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Objective:To explore the reasons for delayed medical treatment in diabetic foot patients using the health ecology model as a framework.Methods:From November of 2021 to March of 2022, descriptive phenomenological research methods was used in 20 patients with diabetic foot who delayed medical treatment were interviewed face-to-face semi-structured in depth, and the data analysis was carried out using the seven-step method of Colaizzi phenomenology to refine the theme.Results:According to the five levels of the health ecology model, the reasons for delayed medical treatment were summarized into 11 themes, and the reasons for the personal trait layer included foot ulcers are not detected promptly, and the perceptual decline of advanced patients. Behavioral characteristics included lack of knowledge of diabetic foot, negative medical psychology. Reasons for the interpersonal network included insufficient family support and lack of social support; reasons for living and working conditions included high economic pressure, low electronic health literacy, and inconvenient medical treatment; the reasons for the policy environment included uneven medical insurance reimbursement ratios and limited medical conditions.Conclusions:The reason for the delay in seeking medical treatment for diabetic foot patients is multi-layered and systematic, and medical staff need to improve the self-management ability of diabetic patients′ feet from the individual level, and also need to guide patients from the system level on how to obtain the best medical resources.
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Objective@#To evaluate the nursing workload in surgical departments by decision tree method.@*Methods@#The indexes of nursing workload of 23 surgical departments were analyzed with decision tree method from February 20 to March 26 in 2017.@*Results@#According to decision tree analysis, the number of admitted patients was high-priority variable (F=39.128, P=0.000), and the nursing workload was divided into four grades by number of admitted patients ≤ 1, 1<number of admitted patients ≤ 4, 4 < number of admitted patients ≤ 7, number of admitted patients >7, respectively. The suboptimal variables were number of operations (F=7.578, P=0.046) and number of electrocardiogram monitors used (F=28.306, P=0.000), the nursing workload was further divided into six grades by number of operations ≤ 5, number of operations>5 and number of electrocardiogram monitors use ≤ 5, number of electrocardiogram monitors use > 5, respectively.@*Conclusions@#The number of admitted patients, electrocardiogram monitors used and operative patients were significant indexes of nursing workload in surgical departments, which helps the nurse managers evaluate the nurse performance and optimize human resource allocation based on decision tree analysis and clinical practice.
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Objective To evaluate the nursing workload in surgical departments by decision tree method. Methods The indexes of nursing workload of 23 surgical departments were analyzed with decision tree method from February 20 to March 26 in 2017. Results According to decision tree analysis,the number of admitted patients was high-priority variable (F=39.128, P=0.000), and the nursing workload was divided into four grades by number of admitted patients ≤ 1, 1<number of admitted patients ≤ 4, 4 < number of admitted patients ≤ 7, number of admitted patients >7, respectively. The suboptimal variables were number of operations (F=7.578, P=0.046) and number of electrocardiogram monitors used (F=28.306, P=0.000), the nursing workload was further divided into six grades by number of operations ≤ 5,number of operations>5 and number of electrocardiogram monitors use ≤ 5,number of electrocardiogram monitors use > 5, respectively. Conclusions The number of admitted patients, electrocardiogram monitors used and operative patients were significant indexes of nursing workload in surgical departments, which helps the nurse managers evaluate the nurse performance and optimize human resource allocation based on decision tree analysis and clinical practice.
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Objective To construct a scientific and feasible evaluation indicator system of health education effect of our country′s hospitalized patients with diabetes. Methods On the basis of literature review and semi-structured interview combined with group discussion, alternative index system were determined,and then the Delphi method were used for two round consultation with 30 diabetes experts to finally determine indicator evaluation system. Results Positive coefficient of the two rounds consultation were 86.7% (26/30) and 100.0% (26/26) respectively, experts′ authority coefficient was 0.889,and the Kendall W coefficients of concordance were 0.447,0.369 and 0.302 respectively (P<0.01). The evaluation indicator system of health education effect was consisted of 6 fisrt-level indicators, 24 second-level indicators and 55 third-level indicators. Conclusions The evaluation indicator system of health education effect is reliable and scientific, which can provide objective and quantitative standards for health education effect of hospitalized patients with diabetes in our country.
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ObjectiveTo investigate the prevalence of preoperative malnutrition and nutrition support among gastrointestinal cancer patients.MethodsA retrospective study was conducted based on the nutritional status and nutrition support of 336 gastrointestinal cancer patients who received elective radical surgery in Peking Union Medical College Hospital from April to December 2009.ResultsMalnutrition was found in 34.6％ gastric cancer patients,23.8 ％ colorectal cancer patients,and 23 ％ esophageal and cardiac cancer patients.The patients with worse nutritional status were given longer duration of nutrition support and higher energy intake.Conclusion Malnutrition occurs in gastrointestinal cancer patients,yet sometimes treated with inappropriate nutrition support.
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Objective To explore the change in nutritional status of perioperative gastrointestinal cancer patients. Methods The nutritional status of 207 gastrointestinal cancer patients who were to undergo elective radical surgery was evaluated by SGA within 48h of admission and 7 days after operation. The investigation results went through analysis. Results Body weight was significantly decreased 7 days after operation compared with 48h of admission, the prevalence of malnutrition 7 days after operation was higher than 48h of admission; weight loss, change of food intake and decreased functional activity were the related factors of change in nutritional status of perioperative gastrointestinal cancer patients. Conclusions There was a decreased nutritional status among perioperative gastrointestinal cancer patients, and appropriate nutrition intervention program and treatment should be taken to improve clinical outcomes according to the risk factors.
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Objective The purpose of this study was to compare the differences of job satisfaction degree between contract nurses and formal nurses. Methods 350 incumbency clinical nurses were ob-tained from 3 provincial and grade three A hospitals(including nurses in internal medicine, surgical,gyne-cologic,pediatric,emergency departments and ICU). Research instruments used in this study included the self-designed demographic questionnaire and the nurses' job satisfaction scale. Results The level of the overall job satisfaction degree among contract nurses was lower than that of the formal nurses. Of all job satisfaction subscales, the scores of professional opportunities, performance and responsibility,salary and welfare, administration and hospital policy, interpersonal relationships among contract nurses were lower than those of formal nurses. But the scores of scheduling and work conditions, professional traits were higher than those of formal nurses. Conclusions It is advocated to adopt different management and incentive mechanisms to improve the job satisfaction degree for contract nurses according to the differ- ences between contract nurses and formal nurses, so that the nursing staff can be stabilized.