Effects of Acupoint Massage Combined with Psychological Nursing on Depression and Hope Level and Coping Style in Hospitalized Patients with Hepatocirrhosis

OBJECTIVE: To explore the effects of acupoint massage combined with psychological nursing on depression and hope level and coping style in hospitalized patients with hepatocirrhosis, and to provide scientific basis for clinical treatment. METHODS: A total of 86 patients with hepatocirrhosis hospitalized in The Sixth Hospital of Handan from June 2015 to June 2018 were selected and divided into 2 groups according to the nursing method. The control group, with a total of 42 patients, were given psychological nursing intervention. The observation group, with a total of 44 patients, were given acupoint massage and psychological nursing intervention. Changes in depression levels, hope levels, and coping style scores were compared between the 2 groups. RESULTS: There was no significant difference in depression, hope level and coping style before the intervention between the 2 groups(P > 0.05). In the observation group, the self-rating depression scale(SDS) score of depression before intervention was 55.16 ± 4.17; and the positive attitude score was 8.40 ± 2.02; the positive action score was 8.33 ± 3.05; and the intimate score was 8.13 ± 2.44. The negative response score was 30.14 ± 3.31, and the positive response score was 30.49 ± 3.26. Before the intervention, the SDS score in the control group was 56.81 ± 4.39, and the positive attitude score was 8.29 ± 1.98. The positive action score was 8.04 ± 2.57, and the intimate score was 8.06 ± 2.31. The total level of hope score was 24.07 ± 3.11. The negative coping score was 30.55 ± 3.06, and the positive coping score was 30.93 ± 3.17. After intervention the SDS scores of the observation group were lower than those of the control group(P < 0.05). The SDS score of the observation group was 36.19 ± 4.19, and the SDS score of the control group was 42.95 ± 3.71. The total level of hope in the observation group was higher than that in the control group after intervention(P < 0.05). The positive attitude score of the observation group was 16.10 ± 2.15, and the score of positive action was 14.74 ± 3.11; the score of intimate relationship was 15.08 ± 5.45; and the total score of hope was 45.71 ± 5.63. The positive attitude score of the control group was 10.92 ± 2.07; the score of positive action was 11.38 ± 3.14; the score of intimate relationship was 10.92 ± 2.33; and the total score of hope was 34.09 ± 5.77. The patients in the observation group had lower response scores after intervention than the control group, and the positive response scores were higher than those in the control group(P < 0.05). The negative response score of the observation group was 20.14 ± 2.19; the positive response score was 38.92 ± 4.33; the negative response score of the control group was 26.61 ± 2.34; and the positive response score was 34.08 ± 2.69. CONCLUSION: Acupoint massage combined with psychological nursing can effectively improve depression in hospitalized patients with hepatocirrhosis, improve the patient's hope level, help patients cope with lifestyle changes from negative to positive, which is worthy of clinical promotion.

Present situation and the countermeasures of health human resources in Guangxi general hospitals at the county - level

[目的] 了解广西县级综合医院卫生人力资源状况,为进一步推进县级医院改革提供建设性意见. [方法]通过问卷调查法、数理统计法等综合分析广西县级综合医院卫生人力资源现状.[结果]广西县级综合 医院在岗人员在编率为41.56%,医护比为1： 1.68, 67.12%的卫生技术人员职称为初级及以下,超七成拥有 大专及以上学历.[结论]广西县级综合医院卫生技术人员在编率较低,医护比、职称及学历结构不合理,整 体年龄偏低,需通过综合措施加以改善.

Assessment of Indoor and Outdoor Noise Pollution at a University Hospital Based on Acoustic Measurements and Noise Mapping

This paper describes an analysis of the sound pressure levels at the exterior fa&ccedil;ade and inside the Hospital de Clínicas of the Federal University of Paraná. Measurements were taken at a total of 45 points, 24 at the exterior facade and 21 points inside the hospital on all the floors of the main building and in the maternity building. These 45 measurements were used to calculate the acoustic map of the hospital, which is located on General Carneiro Street, in the city of Curitiba, state of Paraná, Brazil. A comparison of the measured outdoor sound pressure levels against those established by Curitiba Municipal Law No. 10625 revealed that they all exceeded the daytime limit of 55 dB(A) permitted for areas around hospitals. The indoor sound pressure measurements and the noise levels for acoustic comfort established by the Brazilian technical standard ABNT NBR 10152 were compared, indicating that all the measured points, including those in the neonatal intensive care unit, exceeded the established limit of 35 dB(A) to 45 dB(A).

