Objective To explore the certification management of specialty nurses in China based on the existent problems to provide evidence for practice and decision making for management of the specialty nurses. Methods The modified Delphi technique was applied in this study from July to December 2017. A structured consultation questionnaire based on expert interview and literature review was designed, and modified after preliminary experiment. Then the questionnaires were delivered to 32 nurse experts to complete 3 rounds of Delphi process, which reached consensus gradually. Results The response rates of three round consultations were 96.9% (31/32), 100.0% (31/31), and 96.8% (30/31), respectively. The suggestion rates were 25.8% (8/31), 16.1% (5/31), 0% (0/31), respectively. The familiar coefficient, adjustment coefficient and authority coefficient was 0.82, 0.87 and 0.85, respectively. The experts had the agreement finally for all of the 16 items in the consultation questionnaire, and they formed an expert opinion draft on specialty nurse certification and registration. Conclusion It’s crucial and essential to establish a certification and registration system in China and renew the credentials regularly to promote the management and construction of specialty nurse team.
【摘要】 目的 分析临床实习对护理本科生专业认同的影响，探讨提高专业认同的措施。 方法 2010年6—10月，对某综合性大学60名2007级普通全日制护理本科生进行抽样调查，评价其实习前1个月和实习后3个月的专业认同情况，比较实习前、后的变化并分析影响因素。 结果 实习后专业认同的专业价值观得分[（3.13±0.85）分]高于实习前[（2.78±1.00）分]，实验专业期望得分[（12.09±2.13）分]低于实习前[（13.13±1.30）分]，差异有统计学意义（P=0.045，0.002）；而专业认识、情感、意志、技能和专业认同总分方面，实习前、后差异无统计学意义（Pgt;0.05）；其影响因素由强到弱依次为:带教老师（37.04%）、实际的护理工作（33.33%）、实习科室（22.22%）、他人态度（7.41%）。 结论 临床实习可提高护理本科生的专业价值观，带教老师及实际护理工作对专业认同影响较大。【Abstract】 Objective To analyze the effect of clinical practice on student nurses’ professional identity and explore measures to develop their professional identity. Methods Convenience sampling was used to select 60 general full-time student nurses who entered a comprehensive university in 2007. Then we assessed their professional identity at the time of one month before, and three months after clinical practice, compared the two results, and analyzed the related factors. Results The score of professional value dimension after clinical practice was higher than before (3.13±0.85 vs. 2.78±1.00, P=0.045), while the professional expectation dimension was lower than before (12.09±2.13 vs. 13.13±1.30, P=0.002), and the differences in above-mentioned indexes were statistically significant. There was no statistical difference before and after clinical practice in professional knowledge, professional affection, professional volition, professional skill dimensions, and total score of professional identity (Pgt;0.05). The related factors in a order from b to weak were clinical teacher (37.04%), practice work (33.33%), training department (22.22%), and others’ attitudes (7.41%). Conclusion Clinical practice may improve professional values but impair professional expectations of the student nurses, and clinical teacher and practice work have a great effect on student nurses’ professional identity.
【摘要】 目的 探讨使用营养风险筛查（nutritional risk screening，NRS）2002与生理生化指标联合评估大肠癌患者术前营养及二者的定量关系。 方法 对2008年4月-2009年3月收治的367例大肠癌患者，用NRS 2002与生理生化指标分别评估其术前营养风险和营养状况，对其进行相关性分析。 结果 有28%的大肠癌患者术前即存在营养风险，各评价指标对营养不良状况的检出率存在差异（9.3%～31.6%），且NRS 2002营养风险评分与血红蛋白（r=-0.117，P=0.025）、血清前白蛋白（r=-0.205，P=0.046）、血清白蛋白（r=-0.175，P=00.001）、体量质指数（r=-0.231，P=0.000）均呈负相关。 结论 大肠癌患者术前即存在较高的营养风险和营养不良，且营养风险与术前营养状况有关。【Abstract】 Objective To assess the preoperative nutritional risks and status of patients with colorectal cancer by nutritional risk screening 2002 (NRS 2002) combined with physiological-biochemical indicators, and explore their quantitative relationship. Methods NRS 2002 combined with physiological-biochemical indicators were applied on the 367 patients with colorectal cancer in Gastrointestinal Surgery Center in West China Hospital between April 2008 and March 2009 to assess their nutritional risks and status, and correlation analysis was done to explore their quantitative relationship. Results Among all the patients, 28% had preoperative nutritional risks. Different physiological-biochemical indicators detected different rates of malnutrition (9.3% to 31.6%), and there was a negative correlation between NRS 2002 and such physiological-biochemical indicators as hemoglobin (r=-0.117,P=0.025), pre-albumin (r=-0.205,P=0.046), albumin (r=-0.175,P=0.001), and body mass index (r=-0.231,P=0.000). Conclusion Many colorectal cancer patients have preoperative nutritional risks and malnurtrion, and the nutritional risks are correlated with preoperative nutritional status.
Objective To explore the factors associated with clinic follow-up of old patients with colorectal cancer and provide more evidence to improve the efficiency and quality of clinic follow-up after sugery. Methods The data of 253 patients who were underwent sugery because of old colorectal cancer in our hospital from January 2009 to May 2010 were reviewed. Data about the rate and times of clinic follow-up within 6 months after operation were collected via Hospital Information Systerm, then the follow-up rate was calculated, and to analyse the possible factors associated with follow-up times and rate. Results The total follow-up rate was 84.2%（213/253）, and the total times of follow-up was between 0 to 24 times per one, （4.08±0.03）times on average. On the times of follow-up, patients inside the city was higher than that outside, patients with medical or postoperative complications were higher than those without, and patients with a stoma was lower than that without, and the differences were statistically significant （P＜0.05）.While on the follow-up rate, patients underwent a radical sugery or with a stoma were lower than those not or without, and the differences were statistically significant （P＜0.05）. Conclusions The clinic follow-up of old colorectal cancer patients is not satisfactory, and the possible factors associated with follow-up times or rate are the distance between residence and hospital, have medical complications or not, have postoperative complications or not, radical sugery or not, and with a stoma or without.
With the continuous development of new drugs and immunotherapy, the survival period of patient with multiple myeloma (MM) is continuously prolonged, and the disease is becoming chronic. Due to the involvement of multiple systems and numerous complications, the daily nursing for MM faces significant challenges. The doctor-nurse-patient integration model and the whole life cycle health management model for daily nursing of MM are expected to reduce the social burden related to diseases, improve patients’ quality of life, and reduce medical costs. This article provides a review on three aspects of MM doctor-nurse-patient integration, whole life cycle health management, and daily health management involving multiple systems.