Table of Content

05 January 2016, Volume 51 Issue 1

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The research on nursing job-matching evaluation index system in the ward

YANG Xin, DIAN Hui-juan

2016, 51(1):  6-10.  DOI: 10.3761/j.issn.0254-1769.2016.01.001

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Objective To establish a job-matching evaluation index system for nursing management positions and clinical nursing positions of the ward，thus to provide a basis for scientific selection and training for nurses. Methods Through literature review，semi-structured interviews，and expert consultation method，the job-matching evaluation index system for nursing management positions and clinical nursing positions of the ward was screened and identified. Results The job-matching evaluation index system for nursing management positions included 2 first level indicators， 9 second level indicators，and 36 third level indicators for job expectations and competence； the job-matching evaluation index system for clinical nursing positions included 2 first level indicators，9 second level indicators，and 30 third level indicators for job expectations and competence. Conclusion The job-matching evaluation index system for nursing management positions and clinical nursing positions of the ward can be used for hospital human resource allocation，selection and training.

Construction of job training evaluation criteria for nurses

ZHANG Fang-fang, HUANG Li-hua, HU Yi-yu, FENG Zhi-xian

2016, 51(1):  11-14.  DOI: 10.3761/j.issn.0254-1769.2016.01.002

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Objective To establish job training evaluation criteria for nurses. Methods Based on Miller ability pyramid theory，the nursing job training evaluation criteria including evaluation items and conditions were formulated by group discussion and Delphi method. Results The expert‘s authority coefficient was 0.83，and the evaluation criteria were composed of Mini-CEX（Mini-Clinical Evaluation Exercise），DOPS（Directly Observed Procedural Skills） and CBD（Case-Based Discussion）. The coordination coefficients of indicators were from 0.132 to 0.456，respectively， with statistical significance（P<0.01）. Conclusion The job training evaluation criteria for nurses are reliable and scientific and can be used to evaluate nurses’ job training effects.

Research on the allocation standards of nursing human resources in skilled nursing unit in long-term care facilities

WANG Li, SUN Zhao-yuan, YIN Li, XIE Hong

2016, 51(1):  15-20.  DOI: 10.3761/j.issn.0254-1769.2016.01.003

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Objective To formulate allocation standards of nursing human resources by measuring workload of nursing staff in skilled nursing unit in long-term care facilities. Methods In reference to results of Delphi expert consultation，objective sampling was adopted and 15 nursing assistants and 4 registered nurses，working in skilled nursing unit in long-term care facilities in Tianjin，were investigated. Working hour measuring method was used to calculate nursing workload and human resource allocation formula was used to calculate allocation standard of nursing staff. Results Average daily direct nursing time was less than average daily indirect nursing time significantly provided by nursing assistants/nurses（t=18.761，P＜0.001/t=5.434，P=0.002）. In skilled nursing unit，the practical  proportioning of aged people to nursing assistant and nurse was 1 ∶0.1005 and 1 ∶0.0228 respectively，while the desired proportioning was 1 ∶ 0.3882 and 1 ∶ 0.0741. Conclusion Nursing workload can be determined scientifically by working hour measuring method，by which allocation standard of nursing staff can be calculated. At present，the proportioning of aged people to nursing staff is lower than standard，which can be improved by standardizing nursing working process，defining working scope of nursing staff，equitably distributing direct and indirect nursing time and increasing the number of nursing staff properly.

A path analysis of impacts of self-efficacy，social support and coping style on resilience in acute myocardial infarction patients

LIU Li-li, LIN Ping, ZHAO Zhen-juan

2016, 51(1):  21-25.  DOI: 10.3761/j.issn.0254-1769.2016.01.004

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Objective To determine the impacts of self-efficacy，social support and coping style on resilience in acute myocardial infarction（AMI） patients and to analyze the influence path. Methods A total of 296 patients with AMI in a tertiary hospital in Harbin were recruited by cross-sectional survey method. Patients were investigated using the Connor-Davidson resilience scale，the Self-Efficacy Questionnaire，Social Support Rating Scale and Medical Coping Modes Questionnaire. SPSS 17.0 software package and AMOS 21 were used for statistical analysis. Results The resilience score for patients with AMI was 57.79±12.39；self-efficacy，subjective support，confront and resignation coping style in AMI patients entered the multiple regression equation； self-efficacy and subjective support directly and indirectly influenced resilience of AMI patients，and confront coping style and resignation coping style influenced resilience directly. Conclusion AMI patients have poor resilience，and patients‘ self-efficacy，subjective support， confront and resignation coping style play an important role in enhancing resilience of AMI patients.

