论著

护士的护理伦理敏感性现状及影响因素 Meta 分析

Meta-analysis of the current status and influencing factors of nurses’ ethical sensitivity in nursing

:56-62
 
       目的   系统评价护士的护理伦理敏感性现状及影响因素,为针对性干预提供参考。方法   检索国内外相关数据库,检索时限为2024年7月护士的护理伦理敏感性现状及影响因素的相关文献。由两名分析人员独立筛选文献、提取资料、质量评价后采用Stata 15.0和RevMan 5.3软件进行meta分析。结果   纳入16篇文献,包括4 961例研究对象。Meta分析结果显示,护士的护理伦理敏感性处于中等偏高水平,总分为[OR=67.29,95%CI(53.24,81.34)]分。年龄OR=2.78,95%CI(1.45,5.33),P=0.002]、工作年限[OR=3.55,95%CI(1.35,9.33),P=0.001]、伦理知识教育[OR=14.60,95%CI(4.24,50.32),P<0.001]、共情能力[OR=1.35,95%CI(1.01,1.80),P<0.001]、工作场所氛围[OR=1.85,95%CI(0.42,4.51),P<0.001]、工作嵌入量[OR=3.60,95%CI(0.40,32.84),P=0.001]是护士护理伦理敏感性的主要影响因素。结论   当前证据表明,护士的护理伦理敏感性处于中等偏高水平,影响因素较多,管理者需结合人群特征实施干预,以提高护士护理伦理敏感性水平。
   Objective  To systematically evaluate the current status of nurses’  ethical  sensitivity in  nursing  and influencing factors that influence it,in order to inform targeted interventions.Methods  Domestic and international databases were searched to collect literature related to the current status of nurses’ ethical sensitivity in nursing and the factors influencing it from the year of construction to July 2024.Meta-analysis was performed by two analysts independently screening the literature,extracting information,and quality evaluation using Stata 15.0 and RevMan 5.3 software.Results  Sixteen papers including 4 961 study subjects were included.Meta-analysis results showed that nurses had moderately high level of ethical sensitivity in nursing with a total score of 67.29(95%CI[53.24,81.34]).Age(OR=2.78,95%CI[1.45,5.33],P=0.002),years of experienceOR=3.55,95%CI[1.35,9.33],P=0.001),education on ethical knowledge(OR=14.60,95%CI[4.24,50.32],P<0.001),and empathic ability(OR=1.35,95%CI[1.01,1.80],P<0.001),workplace atmosphere(OR=1.85,95%CI[0.42,4.51],P<0.001),and the amount of job embeddedness(OR=3.60,95%CI[0.40,32.84],P=0.001) were the main influences on nurses’ ethical sensitivity in nursing.Conclusions  The previous evidence suggests that nurses have moderately high levels of nursing ethical sensitivity,with a high number of influencing factors,and managers need to give interventions that incorporate the characteristics of the population in order to increase the level of nursing ethical sensitivity among nurses.
综述

缺氧诱导因子调控的铁死亡及其在胃肠道疾病中的作用研究进展

Research progress in hypoxia-inducible factor regulated ferroptosis and its implications in gastrointestinal disease

:16-23
 
       铁死亡是一种以铁依赖性脂质过氧化为特征的程序性细胞死亡形式。近年来研究表明,铁死亡与缺氧应答的关键调控因子——缺氧诱导因子(HIF)存在密切关联。HIF(包括HIF-1α、HIF-2α、HIF-3α三种亚型)调控的铁死亡在结直肠癌、胃癌、溃疡性结肠炎及其他胃肠黏膜损伤性疾病中发挥作用,影响疾病的发生发展。但目前关于HIF-铁死亡通路在不同胃肠道疾病中的差异化作用及调控机制尚未完全阐明。因此,本文对HIF各亚型调控铁死亡的分子机制及其在胃肠道疾病中的作用进行综述,以期为靶向HIF-铁死亡通路治疗相关疾病提供新的思路。
       Ferroptosis is a form of regulated cell death characterized by iron-dependent lipid peroxidation.Recent 
studies have demonstrated a close association between ferroptosis and hypoxia-inducible factor(HIF),the key  regulator of the hypoxic response.Ferroptosis regulated by HIF(comprising three isoforms:HIF-1α,HIF-2α,and HIF-3α)plays a  role in colorectal cancer,gastric cancer,ulcerative colitis,and other gastrointestinal mucosal injury diseases,impacting their initiation and progression.However,the differential roles and regulatory mechanisms of the HIF-ferroptosis pathway in various gastrointestinal diseases remain incompletely elucidated.Therefore,this  review  summarizes the molecular mechanism networks through which individual HIF isoforms regulate ferroptosis and their roles in gastrointestinal diseases,with the aim of providing new perspectives for targeting the HIF-ferroptosis pathway to treat relevant diseases.
论著

