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find Keyword "能力" 99 results
  • Challenges and Countermeasures for the Development of Nursing Discipline in China

    Objective Based on the acquirable and optimized evidences at present, to explore the challenge and countermeasures for the development of nursing discipline in China, and to provide suggestions for promoting the construction of nursing discipline, platform, and talent team. Methods The study materials were searched in the following electronic databases including PubMed, EMbase, Web of Science, CNKI, VIP and CBM, as well as in the official websites of World Health Organization (WHO), International Council of Nurses (ICN), World Bank, the Ministry of Health (MOH) and the Ministry of Education (MOE) of China, and the domestic universities, colleges or technical secondary schools. Then the statistical analysis was conducted using SPSS 13.0 and Microsoft Excel software. Results a) By 2012, there were 855 nursing schools, 38 212 nursing undergraduates enrolled in universities, and 130 837 nursing students enrolled in junior colleges and senior vocational schools; b) The doctor-to-nurse ratio was 1 to 0.9 in 2010. The actual demand for doctors was 2.6 million, and there were still lack of 346 000 nurses; c) The age of nurses younger than 35 years old accounted for 50%. Those with primary professional title accounted for 64% to 69%, while less than 2.5% with advanced professional title; d) The training cost for a doctor and nurse/midwife in China only accounted for 2/5 of that in India and 1/5 to 1/4 in the sub-Sahara Africa; and e) To date, only 30.1% of disaster nursing studies in China provided research data, 30.6% were clinical experience and 38.3% were review. Conclusion Education and health systems need to be extensively reformed. It is necessary to train nursing students with core competencies using transformative learning. It is necessary to update textbooks and teaching methods, and funding should be appropriately increased. Nursing should cooperate with other disciplines, and apply evidence-based nursing methods to improve the quality of healthcare services and patient satisfaction.

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  • 自护技能指导前移对提高喉癌术后患者自护效果的影响

    目的 讨论自护技能指导前移对提高喉癌术后患者出院后自护能力的效果,寻求切实有效的健康教育方法。 方法 将2010年6月-2011年3月接受喉癌手术的113例患者按病床序号分为对照组54例和观察组59例,对照组按常规在患者出院前2~3 d开始进行自护技能指导,观察组则将指导时间提前至术后第5天,两组自护技能指导内容相同。并于患者出院前1 d和出院后15 d对其自护技能及家庭护理效果进行评价。 结果 观察组患者自护技能得分水平出院前后都明显高于对照组(P<0.05);出院后在套管垫安置正确、能自行排痰、掌握保护气道方法3个方面家庭护理效果优于对照组(P<0.05)。 结论 自护技能指导前移更能提高喉癌术后患者出院后的自护能力水平,减轻患者及家属对出院的焦虑感,促进家庭护理效果。

    Release date:2021-06-23 07:35 Export PDF Favorites Scan
  • Clinical Benefits of Predicting Surgical Risk by E-PASS in Colorectal Cancer Surgery

    ObjectiveTo evaluate the usefulness of estimation of physiologic ability and surgical stress (E-PASS) for predicting postoperative complications in patients undergoing elective colorectal cancer surgery. MethodsPatients underwent colorectal cancer surgery between August 2009 and October 2010 were analyzed retrospectively. E-PASS equations were applied to those patients for estimation of operative risk. The preoperative risk score (PRS), surgical stress score (SSS), and comprehensive risk score (CRS) of the E-PASS were compared with actual postoperative complications. The relationship between E-PASS variables and morbidity after colorectal cancer surgery was identified. ResultsOf the 313 patients, 22 (7.0%) had postoperative complications. Of all the E-PASS variables between complicative group and noncomplicative group, the morbidity was significantly correlated to age (P=0.003), weight (P=0.019), tumor histologic types (P=0.033), Dukes stage (P=0.001), severe heart disease (P=0.019), severe pulmonary disease (P=0.000), performance status (P=0.000), loss of blood volume/body weight (P=0.007), loss of blood volume (P=0.001) and operation time (P=0.001). Differentiation degree of tumor (P=0.503), diabetes (P=0.745), ASA grade (P=0.085), and size of surgical incision (P=0.726) were not significantly associated with postoperative complications. The PRS and CRS were higher in complicative group than those in noncomplicative group (Plt;0.001). But the difference of SSS between the two groups was not statistically significant (P=0.059). ConclusionThe E-PASS scoring system is a relatively simple, fast, and operable tool that can be used to predict short-term postoperative morbidity accurately for clinical decision-making in colorectal cancer surgery.