Awareness of Fathers Regarding Newborn Danger Signs: Evidence from a Tertiary Level Hospital of Kathmandu, Nepal

The neonatal period is a critical period of childhood carrying the highest risk of mortality per day than any other period during the childhood. In Nepal, a country where a neonatal mortality rate is high, raising awareness among fathers regarding newborn danger signs is crucial. This research aims to measure the awareness of fathers regarding newborn danger signs. A hospital based cross sectional descriptive study was done in maternity ward and birthing center of Tribhuvan University Teaching Hospital (TUTH) hospital. Non-probability purposive sampling technique was used to select fathers of neonate. The study was conducted on 103 fathers having newborn baby up to 7 days admitted in Maternity Ward and Birthing Center. Respondents were selected without any discrimination of education, ethnicity, economical status, marital status, religion, etc. The findings of the study showed that out of 103 respondents, most of the respondents had moderate level of awareness (63.1%), 28.2% had low level and minority of the respondents had high level of awareness (8.7%). The researcher concluded that most of the respondents had a moderate level of awareness and minority of the respondents had a high level of awareness on newborn danger signs. The findings show greater need of health education to increase awareness about newborn danger signs among fathers.

Geriatric nursing competence of clinical nursing staff at different hospital levels in Chongqing,China:A cross-sectional study

Objectives:This study aimed to survey the geriatric nursing competencies of clinical nursing staff in Chongqing City,China,and provide suggestions to enhance these competencies.Methods:This study was conducted in 204 hospitals in Southwest China from December 24,2022 to January 7,2023.The“Geriatric Nursing Competence of Clinical Nurse Investigation Tool”was used to explore factors that influence geriatric nurses’competencies via stratified sampling.The survey was conducted by distributing and collecting questionnaires through the online platform Wenjuanxing.Results:A total of 10,692 nurses answered the questionnaires.Of these questionnaires,9,442 were valid.The total geriatric nursing competence score of the clinical nursing staff was 2.29±0.81,the secondary hospital score was 2.23±0.78,and the tertiary hospital’s overall mean score was 2.33±0.83.The factors that influenced secondary hospitals included the department of medicine,age of nurses and total length of career(P<0.05).The factors that influenced tertiary hospitals included the department of medicine,age of nurses,nurses’professional title,and geriatric practical advanced nurses’certification(P<0.05).Conclusions:Geriatric nursing competence among clinical nursing staff is imbalanced at a lower-middle level and is influenced by various factors.Thefindings highlight the need for further clinical training in geriatric nursing.The training of geriatric nurses should focus on necessary clinical skills and on preparing them to adequately manage comprehensive geriatric syndromes.

Assisting Nurses in Basic-Level Hospitals to Improve Three Capacities

The importance of scientific study has received more and more attentions from various levels of hospitals,while paper writing,topic declaring,and achievement and patent grasping have become the fundamental tasks for the hospitals. As nurses in basic-level hospitals,howto find and implement excellent scientific research thoughts in busy work has become a challenge in front of them. Nursing of Integrated Traditional Chinese and Western M edicine attempts to establish a Special Fund for Nursing of Integrated Traditional Chinese and Western M edicine( "Special Fund"for short),aiming to support and assisting nurses in basic-level hospitals to conduct nursing-associated scientific research project approval,achievement declaration and publication,and to promote the co-improvement of scientific research level,academic level and quality of journals in domestic nursing field of integrated traditional Chinese and western medicine by assisting the nurses in basic-level hospitals to improve their declaring,executing and summarizing capacities on nursing research topics.

