护理岗位实施绩效考核的效果探讨

[目的]探讨护理分配制度与护理质量的关系,提高医院护理工作质量。[方法]在护理岗位推行了绩效考核制度,对实行绩效考核制度前后护理工作质量进行比较,分析推行绩效考核对护理质量管理产生的效应。[结果]护理岗位推行绩效考核起到了提高员工绩效、提高员工素质、保证护理目标的实施、增强管理效能等作用,有效地促进了医院护理质量的全面提高。[结论]将绩效考核引入护理管理,是新时期护理管理高效科学的管理模式。     

双轨教学法对普外科实习护士学习成绩及综合素质的影响

目的探究双轨教学法对普外科实习护士学习成绩及综合素质的影响。方法将2018年1月—2019年1月在大连大学附属中山医院实习的210名实习护士按随机数字表法分为观察组与对照组,每组105名。对照组采取常规教学方式(以授课为向导LBL),观察组采取双轨教学(以授课为向导LBL、以问题为向导PBL)。观察比较2组实习护士实习完后的学习成绩、教学满意度、综合素质。结果观察组学习成绩明显高于对照组,教学满意度77.14%(81/105)明显高于对照组64.76%(68/105),差异均有统计学意义(P<0.05);观察组综合素质评分明显高于对照组,差异有统计学意义(P<0.001)。结论双轨教学法能够有效提升普外科实习护士学习成绩、教学满意度,同时可以提高实习护士综合素质。     

Invisible dermatoses: clues and pitfalls to diagnosis

The phrase “invisible dermatoses” has been used in two different contexts: 1) Invisible dermatoses to the clinician, i.e., skin diseases with no significant clinical features, 2) invisible dermatoses to the pathologist, i.e., clinical evident skin diseases that show subtle or hidden histological features resembling normal skin. The list of such diseases, originally comprising only few entities, has been gradually expanded over decades and now is a large one. This paper will focus on entities that fall into this category of subtle or “invisible” dermatoses histopathologically and offers to the dermatopathologist a strategy for their diagnosis, based mainly on proper awareness, recognition of subtle features, liberal use of special stains, immunofluorescence and immunohistochemistry and proper clinicopathologic correlation. The presentation of a series of “invisible dermatoses” will hopefully familiarize the reader with the diagnostic problems and pitfalls associated with and unique to the interpretation of biopsies from this category of dermatoses.     

护理组织承诺与工作绩效的相关研究

[目的]探讨护理组织承诺与工作绩效的关系。[方法]用组织承诺量表和工作绩效量表对187名护士进行测查。然后进行相关和回归分析。[结果]护理组织承诺的总分及其各维度都与工作绩效总分存在显著相关；组织承诺各维度对工作绩效都具有一定的预测性，其中，感情承诺对工作奉献的预测性最大；规范承诺对人际促进和任务绩效的预测性最大。[结论]护理组织承诺对工作绩效具有一定的预测性，护理管理者应通过加强护理组织承诺方面的管理来提高其工作绩效。     

护理大专生学习动机与学业成就的相关性研究

[目的]深入了解学习动机各因素对护生学业成就的影响，为提高护生的学习效果和教学质量提供建议。[方法]采用学习动机和策略问卷（MSLQ）的动机子问卷时护理大专即将毕业的152名护生进行调查，利用临床护理、基础护理以及操作考核成绩作为学业成就指标。对其相关性进行统计分析。[结果]护生学习动机各因素中，学习和操作的自我效能、内在目标取向与学业成就存在显著正相关，考试焦虑与学业成就呈显著负相关。[结论]在护理教育中应通过促进护生的内在动机、自我效能以及学习兴趣来提高护生的肇业成就。     

Treatment gaps in the management of cardiovascular risk factors in patients with type 2 diabetes in Canada

OBJECTIVES:

To evaluate vascular protection treatment patterns and attainment of the 2003 Canadian Diabetes Association’s recommended targets in ambulatory patients with type 2 diabetes.

METHODS:

Between 2005 and 2006, 3002 outpatients with type 2 diabetes were enrolled by 229 primary health care settings across Canada. Baseline characteristics, therapeutic regimens and treatment success – defined as the achievement of a blood pressure (BP) of 130/80 mmHg or lower, glycosylated hemoglobin (A1C) of 7% or lower, low-density lipoprotein cholesterol (LDL-C) lower than 2.5 mmol/L and total cholesterol/high-density lipoprotein cholesterol ratio lower than 4.0 – are reported.

