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Objective To understand the growth experiences of senior nurses in coping with the death of patients so as to provide reference for clinical nursing management and teaching.Methods A phenomenological research method of qualitative study was employed in this study.Twenty-five senior nurses were in-depth interviewed with semi-structured interview guide.Thematic analysis method was adopted to collect and analyze the data,which were then organized into themes and subthemes.Results Three themes were "changes in growth" "ways to grow" and "unmet needs".Senior nurses could cope with patients' death well through accumulation and sharing of clinical experience,as they reorganized of death more definitely,their emotional response transferred reasonable,their coping strategy became matured,whereas the senior nurses still need help in the areas of psychological adaption,social support and professional theory education.Conclusions It is suggested that nursing managers should value the experience sharing and teaching function of senior oncology nurses,pay attention to the physical-mental health of senior nurses and provide professional psychosocial support to them.Otherwise,it is important to provide all oncology nurses with systematic knowledge training concerning hospice/death education to promote their career development ultimately.
RESUMO
BACKGROUND: Mesenchymal stem cells (MSCs) are commonly observed under the scanning electron microscope, transmission electron microscope and inverted microscope. However, above-mentioned observation methods have disadvantages on observing ultrastructure of cell membrane and cytoskeleton. OBJECTIVE: To establish a more effective and appropriate method to isolate, culture and identification of human umbilical cord mesenchymal stem cells (hUCMSCs) in vitro and to study the ultrastructure of osteogenic differentiation with the atomic force microscope. METHODS: The hUCMSCs were isolated from human umbilical cord by digested with collagenase. After serial subcultivation in vitro, the stem cells were passaged, and osteogenic differentiation was determined by alkaline phosphatase calcium-cobalt staining and alizarin red staining. hUCMSCs immunophenotype was measured by Flow cytometry.The membrane surface ultrastructure of osteogenic differentiation was observed by Atomic Force Microscope before and after induction. RESULTS AND CONCLUSION: The isolated hUCMSCs by digested with collagenase was efficient. After seeded 24 hours, the adherent cell showed spindle shape, polygonal shape and fibroblast-cell-like shape and the size of hUCMSCs was homogeneous. Flow cytometry analysis revealed that CD29, CD44, CD105 were highly expressed on the surface of passages 3 cells, but there was negative for CD34, CD45 and HLA-DR. These cells were high positive for alkaline phosphate staining and also showed significant calcium node using alizarin red staining after 4 weeks culture induction of osteogenic differentiation. Under atomic force microscopy, undifferentiated stem cells demonstrated insignificant microtubule protrution in a parallel distribution following analysis of cytoskeleton before and after differentiation.