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Objective:To evaluate nutritional status in elderly patients with chronic heart failure and to investigate its association with unplanned readmission.Methods:From July 2020 to August 2021, 220 elderly patients hospitalized for chronic heart failure in Qilu Hospital of Shandong University were enrolled in a prospective cohort study. Basic information, laboratory tests and other data of the patients were collected. Nutritional status of the patients was assessed by geriatric nutritional risk index and the patients were divided into groups. Data were analyzed by R4.1.1 and SPSS26.0, survival curves were drawn by Kaplan-Meier method, and the relationship between nutritional status and unplanned readmission in elderly patients with chronic heart failure was analyzed by univariate and multivariate Cox regression.Results:Among 220 elderly patients with chronic heart failure, 59.5%(131/220) were in normal nutrition. There were 40.5%(89/220) in the malnutrition, including 26.8%(59/220) in the mild malnutrition and 13.6%(30/220) in the moderate and severe malnutrition. During the follow-up period of 3 months, 25.9% (57/220) had unplanned readmission. Kaplan-Meier survival curve showed that the incidence of unplanned readmissions was higher in the moderate and severe malnutrition than in the normal and mild malnutrition, and the difference among them was statistically significant ( P<0.05). Multivariate Cox regression analysis showed that moderate and severe malnutrition was an independent predictor of unplanned readmission in elderly patients with chronic heart failure ( HR=2.064, 95% CI 1.029-4.138, P<0.05). Conclusions:The prevalence of malnutrition in elderly patients with chronic heart failure is high. Moderate and severe malnutrition is an independent predictor of unplanned readmission in elderly patients with chronic heart failure. The geriatric nutritional risk index is an effective screening tool and can provide a reference for clinical evaluation of nutritional risk in patients.
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Objective:To evaluate the status quo of humanistic care of clinical nursing staff, and analyze its influencing factors to provide theoretical basis for improving the humanistic care ability of clinical nursing.Methods:The self-compiled questionnaire on the knowledge, attitude and practice of humanistic care of clinical nursing staff was adopted in June to July 2019 to select 2 136 nurses from five first-class tertiary general hospitals in Shandong province by random sampling method for the status survey.Results:The total score of humanistic care knowledge and practice of clinical nurses was 259.54±33.55, and the standard score was 82.39±10.65. Single factor analysis showed that the total score of humanistic care knowledge, credit and practice was statistically significant for clinical nurses with different gender, age, fertility status, relationship with parents, employment reasons, initial education background, department, working years, professional title, position, employment mode and night shift frequency ( t value was -2.604, F values were 2.667-23.692, all P < 0.01). Pearson correlation showed that in the pairwise correlation analysis of knowledge, belief/attitude and behavior dimension, there was positive correlation and the correlation coefficient ( r values were 0.638, 0.431, 0.560, all P < 0.01). Multiple stepwise regression analysis showed that: the influencing factors of knowledge, attitude and practice total score of clinical nursing staff on humanistic care were the relationship between the parents, employment way, night shift frequency, fertility status, and the employment reason, the initial degree, department, position ( β values were -0.132-0.126, all P < 0.05). Conclusions:The current situation of humanistic care knowledge and practice of clinical nursing staff is in the middle level. Relationship with parents, position, night shift frequency, fertility status, employment reasons, initial education background, department, and employment mode are the factors that affect the current situation of humanistic care, knowledge, attitude and practice of clinical nurses. Therefore, medical institutions should adopt targeted and focused training methods and intervention measures to improve the level of nursing staff′s knowledge, faith and practice from the aspects of different influencing factors of clinical nursing staff′s humanistic care.
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Objective@#To investigate an occupational hazardous gas poisoning incident caused by gas leakage in the process of hazardous waste treatment.@*Methods@#An investigation was conducted on a case of occupational acute hazardous gas poisoning caused by waste treatment gas leakage in Shandong province in December 2017. Meanwhile, the clinical data of 5 cases of poisoning patients were analyzed, and the accident related poison test report and other relevant data were analyzed.@*Results@#The incident was caused by the toxic waste did not do labeling work, the workers' protection measures were not in place, the illegal operation and the blind rescue, resulting in a total of 5 people died on the spot, 12 people were hospitalized with poisoning. Among them, 5 patients admitted to our hospital showed varying degrees of damage to the nervous system and respiratory system. After active treatment, they all got better and were discharged.@*Conclusion@#The poisoning is mainly caused by hydrogen sulfide dichloromethane hydrogen cyanide gas leakage serious production liability accident, clinical main performance for the nervous system circulatory system respiratory system and other system damage.