希望感提升式心理护理对不孕症患者婚姻质量、希望水平及成功妊娠率的影响

目的:观察希望感提升式心理护理对不孕症患者婚姻质量、希望水平及成功妊娠率的影响。方法:选取郑州大学第一附属医院生殖医学中心收治的156例不孕症患者作为本次研究对象,采集时间为2022年11月-2023年11月,以单双数作为分组标准,将符合标准的患者随机分成观察组与对照组,两组各78例,其中对照组接受临床常规干预,观察组在以上基础联合希望感提升式心理护理,采用焦虑自评量表(SAS)、抑郁自评量表(SDS)、Olson婚姻质量问卷(ENRICH)、Herth希望量表评估两组干预前后负性情绪、婚姻质量、希望水平的变化,并随访统计两组成功妊娠率及住院满意度。结果:干预前两组SAS评分、SDS评分、ENRICH各项目评分、Herth各项目评分比较,差异无统计学意义(P>0.05),干预后两组指标评分均明显改善,且观察组SAS评分、SDS评分均低于对照组,ENRICH各项目评分、Herth各项目评分均高于对照组,差异有统计学意义(t=6.580,5.846,3.877,4.572,8.492,11.423,8.007,7.757;P<0.05);随访计算观察组成功妊娠50例(64.10%),对照组成功妊娠32例(41.03%),两组相比差异有统计学意义(χ^(2)=8.330,P<0.05);统计满意度可知,两组总满意度相比,差异有统计学意义(χ^(2)=4.112,P<0.05)。结论:经研究结果可知,不孕症患者在希望感提升式心理护理联合常规干预下,能显著改善患者心理状态,明显提升其婚姻质量,在改善希望水平的同时还能提高成功妊娠率,对促进妊娠有着良好影响,且患者接受度较高。

四川大学华西医院四位一体中层干部考核体系构建实践

目的:综合运用多种考核方法构建平时考核、年度考核、专项考核、任期考核四位一体的适宜公立医院高质量发展的中层干部考核体系。方法:通过改良专家咨询法,结合工作实际,确定不同维度中层干部的考核指标及权重赋值。结果:以团队业绩体现干部个人业绩,实绩量化建立中层干部四位一体的考核体系。咨询专家对一级指标的重要性、合理性、可测量性、可考核性评分和认可度均较高。结论:统筹兼顾、综合运用各类考核评价,使其相互补充、相互印证,可增强考核体系的完整性和系统性。科学合理、客观公正的干部考核体系有利于培育一支忠诚、干净、担当的高素质专业化干部队伍。

基于TIG模式的层级培训对妇幼医院急诊护士核心能力及岗位胜任力的影响

目的 探讨基于TIG模式的层级培训对妇幼医院急诊护士核心能力及岗位胜任力的影响。方法 选取2020年6月—2022年5月妇幼医院急诊护士68名,采用随机数字表法分为对照组(34名)和研究组(34名)。对照组采用传统培训,研究组采用基于TIG模式的层级培训。对比两组护士培训结束时理论及操作考核成绩、核心能力及岗位胜任力。结果 研究组护士理论及操作考核成绩与对照组比较均明显升高,差异明显(P<0.05)。研究组护士岗位胜任力评估量表各维度评分与对照组比均明显升高,差异明显(P<0.05)。研究组护士核心能力量表各维度评分与对照组比均明显升高,差异明显(P<0.05)。结论 基于TIG模式的层级培训有助于提升妇幼医院急诊护士理论及操作考核成绩、核心能力、岗位胜任力。

基于全流程仿真创伤救治模拟演练下的县域医院创伤救治现状分析

目的通过仿真创伤全流程早期救治模拟演练分析我国县域医院创伤救治能力现状。方法2018年7月—2022年7月在全国40家县域医院举办了中国创伤救治培训基层版(China trauma training basic,CTCT?-B),培训包括仿真的创伤早期全流程救治模拟演练。本研究对演练中创伤院前急救、院前院内信息联动、院内早期评估与处置、院内救治模式和流程、影响救治结局因素等进行归纳统计分析。结果40家县域医院,其中二级医院29家,三级医院11家;院前急救模式:依托型32家,指挥型6家,独立型2家;院前急救能力方面:院前规范处置31家,不规范处置7家,不处置2家;院前院内信息联动方面:电话/微信24家,院前急救系统8家,中国创伤联盟紫云系统6家,无信息交互2家;院内交接和早期评估:能够按照创伤救治规范化培训要求进行评估和处置23家,不规范17家;创伤救治模式方面:以急诊科为主导的多学科会诊模式34家,创伤科主导的创伤救治模式4家,专科主导多学科会诊模式2家;实体创伤病房6家,急诊病房23家,无病房11家;40名模拟创伤患者16人死亡,其余存活,死亡原因为早期评估和处置不规范,输血流程不合理、创伤相关核心技术缺乏,有效运行的创伤多学科团队缺乏。结论县域创伤救治过程中存在创伤早期评估和核心技术不足、缺乏院内高效的多学科救治团队、创伤集中收治模式尚未普及等问题,亟须重视解决。