广州市某三甲医院老年住院患者服务需求现状及影响因素分析

Current status and influencing factors of elderly patients’ service needs in Guangzhou

:1736-1744
 
       目的   调查老年人照护服务需求现状并分析其影响因素,为构建基于需求为导向的老年照护服务体系提供参考依据。方法  采用便利抽样法,选取广州市某三甲医院212名老年人作为调查对象,采用日常生活能力量表、Fried衰弱评估量表及自行编制的老年人需求评估问卷进行调查。结果   老年人对运动与营养(1.96±0.90分)、心理慰藉(2.63±0.85分)、安宁服务(2.73±1.07分)的需求水平较高。多因素线性回归分析结果显示养老方式、日常生活活动能力、爱好数量、性别、衰弱等级、有无主要照顾者是照护服务需求的影响因素(P均<0.05),可解释61.5%的变异量。   老年人的照护服务需求受多种因素的影响。应根据老年人的不同特征,构建供需匹配的多元化,多层次照护体系。
       Objective  To investigate the status quo of care service needs of the elderly and analyze its influencing factors,so as to provide a reference for the construction of a needs-oriented care service system for the elderly.Methods  A total of 212 elderly people from a tertiary hospital in Guangzhou were selected by convenience sampling method and investigated with the Activity of Daily Living scale,Fried frailty scale and the self-designed elderly needs assessment questionnaire.Results  Elderly patients had higher demands for exercise,nutrition,psychological comfort and hospice services.The results of multivariate analysis showed that the influencing factors of care service demand included pension style,activities of daily living,number of hobbies,gender,frailty level,and having main caregivers(all P<0.05),which could explain 61.5% of the variation.Conclusions  The care needs of elderly patients are affected by many factors.A diversified and multi-level care system with matching supply and demand should be constructed according to the different characteristics of the elderly.
论著

经皮冠状动脉介入治疗后恐动症患者不良心理健康状态的影响因素分析

Analysis of the influencing factors of adverse psychological health status in patients with kinesiophobia after percutaneous coronary intervention

