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Ensemble Based Temporal Weighting and Pareto Ranking (ETP) Model for Effective Root Cause Analysis 被引量:1
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作者 Naveen Kumar Seerangan S.Vijayaragavan Shanmugam 《Computers, Materials & Continua》 SCIE EI 2021年第10期819-830,共12页
Root-cause identification plays a vital role in business decision making by providing effective future directions for the organizations.Aspect extraction and sentiment extraction plays a vital role in identifying the ... Root-cause identification plays a vital role in business decision making by providing effective future directions for the organizations.Aspect extraction and sentiment extraction plays a vital role in identifying the rootcauses.This paper proposes the Ensemble based temporal weighting and pareto ranking(ETP)model for Root-cause identification.Aspect extraction is performed based on rules and is followed by opinion identification using the proposed boosted ensemble model.The obtained aspects are validated and ranked using the proposed aspect weighing scheme.Pareto-rule based aspect selection is performed as the final selection mechanism and the results are presented for business decision making.Experiments were performed with the standard five product benchmark dataset.Performances on all five product reviews indicate the effective performance of the proposed model.Comparisons are performed using three standard state-of-the-art models and effectiveness is measured in terms of F-Measure and Detection rates.The results indicate improved performances exhibited by the proposed model with an increase in F-Measure levels at 1%–15%and detection rates at 4%–24%compared to the state-of-the-art models. 展开更多
关键词 root cause analysis sentiment analysis aspect extraction ensemble modelling temporal weighting pareto ranking
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A Causal Fusion Inference Method for Industrial Alarm Root Cause Analysis Based on Process Topology and Alarm Event Data
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作者 Pan Zhang Wenkai Hu +1 位作者 Xiangxiang Zhang Jianqi An 《Journal of Beijing Institute of Technology》 EI CAS 2022年第4期371-381,共11页
Modern industrial systems are usually in large scale,consisting of massive components and variables that form a complex system topology.Owing to the interconnections among devices,a fault may occur and propagate to ex... Modern industrial systems are usually in large scale,consisting of massive components and variables that form a complex system topology.Owing to the interconnections among devices,a fault may occur and propagate to exert widespread influences and lead to a variety of alarms.Obtaining the root causes of alarms is beneficial to the decision supports in making corrective alarm responses.Existing data-driven methods for alarm root cause analysis detect causal relations among alarms mainly based on historical alarm event data.To improve the accuracy,this paper proposes a causal fusion inference method for industrial alarm root cause analysis based on process topology and alarm events.A Granger causality inference method considering process topology is exploited to find out the causal relations among alarms.The topological nodes are used as the inputs of the model,and the alarm causal adjacency matrix between alarm variables is obtained by calculating the likelihood of the topological Hawkes process.The root cause is then obtained from the directed acyclic graph(DAG)among alarm variables.The effectiveness of the proposed method is verified by simulations based on both a numerical example and the Tennessee Eastman process(TEP)model. 展开更多
