精神科与心理科护士心理健康状况调查分析

目的调查精神科与心理科护士心理健康状况。方法采用症状自评量表SCL-90对我市两所精神病院共61名护士进行测查。结果精神科护士的躯体化、恐怖、阳性因子数高于国内常摸(1.49±0.32 vs 1.37±0.48;1.33±0.27 vs 1.23±0.41;31.22±12.02 vs 24.92±18.41;P0.01～0.05),人际关系、偏执因子分数低于国内常模(1.46±0.30 vs 1.65±0.61;1.30±0.24 vs 1.43±0.51;P0.01)。心理科护士SCL-90各因子分数均低于国内常摸(P0.01～0.05)。精神科护士SCL-90各因子分均高于心理科护士(P0.01)。精神科和心理科白班与夜班护士SCL-90各因子分比较无明显差异(P0.05)。结论精神科护士心理健康有些方面可能好于国内常摸,而有些方面可能差于国内常模。心理科护士心理健康水平可能最好。白班与夜班护士心理健康水平可能无差异。     

SARS发病高峰期SARS病房护士焦虑、抑郁状况探讨

目的　了解 SARS发病高峰期 SARS病房护士心理卫生状况。方法　采用焦虑自评量表 ( SAS)、抑郁自评量表( SDS) ,对北京市第一批某 SARS定点医院第一批进入病房的护士进行调查 ,其结果与常模相比较。结果　第 1周 SAS、SDS总粗分分别为 3 4.40± 5 .83、3 8.85± 7.61 ,明显高于我国常模 ,其中焦虑、抑郁状态检出率分别为 2 1 .42 %、2 5 %,忧郁、焦虑、躯体不适感明显 ;第 1周与第 3周 SDS分值相比较具有显著性差异。结论　应关注 SARS病房中护士的心理卫生问题 ,及时给予干预     

影响急诊科护理人员应付方式的心理社会因素分析

目的　了解影响急诊科护理人员应付方式的心理社会因素。方法　用应付方式问卷、一般情况调查表 (年龄、护龄、婚姻、文化程度、是否倒班 )、艾森克个性问卷 (EPQ)和生活事件量表对 3 1名急诊科护理人员进行评定。结果　 1年龄与“自责”、“幻想”因子成负相关 ,护龄与“自责”因子成负相关。2生活事件总值与“自责”、“退避”成正相关。3 E量表分与“解决问题”“求助”因子成正相关 ;N量表分与“自责”、“幻想”、“退避”、“合理化”成正相关 ,与“求助”因子成负相关 ;P量表分与“自责”因子成正相关 ,与“解决问题”、“求助”因子成负相关。结论　年龄小、护龄短、最近 1年内遭遇的生活事件刺激量愈高、具有神经个性倾向或精神病性格特点的急诊科护理人员 ,易采用不成熟的应付方式     

What do clinicians derive from partnering with their patients?: A reliable and valid measure of “personal meaning in patient care”

Objective

Burnout is high among clinicians and may relate to loss of “meaning” in patient care. We sought to develop and validate a measure of “personal meaning” that practitioners derive from patient care.

Methods

As part of a larger study of well-being among genetics professionals, we conducted three focus groups of clinical genetics professionals: physicians, nurses and genetic counselors (N = 29). Participants were asked: “What gives you meaning in patient care?” Eight themes were identified, converted into Likert items, and included in a questionnaire. Next, we mailed the questionnaire to clinical geneticists, genetic counselors and genetic nurses (N = 480) randomly selected from mailing lists of their professional associations. Results were subjected to exploratory factor analysis. The survey also included validated scales of burnout and professional satisfaction, and a 1-item measure of gratitude, to assess predictive validity.

Results

214 eligible providers completed the survey out of an estimated 348 eligible (61% response rate). Factor analysis resulted in a unidimensional scale consisting of 6-items with an alpha of 0.82 and an eigen value of 3.2. Factor loadings ranged from 0.69–0.77. The mean total score was 18.1 (S.D. 3.7) out of a possible high score of 24. Higher meaning scores were associated with being female (p = 0.044), a nurse (p < 0.001), and in practice longer (p = 0.006). Meaning scores were inversely correlated with burnout (p < 0.001), and positively correlated with gratitude (p < 0.001) and professional satisfaction (p < 0.022).

Conclusion

The 6-item “personal meaning in patient care” scale demonstrates high reliability and predictive validity in a select group of health professionals. Future research should validate this scale in a broader population of clinicians.

Practice implications

The scale could be useful in identifying providers at risk of burnout, and in evaluating interventions designed to counteract burnout, enhance meaning and improve communication and partnership between providers and patients.     

