• 文章类型: Journal Article
    目的:术前口服碳水化合物负荷是提高术后恢复的一个组成部分。这项研究的目的是探讨术前口服碳水化合物负荷对脊柱手术患者术后临床结局的影响。
    方法:这是一项前瞻性病例对照研究。
    方法:这项研究是对2020年10月1日至2021年10月1日在教育和研究医院的神经外科诊所接受脊柱手术的患者进行的。干预组(n=46)在手术前至少8小时摄入800mL口服碳水化合物饮料。术后临床结果为恶心,呕吐,止吐和镇痛药物,炎症,和出血。首次排气和排便时间,口服时间,动员时间,术后评估住院时间。术后24小时监测不良事件。对照组(n=46)接受常规禁食方案。
    结果:干预组术后呕吐和出血发生率较低,排便时间和首次动员时间较早,与对照组比较差异有统计学意义。
    结论:术前口服碳水化合物负荷是一种非药物干预措施,对脊柱手术患者的术后临床结局有积极影响,应纳入加速术后恢复方案。
    OBJECTIVE: Preoperative oral carbohydrate loading is a component of enhanced recovery after surgery protocols. The aim of this study is to investigate the effects of preoperative oral carbohydrate loading on postoperative clinical outcomes in spinal surgery patients.
    METHODS: This is a prospective case-control study.
    METHODS: This study was conducted with patients who underwent spinal surgery from October 1, 2020 to October 1, 2021 in a neurosurgery clinic of an education and research hospital. The intervention group (n = 46) ingested 800 mL oral carbohydrate drinks at least 8 hours before surgery. The postoperative clinical outcomes were nausea, vomiting, antiemetic and analgesic drug medication, inflammation, and bleeding. The first flatus and defecation time, oral intake time, mobilization time, and length of stay in hospital were assessed postoperatively. Adverse events were monitored up to 24 hours postoperatively. The control group (n = 46) underwent routine fasting protocols.
    RESULTS: Lower rates of vomiting and bleeding during and after surgery and earlier defecation time and first mobilization time were determined in the intervention group, and the difference compared with the control group was statistically significant.
    CONCLUSIONS: Preoperative oral carbohydrate loading is a nonpharmacological intervention that has a positive effect on postoperative clinical outcomes in patients who underwent spinal surgery and should be included in the enhanced recovery after surgery protocol.
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  • 文章类型: Journal Article
    背景:法国的情况是独一无二的,具有持续深度镇静(CDS)的法律框架。然而,它在重症监护病房(ICU)中的使用,结合生命维持疗法的退出,仍然引发道德问题,尤其是它加速死亡的潜力。协助死亡的合法化,即,应患者要求协助自杀或安乐死,目前正在法国进行讨论。这次全国调查的目标首先是,评估ICU专业人员是否认为给予ICU患者CDS是一种加速死亡的做法,除了减轻难以忍受的痛苦,第二,评估ICU专业人员对死亡援助的看法。
    方法:一项全国性调查,通过法国麻醉学和重症监护医学学会对ICU医师和护士进行在线问卷调查。
    结果:共有956名ICU专业人员回答了调查(38%的医生和62%的护士)。其中,22%的医生和12%的护士(p<0.001)认为CDS的目的是加速死亡。对于20%的医生来说,CDS与末端拔管相结合被认为是死亡的辅助手段。对于52%的ICU专业人员,目前的框架没有充分涵盖ICU中发生的各种情况.在83%的护士和71%的医生中观察到关于死亡援助的潜在合法化的有利意见(p<0.001),在协助自杀和安乐死之间没有偏好。
    结论:我们的研究结果强调了在重症监护的特定背景下CDS与辅助自杀/安乐死之间的紧张关系,并表明ICU专业人员将支持立法发展。
    BACKGROUND: The situation in France is unique, having a legal framework for continuous and deep sedation (CDS). However, its use in intensive care units (ICU), combined with the withdrawal of life-sustaining therapies, still raises ethical issues, particularly its potential to hasten death. The legalization of assistance in dying, i.e., assisted suicide or euthanasia at the patient\'s request, is currently under discussion in France. The objectives of this national survey were first, to assess whether ICU professionals perceive CDS administered to ICU patients as a practice that hastens death, in addition to relieving unbearable suffering, and second, to assess ICU professionals\' perceptions of assistance in dying.