:1712-1723
 
       目的   识别经皮冠状动脉介入治疗(PCI)后恐动症患者抑郁、焦虑和压力的影响因素。方法   采用横断面研究,纳入780例行PCI术后恐动症患者。应用系列量表评估恐动症患者的不良心理健康状况、生活质量、自我感受负担、社会支持和运动自我效能,并通过问卷收集了患者的社会人口学数据。线性回归和Logistic回归用于识别抑郁、焦虑和压力等不良心理状态的影响因素,应用中介分析探索潜在的中介机制。结果  271例(34.7%)、304例(39.0%)和153例(19.6%)恐动症患者存在不同程度的抑郁、焦虑和压力。恐动症患者的抑郁、焦虑和压力水平呈正相关。线性回归和Logistic分析结果表明,较高的家庭月收入与较高的抑郁水平相关(线性回归:β为0.908和1.937;Logistic:OR2.05和5.47),社会支持程度与抑郁水平呈负相关(线性回归:β=-0.079;Logistic:OR=0.93)。单身/离异/寡居患者的焦虑水平显著高于已婚患者(线性回归:β=1.613;Logistic:OR=2.28)。与家庭月收入低于5 000元者相比,家庭月收入为5 000~10 000元之间的患者的压力水平较高(线性回归:β=1.065;Logistic:OR=3.14)。此外,自我感受负担较重的患者具有更高的压力水平(线性回归:β=0.077;Logistic:OR=1.05)。中介分析结果表明,焦虑和压力是社会支持/自我感受负担与抑郁之间关联的潜在中介因子。结论  PCI术后恐动症患者广泛存在心理健康问题,其家庭月收入、年龄、婚姻状况、生活方式和病史等因素对患者的不良心理健康状态具有显著影响。医务人员应关注这些患者的心理健康状况及影响因素,制定综合管理策略以改善其预后。
       Objective  To identify the risk factors associated with depression,anxiety  and  stress in  patients with kinesiophobia after percutaneous coronary intervention(PCI).Methods  In this cross-sectional study,780 patients who developed kinesiophobia after undergoing PCI were enrolled.A series of scales were used to assess the psychological health status,quality of life,self-perceived burden,social support,and exercise self-efficacy of patients with kinesiophobia,and socio-demographic data of the patients were collected through a questionnaire.Linear regression analyses and Logistic regression analyses were used to identify risk factors of adverse psychological outcomes,including depression,anxiety,and stress.Furthermore,mediation analysis was employed to explore the potential mediating mechanisms.Results  Among the 780 patients with kinesiophobia,271(34.7%),304(39.0%)and 153(19.6%)were found to have varying degrees of depression,anxiety,and stress,respectively.The levels of depression,anxiety and stress in patients with kinesiophobia were positively correlated with each other.The results of both linear regression and Logistic regression analyses indicated that higher levels of family monthly income were associated with higher levels of depression(linear:β=0.908 and 1.937;Logistic:OR=2.05 and 5.47),while the degree of social support was negatively correlated with depression levels(linear:β=-0.079;Logistic:OR=0.93).For patients who were single,divorced or widowed,their levels of anxiety were significantly higher than those of married patients(linear:β=1.613;Logistic:OR=2.28).Compared to patients with a monthly household income of less than 5 000 yuan,those with a monthly income between 5 000 and 10 000 yuan reported higher levels of stress(linear:β=1.065;Logistic:OR=3.14).Additionally,patients who perceived a higher personal burden also experienced greater stress(linear:β=0.077;Logistic:OR=1.05).Mediation analysis indicated that anxiety and stress were potential mediating factors in the relationship between social support/self-perceived burden and depression.Conclusions  This study  reported the widespread psychological health issues among patients with kinesiophobia after PCI and the interactions between these issues.Factors such as monthly household income,age,marital status,lifestyle and medical  history were found to  be significantly associated with these negative psychological outcomes.Clinicians and nurses should focus on the psychological health and influencing factors of these patients and develop comprehensive management strategies to improve their prognosis.
论著

急性 DVT 患者 CDT 治疗中血管导管相关感染危险因素及病原菌分析

Risk factors and pathogens analysis of vessel catheter associated infection in acute DVT patients undergoing CDT treatment

:1705-1711
 
       目的   通过对急性深静脉血栓形成(DVT)患者经导管接触性溶栓治疗(CDT)中,影响血管导管相关感染(VCAI)危险因素及病原菌分析,为VCAI的预防提供合理、有效的措施。方法   收集2019年1月—2022年12月徐州市肿瘤医院介入科行CDT治疗的急性DVT患者的临床资料,回顾性调查患者诊疗相关资料及血培养结果,并对发生VCAI和病原菌情况进行分析。结果   本研究共调查急性DVT行CDT治疗的患者437例,发生VCAI的患者共21例,千日感染率为0.543‰。多因素Logistic回归分析结果显示:溶栓频率>3次/天[OR=3.49(95%CI:1.86~6.45)]、导管留置时间>7 dOR=3.86(95%CI:1.26~10.18)]和有导管回送[OR=8.67(95%CI:4.83~12.65)]是患者发生VCAI的危险因素(P<0.05)。发生VCAI的21例患者,血培养共培养出24株病原菌,有3例患者出现复合病原菌感染情况。其中以革兰阳性球菌最为常见,共培养出13株,占比54.17%,革兰阴性菌9株,占比37.5 %。结论   导管留置时间>7 d、溶栓频率>3次/天和有导管回送是急性DVT患者CDT治疗中发生VCAI的危险因素。VCAI的病原菌以单一病原菌为主,可合并其他病原菌感染,其中以革兰阳性球菌为主。
        Objective  By analyzing the risk factors and pathogens of vessel catheter associated infection(VCAI)in patients with acute deep vein thrombosis(DVT)undergoing catheter directed thrombolysis(CDT),to provide  reasonable and effective measures for the prevention and treatment of VCAI .Methods  Clinical data of patients undergoing CDT treatment for acute DVT in the interventional department of the hospital from January 2019 to December 2022 was collected,patient diagnosis and treatment related data and blood culture results were retrospectively investigated and organized,and the occurrence of VCAI and pathogenic bacteria was statistically analyzed.Results  This study investigated 437 patients undergoing CDT treatment for acute DVT,and a total of 21 patients developed VCAI,with an infection rate of 0.543‰.The  results of multiple Logistic  regression analysis show that thrombolysis frequency>3 times/day(OR=3.49[95%CI:1.86-6.45]),catheter retention days>7 daysOR=3.86[95%CI:1.26-10.18]),and the presence of catheter return(OR=8.67[95%CI:4.83-12.65]) were risk factors for the occurrence of VCAI in patients.Among the 21 patients with VCAI,a total of 24 strains of pathogenic bacteria were discoveredin blood culture,and 3 patients developed composite pathogen infections.Among them,Gram  positive cocci were the most common,with a total of 13 strains cultured,accounting for 54.17%,9 strains of Gram negative bacteria,accounting for 37.5%.Conclusions  The duration of catheter retention>7 days,thrombolysis frequency>3 times/day,and the presence of catheter return are risk factors for VCAI in acute DVT patients undergoing CDT treatment.The pathogen of VCAI is mainly single pathogen,which can be combined with other pathogens,among which Gram positive cocci are the main pathogen.
论著

