心内科住院患者人性化护理问题的分析与对策研究

目的:探讨心内科实施人性化护理的问题及产生问题的原因,寻找有效的解决措施。这对提高护理质量,有效保证住院患者的安全,促进住院患者身心健康有重要意义,同时,也为临床护理提供依据。方法:对我院2011年1月-2011年3月心内科住院患者进行护理满意度和护理需求问卷调查。结果:调查数据显示,实施人性化护理患者的满意度为89.86%,较2010年有较大的提高。导致患者不满意的原因依次为护患沟通不足、护理人员专业素质差、护理人员缺乏经验和个别护理人员职业道德低下。根据患者需求调查数据显示,患者在病房环境、个人隐私尊重与保护、服务态度、医疗技术操作水平及职业道德5个方面还有较大需求。结论:人性化护理对改善医患关系,提高护理安全,促进患者的身心健康有积极的作用。依据调查的患者需求量,人性化护理还需要有针对性的改进和提高。     

子宫颈癌放疗的康复护理

目的：探讨子宫颈癌放射治疗的康复护理方法。方法：采用科普宣传、康复期指导、放射治疗前康复指导、并发症护理和出院后康复指导等方法对放射治疗的患者进行护理。结果：科学的康复护理使患者均能耐受高剂量放射治疗,提高了患者的生存质量,5年生存率明显提高。结论：科学护理是宫颈癌患者放射治疗期和康复期的重要手段。     

Attitudes to and knowledge about oral health care among nursing home personnel--an area in need of improvement

doi: 10.1111/j.1741‐2358.2011.00562.x
Attitudes to and knowledge about oral health care among nursing home personnel – an area in need of improvement Background: In 1999, a dental reform became law in Sweden that regulated both dental care to dependent individuals and training in oral health care for nursing home personnel. Substantial resources have been channelled into these efforts, but the outcome of these efforts has not been evaluated. The aim of this study was to explore attitudes to and knowledge about oral health care among nursing home personnel more than 5 years after the law was adopted, that being 2005. Methods: A total of 454 individuals employed at nursing homes answered a questionnaire of 16 multiple‐choice items concerning attitudes to and knowledge about oral health care. Results: Eighty‐nine per cent considered oral health care to be an important part of good nursing. The answers indicated problems, however, when it came to its implementation and knowledge, and 35% stated that they had had no formal education in oral health care. Conclusions: Despite generally positive oral health care attitudes, it is important that oral health care education is available to and made of interest for all nursing home personnel, especially in light of the increase in number of natural teeth and frequency of crowns and bridges among dependent elderly.     

Edentulism and dental caries in Victorian nursing homes

doi: 10.1111/j.1741‐2358.2011.00510.x Edentulism and dental caries in Victorian nursing homes Objectives: The aim of this project was to investigate edentulism and dental caries in nursing home residents in Victoria, Australia. Background: The Australian population is ageing with a growing number of people living in nursing homes. These residents are at increased risk for dental caries, have more teeth present now than at any time in the past 50 years and often have difficulty maintaining adequate oral hygiene. Materials and methods: Clinical dental examinations were conducted at 31 nursing homes in Melbourne and regional Victoria between May 2005 and June 2006. A total of 510 residents were examined out of 1345 eligible participants. Socio‐demographic and medical history was collected via questionnaire. Results: Just over half of the residents were dentate (53.9%), and dentate residents had a mean of 14.4 teeth present and 2.66 untreated decayed teeth. Residents who required total assistance with oral hygiene had more decayed teeth and fewer filled teeth than residents who did not require assistance. Conclusions: Nursing home residents in Victoria are retaining an increasing number of natural teeth and have more tooth surfaces at risk for dental caries. Untreated dental caries was a significant problem for residents, particularly for those who are dependent on others for their daily oral hygiene care.     

'Because we see them naked' - nurses' experiences in caring for hospitalized patients with dementia: considering artificial nutrition or hydration (ANH)

The aim of this study was to explore and describe how Flemish nurses experience their involvement in the care of hospitalized patients with dementia, particularly in relation to artificial nutrition or hydration (ANH). We interviewed 21 hospital nurses who were carefully selected from nine hospitals in different regions of Flanders. 'Being touched by the vulnerability of the demented patient' was the central experience of the nurses, having great impact on them professionally as well as personally. This feeling can be described as encompassing the various stages of the care process: the nurses' initial meeting with the vulnerable patient; the intense decision-making process, during which the nurses experienced several intense emotions influenced by supporting or hindering contextual factors; and the final coping process, a time when nurses came to terms with this challenging experience. From our examination of this care process, it is obvious that nurses' involvement in ANH decision-making processes that concern patients with dementia is a difficult and ethically sensitive experience. On the one hand, the feeling of 'being touched' can imply strength, as it demonstrates that nurses are willing to provide good care. On the other hand, the feeling of 'being touched' can also imply weakness, as it makes nurses vulnerable to moral distress stemming from contextual influences. Therefore, nurses have to be supported as they carry out this ethically sensitive assignment. Practical implications are given.     

