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10 February 2019, Volume 26 Issue 3
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Journal of Nursing. 2019, 26(3): 1-4. https://doi.org/10.16460/j.issn1008-9969.2019.03.001Objective To explore the influence factors of stress injury of adult patients after cardiac surgery in intensive care unit (ICU). Methods A retrospective analysis was performed on 322 cases of postoperative cardiac surgery adult patients admitted to the ICU of the First Affiliated Hospital of Xinjiang Medical University from January to December 2017. The clinical data and stress injury of the patients were described. Univariate analysis and multivariate logistic regression analysis were used to determine the influence factors of stress injury in postoperative cardiac surgery patients. Results The multiple logistic regression analysis showed that age and intraoperative blood transfusion volume were independent risk factors for stress injury after cardiac surgery in ICU patients (P<0.05). Gender, length of extracorporeal circulation, and intraoperative minimum body temperature were protective factors for stress injury after cardiac surgery in ICU patients (P<0.05). Conclusion The incidence of stress injury of adult patients after cardiac surgery in ICU is high, age, gender, intraoperative blood transfusion volume, length of extracorporeal circulation, and intraoperative minimum body temperature were influence factors.A comprehensive assessment of the patients is recommended. More attention should be paid to intraoperative blood transfusion volume, extracorporeal circulation time and intraoperative minimum body temperature. Meanwhile, predictive measures should be taken for patients thus to reduce the incidence of stress injury of ICU patients after cardiac surgery and to improve the quality of nursing service.
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Journal of Nursing. 2019, 26(3): 5-7. https://doi.org/10.16460/j.issn1008-9969.2019.03.005Objective To explore the efficacy of kneading the Jiache acupoint and clicking teeth on saliva flow rate and oral moisture subjective score in healthy people, and provide a early study of TCM nursing care for patients with dry mouth. Methods A randomized controlled trial was conducted in 135 subjects. With envelope method, people were randomly assigned into Jiache acupoint kneading group, clicking teeth group and blank group, with 45 cases in each group. The saliva flow rate and oral moisture subjective score were used to evaluate saliva secretion for all groups. Results There was significant difference in saliva flow rate between acupoint kneading group, clicking teeth group and blank group (P<0.001),and saliva flow rate in clicking teeth group was the highest. The subjective score of oral moisture in acupoint kneading group and clicking teeth group was higher than that in blank group (P<0.001). Conclusion Acupoint kneading and clicking teeth can effectively stimulate saliva secretion , and keep the oral mucosa moist.
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Journal of Nursing. 2019, 26(3): 8-11. https://doi.org/10.16460/j.issn1008-9969.2019.03.008Objective To develop a database of nursing adverse events based on human reliability analysis (HRA), to continuously improve the quality of nursing and management system for adverse care events. Methods The retrospective HRA of 714 nursing adverse events reported from January 2012 to December 2016 was made. Delphi method was used to construct a behavioral impact factor classification system for the operation of nursing adverse events; the expected effect of human reliability of each behavioral impact factor was taken as the reference probability of error by using the analytic hierarchy process (AHP), then human reliability database with the function of human factor analysis and prediction of nursing adverse events was established and applied in clinical departments in 2017. The prediction rate of nursing adverse event predicted by probability of human error was calculated. Results The repetition rate and severity of nursing adverse events caused by human error were decreased after the application of the database (P<0.05). Conclusion Human reliability database for nursing adverse events can reduce the possibility of errors in nursing adverse events and provide data support for the development of new HRA methods.