Effects of teach back method on the compliance of respiratory function exercise in esophageal cancer patients underwent thoracic surgery

HUANG Li, WANG Xiao-xia, ZHANG Juan

2016, 51(1):  26-28.  DOI: 10.3761/j.issn.0254-1769.2016.01.005

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Objective To explore the effects of teach back method on the compliance of respiratory function exercise among esophageal cancer patients underwent thoracic surgery. Methods A total of 50 patients with esophageal cancer received respiratory function exercise based on teach back method. Results After intervention，the compliance of respiratory function exercise was significantly improved（P<0.01）. Only 2 patients developed pneumonia. Conclusion Teach back method can effectively improve the compliance of respiratory function exercise and promote the recovery of the lung function.

The impacts of nursing intervention based on level of perception on consciousness and prognosis in cerebral coma patients

HUANG Chun-min, SUN Jian-hong

2016, 51(1):  29-34.  DOI: 10.376/j.issn.0254-1796.2016.01.006

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Objective To explore clinical effects of intervention on awakening of cerebral coma patients. Methods A total of 82 craniocerebral injured patients with severe cerebral coma were selected from March 2010 to February 2014. The control group（n=43） was provided routine nursing intervention，while the experimental group（n=39） was provided intervention based on level of perception. Glasgow coma score（GCS），dysfunction score（DFS），electroen- cephalogram（EEG） score，auditory brainstem evoked potential（ABEP） and state of consciousness of two groups were recorded and compared. Results At the end of 2，3 and 4 weeks after intervention，GCS and EEG scores of the experimental group were higher than those in the control group（P<0.05），and DFS score was lower than that of the control group （P<0.05）. After 4 weeks’ intervention，both indicators of ABEP in the experimental group were shorter （P<0.05）. Overall，in the experimental group，the rate of awakening was higher（P<0.05），the average days to achieve awakening were shorter（P<0.05），and the total efficiency of awakening was higher（P<0.05）. Conclusion Awakening severe cerebral coma patients using intervention based on level of perception can effectively improve consciousness and promote prognosis.

Acceptance of disability and its influencing factors for initial stroke patients

CHAI Qian-wen, YUAN Zhi-fang, JIN Yi, ZHANG Qing

2016, 51(1):  34-39.  DOI: 10.3761/j.issn.0254-1769.2016.01.007

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Objective To analyze the acceptance of disability for initial stroke patients and its influencing factors，and to provide theoretical evidence for psychological intervention and clinical rehabilitation. Methods A total of 150 hospitalized initial stroke patients were investigated with Adaptation of Disability Scale-Revised，Medical Coping Modes Questionnaire，Functional Activities Questionnaire，Self-Rating Depression Scale and Perceived Social Support Scale. Results The mean score for Adaptation of Disability Scale-Revised was（73.56±15.44），and dimensions in descending order were as follows：enlargement，transformation，containment，and subordination. Multiple linear regression analysis showed that confrontation，understanding of disease control，depression，functional activity，and perceived family support were major factors affecting acceptance of disability among initial stroke patients，which explained 51.8% of the total variance. Conclusion Nurses should detect initial stroke patients who are in low level of disability acceptance. Oriented by each dimension and influencing factors，proper psychological interventions should be provided to enhance the level of disability acceptance and psychosomatic rehabilitation.

The level and influence factors of stigma in people living with epilepsy

SONG Jie, LI Zhen, XU Yang, LI Hao, SHENG Yu

2016, 51(1):  40-44.  DOI: 10.3761/j.issn.0254-1769.2016.01.008

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Objective To describe the level and influence factors of stigma in people living with epilepsy. Methods A total of 109 epileptics were sampled from a hospital in Beijing through convenience sampling.The selected epileptics were asked to independently fill in designed questionnaires including patients’ general information fo rm,Chinese version of Kilifi Stigma Scale for Epilepsy, Social Support Rating Scale, Simplified Coping Style Questionnaire and EPQ-RSC. The score of epileptics’ stigma and 11 influencing factors（independent variable） were analyzed through multiple step-wise regression. Results The score of epileptics’ stigma was 8.27±5.21 and 6 stigmarelated influencing factors were identified.Among these factors, family per capita income （regression coefficient was -1.325，standard regression coefficient was -0.209），course of disease（regression coefficient was 1.382, standard regression coefficient was 0.269），objective support （regression coefficient was -0.474，standard regression coefficient was -0.228） and availability of social support （regression coefficient was -0.877，standard regression coefficient was -0.291) were included in regression equations with an explained variance of 27.4% . Conclusion The stigma of epileptics in China keeps a lower level than that in other developing countries. The research results show that high social support and social support availability, good family economic conditions and short course of disease can effectively reduce stigma. The next step is supposed to focus on how to further reduce epileptics’ stigma through intervention.

