AIM: To investigate whether illness severity has an impact on gastric residual volume (GRV) in medical critically ill patients. METHODS: Medical intensive care unit (ICU) patients requiring nasogastric feeding were en...AIM: To investigate whether illness severity has an impact on gastric residual volume (GRV) in medical critically ill patients. METHODS: Medical intensive care unit (ICU) patients requiring nasogastric feeding were enrolled. Sequential Organ Failure Assessment (SOFA) score was assessed immediately preceding the start of the study. Acute Physiology and Chronic Health Evaluation (APACHE) Ⅱ scores were recorded on the first, fourth, seventh, and fourteenth day of the study period. GRV was measured every 4 h during enteral feeding. The relationship be-tween mean daily GRV and SOFA scores and the correlation between mean daily GRV and mean APACHE Ⅱ score of all patients were evaluated and compared. RESULTS: Of the 61 patients, 43 patients were survivors and 18 patients were non-survivors. The mean daily GRV increased as SOFA scores increased (P < 0.001, analysis of variance). Mean APACHE Ⅱ scores of all patients correlated with mean daily GRV (P = 0.011, Pearson correlation) during the study period. Patients with decreasing GRV in the first 2 d had better survival than patients without decreasing GRV (P = 0.017, log rank test). CONCLUSION: GRV is higher in more severely ill medical ICU patients. Patients with decreasing GRV had lower ICU mortality than patients without decreasing GRV.展开更多
Objective To explore critical care clinicians’knowledge,attitudes and perceptions toward early mobilization of critically ill patients in ICUs.Design A cross-sectional national survey was conducted.From January to Au...Objective To explore critical care clinicians’knowledge,attitudes and perceptions toward early mobilization of critically ill patients in ICUs.Design A cross-sectional national survey was conducted.From January to August 2020,ICU nurses in 11 hospitals were surveyed by using a questionnaire on the knowledge,attitudes and perceptions of ICU early mobilization.Results Totally 512 nurses completed the questionnaire.The respondents’mean score for knowledge of early mobilization was 6.89±2.91.The level of knowledge was good in 2.5%(13/512),fair in 52.3%(268/512).The attitudes toward early mobilization were positive in 31.4%(161/512).In terms of perceived implementation of ICU early mobilization,42.9%(220/512)of nurses did not believe that this should be a top priority in intensive care.The attitudes of nurses from different ICUs were significantly different(F=3.58,P<0.05).The knowledge(7.34±2.78 vs.6.49±2.97,t=3.37,P<0.001)and attitudes(3.82±0.58 vs.3.52±0.56,t=5.63,P<0.001)of nurses who had early mobilization related training were higher than those of nurses who had no training.Conclusions The importance of early ICU early mobilization is increasingly recognized by critical care providers.However,there is still a gap in the knowledge,attitudes and perceptions of ICU early mobilization among nurses.In future studies,it is necessary to further systematically identify the reasons leading to the gaps in these aspects and implement targeted interventions around these gaps.Meanwhile,more nurses should be encouraged to participate in decision-making to ensure the efficient and quality implementation of ICU early mobilization practices.展开更多
Objectives Various authors have explored the combination of competencies necessary for ensuring safe and quality care carried out by nurses in Intensive Care Units(ICUs).Nurses’perception of training is an element th...Objectives Various authors have explored the combination of competencies necessary for ensuring safe and quality care carried out by nurses in Intensive Care Units(ICUs).Nurses’perception of training is an element that must be studied in order to adopt appropriate educational measures.This study aimed to evaluate nurses’perception of the importance of intensive care training in Spain.Methods A descriptive,cross-sectional,multicentre study was conducted on a national level in Spain.Totally 85 ICUs took part in the study.The questionnaire used was developed using the Delphi method and had 66 items to investigate nurses’perception on competency requirements and training needs.The evaluation was conducted by a 10-point Likert scale.Results The sample was 568 Spanish nurses.Significant differences were found on an academic level,in terms of gender and hospital type,and in the professional experience of the nurse when it comes to evaluating the different training items;the differences in overall questionnaire scores among these groups were statistically significant(P<0.05).The nurses analyzed believe that previous training and professional experience in other care services are necessary before starting work in an ICU.Conclusion Implementation of training programs tailored to the needs of critical nurses had benefits for nurses and the health system.Nurses benefited from training focused on the skills and knowledge of each moment of their working life.Nurses have a different evaluation of their training needs throughout their professional cycle.Therefore,their training must be adapted to the professional stage of each nurse.展开更多