Prevalence and misdiagnosis of chronic heart failure in nursing home residents: the role of B-type natriuretic peptides

Background/objectives. Without knowing the exact CHF prevalence, chronic heart failure (CHF) occurs frequently in elderly people both inside and outside nursing homes. For a diagnosis we have to rely on physical examination and additional tests. We therefore run the risk of missing CHF diagnoses or of diagnosing CHF when we should not. Natriuretic peptide assays have emerged as a diagnostic test but their use in nursing home residents is limited. We examined the number of misdiagnoses, the CHF prevalence and the role of natriuretic peptide. Method. Residents in one centre without aphasia, cognitive impairments or metastatic cancer were screened for CHF; the natriuretic peptide levels were measured separately. Results. Of the 150 residents, 103 (64%) were included (79±11 years). The diagnosis of CHF was established in 24 of these 103 residents with NTproBNP 1871 (IQR 539 to 4262) and BNP 194 (IQR 92 to 460) pg/ml. A striking result was that of the 24 residents found to have CHF after the screening, 15 (66%) had previously been undetected: NT-proBNP 1146 (interquartile range (IQR) 228 to 3341) and BNP 200 (IQR 107 to 433) pg/ml. Moreover, in 13 out of 22 residents (62%) who had previously been thought to have CHF, the diagnosis was rejected: NT-proBNP 388 (IQR 174 to 719) and BPN 90 (IQR 35 to 128) pg/ml). Regarding the diagnostic accuracy of NT-proBNP and BNP, the optimal cut-off level of NT-proBNP was 450 pg/ml with a sensitivity of 0.71 and specificity of 0.67, and for BNP it was 100 pg/ml with a sensitivity of 0.71 and specificity of 0.70. Conclusion. Both undetected and incorrect diagnoses of CHF were common. NT-proBNP and BNP were moderately accurate at diagnosing CHF. CHF prevalence was 23%. (Neth Heart J 2008;16: 123-8.)     

Do female degus communally nest and nurse their pups?

We examined the nesting and nursing behavior of females of the caviomorph rodent Octodon degus. We recorded the behavior of two, three-female groups of lactating degus kept in captivity and compared it with that of singly housed lactating females. Grouped females spontaneously nested communally. Five of six lactating females had non-offspring pups hanging from their teats, which suggests that some non-offspring nursing took place. Non-mothers increased their maternal behavior after the delivery of their own pups. Although time allocated to parental care by each communally nesting dam did not differ from that of solitary lactating females, young of communal litters spent less time alone and enjoyed more time cared for by a lactating female than young of single dams. Electronic Publication     

优质护理模式对心肌梗死康复期患者心理障碍及不良情绪的影响研究

目的:研究优质护理模式对心肌梗死康复期患者心理障碍及不良情绪的影响程度,旨在为康复期患者护理方式的选取提供理论依据。方法:将本院2014年1月~2014年12月的70例心肌梗死康复期患者遵照随机数字表法分为对照组和观察组各35例,对照组采用常规的康复护理进行干预,观察组则以优质护理理念为指导进行护理干预,然后将两组护理前和护理后2周、4周及8周的心理障碍及不良情绪状态采用SECD6量表及HAD量表进行评估,并将评估结果进行比较。结果:观察组护理后2周、4周及8周的SECD6量表及HAD量表评估结果均明显优于对照组,P均0.05,均有显著性差异。结论:优质护理模式对心肌梗死康复期患者治疗信心及不良情绪的影响相对更为积极,为患者康复治疗的顺利进行奠定了基础。     

The impact of shift work on eating patterns and self-care strategies utilised by experienced and inexperienced nurses

ABSTRACT

For nurses, shift work is a necessity, required to provide 24-h continuous care for patients. Research posits that fatigue amongst shift-working nurses is associated with inadequate and poorly timed sleep and also strongly influenced by the timing, quality and quantity of food consumed. The aim of this investigation was to examine differences and similarities in the food choices and eating patterns of nurses exposed to different lengths of time in shift work, as a means of understanding how nurses can adapt their eating patterns to better manage fatigue and sleep loss. Qualitative methodology was utilised to study and capture in-depth information about nurses’ daily working lives. A case study approach allowed for the investigation of nurses with limited and extensive experience of shift work. Increased food craving, caffeine consumption and snacking behaviours during night shifts were described by both groups of nurses, as was the inability to drink enough fluids at work. Meal skipping at work, associated with high workload, was detailed more by experienced nurses. Experienced nurses described shopping and preparing home cooked meals in advance to manage food intake and associated fatigue, contrasting with patterns from inexperienced nurses. Experienced nurses recounted drinking alcohol as a way to rest and recover from shift work, unlike their less inexperienced colleagues. These findings indicate organisational and work place issues such as shift work and rostering influence the food choices and eating patterns of shift-working nurses. Experienced nurses, however, draw on a greater range of strategies around diet and eating patterns to minimise these impacts.