    METHODS: A national survey with online questionnaires for ICU physicians and nursesaddressed through the French Society of Anesthesiology and Critical Care Medicine.
    RESULTS: A total of 956 ICU professionals responded to the survey (38% physicians and 62% nurses). Of these, 22% of physicians and 12% of nurses (p < 0.001) felt that the purpose of CDS was to hasten death. For 20% of physicians, CDS combined with terminal extubation was considered an assistance in dying. For 52% of ICU professionals, the current framework did not sufficiently cover the range of situations that occur in the ICU. A favorable opinion on the potential legalization of assistance in dying was observed in 83% of nurses and 71% of physicians (p < 0.001), with no preference between assisted suicide and euthanasia.
    CONCLUSIONS: Our findings highlight the tension between CDS and assisted suicide/euthanasia in the specific context of intensive care and suggest that ICU professionals would be supportive of a legislative evolution.
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  • 文章类型: Journal Article
    该研究旨在描述瑞典RN在家中进行急性评估的经验。由于人口老龄化,更多有复杂护理需求的患者在家中得到照顾。与家庭医疗保健一起工作的注册护士(RN)需要广泛的医疗能力和临床经验,以及适应的决策支持系统,以在家庭医疗保健中的急性评估中维护患者安全。
    对来自瑞典家庭医疗保健工作的RNs(n=19)的定性调查数据的内容分析。
    由于缺乏能力,在国内进行急性评估时面临挑战,因为一些RN在家庭医疗保健中没有太多的RN工作经验。关于病人的重要信息丢失了,例如,由于组织挑战而导致的医疗记录的访问以及对设备和材料的访问有限。RN需要与医生合作的形式的支持,同事的支持,和决策支持系统。
    为了增加在家中进行患者安全评估的可能性,技能发展,大学支持,需要一个适应的决策支持系统。与初级医疗保健的合作,待命医生,和护理人员,并且有机会与某人协商也可以在急性评估中提供安全性。
    UNASSIGNED: The study aims to describe Swedish RNs\' experiences of acute assessments at home. More patients with complex nursing needs are cared for at home due to an ageing population. Registered nurses (RNs) who work with home healthcare need a broad medical competence and clinical experience alongside adapted decision support systems for maintaining patient safety in acute assessments within home healthcare.
    UNASSIGNED: A content analysis of qualitative survey data from RNs (n = 19) working within home healthcare in Sweden.
    UNASSIGNED: There were challenges in the acute assessments at home due to a lack of competence since several of the RNs did not have much experience working as an RN in home healthcare. Important information was missing about the patients, such as access to medical records due to organizational challenges and limited access to equipment and materials. The RNs needed support in the form of cooperation with a physician, support from colleagues, and a decision support system.
    UNASSIGNED: To increase the possibility of patient-safe assessments at home, skills development, collegial support, and an adapted decision support system are needed. Collaboration with primary healthcare, on-call physicians, and nursing staff, and having the opportunity to consult with someone also provide security in acute assessments.
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  • 文章类型: Journal Article
    为了调查移情疲劳的现状,职业身份,护理机构护理人员的睡眠质量。分析共情疲劳,护理人员的职业认同感和睡眠质量。
    这是一项横断面研究。采用方便抽样的方法,从盘锦地区老年机构中抽取224名护理工作者作为调查对象。护士一般资料问卷,中文版的同情疲劳简短量表,护士职业认同量表,匹兹堡睡眠质量指数作为评价工具。采用SPSS26.0统计软件对数据进行整理和分析。
    移情疲劳与睡眠质量呈正相关;移情疲劳与职业认同呈负相关。职业认同与睡眠质量呈负相关。
    移情疲劳,职业身份,护理工作者的睡眠质量。共情疲劳与睡眠质量呈正相关。移情疲劳与职业认同呈负相关。职业认同感与睡眠质量呈负相关。为老年护理人员的管理及相应管理制度和政策的制定提供理论依据,促进老年人护理人员的心理健康,改善睡眠质量,为今后的干预研究提供理论依据和参考。
    UNASSIGNED: To investigate the status quo of empathic fatigue, professional identity, and sleep quality of nursing staff in nursing institutions. To analyze the correlation between empathic fatigue, professional identity and sleep quality of nursing staff.
