Exploration on Optimizing "Five-sphere" Medical Humanistic Care Service in Medical and Nursing Institutions / 中国医学伦理学

The combination of medical care and nursing is an important measure of health care for the aged, and it is also an important part of aging work. Under the background of increasing aging, and under the background of changing from disease-centered and patient-centered medical model to health-centered "big medicine" model, medical humanities are particularly important for how to make the elderly spend their old age in peace and make the road of combining medical care with nursing care wider. Based on the practice of combination of medical care and nursing, under the guidance of the concept of great health, this paper discussed the establishment of a "Five-sphere" all-round humanistic care concept integrating medical care, nutrition care, sports care, mental care and other convalescent health care factors, and provided a series of comprehensive multi-angle humanistic care service measures from physiology to psychology for elderly patients with chronic diseases, which has achieved good results.

Clinical practice, knowledge and attitudes of oncology nurses to the management of gastrointestinal symptoms in cancer chemotherapy and the correlation research of medical and nursing cooperation / 中国实用护理杂志

Objective:To investigate the current situation of clinical practice of cancer chemotherapy-related gastrointestinal symptoms (CGIS) management among oncology nurses in Ningxia, and to explore the correlation between CGIS management and nurses′ knowledge and attitude and medical and nursing cooperation, so as to provide evidence for improving the clinical practice of cancer patients CGIS management among oncology nurses in Ningxia.Methods:This was a cross-sectional study. From January 25 to 31, 2021, the general data questionnaire and the questionnaire of clinical practice of CGIS management for cancer patients were used to survey 289 nurses in oncology department in Ningxia.Results:The scores of medical and nursing cooperation, CGIS knowledge, attitude, and CGIS management clinical practice activities of nurses in oncology department were (24.94 ± 3.20), (20.19 ± 3.82), (52.19 ± 6.17) and (129.93 ± 36.33) points, respectively. Among the scores of CGIS management clinical practice activities, gastrointestinal symptoms evaluation dimension scored the lowest, and the highest was CGIS health education dimension. There was a significant positive correlation between the scores of clinical practice of CGIS management of cancer patients and the scores of knowledge and attitude of oncology nurses ( r values were 0.225-0.293, all P<0.05). Conclusions:The clinical practice of cancer patients′CGIS management by oncology nurses needs to be improved, especially the evaluation of cancer patients′CGIS by oncology nurses. Nursing managers should formulate the activity guide of CGIS management clinical practice as soon as possible, strengthen the training of nurses′ relevant knowledge, and provide nurses with appropriate evaluation tools to improve the clinical practice of CGIS management.

Investigation of medical humanistic practice ability of nurses and factors affecting their practices: a questionnaire-based analysis of 1196 cases in a general hospital in Hunan Province / 南方医科大学学报

OBJECTIVE@#To investigate humanistic practice ability of nurses in a general hospital in Hunan Province and analyze the factors affecting their practices to provide evidence for interventions to improve humanistic practice ability of the nurses.@*METHODS@#A total of 1196 nurses were surveyed using a self-designed questionnaire and a nurse humanistic practice ability assessment scale questionnaire for assessment of their abilities for humanistic care practice, psychological adjustment, interpersonal communication, self-management, ethics and legal practice. Univariate and multivariate analyses were performed for analysis of the factors affecting the practice abilities of the nurses.@*RESULTS@#The total score of humanistic practice ability of the 1196 nurses was 105.69±16.45 (the full score of the scale was 130), and the scores of humanistic care practice ability, psychological adjustment ability, interpersonal communication ability, self-management ability, ethics and legal practice ability were 40.95±6.46, 16.41±2.66, 16.41±2.66, 11.32±2.05 and 12.43±2.00, respectively. Univariate analysis and multiple linear regression analysis showed that gender (P=0.033), age (P < 0.001), department (P=0.015), working years (P < 0.001), professional title (P < 0.001), first academic degree (P < 0.001), highest academic degree (P < 0.001), family location (P=0.010), marital status (P=0.023), number of patients to care for (P=0.022), number of children (P=0.001), previous humanities related training (P < 0.001), training times (P < 0.001), and care received from family members (P < 0.001) and colleagues (P < 0.001) were all the factors affecting humanistic practice ability of the nurses. Among these factors, age, working in department of obstetrics and gynecology and emergency department, professional title, humanities training, and care from family and colleagues explained 20.7% of the variance.@*CONCLUSION@#The humanistic practice ability of nurses in this general hospital is above the average level, but their self-management ability needs to be improved. Intervention measures should be implemented to improve the nurses' humanistic practice ability including more attentions to the key groups and departments, strengthening the training of humanistic practice ability, and improving the promotion assessment system.

