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期刊信息/Journal information
中华现代护理杂志
中华现代护理杂志

沈黎

旬刊

1674-2907

cjmn@cjmn.net

010-83191170

100052

北京市宣武门外大街香炉营东巷2号院1-7-301

中华现代护理杂志/Journal Chinese Journal of Modern NursingCSTPCD
查看更多>>1995年创刊，中国科学技术协会主管，中华医学会主办。本刊是护理学科领域综合性学术期刊，中国科技论文统计源期刊（中国科技核心期刊）。本刊主要以各级各类医疗机构中的护理工作者、高等医（药）院校和科研院所等机构中与护理学科相关的教学、科研人员及护理专业学生为主要的读者、作者对象。主要栏目有述评、论坛、专题报道、论著、讲座、综述、研究荟萃、管理?教育、技术?方法等。
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    安宁疗护服务实践现状与发展

    包慧敏朱冰河朱雪娇杨舒岚...
    841-847页
    查看更多>>摘要：近年来我国安宁疗护服务发展迅速，覆盖范围逐渐扩大，并取得初步成效，但各地区实践差异较大，有待进行系统、全面的总结分析。本文基于实施性研究的整合性理论框架从创新、外部环境、内部环境、个体特征、实施过程5个方面全面分析并总结安宁疗护服务的实施现况，发现促进该服务实施的主要因素为服务项目种类多且个性化、积极开展培训工作、多学科团队分工明确、服务模式多元化、重视服务的宣传工作等。服务面临的主要挑战为内外部激励措施不足、人力及药品可用资源不足、服务提供者知信行水平有待提升、服务流程有待统一、质量评价体系有待完善等。各级有关机构应联动起来，发挥促进因素的积极作用，克服阻碍因素，进一步推动我国安宁疗护的发展。 A rapid growth and steady expansion has been witnessed in hospice care with initial effects in recent years, however, there are significant differences in practice among different regions, and a systematic and comprehensive summary and analysis are needed. Based on the consolidated framework for implementation research, this paper comprehensively analyzes and summarizes the implementation status of hospice care services from five aspects, including innovation, external setting, internal setting, individual characteristics and implementation process. This paper finds that the main factors contributing to the implementation of this service are the varied and individualized services, active implementation of training, clear division of labor among multidisciplinary teams, diversified service models, and emphasis on service publicity. The main challenges faced by the service are insufficient internal and external incentives, insufficient resources available for manpower and medicines, the level of knowledge, attitude, and practice of service providers needs to be improved, the service process needs to be harmonized, and the quality evaluation system needs to be improved. Relevant institutions at all levels should work together to play a positive role in facilitating factors, overcome obstacles, and further promote the development of hospice care in China.

    综述安宁疗护整合性理论框架

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    本科实习护生死亡态度和生命意义感对安宁疗护态度影响的路径分析

    宇寰胡燕王路朱宇...
    848-854页
    查看更多>>摘要：目的 探讨本科实习护生死亡态度和生命意义感对安宁疗护态度的影响路径。 方法 本研究为横断面研究。采用便利抽样法，于2022年10 —12月选取安徽省合肥市2所学校的229名本科实习护生为研究对象。采用一般资料调查表、中文版佛罗梅尔特临终关怀态度B量表、中文版死亡态度描绘量表、中文版生命意义感量表对本科实习护生进行问卷调查。采用Pearson相关分析探讨本科实习护生死亡态度、生命意义感、安宁疗护态度的相关性，并运用结构方程模型检验死亡态度、生命意义感对安宁疗护态度影响的路径关系。 结果 本研究共发放问卷229份，回收有效问卷214份，问卷有效回收率为93.45%（214/229）。214名本科实习护生中文版佛罗梅尔特临终关怀态度B量表得分为（101.06±8.16）分、中文版死亡态度描绘量表得分为（91.21±12.13）分、中文版生命意义感量表得分为（94.45±11.90）分。Pearson相关分析结果显示，生命意义感与安宁疗护态度呈正相关（r=0.290，P<0.01），死亡态度与安宁疗护态度呈负相关（r=-0244，P<0.01）。结构方程模型路径分析结果显示，生命意义感（生活目标、生活态度）可通过死亡态度（逃离接受、自然接受、死亡恐惧）影响安宁疗护态度。 结论 对本科实习护生的生命意义感及死亡态度进行有效干预能够改善其安宁疗护态度。 Objective To explore the effect path of death attitude and purpose in life on attitude toward hospice care of undergraduate intern nursing students. Methods This study was a cross-sectional study. Using the convenient sampling method, a total of 229 undergraduate intern nursing students from two schools in Hefei, Anhui Province were selected as the research objects from October to December 2022. General data questionnaire, Chinese Version of Frommelt Attitudes Toward Care of the Dying Scale Form B (FATCOD-B-C), Chinese Version of Death Attitude Profile-Revised (DAP-R) Scale and Chinese Version of Purpose in Life Test (PIL-C) were used to investigate. Pearson correlation analysis was used to explore the correlation between death attitudes, purpose in life and attitude toward hospice care among undergraduate intern nursing students. Structural equation model was used to examine the path relationship between attitude towards death and purpose in life on attitude toward hospice care. Results A total of 229 questionnaires were sent out in this study, and 214 were effectively recovered, with an effective recovery rate of 93.45% (214/229). Among 214 undergraduate intern nursing students, the scores of FATCOD-B-C, Chinese Version DAP-R Scale, and PIL-C were (101.06±8.16), (91.21±12.13) and (94.45±11.90), respectively. The results of Pearson correlation analysis showed that the purpose in life was positively correlated with attitude toward hospice care (r=0.290, P<0.01), while the attitude to death was negatively correlated with attitude toward hospice care (r=-0244, P<0.01). The results of structural equation model path analysis showed that the purpose in life (life goal, life attitude) can affect attitude toward hospice care through death attitude (escape acceptance, natural acceptance, fear of death) . Conclusions Effective interventions on purpose in life and attitude towards death of undergraduate intern nursing students can improve their attitudes toward hospice care .

