Effect of a comprehensive geriatric assessment nursing intervention model on older patients with diabetes and hypertension

BACKGROUND The Comprehensive Geriatric Assessment(CGA)was introduced late in China and is primarily used for investigating and evaluating health problems in older adults in outpatient and community settings.However,there are few reports on its application in hospitalized patients,especially older patients with diabetes and hypertension.AIM To explore the nursing effect of CGA in hospitalized older patients with diabetes and hypertension.METHODS We performed a retrospective single-center analysis of patients with comorbid diabetes mellitus and hypertension who were hospitalized and treated in the Jiangyin Hospital of Traditional Chinese Medicine between September 2020 and June 2022.Among the 80 patients included,40 received CGA nursing interventions(study group),while the remaining 40 received routine nursing care(control group).The study group's comprehensive approach included creating personalized CGA profiles,multidisciplinary assessments,and targeted inter-ventions in areas,such as nutrition,medication adherence,exercise,and mental health.However,the control group received standard nursing care,including general and medical history collection,fall prevention measures,and regular patient monitoring.After 6 months of nursing care implementation,we evaluated the effectiveness of the interventions,including assessments of blood glucose levels fasting blood glucose,2-h postprandial blood glucose,and glycated hemoglobin,type A1c(HbA1c);blood pressure indicators such as diastolic blood pressure(DBP)and systolic blood pressure(SBP);quality of life as measured by the 36-item Short Form Survey(SF-36)questionnaire;and treatment adherence.RESULTS After 6 months,the nursing outcomes indicated that patients who underwent CGA nursing interventions experienced a significant decrease in blood glucose indicators,such as fasting blood glucose,2-h postprandial blood glucose,and HbA1c,as well as blood pressure indicators,including DBP and SBP,compared with the control group(P<0.05).Quality of life assessments,including physical health,emotion,physical function,overall health,and mental health,showed marked improvements compared to the control group(P<0.05).In the study group,38 patients adhered to the clinical treatment requirements,whereas only 32 in the control group adhered to the clinical treatment requirements.The probability of treatment adherence among patients receiving CGA nursing interventions was higher than that among patients receiving standard care(95%vs 80%,P<0.05).CONCLUSION The CGA nursing intervention significantly improved glycemic control,blood pressure management,and quality of life in hospitalized older patients with diabetes and hypertension,compared to routine care.

Current status of clinical nursing specialists and the demands of osteoporosis specialized nurses in China's Mainland

The clinical nursing specialist(CNS)is an expert who applies an expanded range of practical,theoretical,and research-based competencies to the care of patients within in a specialty clinical area within the larger discipline of nursing.A large number of studies consistently conclude that the CNS is a valuable healthcare resource that provides highquality clinical and evidence-based nursing practice and improves patient outcome.The CNS has been involved in healthcare practices for many years,with an increasingly diverse role.However,the training for the CNS in China is only in a preliminary developmental stage.The aim of this article is to review the history and development of the CNS role.Furthermore,the epidemiologic status of osteoporosis,as well as the feasibility and necessity of developing training programs in China for the osteoporosis CNS,will be discussed.

Impact of specialized nursing outpatient case management on postcoronary artery bypass grafting patients

BACKGROUND Some patients with coronary atherosclerotic heart disease experience major adverse cardiac events(MACE)and require readmission after Coronary Artery Bypass Grafting(CABG)surgery.This is often attributed to patients'unhealthy lifestyles and dietary habits,inadequate understanding of the disease,and poor disease management compliance.Thus,searching for more targeted nursing intervention models that can enhance patients'self-management abilities and reduce the risk of readmission after CABG surgery is significant.AIM To observe the impact of specialized nursing outpatient case management on patients after CABG surgery.METHODS A total of 103 patients who underwent CABG surgery in our hospital between April 2021 and April 2022 comprised the study sample.The patients were divided into two groups using an odd-even number grouping method.The control group received routine nursing care,while the case management group received specialized nursing outpatient case management.The differences in psychological status,adherence to medical treatment,self-care ability,knowledge mastery,quality of life scores,and the occurrence rate of MACE were compared between the two groups.RESULTS After the intervention,the case management group had lower scores on the selfrating depression scale and self-rating anxiety scale and lower MACE rate,as well as higher scores for adherence to a healthy diet,medication adherence,good lifestyle habits,regular exercise,and timely follow-up,higher scores on the Coronary Heart Disease Self-Management Scale,higher scores for managing adverse habits,symptoms,emotional cognition,emergency response,disease knowledge,general lifestyle,and treatment adherence,higher scores for understanding coronary heart disease,recognizing the importance of medication adherence,understanding selfcare points after CABG surgery,and being aware of post-CABG precautions,higher scores for physical well-being,disease condition,general health,social-psychological well-being,and work-related aspects(P<0.05).CONCLUSION Specialized nursing outpatient case management can enhance patient adherence to medical treatment,knowledge mastery,psychological well-being,and overall quality of life in patients after CABG surgery.