    Release date:2016-09-08 10:46 Export PDF Favorites Scan
  • 综合ICU监护记录单在培养护理实习生全面临床思维中的应用

    目的 探讨综合性重症加强治疗病房( ICU) 患者监护记录单在护理实习生全面临床思维能力培养中的应用效果。方法 对 2010 年轮转入ICU实习的150 名大专以上学历的实习生随机分为试验组和对照组, 每组各75 名, 试验组实施每天1 h 共1个月规范的综合性ICU 患者监护记录单书写培训, 对照组按常规带教, 统计比较培训后实习生的临床思维能力。结果 试验组有65.3% 的实习生病情观察全面,64% 护理诊断准确, 60% 对危重病情的反应快, 56% 对危重病情的反应准确, 较对照组均有明显提高( 分别为44% 、28% 、34.7% 和32% , Plt;0.01) 。结论 根据重症医学的特点, 规范的使用综合性ICU患者监护记录单, 能逐渐培养实习生的全面性、评判性、连续性、前瞻性思维, 增强危急抢救意识, 提高反应能力, 从而有效提高实习生的全面临床思维能力。

    Release date:2016-08-30 11:56 Export PDF Favorites Scan
  • The Influence of Temperature and Second Insult on Neutrophil Responsiveness

    Objective To study the responsiveness change of neutrophils when experiencing the second insult after the initial temperature activation in cardiopulmonary bypass (CPB) by using an in vitro model. Methods The neutrophils were isolated from blood which was drawn from each of 60 health volunteers. The samples were divided into 5 groups including normothermia, tepid temperature, moderate hypothermia, deep hypothermia, and rewarming hyperthermia by random digital table with 12 in each group according to the change of temperature during CPB. An in vitro model for studying neutrophil responsiveness was established by using a polymerase chain reaction thermocycler. Five time points were set for each group, including T0: starting CPB, T1: starting rewarming, T2: 0.5 h after rewarming, T3: 1 h after rewarming, and T4: 1.5 h after rewarming. Platelet activating factor (PAF) was added into each group at T2, T3, and T4, and then the value of membranebound elastase (MBE) activity was measured as responsiveness of neutrophils. Analysis of covariance was applied by using SPSS 13.0 for statistic analysis. If the [CM(159mm]covariance had significant difference between main effects, Bonferroni method would be applied for pairwise comparison. Results The main effect difference of neutrophil responsiveness among different groups was statistically different (F=4.372,P=0.002). MBE value had no statistical difference between the normothermia and tepid temperature groups (81.9±4.5 ng/10.6 cells vs. 76.5±3.6 ng/106 cells, P=0.134). while the MBE values in these two groups were higher than those in the other three groups (P=0.001). MBE value in the rewarming hyperthermia group was higher than that in the deep hypothermia group (61.2±2.7 ng/106 cells vs. 50.9±3.7 ng/106 cells, P=0.005). There was no statistical difference between the moderate hypothermia group (56.4±3.2 ng/106 cells) and the rewarming hyperthermia group (P=0.167), so was it between the moderate hypothermia group and the deep hypothermia group (P=0.107). The main effects of neutrophil responsiveness at different time points was statistically different (F=3.566, P=0.03) when PAF was added. MBE value at T4 was higher thanthat at T2 (70.9±2.5 ng/106 cells vs. 59.9±2.3 ng/106 cells, P=0.027). There was no statistical difference among T3 (65.5±1.8 ng/106 cells), T2 (P=0.168), and T4 (P=0.292) in MBE value. Conclusion Normothermia, tepid temperature, and rewarming hyperthermia during CPB can enhance neutrophil responsiveness and MBE release when neutrophils suffer the second insult. There is a time window for neutrophils to be easily activated during rewarming period.

    Release date:2016-08-30 05:57 Export PDF Favorites Scan
  • Survey on Nursing Professional Competence and Its Influencing Factors of Fulltime System Graduated Nurses

    Objective To evaluate the level of nursing professional competence of fulltime system graduated nurses in Sichuan province and determine its influencing factors, so as to provide references for nursing high-education reform and nursing human resource management. Methods With a self-designed questionnaire and stratified cluster sample method, both graduated nurses and their direct nursing managers were investigated and asked to evaluate nursing professional competence. Results The mean scores of nursing professional competence of the nurses’ self-evaluation and their managers’ evaluation were 69.90±10.27 and 68.96±11.33, respectively. Factors influencing nursing professional competence included individual interest in nursing, graduated institution, working position, and training provided by employer. Conclusion The professional competence of the nurses graduated with full-time bachelors of clinical nursing in Sichuan province is close to the intermediate level, and it still needs to be improved on the whole, especially in the aspects of nursing research and management. Besides, nursing institutions should further enhance the construction of inner teaching environment and the professional thoughts education of nurse students, while the employer should offer more professional development opportunities, so as to improve the professional self-identity and competence, and to finally lay the talent foundation for the development of nursing disciplines.

