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Objective:To investigate the demand and influencing factors of home care social support services for the elderly with dementia in urban areas, and provide a decision-making basis for improving home care social support services for the elderly with dementia.Methods:This was a cross-sectional study. From March 2021 to March 2022, 386 family caregivers of elderly people with dementia were randomly selected from tertiary hospitals in four central urban areas of Wuhan by stratified sampling method. A questionnaire was used to investigate the current situation and attributes of the demand for home care social support services for the elderly with dementia in urban areas. The importance of the demand for home care social support services for the elderly with dementia in urban areas was calculated by the Better-Worse coefficient method and sensitivity formula method. The optimal scale regression model was used to analyze the influencing factors and influencing forces of independent variables on service demand.Results:The score of social support service demand for home care was (88.6 ± 29.71) points. The Better coefficient of demand for all social support services was greater than the absolute value of the Worse coefficient. One requirement (pressure ulcer prevention and treatment guidance) was a one-dimensional attribute, and the remaining 29 items were charm attributes. The top 6 items in importance ranking were 2 items of informational support (pressure ulcer prevention and treatment guidance; telephone counselling guidance for family caregivers), 1 items of instrumental support (financial assistance for family caregivers) and 3 items of social companionship support(cultural recreation/physical activity activities, door-to-door accompaniment, accompany the elderly to social activities). Optimal scale regression model test: all four models of social support service demand were statistically significant ( F values were 2.75-4.23, all P <0.01). The gender, education level, number of children of the elderly with dementia, age,education level, self rated physical condition of family caregivers, the average monthly income of families, and the relationship between family caregivers and the elderly with dementia were the influencing factors of self-esteem support (all P<0.05). The educational level, marital status, type of dementia of the elderly with dementia, educational level, self rated physical condition of family caregivers, the average monthly income of the family, and the relationship between family caregivers and the elderly with dementia were the influencing factors of informational support (all P <0.05). The educational level and type of dementia of the elderly with dementia, the educational level, self rated physical condition of family caregivers, and the average monthly income of families were the influencing factors of social companionship support (all P <0.05). The type of dementia of the elderly with dementia, the self rated physical condition of family caregivers, the average monthly income of families, and the relationship between family caregivers and elderly relatives were the influencing factors of instrumental support (all P <0.05). Five times for caregiver human resources, 3 times for family economic resources and 3 times for the elderly with dementia, and 1 time for relatives resource factors were the top 3 times of independent variable influence force entered the ranking. Conclusions:The demand for social support services for home care of the elderly with dementia is low, with the characteristics of expectant tendency and centralized demand. The provision of home-based care social support services should give priority to meeting the needs of "pressure ulcer prevention and treatment guidance", and provide financial assistance, counseling and guidance, social companionship and other services as much as possible. Caregiver human resources are the key factors affecting home care social support services, family economic resources and the elderly with dementia are important factors, it is recommended to fully tap the potential of relatives resources and community resources.
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This article reviewed the concept of spirituality and spiritual needs of family caregivers of cancer patients, types of spiritual needs, assessment tools, priorities, and influencing factors, aiming to provide a reference for hospice teams to identify the spiritual needs of family caregivers of cancer patients and carry out spiritual care.
