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Care of Mechanical Ventilated Patients in General Ward: Nurses Perspective 普通病房机械通气患者的护理:护士的视角
Pub Date : 2014-08-01 DOI: 10.5176/2345-718X_1.2.27
A. Faidy, B. Ouesph, N. Yutuc, S. Melki, E. Tamonan, A. Jamaly, G. Barkat-Ali, S. Al-Eidarous, S. Mohidi
Aim: This study aimed to explore the care of mechanically ventilated patients in general wards from the nurses' perspective. Methodology: A cross-sectional descriptive study using a self administered questionnaire was given to the nurses with a purposive convenient sampling method in adult patients from medical, surgical and isolation units in studied hospital in KSA. Results: 149 participants from general units represents various years of experiences shared their perception on the knowledge and competencies (M= 3.38±.62) the support they received (M= 2.41±.78), their satisfaction and confidence (M= 2.86±.81) and the resources provided (M= 2.44 ±.69) for caring MV patients in their general unit revealed the total mean in each categories were in the state of either neutral or disagree with the items given. The participants admitted that the found themselves are competent in performing suctioning with aseptic technique and ability to identify the possible complications confidently. However the participant concluded that it was inadequate support for them, staffing ratio, equipment and facilities was inappropriate which leads to dissatisfaction and less confident in caring for MV patients. Conclusion: This study concludes that caring for patients in general ward causing dissatisfaction among the staff and place patients in risk. Hospital administration needs to ensure that general ward nurses are trained accordingly, provide adequate staffing ratio, and prepare the physical environment and suitable equipment to care for MV patients in general ward.
目的:本研究旨在从护士的角度探讨普通病房机械通气患者的护理。方法:采用自填问卷的横断面描述性研究,以目的方便的抽样方法,对来自沙特阿拉伯所研究医院内科、外科和隔离病房的成年患者进行护士调查。结果:149名具有不同工作经验的普通单位参与者分享了他们对普通单位护理中老年患者的知识和能力的认知(M= 3.38±0.62)、所获得的支持(M= 2.41±0.78)、满意度和信心(M= 2.86±0.81)以及所提供的资源(M= 2.44±0.69),各类别的总平均值均处于中性或不同意的状态。参与者承认他们发现自己有能力用无菌技术进行吸引,并有能力自信地识别可能的并发症。但嘉宾认为对他们的支援不足,人手比例、设备设施都不合适,导致他们对照顾MV病人感到不满和缺乏信心。结论:普通病房对病人的照顾引起了工作人员的不满,给病人带来了风险。医院管理部门需要确保普通病房护士得到相应的培训,提供足够的人员比例,并准备好物理环境和合适的设备,以照顾普通病房的MV患者。
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引用次数: 6
Gaining clinical wisdom from adversity: Nurse leaders' ethical conflict and resilience experiences 从逆境中获得临床智慧:护士领导的伦理冲突和恢复经验
Pub Date : 2014-08-01 DOI: 10.5176/2345-718X_1.2.30
D. Furlong, B. Harris, K. Weaver
Developing effective nurse leaders in today’s “reengineered” corporate healthcare cultures requires that more attention be given to the preparation of ethical leadership during undergraduate programs and nurses’ formative years in practice. Through analyzing the experiences of three nurse leaders dealing with ethical conflicts and the meaning they made of these experiences, we identified that nurses need practical guidance to successfully negotiate ethical conflicts, take risks to uphold their ethical codes, and foster collaborative relationships. According to these nurse leaders, it was important to mentor student and novice nurses in working through workplace ethical conflicts and help guide them through the formulation of successful practical strategies. Our findings showed that these nurses developed resilience and clinical wisdom which they carried through to their leadership practice and future situations.
