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Objective@#To explore the fitting and its influencing factors of ICU nurses.@*Methods@#There were 268 nurses recruited from the First Affiliated Hospital of Xi′an Jiaotong University, the Ninth Hospital of Xi′an, Shaanxi Provincial People′s Hospital by convenience sampling between April and June 2018. The Fitting Scale, Social Undermining Scale, Perceived Organizational Support Scale and Supportive Communication Scale were used in the investigation.@*Results@#The score of person-organization fit was (32.20±5.17). The score of person-job fit was (55.14±8.24), with the lowest score of supply-value fit subscale (2.58±0.48). The score of perceived organizational support, social undermining and supportive communication were (45.36±9.64), (46.27±7.48) and (68.47±11.25) respectively. Perceived organizational support, social undermining, contract nurses, and educational level could influence person- organization fit, which could explain 59.3% of the total variation. Working time, supportive communication and perceived organizational support could influence person- job fit, which could explain 47.6% of the total variation.@*Conclusions@#Nursing managers should improve the core value system of human resources management and organizational culture construction, enhance organizational support, construct humanities environment and coping strategy of undermining, provide the relevant training of interpersonal communication, and increase their organizational and job fitting.
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Objective@#To investigate the prognostic value of arterial blood lactate for patients with cardiogenic shock receiving extracorporeal membrane oxygenation(ECMO).@*Methods@#A retrospective analysis was conducted. Twenty-three patients diagnosed with cardiogenic shock receiving veno-arterial(V-A) ECMO admitted to department of Emergency Intensive Care Unit(EICU) of Beijing Luhe Hospital Affiliated to Capital Medical University from January 2017 to December 2018 were enrolled.@*Results@#There were 10 cases in the survival group and 13 cases in the death group. Compared with survival group, APACHE-Ⅱ score was higher, CRRT applied higher percentage, PH and oxygenation index was worse in the death group(P<0.05). The lactate of the death group was significantly higher than that of the survival group at initial time at EICU, 1 h before ECMO and 0h before ECMO(P<0.05). During the ECMO operation, lactate levels in the death group at 8 h and 12 h were significantly higher than those in the survival group(P<0.05). There was no statistically significant difference in lactate clearance rate between the two groups before and after ECMO operation in each observation period(P>0.05). On the 2nd day of ECMO operation, CRRT usage time was shorter and daily liquid balance was more negative in the survival group(P<0.05). APACHE-Ⅱscore, initial lactate at EICU, lactate at ECMO 8 h and lactate at ECMO 12 h had predictive value for 30-day death of patients. The area under ROC curve(AUC) of initial lactate at EICU was 0.845, and 95% confidence interval(95%CI)=0.653-1.000. The AUC of ECMO 8 h lactate was 0.836, 95%CI: 0.634-1.000. The AUC of ECMO 12 h lactate was 0.873, 95%CI: 0.697-1.000. The AUC of APACHE-Ⅱscore was 0.891, 95%CI: 0.717-1.000. The sensitivity and specificity of prognosis prediction were 72.7% and 100% when lactate was more than 7.3 mmol/L at the time of admission into EICU as the optimal critical value.@*Conclusion@#Arterial blood lactate could be used as an important marker for evaluating the prognosis of cardiogenic shock patients on ECMO. The value of lactate clearance rate may be affected by combined CRRT.