Construction and verification of a quantitative index system to evaluate the medical and nursing care for the elderly service needs / 中南大学学报(医学版)

OBJECTIVES@#To construct a quantitative index system with the integrated medical and nursing care assessment for the elderly service needs, this system can assess the cost of medical and care services accurately and objectively, so as to provide scientific basis for the allocation of old-age service resources in China.@*METHODS@#Based on the survival needs of the Existence, Relation and Growth theory, an index system is constructed through literature analysis, group discussion, and expert correspondence. Analytic hierarchy process was used to determine the weights of indicators at all levels. The 3-grades service items corresponding to each index were quantified through the measurement of working hours, and the medical and nursing care needs of 624 disabled/demented elderly people over 60 years old in Changsha were investigated to evaluate their reliability and validity.@*RESULTS@#The authoritative coefficients of the 2 rounds of expert correspondence were 88.5% and 88.6%, respectively, and the opinion coordination coefficients were 0.159 and 0.167, respectively. The final quantitative evaluation index system included 4 first-level indicators, 17 second-level indicators, and 105 third-level indicators. The service time of doctor ranged from 6.01 to 22.64 min, the service time of nurses ranged from 0.77 to 24.79 min, and the service time of caregiver ranged from 0.12 to 51.88 min. The Cronbach's αcoefficient was 0.73, the split-half reliability was 0.74, the content validity was 0.93, and the calibration validity was 0.781.@*CONCLUSIONS@#The quantitative evaluation index system of medical and nursing service need for the elderly can be used to accurately evaluate the medical and nursing service need.

Analysis of influencing factors on nursing ability of caregivers in medical and nursing combination institutions in urban area / 中国职业医学

@#Objective To investigate the influencing factors on the nursing ability of caregivers who provide service for elderly Methods patients with cardiovascular disease in medical and nursing combination institutions. A total of 276 caregivers who provide service for elderly patients with cardiovascular disease in medical and nursing combination institutions in Beijing urban area were selected as research subjects using the judgment sampling method. The Chinese Caregiver Task Inventory, eHealth Results Literacy (eHL) Scale and Sense of Coherence (SOC) Scale were used to investigate the nursing ability, eHL and SOC. The scores of nursing ability, eHL and SOC of the caregivers were (28.3±6.1), (17.0±5.9) and (69.0±9.4), respectively. The results of multiple linear regression analysis showed that caregivers who regarded the occupation as a career, had general or good subjective income, cared for disabled subjects, had a good basic knowledge of cardiovascular disease and qualified eHL had P P Conclusion relatively high nursing ability (all <0.01). The higher the SOC score, the higher the nursing ability ( <0.01). Occupational recognition, subjective income, master the basic knowledge of cardiovascular diseases, disability of nursing patients, eHL and SOC were factors affecting the nursing ability of caregivers who provide service for elderly patients with cardiovascular diseases in urban medical and nursing combination institutions.

The development trend of geriatric nursing and combination of medical and nursing by analysis of the keywords of literature in China / 中国实用护理杂志

Objective Through research on the geriatric nursing related literature in Chinese journals and medical care and elderly care combination related keywords from 1979 to 2017, this study provides the development trend of geriatric nursing research. Methods Searching articles in Wanfang, CNKI, VIP database, selecting the keywords and published time of the paper. Employing descriptive statistics to describe literatures information such as publication time, quantity of keywords, word frequency of keywords, heat degree of keywords, character of keywords and so on. Results Totally 134 791 articles were got and 58 031 articles were included in the analysis. The amount of literature growth was slow before 2005,The cumulative amount of literature in 1979-2005 was only 12.75% of the total amount of literature. After 2005, the amount of literature increased rapidly year by year. The number of literature published in 2017 has exceeded 12% . The amount of the geriatric nursing related literature was proportional to the number of people aged 65 and over in China. In the research of geriatric nursing, the content related to medical care and elderly care combination was quite dispersed, and it did not involve research at the level of Medical Association. The medical care and elderly care combination and Medical Association were new areas in the research of geriatric nursing. Conclusion The amount of the geriatric nursing related literature from 1979 to 2017 was proportional to the number of people aged 65 and over in China. There are few researches on how to carry out geriatric nursing under the policy of medical care and elderly care combination and Medical Association, which should be the focus of future research and exploration to actively respond to the challenge of aging population.