在当今“重新设计”的企业医疗文化中,培养有效的护士领导需要更多地关注在本科课程和护士实践形成阶段的道德领导准备。通过分析三位护士领导处理道德冲突的经验以及他们对这些经验的理解,我们发现护士需要实用的指导来成功地解决道德冲突,承担风险来维护他们的道德准则,并培养合作关系。根据这些护士领导的说法,重要的是要指导学生和新手护士如何处理工作场所的道德冲突,并帮助指导他们制定成功的实用策略。我们的研究结果表明,这些护士培养了韧性和临床智慧,并将其运用到领导实践和未来的情况中。
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引用次数: 3
Effectiveness and Cost-effectiveness of Human Papillomavirus (HPV) Vaccines in Cervical Cancer Prophylaxis 人乳头瘤病毒(HPV)疫苗在宫颈癌预防中的有效性和成本效益
Pub Date : 2014-08-01 DOI: 10.5176/2345-718X_1.2.36
W. Chan, K. C. Cheung
Human papillomavirus (HPV) infection is the main cause of cervical cancer. Cervical cancer patients go through painful long-term treatments and high medical costs. Prevention is better than cure. Hence, regular cervical screening is recommended for Hong Kong women to prevent this disease. Some studies have been conducted in Western countries to show that cost-effectiveness can be achieved by combining HPV vaccines with regular screening. The study is guided by three research groups on the future implication of the cost-effectiveness of three cervical cancer prevention strategies: (1) annual Pap smear for women aged 25–42, (2) HPV vaccination at age 12, and (3) HPV vaccination at age 12 combined with annual Pap smear screening at age 25–42. The three groups are compared in terms of their total lifetime cost, cost-effectiveness ratio and incremental life expectancy. The Markov model software is used as the main analytical tool. After analyzing, annual Pap smear screening is a cost-effective method to prevent cervical cancer that the total lifetime cost was approximately USD145.69; cost-effectiveness ratio was USD8.80/DALY; and incremental life expectancy was 2.72 years. Moreover, HPV vaccination combined with annual Pap smear screening is an effective way to prolong the life expectancy of women regardless of race that the total lifetime cost was approximately USD545.12; cost-effectiveness ratio was USD29.56/DALY; and incremental life expectancy was 2.84 years. Such result provides important insight for the formulation of a health care policy to prevent cervical cancer. This policy can save lives and reduce local treatment costs.
人乳头瘤病毒(HPV)感染是宫颈癌的主要原因。子宫颈癌患者要经历痛苦的长期治疗和高昂的医疗费用。预防胜于治疗。因此,建议香港妇女定期进行子宫颈普查,以预防这种疾病。在西方国家进行的一些研究表明,通过将HPV疫苗与定期筛查相结合,可以实现成本效益。该研究由三个研究小组指导,研究三种宫颈癌预防策略的成本效益的未来含义:(1)25-42岁女性每年进行子宫颈抹片检查,(2)12岁时接种HPV疫苗,(3)12岁时接种HPV疫苗并在25-42岁时进行每年的子宫颈抹片检查。比较三组的总寿命成本、成本效益比和预期寿命增量。采用马尔可夫模型软件作为主要分析工具。经分析,每年进行子宫颈抹片检查是一种具有成本效益的预防宫颈癌的方法,其终生总成本约为145.69美元;成本-效果比为8.80美元/年;预期寿命增加了2.72岁。此外,HPV疫苗接种结合每年的巴氏涂片筛查是延长女性预期寿命的有效方法,无论种族,终生总成本约为545.12美元;成本-效果比为29.56美元/年;预期寿命增加了2.84岁。这一结果为制定预防子宫颈癌的保健政策提供了重要的见解。这项政策可以挽救生命并降低当地治疗费用。
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引用次数: 1
Impact of School Experiences and School Contextual Factors on STD/HIV-Related Risk Behaviors among African American College Students 学校经历和学校环境因素对非裔美国大学生性病/艾滋病相关危险行为的影响
Pub Date : 2014-08-01 DOI: 10.5176/2251-3833_GHC14.40
Jiangmin Xu, Jing-Xing Xu
College students, especially African American college students, are among the highest risk groups and are more likely to be at risk for contracting sexually transmitted diseases (STDs) due to their substance abuse and high-risk sexual behaviors. Previous studies and educational interventions have focused on college student knowledge of STDs and Human immunodeficiency virus (HIV), but failed to examine the impacts of some important factors beyond the individual level of behavioral influence such as student’s school experience and school contextual factors. In fact, the college environment offers many opportunities for those STD/HIV-related risk behaviors, including unsafe sex, multiple sexual partners, alcohol use, and substance abuse. Analyses were based on data gathered from 267 African American college students enrolled at Winston-Salem State University (WSSU) who participated in the American College Health Association-National College Health Assessment (ACHA-NCHA) survey. The findings indicate that STD/HIV knowledge and education have no significant effects on African American college students’ substance abuse and high-risk sexual behaviors; instead, students’ experience and school contextual factors are important factors in predicting their substance abuse and high-risk sexual behaviors.
