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The relationships between uncertainty and coping Behaviors of patients with liver Cirrhosis 肝硬化患者不确定性与应对行为的关系
Pub Date : 2017-11-24 DOI: 10.15344/2394-4978/2017/261
Wan-Ju Lin, Hui-Man Huang, Bih-O Lee, F. Sun
Background: Patients tend to develop a sense of uncertainty when they lack control over the progress of the disease, and physical discomforts. The sense of uncertainty that patients develop when facing their disease or treatment may elicit physical and psychological distress which can influence the patients’ coping behaviors. Purpose: This study investigated the relationships between cirrhotic patients’ sense of uncertainty and coping behaviors. Methods: A cross-sectional, correlational research design was used. Convenience sampling was performed to select 76 cirrhotic inpatients in the division of gastroenterology at a hospital in Southern Taiwan. Three structured questionnaires (Personal Characteristics Questionnaire, Mishel Uncertainty in Illness Scale, Coping Behaviors Scale) were used for data collection. Results: (a) Cirrhotic patients perceived a moderate or increased level of uncertainty and problemoriented coping behaviors were the most frequently used coping behaviors. (b) Patients who had no religion, who had fatigue or severe disease conditions exhibited comparatively high levels of uncertainty. (c) Patients who were singled or unemployed, or fatigue often showed emotion-oriented coping behaviors. Consuming alcohol frequency, illness severity was positively correlated with emotionoriented coping behaviors. (d) Patients who were unemployed often exhibited problem-oriented coping behaviors. Educational level and consuming alcohol frequency were positively correlated with problemoriented coping behaviors. (e) Patients’ sense of uncertainty was positively correlated with emotion- and problem-oriented coping behaviors. Conclusions/ Implications for Practice: Since cirrhotic patients frequently exhibit emotion-oriented coping behaviors and have high level of uncertainty, nurses could encourage them to express their emotions and problems, and listen to them patiently. If patients were high levels of uncertainty, and exhibit problem-oriented coping behaviors, by spontaneously providing disease-related information and social support, they can readily adopt to their disease conditions.
背景:当患者无法控制疾病的进展和身体不适时,他们往往会产生一种不确定感。患者在面对疾病或治疗时产生的不确定性可能会引发身体和心理困扰,从而影响患者的应对行为。目的:探讨肝硬化患者的不确定感与应对行为的关系。方法:采用横断面相关研究设计。采用方便抽样方法,选择台湾南部某医院消化内科76例肝硬化住院患者。采用三种结构化问卷(个人特征问卷、Mishel疾病不确定性量表、应对行为量表)进行数据收集。结果:(a)肝硬化患者感知到中度或增加的不确定性,以问题为导向的应对行为是最常用的应对行为。(b) 没有宗教信仰、有疲劳或严重疾病的患者表现出相对较高的不确定性。(c) 单身、失业或疲劳的患者往往表现出情绪导向的应对行为。饮酒频率、疾病严重程度与情绪化应对行为呈正相关。(d) 失业患者往往表现出以问题为导向的应对行为。受教育程度和饮酒频率与问题导向的应对行为呈正相关。(e) 患者的不确定感与情绪和问题导向的应对行为呈正相关。结论/实践意义:由于肝硬化患者经常表现出以情绪为导向的应对行为,并且具有高度的不确定性,护士可以鼓励他们表达自己的情绪和问题,并耐心倾听。如果患者具有高度的不确定性,并表现出以问题为导向的应对行为,通过自发提供与疾病相关的信息和社会支持,他们可以很容易地适应自己的疾病状况。
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引用次数: 2
Effectiveness of Patient Group Meetings for Postoperative Patients with Defecatory Dysfunction 患者小组会议对术后排便功能障碍患者的疗效
Pub Date : 2017-11-22 DOI: 10.15344/2394-4978/2017/260
A. Tsuji, M. Nakayama, K. Takifuji, M. Yamaguchi, I. Ueda, I. Morioka, Yukiko Suzuki, K. Miyashita
Background: Research on a peer support for patients after low anterior resection (LAR) is now limited. Little is then known about the effectiveness of patient group meeting for such patients. The aim of this study was to clarify the effectiveness of patient group meetings for the LAR postoperative patients with defecatory dysfunction. Methods: A longitudinal prospective study was conducted. Twenty-six patients (mean age: 65.6 years old) participated in this study. The patient group meetings were held three times for six months, consisting health education and group discussions. Knowledge and Emotion were measured using visual analogue scale. Defecatory dysfunction was measured using a scale. The QOL was measured by EORTC QLQ-C30. T test, Chi-squared or Fisher’s exact test, paired t test, multiple linear regression analysis and Spearman’s rank correlation were used for the statistical analyses. Results: Participants in the patient group meetings gained information on defecatory dysfunction and coping with diarrhea. Their score of scales estimating defecatory dysfunction were stable. They reported higher, but not significant, global health status/QOL and significantly higher Social Functioning. Significant decreased symptom scores of Fatigue and Diarrhea were obtained depending on the participation rate. A decreased symptom score in Diarrhea was related to the increase in the global health status/QOL and Social Functioning, and not related to the change in the defecatory dysfunction. Conclusion: A patient group meeting for the patients after LAR has positive health effects on the QOL of diarrhea. The results suggest the importance of patient group meeting to survival related to QOL of such patients. Healthcare providers should be aware of the importance of patient group meeting to improve the survival related to QOL in the postoperative patients with defecatory dysfunction.