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Journal of Nursing. 2019, 26(3): 12-14. https://doi.org/10.16460/j.issn1008-9969.2019.03.012Objective To explore the effect of after-action review on improving meeting organization of department of nursing administration. Methods The meeting organization assessment form was used to evaluate 20 meetings organized by department of nursing administration from March to April 2018 for baseline data. In May 2018, the after-action review was introduced. After each meeting, the after-action review was performed in accordance with the following four steps: reviewing the Objectives, evaluating the results, analyzing the causes, and summarizing the experience. The after-action review lasted for 4 months. In the 18 meetings organized by department of nursing administration from September to October 2018, the meeting organization assessment form was used again. The data before and after the after-action review were compared. Results After the implementation of after-action review, the six major parts in meeting organization (pre-meeting arrangement, reception of the participants, venue layout and arrangement, event or conference theme presentation, logistics support services and other items) were significantly improved. The total score increased from 38.05±1.19 to 48.94±3.36, and the difference was statistically significant（P<0.01）. Conclusion The after-action review has a significant effect on improving the organization of the meeting.
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Journal of Nursing. 2019, 26(3): 28-33. https://doi.org/10.16460/j.issn1008-9969.2019.03.028Objective To systematically review the rescue experience of nurses in disaster response. Methods Databases including PubMed, CINAHL, Web of Science, PsycINFO（Ovid）, SAGE, ProQuest, CBM, CNKI, Wanfang data and VIP were searched from the inception to October 2017. Qualitative studies of the rescue experience of nurses participating in disaster response were collected. JBI Critical Appraisal Tool for qualitative studies was used to evaluate the quality of each study and the results were integrated by Meta synthesis. Results Fifteen studies were included in Meta-integration, and 64 major findings were extracted, which were summarized into 10 categories. Finally, 4 integration results were formed: adequate qualified staff and materials, inadequate targeted training and co-ordination of management, more attention to moral and legal issues involved in the relief and good psychological training for nurses. Conclusion Nurses play an important role in disaster relief. In addition to more importance to their own professional ethics, they also need to enhance their resilience to emergencies. Targeted training programs that cover nurses' psychological quality training, situational training of disaster relief and related ethics and legal information are needed. Besides, there is a need to coordinate and manage the rescue teams so as to ensure the refinement and precision of rescue deployment.
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Journal of Nursing. 2019, 26(3): 34-39. https://doi.org/10.16460/j.issn1008-9969.2019.03.034Objective To systematically review the real experience of job burnout in nurses. Methods We searched databases including CNKI, Wan Fang Data, VIP, PubMed, CINAHLand Web of Science form the inception to June 2018 to collect qualitative studies on experience of job burnout in nurses. After quality assessment, Meta synthesis was used to summarize and explain the results. Results Seven qualitative studies were included involving 32 clear results and 8 categories, then 4 integrated themes were extracted: individual factors, organizational factors, demand of support and nurse identity and self-value realization. Conclusion Clinical nursing staff should improve the cognition and processing ability of job burnout. Nursing managers should strengthen the awareness of nurses' job burnout, identify the influence factors of job burnout early and take intervention measures so as to improve the nursing quality.
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Journal of Nursing. 2019, 26(3): 40-45. https://doi.org/10.16460/j.issn1008-9969.2019.03.040Objective To describe the current status of stigma in patients with preventive ostomy and analyze its influence factors. Methods By convenience sampling method, 220 colorectal cancer patients with temporary ostomy in 4 tertiary grade A hospitals participated in the study and they were surveyed by using general information questionnaire, Social Impact Scale(SIS), Perceived Social Support Scale(PSSS), Self-Concealment Scale(SCS) and Medical Coping Modes Questionnaire(MCMQ). Multiple linear regression analysis was carried out for the influence factor of stigma. Results The total score of SIS was 60.62±7.28. Multiple linear regression analysis showed that stigma was affected by self-concealment, house location, social support, coping style, influence degree of stigma on sexual life and ostomy complications（P<0.001）, which could explain 75.0% of the variation. Conclusion Stigma in patients with preventive ostomy is in a mediate level. Alleviating patients' self-concealment tendency, giving them enough social support and helping them cope with the disease correctly can reduce patients' stigma. Sexual health education should be given to patients with sexual needs. For patients living in rural areas, multiple forms of healthy education and follow-up should be provided. Practical ostomy nursing skills and dynamic monitoring of ostomy are beneficial to reducing the incidence of ostomy complications,.
