High-risk factors for delirium in severely ill patients and the application of emotional nursing combined with pain nursing

BACKGROUND Delirium is a neuropsychiatric syndrome characterized by acute disturbances of consciousness with rapid onset,rapid progression,obvious fluctuations,and preventable,reversible,and other characteristics.Patients with delirium in the intensive care unit(ICU)are often missed or misdiagnosed and do not receive adequate attention.AIM To analyze the risk factors for delirium in ICU patients and explore the applica-tion of emotional nursing with pain nursing in the management of delirium.METHODS General data of 301 critically ill patients were retrospectively collected,including histories(cardiovascular and cerebrovascular diseases,hypertension,smoking,alcoholism,and diabetes),age,sex,diagnosis,whether surgery was performed,and patient origin(emergency/clinic).Additionally,the duration of sedation,Richmond Agitation Sedation Scale score,combined emotional and pain care,ven-tilator use duration,vasoactive drug use,drainage tube retention,ICU stay du-ration,C-reactive protein,procalcitonin,white blood cell count,body tempe-rature,Acute Physiology and Chronic Health Evaluation II(APACHE II)score,and Sequential Organ Failure Assessment score were recorded within 24 h after ICU admission.Patients were assessed for delirium according to confusion assessment method for the ICU,and univariate and multivariate logistic regre-ssion analyses were performed to identify the risk factors for delirium in the patients.RESULTS Univariate logistic regression analysis was performed on the 24 potential risk factors associated with delirium in ICU patients.The results showed that 16 risk factors were closely related to delirium,including combined emotional and pain care,history of diabetes,and patient origin.Multivariate logistic regression analysis revealed that no combined emotional and pain care,history of diabetes,emergency source,surgery,long stay in the ICU,smoking history,and high APACHE II score were independent risk factors for de-lirium in ICU patients.CONCLUSION Patients with diabetes and/or smoking history,postoperative patients,patients with a high APACHE II score,and those with emergency ICU admission need emotional and pain care,flexible visiting modes,and early intervention to reduce delirium incidence.

Risk factors for secondary infection after liver failure and effect of comprehensive nursing intervention

BACKGROUND In patients with liver failure(LF),the high rate of secondary infections,which are associated with poor prognosis,highlights the clinical significance of understanding the underlying risk factors and implementing targeted intervention programs.AIM To investigate risk factors for secondary infections in patients with LF and evaluate the effectiveness of comprehensive nursing interventions.METHODS This retrospective study included 64 patients with LF,including 32 with and 32 without secondary infections.A questionnaire was used to collect data on age;laboratory parameters,including total and direct bilirubin,prothrombin time,blood ammonia,and other biochemical parameters;invasive procedures;and complications.Patients with secondary infections received comprehensive nursing intervention in addition to routine nursing care,whereas those without secondary infections received only routine nursing care to compare the effect of nursing intervention on outcomes.RESULTS The infection rate,which was not associated with age or complications,was significantly associated with biochemical parameters and invasive procedures(P<0.05).The infection rate was 61.6%in patients who had undergone invasive procedures and 32.1%in those who had not undergone invasive procedures during the hospital stay.The infection rate was also significantly associated with the type of LF(P<0.05),with the lowest rate observed in patients with acute LF and the highest rate observed in those with subacute LF.The nursing satisfaction rate was 58.3%in the uninfected group and 91.7%in the infected group,indicating significantly higher satisfaction in the infected group(P<0.05).CONCLUSION In patients with LF,the rate of secondary infections was high and associated with biochemical parameters and type of LF.Comprehensive nursing intervention can improve patient satisfaction.

A nursing protocol targeting risk factors for reducing postoperative delirium in patients following coronary artery bypass grafting:Results of a prospective before-after study

