Learning from the Film “Mitorishi (Transition Doula)”—Application to Understanding the End-of-Life in a Gerontological Nursing Practice Course in Japan

Purpose: This study aims to detail what nursing students learned from watching the film “Mitorishi”, which was used among the teaching materials in a gerontological nursing practice course in nursing education in Japan, and demonstrate the applicability of using the film as an element relevant to the teaching of end-of-life care in Japan. Methods: The participants were fourth-year nursing students at University A who had watched the film “Mitorishi” during the course, had submitted a report on what they learned, and provided informed consent to the study participation. The reports submitted by the participants were used as data and analyzed qualitatively using the content analysis approach. Results: The analysis identified the following five categories (number of codes): Characteristics of life during the final days (9), Importance of views on life and death (3), Importance of end-of-life care (3), Assistance in preparation for the final days of life (13), and Understanding the profession of transition doula (9). Discussion: The five categories show that the students have learned about the “role of nurses at the time of end-of-life care” while “visualizing end-of-life care” and learning “preparedness for end-of-life care”. These findings suggest that using the film “Mitorishi” in the teaching curriculum is effective for learning about end-of-life care for older people.

Development of the Transitional Care Model for nursing care in China's Mainland:A literature review

Background:The Transitional Care Model(TCM)for nursing care has yet to be implemented in China despite its success in Western countries.However,rapid social changes have demanded an upgrade in the quality of nursing care;in 2010,the Chinese government has acknowledged the need to implement the TCM in China.Objective:This study has the following objectives:(1)perform a thorough review of the literature regarding the development and implementation of the TCM in China's Mainland within the past 5 years;(2)provide a comprehensive discussion of the current status,problems,and strategies related to the implementation of the TCM in China's Mainland;and(3)suggest strategies pertaining to the future of the TCM in China.Design:The current pertinent literature is systematically reviewed.Data sources:Systematic and manual searches in computerized databases for relevant studies regarding the TCM led to the inclusion of 26 papers in this review.Review methods:Abstracts that satisfied the inclusion criteria were reviewed independently by the two authors of this manuscript,and discrepancies were resolved through discussion.The same reviewers independently assessed the paper in its entirety for selected abstracts.Results:The present English literature reviewrevealed a paucity of updated information about the development and implementation of the TCM in China's Mainland.Nevertheless,the dramatic growth of the TCM in the past 5 years has had a vital impact within the society and in nursing development.This review also revealed numerous issues regarding the focus of the TCM.Overall implications for practiceandrecommendations for future researchare discussed.Conclusion:Despite the potential of this nursing model to have a successful and beneficial impact in China's Mainland,it remains an under-researched topic.Further research on education and training as well as premium policies for nurses under the TCM are needed.

Influence of transitional nursing on the compliance behavior and disease knowledge of children with purpura nephritis

BACKGROUND Purpura nephritis,also called Henoch-Schönlein purpura nephritis,is a systemic disease with small dead vasculitis as the main pathological change.AIM To observe the influence of transitional nursing activities on the compliance behaviors and disease knowledge of children with purpura nephritis.METHODS A total of 82 children with purpura nephritis were included and divided into a general nursing group(41 children)and transitional nursing group(41 children)using the envelope method.The general nursing group received routine nursing care,while the transitional nursing group received transitional nursing care.The behaviors,knowledge of the disease,and self-management ability of the two groups were evaluated after nursing care was provided.RESULTS The scores of four items(self-care ability,self-responsibility,health knowledge level,and self-concept)in the transitional nursing group were significantly higher than those in the general nursing group.CONCLUSION Transitional nursing can directly improve the disease knowledge level and selfmanagement ability of children with purpura nephritis and effectively reduce complications.

Progress in the application of Meleis transition theory in the nursing field

This paper reviews the development of Meleis transition theory,explores the trajectory of the development of transition theory,analyses of the transition theory at home and abroad and research status,discusses the research prospect of transition theory,in order to better apply Meleis transition theory to clinical nursing work,provide a certain basis for discipline development and nursing research.

