基于博弈论的护理管理道德风险控制分析

护理管理过程中的委托代理关系及信息不对称性可能导致道德风险的存在,由此可能引发护患冲突,影响医院的品牌信誉和经济效益。以博弈论为研究方法,对护理管理过程中护理管理部门与护理人员之间和患者与护理人员之间存在的道德风险进行了博弈分析,找出了两种关系下博弈双方的混合战略纳什均衡。护理部与护理人员之间的混合战略纳什均衡是α=D/E与β=（E－B）/E,患者与护理人员之间的混合战略纳什均衡是γ=T/U与δ=（U＋R）/U。为持续维持护理管理中稳定均衡的博弈关系,医院应该采取措施加强道德风险的管理与防范,并开展延续护理服务,政府主导人力资源的配置改革并进行干预。     

患者欺凌行为对护士职业使命感及护理质量的影响

目的 探讨公立医院中患者欺凌行为对护士职业使命感及护理质量的影响。方法 采用问卷调查法收集数据。运用描述性统计、相关分析及多元线性阶层回归分析法处理数据。结果 患者欺凌行为对护士职业使命感（β= -0.148, P＜0.01）和主观护理质量（β= -0.123, P＜0.01）具有显著的负向预测作用,职业使命感在二者之间扮演部分中介效应（β= -0.028, P＜0.01）。结论 患者欺凌行为降低了护士职业使命感,进而威胁到护士的服务质量。     

个性化心理护理对帕金森病伴抑郁状态患者的影响

目的探讨个性化心理护理对帕金森病患者伴抑郁状态的影响。方法选择我院神经内科收治的帕金森病伴抑郁状态患者100例作为研究对象,随机分成对照组和观察组各50例。对照组按帕金森病常规药物治疗和护理,观察组在此基础上给予个性化心理护理,观察两组患者4周后汉密尔顿抑郁量表(HAMD)评定情况。结果通过个性化心理护理后,观察组患者的抑郁发生率明显低于对照组,差异有统计学意义(P0.01)。结论个性化心理护理可显著改善帕金森病患者的抑郁症状,提高患者的生活质量。     

Enhancing captive breeding in giant pandas (Ailuropoda melanoleuca): maintaining lactation when cubs are rejected,and understanding variation in milk collection and associated factors

From 1997 to 2002, a female giant panda (Ailuropoda melanoleuca) was artificially stimulated and lactation was maintained, after her neonates were removed due to the female's inability to provide maternal care. Milk samples were collected and the amount of milk collected was quantified. The lactation curve of this animal was estimated based on the Gamma function: Y_t=at^be^−ct. The amount of milk collected showed significant, positive relationships with the number of days after parturition both in 1999 and in the whole study period from 1998 to 2002. This female's lactation curves fit the type I pattern of a typical mammalian lactation curve. Daily milk collection (g) during the first 30 days after parturition, and from 31 to 60 days after parturition, showed a consistent pattern with one peak at around 8:00 hr. More milk was collected during the latter period than during the former period. The amount of milk (g) collected on mucus excretion days was significantly less than that on days after mucus excretion had ended, yet no significant difference was found between milk collected one day before mucus days and on mucus days, or between milk collected one day before and one day after mucus days. Mucus excretion from the gastrointestinal tract significantly impacted the amount of milk collected. The results from this study may aid the captive propagation and conservation of giant pandas and other endangered and rare captive mammal species. Zoo Biol 28:331–342, 2009. © 2009 Wiley-Liss, Inc.     

Forage quality's influence on mule deer fawns

In many mule deer (Odocoileus hemionus) populations, recruitment of fawns drives population dynamics. The quality of food available to females and their fawns in summer and autumn may play an important role in fawn recruitment. We examined direct links between digestible energy (DE) content of food and the DE intake of females on the nutrient concentration of milk and between the nursing behavior, DE intake, growth, and survival in captive mule deer fawns. We offered females and their fawns diets that simulated the natural decline in DE content of forage from mid-summer to late autumn in many western landscapes. Fawns fed a higher DE diet weighed 14% more at the onset of winter, had fewer unsuccessful nursing attempts, consumed milk with more protein and energy, and had higher survival than fawns fed a low DE diet. Differences between fawn performances among treatments were greatest when diet quality began decreasing earlier in the summer. Because our results indicate that summer and autumn nutrition is likely to influence fawn recruitment, wildlife biologists should include metrics for summer precipitation and late autumn fawn mass in population models, and land managers should focus on methods for improving the nutritional carrying capacity of summer and early autumn habitats. © 2011 The Wildlife Society.     

手术室非惩罚性护理不良事件报告制度的建立

手术室护理不良事件发生率影响因素较多,建立非惩罚性护理不良事件报告制度是非常有效的控制不良事件的方法。通过在本院手术室建立非惩罚性护理不良事件报告制度,对上报的护理不良事件分析发生的根本原因并提出修正方案及预防措施,提升护理质量,完善护理流程及管理制度。     

远程护理管理对经皮冠状动脉介入治疗术后患者心理状态与生活质量的影响

目的:探讨远程护理管理对经皮冠状动脉介入治疗(PCI)术后患者心理状态与生活质量的影响。方法:选取52例PCI术后患者,随机分为照组和试验组,各26例,对照组给予常规护理,试验组在对照组基础上采用远程护理管理进行干预。采用Zung焦虑自评量表(SAS)、抑郁自评量表(SDS)评价两组患者心理状态,并用社会功能缺陷筛选量表(SDSS)对两组患者生活质量进行评价。结果:两组患者干预前SAS、SDS、SDSS评分无差异,实施干预后,两组患者均有SAS、SDS、SDSS评分下降、但试验组患者SAS、SDS、SDSS评分下降更明显,与对照组比较,差异有统计学意义(P0.01)。结论:远程护理管理有助于改善PCI术后患者焦虑、抑郁负性情绪,提高生活质量。     

Infant development in two aquarium bottlenose dolphins

The behavioral development of two aquarium bottlenose dolphin calves, one male (born to a primiparous mother) and one female (born to a multiparous mother), was examined. From birth to 9 weeks of age, a total of 558.7 h of nursing and behavioral data were collected using focal sampling methods. Data from both calves revealed a pattern of increasing independence as they aged, but there were significant differences between the two calves. Suckling rates, mean suckles per bout, suckling bout rates, and bout durations for the male calf were higher than those for the female calf throughout the study. These frequencies declined significantly over time in the male's case but not in the female's case. Her suckling durations (lock-on time) were longer than his. The male spent more time in infant position (under the mother) than the female calf and less time swimming in echelon position (alongside the mother). Over time, the male spent less time in infant position, and the female calf spent more time socializing and less time echelon swimming. Both calves decreased the amount of time spent close to their mothers over the 9 week period, and the mothers decreased their role in proximity maintenance over time. We suggest that factors related to maternal primiparity caused the male calf to develop an effective compensatory response of frequent nursing and spending more time in infant position. Both calves survived and were healthy at the end of the observation period. © 1995 Wiley-Liss, Inc.