大学生,特别是非洲裔美国大学生,是高危人群之一,由于滥用药物和高危性行为,他们更有可能感染性病。以往的研究和教育干预主要关注大学生对性传播疾病和人类免疫缺陷病毒(HIV)的知识,但未能考察学生的学校经历和学校环境因素等个体行为影响水平之外的一些重要因素的影响。事实上,大学环境为那些与性病/艾滋病相关的危险行为提供了很多机会,包括不安全性行为、多个性伴侣、酗酒和滥用药物。分析基于参加美国大学健康协会-全国大学健康评估(aca - ncha)调查的温斯顿-塞勒姆州立大学(WSSU)的267名非裔美国大学生收集的数据。结果表明,性病/艾滋病知识和教育对非裔美国大学生药物滥用和高危性行为没有显著影响;相反,学生的经历和学校环境因素是预测其药物滥用和高危性行为的重要因素。
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引用次数: 1
Sustaining Workforce Effectiveness: Self-Care Practices by Nursing Staff 维持劳动力效率:护理人员的自我护理实践
Pub Date : 2014-08-01 DOI: 10.5176/2345-718X_1.2.39
Jean Chow, P. Burrell
The paper addresses the health maintenance practices and utilization of complementary and alternative therapies by nurses and nursing students from Canada, Hawaii, and American Samoa. Forecasts of an ongoing nursing shortage coupled with a focus on healthy behavior provided an impetus to describe actual practices of self-care and use of alternative therapies. The study addresses the dearth of knowledge in this area. Nurses and students were asked to anonymously complete a two-part survey that enumerated their perspectives on alternative therapies usage and self-care. Indicators of self-care included sleep, nutrition, exercise, and time. Use of alternative therapies is an integral part of self-care for the nurses and students in the three study regions.
该文件涉及加拿大、夏威夷和美属萨摩亚的护士和护理专业学生的保健做法和补充和替代疗法的利用。对持续护理短缺的预测加上对健康行为的关注,为描述自我护理和替代疗法的实际实践提供了动力。这项研究解决了这一领域知识匮乏的问题。护士和学生被要求匿名完成一项两部分的调查,列举了他们对替代疗法使用和自我护理的看法。自我照顾的指标包括睡眠、营养、运动和时间。在三个研究区域,使用替代疗法是护士和学生自我护理的一个组成部分。
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引用次数: 1
Risk factors of Metabolic Syndrome and Lifestyle in Early Adulthood in Korea 韩国成年早期代谢综合征的危险因素与生活方式
Pub Date : 2014-08-01 DOI: 10.5176/2345-718X_1.2.43
Seo Yoo-jin, Byun Young Soon
The objective of this study was to identify risk factors of metabolic syndrome in early adulthood which has currently shown an increase in Korea, due to a westernized lifestyle. Health medical examination data collected from a total of 5801 participants, gathered by the National Health Insurance Service(NHIS) in 2013, was used to proceed with the study. NCEP ATP-III was used as diagnostic criteria for determining metabolic syndrome. The prevalence rate for metabolic syndrome totaled 32.8%, 29.7% for men and 3.1% for women. Among the subjects, 21.5% of men were found to have abnormal waist circumferences compared to a percentage of 2.3% for women. However, the HDL-cholesterol levels for both men and women were very similar, at 13.6% and 13.3% respectively. There were statistically significant differences in their BMIs, family histories of diabetes, smoking periods, smoking frequencies, alcohol consumption, drinking frequencies, and intense physical activities for the metabolic syndrome group and the normal group. The factors influencing metabolic syndrome were BMI(OR=1.645, 95% CI, 1.599-1.692), a high risk of diabetes(OR=8.818, 95% CI, 4.493-17.306), drinking frequency(OR=1.151, 95% CI, 1.074-1.233), smoking period(OR=1.037, 95% CI, 1.010-1.064), whereas the family history of diabetes, smoking frequency, and physical activity showed no significance. The factors attributing to a high risk in diabetes were BMI(OR=1.021, 95% CI, 1.008-1.035), family history of diabetes(OR=1.835, 95% CI, 1.045-3.225), smoking period(OR=1.125, 95% CI, 1.050-1.206), presence of metabolic syndrome(OR=8.519, 95% CI, 4.876-14.885). The result from the data illustrates the necessity in developing programs and management education for such factors (BMI, smoking, drinking) that influence metabolic syndrome in early adulthood. Promotion of the environment and social awareness of metabolic syndrome is also required to make possible improvements in lifestyle.