社区慢性病共病患者自我同情现状及影响因素分析

目的了解社区慢性病共病患者自我同情现状及其影响因素,为护理人员采取针对性措施促进社区慢性病共病患者的身心健康发展提供科学依据。方法采用一般资料调查问卷、自我同情量表、Herth希望量表和领悟社会支持量表对社区402例慢性病共病患者进行调查。结果社区慢性病共病患者的自我同情得分(79.04±7.82)分。多元线性逐步回归分析显示,希望水平和领悟社会支持水平是社区慢性病共病患者自我同情的影响因素(均P<0.05)。结论社区慢性病共病患者自我同情处于中等水平,护理人员应加强患者自我同情的识别与干预,制订针对性护理方案,充分调动患者及其家庭对慢性病共病相关身心健康管理的积极性,以提升社区慢性病共病患者的自我同情水平。

3所三级甲等综合医院护士组织沉默现况及其影响因素分析

目的了解3所三级甲等综合医院护士组织沉默现状,探讨其影响因素。方法采用便利抽样法,2023年4月—8月采用一般资料调查表、护士组织沉默问卷、医院磁性要素量表(the essential of magnetism scale,EMO)对西安市3所三级甲等综合医院的874临床护士进行调查,并采用多重线性回归分析其组织沉默的影响因素。结果共855名护士完成研究。护士组织沉默总分(56.33±8.55)分;医院磁性水平总分(107.63±12.85)分。护士组织沉默与医院磁性水平呈负相关(r=-0.318,P<0.010)。医院磁性水平、年龄、职称、护龄是护士组织沉默的影响因素(均P<0.001),共同解释其62.60%的变异。结论护士组织沉默与医院磁性水平处于中等偏低水平。护士年龄小、职称低、护龄短、医院磁性水平低,其组织沉默水平较高,护理管理者可通过提高医院磁性水平来减少护士的组织沉默。

针对性干预对肺癌化疗伴癌因性疲乏患者的影响

目的:探讨针对性干预对肺癌化疗伴癌因性疲乏患者的影响。方法:选择2021年3月—2023年3月江西省肿瘤医院胸内一病区接收的肺癌化疗伴癌因性疲乏患者80例作为研究对象,按随机数字表法将其分为对照组与观察组,各40例。对照组给予常规干预措施,观察组在对照组的基础上给予针对性干预,比较两组癌因性疲乏程度、心理状态、社会适应性、希望水平、睡眠质量、生存质量。结果:干预后观察组癌因性疲乏程度轻于对照组,差异有统计学意义(P<0.05)。干预后观察组焦虑自评量表(SAS)、抑郁自评量表(SDS)评分均低于对照组,差异均有统计学意义(P<0.05)。干预后观察组社会适应性量表的心理弹性、心理能量、人际适应性、控制倾向维度评分均高于对照组,差异均有统计学意义(P<0.05)。干预后,观察组希望水平、生存质量评分均高于对照组,睡眠质量评分低于对照组,差异均有统计学意义(P<0.05)。结论:对肺癌化疗伴癌因性疲乏患者实施针对性干预可进一步疏解负面情绪,改善癌因性疲乏症状,并增强患者的社会适应性,提高希望水平,恢复良好的睡眠质量和生存质量。