Objectives:The purpose of this study was to describe relationships between negative emotions and perceived emotional support in parents of children admitted to the pediatric intensive care unit(PICU).Methods:This cros...Objectives:The purpose of this study was to describe relationships between negative emotions and perceived emotional support in parents of children admitted to the pediatric intensive care unit(PICU).Methods:This cross-sectional descriptive study conducted face-to-face interviews between January 2019 and January 2020.Study variables included depression(PHQ-9 Scale),anxiety(Emotional Distress-Anxiety-Short Form 8a),anger(Emotional Distress-Anger-Short Form 5a),fear(Fear-Affect Computerized Adaptive Test),somatic fear(Fear-Somatic Arousal-Fixed Form),loneliness(Revised 20-item UCLA Loneliness Scale),and perceived emotional support(Emotional Support-Fixed Form).Results:Eighty parents reported symptoms of depression 8.00(4.00,13.75),anxiety(23.43±7.80),anger(13.40±5.46),fear(72.81±27.26),somatic fear 9.00(6.00,12.75),loneliness(39.35±12.00),and low perceived emotional support(32.14±8.06).Parents who were young,single,low-income,and with limited-post secondary education reported greater loneliness and lower perceived emotional support.Fear correlated with depression(r=0.737,P<0.01)and anxiety(r=0.900,P<0.01).Inverse relationships were discovered between perceived emotional support and loneliness(r=-0.767,P<0.01),anger(r=-0.401,P<0.01),and depression(r=-0.334,P<0.01).Conclusions:The cluster of negative emotions identified will serve as potential targets for future interventions designed to enhance support for parents of critically ill children.展开更多
Objective: The critical illness of pandemic influenza A (H1N1) virus infection may be associated with relatively poor outcomes. The objective of this study is to describe clinical features and factors associated wi...Objective: The critical illness of pandemic influenza A (H1N1) virus infection may be associated with relatively poor outcomes. The objective of this study is to describe clinical features and factors associated with the deaths of critical patients. Methods: Medical records of 26 critical patients with H1N1 infection admitted from Sept. 1 to Dec. 31, 2009, were retrospectively reviewed. Diagnosis was established by real-time reverse transcdptase- polymerase chain reaction (RT-PCR) assay. Results: The mean age of the patients was (40.4+18.4) years and 73.1% of them were male. Clinical manifestations included fever, cough, and sputum production. The laboratory findings included leukocytosis, lymphopenia, C-reaction protein, and lactic dehydrogenase elevation. In this series, 17 subjects survived and 9 died. The parameters between the deaths and survivors were compared, which included acute physiology and chronic health evaluation II (APACHE II) scores (23.8+10.1 vs. 14.3_+6.6, P〈0.05), sequential organ failure assessment (SOFA) scores (13.3_+3.0 vs. 6.6_+3.3, P〈0.05), and multiple organ dysfunction syndrome (MODS) scores (7.4+2.5 vs. 3.3+1.7, P〈0.05). The cases of deaths had higher incidences of cardiovascular failure (100% vs. 41.2%, P〈0.05), renal failure (55.6% vs. 11.7%, P〈0.05), encephalopathy (44.4% vs. 5.9%, P〈0.05), hepatic failure (33.3% vs. 5.9%, P〈0.05), and septic shock (33.3% vs. 17.6%, P〈0.05). Conclusions: The critical patients with H1 N1 infection have high APACHE II, SOFA, and MODS scores, which may be associated with an increased risk of death and complex clinical courses.展开更多
:Objective:To study the epidemiologic characteristics of traffic injuries among people over 60 years old in the Nan' an district(urban)and Jiangjin district(rural)of Chongqing,and to discuss the corresponding s...:Objective:To study the epidemiologic characteristics of traffic injuries among people over 60 years old in the Nan' an district(urban)and Jiangjin district(rural)of Chongqing,and to discuss the corresponding strategies for its prevention and cure.Methods:Records of traffic injuries in people over 60 years old registered by the traffic police between 2000 and 2006 in Nan'an district and Jiangjin district were collected in the Database of Road Traffic Accidents and Traffic Injuries.Epidemiologic characteristics of traffic injuries among the aged people were analyzed and compared.Results:Between the year 2000 and 2006,the average annual incidence of traffic injuries and mortality rate in the aged people in Nan' an district were 124.62/100 000 and 13.85/100 000 respectively,higher than that in Jiangjin district(27.49/100 000,7.13/100 000,P〈0.01).However,the mortality rate for the aged people who were involved in traffic injuries in Jiangjin district was 20.60%,higher than that in Nan'an district(10.00%,P〈0.01).Head injury was the primary cause of death.Totally 76.58% of casualties were pedestrians.Over 90% of the traffic accidents occurred in the areas with no traffic signal or traffic control system.Conclusions:The traffic environment is unfavorable to the aged people.It is important to enhance traffic safety consciousness of drivers and the elderly and to strengthen traffic safety system and traffic law,so as to provide a safe road traffic environment for the aged people.展开更多