关键词 roots cause analysis causality inference process topology alarm events
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Alarm-Based Root Cause Analysis Based on Weighted Fault Propagation Topology for Distributed Information Network
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作者 LYU Xiaomeng CHEN Hao +2 位作者 WU Zhenyu HAN Junhua GUO Huifeng 《ZTE Communications》 2022年第3期77-84,共8页
A distributed information network with complex network structure always has a challenge of locating fault root causes.In this paper,we propose a novel root cause analysis(RCA)method by random walk on the weighted faul... A distributed information network with complex network structure always has a challenge of locating fault root causes.In this paper,we propose a novel root cause analysis(RCA)method by random walk on the weighted fault propagation graph.Different from other RCA methods,it mines effective features information related to root causes from offline alarms.Combined with the information,online alarms and graph relationship of network structure are used to construct a weighted graph.Thus,this approach does not require operational experience and can be widely applied in different distributed networks.The proposed method can be used in multiple fault location cases.The experiment results show the proposed approach achieves much better performance with 6%higher precision at least for root fault location,compared with three baseline methods.Besides,we explain how the optimal parameter’s value in the random walk algorithm influences RCA results. 展开更多
关键词 distributed information network ALARM GRAPH root cause analysis random walk
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A Framework for Modern Risk-Informed Root Cause Analysis Process
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作者 Dorian Conger Ivan Vrbanic +1 位作者 Ivica Basic Kenneth J.Elsea 《Journal of Energy and Power Engineering》 2020年第7期211-224,共14页
The paper discusses the framework for a risk-informed root cause analysis process.Such process enables scaling of the analysis performed based on the risk associated with the undesired event or condition,thereby creat... The paper discusses the framework for a risk-informed root cause analysis process.Such process enables scaling of the analysis performed based on the risk associated with the undesired event or condition,thereby creating tiers of analysis where the greater the risk,the more sophisticated the analysis.In a risk-informed root cause analysis process,a situation is normally not analyzed at a level less than what actually occurred.However,a situation may be investigated as though the consequence were greater than actually happened,especially if only slight differences in circumstances could result in a significantly higher consequence.While operational events or safety issues are normally expected to result only with negligible or marginal actual consequences,many of those would actually have certain potential to develop or propagate into catastrophic events.This potential can be expressed qualitatively or quantitatively.Risk-informing of root cause analysis relies on mapping the event or safety issue into a risk matrix which,traditionally,is a two-dimensional probability-consequence matrix.A new concept employed in the risk matrix for root cause analysis is that,while the probability reflects the observed or expected range of values(retaining,thus,its“traditional”meaning),the consequence reflects not only the observed or materialized impact(such as failure of equipment)but,also,its potential to propagate or develop into highly undesirable final state.The paper presents main elements of risk-informed root cause analysis process and discusses qualitative and quantitative aspects and approaches to determination of risk significance of operational events or safety issues. 展开更多
