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Objective:To explore the mediating effect of nurses′ self-efficacy in palliative care between the past behavioral experience of end-of-life care and core competence, and provide theoretical reference for improving the core competence of clinical nurses in palliative care.Methods:579 clinical nurses from 2 tertiary general hospitals in Shandong Province were investigated by convenience sampling method using general information questionnaire, nurses′ self-efficacy questionnaire for palliative care and palliative care nurses′ core competency questionnaire. The data were analyzed by SPSS 25.0.Results:The total score of core competence of hospice care of 579 nurses was (71.41 ± 22.74), nurses′ self-efficacy of palliative care was positively correlated with their core competence ( r = 0.648, P<0.01), past behavior experience was positively correlated with self-efficacy ( r = 0.479, P<0.01), positively correlated with core competence ( r = 0.427, P<0.01). Nurses′ self-efficacy of palliative care played a partial mediating role between the pastbehavioral experience and core competence, which accounted for 64.67% of the total effect. Conclusions:The past behavioral experience of end-stage nursing can directly or indirectly affect the core competence of nurses in palliative care through self-efficacy. It can improve the core competence of palliative care by taking active measures to enrich the past behavioral experience of end-of-life care and improve self-efficacy.
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Objective@#To investigate the effects of ambient air pollution on the school age children s diseases, symptoms and school absence, and to provide a reference for preventing the harmful effect of air pollution on students.@*Methods@#Health questionnaires surveys were conducted among 792 students of the fourth grade in a primary school in Hangzhou, and the incidence of diseases and symptoms were continuously monitored every day during the winter of 2014-2017. The generalized additive model based on Poisson regression was used to analyze the health effects caused by single pollution. The multivariate Logistic regression model was used to analyze the comprehensive effects of family, living environment and air pollution on student health.@*Results@#Totally 415 students(52.4%) had a history of diseases and 265 students(33.5%) had a history of allergy. During the investigation, the average concentrations of PM 2.5 , PM 10 , SO 2 and NO 2 were (81.0±2.8) (122.2±3.9) (17.9±0.6) and (68.9±1.4)μg/m 3. Strongest associations were found for lag 3 day of exposure among PM 2.5 , PM 10 and NO 2 on illness and absence. Increases of 10 μg/m 3 in PM 2.5 , PM 10 and NO 2 were associated with 1.02(95% CI =1.01-1.02), 1.04(95% CI =1.03-1.06) and 1.03(95% CI =1.02- 1.04 ) increases in daily illness rates. SO 2 lag for 5 days had the most significant effect on students health. Father s education was the protective factor for illness ( OR =0.83) and symptoms( OR =0.84 ). The risk factors for symptoms included furniture replacement within one year( OR =1.78), pet feeding( OR =1.94), respiratory infections within one year( OR =1.82), allergies rhinitis( OR =2.24), family history with coronary heart disease/hypertension( OR =1.46), indoor activity time ( OR =1.02) and atmospheric PM 10 concentration( OR =1.09)( P <0.05).@*Conclusion@#The increase of air pollution concentration has an impact on the illness, symptoms and absence from school, and there is a lag effect. Father s education is a protective factor for the health of students. Indoor pollution and outdoor air pollution can lead to the occurrence of illness and symptoms.
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Objective@#To explore the effect of air pollutants on salivary lysozyme of pupils in Hangzhou,and to provide a reference for effectively improving health index of primary school students.@*Methods@#A total of 248 healthy pupils from one primary school in Xiacheng district, Xihu district and Chun’an county of Hangzhou were selected with cluster random sampling methods during October 2015 to March 2016. Meteorological and air quality data near the three schools during the same period were collected. Mixed linear model was used to analyze the influence of air pollutants on salivary lysozyme of pupils.@*Results@#There was significant difference in the content of salivary enzymes between Xihu District and Xiacheng District (t=-4.49, 2.75, P<0.01). There was no significant difference in salivary lysozyme among pupils of different sex and age. Mixed linear model suggested that for 1 μg/m3 increase of PM2.5, PM10, SO2, NO2 and CO, salivary lysozyme increased by 1.75, 0.82, 6.12, 1.05 and 70.73 μg/L,respectively. Salivary lysozyme increased by 8.17 μg/L for 1 μg/m3 increase of SO2 the day before the test.@*Conclusion@#The level of salivary lysozyme in pupils is positively correlated with the concentration of air pollutants with a lagging effect.
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Objective To establish a stable,repeatable and long-lasting rat model of myocardial infarction,and to evaluate the feasibility of monitoring electrophysiological changes and left ventricular function after myocardial infarction by electrocardiography (ECG) and ultrasonic cardiography(UCG). Methods Wistar rats were ligated on the left anterior descending coronary artery after anaesthesia with 10% chloral hydrate and machinery assisted respiration. Then they were monitored by ECG and UCG afer 4,8 and 12 weeks,and were sacrificed and pathologically examined at 12 weeks after operation. Results The rat model of myocardial infarction was established with a survival rate of 83.3% at 72 hours after the operation and 73.3% at 12 weeks after the operation. In the myocardial infarction group,the PR,QRS,QT and QTc intervals were statistically significantly longer than that in the sham operation group. UCG showed that the left ventricular internal diameter at end-diastole (LVIDd) and the left ventricular internal diameter at end-systole (LVIDs) were statiscally significantly higher in the infarction group,and the ejection fraction (EF) and fractional shortening (FS) significantly lower than those in the sham operation group. Long-lasting pathological changes can be seen in the tissues at 12 weeks after operation. Conclusions The method used in the present study is an simple,less injurious and highly successful technique,and the changes in electrophysiology and left ventricular function can be well monitored by ECG and UCG at different times during this period.
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Objective To investigate the relationship between acute biliary pancreatitis (ABP) and anomalous pancreaticobiliary duetal union (APBDU). Methods 131 patients with ABP were enrolled to test the serum total bilirubin (TB), alanine amintransferase (ALT), aspartate amintransferase (AST), alkaline phosphates (ALP), γ-glutamyl transferase (γ-GT). All the patients received medical treatment, and then these tests were performed again. Thereafter, all the patients underwent selective surgery and intra-operative cholangiography was performed to observe the pancreaticobiliary duetal union. Results 27 patients (20.6%) with APBDU were found in 131 patients. Among them, 8 cases (29.6%) was B-P subtype (TypeⅠ), 16 cases (59.3%) was P-B subtype (TypeⅡ) , and the remaining 3 cases was mixed subtype (TypeⅢ). A significant decrease of ALT, AST, ALP, γ-GT after non-surgical treatment in both group of APBDU and NAPBDU was noted (P＜0.05). The serum levels of ALT, AST,γ-GT in APBDU patients were (71.81± 23.19) U/L, (47.85±27.87) U/L, (52.86±31.49) U/L, respectively; and in NAPBDU patients were (51.96±15.40) U/L, (40.77±16.58) U/L, (34.86±26.47) U/L. The difference was statistically significant (P＜0.05). Condusions APBDU is an important etiology of ABP.