Pharmacist Integration into Transitions of Care at a Community Hospital： Skilled Nursing Facility Discharges

In 2012-2013, CMH （Community Memorial Hospital） had a 10.5% 30-day readmission rate from SNFs （skilled nursing facilities）. The focus of the Connections of Care Coalition was to review the medication reconciliation process and to involve pharmacists in the transition of patients to SNFs. The objective of the project was to work as an interdisciplinary team to improve the communication during transitions of care from our hospital to local SNFs by identifying key issues and initiating pharmacy practice change. This quality improvement project had a pre-post study design. Patients older than 18 years of age discharged to SNFs and/or readmitted from SNFs within 30 days were included. Baseline data was collected, specific pharmacist interventions were identified, educated on and implemented, and post-implementation data was collected. The number of interventions made and documented by pharmacists for patients being discharged from CMH to local SNFs did not significantly change during this quality improvement study. Clinically significant interventions were made on high risk medications, such as warfarin. Finally, a newly redesigned SNF workflow was implemented to include pharmacy, nursing, social work/case management to improve patient care and safety for discharges to SNFs.

Continuing Care for Older Patients During the Transitional Period

Background： The world is facing increasing pressure with the continuous growth of the older population. Older patients are usually discharged with complex medical problems, high stress and vulnerability, and these factors place the elderly at risk for poor outcomes. Purpose： The present review summarizes a method for providing appropriate and affordable health services by nursing professionals to meet older patient＇s health care needs during their transitional period which is defined as a period from discharge after hospitalization for a major disorder to recovery in a home setting. Summary： Older patients with chronic diseases need seamless health care during a transitional period-a highly stressful and vulnerable period for them. Nurse professionals can conduct decent discharge planning to assist older patients with transitional problems through continuous healthcare. This review summarized the need of continuing care for older patients during the transitional period, the definition of discharge planning, the conceptual framework of discharge planning, and the professionals involved in discharge planning. It also highlighted the problems of discharge planning and follow-up intervention implementation in the mainland of China. Clinical implications： Inadequate discharge planning and follow-up were leading factors associ- ated with the readmission of discharged older patients. Further nursing-led discharge planning should be reinforced in China.

The "five senses of success" in nursing students: Assessing first-year support engagement

Objectives: This study aimed to identify School and University support services available and accessed by nursing students transitioning into a university environment as many struggle to adjust to competing demands of personal commitments and expectations at university.Methods: A mixed methods design was used,based on activity theory and Lizzio's Five Senses of Success frameworks as exploratory guides.This study was conducted amongst the first year cohort at one campus of the Bachelor of Nursing (BN) program in Queensland,Australia.An initial baseline assessment of what University and School-based support services were on offer for students,and how the students interacted with the support services was conducted.This was followed by a survey to identify awareness and access to support services.Focus groups were then conducted to clarify the previous results and to determine engagement with these support services.Results: A randomly selected number of students (n =150) in the first-year 2014 cohort of the BN program (n =300) were included in this study.The survey was completed by 54 students and three semistructured focus groups were conducted.The analysis indicated that the support services in place were successful in reaching the majority of students and contributed to their sense of success at university,Specifically students identified that a whole cohort approach to support enhanced their transition to university.Conclusion: Identifying lesser known services early in the first year will ensure that students are supported and encouraged to use all services,contributing to their sense of success at university.

Effect of transition on QOL among Chinese children who underwent liver transplantation more than 5 years earlier

Objective:This study was conducted to test the effect of transition on the quality of life(QOL)among Chinese children who underwent liver transplantation more than 5 years earlier.Methods:We delivered the pediatric quality of life inventory(Peds QL)3.0 transplant module before and after“transition”intervention.Results:In the first posttransition measurement(6 months after“transition”),the sections on“about my medicines I,”“my transplant and others,”“treatment anxiety,”“how do I look,”“communication,”and total score were significantly different from those of the pretransition stage(P<0.05).However,there was no significance in the QOL in the second posttransition measurement(1 year after“transition”;P>0.05).Conclusions:The short-term effect of transition was definite,while the long-term effect needs further evidence.