关键词 root cause risk-inform RISK probability cause analysis safety precedence significance determination risk matrix probabalistic margin conditional probability conditional risk ANALYST training methods
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基于FMEA和RCA的适老化智能家电产品交互设计研究 被引量:1
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作者 魏霜 李永锋 《包装工程》 CAS 北大核心 2024年第18期36-43,共8页
目的为了进行智能家电产品的适老化升级,提升老年人的用户体验。方法提出基于失效模式与效应分析(FMEA)和根本原因分析(RCA)的适老化智能家电产品交互设计方法。首先,通过构建老年人使用智能家电的用户旅程图识别失效模式,利用FMEA对失... 目的为了进行智能家电产品的适老化升级,提升老年人的用户体验。方法提出基于失效模式与效应分析(FMEA)和根本原因分析(RCA)的适老化智能家电产品交互设计方法。首先,通过构建老年人使用智能家电的用户旅程图识别失效模式,利用FMEA对失效模式进行分析并评估风险优先指数;其次,根据风险优先指数绘制帕累托图确定重点失效模式,并运用石川图分析其发生的根本原因;再次,围绕根本原因对智能家电产品交互设计进行改良;最后,对改良后的设计进行测试并评估改良效果。结论选取智能洗衣机作为案例进行研究,结果表明所提出方法能够有效识别老年人使用智能家电时发生的失效模式,并对其发生的根本原因进行分析,可为适老化智能家电产品的设计优化提供方法参考,帮助老年人享受技术红利,跨越数字鸿沟。 展开更多
关键词 交互设计 用户体验 失效模式与效应分析 根本原因分析 适老化
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RCA-PDCA模式对妇科疾病患者宫腔镜、腹腔镜治疗中手术并发症的风险控制作用 被引量:2
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作者 张佳佳 戎丽琴 郭玲 《河北医药》 CAS 2024年第1期154-157,共4页
目的 分析妇科疾病患者宫腔镜、腹腔镜治疗中RCA-PDCA模式应用对手术并发症风险控制作用及术后康复影响。方法 随机抽选2020年8月至2022年12月行宫腔镜或腹腔镜治疗妇科疾病患者79例,术前采用分段随机化分组设置组别后,对照组(n=40)配... 目的 分析妇科疾病患者宫腔镜、腹腔镜治疗中RCA-PDCA模式应用对手术并发症风险控制作用及术后康复影响。方法 随机抽选2020年8月至2022年12月行宫腔镜或腹腔镜治疗妇科疾病患者79例,术前采用分段随机化分组设置组别后,对照组(n=40)配合常规围手术期护理,研究组(n=39)配合RCA-PDCA模式下围手术期护理。比较患者手术操作指标,术后康复时间,术后疼痛评分变化,手术并发症发生率,护理质量评分,护理服务满意度生活质量、睡眠质量评分差异。结果 与对照组比较,研究组术中失血量、手术时间、术后肛门首次排气时间、卧床时间、住院时间,麻醉苏醒后8 h、24 h、48 h时NRS评分及手术并发症发生率均降低(P<0.05)。与对照组比较,研究组护理质量评分(护理评估、护理预防、护理配合、护理态度)及护理满意度NSNS评分、SF-36评分均升高,PSQI评分下降,(P<0.05)。结论 RCA-PDCA模式下临床护理在妇科疾病患者宫腔镜、腹腔镜治疗的应用,可促进患者康复,积极控制并发症风险,优化临床护理质量。 展开更多
关键词 根本原因分析 循环质量管理法 宫腔镜 腹腔镜 妇科手术
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基于RCA的手术纱布清点不良事件改进效果研究
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作者 李俊杰 张琳娟 +1 位作者 梅娜 罗嘉婷 《中国卫生质量管理》 2024年第7期67-71,共5页
目的探讨根本原因分析法(RCA)在手术纱布清点不良事件中的应用效果。方法组建RCA小组,回溯事件经过并使用时间序列表整理资料,找出近端原因后采用改良原因树图分析根本原因,通过屏障分析、拟订行动计划,最终组织实施并长期监测持续改进... 目的探讨根本原因分析法(RCA)在手术纱布清点不良事件中的应用效果。方法组建RCA小组,回溯事件经过并使用时间序列表整理资料,找出近端原因后采用改良原因树图分析根本原因,通过屏障分析、拟订行动计划,最终组织实施并长期监测持续改进效果。结果改进后术后纱布入袋执行率、自然腔道手术物品清点率、台上小纱布定点放置执行率、保洁人员垃圾袋不叠套执行率明显上升(P<0.05),为医务部提供了接台时间检查基线(5 min),并研发了一种可以识别纱布一致性的清点设备。结论应用RCA进行手术纱布清点不良事件分析,能够更加清晰地识别手术室纱布清点流程中的系统缺陷并针对性改进,从而有效规避护理风险,保障患者安全。 展开更多
关键词 根本原因分析法 手术室 物品清点 不良事件 患者安全
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FMEA联合RCA在剖宫产手术患者切口感染预防中的应用
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作者 陈春燕 江帆 +2 位作者 孟芳芳 姚芬芬 陈群好 《护理实践与研究》 2024年第2期204-208,共5页
目的探究失效模式与效应分析(FMEA)联合根因分析(RCA)在妇产科剖宫产手术患者切口感染预防中的应用。方法选取2022年3—12月医院行剖宫产手术的患者72例为研究对象,将2022年3—7月行剖宫产手术的36例患者为对照组,2022年8—12月行剖宫... 目的探究失效模式与效应分析(FMEA)联合根因分析(RCA)在妇产科剖宫产手术患者切口感染预防中的应用。方法选取2022年3—12月医院行剖宫产手术的患者72例为研究对象,将2022年3—7月行剖宫产手术的36例患者为对照组,2022年8—12月行剖宫产手术的36例患者为观察组。对照组实施常规感染预防管理,观察组实施FMEA联合RCA模式的感染预防管理,计算实施前关键风险值(RPN)结果,分析实施前后RPN值,之后观察并记录FMEA与RCA前后RPN值和患者腹部手术切口感染发生的情况,再进行比较分析。结果实施前风险因素中RPN从大到小排序依次为不合理应用抗菌药物、未彻底清洗与消毒灭菌失效、未按无菌技术操作规范执行与手卫生不规范、未严格执行规定与手术室环境未达标、医护人员宣教不足与消毒效果不达标。抽样研究结果显示,实施FMEA与RCA后(观察组)RPN值较实施FMEA与RCA前(对照组)RPN值下降。且干预后观察组患者切口感染发生率低于对照组,差异有统计学意义(P<0.05)。结论FMEA联合RCA模式可有效降低关键RPN值,减少妇产科腹部手术患者切口感染率,从而达到预防感染的目的。 展开更多
关键词 失效模式与效应分析 根因分析 妇产科 剖宫产手术 切口感染 风险值
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基于RCA的路径式质控管理对消毒供应室灭菌合格率、管理质量和感染率的影响
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作者 陈萍茹 林彬红 陈玲娇 《中外医学研究》 2024年第18期156-159,共4页