    学生,护理安宁疗护态度死亡态度生命意义感死亡恐惧逃离接受

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    认知障碍患者安宁疗护的研究进展

    李小雪杨志凝孙梦圆
    855-858页
    查看更多>>摘要：本文对认知障碍患者安宁疗护的发展历程、必要性、准入标准、内容、服务提供者、模式和质量等方面进行综述，以期为我国开展认知障碍患者安宁疗护工作提供参考。 This article reviews the development process, necessity, admission standards, content, service providers, models, and quality of hospice care for cognitive impairment patients, in order to provide reference for the implementation of hospice care for cognitive impairment patients in China.

    综述认知障碍安宁疗护

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    安宁疗护服务质量评价指标体系的构建

    杨舒岚项巧珍柴栖晨孙梦圆...
    859-864页
    查看更多>>摘要：目的 构建安宁疗护服务质量评价指标体系，为评价我国安宁疗护的临床实践质量提供科学依据。 方法 以医疗质量相关理论为基础，通过文献分析法构建初级条目池。于2023年11—12月，采用德尔菲法对18名来自10个省、直辖市的安宁疗护专家进行2轮函询，确立评价指标体系的各级指标，并通过层次分析法计算各级指标的权重及组合权重。专家积极系数以问卷有效回收率表示；专家权威程度以权威系数表示；专家意见协调程度以肯德尔和谐系数、变异系数表示。 结果 2轮专家函询问卷有效回收率分别为88.89%（16/18）、93.75%（15/16），专家权威系数分别为0.885、0.897，整体指标的肯德尔和谐系数分别为0.152、0.191（P<0.01），各级指标的变异系数分别为0～0.31、0～0.21。最终构建的安宁疗护服务质量评价指标体系包括7个一级指标、22个二级指标、42个三级指标。 结论 本研究构建的安宁疗护服务质量评价指标体系具有科学性、全面性和针对性，可为我国安宁疗护服务质量的综合评价提供参考依据。 Objective To construct an evaluation index system for the quality of hospice care services, so as to provide scientific basis for evaluating the clinical practice quality of hospice care in China. Methods Based on theories related to medical quality, a primary item pool was constructed through literature analysis. From November to December 2023, the Delphi method was used to conduct two rounds of consultation with 18 hospice care experts from 10 provinces and municipalities directly under the central government, to establish the indicators at all levels of the evaluation index system. The weights and combination weights of indicators at all levels were calculated using the analytic hierarchy process. The expert's positive coefficient was expressed as the effective response rate of the questionnaire. The degree of expert authority was expressed as the expert authority coefficient. The degree of coordination of expert opinions was represented by Kendall'sW and coefficient of variation. Results In the two rounds of expert consultation, the effective response rates of the questionnaires were 88.89% (16/18) and 93.75% (15/16), the expert authority coefficients were 0.885 and 0.897, the kendall'sW values of the overall indicators were 0.152 and 0.191 (P<0.01), and the coefficients of variation of indicators at all levels were 0 to 0.31 and 0 to 0.21, respectively. The final constructed evaluation index system for the quality of hospice care services included seven first level indicators, 22 second level indicators, and 42 third level indicators. Conclusions The evaluation index system for the quality of hospice care services constructed is scientific, comprehensive, and targeted, which can provide reference for the comprehensive evaluation of hospice care service quality in China.