广东省二、三级医疗机构延续护理部门设立及运作现况调查

目的:了解广东省二、三级医疗机构延续护理部门的设立及运作情况,为医疗机构建设延续护理部门、开展延续护理提供参考和借鉴。方法:采用便利抽样法于2023年5月4日—19日选取广东省110所二、三级医疗机构的护理管理人员进行调查,调查其所在医疗机构延续护理部门的建立情况、运作情况、阻滞因素及相关建议。结果:110所医疗机构中有35所(31.82%)设立了延续护理部门,58所(52.73%)拟计划开展延续护理服务,17所(15.45%)暂无设立延续护理部门及开展延续护理的计划。已开展延续护理的35所医疗机构中,2010年前设立延续护理部门的有3所(8.57%),2010—2018年有9所(25.71%),2019年至今有23所(65.71%)。35所医疗机构延续护理运作情况良好,但在医疗收费、医院-社区联动及延续护理质量指标设置方面需进一步加强和完善。51所(46.36%)医疗机构认为设立延续护理部门开展延续护理服务无障碍,59所(53.64%)认为存在障碍,障碍因素主要包括人力资源短缺(79.66%)、经济效益受限(76.27%)、实施场地缺乏(54.24%)、不知如何开展(32.20%)、院领导不支持(23.73%)等。结论:因缺乏统一、规范的标准及指南,广东省二、三级医疗机构延续护理部门的设立及运作情况参差不齐且存在多方面争议、困惑及不足。建议从“相关政策制度、部门组织架构、信息共享与协调机制、服务收费与支付机制、延续护理质量评价指标、工作人员绩效”等方面完善延续护理部门的设立及运作,从而推进延续护理的发展,助力实施健康中国战略。

老年髋部骨折病人出院过渡期护理质量评价体系的构建

目的:构建老年髋部骨折病人出院过渡期护理质量评价体系。方法:以Donabedian提出的结构-过程-结果三维质量模型为理论框架,采用文献分析法、德尔菲法构建老年髋部骨折病人出院过渡期护理质量评价体系。结果:2轮专家函询问卷有效回收率均为100%,专家权威系数分别为0.930和0.935,指标变异系数分别为0.000~0.218和0.000~0.168,肯德尔和谐系数分别为0.331和0.259(均P<0.001)。最终构建的老年髋部骨折病人出院过渡期护理质量评价体系包括3个一级指标、15个二级指标、52个三级指标。结论:构建的老年髋部骨折病人出院过渡期护理质量评价体系具有较高的科学性、可靠性和实用性,可为老年髋部骨折病人出院过渡期护理实践提供参考。

癌症病人时间感知的研究进展

对癌症病人时间感知的概念、转变特点、影响因素、干预措施等方面进行综述,指出国内关于癌症病人时间感知的研究较少,可借鉴国外相关研究的优点与不足,并进一步探索癌症病人时间感知影响因素,开展纵向前瞻性研究,以探讨其时间感知的纵向变化特征。

新入职护士过渡期不同阶段职场适应的真实体验

目的探索新入职护士在过渡期不同阶段职场适应的工作体验,了解其在护理岗位适应过程中面临的各种压力、情感体验及行为形成,进一步探索并优化新入职护士培训方案的相关内容。方法本研究采用现象学研究方法,于2023年3-6月在西安交通大学第一附属医院对20名新入职护士进行半结构式深入访谈,并使用Colaizzi 7步分析法对访谈内容进行整理分析。结果提炼得出4个主题和9个亚主题,分别为职业认知(入职1个月)(工作环境不熟悉、角色转化困难、职业认同困扰)、学习适应(2~3个月)(岗位能力不足、自我否定、)、融入环境(4~6个月)(缺乏专科知识、缺乏组织归属感、)、职业胜任(7~12个月)(预警和应对突发事件能力不足、岗位不确定性所致的焦虑)。结论新入职护士过渡期的规范化培训对其职业适应及职业发展至关重要,护理管理者可通过了解新护士过渡期不同阶段职场适应的工作体验,优化培训方案,增加新护士职业认同、心理健康的相关培训,帮助新护士尽早适应临床工作。