目的:探究基于根本原因分析(RCA)的路径式质控管理对消毒供应室灭菌合格率、管理质量和感染率的影响。方法:以2021年7月中国人民解放军联勤保障部队第九一〇医院消毒供应室实施基于RCA的路径式质控管理干预为分界线,将2020年1月—2021年... 目的:探究基于根本原因分析(RCA)的路径式质控管理对消毒供应室灭菌合格率、管理质量和感染率的影响。方法:以2021年7月中国人民解放军联勤保障部队第九一〇医院消毒供应室实施基于RCA的路径式质控管理干预为分界线,将2020年1月—2021年6月实施常规消毒灭菌管理的86组手术器械纳为管理前组,将2021年7月—2022年12月实施基于RCA的路径式质控管理的86组手术器械纳为管理后组。观察两组灭菌合格率[目测法、蛋白质残留检测、三磷酸腺苷(ATP)荧光检测、细菌菌落检测]、管理质量(器械管理、医疗垃圾处理、手卫生管理、技能考核培训)、器械相关感染发生率、临床科室及手术室人员对消毒供应中心服务满意度。结果:管理后组目测法、蛋白质残留检测、ATP荧光检测、细菌菌落检测合格率高于管理前组,差异有统计学意义(P<0.05);管理后组器械管理、医疗垃圾处理、手卫生管理、技能考核培训评分高于管理前组,差异有统计学意义(P<0.05);管理后组器械相关感染发生率为3.49%,低于管理前组的12.79%,差异有统计学意义(P<0.05);管理后组服务态度、物品质量、物品交接、器械配送、信息追溯满意度高于管理前组,差异有统计学意义(P<0.05)。结论:基于RCA的路径式质控管理可改善消毒供应中心的灭菌合格率,提升器械管理质量,降低院内器械相关感染率,且临床科室及手术室人员较满意。 展开更多
关键词 根本原因分析 路径式质控管理 消毒供应室 灭菌合格率 管理质量 感染率
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基于RCA法的环节质控措施在成分血制备过程中的应用
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作者 钟泰玉 黄正英 谢淑琳 《海南医学》 CAS 2024年第14期2046-2049,共4页
目的研究基于根本原因分析法(RCA)的环节质控措施在成分血制备过程中的应用效果。方法选择梅州市中心血站2019年1月至2021年12月质量控制前血液离心总袋数283227袋作为对照组,2022年1月至2023年6月质量控制后血液离心总袋数123394袋作... 目的研究基于根本原因分析法(RCA)的环节质控措施在成分血制备过程中的应用效果。方法选择梅州市中心血站2019年1月至2021年12月质量控制前血液离心总袋数283227袋作为对照组,2022年1月至2023年6月质量控制后血液离心总袋数123394袋作为观察组,比较两组各环节血袋破损发生情况。从两组中各随机抽取200袋,比较两组的白细胞残留量、储存期末溶血率和新鲜冰冻血浆Ⅷ因子含量。结果观察组热合、离心、无菌接合、病毒灭活和速冻环节的血袋破损情况分别为4袋、54袋、2袋、0袋和2袋,总破损率为0.050%(62/123394),对照组相应环节的血袋破损情况分别为20袋、280袋、6袋、0袋和12袋,总破损率为0.112%(318/283277),观察组总破损率明显低于对照组,差异有统计学意义(P<0.05);观察组的白细胞残留量、储存期末溶血率分别为(0.53±0.42)×10^(4)个U、(0.12±0.09)%,明显低于对照组的(0.69±0.45)×10^(4)个U、(0.15±0.08)%,差异均有统计学意义(P<0.05);观察组的新鲜冰冻血浆Ⅷ因子含量为(0.92±0.15)IU/mL,明显高于对照组的(0.82±0.13)IU/mL,差异有统计学意义(P<0.05)。结论基于RCA法的环节质控措施在成分血制备过程中的应用效果良好,可显著降低成分血制备过程中的血袋破损率,避免血液浪费,提高血液资源的有效利用率和血液质量,有利于保障临床治疗的顺利进行,提高患者的治疗效果。 展开更多
关键词 成分血 根本原因分析法 血袋破损 质量控制
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基于RCA的预见性护理在后循环缺血性眩晕患者中的应用效果
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作者 禹静 《临床医学研究与实践》 2024年第32期195-198,共4页
目的探讨基于根本原因分析法(RCA)的预见性护理在后循环缺血性眩晕患者中的应用效果。方法选取2021年1月至2022年12月于我院治疗的150例后循环缺血性眩晕患者作为研究对象,按照随机数字表法将其分为对照组与研究组,每组75例。对照组开... 目的探讨基于根本原因分析法(RCA)的预见性护理在后循环缺血性眩晕患者中的应用效果。方法选取2021年1月至2022年12月于我院治疗的150例后循环缺血性眩晕患者作为研究对象,按照随机数字表法将其分为对照组与研究组,每组75例。对照组开展常规护理,研究组开展基于RCA的预见性护理。比较两组的干预效果。结果研究组的干预总有效率为92.00%,明显高于对照组的77.33%,差异具有统计学意义(P<0.05)。护理3、7 d后,两组的眩晕障碍评定量表(DHI)评分明显低于护理前,且研究组明显低于对照组,差异具有统计学意义(P<0.05)。护理7 d后,两组的Barthel指数评分明显高于护理前,且研究组明显高于对照组,差异具有统计学意义(P<0.05)。研究组的不良事件总发生率为5.33%,明显低于对照组的16.00%,差异具有统计学意义(P<0.05)。结论基于RCA的预见性护理在后循环缺血性眩晕患者中的应用效果显著,可有效缓解眩晕症状,同时还能提升患者的生活自理能力,值得应用及推广。 展开更多
关键词 后循环缺血性眩晕 根本原因分析法 预见性护理 生活自理能力
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基于RCA方法的某三级甲等医院非计划再手术分析 被引量:4
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作者 宋涵超 张艳丽 +2 位作者 于涛 董书 胥雪冬 《中国医院管理》 北大核心 2023年第1期49-52,共4页
目的 调查北京市某三级甲等医院非计划再手术现状与存在的问题,分析发生的原因,并提出对策建议。方法 查询医院2019年发生的非计划再手术患者的临床资料,使用根本原因分析方法分析发生非计划再手术的近端原因与根本原因,并提供相应的对... 目的 调查北京市某三级甲等医院非计划再手术现状与存在的问题,分析发生的原因,并提出对策建议。方法 查询医院2019年发生的非计划再手术患者的临床资料,使用根本原因分析方法分析发生非计划再手术的近端原因与根本原因,并提供相应的对策建议。结果 医院共发生非计划再手术388例,非计划再手术率为0.51%,非计划再手术率最高的科室为心脏外科。导致非计划再手术的近端原因包括未达到手术效果、出血、感染、植入物相关并发症、其他以及神经组织损伤或水肿,根本原因包括患者、临床医生和管理制度3方面。结论 非计划再手术可发现医疗过程中的异常情况,并用以评价医疗质量;非计划再手术的近端原因具有特异性,为科室提升医疗质量提供数据支持;完善非计划再手术管理制度建设,形成闭环管理;完善手术分级管理制度,落实手术医师资质与授权管理;提升信息化建设水平,助力医疗安全。 展开更多
关键词 非计划再手术 根本原因分析 医疗质量
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Analysis of Turnaround Time during Casefile and Sample Processing in Forensic Science Laboratory 被引量:2
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作者 G. C. Omari S. V. Manyele G. Mwaluko 《Engineering(科研)》 2018年第2期43-73,共31页