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Objective:To explore the intervention effect of acceptance and commitment therapy on the psychological flexibility, self-compassion, anxiety and depression of the primary caregivers of patients with primary liver cancer, so as to provide reference for the clinical care of the primary caregivers of cancer patients.Methods:This was a prospective study. A total of 80 primary caregivers of patients with primary liver cancer treated in Tianyou Hospital Affiliated to Wuhan University of Science and Technology from July to December 2021 were selected as the observation objects, and they were randomly divided into the control group and the intervention group according to the random drawing method, with 40 cases in each group. The control group was given routine nursing measures, while the intervention group was given acceptance and commitment therapy on the basis of routine nursing. The intervention effect was evaluated by the Acceptance and Action Questionnaire-2nd Edition (AAQ-Ⅱ), Self-Compassion Scale Short-Form (SCS-SF) and Hospital Anxiety and Depression Scale (HADS) before the intervention, on the day of discharge, and one month after discharge.Results:Finally, 71 primary caregivers completed the intervention and follow-up, 36 in the control group and 35 in the intervention group. Before the intervention, there was no statistically significant difference in the scores of AAQ-Ⅱ, SCS-SF, Anxiety subscale of HADS(HADS-A) and Depression subscale of HADS(HADS-D) between the two groups ( P>0.05). The AAQ-Ⅱscores of the intervention group on the day of discharge and one month after discharge were (19.63±2.59), (19.12 ± 2.20) points, which were significantly lower than those of the control group (23.14 ± 2.49), (22.56 ± 2.40) points. The differences were statistically significant ( t=5.83, 6.25, both P<0.01). The SCS-SF scores of the intervention group on the day of discharge and one month after discharge were (39.34 ± 2.68), (39.89 ± 2.81) points, which were significantly higher than those of the control group (36.69 ± 3.08), (37.72 ± 2.41) points, the differences were statistically significant ( t=-3.86, -3.49, both P<0.01). The HADS-A/HADS-D scores of the intervention group on the day of discharge and one month after discharge were (9.31 ± 1.95), (9.09 ± 1.60) points and (8.80 ± 2.15), (8.54 ± 1.75) points,which were significantly lower than those of the control group(11.42 ± 1.50), (11.03 ± 1.70) points and (10.11 ± 1.92), (10.03 ± 1.84) points, the differences were statistically significant( t values were 2.71-5.10, all P<0.01). The scores of AAQ-Ⅱ, SCS-SF, HADS-A and HADS-D of the two groups were analyzed by repeated measures analysis of variance, and there were significant differences in time effect, inter-group effect and interaction effect ( F vaules were 3.42-37.90, all P<0.05). Conclusions:Acceptance and commitment therapy can improve the self-compassion and psychological flexibility, reduce anxiety and depression of the primary caregivers of patients with primary liver cancer.
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Quiet time intervention is an effective strategy to improve the sleep quality of ICU patients.This paper reviews the concept and implementation of quiet time intervention, the evaluation index of improving ICU patients′ sleep quality, and the impact on ICU patients′ sleep quality, aiming to provide reference for clinical medical staff to provide better sleep intervention strategies for ICU patients.
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Objective:To compile the evaluation scale of the quality of education in the clinical practice base of full-time Master of Specialist Nursing (MNS) based on student participation and the SERVQUAL model, evaluate the quality of clinical practice base, and provide reference for the evaluation of clinical practice base.Methods:Based on the theory of student participation and the SERVQUAL model, the evaluation scale of the educational quality of clinical practice base of MNS was constructed. By facilitating sampling methods, 176 MNS students from 11 universities in 6 provinces were selected, and a questionnaire of self-compiled general information and a survey of the evaluation scale of education quality of MNS clinical practice base were distributed.Results:The evaluation scale of education quality of clinical practice base of MNS contained 28 entries in five dimensions: tangibility, reliability, responsiveness, guarantee and empathy. The total Cronbach alpha coefficient of the scale was from 0.983 to 0.987, item level content validity index was from 0.92 to 0.96, scale level content validity index was 1 and the correlated coefficient of the structural validity Pearson was from 0.785 to 0.966. To explore factor analysis, the dimension value of the scale KMO value was greater than 0.7, and the expected part and the actual feel part KMO value were 0.956 and 0.963 respectively. The number of common factors was 2 and 3 respectively, and the cumulative interpretation variation was 79.1% and 78.4% respectively.The actual perception of the quality of education in the clinical practice base of MNS was lower than expected, and the differences in entries were statistically significant ( P<0.05). The analysis of multiple linear regression showed that the teaching time and level of clinical practice base undertaken by clinical practice base were the main factors affecting the expectation and actual feeling value ( P<0.05). The importance performance analysis analysis found that 11 entries were in the advantage zone, 3 entries were in the maintenance area, 12 entries were in the minor improvement area and 2 entries were in the priority improvement area. Conclusions:The evaluation scale of the quality of education of the clinical practice base of MNS have good confidence and validity. The actual degree of educational quality of the clinical practice base of MNS is lower than expected. The teaching time and level of clinical practice base undertaken by clinical practice base are the main factors that affect expectation and actual feeling. It is urgent to improve the theoretical knowledge and practice level of tutors and deal with occupational exposure experienced by MNS students.
