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Objective:To develop a training system for head and neck oncology nurses to improve the emergency response competency to recognize and response to acute and critical medical conditions.Methods:Based on literature review and semi-structured interviews with 12 nurses, two rounds of consultation with 15 head and neck cancer care specialists from 6 Tertiary hospitals using Delphi method were conducted to establish the training system for head and neck oncology nurses.Results:The authority coefficients of experts were 0.87 and 0.89, respectively. The coefficient of variation of each item ranged from 0 to 0.167. The coefficients of concordance ranged from 0.243 to 0.403 ( P<0.01). There was statistical significance after Chi-square test ( χ2 values were 14.60-436.64, all P<0.01). In the final training system, training aims included 5 first-level indicators and 16 second-level indicators; training contents included 5 first-level indicators, 16 second-level indicators, and 60 third-level indicators. Conclusions:The authority coefficients and the coefficients of concordance of the experts for the training system were both high. The training system can be applied to improve the emergency response competency of head and neck oncology nurses.
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Objective:To develop the screening checklist of brief interview for autism disorder suitable for Chinese children and evaluate its reliability and validity.Methods:Based on existed research results and diagnostic criteria for autism spectrum disorder of DSM-5, the screening checklist of brief interview for autism spectrum disorder(SCAD) was developed. A sample of 238 children were selected for investigation and 28 of them were retested for test-retest reliability with 2-4 weeks interval. Cronbach's α coefficient, split-half correlation coefficient, test-retest reliability, and evaluator consistency were used to test the reliability of the scale. Content validity, construct validity and empirical validity were used to test the validity of the scale.All statistical analysis were conducted by SPSS 22.0 and AMOS 17.0.Results:The SCAD contains two components and six dimensions, with a total of 25 items. The Cronbach's α coefficient was 0.936 for the total scale and were 0.938, 0.771 for the two components. The split-half coefficient for the total scale and the two components were 0.962, 0.938 and 0.794. The test-retest reliability for the total scale and the two components were 0.806, 0.795 and 0.766. The Kendall coefficient for the total scale and the two components were 0.968, 0.982 and 0.950. The SCAD item-level content validity index (I-CVI) ranged from 0.66 to 0.98 and the Kappa value ranged from 0.66 to 0.98. The scale-level content validity S-CVI/UA and S-CVI/Ave were 0.89 and 0.94. The correlations between SCAD and calibration tests such as ABC, CARS and M-CHAT were 0.54, 0.53 and 0.87, and the correlation coefficients with the M-CHAT-R/F between the two components were 0.87 and 0.76 respectively (both P<0.01). The result of CFA demonstrated that the model fitted the data with well construct validity(χ 2/ df=0.910, RMR=0.049, AGFI=0.974, RMSEA=0.010, PNFI=0.530, PCFI=0.533, NFI=0.994, RFI=0.988, CFI=1.000). The correlation coefficient of the two components was 0.88 and that with the total scale were 0.97 and 0.90, each dimensions with the total scale ranged from 0.72 to 0.93. Conclusion:The SCAD has a good reliability and validity, and it can be used as a clinical screening tool for children with autism spectrum disorder.
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Objective To observe the effects of homemade head and neck fixation pillow in patients with oral and maxillofacial free flap transplantation. Methods Totally 114 patients who needed head and neck fixation after oral and maxillofacial free flap transplantation were divided into the observation group (58 cases) and the control group (56 cases) based on the admitted consequence. Besides the routine treatment and nursing measures, the observation group received head and neck fixation with homemade head and neck fixation pillow, while the control group received traditional fixation with sandbags. The patients′ comfortable degree, compliance, occipital skin condition and the nurses′evaluation of clinical application were investigated. Results The degree of comfort were (2.93 ± 1.28) points in the observation group and (4.96±1.25) points in the control group, respectively. The comfortable degree was higher in the observation group than that in the control group, the difference was statistically significant (t=-8.569,P<0.05). There were 43 patients with complete compliance, 15 with partial compliance, and 0 with no compliance in the observation group respectively, while 18 with complete compliance, 35 with partial compliance, and 3 with no compliance in the control group respectively. The compliance was better in the observation group than that in the control group, the difference was statistically significant (P<0.05). None of the patients in the observation group had pressure ulcer, while 3 patients in the control group had stageⅠpressure ulcer. 96.9％of the nurses considered the homemade head and neck fixation pillow was easy to operate. 100.0％of the nurses considered the homemade headand neck fixation pillow could immobilize the patient′s head and neck effectively. Conclusion The homemade head and neck fixation pillow is easy to operate and can effectively immobilize the patient′s head and neck, protect the patient′s occipital skin, as well as improve patient′s comfort and compliance.
