论著

住院老年患者PICC相关性血栓的影响因素分析

Analysis of influencing factors for PICC-related thrombosis in hospitalized elderly patients

:433-445
 
      目的 调查住院老年患者因经外周静脉置入中心静脉导管(PICC)而引发的血栓情况,并分析其影响因素,为老年患者置入PICC产生的相关性血栓(PICC-CRT)和症状性血栓的评估与干预提供借鉴。方法 在2023年1月—2023年12月期间,选取广州市第一人民医院接受PICC置管的317例住院老年患者。采用包括患者一般情况调查表、运动功能评定、肌力检测、 Barthel指数评定、Padua评分等多种工具进行综合评估。采用多因素 Logistic 回归构建 PICC-CRT 及症状性血栓的预测模型,并应用逐步回归法优化变量筛选过程。模型性能通过 ROC 曲线进行评估。结果 去除临床资料不完整的患者40例,最终纳入277例患者的完整资料,其中123例患者出现了PICC-CRT,发生率为44.40%(123/277)。血栓分级中,I级78例,Ⅱ级37例,Ⅲ级8例。无症状血栓83例,占67.48%,发生率29.96%(83/277);症状性血栓40例,占32.52 %,发生率14.44%(40/277)。单因素分析联合多因素Logistic回归显示,卒中史、凝血酶原时间(PT)、导管留置时间是住院老年患者PICC-CRT的关键因素(P<0.05),预测模型ROC曲线下面积为0.719;置管史、恶性肿瘤史、导管留置时间、置管后并发症数量是住院老年患者PICC症状性血栓的独立影响因素(P<0.05),预测模型ROC曲线下面积为0.812。结论 文章总结了PICC-CRT和症状性血栓独特的影响因素,基于关键因素构建了预测模型预测其发生,为护理人员预防PICC-CRT和症状性血栓的发生提供了参考。

   Objective To explore the incidence of thrombosis associated with peripherally inserted central catheter(PICC)placement in hospitalized elderly patients and to analyze its influencing factors,in order to provide a reference for the assessment and prevention of PICC-catheter related thrombosis(PICC-CRT)and symptomatic thrombosis in this population.Methods A total of 317 elderly inpatients who underwent PICC placement at a tertiary hospital in Guangzhou between January and December 2023 were enrolled.Comprehensive assessments were conducted using general patient information forms,motor function evaluation,muscle strength testing,Barthel Index,and Padua score.Multivariate Logistic regression analysis was used to construct predictive models for PICC-CRT and symptomatic thrombosis,with variable selection optimized via stepwise regression.Model performance was evaluated using receiver operating characteristic(ROC)curve analysis.Results After excluding 40 patients with incomplete clinical data,277 cases were included in the final analysis.Among them,123 patients developed PICC-CRT,with an incidence rate of 44.40%(123/277).Thrombosis was graded as Grade I in 78 cases,Grade II in 37 cases,and Grade III in 8 cases.Asymptomatic thrombosis occurred in 83 cases(29.96%),accounting for 67.48% of PICC-CRT;symptomatic thrombosis occurred in 40 cases(14.44%),accounting for 32.52%.Univariate and multivariate Logistic regression analyses identified history of stroke,prothrombin time(PT),and catheter dwell time as key risk factors for PICC-CRT(P<0.05),with the area under the curve(AUC)of 0.719.History of catheterization,malignancy,catheter dwell time,and number of post-catheterization complications were independent predictors of symptomatic thrombosis(P<0.05),with an AUC of 0.812.Conclusions This study identified distinct risk factors for PICC-CRT and symptomatic thrombosis in elderly inpatients.Predictive models based on key variables may provide useful references for clinical staff in preventing the occurrence of PICC-related and symptomatic thrombosis.
论著

重型β地中海贫血患儿照顾者负担现状及其影响因素研究

Current burden situation and influencing factors of caregiver in pediatric β thalassemia major