    安宁疗护照护质量评价指标层次分析

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    癌症患者睡眠信念与态度量表的汉化及信效度检验

    马良慧李玉红翁慧袁德慧...
    865-871页
    查看更多>>摘要：目的 汉化癌症患者睡眠信念与态度量表（C-DBAS-14）并检验其信效度。 方法 依据Brislin翻译模型对韩文版C-DBAS-14进行翻译、回译及文化调适，形成中文版C-DBAS-14。采用便利抽样法，选取2022年10月—2023年5月在安徽医科大学第一附属医院住院的361例癌症患者为研究对象，采用一般资料调查表、中文版C-DBAS-14、失眠严重程度指数量表、医院焦虑抑郁量表对患者进行调查，以评价量表的信效度。量表的项目分析采用相关系数法及临界比值法；采用结构效度、内容效度及聚合效度评价量表的效度；采用Cronbach's α系数和组内相关系数评价量表的信度。 结果 本研究共发放问卷361份，回收有效问卷356份，问卷有效回收率为98.6%（356/361）。中文版C-DBAS-14包含4个维度，共14个条目。量表水平的内容效度指数为0.976，条目水平的内容效度指数为0.833～1.000。探索性因子分析共提取出4个公因子，解释总方差的78.8%。验证性因子分析显示，卡方自由度比为1.286，比较拟合指数为0.991，拟合优度指数为0.945，递增拟合指数为0.991，非规准适配指数为0.988，近似误差均方根为0.036。量表总的Cronbach's α系数为0.874、组内相关系数为0.863。量表得分与失眠严重程度指数得分、医院焦虑抑郁量表得分均呈负相关（r值分别为-0.734、-0.639，P<0.01）。 结论 中文版C-DBAS-14具有良好的信度和效度，可作为我国癌症患者不合理睡眠信念的评估工具。 Objective To translate the Dysfunctional Beliefs and Attitudes about Sleep Scale for Cancer Patients (C-DBAS-14) into Chinese and test its reliability and validity. Methods The Korean version of C-DBAS-14 was translated, back-translated, and culturally adapted into Chinese based on Brislin's translation model, forming the Chinese version of C-DBAS-14. From October 2022 to May 2023, 361 hospitalized cancer patients at the First Affiliated Hospital of Anhui Medical University were selected as research objects by convenient sampling method. They were surveyed using a general information questionnaire, the Chinese version of C-DBAS-14, the Insomnia Severity Index (ISI), and the Hospital Anxiety and Depression Scale (HADS) to evaluate the reliability and validity of the scale. The scale's item analysis was based on correlation coefficients and critical ratio values structural validity, content validity, and convergent validity were used to evaluate the scale's validity Cronbach's α coefficient and intraclass correlation coefficient were used to assess its reliability. Results A total of 361 questionnaires were distributed, 356 were effectively returned, with an effective response rate of 98.6% (356/361). The Chinese version of C-DBAS-14 contained 14 items across four dimensions. The scale-level content validity index was 0.976, and the item-level content validity index ranged from 0.833 to 1.000. Totally four common factors were extracted in exploratory factor analysis, explaining 78.8% of the total variance. Confirmatory factor analysis showed a Chi-square/degrees of freedom ratio of 1.286, comparative fit index of 0.991, goodness of fit index of 0.945, incremental fit index of 0.991, Tucker-Lewis index of 0.988, and root mean square error of approximation of 0.036. The total Cronbach's α coefficient of the scale was 0.874, and the intraclass correlation coefficient was 0.863. The C-DBAS-14 score was negatively correlated with the ISI and HADS scores (r=-0.734, -0.639 P<0.01) . Conclusions The Chinese version of C-DBAS-14 has good reliability and validity and can be used as an assessment tool for irrational sleep beliefs in Chinese cancer patients.