背景:对低位前叶切除术(LAR)后患者的同行支持的研究目前有限。当时,人们对患者小组会议对此类患者的有效性知之甚少。本研究的目的是阐明患者小组会议对LAR术后排便功能障碍患者的有效性。方法:采用纵向前瞻性研究。26名患者(平均年龄:65.6岁)参与了这项研究。患者小组会议在六个月内举行了三次,包括健康教育和小组讨论。使用视觉模拟量表测量知识和情绪。排便功能障碍使用量表进行测量。采用EORTC QLQ-C30测定生活质量。统计分析采用T检验、卡方检验或Fisher精确检验、配对T检验、多元线性回归分析和Spearman秩相关。结果:患者小组会议的参与者获得了排便功能障碍和应对腹泻的信息。他们估计排便功能障碍的量表得分是稳定的。他们报告了更高但不显著的全球健康状况/QOL和显著更高的社会功能。根据参与率的不同,疲劳和腹泻症状评分显著降低。腹泻症状评分下降与整体健康状况/生活质量和社会功能的增加有关,与排便功能障碍的变化无关。结论:LAR后患者分组会议对腹泻患者的生活质量有积极的健康影响。结果表明,患者分组会议对此类患者生存的重要性与患者的生活质量有关。医疗保健提供者应意识到患者小组会议的重要性,以提高排便功能障碍术后患者的生存率和生活质量。
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引用次数: 0
The Nuts & Bolts of Developing a Global Health Course 发展全球健康课程的具体细节
Pub Date : 2017-10-31 DOI: 10.15344/2394-4978/2018/291
S. Byrne
As society becomes more culturally diverse and diseases and other health risks continue to cross national and international borders, academic schools preparing future healthcare professionals will need to address the health and wellness needs of individuals and communities worldwide. This article provides an example of many aspects of course design,following an analogy of “nuts and bolts,” used by a nursing department to assist in the development and implementation of a global health course. The course in turn promotes student knowledge and skill in the delivery of culturally humanistic and sustainable healthcare services to populations across the world in their future practice.
随着社会在文化上变得更加多样化,疾病和其他健康风险继续跨越国家和国际边界,准备未来医疗保健专业人员的学术学校将需要解决全球个人和社区的健康和保健需求。本文提供了课程设计的许多方面的示例,按照“螺母和螺栓”的类比,护理部门使用“螺母和螺栓”来协助开发和实施全球健康课程。该课程反过来促进学生的知识和技能,在未来的实践中为世界各地的人们提供文化人文和可持续的医疗保健服务。
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引用次数: 0
Reliability and Validity of an Assessment Algorithm to Predict the Coping Skills of 3- to 6-Year-old Children Undergoing Blood Sampling 一种预测3 ~ 6岁采血儿童应对技能的评估算法的信度和效度
Pub Date : 2017-10-31 DOI: 10.15344/2394-4978/2017/259
Shiho Konta, Yukiko Sato
Background: We developed an assessment algorithm to predict the coping skills of children aged 3 to 6 years who undergo blood sampling. The objective of this study was to determine the reliability and validity of this algorithm. Methods: Subjects were 41 children aged 3 to 6 years who were to undergo blood sampling in two hospitals, and their parents. To use the assessment algorithm, we used a questionnaire to obtain the following information from the parent before the child’s blood sampling: the child’s age, whether they had previously undergone blood sampling, and the parent’s prediction regarding the child’s coping behavior. The coping behavior of the children undergoing blood sampling was directly observed and scored by one researcher. In the examination of reliability, two different researchers independently estimated the coping skills of the child using the assessment algorithm based on the parent’s questionnaire, and the estimates were compared. We analyzed the predictive validity of the coping skills estimated by the assessment algorithm and the child’s actual coping behavior during blood sampling. We evaluated the sensitivity according to the number of children for whom the coping skills estimated by the assessment algorithm exceeded those exhibited in actual coping behavior. Results: The coping skills of the children estimated by the two researchers using the assessment algorithm were concordant (kappa = 1.000, p = 0.000). Spearman’s correlation coefficient between the coping skills estimated for the children using the assessment algorithm and their actual coping behavior was very high (r = -0.74, p = 0.000). Because the assessment algorithm we developed estimated a higher level of coping skill than was exhibited in actual coping behavior for five children, its sensitivity was higher than that of any other classification algorithm. Conclusion: Our analysis showed high reliability and validity of the assessment algorithm.