Development of Specialized Courses and Establishment of Teaching Materials in Nursing of Integrated Chinese and Western Medicine

Since the Third Plenary Session of the 11 thCentral Committee of the Communist Party of China( CPC),with the promotion and development of traditional Chinese medicine(TCM),the pace of TCM nursing work has been accelerated in nationwide,and a group of integrated Chinese and western medicine nurses have been cultivated preliminarily. However,professional nurses of integrated Chinese and western medicine are still deficient extremely. The target of talent cultivation,based on the theory of "focusing on humanism,expanding diathesis,and enhancing practice to highlight the accommodation and integration of nurses of integrated traditional Chinese and western medicine",is to cultivate competent,practical and interdisciplinary senior nursing talents with strong professional basis,skilled operations,rich humanistic literacy,and sharp innovative spirit who not only master modern nursing knowledge and skills,but also can perform comprehensive nursing under the guidance of TCM theory of holistic concept and syndrome differentiation and nursing. This study,through investigating and analyzing the settings of3-year nursing professional courses in about 20 senior medical colleges,including senior nursing education of TCM,reformed the development of professional nursing courses of integrated Chinese and western medicine and the establishment of educational materials according to the course settings and educational work modes,so as to analyze the current status of nursing education of integrated Chinese and western medicine,determine course targets,and establish course system and educational work modes.

Opportunities and challenges for the development of traditional Chinese medicinenursing under the new healthcare reform

Based on the “Opinions on Deepening the Reform of Medicine and Health”, “Strategic planning outline of thedevelopment of Traditional Chinese Medicine （2016-2030）” and the other relevant polices announced by StateAdministration of Traditional Chinese Medicine of the People’s Republic of China, this paper analyzes and summarizesthe opportunities and challenges for the development of Traditional Chinese Medicine nursing （TCM nursing） under thenew healthcare reform, in order to provide reference and thinking for the professional development of TCM nursing.

Child Neglect and Perspectives of Nurses Specializing in Mental Health and Psychiatry in Family Violence:Clinical Case

We live in a changing society in which the family plays a role in fostering close relationships among family members,as well as the responsibility to pass on values and principles to them.When the actions of parents and other families impair the child‟s rights and needs in terms of psychomotor,intellectual,moral,emotional or relationship development,we will face situations of neglect,abuse or violence.Since these behaviors can be active(sexual,physical or psychological violence)or passive(by default,to ensure the well-being of the child).Neglect is a form of abuse that leaves the child feeling ostracized and guilty.

Application and evaluation of improved surgical aseptic technique curriculum in specialty nurse training in Henan Province

Objective:To develop and apply a novel surgical aseptic technique curriculum in specialty training for operating room(OR)nurses.Methods:As surgical environments were improved,related specifications were revised.The proposed surgical aseptic procedure was discussed,improved,and recorded as procedure videos.In the new training program,traditional theoretical lecture training was replaced with sequential theoretical lessons and video demonstration,operation presentation,and skill competition.At the end of the training,the trainees were given questionnaires to assess training outcomes.Differences in student satisfaction regarding the proposed training program and conventional training programs were then compared.Results:A GPA of 3.61±0.58 was recorded after the new training program was implemented.The minimum and maximum average scores of each item were 3.05±0.43 and 4.61±0.33,respectively The satisfaction rate of the trainees in 2013 was significantly higher than that in 2011(t=2.14,P=0.039).Conclusion:Novel surgical aseptic technique and application in the curriculum design of training for OR nurses should be developed to enhance their mastery of theoretical and practical skills and to modify their behaviors.