Objective: The results of postoperative delirium (POD) warrant testing for prevention. The purpose of this study was to determine whether a nursing intervention targeting risk factors could decrease the inci-dence of POD among patients who had coronary artery bypass grafting (CABG) in China.Methods: A prospective before-after study was conducted between April 2014 and April 2015. A nursing delirium intervention protocol targeting risk factors for delirium was performed for 141 patients un-dergoing CABG in a cardiothoracic ICU from November 2014 to April 2015. Intervention consisted of screening for delirium risk factors, followed by targeted risk factor modification, including pain control, early catheter removal, patient orientation using the 5W1H procedure, increased family visits, mini-mizing care-related interruptions, comfortable nursing and monitoring for sleeping difficulties. Out-comes of the Intervention Group were compared with those of the Control Group for 137 CABG patients from April 2014 to October 2014. Delirium was assessed using the confusion assessment method for the intensive care unit (CAM-ICU). The sample size was justified by PASS2000, based on previous data of delirium incidence in our institution (30%). Main results: Delirium incidence during the first seven postoperative days was significantly lower in the Intervention Group at 13.48%(19/141) vs. 29.93%(41/137) for the Control Group (x2=11.112, P=0.001). In addition, POD in the Intervention Group occurred between the 3rd and 6th postoperative days, while POD in the Control Group mainly occurred on the first three days postoperatively. Delirium in the Intervention Group occurred later than delirium in the Control Group (x2=12.743, P<0.001). Length of ICU stay was reduced significantly (Z= -6.026, P<0.001). Conclusion: The application of a nursing protocol targeting risk factors in this study seems to be asso-ciated with a lower incidence of POD in patients after CABG. This finding suggests that managing the predictors properly is one of the effective strategies to prevent delirium.

Research progress on risk factors and non-drug treatment of delirium patients in CICU

Delirium is a clinical syndrome of acute brain dysfunction,especially the incidence of delirium in patients in Cardiac Intensive Care Unit(CICU)is relatively high.This paper mainly describes the main risk factors for delirium in CICU patients are patient characteristic,disease,treatment and environment and the research progress of non-pharmacological treatment is reviewed,aiming at nursing staff should pay more attention to the patient characteristics and actively take non-pharmacological nursing measures and prevent the occurrence of delirium.This article focuses on the main risk factors of CICU patients with delirium and the research progress of non-pharmacological treatment.It aims to provide a reference basis for the management and research of CICU delirium patients in China in the future.

Occupational risk factors among nursing staff in outpatient injection room of cancer hospital and corresponding protective measures: a review

The aim and objective of this review is to figure out potential occupational risk factors among nursing staff in outpatient injection room and to provide corresponding measures.There are several main factors summarized,including needle injury,cytotoxic drug,radiological hazard,disinfection,social and psychological factors and management systems. Findings suggest that stable management system and awareness of self- protections are two key points in prevention and control of occupational hazard in outpatient injection room of cancer hospital.

Family members' perspective of family Resilience's risk factors in taking care of schizophrenia patients

Objectives:The study was conducted to illustrate the risk factors of family resilience when taking care of patients with schizophrenia.Methods:The research used qualitative design with an interpretive phenomenology approach,with indepth interviews.The subjects were 15 family members who cared for patients with schizophrenia at the Menur Mental Hospital,Surabaya,Indonesia.The samples were obtained by purposive sampling technique.The data was collected by interview and using field notes,then analyzed by Collaizi technique.Results:This research produced two themes,they were care burden and stigma.Care burdens felt by families were confusion about the illness,emotional,physical,time,financial and social burdens,which leads to decrease in family quality of life.Families also experienced stigma called labeling,stereotyping,separation and discrimination.Stigmas meant that families faced psychological,social and intrapersonal consequences.This decreased the family quality of life and functionality of the family,and there were opportunities for negative results to family resilience.Health workers,especially psychiatric nurses,should review care burdens and stigma to develop nursing interventions so families are able to achieve resilience.Conclusions:This research explained how care burden and stigma are risk factors that must be managed by families to survive,rise up,and become better in caring for patients with schizophrenia.Nurses have a central role in assessing the level of care burdens and stigma in order to help families achieve resilience.Further research may focus on family-based nursing interventions to lower care burden,and community-based interventions to reduce stigma.

Risk factors and care of early surgical site infection after primary posterior lumbar interbody fusion

