therapy. Microbial translocation and low-level viremia were associated with the high level of monocyte activation observed in patients on MPI. The long-term clinical consequences of these findings should be assessed. 相似文献95.
96.
97.
Sarah Lake MN RN Cheryle Moss PhD RN Jan Duke PhD RN RM 《International journal of nursing practice》2009,15(5):376-388
Every day in clinical settings, nurses practise in complex and dynamic situations. Nurses work to achieve emergent order in these situations through nursing prioritization of the patient need for care. As direct research on nursing prioritization had not been reported, a study, using critical realism as method, was designed to discern the profession's embedded understanding from within the clinical decision-making literature. The research synthesizes a tacit knowledge on nursing prioritization of the patient need for care from key international literature (from 1966 to 2003). Nursing prioritization was discerned in both education and practice literatures; interrelationships between these and theoretical approaches were also identified. Nursing prioritization of the patient need for care was revealed both as a non-sequential decision-making process throughout unfolding patient situations and as an advanced skill of nursing practice. Increasing confidence with this skill is the hallmark of developing expertise. 相似文献
98.
Javier Gualis Ph.D. Mario Castaño Ph.D. Jesús Gómez‐Plana M.D. Carlos Martín M.D. David Alonso M.D. 《Journal of cardiac surgery》2010,25(6):656-658
Abstract Cardiac fibromas are rare benign tumors predominantly diagnosed in children and teenagers. We report a 57‐year‐old male patient with class II dyspnea and angina. During electrocardiographic assessment, recurrent ventricular tachycardia was present and magnetic resonance imaging revealed a giant (12.5 × 5 × 4 cm) intramural left ventricular tumor compatible with cardiac fibroma. After surgical biopsy and histological confirmation, open‐heart surgical resection was successfully performed. After nine months of follow up, the patient remains asymptomatic without evidence of ventricular tachycardia. (J Card Surg 2010;25:656‐658) 相似文献
99.
Alister N. Hodge RN BN Grad. Cert. Critical Care Master of Emergency Nursing Andrea P. Marshall RN IC Cert. BN MN Grad. Cert. Ed. Studies 《Collegian (Royal College of Nursing, Australia)》2009,16(3):101-118
The practice of allowing family to be present during patient resuscitation or invasive procedures (Family Presence) is gaining acceptance in North America and the United Kingdom in controlled circumstances. Research into Family Presence has demonstrated multiple benefits for the patient, family and health care team. These advantages include helping the family to understand the severity of the illness/trauma and to see that appropriate attempts were undertaken to save their loved one. Family Presence can also facilitate improved communication between the health care team and family. In spite of evidence supporting Family Presence as a useful practice for patient, family and health care team, the use of Family Presence is uncommon within Australian emergency departments and hospitals. Clear expectations at organisational, governmental and professional levels are essential to effectively implement this approach. To be supported in the clinical area, the success of a Family Presence program requires an inclusive approach to program development. A critical component of a successful Family Presence program is a family facilitator who is adequately prepared for the role and committed to supporting the family during resuscitation or invasive procedures. Research exploring Family Presence in Australia is lacking and highlights the need for context specific research in this area. 相似文献
100.
Virginia Schmied PhD MA RM Sarah Beake MA RM RN Athena Sheehan PhD MN RM Christine McCourt PhD BA Fiona Dykes PhD MA RM 《分娩》2011,38(1):49-60
Abstract: Background: Both peer and professional support have been identified as important to the success of breastfeeding. The aim of this metasynthesis was to examine women’s perceptions and experiences of breastfeeding support, either professional or peer, to illuminate the components of support that they deemed “supportive.” Methods: The metasynthesis included studies of both formal or “created” peer and professional support for breastfeeding women but excluded studies of family or informal support. Qualitative studies were included as well as large‐scale surveys if they reported the analysis of qualitative data gathered through open‐ended responses. Primiparas and multiparas who initiated breastfeeding were included. Studies published in English, in peer‐reviewed journals, and undertaken between January 1990 and December 2007 were included. After assessment for relevance and quality, 31 studies were included. Meta‐ethnographic methods were used to identify categories and themes. Results: The metasynthesis resulted in four categories comprising 20 themes. The synthesis indicated that support for breastfeeding occurred along a continuum from authentic presence at one end, perceived as effective support, to disconnected encounters at the other, perceived as ineffective or even discouraging and counterproductive. A facilitative approach versus a reductionist approach was identified as contrasting styles of support that women experienced as helpful or unhelpful. Conclusions: The findings emphasize the importance of person‐centered communication skills and of relationships in supporting a woman to breastfeed. Organizational systems and services that facilitate continuity of caregiver, for example continuity of midwifery care or peer support models, are more likely to facilitate an authentic presence, involving supportive care and a trusting relationship with professionals. (BIRTH 38:1 March 2011) 相似文献