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This paper reviews the research progress of nurses' resilience from the definition and classification, evaluation tools, influencing factors and intervention status. In addition, the paper also explores the current situation and development trend of nurses' resilience research to point out that further research on nurses' resilience in China can deepen the research on factors of nurses' resilience.We should strengthen the intervention of nurses' resilience, develop localized measuring tools of nurses' team resilience, and strengthen the direction of qualitative research and longitudinal research.
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Objective To evaluate the effect of weight managementfor the quality of life of patients with chronic heart failure. Methods The randomized controlled trials (RCT) on the effect of weight management for the quality of life of patients with chronic heart failure interventions were collected using the databases of China National Knowledge Infrastructure (CNKI), The Wan fang database, CBM, Chinese Science and Technology Periodical Databases (VIP), PubMed, Cochrane Library, Web of Science, Embase, time for the construction of the database to December 2017. Quality evaluation and data extraction of the included literature. Data were analyzed with Revman5.3 software. Results Five RCTs were included in the study, with a total of 739 people. The results of Meta-analysis showed that the total score of QOL [MD=-10.38(95％CI-19.83--0.93), Z=2.15,P=0.03], QOL emotional domain score [MD=-2.45(95％CI-4.35--0.55), Z=2.53, P=0.01] and body domain score [MD=-6.61(95％CI-12.81--0.41), Z=2.09, P=0.04] of patients with chronic heart failure in weight management group were lower and statistically significant. Conclusions Weight management improve the quality of life in patients with chronic heart failure, weight management improve the quality of life in patients with chronic heart failure and the physical and emotional areas. However, it is necessary to carry out high-quality, large sample randomized controlled trials to confirm the above results.
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This paper reviews the research progress of nurses' resilience from the definition and classification, evaluation tools, influencing factors and intervention status. In addition, the paper also explores the current situation and development trend of nurses'resilience research to point out that further research on nurses'resilience in China can deepen the research on factors of nurses'resilience.We should strengthen the intervention of nurses' resilience, develop localized measuring tools of nurses' team resilience, and strengthen the direction of qualitative research and longitudinal research.
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Objective@#To investigate a poisonous mushroom poisoning incident and analyze its clinical data.@*Methods@#Investigate a poisonous mushroom poisoning incident in a place in Shandong in July 2018, at the same time, the clinical data of 2 cases of mushroom poisoning were analyzed and summarized.@*Results@#The incident was caused by a poisoning incident caused by residents eating poisonous mushrooms. The poisonous mushroom in this incident was identified as a scaled white goose cream. Two patients with poisoning developed gastrointestinal symptoms such as nausea and vomiting, abdominal pain and diarrhea, and liver damage occurred later. After active rescue and treatment, one patient was discharged from hospital, and the other patient developed acute pulmonary embolism during the treatment. He was discharged after interventional thrombolysis and follow-up treatment.@*Conclusion@#After investigation, the incident was caused by the ingestion of poisonous mushrooms mainly based on the scalloped white goose cream. After active treatment, they were cured and discharged.
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Objective To analyze the relationship among perceived stress, resilience and sleep quality in patients with coronary heart disease, and to examine the mediating effect of resilience between perceived stress and sleep quality. Methods Totally 231 patients with coronaryheartdisease were selected. The Pittsburgh Sleep Quality Index (PSQI), Perceived Stress Scale (PSS), and 10-item Connor-Davidson Resilience Scale (CD-RISC-10) were used to assess the sleep quality, perceived stress and resilience respectively. Results The average scores of PSQI were (7.2 ± 2.8) points, and 71.4％ (165/231) of the participants had sleep problems (PSQI>5). CD-RISC-10 scores were negatively correlated with PSQI scores and PSS scores (r=-0.62,-0.43, P<0.01), and PSS scores were positively correlated with PSQI scores (r=0.33, P<0.01). Furthermore, Bootstrap-generated 95％CI was (0.130-0.319, P<0.01) and did not include 0, which indicated that resilience significantly mediated the relationship between perceived stress and sleep quality. The mediating effect size of resilience was 56.1％. Conclusion It suggests that patients with coronary heart disease have poor sleep quality. Perceived stress and resilience could affect sleep quality, and resilience could mediate the relationship between perceived stress and sleep quality.