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Objective To study the predictive validity of fidgety general movement assessment in pre-term twins and multiplets for motor development outcomes.Methods A total of 53 pre-term twins or multiplets delivered between July 2011 and February 2016 participated in this study.They were assessed using a general movements (GM) assessment and participated in the follow-up program until one year old.The motor development outcomes of the infants at one year old were determined according to clinical diagnoses and the Peabody developmental motor scale number two (PDMS-2) evaluation.The predictive validity of fidgety general movement assessment for motor development outcomes was calculated against the standard motor development of infants at one year old.Results There were 53 twins or multiplets who accepted the GM assessment of fidgety movement period.Of these,43 were assessed as normal (NF) and ten (19％) as lacking a normal level of fidgety movement (F-).All 53 cases were followed-up for the motor development outcome.Forty-three cases (81.1％) were assessed as normal at one year old,while ten (18.9％) were assessed as abnormal.All ten had cerebral palsy,and no motor development retardation was found.The predictive value of F-for cerebral palsy was 90.0％ in terms of sensitivity,97.7％ in terms of specificity,90.0％ in positive predictive value,and 97.7％ in terms of negative predictive value.Conclusions Among pre-term twins or multiplets,the fidgety general movement assessment can be a useful early indicator of motor development difficulties.
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Objective To evaluate the effectiveness of discharge planning in patients after total laryngectomy. Methods One hundred and four patients were randomly divided into the intervention group and the control group, there were 52 cases in each group. The patients in the control group were received routine nursing, while the patients in the intervention group were received discharge planning based on routine nursing. The patients'days of hospitalization, scores of the Exercise of Self-care Agency Scale (ESCA) at discharge and 4 weeks after discharge, scores of University of Washington Quality of Life Questionnaire (UW-QOL) at 4 weeks after discharge and re-admission rate were compared between the two groups. Results The ESCA scores in the intervention group at discharge (108.62 ± 11.23) and 4 weeks after discharge (116.35 ± 12.08) were significantly higher than those of the control group at discharge (96.16±10.34) and 4 weeks after discharge (105.20±10.76) respectively (t=5.886, 4.970, P0.05). The re-admission rate in the intervention group (2/52,3.85%) was significantly lower than that of the control group (8/52,15.38%) (χ2=3.983, P<0.05). Conclusions Discharge planning can improve the ability of self-care and quality of life in patients after total laryngectomy, and reduce the re-admission to hospital.
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Objective To investigate Zunyi C Class infectious diseases ,and provide basis for formulating prevention and control measures .Methods A network report of class C infectious diseasesfrom in Zunyi city from 2009 to 2012 was statistically analyzed by Excel software ,and data analysis was conducted by descriptive epidemiological method for .Results In Zunyi city from 2009 to 2013 reported a total of 8 kinds of class C infectious diseases (68 915 cases) ,annual report incidence rate was 213 .23/10 million;the top three are hand foot and mouth disease ,mumps and other infectious diarrhea ,accounted for 62 .22% of the total reported ca‐ses ,19 .68% and 13 .44% .There was slightly higher incidence rate of the disease from March to August and the main risks were in scattered children ,kindergarten children and students ;the age of onset lie in the population under 14 years old ,the male to female ratio was 1 .67∶1 .00 (χ2 =3 445 .64 ,P<0 .01) .Conclusion Hand foot and mouth disease ,mumps ,other infectious diarrhea and other infectious disease has become an important public health problem in Zunyi city .Therefore ,the kindergarten ,school infectious disease epidemic monitoring should be strengthened ,the infectious disease outbreaks should be reduced ,and communicable disease diagnosis and reporting standards ,which is helpful to improve the epidemic situation of infectious diseases research and prevention and control level should be improved to maintain the protection of public health .