分阶段心理干预在重症肌无力手术患者中的应用

目的探讨分阶段心理干预在重症肌无力患者中的应用效果。方法:将64例重症肌无力手术患者随机分为对照组与观察组观察组各32例。对照组予以常规护理方法。观察组在对照组的基础上对患者进行分阶段心理干预,用Zung焦虑自评量表(SAS)和Zung抑郁自评量表(SDS)在患者术后5天进行问卷调查。结果观察组较对照组焦虑和抑郁评分低,差异有统计学意义(P相似文献   

优质护理服务理念在慢阻肺(COPD)患者临床护理中的应用效果评价要素探索

目的 分析在慢阻肺患者护理中应用优质护理服务理念的实际效果。方法 病例选取自2020年1月～2021年1月本院,共计76例,均确诊为慢阻肺,随机数字表法平均分为两组,即对照组、观察组,各组均为38例患者,对照组患者应用常规护理,观察组则联合运用优质护理服务,就两组患者的心理状态、生活质量、护理满意度、血气指标以及肺功能指标等进行对比。结果 两组护理前SAS焦虑、SDS抑郁评分较高P>0.05,护理后观察组的SAS焦虑、SDS抑郁评分均低于对照组P<0.05;两组护理前SF-36生活质量评分较低P>0.05,护理后观察组SF-36生活质量评分高于对照组P<0.05;观察组护理满意度100.00%,对照组89.47%,P<0.05;护理前两组Sp O₂、Pa O₂、Pa CO₂相比差异小P>0.05,护理后SpO₂、Pa O₂观察组高于对照组,Pa CO₂观察组低于对照组P<0.05;护理前两组FEV₁     

基于“互联网+”平台的个案管理在主动脉夹层患者术后延续性护理中的应用

目的 探讨基于“互联网+”平台的个案管理在主动脉夹层术后患者延续性护理中的应用效果。方法选取2017年1月～2019年6月在我科行主动脉夹层腔内修复术后的患者64例,随机分为两组,实验组采用基于“互联网+”平台的个案管理进行延续性护理,对照组采用常规出院指导。比较两组患者的遵医依从性（包括正确服药、饮食控制、运动治疗、自我检测、定期复诊）、生活质量、焦虑抑郁行为及护理满意度。结果 出院后12个月,实验组正确服药、饮食控制、运动治疗、自我监测、定期复诊等遵医依从性形成率分别为87.5%、93.8%、90.6%、90.6%、87.5%,均高于对照组,除饮食控制外（P>0.05）,其他差异均有统计学意义（P<0.05）;实验组生活质量评分（83.07±6.17）,对照组生活质量评分（72.11±7.51）,差异有统计学意义（P=0.00）;两组焦虑行为程度比较,差异有统计学意义（P<0.05）,而抑郁行为程度比较却无统计学意义（P>0.05）;实验组患者护理满意度为96.88%,对照组患者护理满意度为75.00%,差异具有统计学意义（P<0.05）。结论 针对主...     

优化护患沟通用于下肢骨折病人中护理效果评价

目的 评价将优化护患沟通护理措施施于下肢骨折患者的临床应用效果。方法 研究目标选取2019～2020年甘肃省定西市人民医院收治的80例下肢骨折患者,均分为两组,分别实施常规护理（对照组）与优化护患沟通护理（观察组）,从并发症、满意度、患者焦虑（SAS）、抑郁（SDS）情绪评分等方面来对比两种护理方式的差异。结果 焦虑、抑郁评分比较,观察组更低（P<0.05）;护理满意度比较,观察组更高（P<0.05）;并发症发生概率比较,观察组更低,统计学数值P小于0.05。结论 针对下肢骨折患者的临床护理,以常规护理为基础联合优化护患沟通护理,可以对患者心理情绪的改善产生非常积极的影响,以此确保治疗效果,控制并发症的发生,临床意义深远。     