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Objective@#To explore the comprehensive intervention mode of compliance with analgesics for home-based patients with moderate or severe cancer pain and to improve the medication compliance of home-based patients with cancer pain.@*Methods@#A self-designed questionnaire was designed to investigate the influencing factors of taking analgesics for home-based patients with moderate or severe cancer pain, 143 home-based patients with moderate to severe cancer pain were conveniently selected from Hospice Unit of Zhongnan Hospital of Wuhan University, from February 2016 to December 2017. To investigate the subjective, objective and psychological factors affecting patients' compliance with analgesics, comprehensive interventions such as health education, behavioral intervention, cognitive intervention and psychological counseling were carried out. Before and after the intervention, Morisky′s self-report questionnaire on medication compliance, pain digital grading (NRS score), and pain relief degree were assessed. Using self control design method and comparing the compliance of patients taking analgesics, number of complete compliance and non-compliance in patients taking analgesics and NRS score and pain relief before and after 8 weeks of intervention. Pain degree, pain relief degree and pain relief efficiency between patients with complete compliance and non-compliance after comprehensive intervention were evaluated.@*Results@#The main factors affecting patients' medication compliance with analgesics were fear of morphine addiction(16.37%, 37/226), single use of drugs and insufficient dosage (15.93%, 36/226), and fear of adverse drug reactions(13.72%, 31/226). The scores of NRS decrease in patients with different influencing factors were compared, with statistical difference (F=5.367, P=0.006). There were significant differences in the number and compliance of patients with complete compliance and non-compliance before and after 8-week-comprehensive intervention (χ2=25.583, P=0.000; t=-7.387, P=0.000). There were significant differences in pain degree, pain relief degree and pain relief efficiency between patients with complete compliance and non-compliance after 8-week-comprehensive intervention (χ2=76.572, 62.998, all P=0.000).@*Conclusions@#Comprehensive intervention on subjective, objective and psychological factors affecting the medication compliance of home-based patients with moderate or severe cancer pain can improve the medication compliance of patients to take analgesics and alleviate pain.
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Objective To explore the comprehensive intervention mode of compliance with analgesics for home-based patients with moderate or severe cancer pain and to improve the medication compliance of home-based patients with cancer pain. Methods A self-designed questionnaire was designed to investigate the influencing factors of taking analgesics for home-based patients with moderate or severe cancer pain, 143 home-based patients with moderate to severe cancer pain were conveniently selected from Hospice Unit of Zhongnan Hospital of Wuhan University, from February 2016 to December2017. To investigate the subjective, objective and psychological factors affecting patients' compliance with analgesics, comprehensive interventions such as health education, behavioral intervention, cognitive intervention and psychological counseling were carried out. Before and after the intervention, Morisky′s self-report questionnaire on medication compliance, pain digital grading (NRS score), and pain relief degree were assessed. Using self control design method and comparing the compliance of patients taking analgesics, number of complete compliance and non-compliance in patients taking analgesics and NRS score and pain relief before and after 8 weeks of intervention. Pain degree, pain relief degree and pain relief efficiency between patients with complete compliance and non-compliance after comprehensive intervention were evaluated. Results The main factors affecting patients' medication compliance with analgesics were fear of morphine addiction(16.37％, 37/226), single use of drugs and insufficient dosage (15.93％, 36/226), and fear of adverse drug reactions(13.72％, 31/226). The scores of NRS decrease in patients with different influencing factors were compared, with statistical difference (F=5.367, P=0.006). There were significant differences in the number and compliance of patients with complete compliance and non-compliance before and after 8-week-comprehensive intervention (χ2=25.583, P=0.000; t =-7.387, P=0.000). There were significant differences in pain degree, pain relief degree and pain relief efficiency between patients with complete compliance and non-compliance after 8-week-comprehensive intervention (χ2=76.572, 62.998, all P=0.000). Conclusions Comprehensive intervention on subjective, objective and psychological factors affecting the medication compliance of home-based patients with moderate or severe cancer pain can improve the medication compliance of patients to take analgesics and alleviate pain.