Objectives:To explore the risk factors and nursing measures of early surgical site infection(SSI)after posterior lumbar interbody fusion(PLIF).Methods:A total of 468 patients who received PLIF in our hospital from January 2017 to June 2020 were enrolled into this study.According to the occurrence of early SSI,the patients were divided into two groups,and the general data were analyzed by univariate analysis.Multivariate logistic regression analysis was conducted with the dichotomous variable of whether early SSI occurred and other factors as independent variables to identify the risk factors of early SSI and put forward targeted prevention and nursing measures.Results:Among 468 patients with PLIF,18 patients developed early SSI(3.85%).The proportion of female,age,diabetes mellitus and urinary tract infection(UTI),operation segment,operation time,post-operative drainage volume,and drainage time were significantly higher than those in the uninfected group,with statistical significance(P<0.05),whereas the preoperative albumin and hemoglobin in the infected group were significantly lower than those in the uninfected group,with statistical significance(P<0.05).There was no significant difference between the two groups in the American Society of Anesthesiologists(ASA)grading,body mass index(BMI),complications including cardiovascular and cerebrovascular diseases or hypertension(P>0.05).Logistic regression analysis showed that preoperative diabetes mellitus(OR=2.109,P=0.012)/UTI(OR=1.526,P=0.035),prolonged drainage time(OR=1.639,P=0.029)were risk factors for early SSI.Men(OR=0.736,P=0.027)and albumin level(OR=0.526,P=0.004)were protective factors in reducing early SSI.Conclusions:Women,preoperative diabetes/UTI,hypoproteinemia,and prolonged drainage time are risk factors for early SSI after PLIF.Clinical effective preventive measures should be taken in combination with targeted nursing intervention to reduce the risk of early SSI.

Cardiovascular Risk Factors and Evidence-Based Health Education

The number of deaths associated with cardiovascular events remains constant in many countries due to new therapeutic approaches for prevention and treatment of atherosclerosis. This condition is widely attributable to unhealthy outcomes in its association with risk factors such as smoking and sedentary behavior. Risk factors play a significant role in the progression of coronary artery disease. We conducted a review of the literature with the purpose of identifying primary risk factors for coronary disease, lifestyle change interventions, and expectations for a reduction in cardiovascular events on the basis of evidence-based health education strategies. In addition, we sought to contextualize this review so that nurses are trained to use these findings in their practice at different levels of care.

Analysis of Risk Factors of Fever among Inpatients in Rehabilitation Department Based on Lasso Regression Analysis

Purpose: To explore the fever-related risk factors of inpatients in Rehabilitation Department, and to provide reference for patients with high risk of fever to take corresponding nursing measures. Methods: The study was conducted on the Rehabilitation Department of The First Affiliated Hospital of Jinan University from July 2019 to December 2019. The fever group included 51 patients and the non-fever group included 49 patients without fever. The two groups of clinical data, comorbidities, related laboratory values, possible risk factors of fever were analyzed by case regression analysis, and the relevant risk factors were screened out by LASSO (least absolute shrinkage and selection operator) regression analysis. Results: According to the results of Lasso regression analysis, pressure sore or skin infection, history of hypertension, current history of respiratory tract infection, feeding patterns were the higher risk factors of fever in inpatients in Rehabilitation Department, while the first course of disease, main diagnosis, history of respiratory tract infection within half a year, kidney damage and hospitalization days were lower risk factors. Conclusion: This study is helpful to early identify the fever risk of inpatients in Rehabilitation Department, and provide reference basis for high-risk fever patients to take positive and effective nursing measures.

Current patterns of the sun protection measures adopted by nurses and the risk factors influencing their compliance

The incidence of skin cancer is increasing worldwide. Included in high risk group are people who have light common phenotypic factors (hair, skin, eyes), have high number of naevi, report previous sunburns and have a family history of skin cancer. Protecting the skin from the sun by wearing protective clothing, using sunscreen and avoiding sun exposure are recommended among primary preventive activities. The purpose of this study was to describe the current patterns of sun protection measures adopted by nurses and to examine the association between compliance with sun protection measures and the main risk factors of melanoma. This cross sectional study was conducted in 2007 during the Annual Greek National Conference of Nursing. Nurses most commonly chose to use sunscreen, to wear glasses, to use an umbrella or to seek for shade in order to protect themselves against sun exposure. Finally, phenotypic factors, previous sunburns and common naevi presence were found to affect nurses’ attitude towards protective measures. This study poses the necessity of targeting high risk groups for melanoma through campaigns aiming to foster sun protection behaviours.