Influence of two training methods on hand hygiene compliance of health care workers / 中国中西医结合急救杂志

Objective To evaluate the effects of the two methods of propaganda and education, conventional training method and that combined with hand contamination survey method, on the medical and nursing staffs' hand hygiene compliance. Methods From October 2017 to April 2018, all medical and nursing staffs in 6 Departments:General Surgery Ⅰ, General Surgery Ⅱ, Orthopedics Ⅰ, Orthopedics Ⅱ, Internal Medicine Ⅰ and Internal Medicine Ⅲin Cangnan Second People's Hospital receiving health education were divided into two groups; both groups received routine training, while in the observation group, on the basis of routine training, the hand hygiene pollution investigation training mode was added, In the combined training method, when the wrong hand hygiene mode occurred, the hand specimens were collected and the correct hand washing method was instructed on the spot, and then the following hand specimens were taken to investigate the contaminated condition. One month before the training, the real situations of hand hygiene compliance in the two groups were investigated. In the 1st month after the beginning of training, both groups were cultivated by conventional propaganda and training methods. From the second month to the sixth month, the observation group was additionally trained to investigate hand hygiene pollution situation on the basis of conventional propaganda and training methods. After 6 months, the compliance rates of hand hygiene in the two groups were observed. Results Before training, there was no significant differences in the compliance rate of hand hygiene in the observation group and the routine trainning group [37.14% (52/140) vs. 36.36% (48/132), P > 0.05]. The compliance rates of hand hygiene after 1, 2, 3 months of training in the observation group were 56.61% (77/136), 60.61% (80/132) and 61.20% (82/134), respectively, and those in the routine trainning group were 56.25% (72/128), 59.26% (80/135) and 58.70% (81/138), which were all significantly higher than those before the training (all P < 0.05), but there were no statistical significant differences between the two groups (all P > 0.05). From the 4th month to the 6th month after training, the compliance rates of hand hygiene in the observation group were significantly higher than those in the observation group [61.97% (88/142) vs. 49.23% (64/130), 62.50% (80/128) vs. 47.73% (63/132), 62.31% (81/130) vs. 46.03% (58/126)], the differences between the two groups being statistically significant (all P < 0.05). Conclusion The routine training combined with hand contamination investigation survey training for consecutive 3 months can nicely promote the improvement of hand hygiene compliance of medical and nursing staffs.

Feasibility study on the application of Internet + and health care integration mode in drug compliance of children discharged from Kawasaki disease / 中国实用护理杂志

Objective To explore the effect of the combination of Internet +and medical care in the compliance of the discharged children with Kawasaki disease. Methods A total of 76 children with Kawasaki disease who were discharged from a third-grade hospital were selected. The control group (37 cases) and the intervention group (39 cases) were selected by random sampling at different time intervals. Both groups received routine guidance during hospitalization. The intervention group was admitted to the WeChat work platform (WeChat group, WeChat public number) and"Almond"doctors' follow-up platform. Six months after discharge, the Kawasaki disease basic knowledge questionnaire was used and the medication compliance (Morisky medication compliance scale) was used for investigation and evaluation. Results The score of the Kawasaki disease basic knowledge questionnaire was (53.38±13.66) points in the control group, and (62.36± 13.48) points in the intervention group, there was significant difference (t=-3.388, P<0.05).The score of Morisky medication compliance scale was (5.97 ± 0.94) points in the control group, and (6.53 ± 1.40) points in the intervention group, and there was significant difference (t=-2.112, P<0.05). Conclusions The integration ofInternet+and medical care can improve the compliance of the parents of children with Kawasaki disease, and can be used in the continuous nursing of children with chronic disease.

Application of standardized communication mode in interventional ward / 介入放射学杂志

Objective To evaluate the application effect of standardized communication mode, which was based on the situation, background, assessment and recommendation (SBAR communication mode), in interventional ward. Methods SBAR communication mode was implemented in interventional ward. Through the discussion of doctors and nurses, the SBAR communication template of common symptoms of specialized diseases was revised. The training, examination, utilization and evaluation of the SBAR communication template were conducted for all nurses. The medical adverse events caused by poor medical and nursing communication, the patients' recognition of the professional abilities of medical teams and the doctors' satisfaction with nurses were recorded before and after the implement of SBAR communication mode, and the results were compared. Results After the implementation of SBAR communication mode, both the patients' recognition of the professional abilities of medical teams and the doctors' satisfaction degree with nurses were significantly improved, the differences were statistically significant (P<0.05); and the incidence of medical adverse events caused by poor medical and nursing communication was remarkably decreased, the difference was statistically significant (P<0.05) . Conclusion The implementation of SBAR communication mode in the intervention ward can significantly improve the patients' recognition of the professional abilities of medical teams and the doctors' satisfaction degree with nurses, and decrease the incidence of medical adverse events caused by poor medical and nursing communication, thus, the safety of patients can be guaranteed, meanwhile, the establishment of a harmonious medical and nursing team is promoted.