:481-490
 
       目的 调查重型β地中海贫血患儿照顾者的负担现状,并分析其影响因素,为医护人员制定干预方案提供依据。方法 采用便利抽样法,于2024年1月—12月选取华南地区5家医院就诊的重型β地中海贫血患儿的主要照顾者作为调查对象,采用一般资料调查表、Zarit照顾者负担量表、中文简化版家庭弹性量表和社会支持评定量表进行调查,并采用单因素分析、相关性分析及多重线性回归探究其影响因素。结果 共发放问卷242份,回收232份,回收率为95.87%。重型β地中海贫血患儿主要照顾者照顾负担的总体平均得分为(36.67±18.63)分。多重线性回归分析结果显示,患儿输血频率、输血相关性皮肤过敏和社会支持是患儿照顾负担的影响因素(P<0.001),可解释总变异的23.9%。结论 重型β地中海贫血患儿照顾者负担程度以中重度为主。患儿曾出现输血不良反应、输血频率更高,其照顾者负担更重;而主要照顾者具有良好的社会支持水平有助于降低其照顾者负担。医护人员应针对以上因素制定干预方案,以减轻重型β地中海贫血患儿照顾者负担水平。

      Objective To investigate the current burden in caregivers of children with β thalassemia major and analyze its influencing factors,so as to provide a basis for medical staff to formulate intervention plans.Methods By using the convenience sampling method,primary caregivers of children with β thalassemia major from five hospitals in South China from January to December 2024 were selected as the survey subjects.The general information questionnaire,Zarit Caregiver Burden Scale,Simplified Chinese Family Resilience Scale and Social Support Rating Scale were used for the survey.And univariate analysis,correlation analysis and multiple linear regression were adopted to explore its influencing factors.Results A total of 242 questionnaires were distributed and 232 were retrieved,with a recovery rate of 95.87%.The overall average score of care burden for primary caregivers of children with β thalassemia major was(36.67±18.63).The results of multiple linear regression analysis showed that the frequency of blood transfusion in children,transfusion-related skin allergy and social support were the influencing factors of the care burden(P<0.001),which could explain 23.9% of the total variation.Conclusions The burden level in caregivers of children with β thalassemia major is mainly moderate to severe.The children with adverse reactions to blood transfusion and higher frequency of blood transfusion impose a heavier burden on its caregivers.The primary caregivers who have good social support can help reduce the burden.Medical staff should formulate intervention plans based on the above factors to reduce the burden level of caregivers of children with β thalassemia major.

论著

广州市公职人员眼睑黄色瘤患病情况及影响因素分析

Xanthelasma palpebrarum in Guangzhou government employees:Prevalence and risk factors

:500-506
 
      目的 探讨广州市公职人员中眼睑黄色瘤(XP)患病情况与生化检验指标异常的相关性。方法 从2018年来广州市干部和人才健康管理中心体检的公职人员中选取1 090例,其中筛选患XP人员545例,作为病例组,依性别、年龄分层随机抽取的未患XP的人员作为对照组,测定空腹血糖、血脂、甲状腺功能等生化指标,采用回顾性病例对照研究的方式,比较两组相关指标水平。P<0.05为差异有统计学意义。结果 XP的患病率为0.94%(男性为0.89%,女性为1.01%)。男性和女性的XP患病率比较差异无统计学意义(χ2=2.142,P=0.143)。两组间体质量、舒张压、血脂等多项指标上的差异具有统计学意义(P<0.05)。高体质量(OR=1.021,95%CI:1.004~1.038,P=0.017)、高舒张压(OR=1.019,95%CI:1.004~1.035,P=0.011)、低高密度脂蛋白(OR=6.127,95%CI:2.568~14.619,P<0.001)、高低密度脂蛋白(OR=2.084,95%CI:1.456~2.981,P<0.001)是患病的危险因素。结论 广州市公职人员中XP的患病率男性和女性接近;高体质量、高舒张压、高密度脂蛋白水平降低、低密度脂蛋白水平升高是患XP的危险因素。
   Objective To investigate the correlation between xanthelasma palpebrarum(XP)and abnormal biochemical indices in healthy individuals in Guangzhou,China.Methods A retrospective case-control study was conducted,selecting 1 090 individuals from a total of 58 053 who underwent health examinations at the Guangzhou Cadre and Talent Health Management Centre in 2018.The case group consisted of 545 individuals diagnosed with XP,while the control group included age- and sex-matched individuals without XP,randomly selected from the same database.Biochemical indices analyzed included fasting blood glucose,blood lipids,liver and kidney function,thyroid indicators,body weight,and blood pressure.Statistical significance was set at P<0.05.Results The prevalence of XP was 0.94%(0.89% in men and 1.01% in women).No significant difference was observed in the prevalence of XP between men and women(χ2=2.142,P=0.143).Similarly,no significant differences were observed in thyroid-stimulating hormone(P=0.937),free triiodothyronine(P=0.216),free thyroxin(P=0.206),or fasting blood glucose levels(P=0.668)between the case and control groups.However,significant differences were noted in body weight,diastolic blood pressure,blood lipid levels,and liver and renal biochemical indicators between the two groups(P<0.05).Specifically,higher body weight(OR=1.021,95%CI:1.004–1.038,P=0.017),higher diastolic blood pressure(OR=1.019,95%CI:1.004–1.035,P=0.011),lower high-density lipoprotein(OR=6.127,95%CI:2.568–14.619,P<0.001),and higher low-density lipoprotein(OR=2.084,95%CI:1.456–2.981,P<0.001)were identified as risk factors for XP.Conclusions The prevalence of XP did not differ between males and females.However,high body weight,high diastolic blood pressure,low high-density lipoprotein,and high low-density lipoprotein are risk factors for XP.