Cardiovascular Risk Assessment in the Nursing Team of a Cardiology Hospital

Objective: Cardiovascular diseases are the most common causes of morbidity and the leading cause of mortality in the world scenario, accounting for about 20% of all deaths in individuals over 30 years. It has attributed this to the increase in the company’s exposure to risk factors. It identifies cardiovascular risk factors in the nursing team and compares the cardiovascular risk by Framingham score among professionals of middle and upper working in a referral hospital in cardiology. Method: Cross-sectional quantitative study was conducted in 2014, in a reference hospital in cardiology located in Recife/Pernambuco, Brazil. Data of cardiologic risk factors were collected from 82 nursing team members, comprised of technical, auxiliary nurses, and nurses between 30 and 74 years of age. The cardiovascular risk level was evaluated by the Framingham Score. Data were organized and analyzed by means of the SPSS, with descriptive statistics and Student-t test for the continuous variables. Results: Family history, stress and sedentary life style were the prevalent risk factors in more than half of the professionals. Only 5.23% of the technical and auxiliary nurses had a high risk score for cardiovascular event. Conclusion: The data indicates a low cardiovascular risk for these professionals and the presence of risk factors that can be modified. Health surveillance of these professionals is necessary in order to avoid a change to a risk of greater vulnerability.

High Preoperative Anxiety Level and the Risk of Intraoperative Hypothermia

Aim: The relationship between preoperative anxiety level and intraoperative hypothermia (<36℃) was investigated. Background: Core temperature often decreases during surgery, with an initial rapid decrease followed by a slower decrease for about 2 hours. Preoperative anxiety may influence perioperative physiological responses. The relationship between preoperative anxiety level and perioperative decrease in core temperature has not been studied closely. Design: A prospective observational study. Methods: This study enrolled 120 adult patients who underwent elective major abdominal surgery under combined epidural and general anesthesia. Tympanic membrane temperature was used to measure core temperature preoperatively and during the operation. The relationship between anxiety level according to the State-Trait Anxiety Inventory (STAI) and core temperature was examined using descriptive and multivariate risk analysis. Results: High anxiety level was found in 61 patients (51%), of which 26 (43%) developed hypothermia during the first hour and 40 (66%) developed hypothermia during the first 2 hours of anesthesia. After adjustment for covariates, patients with a high anxiety level were found to have a 2.17-fold higher risk of hypothermia during the first hour and a 1.77-fold higher risk of hypothermia during the first 2 hours than patients with a low/moderate anxiety level. Conclusions: The risk of hypothermia in the early phase of general anesthesia can be predicted by measurement of the preoperative anxiety level using the STAI. Relevance to Clinical Practice: Patients with a high anxiety level had a significantly higher risk of intraoperative hypothermia. Preoperative preventive nursing care programs should include anxiety management and thermal care.

Relationship of Pre-Existing Maternal/Caregiver Acute Respiratory Infection in the Pattern and Risk of Acute Respiratory Infection among Infants in Rivers State, Nigeria

History of upper respiratory tract infection in the mother or siblings was associated with higher risk of acute lower respiratory tract infection in cases. Most upper respiratory tract infections were caused by viral pathogens and likely to occur in many members of the family. The study aimed to determine the existence and pattern of relationship between risk of acute respiratory infection (ARI) among infants and exposure to pre-existing maternal/caregiver acute respiratory tract infection. The study was designed as a community-based Nested case-control study of 1100 infants randomly selected from 12 communities out of 6 Local Government Areas of the 3 senatorial districts of Rivers State. A multistage random sampling technique was used in selecting the subjects up to the community level. Descriptive method was used to represent the characteristics of the subjects and the differences in ARI between exposed and unexposed infants were tested in a bivariate logistics regression at 5% level of significance. Odds ratio (OR) was used to interpret the size effect measures of ARI on exposure to pre-existing maternal/caregiver ARI differences. A total of 275 Cases of ARI and 825 controls were included in the study. Among exposed infants (N = 104), ARI cases were found to be higher n = 80 (76.9%) than in control n = 24 (23.1%). Whereas, among unexposed infants N = 991, ARI cases were found to be lower n = 195 (19.7%) than in control n = 796 (80.3%). For the exposed infants, the odds for ARI were 13.5 times significantly higher compared to those of their unexposed counterparts (OR-Unadjusted = 13.52, (p < 0.0001, 95% CI = 0.047 - 0.121)). The findings will widen the horizon in the etiological consideration of ARI among infants vis-à-vis exposure potential to pre-existing maternal/caregiver ARI via nursing care. Therefore, community-based sensitization programme on barrier nursing care techniques and personal hygiene practices should be on focus.