围透析期慢性肾脏病患者夫妻疾病感知与希望水平的关系研究

目的探讨围透析期慢性肾脏病患者夫妻疾病感知对希望水平的影响,为后期临床开展以夫妻为中心的二元干预提供理论支持及依据。方法纳入郑州大学第一附属医院肾病内科的140对围透析期慢性肾脏病患者夫妻为研究对象,采用简易疾病感知问卷和中文版希望量表进行调查研究。通过主客体互倚模型,分析围透析期慢性肾脏病患者夫妻疾病感知对希望水平的影响。结果围透析期慢性肾脏病患者夫妻希望水平处于中等水平,患者希望量表总分及各维度评分均低于配偶,简易疾病感知问卷总分及认知、情绪维度评分均高于配偶(P<0.05或0.01)。围透析期慢性肾脏病患者夫妻的疾病感知和希望水平存在相关性(P<0.01)。主体效应方面,围透析期慢性肾脏病患者夫妻的疾病感知都会对其希望水平产生影响(P<0.01);客体效应方面,围透析期慢性肾脏病患者的疾病感知都会对其配偶的希望水平产生影响(P<0.05)。结论围透析期慢性肾脏病患者夫妻的希望水平受自身和对方疾病感知的交互影响。医护人员应将围透析期慢性肾脏病患者夫妻视为一个共同体,有助于实施以夫妻为中心的相互支持应对策略,从而提高他们应对围透析期时的希望水平。

阶段性术前心理护理联合肠内营养支持在食道癌患者中的应用

目的:探究阶段性术前心理护理联合肠内营养支持在食道癌患者中的应用效果。方法:选取2022年3月—2023年6月南通大学附属医院收治的97例食道癌患者作为研究对象,按照干预方案不同分为对照组(n=48例)和研究组(n=49例)。对照组给予常规肠内营养支持方案,研究组在对照组基础上联合使用阶段性术前心理护理干预。比较两组干预前后心理状态[焦虑自评量表(SAS)、抑郁自评量表(SDS)]、希望水平(Herth希望量表)、生活质量[生活质量综合评定问卷(GQOLI-74)]。结果:干预后,研究组SAS和SDS评分均低于对照组,差异有统计学意义(P<0.05);干预后,研究组Herth希望量表各维度评分均高于对照组,差异有统计学意义(P<0.05);干预后,研究组GQOLI-74量表各维度评分均高于对照组,差异有统计学意义(P<0.05)。结论:在给予肠内营养支持的基础上联合使用阶段性术前心理护理,不仅可以改善食道癌患者的心理状态,还可以提高患者的希望水平和生活质量。

项目管理在公立医院等级评审中的应用

在各级公立医院整体医疗服务能力与综合实力评价中,等级评审是非常重要的评估方法,可以从多角度、全方位了解医院运行和管理情况,在此基础上对医院总体情况进行评估,医院的整体服务能力体现更加全面。随着医改的深入以及公立医院高质量发展的新要求,各级医院开始运用项目管理对院内各项事务进行管理。淮安某大型公立医院将项目管理方法应用于医院等级评审,从项目启动、项目计划、项目执行与监管到项目结束,结合各种管理工具,使得工作计划更有系统性、目标更明确、项目执行更有重点、团队更有凝聚力,最终顺利完成医院等级评审全过程,为公立医院高质量发展提供新思路。

适应-系统双模式心理护理在结直肠癌手术病人的应用及对希望水平、生活质量的影响

目的:探讨适应-系统双模式心理护理在结直肠癌手术病人的应用及对希望水平、生存质量的影响。方法:选取78例结直肠癌手术病人为研究对象,按入院顺序将2019年6月至2021年6月入院病人分成对照组(40例),2021年7月至2022年6月入院病人分成观察组(38例)。对照组给予常规心理护理干预,观察组给予适应-系统双模式心理护理干预,比较2组病人的心理状态量表(SCL-90)评分、Herth希望量表(HHI)评分、适应能力量表评分、癌症生命质量量表(FACT-G)评分和治疗依从性的差异。结果:干预后,2组焦虑、抑郁、恐惧、紧张评分均低于同组干预前,且观察组SCL-90各项评分均低于对照组(P<0.05~P<0.01);2组HHI、适应能力量表、FACT-G各项评分均高于同组干预前,且观察组均高于对照组(P<0.05~P<0.01);观察组的治疗依从性高于对照组(P<0.05)。结论:结直肠癌手术病人适应-系统双模式心理护理干预对结肠癌手术病人的护理效果显著,能有效改善病人负面心理状态,提高希望水平、适应能力和治疗依从性,进而提高生活质量。