    UNASSIGNED: This is a cross-sectional study. The method of convenient sampling was used to select 224 nursing workers from the older adult\'s institutions in the Panjin area as the investigation objects. The nurses\' general data questionnaire, the Chinese version of the compassion fatigue short scale, the nurses\' professional identity Scale, and the Pittsburgh Sleep Quality Index were used as evaluation tools. SPSS26.0 statistical software was used to sort out and analyze the data.
    UNASSIGNED: There was a positive correlation between empathic fatigue and sleep quality; there was a negative correlation between empathy fatigue and professional identity. Occupational identity and sleep quality were negatively correlated.
    UNASSIGNED: There is a correlation between empathic fatigue, professional identity, and sleep quality of nursing workers. Empathy fatigue is positively correlated with sleep quality. Empathy fatigue was negatively correlated with professional identity. Occupational identity was negatively correlated with sleep quality. To provide a theoretical basis for the management of older adult\'s nursing staff and the formulation of corresponding management systems and policies, promote the mental health of older adult\'s nursing staff, improve sleep quality, and provide a theoretical basis and reference for future intervention research.
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  • 文章类型: Journal Article
    背景:术前营养不良是胰腺肿瘤患者接受胰十二指肠切除术的一个重要因素。这项研究的目的是评估术前营养不良与十天内延迟出院之间的关系,以及术前营养不良与术后手术并发症之间的潜在相关性。
    方法:进行了一项回顾性队列研究,从2015年至2022年招募79例良性或恶性头胰腺肿瘤患者的最终样本。使用营养不良通用筛查工具评估营养不良的风险,同时从临床文件中提取住院时间和相关临床数据。
    结果:21.52%的患者术前营养不良风险较高,中度在36.71%,低在41.77%。体重指数(BMI)(p=0.007)和术后并发症(p<0.001)与延迟出院显着相关。在营养不良风险水平和延迟出院之间没有发现统计学上的显着差异(p=0.122),或术后手术并发症(p=0.874)。
    结论:术后并发症和BMI是显著的危险因素。有限的样本量可能损害了同质和重要数据的收集。未来的研究应该评估个性化营养筛查工具的实施。营养评估计划,以及专业卫生专业人员的参与。
    BACKGROUND: Preoperative malnutrition is a significant factor in patients with pancreatic tumors undergoing pancreaticoduodenectomy. The aim of this study was to assess the association between preoperative malnutrition and delayed discharge within a ten-day timeframe and potential correlations between preoperative malnutrition and postoperative surgical complications.
    METHODS: A retrospective cohort study was conducted, recruiting a final sample of 79 patients with benign or malignant cephalic pancreatic tumors from 2015 to 2022. The risk of malnutrition was assessed using the Malnutrition Universal Screening Tool, while length of hospital stay and relevant clinical data were extracted from clinical documentation.
    RESULTS: The preoperative malnutrition risk was high in 21.52% of the sample, moderate in 36.71%, and low in 41.77%. Body mass index (BMI) (p = 0.007) and postoperative surgical complications (p < 0.001) were significantly correlated with delayed discharge. No statistically significant differences were found between levels of malnutrition risk and delayed discharge (p = 0.122), or postoperative surgical complications (p = 0.874).
    CONCLUSIONS: Postoperative complications and BMI emerge as significant risk factors. The limited sample size may have compromised the collection of homogeneous and significant data. Future studies should evaluate the implementation of personalized nutritional screening tools, nutritional assessment plans, and the involvement of specialized health professionals.