老年危重症患者发生再喂养综合征的危险因素回归方程的构建及干预措施分析

目的构建老年危重症患者发生再喂养综合征(RFS)的危险因素回归方程,并分析相应的干预措施。方法回顾性分析2021年1月—2023年3月重症监护室(ICU)收治的154例老年危重症患者的临床资料,根据RFS发生情况分为RFS组51例和非RFS组103例。采用Logistic回归模型分析影响发生RFS的因素;采用受试者工作特征(ROC)曲线分析预测因子对RFS的预测价值;构建并验证相关Logistic回归方程,拟定相关护理干预内容。结果老年危重症患者发生RFS与急性生理学和慢性健康状况评分系统Ⅱ(APACHEⅡ)评分、营养风险筛查2002(NRS2002)评分、有创机械通气、喂养前禁食时间、D-二聚体水平、营养摄入方式和喂养前血磷、血钾、血镁水平有相关性(P<0.05)。Logistic回归分析显示,APACHEⅡ评分、NRS2002评分、营养摄入方式和喂养前血磷、血钾水平均为影响老年危重症患者发生RFS的独立危险因素(P<0.05)。ROC曲线结果显示,APACHEⅡ评分、NRS2002评分、营养摄入方式和喂养前血磷、血钾水平和联合预测因子预测老年危重症患者发生RFS的曲线下面积(AUC)分别为0.754、0.723、0.707、0.783、0.774和0.859(P<0.05)。发生RFS的Logistic回归方程为L=0.085×APACHEⅡ评分-0.337×NRS 2002评分+0.537×营养摄入方式-0.776×喂养前血磷水平-0.207×喂养前血钾水平+0.942。该方程预测价值良好,可根据方程拟定针对性的护理干预措施。结论危险因素回归方程可用于老年危重症患者RFS发生风险的临床预测,临床可根据回归方程制订相关护理干预措施,预防RFS的发生。

脊髓损伤病人膀胱功能障碍风险预测模型及其应用

目的:构建脊髓损伤病人膀胱功能障碍风险预测模型,并进行效果检验。方法:采用便利抽样法将2021年1月—2022年12月110例脊髓损伤病人纳为研究对象,按照是否发生膀胱功能障碍分为障碍组和正常组,采用单因素、多因素Logistic回归分析筛选脊髓损伤病人膀胱功能障碍的独立危险因素,据此拟合风险预测模型的回归方程,检验模型预测效果。结果:共29例(26.36%)脊髓损伤病人发生膀胱功能障碍;多因素分析结果显示,病程、损伤部位、排尿方式、泌尿系统感染、膀胱顺应性、逼尿肌括约肌失调为脊髓损伤病人膀胱功能障碍的独立影响因素(P<0.05);预测模型Hosmer-Lemeshow卡方检验结果显示,χ^(2)=8.203,P=0.336;C-index为0.818;AUC为0.794[95%CI(0.750,0.837)],约登指数为0.690,最佳截断值0.122,敏感度为94.4%,特异性为74.6%;模型预测准确率为81.81%。结论:本研究在脊髓损伤病人膀胱功能障碍的危险因素基础上,建立的风险预测模型具有良好拟合程度和区分能力,且准确度较高,能为临床早期预防、早期筛选、早期治疗和管理脊髓损伤病人膀胱功能障碍提供一定依据。

老年科护士对皮肤撕裂伤的认知现状及影响因素研究

目的了解老年科护士对皮肤撕裂伤的认知现状,分析其影响因素,为开展相关培训提供参考。方法采用便利抽样法,使用一般资料调查表、皮肤撕裂伤知识评估工具对武汉市3所三级甲等综合医院的286名老年科护士进行横断面调查。结果老年科护士的皮肤撕裂伤认知得分为(9.53±2.02)分。老年科护士对皮肤撕裂伤认知正确率排名前5个条目分属于特殊群体、病因学、分类和观察维度;排名最低的5个条目分属于预防、治疗和风险评估维度。影响老年科护士对皮肤撕裂伤认知水平的主要因素为学历、工作年限、是否为专科护士、皮肤撕裂伤相关培训(均P<0.05),共解释总变异的31.7%。结论老年科护士对皮肤撕裂伤认知水平处于中等偏低水平,对与临床实践相关的预防、治疗和风险评估认知相对不足,应加强相关培训,提高老年科护士对皮肤撕裂伤的关注度,从而提高皮肤撕裂伤整体预防及护理水平。