基于循证医学理念的护理应用于重症急性胰腺炎患者的价值及对其生命质量的影响

目的分析基于循证医学理念的护理应用于重症急性胰腺炎患者的价值及对其生命质量的影响。方法选取2019年7月至2021年7月无锡市人民医院消化内科收治的100例重症急性胰腺炎患者作为研究对象,按照随机数字表法分为对照组与观察组,每组50例。对照组行常规护理,观察组行基于循证医学理念的护理。比较两组的症状缓解情况、血清康复自我效能指标[WBC、C反应蛋白(CRP)、血淀粉酶(AMS)、血清脂肪酶(LPS)]、希望水平评分及生命质量评分。结果观察组高热、腹部疼痛和腹胀的消失时间及排气恢复时间均短于对照组,差异有统计学意义(P<0.05)。护理后,观察组血清WBC、CRP、AMS、LPS水平均低于对照组,差异有统计学意义(P<0.05)。护理后,观察组积极行动态度、对未来与当前的积极态度、与他人维持亲密关系的积极态度评分及总分均高于对照组,差异有统计学意义(P<0.05)。护理后,观察组标准生理组分、标准心理组分的生命质量评分均高于对照组,差异有统计学意义(P<0.05)。结论基于循证医学理念的护理应用于重症急性胰腺炎患者中的价值显著,有助于缓解患者症状,改善血清指标,提高希望水平及生命质量。

广东省县区级医院感染管理质量控制中心的现状调查

目的调研广东省县区级医院感染管理质量控制中心现实情况,为本省院感质控中心对县区级院感质量控制中心质控管理方案的制定提供参考依据,并探讨相应的管理对策。方法通过问卷星问卷调查平台对广东省2023年12月31日前成立的县区级质控中心进行调研,内容包括医院感染管理专业质控中心的成立时间、人员架构、信息化水平、管理、质控及培训工作情况等。结果广东省有68家县区级院感质控中心,覆盖率达50.37%,近五年成立的占95.59%。专家以临床和护理为主(分别占23.75%、62.97%),学历以本科为主(占71.06%)。仅13%有运行经费。39家已建医院感染信息化监测,23家未配备,6家在建。20家进行质控督导出具质控报告,占29.41%;41家举办培训,占60.29%。结论广东省医院感染管理质量控制组织体系县区级覆盖率正在稳步提升,但是未完全覆盖所有县区,缺乏政策、经费支持,人员配备、人员专业覆盖面不足。卫生健康行政部门及县区级院感质控中心需统一监测标准、质控规范及考核评价方案,提升院感质控能力,完善“四级”管理与培训体系,以有效推动提升基层医疗机构的质量安全管理水平。

压力接种训练联合结构式心理干预对老年心脏瓣膜置换术患者希望水平、自我感知压力及生存质量的影响

目的:观察压力接种训练联合结构式心理干预对老年心脏瓣膜置换术患者希望水平、自我感知压力及生存质量的影响。方法:选取2020年4月-2023年4月110例老年心脏瓣膜置换术住院患者为研究对象,按随机数字表法分为干预组、对照组各55例。对照组接受结构式心理干预,干预组采取压力接种训练联合结构式心理干预,共8周。评价两组患者术后服药依从性;采用汉密顿焦虑量表(HAMA)、汉密顿抑郁量表(HAMD)评价患者心理状态,Herth希望指数(HHI)评价希望水平,自我感受负担量表(SPBS)评价自我感知压力,明尼苏达心功能不全生命质量量表(MLHFQ)评价生存质量。结果:干预组服药总依从率94.55%,较对照组的81.82%更高(χ^(2)=4.274,P<0.05);干预后8周,干预组HAMA、HAMD评分均低于对照组(t=-6.483,-5.450;P<0.05),HHI评分中对现实/未来的积极态度、采取积极行动、与他人保持亲密关系及总分均高于对照组(t=5.901,4.308,4.321,5.886;P<0.05),SPBS评分中身体负担、情感负担及总分均低于对照组(t=-3.622,-4.119,-3.701;P<0.05),MLHFQ评分中身体领域、情绪领域、其他领域及总分均低于对照组(t=-5370,-3.849,-4.311,-5.288;P<0.05)。结论:老年心脏瓣膜置换术患者采用压力接种训练联合结构式心理干预能改善患者心理状态、提升希望水平、减轻自我感知压力,有利于提高患者服药依从性、改善生命质量。