基于Mini-CEX评价的PBL教学模式对胸外科教学质量的影响研究

目的 探讨以迷你临床演练评估（Mini-CEX）为基础的以问题为中心的教学模式（PBL）对胸外科教学质量所产生的影响。方法 基于特定时间（2020年6-12月）及固定范围内（本院胸外科）,选取实习医生60名,将其依据随机数字表法分成两组,对照组30名开展传统带教模式教学,观察组则实施以Mini-CEX评价为基础的PBL教学模式,对比两组临床综合能力考核成绩、压力指数、教学满意度、职场正念评分。结果 观察组临床综合能力考核成绩各项评分均较对照组高（P<0.05）。观察组临床教学满意度较对照组高（P<0.05）。观察组压力指数评分较对照组低（P<0.05）,而职场正念评分均较对照组高（P<0.05）。结论 针对胸外科实习医生,通过采取基于Mini-CEX评价的PBL教学模式,能提高其临床综合能力及对临床教学的满意度,减轻工作压力,提高职场正念,应用价值突出。     

快速康复外科理念在腹腔镜直肠癌手术治疗中的临床应用及可行性分析

目的 探讨快速康复外科理念在腹腔镜直肠癌手术治疗中的临床效果。方法 选择甘肃省定西市人民医院100例直肠癌手术患者进行腹腔镜手术治疗后分组干预,对照组进行常规干预,实验组在对照组基础上进行快速康复外科理念。观察两组患者的临床数据。结果 实验组的临床疗效及患者满意度均高于对照组（P<0.05）,且手术时长、术中出血量、切口长度、住院时间及并发症发生率均少于对照组（P<0.05）。结论 在腹腔镜直肠癌手术治疗中进行快速康复外科理念的疗效显著,可有效降低并发症发生率,提高患者满意度。     

混合式教学在护理中职生神经内科临床教学中的应用

目的 探讨混合式教学在护理中职生神经内科临床教学中的应用效果。方法 选取2018年12月～2020年11月间我校护理中职生98例作为研究对象,分为观察组49例、对照组49例。对照组接受传统教学方式,观察组在常规护理基础上采用混合式教学。对比两组中职生的学习成绩情况,对比两组学生的教学满意度情况。结果 观察组中职生在基础操作、专科操作和理论成绩方面上的学习成绩明显高于对照组,P<0.05,观察组学生的教学满意度明显高于对照组,P<0.05。结论 混合式教学在护理中职生神经内科临床教学中的应用效果显著,能够提高学生的学习成绩,获得满意的教学质量,值得临床推广。     

盐酸度洛西汀联合盐酸乙哌立松治疗慢性紧张型头痛的临床研究

目的:评价盐酸度洛西汀联合盐酸乙哌立松治疗慢性紧张型头痛的疗效。方法:收集神经内科门诊及住院就诊的符合慢性紧张型头痛诊断标准的患者220例,依据汉密尔顿抑郁量表(HAMD17)、汉密尔顿焦虑量表(HAMA14)评价患者的情感障碍状态,将其分为A组(不伴焦虑抑郁组,124例)和B组(伴焦虑抑郁组,96例),A、B组再各自随机分为治疗组(A1组62例,B1组48例)和对照组(A2组62例,B2组48例);对照组单用盐酸乙哌立松治疗,治疗组在此基础上加用盐酸度洛西汀。分别于治疗前与治疗2周末、4周末、8周末统计患者头痛发作次数、持续时间、头痛程度;B组(伴焦虑抑郁)患者同时采用HAMD17、HAMA14评价患者的抑郁、焦虑程度。结果:治疗后,A、B两组中治疗组患者的头痛发作次数、头痛持续时间、头痛程度与对照组比较,差异有统计学意义(P<0.05);治疗2周末、4周末、8周末,B组(伴焦虑抑郁)患者的HAMD、HAMA评分与对照组比较,差异有统计学意义(P<0.01);治疗后A、B两组患者中,治疗组的总有效率与对照组比较,差异有统计学意义(P<0.05);两组患者均未见明显不良反应发生。结论:盐酸度洛西汀联合乙哌立松治疗伴或不伴焦虑、抑郁的慢性紧张型头痛患者的疗效较好、安全性高。     

