摘要：从国家精品课程资源网对护理网络精品课程的呈现及应用情况进行分析,结合文献对护理网络课程的开发与设计的分析得出,我国护理网络课程发展起步晚但发展迅速,但存在护理网络课程的资源分布不均、护理网络课程资源重复性差并缺乏共享性、护理网络课程开发与设计的研究较少、课程内容表现形式过于简单且资源不足、课程评价体系过于机械化。建议:护理网络课程应从学习者的实际需要出发,增加智能反馈系统,增加互动交流,实现资源共享,不断更新、完善护理网络课程。

摘要：Objective:This study aimed at exploring the attempters'perception of community social services included any barriers to seeking help and ***:The participants were patients with self-harming behavior aged 15 years or above.A set of guiding questions were designed to explore the general barriers and accessibility to community social services.A voice recording was made,which was later converted into a text transcript and then preceded for content analysis with co-occurrence and similarity matrix *** males and nine females with a history of self-harm aged between 24 and 58 years were recruited for the ***:The participants had diverse experiences and backgrounds,and attitudes toward community social ***,there was a shared perception of the need to enhance community social *** were four main themes and 12 sub themes *** main theme included the service availability,service accessibility,affordability and *** details,participants were unaware of the available types of care/social services in the community,and were unaware about the nearby social *** also suggested extending service hours and focused services should be offered to help people with different backgrounds and ***,those with experience of service utilization had both positive and negative perspectives and they gave suggestions for service delivery,mainly extending service hours and offering focused services such as for gambling control and financial *** view of interaction with service providers,counseling skills and trust were highly appreciated by the ***:The results identified common circumstances of falling into financial hardship(gambling)and social fragmentation(divorce,poor family relationships,and poor marital relationships),which also suggested to enhance services on center location,service arrangement,and skill of caregivers.

摘要：目的了解我国护生生命伦理意识及其特征,为今后开展生命伦理教育及研究提供依据。方法利用Kown研制的生命伦理意识问卷及自行设计的生命伦理特征问卷对杭州市2所护理院校的509名护生进行调查。结果 24.4%的护生生命伦理价值观明确;护生最为纠结的生命伦理问题为安乐死;护生生命伦理意识总均分2.94分;各维度中新生儿生命权得分最高(3.27),安乐死得分最低(2.56)。结论大部分护生仍持传统的生命神圣论、道德义务论观点;在护理伦理教育中有必要通过个案分析、小组讨论等多种教学方式探讨公益论等不同的生命伦理问题立场,扩大护生的伦理视野,使护生树立正确的生命伦理价值观。

摘要：目的汇总11个开展家庭医疗服务的专业姑息治疗团队效应。设计进行一项回顾性队列研究的汇总分析。地点加拿大，安大略省。参与者3109名在2009-2011年接受专业姑息治疗团队医疗服务的患者（暴露组）及3109名在此期间接受常规医疗服务的患者（非暴露组）。干预措施虽然这些姑息治疗团队所在地区和规模不同，但包含了相同的核心团队成员和角色分配，即能够为患者在其家中提供综合姑息治疗的姑息治疗专科医师、护士和家庭医生，团队任务包括全天候的管理症状、给予医疗信息和治疗措施以及协调服务。主要结局测量指标患者（a）在死亡前最后2周在医院度过；（b）死亡前最后2周有过急诊；（c）在医院内死亡。结果暴露组和非暴露组中癌症患者约占80％，且78％患者接受临终家庭医疗护理服务的平均时间相同。在所有姑息治疗团队中，暴露组中分别有970（31．2％）和896（28．9％）名患者在生命最后2周住院治疗和有急诊经历，而在非暴露组，分别为1219（39．3％）和1070（34．5％）名患者（P〈0．001）。暴露组与非暴露组患者在生命终期住院和经历急诊的汇总相对危险度分别为0．68[95％可信区间（CI，0．61～0．76）]和0．77[95％CI（0．69～0．86）]。与非暴露组相比，暴露组患者选择院内死亡的更少[503（16．2％）比887（28．6％），P〈0．01]，且在医院内濒死的汇总相对危险度为0．46（0．40-0．52）。结论尽管社区专业姑息治疗团队的组成和地区不同，但均能有效降低患者临终时急诊及选择在医院内死亡比例。

摘要：居住在护理院的老年人这一脆弱人群,有着复杂的健康和功能性需求,再加上众多的跌倒风险诱因,以及护理院的背景,致使以往的跌倒预防试验都不成功。设计并最终确定干预措施,以对护理院住户的日常生活产生积极影响,确实并不容易。然而,尽管存在这些困难,Logan及其同事发表的文章(doi:10.1136/BMJ-2021-066991)仍然对一项复杂的干预措施进行了很好的描述和展示,这项干预措施与英国长期居住在护理院的老年人跌倒率显著降低相关。

摘要：Objective To examine the resilience of parents of children with congenital heart disease and to investigate socio-demographic factors that may influence parents’*** This is a web-based survey study using a cross-sectional design.A purposive sampling method was utilized to recruit 515 parents who care for children with congenital heart *** was assessed using the Dispositional Resilience Scale-Ⅱ.Based on expert-interviews,a questionnaire was designed to collect socio-demographic *** statistics,factor analysis,and linear regressions were used to analyze *** A total of 413 parents completed the survey *** mean resilience score was 3.75(SD=0.61;range=1.89–4.89)with higher scores indicating higher *** linear regression models demonstrated that parents who had lower education levels and lower gross household income had lower resilience(P<0.05).Conclusions Parents reported resilience that reflected their ability to cope with stressful events and mitigate stressors associated with having and caring for children with congenital heart *** education levels and lower gross household income are associated with lower *** increase parents’resilience,nursing practice and nurse-led interventions should target screening and providing support for parents at-risk for lower *** lower education level and financial hardship are factors that are difficult to modify through personal efforts,charitable foundations,federal and state governments should consider programs that would provide financial and health literacy support for parents at-risk for lower resilience.