肺癌伴癌性疼痛患者心理僵化现状及其影响因素分析

Analysis of psychological rigidity and its influencing factors in patients with lung cancer and cancer pain

:1586-1592
 
      目的   探讨肺癌伴癌性疼痛患者心理僵化现状及其影响因素,为临床制定改善患者心理僵化的针对性干预措施以及提升患者生活质量提供参考依据。方法   采用便利抽样法,选取2023年10月—12月期间焦作市某三级甲等医院收治的肺癌伴癌性疼痛患者为研究对象,采用一般资料调查问卷、疼痛心理僵化量表(PIPS)、简易疾病感知问卷(BIPQ)、家庭功能问卷(APGAR)进行调查,采用Pearson相关性分析肺癌伴癌性疼痛患者心理僵化与疾病感知、家庭功能的关系。采用多元线性回归分析肺癌伴癌性疼痛患者心理僵化的影响因素。结果   本次研究共发放问卷152份,回收有效问卷150份,有效回收率为98.68%。150例肺癌伴癌性疼痛患者心理僵化量表总分为(61.66±2.85)分,回避型经验维度得分为(45.52±1.97)分,认知融合维度得分为(19.74±1.59)分。不同文化程度、家庭人均月收入、疼痛程度的肺癌伴癌性疼痛患者心理僵化得分比较,差异有统计学意义(P<0.05)。Pearson相关性分析结果显示:肺癌伴癌性疼痛患者心理僵化总分、经验性回避维度得分、认知融合维度得分与疾病感知得分均呈正相关关系(P<0.001),与家庭功能得分均呈负相关关系(P<0.001)。多元线性回归结果显示:文化程度、家庭人均月收入、疾病感知、家庭功能是肺癌伴癌性疼痛患者心理僵化的影响因素(P<0.05),可解释肺癌伴癌性疼痛患者心理僵化43.9%的变异度。结论   肺癌伴癌性疼痛患者心理僵化处于较高水平,且受到文化程度、家庭人均月收入、疾病感知和家庭功能的影响,临床医护人员可从疾病感知、家庭支持等角度出发,采用认知干预、同伴支持等方法,加强对患者的健康教育,以缓解其对疾病的负性认知,从而缓解心理僵化,促进身心健康恢复。
       Objective  To explore the status and influencing factors of psychological  rigidity in patients with lung cancer and cancer pain,and to provide reference for clinical development of targeted interventions to improve patients’psychological rigidity andquality of life.Methods  The convenience sampling method was used to select patients with lung cancer and cancer pain who were admitted to a tertiary hospital in Jiaozuo City from October to December 2023 as the research object.The general data questionnaire,Psychological Inflexibility in Pain Scale(PIPS),Brief Illness Perception Questionnaire(BIPQ),and family function questionnaire(APGAR)were used to investigate.Pearson correlation analysis was used to analyze the relationship between psychological rigidity and disease perception and family function in patients with lung cancer and cancer pain.Multivariate linear regression was used to analyze the influencing factors of psychological rigidity in patients with lung cancer and cancer pain.Results  A total of 152 questionnaires were distributed in this study,and 150 valid questionnaires were recovered,with an effective recovery rate of 98.68 %.The total score of PIPS of 150 patients with lung cancer and cancer pain was(61.66±2.85),the score of avoidance experience dimension was(45.52±1.97),and the score of cognitive fusion dimension was(19.74±1.59).There were statistically significant differences in the scores of psychological rigidity among lung cancer patients with cancer pain with different educational levels,family per capita monthly income,and pain degree(P<0.05).The  results of Pearson correlation analysis showed that the total score of PIPS,the score of empirical avoidance dimension and the score of cognitive fusion dimension were positively correlated with the score of disease perception(P<0.001),and negatively correlated with the score of family functionP<0.001).The results of multiple linear regression showed that education level,family per capita monthly income,disease perception and family function were the influencing factors of psychological rigidity in patients with lung cancer and cancer painP<0.05 ),which could explain 43.9 % of the variation of psychological rigidity in patients with lung cancer and cancer pain.Conclusions  The psychological rigidity of lung cancer patients with cancer pain is at a high level,and is affected by education level,family per capita monthly income,disease perception and family function.Clinical medical staff can use cognitive intervention and peer support from the perspective of disease perception and family support to strengthen the health education of patients,so as to alleviate their negative cognition of the disease,to alleviate the psychological rigidity and promote the recovery of physical and mental health.
论著