    Release date:2016-09-07 11:00 Export PDF Favorites Scan
  • Study on Oxygen Carrying Capacity of Red Blood Cell in Children with Congenital Left-to-Right Shunt

    Objective To study oxygen carrying capacity of red blood cell in children with congenital left-to-right shunt (CLRS) and discuss its clinical significance. Methods A total of 62 children with CLRS were selected as a trial group and 40 healthy children who had accepted clinical physical examination as a control group. ELISA test was applied to determine 2,3 -DPG content of red blood cells. At the same time, pH, PaO2, PaCO2, Hb, P50O2 and relevant outcomes were tested for correlation analysis. Results Red blood cell 2,3-DPG (2.76±0.98 μmol/mL) was higher than that of the control group. PaO2, pH, Hb were lower than those of the control group with significant differences. Among the types of CLRS, 2,3 -DPG of ventricular septal defect was the highest and that of patent ductus arteriosus ranked the second, the two of which had a significant difference (P=0.007). As for red blood cell of children with congenital heart diseases, there was linear correlation between 2,3- DPG and PaO2 as [2,3-DPG=12.007 8– (0.154 7×PaO2)], as well as between P50O2 and 2,3 -DPG as [P50O2=26.303 6+ (1.799 2×2,3-DPG)]. Conclusion Children with congenital left-to-right shunt tend to have low oxygen. Therefore, it is important to detect 2,3-DPG of red blood cell, blood gas analysis, and hemoglobin level change, in order to well understand the mechanism of congenital heart disease as well as to guide clinical practice.

    Release date:2016-09-07 11:00 Export PDF Favorites Scan
  • Medical Education Model with Core Competency as Guide, Evidence-Based Medicine as Carrier and Lifelong Learning as Purpose (3): Current Status of Information Literacy on Medical Students

    Objective To investigate the information literacy status of medical students, so as to provide references for further developing information literacy education. Methods A total of 764 medical undergraduates and postgraduates in Sichuan University were investigated by using “information literacy questionnaire”. Results A total of 744 feedbacks among 764 distributed questionnaires were qualified, accounting for 97.4%. Among then, 37.2% students could easily tell the key words for required information, 26.1% students could make a plan before searching information, 25.5% students could choose appropriate databases for searching, 14.7% students could critically appraise the information, and only 12.4% students had received systematic trainings on intellectual property rights and copyrights. Conclusion Most students of West China School of Medicine of Sichuan University possess good information consciousness, but their critical appraisal for information and information morality need to be improved further.

    Release date:2016-09-07 11:06 Export PDF Favorites Scan
  • Means Testing for Targeting Population in Health Programs: A Systematic Review

    Objectives To describe the mechanism of means testing used in health programs for targeting poor population and to describe how the authors have assessed effects of means testing approaches where applicable. Method We searched 24 electronic resources which included evidence-based, health, economic and social databases, 7 international institution websites, grey literature review resources and Google. Screening and data extraction were conducted by two reviewers separately, and the differences were discussed by the third person or a review group. We systematically analyzed the included studied by theme analysis method from different dimensions. We also described the evaluation outcomes by the authors. Result A total of 10244 records were searched, and 58 studies were included after screening by title, abstract and full texts. A total of 13 studies described verified means testing (VMT) conducted as a targeting method in the US; simple testing method (SMT) was conducted in 16 countries; 26 studies described how proxy means testing (PMT) was used in 14 countries; andmixed means testing (MA) was conducted in 14 countries. Means testing as a targeting method was widely used in four health programs which included health insurance, cash transfer, provision of free health service and fee structure. The target population was poor. Only few studies analyzed the outcomes of means testing; 3 studies analyzed under-coverage and 11studies analyzed leakage as their indicators. Scare cost information could be obtained from the included studies. Conclusion Means testing is widely used in various health programs for targeting the eligible population in distributing benefits, especially in developing countries. Targeting as a means for allocating health resources is particularly important in LMICs for their constraints in budgets available for health. Meanwhile, a universal coverage strategy has become a worldwide issue, and how current health resources can be used equitably and efficiently is a concern from the policy practice. Means testing, as one of the tools in targeting eligible population, would help in this process.

    Release date:2016-09-07 11:23 Export PDF Favorites Scan
  • Effectiveness of Evidence-based Medicine Curriculum for Improving Global EssentialCompetencies of Undergraduate Medical Students: A Systematic Review

    Objective To assess the effectiveness of evidence-based medicine for improving core competencies of undergraduate medical students. Methods MEDLINE, ERIC, Academic Source Premier, Campbell Library databases and three Chinese Databases (CBM, CNKI, VIP) were searched from January 1992 to May 2009.We also used Google to searching related literature. The design is a systematic review of randomized, non-randomized, and before-after studies. Two reviewers did study selection, quality assessment, and data abstraction independently. Different opinions were resolved by consensus. We used an adaptation of the quality measure from Gemma Flores-Mateo et al to assess the quality of selected studies. And descriptive analysis was conducted. Results A total of 17 studies met the selection criteria, 2 of them were of high quality, the others were of moderate quality. Studies involved Competencies of Scientific Foundation of Medicine, Clinical Skills, and Management of Information. Conclusion Competencies of Scientific Foundation of Medicine, Clinical Skills, and Management of Information are improved by evidence-based medicine teaching. No study on professional values, attitudes, behavior and ethics, population health and health systems, management of information, critical thinking and research is available. It is impossible to assess the four domains above.

    Release date:2016-09-07 02:08 Export PDF Favorites Scan
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