优质护理应用于胆囊结石腹腔镜术后患者的效果研究

目的研究经过腹腔镜手术的胆囊结石患者在术后接受优质护理方式起到的临床作用。方法选择80例胆囊结石患者,治疗时间为2018年10月到2019年10月,这80名患者的手术方式均为腹腔镜手术。将患者平均分成两组,各40人。一组为对照组,在腹腔镜手术后进行常规护理干预。一组为观察组,在腹腔镜手术后进行优质护理干预。通过护理干预使患者术后身体可以得到有效地修复。在护理之后,比较两组患者的各项生理指标,包括术后恢复时间、生活情况、疼痛程度评估。调查患者的满意度。将两组患者的术后生理指标与个人满意度的调查结果进行对比,比较两种护理方式起到的作用。结果观察组患者的术后恢复时间相对较短;生活质量较好,疼痛改善状况较为优良,均优于对照组;调查结果显示,与对照组相比,观察组患者对护理的满意度评分更高。在几项数据的比较中,P<0.05,数据存在显著差异,具有统计学意义。结论胆囊结石患者进行腹腔镜手术后,在术后护理中应用优质护理对患者的恢复更有利,加快患者身体恢复,提升了生活水平,明显减弱患者身体上的疼痛感,提高了患者在住院期间的满意度。     

IMB模型护理对哮喘患者的效果及对动脉血气、生活质量的影响

目的 探讨信息—动机—行为(IMB)模型护理对哮喘患者的效果及对动脉血气、生活质量的影响。方法 本研究选择重庆医科大学附属第一医院2020年4月—2021年4月接诊的60例哮喘患者作为研究对象,采用抽签法将患者分为对照组、观察组,每组30例。对照组给予常规护理干预,观察组采用IMB模型护理干预,两组患者均连续干预1个月。比较两组在临床疗效、动脉血气指标及生活质量上的变化。结果 观察组患者干预后的临床疗效高于对照组,差异具有统计学意义(P<0.05);观察组患者干预后的PaO₂、SpO₂水平为(88.46±6.73)mmHg、(86.25±12.31)%,均明显高于对照组的(82.33±7.94)mmHg、(78.37±13.62)%,观察组患者干预后的PaCO₂为(34.48±8.62)mmHg,低于对照组的(40.63±6.24)mmHg,差异具有统计学意义(P<0.05);观察组患者干预后的家庭生活、精神动力、社会交往及心理承受评分分别为(39.14±1.58)分、(35.02±1.57)分、(37.20...     

Health, well-being and burnout of ICU nurses on 12- and 8-h shifts

It is generally agreed that some features of shift systems can influence the extent of well-being and health problems experienced by the workers involved. Extended working days (9-12 h) have been found to aggravate some problems associated with shiftwork, especially when the work is mentally and emotionally demanding. The aim of the study was to compare measures of health, sleep, psychological and social well-being, job satisfaction and burnout of ICU nurses on 12- and 8-h shifts. The groups of subjects were matced for age, length of shiftwork experience, marital status and number of hours worked. the 12-h shift nurses, when compared to their 8-h shift colleagues, experienced more chronic fatigue, cognitive anxiety, sleep disturbance and emotional exhaustion. Job satisfaction seems to be independent of the shift duration. The nurses on 12-h shifts reported less social and domestic disruption than those on 8-h shifts. The 12-h shift nurses showed worse indices of health, well-being and burnout tan the 8-h shift nurses. It is suggested that this may be associated with their longer daily exposure to the stress of work. The increased number of rest days of 12-h shift nurses seems tobe insufficient to dissipate the adverse health and well-being effects that built up over their longer shifts.     

Job satisfaction and occupational stress in UK general hospital nursing staff

This study investigated factors associated with the perceptions of stress reported by nurses in a general hospital environment in the UK. The levels and sources of stress experienced by nursing staff were examined in relation to the type of ward or department, and nursing grade. The association between reported stress and job satisfaction was also examined. By means of a self-completion questionnaire survey, data were collected from 234 nurses from 24 wards in a single general hospital. The Brayfield and Rothe job satisfaction index was used to provide data for analysis. Factor analysis, analysis of variance, and Pearson product moment correlation procedures were performed on these data. The factor analysis identified two main factors concerned with sources of stress: interpersonal relations and resource problems, and dealing with death. Although there were no differences found across wards, the analyses of variance revealed that reported stress varied over different nursing grades. It was also found that job satisfaction was correlated with nursing experience and negatively related to stress.     

Work satisfaction, health, and stress: A study of Dutch nurses

A study was conducted to compare nurses' work satisfaction and feelings of health and stress in five different nursing departments: a cardiac care unit and a general surgical ward in a general hospital; and an admissions department, a short-stay department, and a long-stay department in a psychiatric hospital. One hundred nurses took part in the study: the instruments used were questionnaires and structured interviews. The main results showed that:

(1) nurses in the cardiac care unit had the most positive satisfaction scores

(2) nurses in the general surgical ward had the most positive scores on the health and stress variables

(3) feelings of dissatisfaction and stress were most prominent in the short-stay department and, to a lesser extent, in the long-stay department.