非霍奇金淋巴瘤患者化疗后感染及平均住院日的影响因素分析

Factors influencing post-chemotherapy infections and length of hospital stay in patients with non-Hodgkin’s lymphoma

:1511-1518
 
       目的   探讨营养评估及炎症因子水平对非霍奇金淋巴瘤(NHL)患者化学治疗(化疗)后感染及平均住院日的影响。方法   回顾性分析接受R-CHOP治疗的NHL患者95例。通过受试者工作特征(ROC)曲线确定患者主观整体营养评估(PG-SGA)预测患者化疗后感染的界值。将患者分为PG-SGA<4组与PG-SGA≥4组,比较两组间营养及炎症相关指标的差异。采用单因素与多因素回归分析NHL患者化疗后感染及平均住院日延长的危险因素。结果  ROC曲线显示PG-SGA为3.5时,约登指数最大,预测NHL患者化疗后感染灵敏度为92%,特异度为11.1%。PG-SGA≥4组患者平均年龄、国际预后指数(IPI)及Ann arbor Ⅲ~Ⅳ期比例均高于PG-SGA<4组(P<0.05)。与PG-SGA<4组相比,PG-SGA≥4组患者白介素6(IL-6)及中性粒细胞与淋巴细胞比值(NLR)明显升高,且化疗后感染率及平均住院日≥5 d比例高于对照组P<0.05);与对照组相比,PG-SGA<4组患者前白蛋白、白蛋白和血红蛋白水平升高(P均<0.05)。多因素回归分析显示,PG-SGA≥4及合并糖尿病是NHL患者化疗后感染率的独立危险因素(P均<0.05)。白蛋白低于35 g/L及合并化疗后感染是NHL患者平均住院日延长的独立危险因素(P均<0.05)。结论   基于PG-SGA的营养评估及炎症因子分析对NHL患者化疗后感染及平均住院日的预测具有临床指导意义。
       Objective  To explore the effects of nutritional assessment and inflammatory factor levels on post-chemotherapy infections and length of hospital stay in patients with non-Hodgkin’s lymphoma(NHL).Methods  A total of 95 NHL patients treated with the R-CHOP regimen were retrospectively analyzed.The  cut-off  value  of  Patient-Generated  Subjective Global Assessment (PG-SGA) for post-chemotherapy infection in NHL patients was evaluated by Receiver Operating Characteristic(ROC)curves.Patients were categorized into PG-SGA<4 and PG-SGA≥4 groups and compared for differences of nutritional and inflammation-related factors.Univariate and multivariate logistic regression were used to analyze the risk factors for post-chemotherapy infection and length of hospital stay(LHS).Results  The ROC curve showed that the Youden index was largest at PG-SGA of 3.5,which predicted post-chemotherapy infection in NHL patients with a sensitivity of 92% and a specificity of 11.1%.The mean age,International Prognostic Index(IPI),and Ann Arbor stage Ⅲ~IV proportion in patients with PG-SGA≥4 were higher compared with the control(P<0.05).Patients with PG-SGA≥4 had significantly higher interleukin-6 and neutrophil-to-lymphocyte ratio(NLR),and the infection rate and the proportion of LHS≥5 days after chemotherapy were higher than those in the control group(P<0.05).Patients in the PG-SGA<4 group had significantly higher prealbumin,albumin,and hemoglobin levels compared to the PG-SGA≥4 group(P<0.05).Multifactorial logistic regression analysis revealed that PG-SGA≥4 and combined diabetes mellitus were independent risk factors for post-chemotherapy infection rate in NHL patients(both P<0.05).Albumin less than 35 g/L and combined post-chemotherapy infection were independent risk factors for prolonged LHS in NHL patients(both P<0.05).Conclusions  PG-SGA nutritional assessment and inflammatory factor analysis are clinically instructive in predicting post-chemotherapy infections and LHS in NHL patients.
综述