背景:我们开发了一种评估算法来预测接受血液采样的3至6岁儿童的应对技能。本研究的目的是确定该算法的可靠性和有效性。方法:研究对象为41名3 ~ 6岁的儿童及其父母。为了使用评估算法,我们采用问卷调查的方式,在孩子采血前从父母那里获得以下信息:孩子的年龄,是否曾经采血,以及父母对孩子应对行为的预测。接受抽血儿童的应对行为由一位研究者直接观察并评分。在信度检验中,两位研究者分别使用基于家长问卷的评估算法对儿童的应对技能进行了独立评估,并对评估结果进行了比较。我们分析了评估算法估计的应对技能和儿童在采血过程中的实际应对行为的预测效度。我们根据评估算法估计的应对技能超过实际应对行为的儿童数量来评估敏感性。结果:两名研究者使用评估算法对儿童应对技能的评估结果具有一致性(kappa = 1.000, p = 0.000)。使用评估算法估计的儿童应对技能与实际应对行为的Spearman相关系数非常高(r = -0.74, p = 0.000)。由于我们开发的评估算法估计的应对技能水平高于5名儿童的实际应对行为,因此其敏感性高于任何其他分类算法。结论:分析结果表明,该评估算法具有较高的信度和效度。
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引用次数: 0
The impact of smoking on Healthcare provision 吸烟对医疗保健的影响
Pub Date : 2017-10-30 DOI: 10.15344/2394-4978/2017/258
L. Delaney
Increasing health expenditure requires clinical leaders to have a functional understanding of health economics and its implications on the provisions of healthcare services. The subsequent health related illnesses associated with tobacco use, contribute to considerable economic burden to the health care system. Epidemiological analysis of tobacco use, suggests that it will become the leading cause of death in developed countries. The relative impact smoking has on the healthcare systems has been proffered to negate the burden of cost on health services secondary to reduced lifespans. Investing in chronic disease management programs such as pulmonary rehabilitation may reduce the impact of exacerbations of respiratory diseases on the individuals functioning, and alleviate some of the burden on acute care systems.
增加卫生支出需要临床领导者对卫生经济学及其对医疗服务提供的影响有一个功能性的理解。随后与吸烟有关的健康相关疾病给医疗保健系统带来了相当大的经济负担。对烟草使用的流行病学分析表明,烟草将成为发达国家的主要死亡原因。吸烟对医疗保健系统的相对影响被认为是为了抵消寿命缩短所带来的医疗服务成本负担。投资于肺部康复等慢性病管理项目可以减少呼吸系统疾病恶化对个体功能的影响,并减轻急性护理系统的一些负担。
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引用次数: 2
Statistics Used in Scholarly Projects of Doctor of Nursing Practice Graduates 统计学在护理学博士研究生学术项目中的应用
Pub Date : 2017-10-28 DOI: 10.15344/2394-4978/2018/276
Aliya Kuerban
Background: Most of the DNP programs provide only one Biostatistics course for the students, which means instructors have limited time to prepare DNP students in mastering the statistics skills they need to complete their scholarly project. Methods: Quantitative content analysis was conduct on 100 DNP projects to retrieve information regarding the subjects, sample size, sampling strategies, and statistics methods used. These projects were selected from two online DNP projects repositories, where DNP graduates uploaded their projects voluntarily. Results: Almost half of the projects had a sample size less than 50, majority of the studies adopted convenience sampling strategy, and the most often used statistics methods discovered were descriptive analysis, t Test, and Chi square analysis. Conclusion: Small sample size is an intrinsic problem of most DNP projects. The results of this study give DNP students and faculty a more clear teaching map that focuses on skills used most often.