2018 Special Issue on Advanced Practice Nursing: Call for papers

Advanced practice nursing(APN)is considered not only as a set of knowledge and skills but also as a concept.It is a powerful idea:APN is the patient-focused application of an expanded range of competencies to improve health outcomes for individuals and populations in a specialized clinical area of the larger discipline of nursing[1].The concept of APN could provide a stable core understanding for all APN roles,it could promote consistency in practice that can help others to understand what this level of nursing entails,and it could advance the achievement of valueadded patient outcomes and improvement in health care delivery process.

Relaxation technique training to alleviate emotional stress in patients with chronic pain: A report of two cases

Aim: Chronic pain can leads to uncomfortable sensory and emotional experiences and remarkably decrease one’s quality of life. The purpose of this report is to describe our experience of treatment with relaxation techniques for two outpatients with chronic pain-related emotional stress. Methods: We offer outpatient relaxation treatment as a specialized out-patient nursing service. Two patients were motivated to self-manage their pain, and thus sought outpatient instruction in relaxation techniques to provide methods of pain self-management. We examined the usefulness of relaxation techniques as pain self-management methods based on subjective information and the Mental Health Pattern questionnaire. Results: Two patients were able to incorporate the relaxation techniques into their daily schedules and control their symptoms. Ultimately, their attitudes toward their pain changed, which lessened their stress levels and improved their quality of life. Conclusions: Our results suggest that nursing care using continuous relaxation techniques improves pain self-management in patients with chronic pain.

基于客观结构化临床考试的情景模拟式教学在手术室专科护士培训中的应用

目的探讨基于客观结构化临床考试(objective structured clinical examination,OSCE)的情景模拟式教学在手术室专科护士培训中的应用效果。方法选取参加郑州大学第一附属医院手术室专科护士培训的78名学员为研究对象。按照培训时间先后顺序,将2021年4月-6月参加培训的40名学员作为对照组,将2022年4月-6月参加培训的38名学员作为观察组。对照组采用常规情景模拟式教学,观察组采用基于OSCE的情景模拟式教学,比较2组操作考核成绩、临床思维能力。结果观察组操作考核中患者核查交接、手术体位安置、职业暴露防护的考核成绩均好于对照组(t=4.616,P<0.001;t=3.004,P=0.004;t=3.574,P=0.001),观察组临床思维能力得分高于对照组(t=7.309,P<0.001)。结论将基于OSCE的情景模拟式教学应用于手术室专科护士培训,有助于提高其操作技能和临床思维能力,值得临床推广应用。

基于计划行为理论探索心肺康复专科护士临床实践影响因素的质性研究

目的:探讨心肺康复专科护士参与临床实践培训的障碍及其影响因素。方法:基于计划行为理论对22名心肺专科护士、7名带教老师进行焦点小组访谈,并根据Colaizzi 7步分析法对原始资料进行整理分析。结果:提炼出心肺康复专科护士积极参与临床实践教学的行为信念、规范信念、控制信念3个部分,包括对参加实践培训的认知、态度、学员压力、师资支持、资源支持、角色认同感、角色定位不明7个主题。结论:心肺康复专科护士积极参与临床实践教学培训受态度、主观规范、自我控制信念的影响,建议培训基地应在实践中逐步调整教学计划、编制相关指南或教程,提升角色认同感,形成规范教学模式,从而达到更优质的培训效果。

