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Objective:To explore the chain mediating effect of self-efficacy and positive coping styles between nurses′ adversity quotient on work engagement, so as to provide a theoretical reference for nursing managers to promote work engagement.Methods:A convenience sampling method was used to select 512 nurses from four tertiary hospitals in Shaanxi Province, and a cross-sectional study was conducted on them using the general information questionnaire, Adversity Response Profile, General Self-Efficacy Scale, Simplified Coping Style Questionnaire and Utrecht Work Engagement Scale-9.Results:The total scores of nurses' adversity response profile, self-efficacy, positive coping style and work engagement were 132.00(120.00, 139.00), 27.00(23.00, 29.00), 24.00(20.00, 25.00), 27.00(25.00, 35.00) points. Nurses' work engagement was significantly positively correlated with adversity quotient, self-efficacy and positive coping styles( r values were 0.523-0.614, all P<0.01). The independent mediation of self-efficacy or positive coping styles and the chain mediation of both accounted for 23.6%,40.9% and 15.9% of the total effect respectively. Conclusions:Nurses′ adversity quotient not only directly affected work engagemnet, but also indirectly affected work engagement through self-efficacy and positive coping style. The research suggested that managers should pay attention to the improvement of nurses′ self-efficacy and positive coping style, so as to promote nurses′ work engagement.
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Objective: To explore the therapeutic effects of sequential chemoradiotherapy with pemetrexed and cisplatin on locally advanced laryngeal cancer [LALC]
Methods:Fifty LALC patients who were treated in our hospital between January 2010 and January 2012 were selected and randomly divided into an observation group and a control group [n=25]. The two groups were given conventional radiotherapy in the same manner, before which two cycles of chemotherapy were performed. The observation group intravenously infused with 500 mg/m[2] pemetrexed on d1 and 25 mg/ m[2] cisplatin on d1-3, with 28 days as a cycle. The control group was intravenously infused with 25 mg/m[2] cisplatin on d1-3 and 400 mg/m[2] fluorouracil, with 28 days as a cycle. The short-term effects and adverse reactions of both groups were observed after treatment, and their survival was observed by follow-up for five years
Results:The response rate was 84% [21/25] in the observation group and 64% [16/25] in the control group, between which the difference was statistically significant [P<0.05]. The differences in the incidence rates of short-term adverse reactions such as grade III-IV gastrointestinal reactions and bone marrow suppression were not statistically significant between PC regimen [pemetrexed combined with cisplatin] and PF regimen [cisplatin combined with fluorouracil] [P>0.05]. The incidence of long-term adverse reactions such as grade III-IV laryngeal edemas, laryngeal cartilage inflammation and laryngeal cartilage necrosis showed no significant differences between the two groups [P>0.05]. The median survival was 3.3 years after PC chemotherapy and 2.8 years after PF chemotherapy, between which the difference was not statistically significant [P>0.05]. The levels of serum tumor markers significantly decreased after PC and PF treatments compared with those before [P<0.05]
Conclusion:Combining PC chemotherapy with radiotherapy has satisfactory short-term therapeutic effects on LALC, and the resulting adverse effects can be tolerated. Therefore, this strategy is worthy of promotion and application in clinical practice
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Objective To analyze effect of the exercise reducting and improving fistula complications and the quality of life for continuous hemodialysis patients.Methods 106 patients with end-stage renal failure and hemodi-alysis were randomly divided into all 53 patients in observation group (using yoga exercise intervention)and 53 pa-tients in the control group (no intervention measures).Incidence of venous thrombosis,arterial thrombosis,false aneu-rysm,vascular complications were observed in patients of two groups.The quality of patients′life after dialysis care sit-uation in two groups was evaluated by a simple scale of health survey Mos SF-36.Results The comparison result of complication occurs case showed that the incidence of venous thrombosis,arterial thrombosis end,false aneurysm,vas-cular complications in the observation group were respectively 13.21%,0,3.77% and 20.75%;The same indexes were 33.96%,9.43 %,15.09% and 58.49% in the control group,and the complications in the observation group were significantly fewer than the control group (χ2 =6.33,5.15,3.98,10.44,P<0.01,P=0.02,P=0.04).the improved situation of life quality in the two groups showed physiological function,physical function,bodily pain,g en-eral health,vitality,social function,emotional function were significant differences before and after the mental health care in the observation group (t=5.05,4.57,2.85,6.95,10.06,3.28,6.71,8.11,P<0.01);in addition to the physiological functions in the control group,social function,the other were also statistically significant (t =2.42, 1.27,2.06,4.54,4.76,2.19,1.46,3.83P<0.02,P<0.05,P<0.01).In addition to the social function,other improvements in the observation group were better than that in the control group after the mental health care (t=3.06,3.59,2.02,3.79,7.14,1.74,4.22,2.25,P<0.05,P<0.01).Conclusion Through Yoga intervention continued dialysis,the patients'own immune system and disease resistance are improved,the patient's ability to withstand continuous hemodialysis are also improved,thereby to increase the effect of continued hemodialysis.