The development trend of geriatric nursing and combination of medical and nursing by analysis of the keywords of literature in China / 中国实用护理杂志

Objective@#Through research on the geriatric nursing related literature in Chinese journals and medical care and elderly care combination related keywords from 1979 to 2017, this study provides the development trend of geriatric nursing research.@*Methods@#Searching articles in Wanfang, CNKI, VIP database, selecting the keywords and published time of the paper. Employing descriptive statistics to describe literatures information such as publication time, quantity of keywords, word frequency of keywords, heat degree of keywords, character of keywords and so on.@*Results@#Totally 134 791 articles were got and 58 031 articles were included in the analysis. The amount of literature growth was slow before 2005, The cumulative amount of literature in 1979-2005 was only 12.75% of the total amount of literature. After 2005, the amount of literature increased rapidly year by year. The number of literature published in 2017 has exceeded 12%. The amount of the geriatric nursing related literature was proportional to the number of people aged 65 and over in China. In the research of geriatric nursing, the content related to medical care and elderly care combination was quite dispersed, and it did not involve research at the level of Medical Association. The medical care and elderly care combination and Medical Association were new areas in the research of geriatric nursing.@*Conclusion@#The amount of the geriatric nursing related literature from 1979 to 2017 was proportional to the number of people aged 65 and over in China. There are few researches on how to carry out geriatric nursing under the policy of medical care and elderly care combination and Medical Association, which should be the focus of future research and exploration to actively respond to the challenge of aging population.

Narrativas de estudantes de Medicina e Enfermagem: currículo oculto e desumanização em saúde / The narratives of medicine and nursing students: the concealed curriculum and the dehumanization of health care / Narrativas de estudiantes de Medicina y Enfermería: currículo oculto y deshumanización en Salud

Um enfoque predominantemente biomédico atribuído ao ensino e à prática das Ciências da Saúde contribui para o processo de desumanização, que representa uma das principais queixas dos usuários dos sistemas de saúde em nosso país. Qualquer estratégia para enfrentar a questão depende da presença de profissionais de saúde bem formados de um ponto de vista técnico e humanístico. As maiores deficiências concernem à formação humanística. Este artigo constitui um recorte de um estudo cujo objetivo foi investigar a efetividade da utilização de narrativas como recurso didático na formação humanística de estudantes de Medicina e Enfermagem. Entre os temas emergentes a partir de métodos qualitativos, destacou-se o currículo oculto, que permeou todos os demais e contra o qual os estudantes poderiam ser imunizados mediante a exposição a um modelo de ensino centrado no paciente e que prioriza a reflexão ética.(AU)

A predominantly biomedical focus attributed to teaching and practice in health sciences contributes to a dehumanization process, which is one of the main complaints of Brazil's health system users. Any strategy that intends to address the issue depends on the presence of well-educated health professionals from both the technical and humanistic point of view. The greatest deficits concern humanistic education. The present article presents part of a larger study that aimed to investigate the effectiveness of using narratives as a didactic resource in humanistic teducation of medical and nursing students. Among the themes that emerged from the qualitative methods, emphasis goes to the concealed curriculum, which permeated all the other themes and against which students could be inoculated through exposure to a patient-centered teaching model that gives priority to ethical reflections.(AU)

Un enfoque predominantemente biomédico atribuido a la enseñanza y práctica de las Ciencias de la Salud contribuye al proceso de deshumanización que representa una de las principales quejas de los usuarios de los sistemas de salud de nuestro país. Cualquier estrategia para enfrentar la cuestión depende de la presencia de profesionales de salud bien formados desde un punto de vista técnico y humanístico. Las mayores deficiencias se refieren a la formación humanística. Este artículo constituye un recorte de un estudio cuyo objetivo fue investigar la efectividad de la utilización de narrativas como recurso didáctico en la formación humanística de estudiantes de Medicina y Enfermería. Entre los temas emergentes a partir de métodos cualitativos se subrayó el currículo oculto que estuvo presente en todos los demás y contra el cual los estudiantes podrían inmunizarse mediante la exposición a un modelo de enseñanza centrado en el paciente y que prioriza la reflexión ética.(AU)