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  • 文章类型: Journal Article
    (1)背景:科学文献强调,被诊断患有乳糜泻(CD)的儿童经历身体疾病的风险更高,心理,和社会挑战,影响他们整体的儿童健康发展。然而,对造成这种脆弱性的因素仍然缺乏明确的了解。这项研究的目的是分析和绘制有关这些儿童的社会身心脆弱性的证据,并确定该主题的差距。(2)方法:遵循乔安娜·布里格斯研究所的范围审查指南,我们对关键电子数据库进行了详细搜索,并探索了灰色文献以捕获广泛的研究。我们的重点是确定研究脆弱性的多个维度-物理,心理,和社交儿童CD。我们包括了各种各样的研究设计以及系统评价,确保全面分析。选择过程很严格,利用明确定义的纳入和排除标准。(3)结果:我们确定了61项符合我们纳入标准的研究。该审查强调了CD儿童的重大不利健康后果,并阐明了影响这些脆弱性的各种个人和环境决定因素。它还强调缺乏评估该人群健康问题风险的评估工具。(4)结论:研究结果强调了进一步研究的迫切需要,以加深我们对与儿童CD相关的脆弱性的理解。开发有针对性的评估工具对于分层健康风险和加强针对这一弱势群体的护理战略至关重要。
    (1) Background: The scientific literature highlights that children diagnosed with celiac disease (CD) are at a heightened risk of experiencing physical, psychological, and social challenges, impacting their overall healthy childhood development. However, there remains a lack of a clear understanding regarding the factors that contribute to this vulnerability. The purpose of this study is to analyze and map the evidence on the sociopsychosomatic vulnerability of these children and identify gaps in this topic. (2) Methods: Following Joanna Briggs Institute\'s guidelines for scoping reviews, we executed a detailed search of key electronic databases and explored the grey literature to capture a broad spectrum of studies. Our focus was on identifying research that looked into the multiple dimensions of vulnerability-physical, psychological, and social-in children with CD. We included a diverse range of study designs as well as systematic reviews, ensuring a comprehensive analysis. The selection process was stringent, utilizing clearly defined inclusion and exclusion criteria. (3) Results: We identified 61 studies that met our inclusion criteria. The review highlighted significant adverse health outcomes in children with CD and elucidated various individual and environmental determinants that influenced these vulnerabilities. It also underscored the lack of assessment tools to evaluate the risk of health problems in this population. (4) Conclusions: The findings underscore a critical need for further research to deepen our understanding of the vulnerabilities associated with CD in children. Developing targeted assessment tools will be crucial in stratifying health risks and enhancing care strategies for this vulnerable population.
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  • 文章类型: Journal Article
    社会支持促进了应对困难的适应性策略的发展,这可能会影响心理健康。睡眠质量已被强调为在心理健康中具有相关作用。本研究旨在分析与普通人群相比,社会支持和睡眠质量在卫生专业人员(护士和医生)心理健康中的作用。样本包括466名年龄在18至75岁之间的成年人(M=43.4;SD=10.8),其中272人是普通人群,194名护士和医生。数据是通过社会人口统计问卷收集的,领悟社会支持的多维尺度,匹兹堡睡眠质量指数,和心理健康表现量表。护士呈现较少平衡(也包括医生),比其他专业人士更有社交能力和幸福感。与医生相比,护士的社交能力较低。结果还使我们能够观察到重要他人的社会支持对社会参与和社交能力的积极作用,以及家庭在自尊中的积极作用。朋友的社会支持在心理健康的各个方面都起着积极的作用。男性心理健康的患病率较高。其他专业人员和睡眠质量在各个方面都显示出高水平的心理健康。数据讨论强调了社会支持的作用,睡眠,和性别以及卫生专业(护士和医生)对心理健康的影响。
    Social support enhances the development of adaptive strategies to cope with difficulties, which may affect psychological well-being. Sleep quality has been highlighted as having a relevant role in psychological well-being. The present study aimed to analyse the role of social support and sleep quality in the psychological well-being of health professionals (nurses and doctors) compared to the general population. The sample comprised 466 adults aged between 18 and 75 (M = 43.4; SD = 10.8), of which 272 were the general population and 194 nurses and doctors. Data were collected through a Sociodemographic Questionnaire, the Multidimensional Scale of Perceived Social Support, the Pittsburgh Sleep Quality Index, and the Psychological Well-Being Manifestation Measure Scale. Nurses presented less balance (also doctors), sociability and happiness than other professionals. Less significant sociability was observed in nurses compared with doctors. The results also allowed us to observe the positive role of social support from significant others on social involvement and sociability and the positive role of the family in self-esteem. Social support from friends played a positive role in all dimensions of psychological well-being. Males had a higher prevalence of psychological well-being. Other professionals and sleep quality show high levels of psychological well-being in all dimensions. Data discussion highlights the role of social support, sleep, and sex and the implications of health professions (nurses and doctors) on psychological well-being.