专项护理干预在重症肺炎合并呼吸衰竭患者中的应用效果

目的探讨专项护理干预在重症肺炎合并呼吸衰竭患者中的应用效果。方法选取2020年2月—2022年11月首都医科大学附属北京潞河医院收治的75例重症肺炎合并呼吸衰竭患者为研究对象,根据护理干预方法不同分为观察组(n=39)和对照组(n=36)。对照组采用常规护理干预,观察组患者在对照组基础上采用专项护理干预。比较2组患者干预前后汉密尔顿焦虑量表(HAMA)和汉密尔顿抑郁量表(HAMD)评分、匹兹堡睡眠质量指数(PSQI)量表评分、世界卫生组织生存质量测定简表(WHOQOL-BREF)评分及干预期间并发症发生情况。结果2组患者干预前HAMA及HAMD评分比较,差异均无统计学意义(P>0.05);2组患者干预后HAMA及HAMD评分均低于干预前,且观察组患者均低于对照组,差异均有统计学意义(P<0.05)。2组患者干预前PSQI量表7个维度评分及总分比较,差异均无统计学意义(P>0.05);2组患者干预后PSQI量表的睡眠持续时间、睡眠效率、入睡所需时间、睡眠质量、促睡眠药物、睡眠障碍、日间功能障碍7个维度评分及总分均低于干预前,且观察组患者均低于对照组,差异均有统计学意义(P<0.05)。2组患者干预前WHOQOL-BREF量表各维度评分比较,差异均无统计学意义(P>0.05);2组患者干预后WHOQOL-BREF量表的生理功能、心理状态、躯体健康、社会功能4个维度评分均高于干预前,且观察组患者均高于对照组,差异均有统计学意义(P<0.05)。观察组患者并发症发生率为7.69%(3/39),低于对照组的27.78%(10/36),差异有统计学意义(χ^(2)=5.271,P=0.022)。结论将专项护理干预应用于重症肺炎合并呼吸衰竭患者的护理中,能有效改善患者的心理状况及睡眠质量,提高患者生活质量,降低并发症的发生风险。

中医特色护理门诊医护协作出诊实践分析

目的 探讨脾胃病专科中医特色护理门诊医护协作出诊开展的可行性及成效。方法 运用医院选拔原则确定出诊护师,与专科医师合作开设脾胃病专科中医特色护理门诊。通过对2023年医护协作出诊和2019年护师单独出诊的脾胃病专科中医特色护理门诊就诊患者进行问卷调查,分析对医疗护理服务的满意度。结果 脾胃病专科中医特色护理门诊医护协作出诊开展以来,护理门诊量由2019年的35人次/月上升到2023年的148人次/月,出诊时间由2019年的1次/周增设至2023年的3次/周。2023年护理门诊医护协作出诊的就诊患者对医疗护理服务的满意度高于2019年护师单独出诊,差异有统计学意义(P<0.05)。结论 脾胃病专科中医特色护理门诊医护协作出诊的开展,拓展了中医护理服务内涵,满足患者日益增长的个体化、多元化需求,提高患者对医疗护理服务的满意度。

四川省精神专科护士系统培训对提升护理人员一般自我效能感及心理弹性的效果评价

目的评估四川省精神专科护士培训对其一般自我效能感、心理弹性及其各维度(坚韧、自强和乐观)的提升效果。方法采用自身前后对照试验设计,对2023年9—11月参加四川省精神专科护士培训班的57名护士进行系统培训,包括理论教学、临床实践、团体督导、主题沙龙等多个模块,共500学时。在培训前和培训后采用一般自我效能感量表(GSES)和中文版Connor-Davidson心理弹性量表(CD-RISC)对精神专科护士进行测量。结果与培训前比较,培训后护士的GSES得分和CD-RISC得分差异有统计学意义(P<0.05),其中坚韧、自强和乐观3个维度差异有统计学意义(P<0.05)。结论本研究通过系统培训,提升了精神专科护士的自我效能感和心理弹性,证明培训方案有效。