护理本科实习生自我效能和职业认同在转型冲击与职业决策困难间的链式中介效应

目的 探讨护理本科实习生自我效能和职业认同在转型冲击与职业决策困难间的中介作用。方法 2022年12月—2023年3月采用方便抽样法,采用护理本科实习生转型冲击评价量表、一般自我效能感量表、护生职业认同问卷、职业决策困难问卷对来自北京市、山东省、河南省13所高校的365名护理本科实习生进行问卷调查。结果 护理本科实习生的职业决策困难得分为(37.85±9.37)分。自我效能、职业认同在转型冲击与职业决策困难之间起中介作用,包括自我效能的独立中介效应(效应值0.145)、职业认同的独立中介效应(效应值0.171)、自我效能—职业认同的链式中介效应(效应值0.048)。结论 护理本科实习生转型冲击通过自我效能和职业认同间接对职业决策困难发挥作用。护理教育者可通过降低护理本科实习生的转型冲击,提高其自我效能和职业认同,从而减轻实习生的职业决策困难。

新毕业护士转型冲击与职业认同的相关性研究

目的 探讨新毕业护士转型冲击与职业认同的相关性。方法 选取深圳市罗湖区人民医院127名毕业三年内的护士作为调查对象,采用一般情况问卷、转型冲击量表和职业认同量表进行调查。结果 深圳市罗湖区人民医院新毕业护士转型冲击总分为88.88±0.22分,职业认同总分为99.05±0.18分。新毕业护士转型冲击的社会文化与发展维度和职业认同呈负相关(r=-0.309, p<0.05)。其中转型冲击中的社会文化与发展维度对职业认同有负向影响作用(p<0.05)。结论 新毕业护士转型冲击及职业认同情况均处于中等水平,转型冲击与职业认同有相关性,其中社会文化与发展对职业认同影响最大。管理者应通过开设有针对性的培训项目,协助新护士完成角色转变,从而降低其压力感受,提高职业认同水平。

儿科护士的慢性病患儿过渡期护理态度问卷编制及信效度检验

目的编制儿科护士对慢性病患儿过渡期护理态度问卷并检验其信效度。方法以态度理论为框架,结合文献回顾、专家咨询和预调查,形成初始问卷。2022年10—11月,采用便利抽样法选取武汉市某三级甲等医院299名符合纳排标准的儿科护士进行正式调查并进行信效度分析。采用SPSS 26.0和AMOS软件对问卷进行因子分析及信效度分析。结果构建的儿科护士对慢性病患儿过渡期护理态度问卷包括认知、情感、行为意向3个维度,29个条目。问卷总Cronbachα系数为0.973,折半信度为0.971,问卷总内容效度指数为0.984,各条目内容效度指数为0.875~1.000探索性因子分析共提取3个公因子,累积方差贡献率为89.472%,验证性因子分析结果显示模型拟合度良好(χ^(2)/df=2.845,χ^(2)=1063.937,df=374,P<0.001,RMSEA=0.077),问卷因子结构良好。结论研制的儿科护士对慢性病患儿过渡期护理态度问卷信效度良好,可作为儿科护士对慢性病患儿过渡期护理态度的评价工具,为慢性病患儿过渡期护理的实践提供参考。

过渡监护病房护士胜任力现状及影响因素研究

目的分析过渡监护病房护士胜任力现状及影响因素,为过渡监护病房护士胜任力培训提供依据。方法采用便利抽样法,于2023年4月—5月选取浙江省4所三级甲等医院过渡监护病房的171名护士进行问卷调查。结果过渡监护病房护士胜任力总均分(7.27±1.41)分,处于中高水平;不同年龄、职称、岗位级别、工作年限、婚姻状况、有无进修经历的过渡监护病房护士胜任力得分差异具有统计学意义(P<0.05)。结论过渡监护病房护士胜任力总体处于较高水平,其中个人特质的得分水平较高,专业技能得分相对较低。建议管理部门加大对过渡监护病房护士的专业技能培训。