Turnaround time (TAT), is the total time interval from when a request for forensic laboratory analysis is received until when the results are collected by the client. The performance of the forensic science laboratory... Turnaround time (TAT), is the total time interval from when a request for forensic laboratory analysis is received until when the results are collected by the client. The performance of the forensic science laboratory (FSL) is affected by extended TAT in the case-file and sample processing steps necessitating critical analysis reported in this paper. The total TAT was obtained as the sum of measured time interval for each work station (six of which were studied). Extended TAT leads not only to customer complaints, but also paves way for customers to seek for services from competitors, leading to lost competitive edge for the FSL. This study was conducted to establish the baseline data on TAT (between 2014 and 2015) to enable implementation of corrective actions. Six casefile processing steps were identified for which starting and completion times were recorded in dates, giving TAT values in days. The TAT data for each step was collected as each case file is processed and analyzed separately using statistical analysis while comparing the data for the two years (Y2014 and Y2015) and?among?three forensic science laboratory disciplines (biology/DNA, chemistry and toxicology). The overall turnaround time (TTAT) was?the?highest for forensic biology/DNA compared to forensic toxicology and chemistry. The analysis time (TAT2) was the longest of all six case-file processing steps. Using Pareto analysis, the three major steps necessitating root-cause analysis and intervention to minimize TAT were analysis turnaround time (TAT2), report collection time (TAT6) and report review time (TAT4). It was concluded that the causes for extended TAT are within control by the FSL management, although financial and human resources are required. 展开更多
关键词 Turnaround Time Forensic Science LABORATORY Forensic Biology/DNA Forensic Chemistry Forensic TOXICOLOGY Statistical analysis PARETO analysis root cause analysis
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Other Possible Causes of a Well-Publicized Outbreak of <i>Pseudomonas aeruginosa</i>Following Arthroscopy in Texas 被引量:1
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作者 Lawrence F. Muscarella 《Advances in Infectious Diseases》 2013年第2期134-145,共12页
Background: Seven patients at a hospital in Houston, TX, were diagnosed during a two-week period in 2009 with joint space infection of pansusceptible P. aeruginosa following arthroscopic procedures of the knee or shou... Background: Seven patients at a hospital in Houston, TX, were diagnosed during a two-week period in 2009 with joint space infection of pansusceptible P. aeruginosa following arthroscopic procedures of the knee or shoulder. Tosh et al. (2011), who investigated and published the principal report discussing this bacterial outbreak, conclude that its most likely cause was the improper reprocessing of certain reusable, physically-complex, heat-stable arthroscopic instruments used during these arthroscopic procedures. These reusable instruments reportedly remained contaminated with remnant tissue, despite diligent efforts by the hospital to clean their internal structures. This retained bioburden presumably shielded the outbreak’s strain of embedded P. aeruginosa from contact with the pressurized steam, reportedly resulting in ineffective sterilization of these arthroscopic instruments and bacterial transmission. Objectives: First, to clarify which specific sterilization methods, in addition to steam sterilization, Methodist Hospital employed to process its reusable arthroscopic instrumentation at the time of its