摘要：目的克罗恩病因其无法治愈及肠道症状特点,不可避免地影响了患者生活,并可能导致病耻感。本研究旨在调查克罗恩病患者病耻感的现状及影响因素。方法采用便利抽样的方法,于2020年10月至2021年3月对广州市某三级甲等医院消化内科病房的146例克罗恩病患者进行问卷调查。采用自行设计的一般资料问卷、社会影响量表(Social Impact Scale,SIS)、炎症性肠病自我效能量表(Inflammatory Bowel Disease-Self-Eficacy Scale,IBD-SES)及社会支持评定量表(Social Support Rating Scale,SSRS)分别对克罗恩病患者的一般资料、病耻感现状、自我效能和社会支持水平进行调查。采用多重线性回归分析对克罗恩病患者病耻感的影响因素进行分析。结果克罗恩病患者病耻感得分为(58.14±10.74)分,处于中等水平。85.6%(125/146)的克罗恩病患者存在中重度的病耻感。多重线性回归分析结果显示,患者感知到的社会公众对疾病的了解情况、家庭人均月收入、年龄、自我效能为克罗恩病患者病耻感的影响因素,可解释病耻感总变异的52%。结论绝大部分克罗恩病患者存在中重度的病耻感。感知到的社会公众对疾病的了解少、家庭人均月收入低、年龄≥40岁、自我效能低的克罗恩病患者表现出更高程度的病耻感。

摘要：Objectives: To examine if a low level of psychosocial resources in early pregnancy is associated with the occurrence of prolonged labour. Study design: A cross sectional study of 644 women expecting their first child. Participants were asked to complete a questionnaire at their first antenatal visit, measuring psychosocial resources defined as social network and support, work-related psychosocial factors, control of daily life and health characteristics. Outcome was prolonged labour at the end of the pregnancy. Results: A low level of psychosocial resources was not associated with prolonged labour. The majority of women reported that the degree of support was high in early pregnancy. Conclusions: A perceived low level of psychosocial resources in early pregnancy did not increase the risk of prolonged labour at the subsequent delivery.

摘要：目的确定12周指导性集体锻炼对治疗中的早期乳腺癌患者在机体功能和心理上的获益,并随访6个月。设计实用性、前瞻性、随机对照、开放性试验。地点苏格兰3家国家医疗卫生服务体系肿瘤门诊和社区运动设施。参加者共203位妇女参加研究;其中177位完成6个月随访。干预与常规护理相对照,干预组予12周指导性集体锻炼加常规护理。主要结果评价癌症治疗功能评价(FACT)问卷、贝克抑郁问卷、正性和负性情绪量表、体重指数、7日体力活动回忆问卷、12分钟步行实验和肩关节活动度评估。结果对基线值、研究中心、基线治疗和参加干预试验时的年龄进行校正后,综合效应模型的评估结果(干预组减对照组)显示第12周时:12分钟步行距离为129米(95%可信区间83～176),1周的中等强度活动时间182分钟(75～289),肩关节活动度2.6(1.6～3.7),乳腺癌特定的生活质量量表2.5(1.0～3.9),正性情绪4.0(1.8～6.3)。初步结果未发现干预锻炼对生活质量综合量表(FACT-G)有影响。随访6个月后,大多数效果维持不变,并且在乳腺癌特定的生活质量上得到改善。尚未有不良反应的报道。结论在12周干预锻炼结束时以及6个月后,指导性集体锻炼均显示出机体功能和心理上的获益。因此临床医生应该鼓励患者活动,决策者们应该考虑把体育锻炼纳入到癌症康复服务中来。试验注册号当前对照试验 ISRCTN12587864[***]。

摘要：背景:对于与随机对照试验(randomized controlled trial,RCT)有关的学术会议论文或期刊中发表的文章来说,清楚、明了、信息量充足的摘要是十分重要的,因为读者经常仅仅根据报告的摘要对一个临床试验作出评价。为此,我们需要对"临床试验报告的统一标准(Consolidated Standards of Reporting Trials,CONSORT)声明"进行扩充,制定一个期刊与学术会议论文摘要中报告RCT的必备条目清单。今后在任何期刊发表的论文或学术会议论文摘要中,作者对RCT结果的报告都要包含这些内容。方法与结果:我们根据现有的质量评价工具和基于经验的证据总结出一个条目清单。运用三轮修正式德尔菲法(modified-Delphi process)进行条目筛选。邀请共计109人参与电子网络调查,反馈率为61%。调查结果于2007年1月在加拿大蒙特贝罗举行的CONSORT小组会议中公布,与会的26人中有临床试验实施人员、统计学家、流行病学家以及生物医学编辑。经过讨论最终确定条目,随后对其进行修订以保证这些条目体现了会议期间以及会后的讨论思路。摘要CONSORT建议RCT报告的摘要需要有一个结构化的格式,其中应该包括具体的试验目的、试验设计(随机分配的方法、盲法或遮蔽等)、研究对象(对象描述、随机分组的样本量以及用于分析的样本量)、每组实施的干预、实施的干预对主要疗效结果的影响及其危害、试验结论、试验注册名称和编号以及资金来源。本文对每一条能够找到例子的纳入条目都配有良好报告范例、基本原理以及证据等,十分明了易懂,因此我们建议与清单同时使用。结论:摘要CONSORT旨在改善期刊与学术会议中发表的论文摘要的质量,这将有助于摘要提供详尽清晰的信息,这些信息能够帮助读者对试验的有效性和试验结果的适用性做出正确的评价。