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Objective To explore the effect of nurse-social worker-college student volunteer team guide on care-giving competence of the primary caregivers for the long-term bedridden elderly. Methods The research was conveniently focused on a total of 60 long-term bedridden elderly and 30 primary caregivers, pension caregiver in welfare home from March to May 2015. The nurse-social worker-college student volunteer team guide for the primary caregivers included distributing health manual, training skill, psychological support, respite care and so on. The intervention lasted for 3 months, twice a month, 150 minutes each time. This was a self comparison study. The care competence for the primary caregivers and self-care ability of daily activities for the long-term bedridden elderly were conducted before and after intervention. Results Before intervention, the total score of care-giving competence was 59.07 ± 13.42. After intervention, the total score was 66.64 ± 14.16. Before intervention, the scores of caring knowledge, operation technique, behavior and attitudes, decision-making and self-efficacy were as follows:18.48±3.46, 17.95±3.98, 12.16±3.08, 7.98±2.56. Whereas, after intervention, the scores were as follows:20.32±3.58, 20.48±2.74, 14.29±3.03, 9.65±2.07. Each dimension score after intervention was significantly higher than that before intervention (t=-2.87--2.02, P<0.01). For bathing, dressing, indoor transferring and eating in self-care ability of daily activities, the numbers of people in 60 long-term bedridden elderly were 8, 13, 21, 18 before intervention and 17, 24, 43, 29 after intervention. The self-care ability of daily activities of the primary caregivers such as bathing, dressing, indoor transferring and eating after intervention were significantly higher than that before intervention (χ2=4.093-4.857, P<0.05). Conclusions Nurse-social worker-college student volunteer team guide can enhance the care-giving competence of the primary caregivers as well as improve the self-care ability of daily activities for the long-term bedridden elderly.
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Objective To compare the effect of nursing students acting as social volunteers to participate in gerontological nursing practice teaching with traditional practice teaching mode, and promote the reform of teaching mode in nursing practice. Methods Students of two classes from department of nursing, medical college of Wuhan University of Science and Technology were selected as research objects. In class one nursing students acted as social volunteers to participate in gerontological nursing practice teaching (the experimental group), In class two nursing students took practice in geriatric wards according to traditional practice mode(the control group). The practice effect was compared between two groups. Results The average final grade of the experimental group was 86.50, and 78.51 in the control group. Ridit analysis revealed that, setting class one as the experimental group, R=0.796 8,95% confidence interval was 0.715 1-0.878 4, in the control group, R =0.500 0. The investigation showed that the experimental group and the control group were different in moral elevation aspect, teaching level, capability improving aspect and employment promotion aspect, the difference was significant (P<0.01). Conclusions The mode of nursing students acting as social volunteers to participate in gerontological nursing practice teaching has advantage over traditional practice teaching, and it can gain satisfying teaching effect.
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The article describes the current situation of training mode of community nurses in community health service institutions in Hubei province from several aspects,including training object,training target,training base,teaching staff,training organization and government,training method and time,training curriculum,training effect evaluation and certification.The article suggests a multitude of factors influencing the training quality,such as formal training,dominant job training,and monotonous community training content and less training time.Overall,the government should be done something to increase government support and funding and accelerate the community nursing services and community nursing education.It is also essential to establish community nursing personnel training mechanism,improve and perfect the community health personnel training system,increase the construction of community nursing practice base and facilities and strengthen clinical practice skills.
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From the standpoint of training mode,the paper makes an effort to analyze the present situation on Sino-Foreign cooperation in nnning schools in mode of nursing personnel training in Hubei Province,find out the existing problems and put forward the corresponding proposals in order to ensure sustainable development of the Sino-Foreign cooperation in running schools in mode of nursing personnel training.
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Objective To understand the status quo of related knowledge,attitude and practice of religious belief among undergraduate nursing students and provide reference for education on religious belief.Methods A self-filled questionnaire on religious belief was used randomly among undergraduate nursing students in 4 medical universities in Wuhan.Results Most nursing students were inferior to the cognitive degree of related knowledge on belief religious,which was greatly related to the grade,nationality,parents’ religious belief and family residence factors.The notion of nursing students towards religious belief policy was nebulous.Most students could cognize the relationship between religion and science correctly.The university had minor effect on students’ religion view.Students contacted religious belief with various channels and the role of the network could not be underestimated.Undergraduate nursing students understood and pardoned their religious belief and other students’.Their religious belief was not the mainstream of current belief.The Buddhist belief of religion was in the first place.The majority of students went to religious activities not for the belief.Conclusions We should face the reality,examine rationally at this society and strengthen the social,school,family and individual guidance on religion together with related education coustruction.