The findings are interpreted in terms of the different work situations and die implications for hospital management are discussed.

Dr J. A. Landeweerd graduated in industrial and organizational psychology in 1968 (PhD in 1978). He has worked at Eindhoven University of Technology (Department of Industrial Engineering) and now holds a position as senior lecturer at Limburg University (Department of Health Sciences), where he is project-leader for a number of research projects on the relationships between work and health.

Nicolle Boumans, MA, graduated in health sciences in 1985 (specialization: nursing science) and is now a research assistant. She is working on a PhD thesis concerned with the relationship between task characteristics of nurses and their reaction in terms of job satisfaction, health and stress.     

Work satisfaction,health, and stress: A study of Dutch nurses

Abstract

A study was conducted to compare nurses' work satisfaction and feelings of health and stress in five different nursing departments: a cardiac care unit and a general surgical ward in a general hospital; and an admissions department, a short-stay department, and a long-stay department in a psychiatric hospital. One hundred nurses took part in the study: the instruments used were questionnaires and structured interviews. The main results showed that:

(1) nurses in the cardiac care unit had the most positive satisfaction scores

(2) nurses in the general surgical ward had the most positive scores on the health and stress variables

(3) feelings of dissatisfaction and stress were most prominent in the short-stay department and, to a lesser extent, in the long-stay department.

The findings are interpreted in terms of the different work situations and die implications for hospital management are discussed.

Dr J. A. Landeweerd graduated in industrial and organizational psychology in 1968 (PhD in 1978). He has worked at Eindhoven University of Technology (Department of Industrial Engineering) and now holds a position as senior lecturer at Limburg University (Department of Health Sciences), where he is project-leader for a number of research projects on the relationships between work and health.

Nicolle Boumans, MA, graduated in health sciences in 1985 (specialization: nursing science) and is now a research assistant. She is working on a PhD thesis concerned with the relationship between task characteristics of nurses and their reaction in terms of job satisfaction, health and stress.     

Impact of shift work and department type upon strain and attitudinal measures of hospital nurses

The effects of shift work (fixed versus rotating), type of hospital department (intensive care unit versus non-ICU), and job scope on stress and attitudes have been reported previously. The goal of the present study was to examine the interactive, as well as individual, impact of these variables on measures of perceived work stress, strain, work satisfaction and withdrawal intentions. Respondents in the study were nurses in a large general hospital in Israel. None of the two- or three-way interactions received empirical support. However, significant multivariate main effects for each of the three independent measures were found. The negative influence of rotating work shift compared to fixed work shift was supported. Nurses who thought that their job was more enriching were more satisfied and perceived their workload as being lower. Department type affected only burnout level; nurses in non-ICUs were lower in burnout. Several theoretical and practical possible interpretations and possible implications are presented.     

Four-stage process model of the core factors of burnout: the role of work stressors and work-related resources

The impact of work stressors and work-related resources on emotional exhaustion and depersonalization, as the two core factors of burnout, is investigated. According to the German Action Regulation Theory work stressors are conceptualized as regulation problems that lead to work stress in terms of additional effort (e.g. working longer hours), increased intensity of effort (e.g. working at a faster pace), and risky action (e.g. by neglecting safety rules). Consequently, an extended process model consisting of objective work stressors, work stress, emotional exhaustion and depersonalization is proposed. Nurses from three general hospitals (N=482) provided data for evaluating this model. Complete mediation of work stress and emotional exhaustion were analysed by hierarchical regression analysis. The overall model was tested by structural equation analysis in two steps; in the first step the basic model was analysed while in the second step the model was extended by autonomy as a work-related resource. The process model could be confirmed with respect to: (1) the mediating function of work stress and emotional exhaustion, and with regard to (2) the direct impact of autonomy as a work-related resource on work stressors but not on emotional exhaustion and depersonalization. Methodological considerations and implications for work design and burnout prevention are discussed.     