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  • 文章类型: Journal Article
    背景:随着医疗保健领域技术集成的增加,重要的是要了解新兴技术在减少对医疗保健系统的需求方面可能发挥的好处。Steadiwear防振手套有望增强患有原发性震颤的人的功能能力的独立性,并减轻对医疗保健系统支持的需求。这项研究的目的是检查注册护士(RN)对Steadiwear防振手套减少社区医护人员面对面支持的潜力的看法。
    方法:11个RN,在农村社区提供护理方面经验丰富,参加了半结构化访谈,分享了他们在社区实践环境中使用Steadiwear防振手套的观点。在布劳恩和克拉克的指导下进行了主题分析。
    结果:护士描述了该技术的价值,以减少客户对日常生活活动的支持需求(例如,敷料,喂养)和日常生活的独立活动(例如,banking,运输)。
    结论:增强对该技术的访问可能会减少卫生系统对护理和个人护理支持的需求。因此,Steadiwear防振手套还显示出延迟和/或防止需要更密集的支撑和减轻过渡到长期护理设施的需要的潜力。
    BACKGROUND: With the increased integration of technologies in the healthcare sector, it is important to understand the benefits emerging technologies may play to reduce demands on the health care system. The Steadiwear antivibration glove shows promise for enhancing the independence in functional abilities for persons with essential tremors and for alleviating the need for support from the health care system. The objective of this study was to examine Registered Nurses\' (RN) perceptions of the potential for the Steadiwear antivibration glove to reduce the need for in-person support from community healthcare workers.
    METHODS: Eleven RNs, experienced in providing care in rural communities, participated in a semi-structured interview sharing their perspectives towards use of the Steadiwear antivibration glove in community practice settings. Thematic analysis guided by Braun and Clarke was undertaken.
    RESULTS: Nurses described the value of this technology to reduce client needs for support for activities of daily living (e.g., dressing, feeding) and independent activities of daily living (e.g., banking, transportation).
    CONCLUSIONS: Enhanced access to this technology may reduce the need for nursing and personal care support from the health system. Therefore the Steadiwear antivibration glove also shows potential to delay and/or prevent the need for more intensive support and mitigate the need for transition to a long-term care facility.
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  • 文章类型: Journal Article
    这项研究旨在研究护士角色的激活和作为护士的职业认同如何从道德和功利主义倾向的角度影响道德判断。在研究1中,使用了启动技术来评估激活护理概念对道德推理的影响。参与者被随机分配到护理主要或中性主要条件。通过使用一个混乱的句子任务,参与者被提示思考与护理相关的或中立的想法.启动任务后,参与者被要求对20个道德困境做出回应。过程分离方法被用来衡量道德推理中道义主义和功利主义倾向的程度。在研究2中,参与者在从事与研究1类似的道德判断之前,完成了护理专业认同量表和道德取向量表。研究结果表明,启动成为保姆的概念会导致道义学临床倾向的增加,而对功利主义倾向没有显着影响。此外,在对护理专业的认同和义务学临床倾向之间观察到正相关,而与功利主义倾向呈负相关。在护理专业认同与道义倾向之间的关系中,协商取向是完全的中介者,也是功利主义倾向的部分中介者。
    This study aims to examine how the activation of the role of nursee and professional identification as a nurse can influence moral judgments in terms of deontological and utilitarian inclinations. In Study 1, a priming technique was used to assess the impact of activating the nursing concept on moral reasoning. Participants were randomly assigned to either a nursing prime or neutral prime condition. By using a scrambled-sentence task, participants were prompted to think about nursing-related or neutral thoughts. Following the priming task, participants were asked to respond to 20 moral dilemmas. The process dissociation approach was employed to measure the degree of deontological and utilitarian tendencies in their moral reasoning. In Study 2, participants completed the nursing profession identification scale and the moral orientation scale before engaging in moral judgments similar to those in Study 1. The findings revealed that priming the concept of being a nursee resulted in an increase in deontological clinical inclinations while having no significant effect on utilitarian inclinations. Additionally, a positive correlation was observed between identification with the nursing profession and deontological clinical inclinations, whereas a negative correlation was found with utilitarian inclinations. Deliberation orientation acted as a complete mediator in the relationship between nursing professional identification and deontological tendencies and as a partial mediator for utilitarian tendencies.