基金Supported by Kaohsiung Veterans General Hospital, Grant No.VGHKS 94-082
文摘AIM: To investigate whether illness severity has an impact on gastric residual volume (GRV) in medical critically ill patients. METHODS: Medical intensive care unit (ICU) patients requiring nasogastric feeding were enrolled. Sequential Organ Failure Assessment (SOFA) score was assessed immediately preceding the start of the study. Acute Physiology and Chronic Health Evaluation (APACHE) Ⅱ scores were recorded on the first, fourth, seventh, and fourteenth day of the study period. GRV was measured every 4 h during enteral feeding. The relationship be-tween mean daily GRV and SOFA scores and the correlation between mean daily GRV and mean APACHE Ⅱ score of all patients were evaluated and compared. RESULTS: Of the 61 patients, 43 patients were survivors and 18 patients were non-survivors. The mean daily GRV increased as SOFA scores increased (P < 0.001, analysis of variance). Mean APACHE Ⅱ scores of all patients correlated with mean daily GRV (P = 0.011, Pearson correlation) during the study period. Patients with decreasing GRV in the first 2 d had better survival than patients without decreasing GRV (P = 0.017, log rank test). CONCLUSION: GRV is higher in more severely ill medical ICU patients. Patients with decreasing GRV had lower ICU mortality than patients without decreasing GRV.
基金This project is supported by the Fundamental Research Funds for the Central Universities(Project number:3332019171).
文摘Objective To explore critical care clinicians’knowledge,attitudes and perceptions toward early mobilization of critically ill patients in ICUs.Design A cross-sectional national survey was conducted.From January to August 2020,ICU nurses in 11 hospitals were surveyed by using a questionnaire on the knowledge,attitudes and perceptions of ICU early mobilization.Results Totally 512 nurses completed the questionnaire.The respondents’mean score for knowledge of early mobilization was 6.89±2.91.The level of knowledge was good in 2.5%(13/512),fair in 52.3%(268/512).The attitudes toward early mobilization were positive in 31.4%(161/512).In terms of perceived implementation of ICU early mobilization,42.9%(220/512)of nurses did not believe that this should be a top priority in intensive care.The attitudes of nurses from different ICUs were significantly different(F=3.58,P<0.05).The knowledge(7.34±2.78 vs.6.49±2.97,t=3.37,P<0.001)and attitudes(3.82±0.58 vs.3.52±0.56,t=5.63,P<0.001)of nurses who had early mobilization related training were higher than those of nurses who had no training.Conclusions The importance of early ICU early mobilization is increasingly recognized by critical care providers.However,there is still a gap in the knowledge,attitudes and perceptions of ICU early mobilization among nurses.In future studies,it is necessary to further systematically identify the reasons leading to the gaps in these aspects and implement targeted interventions around these gaps.Meanwhile,more nurses should be encouraged to participate in decision-making to ensure the efficient and quality implementation of ICU early mobilization practices.
文摘Objectives Various authors have explored the combination of competencies necessary for ensuring safe and quality care carried out by nurses in Intensive Care Units(ICUs).Nurses’perception of training is an element that must be studied in order to adopt appropriate educational measures.This study aimed to evaluate nurses’perception of the importance of intensive care training in Spain.Methods A descriptive,cross-sectional,multicentre study was conducted on a national level in Spain.Totally 85 ICUs took part in the study.The questionnaire used was developed using the Delphi method and had 66 items to investigate nurses’perception on competency requirements and training needs.The evaluation was conducted by a 10-point Likert scale.Results The sample was 568 Spanish nurses.Significant differences were found on an academic level,in terms of gender and hospital type,and in the professional experience of the nurse when it comes to evaluating the different training items;the differences in overall questionnaire scores among these groups were statistically significant(P<0.05).The nurses analyzed believe that previous training and professional experience in other care services are necessary before starting work in an ICU.Conclusion Implementation of training programs tailored to the needs of critical nurses had benefits for nurses and the health system.Nurses benefited from training focused on the skills and knowledge of each moment of their working life.Nurses have a different evaluation of their training needs throughout their professional cycle.Therefore,their training must be adapted to the professional stage of each nurse.