踝关节骨折伴三角韧带损伤术后骨折延迟愈合的风险预测模型及护理对策

目的探讨踝关节骨折伴三角韧带损伤术后骨折延迟愈合的风险因素,进一步构建风险预测模型,为临床及时采取针对性护理对策提供依据。方法选取2020年1月至2023年6月郑州大学第一附属医院踝关节骨折伴三角韧带损伤术后骨折延迟愈合患者248例作为延迟组,同期选取术后骨折正常愈合患者265例作为未延迟组,收集两组资料,logistic回归分析踝关节骨折伴三角韧带损伤患者术后骨折延迟愈合的影响因素,进一步构建nomogram预测模型并进行验证。结果年龄、开放性骨折、内固定松动、骨质疏松、维生素缺乏、合并糖尿病、合并OSAHS、营养不良、激活素A是踝关节骨折伴三角韧带损伤患者术后骨折延迟愈合的危险因素,康复锻炼依从性、延续康复指导、术后中医药治疗、鸢尾素是其保护因素;nomogram预测模型预测术后骨折延迟愈合的曲线下面积(AUC)为0.874(95%CI:0.762~0.913),预测敏感度、特异度依次为86.75%、72.16%。结论延迟愈合是踝关节骨折伴三角韧带损伤患者术后常见问题,与多种因素有关,加强nomogram预测模型构建可及时识别高危人群,以此为依据及时采取针对性护理对策可能是促进骨折愈合、降低延迟愈合风险的新途径。

脊髓损伤患者深静脉血栓形成的危险因素和预防及护理研究进展

脊髓损伤是一种高致残性损伤,深静脉血栓形成是脊髓损伤后严重并发症之一,致死率高。通过对相关文献的检索和分析,对脊髓损伤患者深静脉血栓形成的危险因素、预防及护理进展进行综述,为脊髓损伤患者深静脉血栓形成的护理提供依据,从而提高患者及医护人员的认知水平,促进脊髓损伤合并深静脉血栓形成患者的早日康复。

眼睑痉挛患者治疗期间习得性无助感的影响因素

目的 分析眼睑痉挛患者治疗期间习得性无助感的影响因素。方法 采用纵向研究设计,于注射用A型肉毒素治疗前、治疗1周后、治疗4周后采用临床资料问卷、习得性无助感量表(LHS)对138例眼睑痉挛患者展开调查,运用重复测量方差分析、广义估计方程分析变化趋势及影响因素。结果 研究对象治疗前、治疗1周后、治疗4周后绝望感得分、无助感得分、LHS总分均呈降低趋势(P<0.05);治疗前后不同年龄、痉挛强度、病程、受教育程度、家庭月收入、性格特征、自我效能感、社会支持研究对象LHS总分呈降低趋势(P<0.05);广义估算方程显示,年龄(OR=0.569)、痉挛强度(OR=5.270)、受教育程度(OR=0.516)、家庭月收入(OR=0.522)、自我效能感(OR=0.576)、社会支持(OR=0.547)是眼睑痉挛患者治疗期间习得性无助感的影响因素(P<0.05)。结论 眼睑痉挛患者治疗期间习得性无助感呈下降趋势,医护人员应加强眼睑痉挛患者习得性无助感多时间点筛查,重点针对低自我效能感、低社会支持、内向、低受教育程度患者采取合理措施,满足患者身心需求,提高身心健康水平。

呼吸专科护士核心能力现状及对策

目的通过质性和量性研究相结合的方法,全面了解呼吸专科核心能力现状,为制订适宜的培养对策、提高呼吸专科护士核心能力提供科学依据。方法于2023年3—5月采用一般情况问卷、呼吸专科护士核心能力评价量表对2017—2022年在重庆市呼吸专科护士培训基地参加学习的来自重庆、四川、贵州、陕西、河北、湖北、云南、海南8个省和直辖市的320名呼吸专科护士进行问卷调查,并从中选取有代表性的16名专科护士进行质性访谈。共发放问卷320份,回收有效问卷314份,有效回收率为98.1%。结果呼吸专科护士的核心能力总分为(196.99±13.86)分,处于中等偏下水平;多元逐步回归分析显示医院等级、专科工作年限、学历是影响呼吸专科护士核心能力的主要因素。质性访谈提炼出的主题包括呼吸专科护士需求迫切、核心能力亟需提高、胜任应具备一定条件和资质、提高核心能力举措、发展前景好。结论以提高呼吸专科护士核心能力为导向,通过加大呼吸专科护士培养和使用力度,完善呼吸专科护士培养、考核、评价体系,重视薄弱环节,根据核心能力影响因素制订相应的培训计划,能够提高呼吸专科护士核心能力水平。