Effect of medical and nursing integration notification on anxiety, depression and quality of life in cancer patients undergoing chemotherapy / 中华行为医学与脑科学杂志

Objective To explore the effect of medical and nursing integration notification on the truth knowing rate,anxiety,depression and quality of life in cancer patients undergoing chemotherapy. Meth-ods From February to March 2017,34 patients for the first time needing chemotherapy were included as control group,using normal disclosure.From June to July 2017,35 cases for the first time needing chemother-apy were included as the experimental group. The experimental group was informed of the medical and nurs-ing integration notification. The truth knowing rate,anxiety,depression and quality of life were compared be-fore and after three cycles of chemotherapy. Results After three cycles of chemotherapy,the truth knowing rate of patients in the experimental group (completely 57.14%,partly 34.29% and none 8.57%) was signifi-cantly different with the control group (completely 29.42%,partly 35.29% and none 35.29%,P＜0.01). The scores of anxiety and depression in the experimental group(39.43±4.60,41.86±5.23) were significantly low-er than those before chemotherapy(42.37±4.76,45.69±5.49,P＜0.01). The scores of anxiety and depression in the control group (45.74±5.20,49.74±5.42) were significantly higher than those before chemotherapy (42.77±5.62,45.56±6.27,P＜0.01).After three cycles of chemotherapy,the scores of anxiety and depression in the experimental group were lower than the control group (P＜0.01). After three cycles of chemotherapy, the total health status,body function,role function,emotional function,cognitive function,social function,fa-tigue,nausea and vomiting,and loss of appetite were statistically significant between the experimental group and control group (P＜0.05). Conclusion The medical and nursing integration notification has a positive effect on the truth knowing rate,anxiety,depression and quality of life in cancer patients undergoing chemo-therapy.

Effect of personality development program for medical and nursing students: A pilot study.

Background: Personal development is an ongoing but complex process and it is crucial for the medical educator to recognize the trait and design the training for optimal development of students. Though importance of human personality is widely recognized for functional efficiency of an individual and organization, but its recognition is grossly missing from medical curriculum. Aim: To organize and evaluate the 'Personality Development Program' for medical and nursing students. Methods: First year medical and nursing students were recruited through total enumeration method. 'Personality development program' was conducted by a trained psychologist and it was evaluated through 'partially open ended anonymous structured feedback'. Results: Majority of the students found this program relevant, comprehensive and purposeful. Again majority had perceived some improvement in their confidence and level of communication, interpersonal relationships, planned time schedule, emotional confidence, and better stress management. They have also narrated shortcomings of the program along with some constructive suggestions. Conclusion: This preliminary attempt for personality development was highly appreciated by the students as well as their supervisors as a means to professional development. It further emphasizes the vital need of ongoing programs both for enhancing personality and professionalism.

Narrativas de estudantes de Medicina e Enfermagem: o que elas nos revelam? / Medical and Nursing students´ narratives: what have we learned?

Com o objetivo de preparar profissionais humanizados e fomentar o profissionalismo, muitas escolas médicas em todo o mundo incluíram em seus currículos o ensino das Humanidades. As diversas estratégias para incorporar as Humanidades na Educação em Saúde - ainda pouco sistematizadas no nosso meio - correm o risco de estabelecer um marco teórico ideal que, na prática clínica diária, é de difícil aplicação. No presente artigo se recolhe uma experiência que une o embasamento acadêmico com a aplicabilidade no dia-a-dia do estudante. Descreve-se uma disciplina eletiva oferecida a estudantes de Enfermagem e Medicina de segundo e terceiro anos baseada no modelo denominado Medicina Baseada em Narrativas. O cenário docente propiciado por esta disciplina cria um ambiente propício à reflexão sobre questões humanísticas a partir de narrativas - médicas e literárias. Os resultados, apurados em abordagem qualitativa de corte fenomenológico, apontam importantes temas que emergem na discussão: lidando com as emoções próprias e alheias, promovendo a empatia, trabalhando o currículo oculto, incorporando o aprendizado humanista na prática.

Medical and Nursing Staff's Clinical Aesthetic Ability and Training / 中华医学教育探索杂志

Aesthetic ability is the best fundamental psychological quality of medical and nursing staff.The article elaborated the intentions of clinical aesthetic ability and its inherent factors and the external expressions.It also pointed out the means and methods of medical and nursing workers' aesthetic ability training.