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  • 文章类型: Journal Article
    母婴关系受损会对母婴关系产生负面影响,影响社会,情感,和孩子的认知发展。在乌干达,关于母婴关系受损的文献很少。这个定量的,横断面研究旨在确定母婴结合受损的患病率和相关因素。在Kawempe国家转诊医院的幼儿诊所就诊的产后母亲(n=422)参加了该研究。使用产后粘合问卷(PBQ)测量母婴粘合。PBQ评分≥13的参与者被认为母婴结合受损。母亲中母婴结合受损的患病率为45%(190/422)。使用Logistic回归确定与母婴结合受损相关的因素。未婚母亲(AOR=2.05,95%[CI=1.03-4.09],p=0.041),非计划妊娠(AOR=5.19,95%[CI=3.07-8.82],p<0.001),首次母亲(AOR=2.46,95%[CI=1.37-4.43],p=0.003),女婴(AOR=1.80,95%[CI=1.13-2.86],p=0.013),无/低教育水平的母亲(AOR=2.29,95%[CI=1.05-4.50],p=0.036),以及在任期结束后交付的人(AOR=2.49,95%[CI=1.10-5.67],p=0.028)更有可能受损的母婴结合。产后护理中的护士和助产士应在其客户的评估中包括母婴联系,并提供以母亲为中心的支持性护理。应在临床实践中创建和实施改善母婴结合的干预措施。
    Impaired maternal-infant bonding can have a negative impact on the mother-infant relationship, affecting the social, emotional, and cognitive development of a child. In Uganda, there is a paucity of literature on impaired maternal-infant bonding. This quantitative, cross-sectional study aimed to determine the prevalence and factors associated with impaired maternal-infant bonding. Postnatal mothers (n = 422) attending the Young Child Clinic at Kawempe National Referral Hospital participated in the study. Maternal-infant bonding was measured using the Postpartum Bonding Questionnaire (PBQ). Participants with a score ≥ 13 on the PBQ were considered to have impaired maternal-infant bonding. The prevalence of impaired maternal-infant bonding among mothers was 45% (190/422). Logistic regression was used to determine factors associated with impaired maternal-infant bonding. Unmarried mothers (AOR = 2.05, 95% [CI = 1.03-4.09], p = 0.041), unplanned pregnancy (AOR = 5.19, 95% [CI = 3.07-8.82], p < 0.001), first-time mothers (AOR = 2.46, 95% [CI = 1.37-4.43], p = 0.003), female infant (AOR = 1.80, 95% [CI = 1.13-2.86], p = 0.013), mothers with no/low education levels (AOR = 2.29, 95% [CI = 1.05-4.50], p = 0.036), and those who delivered post term (AOR = 2.49, 95% [CI = 1.10-5.67], p = 0.028) were more likely to have impaired maternal-infant bonding. Nurses and midwives in postnatal care should include maternal-infant bonding within their client\'s assessment and provide supportive mother-centered care. Interventions to improve maternal-infant bonding should be created and implemented in clinical practice.
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