本研究的目的是确定成年早期代谢综合征的危险因素,由于西方化的生活方式,目前在韩国代谢综合征的发病率有所增加。该研究使用了国民健康保险局(NHIS)在2013年收集的5801名参与者的健康体检数据。以NCEP ATP-III作为代谢综合征的诊断标准。代谢综合征患病率为32.8%,男性为29.7%,女性为3.1%。在研究对象中,21.5%的男性腰围异常,而女性腰围异常的比例为2.3%。然而,男性和女性的高密度脂蛋白胆固醇水平非常相似,分别为13.6%和13.3%。代谢综合征组与正常组在bmi、糖尿病家族史、吸烟时间、吸烟频率、饮酒频率、剧烈运动等方面存在统计学差异。影响代谢综合征的因素有BMI(OR=1.645, 95% CI, 1.599-1.692)、糖尿病高危人群(OR=8.818, 95% CI, 4.493-17.306)、饮酒频率(OR=1.151, 95% CI, 1.074-1.233)、吸烟时间(OR=1.037, 95% CI, 1.010-1.064),而糖尿病家族史、吸烟频率和身体活动无显著性差异。导致糖尿病高危的因素有BMI(OR=1.021, 95% CI, 1.008-1.035)、糖尿病家族史(OR=1.835, 95% CI, 1.045-3.225)、吸烟时间(OR=1.125, 95% CI, 1.050-1.206)、有无代谢综合征(OR=8.519, 95% CI, 4.876-14.885)。数据的结果表明,有必要针对这些影响成年早期代谢综合征的因素(BMI、吸烟、饮酒)制定计划和管理教育。还需要提高环境和社会对代谢综合征的认识,以可能地改善生活方式。
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引用次数: 0
Optimizing the Home-based Cardiac Rehabilitation Programme by Internet-based Interventions: A literature review 通过网络干预优化家庭心脏康复方案:文献综述
Pub Date : 2014-08-01 DOI: 10.5176/2345-718X_1.2.47
H. K. Choy, W. Chan
Cardiac rehabilitation program which includes exercise training, nutritional advice, psychosocial and risk factors counseling is traditionally applied for myocardial infarction survivor. However, the low participation rate [1] of cardiac rehabilitation has been reported globally. Recently home-based cardiac rehabilitation program is developed as an alternative approach [2][3][4] to overcome the challenges of low referral rate, inaccessibility of program site, and optimize the utilization of the program. Unfortunately, client may not be able to sustain the modified health behavior in their daily life after the completion of the cardiac rehabilitation programme. To date, the internet-based cardiac rehabilitation program has showed significant in improving the cardiovascular risk factors at the end of the cardiac rehabilitation program. [5][6][7][8] However, there are limited studies to review the significant of internet- based interventions of home- based cardiac rehabilitation in sustention of health behavior in long term. This review will fill the knowledge gap of how the internet-based interventions on home-based cardiac rehabilitation program modify the risk behavior for myocardial infarction survivor in the long run.