职业延迟满足与工作满意度对军队医院护士离职意愿的影响

目的 调查军队医院护士职业延迟满足与工作满意度对离职意愿的影响.方法 应用护士一般资料调查表、职业延迟满足量表、工作满意度量表和离职倾向量表对93名军队医院在职护士进行问卷调查.结果 军队医院护士职业延迟满足、职业延迟满足特质、职业延迟满足过程为得分分别为（17.32±4.23）,（7.62±2.51）,（9.70±2.49）分,处于中等偏上水平;工作满意度总分、内在满意度、外在满意度得分分别为（72.02±10.96）,（41.53±7.15）,（30.48±4.41）分,处于低水平;离职意愿得分为（9.30±2.64）分,处于高水平.护士职业延迟满足与离职意愿呈负相关（r =-0.220,P＜0.05）,与工作满意度呈正相关（r=0.207,P＜0.05）,与外在满意度呈正相关（r=0.208,P＜0.05）;职业延迟满足能力与工作满意、内在满意度、外在满意度呈正相关（r分别为0.234,0.219,0.227;P＜0.05）;离职意愿与工作满意度、内在满意度、外在满意度呈负相关（r分别为-0.522,-0.490,-0.505;P＜0.01）.结论 军队医院护士职业延迟满足水平较高,工作满意度较低,离职意愿水平较高.军队医院护士职业延迟满足水平影响工作满意度及离职意愿.     

SARS一线护士的健康调查及防治对策的探讨

目的 调查从事SARS一线护理工作的护士健康状况，为制定合理的卫生保健措施提供可借鉴的建议。方法 对一线工作人员不同时间点的各项生理指标进行观测，并根据结果采取针对措施。结果 一线工作护士各项生理指标均较正常时出现明显波动，采取相应措施后有明显改善。结论 良好的防治措施对改善一线护士的健康状况大有裨益。     

护士职业压力与职业倦怠的调查研究

目的1、调查护士在工作中面临的职业压力与工作倦怠程度;2、研究职业压力对工作倦怠的影响。方法采用问卷调查法,对贵州省贵阳市多所医院173名护士的职业压力与工作倦怠状况进行调查分析。结果1、被试的职业压力处于中度水平;2、被试的情感枯竭程度中等,冷漠程度较轻,职业效能感较高。3、被试的职业压力与情感枯竭、冷漠显著正相关。结论职业压力是情感枯竭的一个有效的预测因子,情感枯竭达到一定程度会导致冷漠,冷漠最终将使得职业效能感减退。     

护患沟通在整体护理中的应用

随着社会的进步，医学模式与护理观念的改变，在以患者为中心的整体护理工作中，与患者进行有效的交流，从不相识到相互信赖，在建立良好的护患关系中语言是重要的载体与工具。良好的护患关系是护理工作中的一个重要环节，也是护理人员获得有效信息进行护理活动的基础。整体护理的开展，为患者提供了生理、心理、社会、文化、精神等方面的全身心护理。     

Dermal exposure to cyclophosphamide in hospitals during preparation, nursing and cleaning activities

Objectives: To determine levels of potential and actual dermal exposure to cyclophosphamide (CP) during performance of oncology-related tasks in hospitals and to investigate the relationship with potential sources and surface contamination levels of CP. Methods: Dermal exposure to CP was determined for tasks with potential exposure to CP: preparation of CP, decanting of patients urine, washing of the patient, removal of bed sheets of treated patients and cleaning of patients toilets on oncology wards. Exposure was assessed by the collection of nitrile and latex protective medical gloves (potential exposure), washing of hands (actual exposure), from cotton pads attached to (un)covered forearms (potential or actual exposure) and a wipe sample of the forehead (actual exposure). Bulk samples (i.e. application fluids and patients excreta) and possible contact surfaces were monitored to assess the amount of CP available for dermal exposure. Results: Pharmacy technicians, oncology nurses and cleaning personnel showed actual and potential dermal exposure to CP during performance of their daily duties. Exposure occurred predominantly on the hands and sporadically on the forehead and forearms. Although all nurses used gloves during handling of patients urine and sometimes during the other nursing tasks, skin underneath gloves was repeatedly contaminated. Results of tests on bulk and surface contamination samples confirmed that patients intravenously treated with CP excrete the unmetabolised drug, which could subsequently lead to dermal exposure of hospital personnel. A clear relationship was found between dermal exposure levels and direct sources of exposure for all tasks, except for handling patients urine. Conclusions: We demonstrated for the first time that actual dermal exposure to CP is common among oncology nurses working with patients treated with this anti-neoplastic drug. Pharmacy technicians and cleaning personnel, on the other hand, are potentially exposed to CP, and protection provided by gloves seemed to be sufficient.     

Risky procedures by nurses in hospitals: problems and (contemplated) refusals of orders by physicians, and views of physicians and nurses

Occurrence of problems with, refusals of orders and contemplated refusals of orders for risky procedures by nurses in Dutch hospitals and views on the safety of performance was studied using postal questionnaires (600 physicians and 3200 nurses, response 60-71%). Of the respondents, 11-30% experienced problems with and (contemplated) refusals of orders for risky procedures in the previous 12 months. Gynaecologists and internists most frequently mentioned problems concerning the practical performance of the procedure (44% and 30%, respectively). The reason for a problem or a contemplated refusal most frequently given by nurses was that they disagreed with the medication policy (34% and 35%, respectively). The reason for a refusal most frequently given by the gynaecologists, internists and nurses was that the nurses themselves were of the opinion that they did not have the necessary authorisation (95%, 67%, and 62%, respectively). With regard to certain procedures, the views of professionals are more strict than the current legal regulations.