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Objective Using Omaha system to construct continuing nursing assessment system in patients with cancer at the intermission of chemotherapy.Methods Based on the Omaha system as the theoretical basis,combined with literature review and semi structural interview,a preliminary construction of sensitive index system for continuous nursing of cancer patients was constructed,and the index system was deleted and supplemented through Delphi 2 rounds of expert consultation.Results The expert's positive coefficients of 2 rounds were 90.91%(20/22)and 16/18 respectively,authority coefficient were 0.839 and 0.853,generally coordination coefficients were 0.213 and 0.606 respectively.The continuing nursing assessment system in patients with cancer at intermission of chemotherapy was constructed containing 4 one-level indicators,24 secondary indicators and 71 third indicators.Conclusions The continuing nursing assessment system in patients with cancer at intermission of chemotherapy is analyzed by Delphi could comprehensively reflect characteristic of cancer patients'continue nursing demand.
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Objective To explore a reasonable transitional care quality management model, in order to standardize the management system of transitional care. Methods Using "three-dimensionalquality structure" mode as the theoretical framework, after reviewed relevant literatures, we established the rudiment of quality evaluation index system.Twenty-two experts were enrolled,and expert consultation was conducted using Delphimethod. The experts were evaluated by authority, positivity and degree of opinion coordination. Results The experts′authority coefficient was 0.846;the coefficient of determination was 0.891;the degree of familiarity was 0.80.The positive coefficients of the two rounds of consultation were 0.958,0.957. The evaluation system for transitional care consisted of 3 level- 1 indicators,12 level-2 indicators,and 64 level-3 indicators.The Kendall coefficients of concordance of the three level Indicators were 0.519, 0.525, and 0.432(P<0.05 for all). Conclusion The quality evaluation index system with With high reliability, providing standard reference for the work of quality management and nursing quality improvement.
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Objective To investigate the job stressors and burnout of senior nurses, and explore the possible strategies for alleviating stress and reduction of demission rate of senior nurses. Methods Two hundred and thirty head nurses and senior nurses were included in this study. Nurse Job Stressors Inventory (NJSI) and Maslach Burnout Inventory (MBI) were applied to evaluate the burnout and work-related stress of nurses with the combination of convenience sampling and cluster sampling. Results The NJSI scores of senior nurses and head nurses were (2.62 ± 0.56) points, (2.45 ± 0.47) points, the two scores were significantly different (t=-2.465,P<0.05); the scores of three dimensions of MBI in senior nurses were (30.01±11.86) points, (8.01±5.74) points, (35.35±9.57) points, while the scores in head nurses were (21.65±10.39) points, (5.14±3.37) points, (38.81±8.45) points. Statistically significant difference was seen between the two groups (t=-5.261,-4.705, 2.691,P<0.05). There was a higher positive correlation between job stressors and burnout of senior nurses (r=0.521) than head nurses (r=0.432). Conclusions The level of job burnout is higher in senior nurses than head nurses, attributing to the higher controllability of head nurses. It is suggested to reduce the job burnout of senior nurses and to keep senior nurses in the profession fields, based on the theory of magnetic hospital.