背景:大多数DNP项目只为学生提供一门生物统计学课程,这意味着教师只有有限的时间来帮助DNP学生掌握完成学术项目所需的统计技能。方法:对100个DNP项目进行定量内容分析,检索研究对象、样本量、抽样策略、统计方法等信息。这些项目是从两个在线DNP项目库中选出的,DNP毕业生自愿上传他们的项目。结果:近一半的项目样本数量小于50个,大多数研究采用方便抽样策略,发现最常用的统计方法是描述性分析、t检验和卡方分析。结论:样本规模小是大多数DNP项目的内在问题。这项研究的结果为DNP的学生和教师提供了一个更清晰的教学地图,重点关注最常用的技能。
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引用次数: 2
Promoting Caring by Increasing Realism in the Simulated Environment 通过在模拟环境中增强现实主义来促进关爱
Pub Date : 2017-10-23 DOI: 10.15344/2394-4978/2017/257
Gail Dove Ward, L. Robinson, L. Ware
High-fidelity human patient simulators provide students learning opportunities for performing skills, attaining knowledge, critical thinking, and building self-confidence. Absent from this list is the essential component of learning caring in nursing. Simulation-based learning can present a challenge to students learning caring behaviors. The purpose of this paper is to address strategies helpful in creating realistic high-fidelity simulation-based learning experiences promoting learning caring during simulation. Simulation specialists who create a realistic clinical scenario and add the human component to the simulated experience were found to make the simulated environment more realistic and consequently more conducive to learning caring behaviors.
高保真人体患者模拟器为学生提供了学习技能、获得知识、批判性思维和建立自信的机会。这份清单中没有学习护理的重要组成部分。基于模拟的学习可能会对学生学习关爱行为提出挑战。本文的目的是探讨有助于创造逼真的高保真模拟学习体验的策略,促进模拟过程中的学习关怀。模拟专家创建了一个现实的临床场景,并将人类成分添加到模拟体验中,他们被发现可以使模拟环境更加现实,从而更有利于学习关爱行为。
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引用次数: 1
Factors Influencing Recovery from Fatigue after a 16-hour Night Shift among Female Japanese Nurses 影响日本女护士夜班16小时疲劳恢复的因素
Pub Date : 2017-10-16 DOI: 10.15344/2394-4978/2017/255
Narumi Ooshige, Tae Yamaguchi, Mitsuyo Nakashima, K. Minematsu, T. Tobina, N. Tsunawake
Background: The present study aimed to evaluate self-reported fatigue recovery among Japanese nurses who perform shift work and to evaluate how their fatigue was affected by a day off after a night shift. Methods: We recruited 66 healthy female Japanese nurses at three regional private hospitals. The nurses were divided into a recovery group and a non-recovery group, based on their self-reported experience of fatigue during the interval from the time before their night shift to after a following day off. Unpaired t-test and logistic regression analyses were used to find associations of self-reported fatigue with demographic and lifestyle factors. Results: The recovery group included 45 nurses, and the non-recovering group included 21 nurses. The recovery group exhibited a high degree of fatigue at five assessment points, while the non-recovery group only exhibited a high degree of fatigue at the post–day off assessment. The adjusted odds ratios (95% confidence intervals) for self-reported fatigue during the night shift were 1.27 (1.00–1.61) for the age of the nurse’s youngest child and 1.04 (1.00–1.08) for the nurse’s time spent napping (P < 0.05). Conclusion: Sleeping before a night shift may facilitate recovery after the shift, although fatigue was also influenced by the age of the nurse’s youngest child and the nurse’s napping time.