急性中毒导致缺血缺氧性脑病患者预后的影响因素及预测模型研究

Study on the influencing factors and prediction model of prognosis in patients with hypoxic-ischemic encephalopathy caused by acute poisoning

:-
 
目的:分析急性有机磷农药中毒(AOPP)引发缺血缺氧性脑病预后相关因素,建立相关的预后预测模型。方法:回顾性分析90例(33例预后不良、57例预后良好)AOPP致HIE患者(2022年3月~2025年8月)的临床资料、中毒指标和血清学指标,独立危险因素用Logistic回顾分析筛选,并构建预后不良预测模型,采用ROC工具对模型效能进行验证。结果:Logistic 回归分析显示,年龄≥60岁、重度中毒、中毒至就诊时间、LAC水平、CHE水平、CRP水平及NSE水平均为患者预后不良的独立危险因素(P<0.05);AUC、灵敏度、特异度为0.943、90.91%、87.72%。结论:高龄、中毒程度高及中毒至就诊时间长等因素可导致AOPP致HIE患者出现不良结局,据此构建风险预测模型可有效预测预后不良的发生风险。
To determine the key impacting factors for hypoxic ischemic encephalopathy (HIE) caused by acute organophosphorus pesticide poisoning (AOPP) and build a prediction model. Methods: The clinical data, poisoning indicators and serological indicators of 90 patients (33 cases with poor prognosis and 57 cases with good prognosis) with HIE caused by AOPP (from March 2022 to Aug 2025) were analyzed. Independent risk factors were screened using logistic retrospective analysis, and a poor prognosis prediction model was constructed. The model efficiency was verified by the receiver operating curve (ROC). Results: Logistic regression analysis showed that age ≥ 60 years, severe poisoning, time from poisoning to treatment, LAC level, CHE level, CRP level, and NSE level were all risk factors for the prognosis in patients (P < 0.05). The AUC, sensitivity, and specificity were 0.943, 90.91%, and 87.72%.Conclusion: Factors such as advanced age, high degree of poisoning, and long time from poisoning to treatment can lead to adverse outcomes in patients with HIE caused by AOPP. Based on this, building a risk prediction model can effectively predict the risk of poor prognosis.

2022-2024年深圳市福田区危重症孕产妇流行病学特征及相关因素分析

Analysis of Epidemiological Characteristics and Related Factors of Critically Ill Pregnant Women in Futian District, Shenzhen (2022–2024)