心脏康复计划包括运动训练、营养建议、社会心理和风险因素咨询,传统上适用于心肌梗死幸存者。然而,在全球范围内,心脏康复的参与率[1]较低。近年来,以家庭为基础的心脏康复方案作为一种替代方案[2][3][4],克服了转诊率低、项目场地不可及的挑战,并优化了项目的利用率。不幸的是,病人在完成心脏康复计划后,可能无法在日常生活中维持改变后的健康行为。迄今为止,基于互联网的心脏康复计划在改善心脏康复计划结束时的心血管危险因素方面表现出了显著的效果。然而,关于基于互联网的家庭心脏康复干预在长期维持健康行为方面的意义的研究有限。这篇综述将填补基于互联网的家庭心脏康复计划干预如何从长远来看改变心肌梗死幸存者的危险行为的知识空白。
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引用次数: 0
Therapeutic Relationship of Staff Nurses with Medical Patients: Basis for In-Service Training Program 护理人员与病人的治疗关系:在职培训的基础
Pub Date : 2014-08-01 DOI: 10.5176/2345-718X_1.2.29
Norvin T. Miguel
Originally highlighted in the psychiatric nursing literature, the therapeutic relationship has been recognized as fundamental to all nursing practice.15,16,18However, the researcher found out during his clinical duties that seldom the therapeutic relationship was established because of nurses' heavy workload. This captured the researcher's interest to help nurses develop their skills in establishing therapeutic relationship. Descriptive-correlational design was used with questionnaire as data gathering tool. This study was conducted in the general wards of four private tertiary hospitals in Cabanatuan City and participated by 129 staff nurses and 331 medical patients with the use of total enumeration and quota sampling techniques, respectively. Data gathered were treated statistically to determine the socio-demographic profile of staff nurses and to describe the therapeutic relationship established by staff nurses. Results revealed that staff nurses "Always" performed the roles pertaining to building trust, genuine interest, conveying acceptance, giving positive regard, self-awareness, and therapeutic use of self as perceived by both groups of respondents. Only in items pertaining to showing empathy did the two groups had difference in description. Moreover, there was significant difference between nurses' and medical patients' descriptions on the therapeutic relationship being rendered. A significant difference also exists among patients' description when they are grouped according to hospitals where they work. As recommendation, the researcher was able to develop an intensive in-service training program that addressed the weaknesses and problems identified in various aspects of therapeutic relationship.
最初在精神科护理文献中强调,治疗关系已被认为是所有护理实践的基础。15,16,18然而,研究者在临床工作中发现,由于护士工作量大,很少建立治疗关系。这抓住了研究者的兴趣,帮助护士发展他们的技能,建立治疗关系。采用描述性相关设计,问卷调查为数据收集工具。本研究在卡巴那端市四家民营三级医院的普通病房进行,采用全枚举法和定额抽样法,分别有129名护士和331名医疗患者参与。对收集到的数据进行统计处理,以确定护士工作人员的社会人口学概况,并描述护士工作人员建立的治疗关系。结果显示,两组受访者都认为护士工作人员“总是”在建立信任、真正的兴趣、传达接受、给予积极关注、自我意识和自我治疗方面发挥作用。只有在表达同理心的项目上,两组在描述上有差异。此外,护士和住院患者对所呈现的治疗关系的描述也存在显著差异。根据工作医院分组时,患者的描述也存在显著差异。作为建议,研究人员能够制定一个强化的在职培训计划,以解决治疗关系中各个方面的弱点和问题。
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引用次数: 1
The use of smart phones and their mobile applications among older adults in Hong Kong: An exploratory study 香港老年人使用智能手机及其移动应用程序的情况:一项探索性研究
Pub Date : 2014-08-01 DOI: 10.5176/2345-718X_1.2.45
M. Tse, K. Chan, A. Wong, E. Tam, E. Fan, G. Yip
The purpose of this study was to explore social participation using smart phones by the older population in Hong Kong. The present study was conducted from 10-June-2013 to 16-August-2013. It was a cross-sectional survey study, and data were collected from street interviews. Potential participants were approached and invited to respond to a questionnaire. The locations for collecting data were evenly distributed on Hong Kong Island, Kowloon, and the New Territories. The size of the samples for Hong Kong Island, Kowloon, and the New Territories were calculated based on their respective proportion of the Hong Kong population in 2011. The estimated time to complete the questionnaire was approximately 10 minutes. The questionnaire included questions on demographic data and the use of smart phones and their related features. A total of 982 participants were interviewed, 46% of whom were male and 54% female. The participants were divided into the following two groups: the young-old (age 50-69) and the old-old (age 70 or above). The mean age was 67.93±10.386. The findings showed that, in comparison with the young-old group (age 50 to 69), a smaller percentage of the old-old group (70 and over) used smart phones and mobile messaging applications to communicate with others. There were no differences in patterns with regard to the type and frequency of the mobile applications being used. However, a smaller percentage of the old-old group had installed the mobile app by themselves and introduced the mobile app to others. This study reveals the behavioral patterns of the young-old and the old-old groups in the use of mobile devices to communicate. The young-old and old-old groups exhibited the same patterns in terms of the types and frequency of the mobile apps used; however, a smaller percentage of the old-old group used mobile apps to communicate. Different educational programs on the importance of social support should be established, and the promotional strategies for these programs need to be tailored to older adults.