outbreak, in 2009;second, to evaluate Tosh et al.’s (2011) conclusion that ineffective steam sterilization due to inadequate cleaning was the most likely cause of this hospital’s outbreak;third, to consider whether any other hitherto unrecognized factors could have plausibly contributed to this outbreak;and, fourth, to assess whether any additional recommendations might be warranted to prevent disease transmission following arthroscopic procedures. Methods: The medical literature was reviewed;some of the principles of quality assurance, engineering and a root-cause analysis were employed;and Tosh et al.’s (2011) findings and conclusions were reviewed and compared with those of other published reports that evaluated the risk of disease transmission associated with the steam sterilization of physically-complex, heat-stable, soiled surgical instruments. Results and Conclusion: Reports documenting outbreaks of P. aeruginosa or another vegetative bacterium associated with the steam sterilization of inadequately cleaned surgical or arthroscopic instruments are scant. This finding—coupled with a number of published studies demonstrating the effective steam sterilization of complex instruments contaminated with vegetative bacteria mixed with organic debris, or, in one published series of tests, with resistant bacterial endospores coated with hydraulic fluid—raises for discussion whether Methodist Hospital’s outbreak might have been due to one or more factors other than, or in addition to, that which Tosh et al. (2011) conclude was its most likely cause. An example of such a factor not ruled out by Tosh et al. (2011) findings would be the re-contamination of the implicated arthroscopic instruments after sterilization. The specific methods that Methodist Hospital employed at the time of its outbreak to sterilize some of its arthroscopic instrumentation remain unclear. A number of additional recommendations are provided to prevent disease transmission following arthroscopic procedures. 展开更多
关键词 Pseudomonas AERUGINOSA ARTHROSCOPY Disease Transmission HEALTHCARE-ASSOCIATED Infection root cause analysis Instrument Reprocessing Bacterial OUTBREAK Sterilization Sterile Technique
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Analysis of the present situation and influencing factors of self-perceived burden in primary glaucoma patients 被引量:1
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作者 Fu-Liang Sun Xiao-Hui An Shu-Qing Cao 《TMR Integrative Nursing》 2020年第1期15-21,共7页
Objective:To explore the status of self-perceived burden(SPB)in primary glaucoma patients and to analyze its influencing factors.Subject and setting:A questionnaire survey was administered to 236 inpatients from a ter... Objective:To explore the status of self-perceived burden(SPB)in primary glaucoma patients and to analyze its influencing factors.Subject and setting:A questionnaire survey was administered to 236 inpatients from a tertiary general hospital and a eye hospital in Tianjin.The investigation was conducted after obtaining informed consent from each participant.Instruments:They were investigated using general data questionnaire,Self-Perceived Burden Scale(SPBS),Medical Coping Modes Questionnaire(MCMQ).Design:A descriptive cross-sectional design was used to gather data in this study.Results:The total SPBS score of primary glaucoma patients was(31.10±9.34)was medium.Regression consults showed that avoidance and surrender coping style,medical burden and right eye vision were the influencing factors of patients’SPB(P<0.05).Conclusion:Patients with primary glaucoma have a relatively heavy SPB,so medical staff should encourage them to actively face it.Tailored strategies in line with the patient’s economic and visual conditions to reduce the SPB. 展开更多