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Objective To investigate the prognostic value of arterial blood lactate for patients with cardiogenic shock re-ceiving extracorporeal membrane oxygenation( ECMO) . Methods A retrospective analysis was conducted. Twenty-three pa-tients diagnosed with cardiogenic shock receiving veno-arterial( V-A) ECMO admitted to department of Emergency Intensive Care Unit( EICU) of Beijing Luhe Hospital Affiliated to Capital Medical University from January 2017 to December 2018 were enrolled. Results There were 10 cases in the survival group and 13 cases in the death group. Compared with survival group, APACHE-Ⅱ score was higher, CRRT applied higher percentage, PH and oxygenation index was worse in the death group (P<0. 05). The lactate of the death group was significantly higher than that of the survival group at initial time at EICU, 1 h before ECMO and 0h before ECMO(P<0. 05). During the ECMO operation, lactate levels in the death group at 8 h and 12 h were significantly higher than those in the survival group(P<0. 05). There was no statistically significant difference in lactate clearance rate between the two groups before and after ECMO operation in each observation period(P>0. 05). On the 2nd day of ECMO operation, CRRT usage time was shorter and daily liquid balance was more negative in the survival group(P<0. 05). APACHE-Ⅱscore, initial lactate at EICU, lactate at ECMO 8 h and lactate at ECMO 12 h had predictive value for 30-day death of patients. The area under ROC curve( AUC) of initial lactate at EICU was 0. 845, and 95％ confidence interval (95％CI) =0. 653-1. 000. The AUC of ECMO 8 h lactate was 0. 836, 95％CI:0. 634-1. 000. The AUC of ECMO 12 h lactate was 0. 873, 95％CI:0. 697-1. 000. The AUC of APACHE-Ⅱscore was 0. 891, 95％CI:0. 717-1. 000. The sensi-tivity and specificity of prognosis prediction were 72. 7％ and 100％ when lactate was more than 7. 3 mmol/L at the time of ad-mission into EICU as the optimal critical value. Conclusion Arterial blood lactate could be used as an important marker for e-valuating the prognosis of cardiogenic shock patients on ECMO. The value of lactate clearance rate may be affected by combined CRRT.
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Objective To explore the fitting and its influencing factors of ICU nurses. Methods There were 268 nurses recruited from the First Affiliated Hospital of Xi′an Jiaotong University, the Ninth Hospital of Xi′an, Shaanxi Provincial People′s Hospital by convenience sampling between April and June 2018. The Fitting Scale, Social Undermining Scale, Perceived Organizational Support Scale and Supportive Communication Scale were used in the investigation. Results The score of person-organization fit was (32.20±5.17). The score of person-job fit was (55.14±8.24), with the lowest score of supply-value fit subscale (2.58±0.48). The score of perceived organizational support, social undermining and supportive communication were (45.36 ± 9.64), (46.27 ± 7.48) and (68.47 ± 11.25) respectively. Perceived organizational support, social undermining, contract nurses, and educational level could influence person- organization fit, which could explain 59.3% of the total variation. Working time, supportive communication and perceived organizational support could influence person- job fit, which could explain 47.6% of the total variation. Conclusions Nursing managers should improve the core value system of human resources management and organizational culture construction, enhance organizational support, construct humanities environment and coping strategy of undermining, provide the relevant training of interpersonal communication, and increase their organizational and job fitting.
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Objective To explore the relocation stress in families of patients transferred from ICU, and the influence of social comparison orientation and family function on it. Methods There were 168 participants recruited from Critical Medical Department of the First Affiliated Hospital of Xi′an Jiaotong University by convenience sampling method between June 2017 and February 2018. The ICU patients′Family Relocation Stress Scale, Chinese version of the Iowa-Netherland Social Comparison Orientation Measure and Family Adaptation and Cohesion Evaluation Scale Ⅱ were used. Results The score of relocation stress and social comparison orientation were 58.47±7.66 and 37.83±9.11. The score of family real cohesion was 65.85 ± 7.83, which was higher than norms (t=-2.067, P<0.05). The score of dissatisfaction of adaptation was 9.22±4.41, which was higher than norms (t=-3.093, P<0.05). The results of regression analysis showed that the time of patient staying in ICU, education level, religion, social comparison orientation, family real cohesion and dissatisfaction of adaptation could influence relocation stress. Conclusion Health professionals should pay attention to the relocation stress in families, provide emotional support and effective information support, guide family members to correctly understand the patients′ condition and prognosis, respect their religious beliefs, give full play to their family functions, help them adapt to the role changes quickly and reduce the level of relocation stress.