背景:本研究旨在评估轮班工作的日本护士自我报告的疲劳恢复情况,并评估夜班后休息一天对他们疲劳的影响。方法:在三所地区私立医院招募66名健康的日本女护士。根据护士从夜班前到第二天休息后的自我报告疲劳经历,将他们分为恢复组和非恢复组。使用非配对t检验和逻辑回归分析来发现自我报告疲劳与人口统计学和生活方式因素的相关性。结果:康复组包括45名护士,非康复组包括21名护士。恢复组在五个评估点表现出高度疲劳,而非恢复组仅在休息日后评估中表现出高度疲倦。护士最小孩子年龄的夜班期间自我报告疲劳的调整比值比(95%置信区间)为1.27(1.00–1.61),护士打盹时间的调整比值比为1.04(1.00–1.08)(P<0.05),尽管疲劳也受到护士最小孩子的年龄和护士打盹时间的影响。
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引用次数: 0
Changes in the Mood and Emotion of Elderly Day Care Users Undergoing Tapping Touch and Laughter Yoga Intervention 轻拍触摸和大笑瑜伽干预老年日托用户的情绪变化
Pub Date : 2017-10-16 DOI: 10.15344/2394-4978/2017/256
Minako Kobayashi
Background: The present study was conducted to compare and examine the effects of tapping touch and laughter yoga for alleviating depression symptom and stress reactions among older adults requiring home care. Methods: Tapping touch and laughter yoga were administered to 18 older adult day care users. We evaluated participants’ emotional reactions via a two-dimensional mood scale and VAS before and after tapping touch and laughter yoga activities. Results: Activity-based care utilizing tapping touch was effective for reducing feelings of stress, pain, anxiety, and tension by placing users in a more relaxed and stable state. Laughter yoga revealed no significant effects, with the exception of a tendency toward increased comfort. Conclusion: Tapping touch was effective at reducing stress and pain in the present sample. Although laughter yoga was not similarly effective, there is a possibility that modifying its implementation could enhance its efficacy.
背景:本研究旨在比较和检验敲击触摸和大笑瑜伽在需要家庭护理的老年人中缓解抑郁症状和压力反应的效果。方法:对18名老年日托用户进行轻拍触摸和大笑瑜伽。我们通过二维情绪量表和VAS评估了参与者在敲击触摸和大笑瑜伽活动前后的情绪反应。结果:利用轻拍触摸的基于活动的护理通过使用户处于更放松和稳定的状态,有效地减轻了压力、疼痛、焦虑和紧张感。笑瑜伽没有显示出显著的效果,只是有增加舒适度的趋势。结论:轻拍触摸能有效地减轻受试者的压力和疼痛。尽管笑瑜伽并没有同样的效果,但改变它的实施方式有可能提高它的疗效。
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引用次数: 0
Study of the Midwifery Care in 6 Obstetrical Facilities in Okinawa-Self- Completed Retrospective Questionnaires for One Month Postpartum Women 冲绳县6家产科机构助产护理的研究——产后1个月妇女自填回顾性问卷
Pub Date : 2017-10-09 DOI: 10.15344/2394-4978/2017/254
Yoko Tamashiro, F. Omine, Yumiko Endoh, Tsugiko Gima, Chikako Maeshiro, N. Toyama, Rika Takemoto, Tomomi Takayama, Miki Hirata
The purpose of this study was to investigate the effective midwifery care from pregnancy to postpartum in order to promote evidence-based midwifery practice in improving childbirth satisfaction and breastfeeding. The subjects were one-month postpartum mothers who came to one-month check-up during July to October in 2010. The purpose of the self-administered questionnaire developed by the research group was explained, then provided to mothers who agreed to participate in the survey at 4 hospitals each with more than 300 beds and 1 clinic with more than 500 deliveries annually in Okinawa. The questionnaire was collected on the same day or via postal mail. A total of 540 mothers agreed to complete the survey, and 434 responses were considered valid for this study (valid response rate: 80.4%). Vaginal delivery group was 223 (82.3% with medical intervention rate of 15.2%), and the cesarean section group was 48 (17.7%). The most helpful one-on-one guidance was
本研究的目的是调查从怀孕到产后的有效助产护理,以促进循证助产实践,提高分娩满意度和母乳喂养。受试者是产后一个月的母亲,她们在2010年7月至10月期间进行了一个月检查。解释了研究小组编制的自我管理问卷的目的,然后提供给同意在冲绳4家医院和1家诊所参加调查的母亲,每家医院拥有300多张床位,每年有500多个分娩。问卷是在同一天或通过邮寄方式收集的。共有540名母亲同意完成调查,434份回复被认为对本研究有效(有效回复率:80.4%)。阴道分娩组为223份(82.3%,医疗干预率为15.2%),剖宫产组为48份(17.7%)。最有帮助的一对一指导是
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引用次数: 0
期刊
International journal of nursing & clinical practices
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