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Journal of Nursing. 2019, 26(3): 51-55. https://doi.org/10.16460/j.issn1008-9969.2019.03.051Objective To investigate the effects of resistance exercise on elderly patients with type 2 diabetes mellitus and frailty. Methods Totally 180 elderly patients with type 2 diabetes mellitus and frailty in our hospital from April 2017 to April 2018 were selected and assigned into 2 groups, with 90 cases in each group. The control group was given conventional treatment and health education and the observation group was given resistance exercise intervention. The physiology indexes including blood sugar, blood fat and body weight were measured and the frailty level were assessed using Fried Frailty Phenotype before the intervention, 1 month and 3 months after the intervention. Results Before the intervention, there was no significant difference in physiology indexes and frailty between the two groups(P>0.05);1 month and 3 months after the intervention, physiology indexes including blood sugar, blood fat indexes and body weight in observation group were better than those in control group and the proportion of patients with frailty in the observation group was lower than that in the control group (P<0.05). Conclusion Resistance exercise in elderly patients with type 2 diabetes mellitus and frailty can lower blood sugar, blood fat and body weight, and improve patients' frailty.
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Journal of Nursing. 2019, 26(3): 62-65. https://doi.org/10.16460/j.issn1008-9969.2019.03.062Objective To test the reliability and validity of the Chinese version of non-nutritive sucking scoring system (NNS) in preterm newborns (PTNB). Methods NNS in PTNB was translated from English to Chinese. The reliability and validity were tested among 180 premature infants in NICU. Results Content validity index of the scale was 0.893, and the average content validity index 0.937. Two common factors were extracted from the scale, which explained 68.475% of the total variance. The loading factor of all items was exceeded 0.4. The correlation coefficient between the 2 factors and the total was 0.979 and 0.449 respectively, showing statistical significance (P<0.01). Convergent validity was 0.460~0.932, and discriminant validity 0.004~0.389. Cronbach α coefficient of the scale was 0.896; the split-half reliability 0.873, and retest reliability 0.798. Conclusion The Chinese version of NNS in PTNB has been proved to be reliable and valid. It is a valuable tool for evaluating oral motor function of premature infants in China.
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Journal of Nursing. 2019, 26(3): 73-78. https://doi.org/10.16460/j.issn1008-9969.2019.03.073Objective To assess post-traumatic growth（PTG）of hematopoietic stem cell transplant (HSCT) patients with hematologic malignancies, to explore its intrinsic relationship with perceived social support, coping style and psychological resilience and to identify the mediating role of perceived social support and coping style. Methods With convenient sampling method, the 207 HSCT patients were selected from July to December 2016 and they were investigated by using the Posttraumatic Growth Inventory（PTGI）, Perceived Social Support Scale（PSSS）, Medical Coping Modes Questionnaire（MCMQ）and the score of the 10-item Connor-Davidson Resilience Scale（CD-RISC10）. Results The total score of PTGI in HSCT patients was 73.31±16.45, and that of PSSS was 66.51±11.45, the total score of MCMQ was 54.75±6.57, and the score of CD-RISC10 29.34±7.17. The scores of PTGI, PSSS, MCMQ and CD-RISC10 of HSCT patients were significantly positively correlated (r=0.441~0.551,all P<0.001). The constructed mediation model showed that resilience (β=0.535, P<0.01) and coping style (β=0.297, P<0.01) had a positively predictive effect on PTG and resilience had had a positively predictive effect on social support (β=0.563,P<0.01). Perceived social support and coping style played a mediating role in the psychological resilience and PTG of HSCT patients. Conclusion Score of PTG, social support, coping style and resilience of HSCT patients is in a mediate or above level. PTG is significantly positively correlated with perceived social support, coping style and resilience. Perceived social support and coping style play a mediating role in the psychological resilience and PTG of HSCT patients. Positive measures are proposed to take to improve patients' psychological resilience and social support, and guide them to adopt a positive coping style to face difficulties, so as to cultivate PTG.
