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Objective:To explore whether the 15-minute retention rate (R15) of indocyanine green (ICG) in the indocyanine green excretion test and the effective hepatic blood flow (EHBF) can predict the occurrence of mild hepatic encephalopathy (MHE).Methods:Using the convenience sampling method, we collected clinic data from 153 patients diagnosed with liver cirrhosis or liver failure from June 2019 to December 2019 in the Third Affiliated Hospital of Sun Yet-sen University in Guangzhou. We screened the MHE patients with the number connect test-A and the digital symbol test, and analyzed the clinical data. By taking different values for R15 and EHBF as cut-off points, the significance of the two factors in predicting MHE is explored respectively.Results:The incidence of MHE was 38.56% (59/153). Single factor analysis showed that the difference of Child-Pugh grade between the MHE group and the non-MHE group was statistically significant ( χ2 value was 7.606, P<0.05), while the differences between cirrhosis and liver failure diagnosis, fasting blood glucose, and serum creatinine were not statistically significant ( P>0.05). When most points between 0.11 and 0.61 were selected as normal and abnormal cut-off points of R15, R15 had statistical significance ( P<0.05) and when R15 selected 0.18, it was most significant (Fisher exact test P=0.00024). When most points between 0.08 and 0.76 were selected as normal abnormal cut-off points of EHBF, EHBF had statistical significance ( P<0.05) and when EHBF selected 0.25, it was most significant (Fisher exact test P=0.00022). Through Logistic stepwise regression analysis, the risk factors for MHE were R15 and EHBF. The ROC curve was used to illustrate the predictive effects of two factors on MHE. Conclusions:The incidence of MHE in patients with cirrhosis or liver failure is high. When R15≥0.18 or EHBF≤0.25 L/min, R15 and EHBF in indocyanine green excretion test can better predict the occurrence of MHE than Child-Pugh classification, and can be help to evaluate and manage patients in time.
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Objective:To explore the suitability of using Rasch analysis to transform scores on the Activities and Participation component of the ICF Rehabilitation Set.Methods:Between January and May 2017, five hundred and fifteen post-acute rehabilitation patients were recruited in 13 research centers through quota sampling. Specially-trained health professionals used the Activities and Participation component of the ICF Rehabilitation Set to collect data. Rasch analysis was performed using RUMM 2030 software to test for goodness of fit, threshold estimates, and local dependency.Results:Of the five hundred and fifteen participants, 279 (54.2%) had a neurological condition, 119 (23.1%) a cardiopulmonary condition, 49 (10.0%) a musculoskeletal condition, and 68 (13.2%) some other condition. After Rasch analysis, the Activities and Participant component of the ICF Rehabilitation Set was divided into two domains: Activities, and Participation with 9 categories under activities and five under participation.Conclusions:After rescoring the response options, deleting four poorly-fitting categories and generating one testlet, it was found that the activities and participation component the ICF Rehabilitation Set can be divided into two outcome measures to be applied in clinical practice.
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Nursing work environment impacts patient outcomes. This article summarized the concept and connotation of nursing work environment, related theories of how nursing work environment impacts patient safety outcomes and related researches conducted by foreign scholars. The effort of this review article aims to put forward new research direction.
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Objective To investigate the current status of agitated behaviors among institutionalized elderly with dementia. Methods The Cohen-Mansfield Agitation Inventory (CMAI) and General Information questionnaire were used to collect information of agitated behaviors among 141 institutionalized elderly with dementia in a long-term care facility in Guangzhou. Results Nearly 90.07％(127/141) of the elderly with dementia had the symptoms of agitation. Among the four categories of the agitated behaviors, the incidence for physically non-aggressive behaviors (82.27％, 116/141) was the highest, followed by physically aggressive behaviors (78.72％ , 111/141), verbally non- aggressive behaviors (74.47％, 105/141) and verbally aggressive behaviors (64.54％, 91/141). Spitting, repetitive sentences or questions, complaining occurred frequently. Conclusions The incidence of the agitated behaviors was high and the manifestation and types of agitated behaviors were varied, which should be paid attention to by the institution. It is necessary to develop the personalized, systematic, standardized nursing intervention to provide the support for caregivers and help the elderly with dementia to cope with agitation.