    肿瘤信度效度睡眠信念与态度

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    参与隔代抚养的城市老年人成功老龄真实体验及需求的质性研究

    赵凤仪季红庞慧徐真真...
    872-878页
    查看更多>>摘要：目的 了解参与隔代抚养的城市老年人成功老龄的真实体验及需求。 方法 本研究为质性研究。于2023年2—4月，采用目的抽样法选取济南市长清区范景家苑社区的10名参与隔代抚养的老年人为研究对象，采用半结构式访谈和面对面非语言行为观察法收集资料，并采用Colaizzi 7步分析法对资料进行归纳分析并提炼主题。 结果 共提炼出3个主题与10个亚主题，分别为正性心理感受（自我实现、获得情感支持、健康获益）、负性心理感受（隔代教养压力、生活满意度下降、精神压力、身心疲惫）、为促进成功老龄的需求（家庭支持、社区支持、政策支持）。 结论 参与隔代抚养的城市老年人存在负性心理体验同时也表现出正性心理体验，家庭及社会应该重视城市社区中参与隔代抚养老年人的心理感受，从而促进老年人群体实现成功老龄。 Objective To explore the real experience and needs of successful aging among urban elderly people who participated in intergenerational raising. Methods This study was a qualitative study. From February to April 2023, purposive sampling was used to select 10 elderly individuals from Fanjingjiayuan Community in Changqing District, Jinan City who participated in intergenerational raising as the research subject. Semi-structured interviews and face-to-face nonverbal behavior observation methods were used to collect data, while Colaizzi's 7-step analysis method was used to summarize, analyze the data and extract themes. Results A total of three themes and 10 sub-themes were extracted, namely positive psychological feelings (self-realization, obtaining emotional support, health benefits), negative psychological feelings (intergenerational raising pressure, decreased life satisfaction, mental stress, physical and mental exhaustion), and the need to promote successful aging (family support, community support, policy support) . Conclusions Urban elderly people who participate in intergenerational raising have both negative and positive psychological experiences. Families and society should pay attention to the psychological feelings of participating in intergenerational raising of elderly people in urban communities, so as to promote successful aging of the elderly people.

    老年人隔代抚养成功老龄需求体验质性研究

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    一种自动配比药液泡脚装置的设计与介绍

    王慧捷李亚楠王文娟孙梦圆...
    878页
    查看更多>>摘要：部分下肢关节镜手术为防止足部皮肤细菌影响伤口愈合，患者术前常采用高锰酸钾溶液浸泡双脚，需要将高锰酸钾加入水中，配比出合适比例的药液。但目前临床中尚不能精准地调节水与高锰酸钾的比例，导致药物浓度不够精确，影响浸泡效果，因此，笔者设计了一种泡脚装置，解决常规的泡脚装置的不足，现报道如下。
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    基于HAPA模型的鼻咽癌放化疗患者自我营养管理的质性研究

    陈小爱梁聪徐丽丽廖姿艺...
    879-884页
    查看更多>>摘要：目的 以健康行动过程取向（HAPA）模型为理论基础，探讨鼻咽癌放化疗患者自我营养管理的体验与内心感受。 方法 本研究为质性研究。采用目的抽样法，于2023年3—4月对南华大学附属第二医院肿瘤中心二区的15例鼻咽癌放化疗患者进行半结构式访谈，采用Colaizzi 7步分析法对原始资料进行分析。 结果 根据HAPA模型的2个阶段，共提炼出3个主题，分别为自我营养管理正向认知、自我营养管理困难多、自我营养管理能力不足。 结论 医护人员应分析患者的个体差异，了解患者自我营养管理的主观感受、困惑及需求，为其提供个体化的营养教育与支持，改善其自我营养管理体验，提升其自我营养管理能力。 Objective To explore the experience and inner feeling of self-nutrition management in patients with nasopharyngeal carcinoma undergoing radiotherapy and chemotherapy based on health action process approach (HAPA) model as the theoretical foundation. Methods This study was a qualitative sutdy. Using the purposive sampling method, the semi-structured interview was conducted on 15 nasopharyngeal carcinoma patients with radiotherapy and chemotherapy in Department of Tumor Center Area 2 in the Second Affiliated Hospital of University of South China. Colaizzi 7-step analysis method was used to analyze the original data. Results According to the two stages of HAPA model, three themes were extracted, namely, positive cognition of self-nutrition management, difficulty in self-nutrition management and lack of self-nutrition management ability. Conclusions Medical staff should analyze individual differences among patients, understand their subjective feelings, confusion and needs for self nutrition management, provide personalized nutrition education and support, improve their self nutrition management experience and enhance their self nutrition management abilities.