基金This work was supported by the West Virginia University School of Nursing Research Investment Fund.
文摘Objectives:The purpose of this study was to describe relationships between negative emotions and perceived emotional support in parents of children admitted to the pediatric intensive care unit(PICU).Methods:This cross-sectional descriptive study conducted face-to-face interviews between January 2019 and January 2020.Study variables included depression(PHQ-9 Scale),anxiety(Emotional Distress-Anxiety-Short Form 8a),anger(Emotional Distress-Anger-Short Form 5a),fear(Fear-Affect Computerized Adaptive Test),somatic fear(Fear-Somatic Arousal-Fixed Form),loneliness(Revised 20-item UCLA Loneliness Scale),and perceived emotional support(Emotional Support-Fixed Form).Results:Eighty parents reported symptoms of depression 8.00(4.00,13.75),anxiety(23.43±7.80),anger(13.40±5.46),fear(72.81±27.26),somatic fear 9.00(6.00,12.75),loneliness(39.35±12.00),and low perceived emotional support(32.14±8.06).Parents who were young,single,low-income,and with limited-post secondary education reported greater loneliness and lower perceived emotional support.Fear correlated with depression(r=0.737,P<0.01)and anxiety(r=0.900,P<0.01).Inverse relationships were discovered between perceived emotional support and loneliness(r=-0.767,P<0.01),anger(r=-0.401,P<0.01),and depression(r=-0.334,P<0.01).Conclusions:The cluster of negative emotions identified will serve as potential targets for future interventions designed to enhance support for parents of critically ill children.
文摘Objective: The critical illness of pandemic influenza A (H1N1) virus infection may be associated with relatively poor outcomes. The objective of this study is to describe clinical features and factors associated with the deaths of critical patients. Methods: Medical records of 26 critical patients with H1N1 infection admitted from Sept. 1 to Dec. 31, 2009, were retrospectively reviewed. Diagnosis was established by real-time reverse transcdptase- polymerase chain reaction (RT-PCR) assay. Results: The mean age of the patients was (40.4+18.4) years and 73.1% of them were male. Clinical manifestations included fever, cough, and sputum production. The laboratory findings included leukocytosis, lymphopenia, C-reaction protein, and lactic dehydrogenase elevation. In this series, 17 subjects survived and 9 died. The parameters between the deaths and survivors were compared, which included acute physiology and chronic health evaluation II (APACHE II) scores (23.8+10.1 vs. 14.3_+6.6, P〈0.05), sequential organ failure assessment (SOFA) scores (13.3_+3.0 vs. 6.6_+3.3, P〈0.05), and multiple organ dysfunction syndrome (MODS) scores (7.4+2.5 vs. 3.3+1.7, P〈0.05). The cases of deaths had higher incidences of cardiovascular failure (100% vs. 41.2%, P〈0.05), renal failure (55.6% vs. 11.7%, P〈0.05), encephalopathy (44.4% vs. 5.9%, P〈0.05), hepatic failure (33.3% vs. 5.9%, P〈0.05), and septic shock (33.3% vs. 17.6%, P〈0.05). Conclusions: The critical patients with H1 N1 infection have high APACHE II, SOFA, and MODS scores, which may be associated with an increased risk of death and complex clinical courses.
文摘:Objective:To study the epidemiologic characteristics of traffic injuries among people over 60 years old in the Nan' an district(urban)and Jiangjin district(rural)of Chongqing,and to discuss the corresponding strategies for its prevention and cure.Methods:Records of traffic injuries in people over 60 years old registered by the traffic police between 2000 and 2006 in Nan'an district and Jiangjin district were collected in the Database of Road Traffic Accidents and Traffic Injuries.Epidemiologic characteristics of traffic injuries among the aged people were analyzed and compared.Results:Between the year 2000 and 2006,the average annual incidence of traffic injuries and mortality rate in the aged people in Nan' an district were 124.62/100 000 and 13.85/100 000 respectively,higher than that in Jiangjin district(27.49/100 000,7.13/100 000,P〈0.01).However,the mortality rate for the aged people who were involved in traffic injuries in Jiangjin district was 20.60%,higher than that in Nan'an district(10.00%,P〈0.01).Head injury was the primary cause of death.Totally 76.58% of casualties were pedestrians.Over 90% of the traffic accidents occurred in the areas with no traffic signal or traffic control system.Conclusions:The traffic environment is unfavorable to the aged people.It is important to enhance traffic safety consciousness of drivers and the elderly and to strengthen traffic safety system and traffic law,so as to provide a safe road traffic environment for the aged people.