Anxiety, burnout and coping styles in general hospital staff exposed to workplace aggression: a cyclical model of burnout and vulnerability to aggression

Although an increasing problem, the aggression ( physical assault, threatening behaviour and verbal aggression) directed toward general hospital staff rather than staff in psychiatric institutions has not been widely investigated. The present study first compared anxiety, coping styles and burnout according to the frequency of aggressive experiences. Second, a sub-sample was examined to determine any immediate after-effects from aggressive encounters. Healthcare staff ( n = 375) across professions completed the State-Trait Anxiety Inventory, the Maslach Burnout Inventory and the Coping Responses Inventory, which were analysed according to the type and frequency of aggression experienced within the preceding year. There were no significant differences in levels of anxiety or in coping styles. However, significant differences were determined in levels of burnout. Emotional exhaustion and depersonalization were significantly higher in those staff more frequently victimized suggesting that aggressive encounters might lead to an increase in burnout. Equally, the converse might be true. Therefore, a cyclical model is put forward in which we propose that elevated levels of burnout from all sources might increase vulnerability to victimization. Increases in emotional exhaustion lead directly to an increase in depersonalization as a coping mechanism, which subsequently manifests as a negative behavioural change toward patients, thus rendering staff more vulnerable to further aggression.     

Four-stage process model of the core factors of burnout: The role of work stressors and work-related resources

The impact of work stressors and work-related resources on emotional exhaustion and depersonalization, as the two core factors of burnout, is investigated. According to the German Action Regulation Theory work stressors are conceptualized as regulation problems that lead to work stress in terms of additional effort (e.g. working longer hours), increased intensity of effort (e.g. working at a faster pace), and risky action (e.g. by neglecting safety rules). Consequently, an extended process model consisting of objective work stressors, work stress, emotional exhaustion and depersonalization is proposed. Nurses from three general hospitals (N=482) provided data for evaluating this model. Complete mediation of work stress and emotional exhaustion were analysed by hierarchical regression analysis. The overall model was tested by structural equation analysis in two steps; in the first step the basic model was analysed while in the second step the model was extended by autonomy as a work-related resource. The process model could be confirmed with respect to: (1) the mediating function of work stress and emotional exhaustion, and with regard to (2) the direct impact of autonomy as a work-related resource on work stressors but not on emotional exhaustion and depersonalization. Methodological considerations and implications for work design and burnout prevention are discussed.     

Anxiety,burnout and coping styles in general hospital staff exposed to workplace aggression: A cyclical model of burnout and vulnerability to aggression

Although an increasing problem, the aggression ( physical assault, threatening behaviour and verbal aggression) directed toward general hospital staff rather than staff in psychiatric institutions has not been widely investigated. The present study first compared anxiety, coping styles and burnout according to the frequency of aggressive experiences. Second, a sub-sample was examined to determine any immediate after-effects from aggressive encounters. Healthcare staff ( n = 375) across professions completed the State-Trait Anxiety Inventory, the Maslach Burnout Inventory and the Coping Responses Inventory, which were analysed according to the type and frequency of aggression experienced within the preceding year. There were no significant differences in levels of anxiety or in coping styles. However, significant differences were determined in levels of burnout. Emotional exhaustion and depersonalization were significantly higher in those staff more frequently victimized suggesting that aggressive encounters might lead to an increase in burnout. Equally, the converse might be true. Therefore, a cyclical model is put forward in which we propose that elevated levels of burnout from all sources might increase vulnerability to victimization. Increases in emotional exhaustion lead directly to an increase in depersonalization as a coping mechanism, which subsequently manifests as a negative behavioural change toward patients, thus rendering staff more vulnerable to further aggression.     

Gender differences in the effects of coping assistance on the reduction of burnout in academic staff

This study examined gender differences in the effectiveness of five sources of coping assistance to reduce dissatisfaction and emotional exhaustion among 403 female and 664 male academic staff of a Dutch university. It was hypothesized that support at work ((1) socio-emotional aid from the supervisor and colleagues, (2) a supportive climate in the department, and (3) practical assistance in the department) and support at home ((4) socio-emotional aid from the spouse, and (5) practical assistance from the spouse) would reduce dissatisfaction and burnout, and that women especially would benefit from these coping assistance measures. Using moderated regression analyses, the results showed that coping assistance from a supervisor and colleagues is an important measure to reduce both dissatisfaction and emotional exhaustion. Further, a supportive departmental climate and practical assistance in the department reduced emotional exhaustion and especially female academic staff benefited from these types of coping assistance at the aggregate level. However, contrary to expectations, such beneficial effects were not found for both socio-emotional aid and practical assistance from the spouse.