本研究的目的是探讨香港老年人使用智能手机的社会参与情况。本研究于2013年6月10日至2013年8月16日进行。这是一项横断面调查研究,数据是从街头访谈中收集的。他们找到潜在的参与者,并邀请他们回答一份问卷。收集数据的地点平均分布在香港岛、九龙和新界。香港岛、九龙和新界的样本规模是根据它们各自在2011年占香港人口的比例计算的。完成问卷的估计时间约为10分钟。调查问卷的问题包括人口统计数据、智能手机的使用情况及其相关功能。共有982名参与者接受了采访,其中46%为男性,54%为女性。参与者被分为以下两组:年轻人(50-69岁)和老年人(70岁或以上)。平均年龄67.93±10.386岁。调查结果显示,与年轻老年人(50岁至69岁)相比,老年老年人(70岁及以上)使用智能手机和移动消息应用程序与他人交流的比例较小。在使用移动应用程序的类型和频率方面,模式没有差异。然而,较小比例的老年人自己安装了手机应用,并向他人介绍了手机应用。本研究揭示了年轻人和老年人群体在使用移动设备进行交流时的行为模式。年轻人和老年人在使用移动应用程序的类型和频率方面表现出相同的模式;然而,老年人群体中使用移动应用程序进行交流的比例较小。应该建立不同的社会支持重要性的教育项目,这些项目的推广策略需要针对老年人。
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引用次数: 5
Academic & Non-Academic Variables Impacting BSN Students Who are Unsuccessful on Initial NCLEX-RN 影响BSN学生在初始NCLEX-RN中不成功的学术和非学术变量
Pub Date : 2014-08-01 DOI: 10.5176/2345-718X_1.2.31
Kerri L Outlaw, D. Burns, D. Rushing, A. Spurlock, Cathy Dunn, Judy L. Bazzell, Kelli K. Cleveland
Nursing program quality is measured by first time National Council Licensure Examination- Registered Nurse (NCLEX-RN) pass rates. Therefore, many schools of nursing have implemented aggressive prediction and remediation measures to improve first time NCLEX-RN pass rate success. The purpose of this retrospective study was to determine predictors of success or failure on the NCLEX-RN for graduates of a Southeastern, Baccalaureate nursing program. Data was examined from academic records of students who completed Baccalaureate School of Nursing (BSN) program of study from Spring 2007 to Fall 2011. Results of the study reveal the importance of early identification of at risk students. Early identification allows for the implementation of strategies to aid in promoting student success on NCLEX-RN. These strategies include tutoring, state board review courses, study skills classes, time management classes and practice questions.
护理课程的质量是由第一次全国委员会执照考试-注册护士(NCLEX-RN)的通过率来衡量的。因此,许多护理学院都采取了积极的预测和补救措施,以提高NCLEX-RN的首次通过率成功率。本回顾性研究的目的是确定东南护理学士学位课程毕业生在NCLEX-RN上成功或失败的预测因素。数据来自2007年春季至2011年秋季完成护理学士学院(BSN)课程的学生的学业记录。研究结果揭示了早期识别有风险学生的重要性。早期识别有助于实施有助于促进学生在NCLEX-RN上取得成功的策略。这些策略包括辅导、国家委员会复习课程、学习技巧课程、时间管理课程和练习题。
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引用次数: 0
期刊
GSTF journal of nursing and health care
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