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 分析臨床實習對護理本科生專業認同的影響，探討提高專業認同的措施。 方法 2010年6—10月，對某綜合性大學60名2007級普通全日制護理本科生進行抽樣調查，評價其實習前1個月和實習后3個月的專業認同情況，比較實習前、后的變化并分析影響因素。 結果 實習后專業認同的專業價值觀得分[（3.13±0.85）分]高于實習前[（2.78±1.00）分]，實驗專業期望得分[（12.09±2.13）分]低于實習前[（13.13±1.30）分]，差異有統計學意義（P=0.045，0.002）；而專業認識、情感、意志、技能和專業認同總分方面，實習前、后差異無統計學意義（Pgt;0.05）；其影響因素由強到弱依次為:帶教老師（37.04%）、實際的護理工作（33.33%）、實習科室（22.22%）、他人態度（7.41%）。 結論 臨床實習可提高護理本科生的專業價值觀，帶教老師及實際護理工作對專業認同影響較大。【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.
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.
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.
【摘要】 目的 探討使用營養風險篩查（nutritional risk screening，NRS）2002與生理生化指標聯合評估大腸癌患者術前營養及二者的定量關系。 方法 對2008年4月-2009年3月收治的367例大腸癌患者，用NRS 2002與生理生化指標分別評估其術前營養風險和營養狀況，對其進行相關性分析。 結果 有28%的大腸癌患者術前即存在營養風險，各評價指標對營養不良狀況的檢出率存在差異（9.3%～31.6%），且NRS 2002營養風險評分與血紅蛋白（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）、體量質指數（r=-0.231，P=0.000）均呈負相關。 結論 大腸癌患者術前即存在較高的營養風險和營養不良，且營養風險與術前營養狀況有關。【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.