脓毒症患者发生心肌损伤的高危因素分析

High-risk factors for the development of myocardial injury in patients with sepsis

:1338-1345
 
脓毒症当前仍然是全球范围内重要的医疗卫生问题,其对世界公共卫生及患者安全带来重大威胁。脓毒症是指宿主对感染反应失调引起的危及生命的器官功能障碍, 其发病率和病死率均极高,是临床重症医学中的重大挑战。在脓毒症病情的进展过程中, 可出现组织灌注不足、血流动力学不稳定等变化, 从而导致多器官功能受损,而心脏是常见的被累及的重要靶器官之一, 这种由脓毒症所导致的不同程度的心肌损伤, 被称为“脓毒性心肌病”, 其发生和发展机制复杂多样, 涉及循环心肌抑制因素、心肌自身因素及自主神经失调等多个方面。文章综述了脓毒症患者发生心肌损伤的高危因素, 以期为临床治疗和预防提供参考。
Sepsis currently remains an important global healthcare issue, and a major threat to world public health and patient safety.Sepsis is a life-threatening organ dysfunction caused by dysregulation of the host response to infection, with extremely high morbidity and mortality,which is a major challenge in clinical critical care medicine.During the progression of sepsis, changes such as inadequate tissue perfusion and haemodynamic instability may occur, leading to impairment of multiple organ functions, while the heart is one of the commonly involved vital target organs, and the varying degree of myocardial damage caused by sepsis is known as “septic cardiomyopathy”.The mechanisms of its occurrence and development are complex and diverse, involving circulating myocardial inhibitory factors, myocardial auto-factors, and autonomic dysregulation.In this paper, we review the high-risk factors for myocardial injury in septic patients, providing a reference for clinical treatment and prevention.
论著

广州市越秀区青少年近视特点和危险因素分析

Analysis on the characteristics and risk factors of myopia among adolescents in Yuexiu District,Guangzhou