关键词 Primary glaucoma Self-perceived burden root cause analysis
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Analysis on the status and influencing factors of undergraduate nursing students’ online learning engagement in the context of the pandemic
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作者 Lian-Di Ding Ming-Jin Li 《TMR Integrative Nursing》 2021年第4期120-126,共7页
Objective:This project has mainly studied the online learning engagement of undergraduate nursing students and analyzes influencing factors of online learning and teaching mode during the Novel Coronavirus(COVID-19).T... Objective:This project has mainly studied the online learning engagement of undergraduate nursing students and analyzes influencing factors of online learning and teaching mode during the Novel Coronavirus(COVID-19).This research has significant references for improving the efficiency and quality of the online learning mode of students.Methods:In this study,212 undergraduate nursing students were selected from a comprehensive university in Jilin Province by combining convenience sampling and cluster sampling methods.And these students were conducted with a general information questionnaire,Online Academic Emotion Scale,and Online Learning Engagement Scale.The influencing factors of this teaching mode were analyzed by multiple linear stepwise regression.Results:The total score of online learning engagement of undergraduate students was 53.85±7.38,which positively correlated with positive high arousal emotion and negative high arousal emotion,but weakly negatively correlated with negative low arousal emotion(r=0.661,0.246,-0.187,P<0.001).Grade,type of online class,online learning time,and positively high arousal emotion were mainly affected the online learning engagement of undergraduate nursing students,which explained 78.5%of the total variation(P<0.001).Conclusion:The online learning engagement of undergraduate nursing students was above the middle level under the background of the COVID-19 pandemic.Lectures and professors who teach undergraduate nursing students,should integrate the individuation characters of nursing students,and motivate their positively high arousal emotion to improve online learning engagement of students to ensure the quality of online teaching mode. 展开更多
关键词 Undergraduate nursing students Online learning engagement Online academic emotion root cause analysis
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长期维持性透析患者的衰弱现况及其影响因素 被引量:3
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作者 李娜 白彝华 +3 位作者 蒋红樱 张凤 李萌 杨娇 《实用医学杂志》 CAS 北大核心 2024年第3期330-335,共6页
目的分析长期维持性透析(简称:透析)患者的衰弱现况及其影响因素,探讨不同的透析方式和新型冠状病毒感染(COVID-19)复阳与衰弱综合征的相关性。方法选取2023年2-6月在肾内科规律透析的患者为研究对象。采用横断面的方法进行调查,收集患... 目的分析长期维持性透析(简称:透析)患者的衰弱现况及其影响因素,探讨不同的透析方式和新型冠状病毒感染(COVID-19)复阳与衰弱综合征的相关性。方法选取2023年2-6月在肾内科规律透析的患者为研究对象。采用横断面的方法进行调查,收集患者的临床资料,了解患者的透析方式,明确患者是否为COVID-19复阳。使用Fried衰弱表型评估标准将患者分为3组:无衰弱组、衰弱前期组和衰弱综合征组。比较3组患者衰弱表型的临床特征,分析各组患者的临床资料、透析方式及COVID-19复阳与衰弱的相关性,采用多因素logistic回归分析患者发生衰弱综合征的影响因素。结果本研究共纳入透析患者246例,其中无衰弱组77例(31.3%),衰弱前期组83例(33.7%),衰弱综合征组86例(35.0%)。衰弱综合征组呈现出高龄、高透析前血肌酐水平、低血清白蛋白水平及合并胸腔积液的特征(均P<0.05)。血透组和腹透组的衰弱情况比较差异无统计学意义(P=0.960)。COVID-19复阳患者的衰弱评分较未复阳者高(P<0.001)。多因素logistic回归显示,年龄、COVID-19复阳、血清白蛋白、透析前血肌酐及胸腔积液与患者发生衰弱综合征独立相关(均P<0.05)。结论透析患者衰弱综合征呈现出较高的发生率,其发生与透析方式无关;高血清白蛋白水平是患者发生衰弱综合征的保护性因素,而COVID-19复阳、高龄、透析前高血肌酐水平及胸腔积液是其发生衰弱综合征的危险因素。 展开更多
关键词 肾透析 衰弱 新型冠状病毒感染 复阳 影响因素分析
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心房颤动患者射频消融术后居家运动康复强度-时间依从性轨迹及预测因素的纵向研究 被引量:4