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Objective To explore the impact of nursing work environment on the occurrence of nosocomial infections in ICU. Methods The sample consisted of 1890 nurses who provided direct care for patients in ICUs of level 2 and level 3 hospitals in mainland China. The nursing work environment of ICU was measured with a Chinese translation version of the Practice Environment Scale of Nursing Work Index (PES-NWI). Nurses were asked to estimate how frequently nosocomial infections occurred including surgical site infection, urinary tract infection, central line infection, and ventilator associated pneumonia. Results The composite score of PES-NWI of ICU nurse was 3.35(2.77, 3.81)points. The percentage of nurses who reported the 4 kinds of nosocomial infections in ICU"had happen"were 60.4%(surgical site infection,1122/1858),68.0%(urinary tract infection,1265/1859),52.9%(central line infection, 981/1856), and 66.0%(ventilator associated pneumonia, 1229/1861). Nurses who graded higher in PES-NWI would be less likely to report the 4 kinds of nosocomial infections had happen,OR:0.591(surgical site infection), 0.664(urinary tract infection), 0.573(central line infection), 0.567(ventilator associated pneumonia), all P<0.01. Conclusions A better nursing work environment is significantly related to lower occurrence of nosocomial infections in ICU.
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Objective To explore the impact of nursing work environment on the occurrence of nosocomial infections in ICU. Methods The sample consisted of 1890 nurses who provided direct care for patients in ICUs of level 2 and level 3 hospitals in mainland China. The nursing work environment of ICU was measured with a Chinese translation version of the Practice Environment Scale of Nursing Work Index (PES-NWI). Nurses were asked to estimate how frequently nosocomial infections occurred including surgical site infection, urinary tract infection, central line infection, and ventilator associated pneumonia. Results The composite score of PES-NWI of ICU nurse was 3.35(2.77, 3.81)points. The percentage of nurses who reported the 4 kinds of nosocomial infections in ICU"had happen"were 60.4%(surgical site infection,1122/1858),68.0%(urinary tract infection,1265/1859),52.9%(central line infection, 981/1856), and 66.0%(ventilator associated pneumonia, 1229/1861). Nurses who graded higher in PES-NWI would be less likely to report the 4 kinds of nosocomial infections had happen,OR:0.591(surgical site infection), 0.664(urinary tract infection), 0.573(central line infection), 0.567(ventilator associated pneumonia), all P<0.01. Conclusions A better nursing work environment is significantly related to lower occurrence of nosocomial infections in ICU.
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Objective To describe the prevalence and change of rationing of nursing care (RNC) in medical and surgical units of level 2 and level 3 general hospitals across Guangdong province. Methods RNC were measured by asking nurses about the completion status of 12 necessary nursing care activities, and the prevalence of RNC in 2014 was compared with the study results from the China Hospital Nursing Workforce Research(CNWR) in 2009 (exclusively using the data of Guangdong province) to describe the change of RNC. Results Six activities were rationed averagely in 2014, and the most frequent activities rationed wereComfort/talk with patients accounted for 69.8% (975/1 396) andEducating patients and familiesaccounted for 67.3%(940/1 396). According to the CNWR in 2009, the average number of nursing care activities rationed was 3 which was statistically lower than the number in 2014 (P < 0.01). Conclusions RNC is prevalent in level 2 and level 3 general hospitals across Guangdong province, especially psychosocial care to the patients; the prevalence of RNC has not decreased since 2009.
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The important role of nursing work environment has received much attention in the management of nursing workforce and the quality of health care services. This paper analyzed current studies on nursing work environment, and suggested that the government and hospital administrators pay more attention to the development of nursing workforce, adequate clinical nurse staffing levels and promoting healthy work environment for nurses.