    鼻咽癌健康行动过程取向模型放化疗自我营养管理质性研究

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    社区老年人内在能力现状及影响因素分析

    刘雪肖树芹王凌云温慧敏...
    885-892页
    查看更多>>摘要：目的 了解社区老年人的内在能力的现状，并分析影响因素。 方法 采取便利抽样法，于2022年9月—2023年3月选取北京市西城区及河北省邢台市的360名社区老年人为研究对象，采用内在能力评估表、内在能力影响因素调查表、日常生活活动能力量表、工具性日常生活活动量表对研究对象进行调查。采用多重线性回归分析探讨社区老年人内在能力的影响因素。 结果 本研究共发放问卷360份，回收有效问卷360份，问卷有效回收率为100.0%（360/360）。360名社区老年人内在能力总体受损率为90.3%（325/360），各领域受损率由高到低分别是感觉、心理、活力、认知、运动。多重线性回归分析结果显示，年龄、性别、居住方式、受教育程度、工作状态、握力、老年综合征数量、自评健康状况、负性生活事件、社交活动数量、交通条件、社会安全保障是社区老年人内在能力的影响因素（P<0.05）。 结论 社区老年人内在能力受损率较高。基层医务人员在健康促进工作中应重视社区老年人内在能力的评估，及早识别内在能力下降的老年人，进行有效干预，以预防老年人失能和照护依赖。 Objective To explore the current situation of the intrinsic capacity of elderly people in the community and analyze its influencing factors. Methods From September 2022 to March 2023, convenience sampling was used to select 360 elderly community residents from Xicheng District, Beijing, and Xingtai City, Hebei Province, as the research subjects. The subjects were surveyed using the Intrinsic Capacity Assessment Questionnaire, Intrinsic Capacity Influencing Factors Questionnaire, Barthel Index, and Lawton Instrumental Activities of Daily Living Scale. Results A total of 360 questionnaires were distributed, and 360 valid questionnaires were collected, with an effective response rate of 100.0% (360/360). The overall impairment rate of intrinsic capacity among 360 elderly people in the community was 90.3% (325/360), and the impairment rates in various fields from high to low were sensation, psychology, vitality, cognition, and exercise. Multiple linear regression analysis showed that age, gender, residential pattern, education level, work status, grip strength, number of geriatric syndrome, self-rated health status, adverse life events, number of social activities, transportation conditions, and social security were the influencing factors of the intrinsic capacity of elderly people in the community, and the difference was statistically significant (P<0.05) . Conclusions The impairment rate of intrinsic capacity among elderly people in the community is relatively high. Grassroots medical and nursing staff should assess the intrinsic capacity of elderly people in the community in health promotion work, identify elderly people with decreased intrinsic capacity early and carry out effective interventions to prevent elderly people from becoming disabled and dependent on care.

    老年人内在能力影响因素

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    肺癌患者围手术期症状管理体验和需求的质性研究

    毛莹颖丁君蓉胡颖燕石敏...
    893-899页
    查看更多>>摘要：目的 了解肺癌患者围手术期症状管理的体验及需求，为进一步制订肺癌患者症状群自我管理干预措施提供参考。 方法 本研究为描述性质性研究。采用目的抽样法，选取2023年2—3月于同济大学附属上海市肺科医院接受手术治疗的18例肺癌患者作为研究对象，对其进行半结构式访谈。采用主题分析法进行资料分析。 结果 共提炼出4个主题，包括围手术期症状负担重、症状群对患者的负面影响、症状管理的阻碍因素、对症状自我管理的需求。 结论 肺癌患者在围手术期存在多种负担，对患者产生严重困扰，患者在症状自我管理方面存在阻碍因素和不同需求，医护人员应采取针对性的干预措施及改善策略，以提高患者症状自我管理能力、减轻症状负担并改善生活质量。 Objective To explore the experience and needs of perioperative symptom management in lung cancer patients, so as to provide reference for further developing self-management interventions for symptom clusters in lung cancer patients. Methods This study was descriptive and qualitative. From February to March 2023, purposive sampling was used to select 18 lung cancer patients who underwent surgery at the Shanghai Pulmonary Hospital Affiliated to Tongji University as the research subject, and semi-structured interviews were conducted on them. The thematic analysis method was used for data analysis. Results Four themes were extracted, including the heavy burden of perioperative symptoms, the negative impact of symptom clusters on patients, obstacles to symptom management, and the need for symptom self-management. Conclusions Lung cancer patients face various burdens during the perioperative period, causing serious distress to the patients. Patients have obstacles and different needs in symptom self-management. Medical and nursing staff should adopt targeted interventions and improvement strategies to enhance patient symptom self-management ability, reduce symptom burden, and improve quality of life.

    肺肿瘤症状体验症状管理质性研究

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