:541-547
 
目的 探讨广州市越秀区青少年近视特点和危险因素,为降低青少年近视发病率提供参考依据。方法 本项目采用分层随机整群抽样的研究方法,抽取分布于广州市越秀区2 774名青少年作为研究对象,根据近视检查情况将其分为近视组(n=1 657)与非近视组(n=1 117),通过问卷调查的方式,分析青少年近视整体现况、流行病学特征以及影响青少年近视发生、发展的相关行为和因素。结果 2 774名青少年中,1 657名近视,检出率为59.73%;其中女生为872名,多于男生的785名;幼儿园、小学生、初中生、高中生近视人数分别为20名、446名、484名、707名,呈升高趋势。学段、校内用眼环境、校外用眼环境、读写姿势、电子屏幕使用情况、近距离用眼情况、户外活动及睡眠情况、近视检查及矫治情况是广州市越秀区青少年近视的影响因素(P<0.05)。广州市越秀区青少年近视程度均与学段、校外用眼环境、电子屏幕使用情况、户外活动及睡眠情况、近距离用眼情况呈正相关(P<0.05),与校内用眼环境、读写姿势、近视检查及矫治情况呈负相关(P<0.05)。对不同预后组间存在统计学差异的因素进行Logistic多因素分析后得到,学段、校内用眼环境、校外用眼环境、读写姿势、电子屏幕使用情况、近距离用眼情况、户外活动及睡眠情况、近视检查及矫治情况是广州市越秀区青少年近视的相关影响因素(P<0.05)。结论 广州市越秀区青少年近视发生人群呈现高龄化,学段、校内用眼环境、校外用眼环境、读写姿势、电子屏幕使用情况、近距离用眼情况、户外活动及睡眠情况、近视检查及矫治情况是青少年近视的相关影响因素,建议加强组织学生到户外进行多种课间户外体育活动,同时鼓励家长在校外从自身做起,树立爱眼护眼好榜样,与学校共同保护孩子的视力。
Objective To explore the characteristics and risk factors of myopia among adolescents in Yuexiu District,Guangzhou,and to provide reference for reducing the incidence of myopia among adolescents.Methods This project adopted stratified random cluster sampling to select 2 774 adolescents distributed in Yuexu District,Guangzhou as the research objects,which were divided into myopia group(n=1 657)and non-myopia group(n=1 117)according to the myopic examination.Through questionnaire survey,the overall situation and epidemiological characteristics of myopia among adolescents in our district were comprehensively known,in order to explore the related behaviors and factors affecting the occurrence and development of myopia among adolescents in our district,explore reasonable intervention measures,and put forward scientific and effective myopia prevention and control technical means and strategies.Results Among 2 774 adolescents,1 657 were nearsighted(59.73%).Among them,872 were female and 785 were male.The number of myopia in kindergarten,primary school,middle school and high school students were 20,446,484 and 707 respectively,showing an increasing trend.School period,eyes use environment in school and outside school,reading and writing posture,situations of electronic screen use,close distance eye use,outdoor activities and sleep,myopia examination and correction were the relevant influencing factors on myopia of adolescents in Yuexui District of Guangzhou(P<0.05).The myopia degree of adolescents in Yuexiu District of Guangzhou was positively correlated with school period,out-of-school eyes use environment,electronic screen use,outdoor activities and sleep conditions,and close distance eyes use(P<0.05),and negatively correlated with in-school eyes use environment,reading and writing posture,myopia examination and correction conditions(P<0.05).After Logistic multivariate analysis of the factors with statistical difference between different prognostic groups,school period,eyes use environment in school and outside school,reading and writing posture,electronic screen use,close distance eyes use,outdoor activities and sleep conditions,myopia examination and correction were the relevant influencing factors on myopia of adolescents in Yuexui District of Guangzhou(P<0.05).Conclusions In Yuexiu District,Guangzhou,the population with myopia is gradually moving to a younger age.School period,eyes use environment in school and outside school,reading and writing posture,electronic screen use,close distance eyes use,outdoor activities and sleep condition,myopia examination and correction are the relevant influencing factors.It is recommended to strengthen the organization of students to go outdoors for a variety of outdoor sports activities between classes,while encouraging parents to set a good example of eye care outside the school and work with the school to protect their children’s eyesight.
论著

脑出血患者家属参与治疗共享决策满意度现状及影响因素分析

Analysis of the satisfaction status and influencing factors of family members' participation in treatment and shared decision-making of patients with cerebral hemorrhage

:535-540
 
目的 了解脑出血患者家属参与治疗共享决策满意度现状及其影响因素,为提升脑出血患者的护理质量和家属体验提供参考。方法 采用横断面研究设计,便利抽取2022年1月—2023年7月许昌中医院收治的脑出血患者及其家属进行问卷调查。结果 共回收问卷178份,全部纳入分析。患者家属参与医疗决策的满意度得分为(48.58±6.34)分,其中维度得分最低的为交流协商。多因素分析结果显示,家属教育程度、家属年龄、家庭总年收入以及患者家属对医疗决策知情程度为患者家属参与医疗决策满意度的影响因素(F=30.872,P<0.001),解释40.3%的变异。结论 脑出血患者家属参与治疗共享决策满意度处于中等水平,患者家属对医疗决策知情程度越高、家属教育程度越高、家属年龄较大以及家庭总年收入越高的脑出血患者家属参与治疗共享决策满意度越高。
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