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Objective To explore the influencing factors of job burnout among nurses in level 2 and level 3 hospitals in Guangdong province. Methods A total of 2 066 first line nurses from 133 medical, surgical and intensive care units (ICU) of 23 level 2 and level 3 hospitals in Guangdong province were surveyed employing the questionnaire Hospital Nursing Human Resources Research during December 2013 to August 2014. Results In the multivariate logistic regression models, each additional doctor per nurse was associated with 1.34 times increase in the likelihood of high level of emotional exhaustion(EE). Nurses had a 57.4%higher risk of high level of EE when they worked overtime. Every one point increase in ancillary service score, and every one more year working as a nurse was associated with 5.4%, 2.3%increase in the likelihood of high level of EE, respectively. Nurses were 42.1%,40.9%more likely to exhibit high level of depersonalization(DP) when they worked in medical units or hospitals of level 3, compared with nurses of surgical units and hospitals of level 2. Nurses had a 29.5%higher risk of high level of DP when they worked overtime. Nurses holding higher positions had a lower likelihood(37.7%) of high level of reduced personal accomplishment(PA) compared with nurses holding lower positions. Nurses in medical units or ICUs had a 31.2%, 51.6%higher risk of high level of PA than nurses in surgical units, respectively. Conclusions Job burnout of nurses is at a quite high level in level 2 and level 3 hospitals in Guangdong province. The probability of the occurrence of burnout is related to the hospital, unit and nurse characteristics and nursing workloads.
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The occupational hazards to nurses are important factors which may influence the physical and mental health of nurses, and further more influence the quality of care the nurses providing to patients. This article reviewed the occupational hazards to nurses and the related factors in organizational environments and nursing human resources, so as to provide references for further studies and evidence for taking measures to prevent occupational hazards to clinical nurses.
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Increasing aged care requisite has become a serious challenge all over the world. Compared with developed countries, aged care in China still has some limitations, i.e., lack of qualified professionals, aged care system needs to be improved, and lack of aged long term care insurance. This article discussed these points and put forward the corresponding countermeasures.
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The research is to establish a Continuing Nursing Project after discharge which conforming to the actual conditions of our country and explore whether such Continuing Nursing Project could effectively improve therapy compliance and blood glucose control of diabetic patients. Methods: mainly analyzing pathological mechanisms of diabetic patients and exploring the clinical effect and the complication after implementing Continuing Nursing to patients. Results: after implementing Continuing Nursing, the diabetic patients could be better at controlling their diet, the drug usage rate and exercise rate have been improved significantly, complication rate have been decreased and the clinical effect is remarkable. Conclusion: the application of Continuing Nursing in the nursing service for diabetic patients, which could effectively improve living quality and clinical symptoms of patients, deserves to be popularized
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Objective To explore the application of Chinese version of PedsQLTM Multidimensional Fatigue Scale(PedsQLTM MFS) in children with leukemia.Methods 141 children with leukemia and their main caretakers (one parent) were surveyed with the Chinese version of PedsQLTMMFS.Results The Cronbach α was 0.836-0.949 and 0.761-0.930 for parent-proxy scale and children's self-report scale respectively.The correlation coefficients between each item and its subscale were higher than those between each item and other subscales.The scores of parent-proxy scale and children's self-report scale were positively correlated with the correlation coefficient as 0.373-0.738,P＜0.01.Conclusions The Chinese version of PedsQLTMMFS has good reliability and validity.It is a reliable scale in measuring fatigue in children with leukemia.
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Objective To describe fatigue among children with acute lymphoblastic leukemia (ALL)receiving chemotherapy in hospital and explore its related factors.Methods A total of 100 hospitalized children with ALL receiving chemotherapy and their main caregivers were surveyed on demographic information,treatment data,Wong-Baker facial scale and the PedsQLTMMFS Multidimensional Fatigue Scale.Results The incidence of fatigue was 99％ (99/100).The total score of fatigue scale was (56.71±17.32) on average.Multiple linear regression modeling showed that the factors related with fatigue included the time of dexamethasone use,childen's sleep quality,hemoglobin content,pain score,the time for the present chemotherapy,age and main caregivers' self-rating health status (P＜ 0.05 or 0.01).Conclusions Fatigue is serious among children with ALL receiving chemotherapy and is related with demographic factors,diseases,treatment condition and health status of the caregivers.