RESULTS:

Overall, 46% of individuals had a BP that was above the Canadian Diabetes Association’s recommended target. Of these, 11% were untreated, 28% were receiving monotherapy, 38% were not receiving an angiotensin-converting enzyme inhibitor and 16% were not receiving either an angiotensin-converting enzyme inhibitor or an angiotensin receptor blocker. Optimal A1C levels were achieved in 53% of patients. Of those who did not attain A1C targets, 3% were not on glucose-lowering pharmacotherapy and 27% were receiving monotherapy. A total of 74% of patients were treated with statins. Overall, 64% and 62%, respectively, met the target LDL-C and the target total cholesterol/high-density lipoprotein cholesterol ratio. Statins were not prescribed to 43% of patients with LDL-C above target. Antiplatelet therapy was implemented in 81% of patients. In total, 21% achieved the combined targets for BP, A1C and LDL-C.

INTERPRETATION:

A substantial proportion of patients did not achieve guideline-recommended targets and were not receiving evidence-based therapy for vascular protection two years after publication of the Canadian guidelines. More research is warranted, and novel and effective strategies must be tested and implemented to correct this ongoing treatment gap.     

焦虑对护生实习成绩的影响

目的：探索焦虑对护生临床实习成绩的影响,为做好实习护生焦虑的干预提供相关依据。方法：随机抽取两组护生,实验组护生实习前给予专业思想、择业就业教育干预,实习前教学与操作干预,人际沟通干预等措施,用IAS（Interaction Anxiousness Scale交往焦虑量表）对两组护生干预前后进行焦虑程度的测量对比,并对两组学生实习初期和实习末期成绩进行对比。结果：干预前两组焦虑程度无明显差异,干预后实验组护生焦虑程度明显低于对照组。实习初成绩干预组高于未干预组（P=0.025）,实习末期成绩两组无明显差异（P=0.550）。结论：针对实习护生焦虑给予适当的情感支持和干预,引导学生采用积极、有效的方式应对实习中的压力,缓解焦虑与担心,有利于提高实习效果。     

论《验方新编》的学术成就

《验方新编》作者鲍相璈,字云韶,清代善化（湖南长沙）人。约生活于道光至咸丰年间,曾任职广西省武宣县。鲍氏自幼爱好医药之学,心存济世救人之情,自谓：“余幼时,见人有良方,秘而不传世,心窃鄙之。因立愿广求,不遗余力,或见于古今之载籍。或得之戚友之传闻．皆手录之。久之,荟萃甚富,各门俱备,乃删其不甚经验及数方相同与贵药不能力致者。     

Self-efficacy and academic achievement in Australian high school students: The mediating effects of academic aspirations and delinquency

Studies have shown that self-efficacy, aspirational, and other psychosocial influences account for considerable variance in academic achievement through a range of mediational pathways, although no research to date has tested the mediational relationships identified. The present research investigated the structural relations among self-efficacy, academic aspirations, and delinquency, on the academic achievement of 935 students aged 11–18 years from ten schools in two Australian cities. The Children's Self-Efficacy Scale, Adapted Self-Report Delinquency Scale (Revised), and Children's Academic Aspirations Scale were administered to participants prior to academic achievement being assessed using mid-year school grades. Structural equation modeling was employed to test three alternative models for the relationships from academic, social, and self-regulatory efficacy on academic achievement. A partial mediation model showed the best overall fit to the data. Academic and self-regulatory efficacy had an indirect negative effect through delinquency and a direct positive effect on academic achievement. Academic and social self-efficacy had positive and negative relationships, respectively, with academic aspiration and academic achievement; however, the relationship between academic aspiration and academic achievement was not significant in the final model.     

小学高年级学生心理健康相关因素统计分析

目的 了解4～6年级小学生的心理健康状况,对其相关因素进行分析.方法 采用心理健康诊断测验(MHT),同伴提名、班级戏剧量表对某小学228名4～6年级学生进行问卷潮试;同时收集教师的学业成绩等级评价结果 和教师接纳性结果 .结果 小学生心理健康问题总分检出率为1.6%;心理健康问题总分与学业成绩显著正相关,与同伴接纳性显著负相关;学业成绩对心理健康问题总分具有正向预测作用,社会行为的孤立/消极因子和年龄具有负向的预测作用.结论 小学高年级学生的心理健康水平与学业成绩高度相关.

Abstract：

Objective To study the mental health conditions of primary school students in Grade 4～6 and effects of its affected factors. Methods A total of 228 pupils in Grade 4～6 in primary school were examined by mental health tests (MHT), Peer Namination and Class Play Questionnarie, and their rating academic achievement by tescher and teacher acceptance were collected too. Results 1. 6%students suffered from mental health problems. Sum score of mental health problem correlated with academic achievement positively, and with peer acceptance negatively. Academic achievement could predict the sum score of mental health problem positively, and the factor "peasive/sclitary" of social behavior and age could predict negatively. Conclusion The mental health correlates highly with academic achievement.