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作者 王洁 孙国珍 +6 位作者 鲍志鹏 王琳 高敏 刘沈馨雨 于甜栖 王琴 高蓉蓉 《中国全科医学》 北大核心 2024年第2期168-176,183,共10页
背景我国心房颤动(以下简称房颤)患病率逐年升高,患者的预后及生活质量亟需关注。现有研究证实运动康复是改善房颤射频消融术后患者预后及生活质量不佳的有效方式。依从性是衡量运动康复益处是否持续存在的关键指标,但其变化轨迹未知。... 背景我国心房颤动(以下简称房颤)患病率逐年升高,患者的预后及生活质量亟需关注。现有研究证实运动康复是改善房颤射频消融术后患者预后及生活质量不佳的有效方式。依从性是衡量运动康复益处是否持续存在的关键指标,但其变化轨迹未知。目的基于前瞻性纵向观察的心房颤动患者射频消融术后居家运动康复强度-时间依从性5期追踪数据,考察发展轨迹及预测因素。方法采用便利抽样法,选取2020年5—11月就诊于南京医科大学第一附属医院心血管内科行射频消融术的246例房颤患者为研究对象进行随访。其中入组1周为基线调查,入组后3、6、9个月和12个月为追踪调查。收集患者的一般资料;本研究使用智能设备或运动日志对依从性进行监督和记录,从强度-时间依从性评估运动依从性;采用运动自我效能量表(SEE)、运动恐惧量表(Fact-CHF)、领悟社会支持量表(PSSS)、患者积极度量表(PAM13)分别评估患者的运动自我效能、运动恐惧水平、社会支持情况、积极度水平。利用Mplus工具构建潜类别增长模型(LCGM),取最优的拟合模型确定房颤患者射频消融术后居家运动康复强度-时间依从性的发展轨迹,采用Logistic回归分析识别轨迹类别的预测因素。结果44例患者失访,最终共202例纳入分析。基线、运动3个月、运动6个月、运动9个月、运动12个月患者例数分别为202、201、185、174例和159例,患者强度-时间依从性分别为(0.83±0.55)、(1.07±0.54)、(0.99±0.57)、(0.91±0.55)、(0.89±0.60)。LCGM结果显示,患者的运动康复强度-时间依从性变化过程具有群体异质性,分为3个潜类别轨迹组:缓慢下降-低水平组(n=69,34.2%)、快速上升-高水平组(n=14,6.9%)、持续依从组(n=119,58.9%)。无序多分类Logistic回归分析结果显示,以缓慢下降-低水平组为参照组,快速上升-高水平组和持续依从组男性患者的强度-时间依从性水平更高(P<0.001);快速上升-高水平组和持续依从组患者的年龄更大,运动自我效能水平更高(P<0.05);快速上升-高水平组患者的运动恐惧水平更低(P<0.05);持续依从组患者的积极度水平更高(P<0.05)。结论房颤患者射频消融术后居家运动康复强度-时间依从性呈多类别曲线增长的发展轨迹;未来可依据依从性的时变特点和因素定期进行强化干预,进而提高患者居家运动康复依从性水平且保持稳定。 展开更多
关键词 心房颤动 射频消融术 居家运动康复 依从性 影响因素研究 纵向研究
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基层老年慢性病患者心血管疾病综合发生风险的影响因素研究 被引量:3
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作者 余新艳 苏鹏 +5 位作者 袁晓静 姜清茹 杨建云 赵旭东 王一凡 张海澄 《中国全科医学》 北大核心 2024年第10期1186-1193,1200,共9页
背景心血管疾病是造成我国居民死亡和疾病负担的首要病因,防控形势严峻。心血管疾病风险影响因素管理是预防心血管疾病的重要基础。但目前国内外应用单导联可穿戴心电设备针对基层老年慢性病患者心血管疾病发生风险的影响因素调查研究较... 背景心血管疾病是造成我国居民死亡和疾病负担的首要病因,防控形势严峻。心血管疾病风险影响因素管理是预防心血管疾病的重要基础。但目前国内外应用单导联可穿戴心电设备针对基层老年慢性病患者心血管疾病发生风险的影响因素调查研究较少,且在既往研究中也未以整体观对患者包含不同数量风险的变量重要性进行排序。目的分析基层管理的65岁以上老年慢性病患者心血管疾病综合发生风险的影响因素,为基层心血管疾病综合防控提供客观依据及帮助。方法选取2021年12月—2022年9月宁夏回族自治区26家基层医疗卫生机构的3039例65岁以上+高血压、糖尿病、冠心病其中至少1种慢性病的患者为研究对象。依据72 h心电图分析结果划分为正常组632例、风险组2407例。分析两组患者基本资料,确定最佳λ值,绘制模型,采用LASSO回归和多因素Logistic回归分析探讨老年慢性病患者心血管疾病综合风险影响因素;并对影响心血管疾病综合风险及包含不同数量风险的变量排序。结果两组患者年龄、性别、BMI、教育程度、职业、城乡分布、吸烟、运动、冠心病+糖尿病、高血压+冠心病及糖尿病比较,差异均有统计学意义(P<0.05);最佳λ值为0.01568531。LASSO回归和多因素Logistic回归模型分析显示年龄、BMI、城乡分布、吸烟、高血压+冠心病+糖尿病是心血管疾病综合风险的影响因素(P<0.05)。受试者工作特征曲线下面积(AUC)=0.650(95%CI=0.627~0.673,P<0.001)。影响综合风险及不同数量风险种类变量排序前五位的分别为:年龄、BMI、城乡分布、饮茶、运动;年龄、高血压+冠心病、性别、城乡分布、吸烟;年龄、高血压+冠心病、性别、BMI、城乡分布;糖尿病+冠心病、年龄、高血压+冠心病、高血压+冠心病+糖尿病、高血压+糖尿病。结论年龄、BMI、城乡分布、吸烟、高血压合并冠心病及糖尿病是65岁以上+慢性病患者发生心血管疾病风险的影响因素。除年龄外,BMI及生活习惯对心血管疾病综合风险的发生影响较为重要,随着+风险种类数量的增多,慢性病尤其慢性病共病的影响增强。基层医护团队应以单导联可穿戴设备为载体定期对老年慢性病患者进行心血管疾病综合发生风险管理,其不但可高效、低成本的实现心血管疾病发生风险的一级、二级预防及健康管理,并可加速基层医疗服务应加快从不连贯的诊疗服务向全程健康管理的转变。 展开更多
关键词 慢性病 基层医疗卫生机构 老年人 心血管疾病 影响因素分析 变量排序
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基于健康社会决定因素的宁夏中老年人慢性病共病的影响因素研究 被引量:7
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作者 马春芳 汤榕 +1 位作者 杨晓花 李月 《中国全科医学》 北大核心 2024年第4期447-453,共7页
背景人口老龄化进程日益加快,中老年人健康问题突出。慢性病共病严重威胁中老年人的健康和生活质量,阻碍健康中国行动的进展,探讨其与健康社会决定因素的关系具有积极意义。目的了解宁夏中老年人慢性病共病情况及健康社会决定因素情况,... 背景人口老龄化进程日益加快,中老年人健康问题突出。慢性病共病严重威胁中老年人的健康和生活质量,阻碍健康中国行动的进展,探讨其与健康社会决定因素的关系具有积极意义。目的了解宁夏中老年人慢性病共病情况及健康社会决定因素情况,分析中老年人健康社会决定因素与慢性病共病的关联,为中老年慢性病共病患者的健康管理和干预策略制定提供参考。方法采用多阶段分层随机抽样方法于2022-06-27—08-27调查宁夏石嘴山市、银川市、固原市的10个区/县1997名中老年人的健康相关数据,应用Apriori算法分析宁夏地区中老年人的共病模式,采用非条件Logistic回归分析探讨宁夏中老年人慢性病共病与健康社会决定因素的关联性。结果宁夏地区中老年人慢性病共病人数418例,慢性病共病率20.9%;关联规则结果显示有14条共病模式,其中11条与冠心病有关,9条与高血压有关,9条与糖尿病有关;非条件Logistic回归分析结果显示,年龄≥60岁、子女数量为2~3个、已建立健康档案、工作状况为离退休和无业、养老保险为城乡居民基本养老保险的中老年人慢性病共病率较高(P<0.05),夜间睡眠时长为7~8 h和>8 h、大专及以上文化水平的中老年人慢性病共病率较低(P<0.05)。结论中老年慢性病共病的影响因素涉及个体、社区、社会各个方面,建议从多维度对慢性病共病患者进行干预,以期提高其健康水平。 展开更多
关键词 慢性病共病 中老年人 健康社会决定因素 关联规则 影响因素分析
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