A survey of maternal needs toward midwife outpatient services

ZHAI Jin-guo, ZHENG Yan-fang, CAI Wen-zhi, ZHONG Mei, SHEN Jian, ZENG Fan-li

2016, 51(1):  45-48.  DOI: 10.3761/j.issn.0254-1769.2016.01.009

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Objective To explore maternal needs toward midwife outpatient services and to analysis the related fa ctors. Methods We investigated 319 cases of maternal women in January 2013 to March 2015 by purposive sampling method.A midwife outpatient services survey questionnaire was used. Results Age，educational background， fa mily income，delivery history affected maternal needs toward midwife outpatient services； differences of occupation and type of payment had no statistical significance. Multiple regression analysis showed that age，family income，delivery history entered into the regression equation. B coefficients were 0.16，-0.27 and -0.35. Conclusion Age，family income，delivery history are important factors affecting maternal needs toward midwife outpatient service. By understanding maternal needs toward midwives outpatient services，midwives can continuously improve quality of service.

The effect of individualized semi-demand feeding in premature infants

TAO Ya-qin, MA Lan, JIANG Pan-hua, LING Hui

2016, 51(1):  49-52.  DOI: 10.376/j.issn.0254-1769.2016.01.010

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Objective To evaluate the effect of individualized semi-demand feeding on the progress and performance of oral feeding，the time of body weight regain and length of hospital stay in premature infants. Methods Totally 140 premature infants were randomly assigned into the experimental group and the control group. The infants in the experimental group（n=70） received individualized semi-demand feeding in addition to the routine care. The control group（n=70） received routine care of NICU including intermittent feeding，postural support，and oral support. The postmenstrual age （PMA） and the total intake volume were recorded. Then，the progress and performance of oral fe eding，the time of body weight regain and length of hospital stay were calculated. Results Feeding efficiency，feeding proficiency and oral intake of milk in the experimental group were higher than those in the control group with statistically significant difference（P<0.05）. The transitional time from initiation of oral feeding to full oral feeding，the time of body weight regain and length of hospital stay in the experimental group were significantly shorter than that of the control group（P<0.05）. Conclusion The individualized semi-demand feeding is beneficial for premature infants to improve oral feeding.

Effects of compound essential oil acupressure on quality of life in perimenopausal syndrome patients

GAO Jing, BAI Ding-xi, WU Chen-xi, YANG Xiang-yu, ZHANG Qian

2016, 51(1):  53-57.  DOI: 10.376/j.issn.0254-1796.2016.01.011

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Objective To evaluatethe effects of compound essential oil acupressure on perimenopausal syndrome （PMS） patients‘ quality of life. Methods In this quasi-experimental study，64 patients in gynecology clinic in Neijiang City Hospital of TCM were recruited using convenience sampling method from November 2013 to April 2014，and were divided into two groups in accordance with random number table. The experimental group（n=32） received compound essential oil acupressure，while the control group（n=32） received acupressure. Both groups were provided with Qijudihuang Tang for oral therapy. Menopause-Specific Quality of Life （MENQOL） was used to evaluate quality of life of PMS patientsbefore and 4 weeks after intervention. Results After 4 weeks’ intervention，the overall quality of life in the experimental group was better than that in the control group，and the difference was statistically significant（P<0.01）； compared with the control group，each dimensionof MENQOL in the experimental group was lower，with statistically significant difference（P<0.05） in vasomotor symptoms，psychological symptoms，sexual symptoms， and no significant difference in sexual symptoms（P>0.05）. Conclusion Compound essential oil acupressure can improve quality of life of PMS patients.

Effects of percutaneous electrical stimulation on bone marrow suppression after chemotherapy in patients with lung cancer

HOU Li-li, GU Fen, ZHOU Cai-cun

2016, 51(1):  57-61.  DOI: 10.376/j.issn.0254-1796.2016.01.012

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Objective To investigate the effects of percutaneous electrical stimulation on bone marrow suppression in patients with lung cancer after chemotherapy. Methods A total of 110 non-small cell lung cancer patients with primary chemotherapy were divided into the experimental group and the control group（55 patients in each group）. The control group received routine nursing care，the experimental group received nursing care of acupoint electric stimulation. Red blood cell count，white blood cell count，platelet count and hemoglobin count mainly reflecting inhibition of bone marrow were measured and general comfort questionnaire was used. Results On the 5th day of chemotherapy，the platelet count in the experimental group was significantly higher than that in the control group （P＜0.05）；on the 8th day，the white blood cell count， platelet count and comfort score were significantly higher than those in the control group（P＜0.05）；on the 11th day，the platelet count was significantly higher than that in the control group （P＜0.05）；on the 14th day，the white blood cell count was significantly higher than that in the control group （P＜0.05）. Conclusion Percutaneous acupoint electric stimulation can prevent bone marrow suppression of lung cancer patients after chemotherapy and promote patients‘ comfort which ensure the smooth progress of chemotherapy.