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ObjectiveTo explore the correlations of simple bladder capacity measurement and urodynamic examination used for assessing the bladder function of patients with spinal cord injury.Methods From December 2011 to September 2013,a total of 37 patients with spinal cord injury were recruited.Their bladder functions were examined by both simple bladder capacity measurement and urodynamics in the first week after admission.The type of neurogenic bladder,residue urine,bladder capacity and the changes of bladder pressure were documented and compared.Results The simple bladder capacity measurement and urodynamics showed no significant differences in the parameters including residual urine,and bladder pressures when inputting 50mL,100mL,300mL and 400mL water(P>0.05). But there were significant differences in the results of bladder capacity and bladder pressure when inputting 200mL water(P<0.05). The intra-class coefficients between the results by the two methods were 0.606~0.919(P<0.01).The Kappa coefficient of the health professionals’judgments according to the two methods was 0.825(P<0.001).Conclusions The results of simple bladder capacity measurement are reliable.It can be used as the supplement for urodynamics to monitor the bladder function of patients with spinal cord injury.
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Objective To investigate the scale and educational-level composition of nursing education in Guangdong Province,identify the issues in the development process,and provide suggestions accordingly.Methods Data on the scale and education level of nursing education were obtained from the Ministry of Education of China.Results Scale of nursing education at three levels for entering nursing (secondary diploma,advanced diploma,and baccalaureate degree) expanded rapidly during 2006～2010 in Guangdong,with 25.6 thousand recruitments totally in 2010,which as 2.05 times as in 2006.The portion of students recruited in secondary diploma programs had increased gradually,resulted in 83.53％ in 2010 (9.41％ for recruitments in advanced diploma programs and 7.06％ for baccalaureate degree programs).179 and 16 students were recruited in master's and doctoral programs in Guangdong,respectively,during 2006～ 2010.Conclusions The current scale and composition of nursing education in Guangdong should be improved according to the dynamic supply-need relationship of nursing workforce.Initial nursing education should be upgraded by increasing the recruitments of advanced diploma and baccalaureate programs and decreasing the recruitments of secondary diploma programs,expand graduate education,and ensure the quality of education.
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Objective To explore the factors of treatment adherence for patients with hypertension.Methods Data were collected among 520 patients with essential hypertension from 2009 to 2010.It investigated the factors of treatment adherence for patients with hypertension by self-report scales.Results Structural equation model analysis showed age,self-rated health,self-eificacy,quality of life,family function and health concept were all directly associated with treatment adherence,and these variables explained 52.0％ of the total variance.Self-efficacy and quality of life were regarded as mediators in predicting treatment adherence of hypertensive patients,other variables indirectly affected adherence behavior by two mediators.Age and self-efficacy showed a strong independent predictive role to adherence.Conclusions Healthcare providers should take effective measures to improve treatment adherence for patients with hypertension based on patients characteristic once they make reasons for adherence clear,which can enhance quality of life,control blood pressure and prevent complications.
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Objective To investigate the current staffing of nurses and need of hospital nursing human resources in China.Methods Data were collected from 181 secondary and tertiary hospitals and 9774 nurses in mainland China by questionnaires.Results The average doctor-nurse ratio was 1 ∶ 1.39 in tertiary hospitals and 1 ∶ 1.31 in secondary hospitals.The doctor-nurse ratios in 164 hospitals (97.6％) and the proportion of nurses in health care staff in 105 hospitals (61.8％) had not reached the standard set by the Ministry of Health of China.62.3％ nurses held secondary diploma for their initial nursing education.The constituent ratio of nurses held secondary diploma decreased,while the ratio of nurses held advanced diploma and bachelor degree increased in the last 5 years from 2003 to 2007.Sixty percent of newly employed nurses were contract nurses in 2003.The proportion increased to 78％ in 2007,and in some regions it accounted for more than 90％ of new nurses.The needs and constituent ratio of nurses with.secondary diploma and advanced diploma would decrease while nurses with bachelor degree and master degree would increase in the next 5 years (from 2009 to 2013).Conclusions The nursing shortage is still severe in China,and nursing staff mainly held secondary diploma for their initial nursing education.Most of new nurses were employed as conwact nurses.The need of hospitals for nurses has increased,especially for nurses with higher educational level such as bachelor degree and master degree,while the need for secondary diploma hold ers have decreased.The need for advanced diploma holders has increased in the last 5 years and would decrease in the next 5 years,but they would still be the majority of employed nurses.The authors suggested that the staffing of nursing manpower,the work environments and career development of contract nurses should be improved,and the initial nursing education should be upgraded to meet the needs of hospitals.