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Cancer patients need not only advanced therapeutic method but also spiritual counseling. Therefore clinical nurses need to analyze the negative psychological status and discuss the effect of psychological support and intervention on the improvement of patients' psychological burden, thus to establish effective intervention plans for patients. A total of 30 patients with cancer were selected for study. They were divided into blank group, intervention group and control group. Patients in three groups were orally administrated amitriptyline if necessary. Patients in blank group directly filled in the form of self-perceived burden and self-made questionnaire of general material of patients. Different groups were interfered with psychological support in different patterns for 3 months. The differences of SPB experience, MCMQ and QLQ-CCC in two groups were compared respectively. It was found that SPB score of cancer patients in blank group was in moderate level of burden, while SPB score in intervention group and control group were relatively lower, and score of MCMQ and QLO-CCC in intervention group were higher than that in control group. It was concluded that the experience of self-perceived burden existed in most cancer chemotherapy patients. Psychological support and intervention can obviously reduce the SPB experience of cancer patients and improve patients' living quality
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Objective To investigate the feasibility of Six Dimensions Scale (6-D scale) of Nursing Performance used for evaluating the effect of standardized hospital-department training on new graduate nurses.Methods 6-D Scale of Nursing Performance was conducted to evaluate the nursing ability of 216 new graduate nurses (2013) of our hospital pre and post the three-month intervention,including the self-appraisal and appraisals by head nurses.Results The nursing ability was improved significantly after the training.The total score of self-appraisal 6-D scale were significantly higher than that before the training (142.34±19.92 vs 135.81±18.30),in which the subscales scores within the dimensions of leader-ship,critical care,teaching/collaboration,planning/evaluation,interpersonal relations/communication were increased significantly,while the increase of professional development was not significant.Six-D Scale and six subscales scores based on self-appraisal were higher than that based on the head nurses' appraisals.Conclusions The application of 6-D scale is scientific to evaluate the effect of standardized nurse training.We had demonstrated that standardized hospital-department training is of great benefit for new graduates to improve the nursing ability and adapt to the clinical circumstances.
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Objective To evaluate the effect of health education on lung function,quality of life,awareness degree and treatment compliance in chronic obstructive pulmonary disease (COPD) patients during stationary phase.Methods 106 COPD patients during stationary phase were randomly divided into 4 groups,25 patients in group Ⅰ,26 patients in group Ⅱ,20 patients in group Ⅲ,35 patients in group Ⅳ.Group Ⅰ did not accepted the health education,and group Ⅱ,Ⅲ,Ⅳ accepted two,four and eight (or＞eight) weeks health education in file.The lung function,quality of life,awareness degree and inerratic treatment rate were compared before and 6 months after health education by questionnaire and follow-up survey.Results Health education could be successful in delaying the decline of FEV1,FVC and FEV1/FVC and was effective in decreasing the SGRQ score among the COPD patients during stationary phase.The results showed that group Ⅱ,Ⅲ,Ⅳ were superior to group Ⅰ,while group Ⅲ,Ⅳ were superior to group Ⅰ,Ⅱ.Health education could remarkably increase awareness degree and inerratic treatment in COPD patients during stationary phase,and the effect on inerratic treatment was connected with the health education number of times.There were distinct different results among 4 groups.Conclusions Health education could remarkably increase awareness and inerratic treatment rate,and have positive effect to delay lung function decline and to promote quality of life in COPD patients during stationary phase.
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Objective To observe levosimendan-induced hemodynamic improvement of chronic decompensated heart failure patients and adverse effects,and sum up the nursing experience of Levosimendan.Methods Sixty-three patients with decompensated heart failure were treated with Levosimendan,based on optimized conventional treatment for heart failure.Aminoterminal pro-brain natriuretic peptide (NT-proBNP) and left ventricle ejective fraction (LVEF) were measured at baseline and one week after Levosimendan administration.In addition,we summarized the clinical observation,adverse effects and nursing experiences of treatment with Levosimendan in decompensated heart failure patients.Results Levosimendan increased 24-hour urine output in patients at the first day after treatment.This effect of levosimendan persisted for 7 days at least.We observed an improvement in LVEF and a reduction of NT-pro-BNP at 7 days after the initiation of levosimendan treatment.Clinical efficiency of levosimendan in patients was 84.1％ in this study.Twenty two patients(34.9％) experienced different adverse events.Conclusions Levosimendan therapy can improve cardiac function and reduce BNP in patients with decompensated heart failure.The rate of adverse effects of Levosimendan is high.It is important to enhance therapy effect by careful nursing and observing variety state during treatment with Levosimendan.These data will be useful for the nursing care of Levosimendan in clinical practice.