Clinical studies of four skin care interventions for prevention of incontinence associated dermatitis

SONG Juan, JIANG Qi-xia, WANG Xue-mei

2016, 51(1):  62-65.  DOI: 10.376/j.issn.0254-1796.2016.01.013

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Objective To compare the effects of 4 skin nursing interventions on prevention of severe incontinent associated dermatitis （IAD）. Methods A total of 112 incontinence patients in ICU were randomly divided into Group A，B，C and D，respectively. Apart from identical skin care in all groups，for Group A，silicone dressing on perineal skin was applied once every 12h；for Group B，silicone dressing was applied every 8h；for Group C，Barrier fi lm on perineal skin was applied once every 12h；for Group D，Barrier film was applied every 8h. All interventions were conducted for 7 days，and rate of IAD，time to occur and severity was recoded. Results The total rate of IAD was 26.78%. The rates of IAD in Group A and B were lower than those in Group C and D（P<0.05）； for the same dressing with different frequency，there was no statistically significant difference regarding the rate of IAD. The differences about time to occur and severity in 4 groups had no statistical significance. Conclusion Applying silicone dressing every 8 hours and 12 hours can reduce rate of IAD. The frequency of applying silicone dressing can vary according to the frequency of incontinence.

Construction and application of information system of layered training for nurses

CUI Cui, ZHENG Xian-lan, SONG Hong, WU Wan-chun

2016, 51(1):  66-69.  DOI: 10.3761/j.issn.0254-1769.2016.01.014

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Objective To construct and apply the information system of layered training in order to improve nurses’ training practices. Methods The system was applied to cover the training practices of resource， operation， evaluation and promotion for nurses’ layered training through N1 to N4. Results After application， nurses’ technical practice， nursing theoretical knowledge，examination scores of first aid skills and satisfaction of layered training were improved significantly（P＜0.01），and nursing quality assessment scores were higher than before（P＜0.05）. Conclusion The information system is an effective tool for layered training practices for nursing staff， and provides scientific path for nursing layered management， which can improve training quality and management efficiency.

The effects of colleague solidarity on job satisfaction among operating room nurses

ZHANG Li-qing, ZHENG Dong-hua, XU Duo, CHEN Li-li

2016, 51(1):  70-74.  DOI: 10.376/j.issn.0254-1796.2016.01.015

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Objective To explore the effects of colleague solidarity on job satisfaction among operating room nurses. Methods A total of 268 operating room nurses were recruited from 3 tertiary hospitals in Wenzhou by convenience sampling method， and were investigated with Colleague Solidarity of Nurses’ Scale and Minnesota Satisfaction Questionnaire. The relationship between colleague solidarity of nurses and job satisfaction was analyzed. Results The total score of job satisfaction among operating room nurses was （56.0±14.0）. There were significant positive correlations between score of colleague solidarity of operating room nurses and score of job satisfaction. Regression analysis showed that the factor scores of colleague solidarity of nurses such as emotional solidarity and academic solidarity could independently explain 30.1% of the variance for job satisfaction after controlling demographic variables. Conclusion Clinical managers should focus on the shortcomings of colleague solidarity of operating room nurses， and take effective measures to improve job satisfaction in operating room nurses.

The application of action research method in scientific research ability training for nurses

GE Yu-rong, YAN Shu-ying, ZHAO Li-li, MENG Lan, LI Hai-xia, ZHAO Feng-mei

2016, 51(1):  75-79.  DOI: 10.3761/j.issn.0254-1769.2016.01.016

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Objective To improve nursing scientific research ability using action research method and to construct the curriculum of nursing scientific research training. Methods Action research method was adopted to improve scientific research ability for nurses. Forty-five nurses were divided into three rounds. The training was carried out through a cycle of “plan-action-observation-reflection”. Data were collected by group interview and self-assessment in order to find problems and improve training course. Results After the application of three rounds of training， there were significant increases in test scores of each course. The average score of the same course was significantly higher than before（P<0.05），and the scores of trainees in three rounds were gradually increased（F=48.481，P<0.001）. The group interview results showed that the trainees’ learning interest and learning autonomy were improved. Conclusion The action research method improves the effects of nursing scientific research training，and the curriculum of nursing scientific research training is constructed simultaneously.