基于CiteSpace的国内外延续性护理模式研究热点的可视化分析

目的:基于CiteSpace软件了解国内外延续性护理模式研究的作者、机构合作、领域热点及研究前沿,探究未来趋势,为今后的延续性护理模式研究提供参考。方法:计算机检索2003年1月—2023年9月发表于中国知网(CNKI)和Web of Science数据库有关延续性护理模式研究的文献,运用CiteSpace软件对纳入文献进行可视化分析。结果:国内共纳入770篇,2012年前发文量较少,而后呈现增长趋势,在2018年达到高峰;国外共纳入201篇。在研究热点和前沿方面,国内延续护理服务对象集中于老年慢性病人群,依托互联网平台,多侧重于对某一疾病本身的延续性护理,相对零散。而国外已有相对成熟完备的各类延续性护理模式体系,延续性护理服务的场所、人群、内容相对宽泛和丰富,研究的质量、深度和广度较国内高。结论:近20年以来,我国引进延续性护理模式进行推广和发展,从无到有,日益壮大,应继续关注国际前沿趋势,不断探索适合我国国情的延续性护理模式。

基于过渡理论的回肠代膀胱术后病人支持方案的应用

目的:探讨基于过渡理论的回肠代膀胱术后病人支持方案的应用效果。方法:采用便利抽样法选取60例上海某三级综合医院回肠代膀胱造口术后病人为研究对象,采用非同期对照研究,对照组和试验组各30例。对照组采用常规护理,试验组采用基于过渡理论的回肠代膀胱术后病人支持方案,比较两组病人的出院准备度及出院3个月后尿路造口自护能力、造口适应、并发症发生情况和满意度。结果:试验组出院后3个月尿路造口自护能力评分、造口适应评分、满意度均高于对照组;出院时出院准备评分高于对照组;出院后3个月尿路造口并发症发生率低于对照组,差异均有统计学意义(P<0.05)。结论:基于过渡理论的回肠代膀胱术后病人支持方案可以提高病人的尿路造口自护能力、出院准备度、造口适应能力、满意度,减少尿路造口并发症发生率,改善临床预后。

过渡期护理联合心理干预对腰椎间盘突出症患者早期临床疗效及生活质量的影响

目的探讨过渡期护理联合心理干预方式对腰椎间盘突出症患者术后并发症、疼痛程度及生活质量的影响。方法选取2020年1月—2022年1月医院收治的63例腰椎间盘突出症患者为研究对象,按组间基本资料具有可比性的原则将其分为对照组31例和观察组32例。围手术期中,对照组接受常规护理,观察组在对照组的基础上接受过渡期护理联合心理干预方式。使用疼痛视觉模拟评分(VAS)来评估两组患者在术前、术后24 h和术后1个月随访时的疼痛程度。同时,使用ODI残障指数(ODI)评估患者术前、术后24 h和术后1个月随访时的功能状况。术后1周和术后1个月,采用SAS量表评估患者的术前焦虑水平和电话随访焦虑水平。术后1个月随访时使用欧洲五维三水平健康量表(EQ-5D-3L)评估两组患者的生活质量。结果两组患者术前相较术后ODI及VAS评分均呈降低趋势,时间之间差异有统计学意义(P时间<0.05),组别及交互效应差异不显著(P>0.05)。随访时SAS评分呈降低趋势,时间之间差异有统计学意义(P时间<0.05);术后各时点均以观察组低于对照组,差异有统计学意义(P组间<0.05),EQ-5D-3L健康描述系统结果中,观察组5个维度均优于对照组,差异有统计学意义(P<0.05)。结论过渡期护理联合心理干预在腰椎间盘突出症患者围术期护理中的应用可改善疼痛程度、减轻焦虑状况、提高生活质量,对于改善腰椎间盘突出症患者的康复效果具有重要的临床意义。

脑卒中患者医院-家庭过渡期护理的研究进展

对过渡期护理的概念、脑卒中患者医院-家庭过渡期护理发展现状、我国脑卒中患者过渡期护理存在问题及顺利过渡的改善策略等进行综述,旨在为构建适合我国脑卒中患者的过渡期护理模式、护理方案提供依据,为更好地维护并促进脑卒中患者的康复和健康提供借鉴。