专病一体化护理联合协同护理模式对老年慢性心力衰竭患者的影响

目的:探讨专病一体化护理联合协同护理模式对老年慢性心力衰竭(CHF)患者的影响。方法:选取2022年2月1日~2023年2月28日收治的98例老年CHF患者作为研究对象,依据入院时间采用抽签法分为对照组和观察组各49例,对照组给予常规护理,观察组在此基础上实施专病一体化护理联合协同护理模式;比较两组入院时、出院时、出院3个月的积极度评分,护理前后生命质量[简明健康状况调查问卷(SF-36)]评分、睡眠质量(明尼苏达心力衰竭睡眠质量量表)评分、自我护理(欧洲心力衰竭自我护理行为量表)评分、汉密顿焦虑量表(HAMA)评分、汉密顿抑郁量表(HAMD)评分,护理满意度。结果:干预后,两组积极度评分逐渐提高(P<0.01),观察组出院时、出院3个月积极度评分高于对照组(P<0.01);护理后,两组生命质量评分高于护理前(P<0.05),且观察组高于对照组(P<0.01);护理后,两组睡眠质量、自我护理评分及HAMA、HAMD评分低于护理前(P<0.05),且观察组低于对照组(P<0.01);观察组护理满意度高于对照组(P<0.01)。结论:专病一体化护理联合协同护理模式能够有效改善CHF患者的不良情绪和积极度,提高睡眠质量和生命质量,提升护理满意度。

专科护理敏感指标干预对患者肠道准备清洁度及满意度的影响

目的研究专科护理敏感指标干预对患者肠道准备清洁度及满意度的影响。方法选取2021年1月至2022年6月接受肠镜检查患者97例,随机数字表法分为对照组(n=48)和观察组(n=49)。对照组给予常规护理干预,观察组给予专科护理敏感指标干预,比较2组肠道准备依从性和清洁度,统计肠道检查围检查期不良反应和事件发生情况,并比较2组患者护理满意度。结果观察组肠道准备依从性、肉眼下肠道准备合格率、镜下肠道准备清洁度总分、满意度高于对照组(P<0.05),肠道检查围检查期不良反应和事件总发生率低于对照组(P<0.05)。结论给予接受肠镜检查患者专科护理敏感指标干预可提升其肠道准备依从性,提升肠道准备质量,减少肠镜准备和检查不良情况的发生,使肠镜检查可顺利进行,患者满意度较高。

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。

门诊患者膝关节腔注射治疗中应用专科护理小组多学科合作模式的效果分析

目的:分析在门诊患者膝关节腔注射治疗中应用专科护理小组多学科合作模式的效果。方法:选取2020年6月—2021年3月于苏北人民医院门诊注射室行膝关节腔注射治疗的260例患者作为研究对象,将2020年6—10月的130例患者设为对照组,2020年11月—2021年3月的130例患者设为观察组。对照组实施常规护理,观察组建立专科护理小组并实施多学科合作模式。比较两组护理效果。结果:观察组穿刺失败、穿刺部位感染、疼痛加剧、残肢血运障碍及并发症总发生率高于对照组,差异有统计学意义(P<0.05)。观察组满意率高于对照组,差异有统计学意义(P=0.043)。结论:门诊患者膝关节腔注射治疗中建立专科护理小组的效果显著,能够降低并发症发生率,提高患者满意度,值得临床应用并予以推广。

介入专科护士岗位胜任力模型的构建

目的 构建介入室专科护士岗位胜任力模型。方法2023年3月至2024年3月,组建课题小组,查阅国内外文献,运用德尔菲法对7名护理专家、9名医疗专家进行2轮问卷函询。结果 2轮函询问卷的有效回收率均为100%。经过16名专家2轮咨询,构建了4个一级指标及28个二级指标。结论 探索专科护士岗位胜任力模型构建,构建结果可信,具有一定的科学性和适用性,但指标体系仍需在实践中不断验证、修改、完善。

护理专案联合共情护理对老年患者结肠镜检查前肠道准备的影响

目的 探究护理专案联合共情护理对老年患者结肠镜检查前肠道准备的影响。方法 便利选取2021年7月-2023年7月临沂市中医医院收治的96例行结肠镜检查的老年患者为研究对象,采用Excel表格法均分为研究组、基础组,各48例。基础组行一般护理,研究组加用护理专案联合共情护理。比较两组的心理状态、肠道准备情况、依从性。结果 护理前,两组心理状态评分比较,差异无统计学意义(P>0.05);护理后,研究组心理状态评分低于基础组,差异有统计学意义(P<0.05)。研究组肠道准备情况优于基础组,差异有统计学意义(P<0.05)。研究组依从率为97.92%,高于基础组的85.42%,差异有统计学意义(χ^(2)=4.909,P<0.05)。结论 护理专案联合共情护理能够改善老年结肠镜检查患者的心理状态,提高肠道准备情况及依从性。