Caring experience-oriented integrated competence training and thinking for pre-practicum nursing students

LIU Lu, HU Hua-gang, LI Hui-ling, MENG Hong-yan, LI Xiao-ping, WANG Jun, YANG Xiao-jun

2016, 51(1):  79-83.  DOI: 10.3761/j.issn.0254-1769.2016.01.017

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Objective To discuss the model and significance of caring experience-oriented integrated competence training for nursing students. Methods “Warm-up training” course of integrated competence training was carried out among nursing students before clinical practicum. The effects of training were measured by comprehensive assessment and self-experience reports before and after the practicum. Results Two themes were extracted by analyzing 250 self-experience reports，which were “caring experience in the teaching” and “caring experience in clinical practice”. Students before practicum responded that the course greatly promoted their personal growth and quality， helped them to eliminate the strangeness of clinical work. Students after practicum responded good self-perception； they showed a strong comprehensive ability and caring communication skills； they were more willing to dedicate themselves and to perceive patients thoroughly. Conclusion The pre-practicum integrated competence training can help students to develop the quality of caring，the skills of communication and creative thinking.

Development and psychometric test of a self-management behavior scale for young stroke patients

XU Na, JIN Yi, MA Zhan-ying

2016, 51(1):  103-107.  DOI: 10.3761/j.issn.0254-1769.2016.01.022

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Objective To develop a self-management behavior scale for young stroke patients and test its reliability and validity. Methods Literature review，semi-structured interviews and expert consultations were used to identify draft of the scale. A total of 140 young stroke patients were investigated by the scale，and the reliability and validity were tested，and the final scale was developed. Results Five factors and 26 items of the scale were finally determined. The cumulative contribution of variance was 75.75%; the content validity index was 0.857； the Cronbach’s alpha coefficient was 0.908； the split-half coefficient was 0.958； the test-retest coefficient was 0.923. Conclusion The self-management behavior scale was proved to be reliable and valid. It can be used to assess the self-manage-ment behavior of young stroke patients.

Development and reliability and validity tests of patient safety assessment scale

TIAN Min, LIU Feng, SONG Hong-xia, ZHANG Can-ling, LI Xiang-min, CUI Yu-fen

2016, 51(1):  108-112.  DOI: 10.3761/j.issn.0254-1769.2016.01.023

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Objective To develop the patient safety assessment scale and test its reliability and validity. Methods The scale was initially built through literature review，expert interviews and expert consultation method. A total of 351 nurses were selected to conduct pilot investigation. Item analysis，correlation analysis，exploratory factor analysis and Cronbach’s alpha were used to screen items. A total of 544 nurses were recruited to conduct formal investigation. The reliability of the scale was evaluated by consistency reliability analysis and split-half reliability analysis， and the validity was evaluated by exploratory factor analysis and confirmatory factor analysis. Results The scale was consisted of 7 dimensions and 54 items. Cronbach's alpha coefficient was 0.98，content validity index was 0.99，and accumulative contribution rate of each dimension was 63.28% to 78.26% . Confirmatory factor analysis showed the scale had good construct validity. Conclusion This scale has been proved reliable and valid and can be used for patient safety assessment.

Crisis intervention for a breast cancer patient with amputation after chemotherapy

YAO Lin-yan, ZHU Hong-fang, Feng Rui

2016, 51(1):  113-116.  DOI: 10.3761/j.issn.0254-1769.2016.01.024

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It reports a process of crisis intervention for a breast cancer patient with amputation after conservative radical mastectomy and chemotherapy，suffering from psychological crisis and suicide ideas. According tocrisis intervention model presented by Gilliland & James，through 6 steps of problem identification，ensuring safety，giving psychological support，proposing and validating the alternative coping style，working out the plan，and obtaining commitments from the patient，the Mental Health Liaison Nurse implemented 13 crisis interventions during 12 months with a satisfied result. The patient received the operation of amputation and recovered from the crisis event.

Evidence-based nursing of a scoliosis and respiratory failure patient with prolonged weaning from the ventilator

FENG Jie-hui, XU Jian-ning, FANG Xue-ling

2016, 51(1):  116-120.  DOI: 10.3761/j.issn.0254-1769.2016.01.025

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This paper introduces the evidence-based practice for prolonged weaning a patient from the ventilator with scoliosis and respiratory failure. The measures included identifying clinical problems，searching references through databases of Cochrane Library，PubMed and CNKI，evaluating quality of evidence and applying the best evidence for monitoring of pain，agitation and delirium，airway management，and implementation of early exercise. The patient got improvement after evidence-based nursing and weaned successfully from the ventilator for 21 days.