:-
 
摘要:目的 分析2022—2024年深圳市福田区危重症孕产妇不同亚组(不同并发症/合并症)的流行病学特征、病因构成及相关因素,为优化区域孕产妇健康管理提供依据。方法 基于福田区危重症孕产妇监测网络,对2022年1月1日至2024年12月31日期间107921例孕产妇个案资料进行回顾性描述性分析,采用描述性流行病学方法及卡方检验分析不同因素与危重症主要并发症的关联。结果 深圳市福田区3年间危重症孕产妇共729例,总体发生率为6.75‰。各年度发生率分别为2022年6.67‰、2023年7.38‰和2024年6.33‰。危重症孕产妇中,≥35岁者占33.7%,本科及以上学历者占53.8%。初检妊娠风险评级为黄色者占比最高(41.98%),高危者占21.9%。最常见并发症为产后出血(43.89%),其次为宫缩乏力(17.28%)、前置胎盘(16.59%)、子痫/子痫前期(14.67%)和胎盘植入(13.99%)。血液系统疾病为最常见合并症(57.75%),内分泌系统疾病次之(24.42%)。单因素分析显示,产后出血的发生与高龄、产检次数不足5次、经产妇身份存在统计学关联(均P<0.05);前置胎盘的发生与高龄、低学历、非汉族、初检高危评级、产检不足5次、经产存在统计学关联(均P<0.05)。结论 深圳市福田区危重症孕产妇发生率约为6.75‰,产后出血和前置胎盘为主要并发症。单因素分析显示,高龄、产检不足、初检高危分级及经产与上述主要并发症的发生相关。应加强动态妊娠风险管理和多学科协作,完善产科早期预警体系,以降低危重症孕产妇发生率,提高母婴安全水平。
Abstract: Objective To analyze the epidemiological characteristics, etiology composition, and related factors of critically ill pregnant women in Futian District, Shenzhen, from 2022 to 2024. Methods Based on the surveillance network, a retrospective descriptive analysis was conducted on 107,921 pregnant women. Chi-square tests were used to analyze the association between different factors and major complications. Results A total of 729 critically ill pregnant women were identified (overall incidence 6.75‰).??The most common complication was postpartum hemorrhage (43.89%), followed by uterine atony (17.28%), placenta previa (16.59%), eclampsia/preeclampsia (14.67%), and placenta accreta (13.99%). Univariate analysis showed that postpartum hemorrhage was statistically associated with advanced age, <5 antenatal visits, and multiparity (all P<0.05). Placenta previa was statistically associated with advanced age, low education level, non-Han ethnicity, high-risk initial assessment, <5 antenatal visits, and multiparity (all P<0.05). Conclusion The incidence of critically ill pregnant women in Futian District is approximately 6.75‰. Univariate analysis suggested that advanced age, insufficient antenatal visits, high-risk classification, and multiparity were associated with the main complications. Dynamic risk management and multidisciplinary collaboration should be strengthened.

乙型肝炎病毒感染患者并发2型糖尿病风险因素分析

Analysis of Risk Factors for Type 2 Diabetes in Patients with Hepatitis B Virus Infection

:-
 
目的 分析乙型肝炎病毒(HBV)感染患者并发2型糖尿病(T2DM)相关风险因素。方法 研究收集2024年1月~2025年5月期间,于周口市传染病医院(周口市结核病防治所、周口市第五人民医院)接受治疗的HBV感染患者临床资料,共纳入患者95例,根据HBV感染后是否并发T2DM分组,合并T2DM患者纳入并发组(n=21),非合并T2DM患者纳入对照组(n=74),比较两组患者基线资料及实验室检查数据,逻辑回归分析HBV感染患者并发T2DM风险因素。结果 并发组年龄、体重指数(BMI)、甘油三酯(TG)高于对照组(P<0.05),年龄≥45岁、BMI肥胖、HBV感染时间≥6个月、TG≥1.7mmol/L、吸烟、乙型肝炎表面抗原(HBsAg)阳性及纤维化-4(FIB-4)指数≥2.67例数占比高于对照组(P<0.05)。年龄≥45岁[OR=21.599(95%CI:2.875-162.262)]、BMI(肥胖)[OR=16.729(95%CI:1.443-193.981)]、HBV感染时间≥6个月[OR=6.199(95%CI:1.101-34.904)]、吸烟[OR=9.429(95%CI:1.344-66.141)]、TG≥1.7mmol/L[OR=71.834(95%CI:7.060-730.897)]是HBV感染患者并发T2DM危险因素(P<0.05)。结论 HBV感染患者并发T2DM受人口学特征年龄、BMI、临床病程HBV感染时间、共病血脂异常及生活方式吸烟的共同影响。
Abstract: Objective To analyze risk factors associated with the development of type 2 diabetes mellitus (T2DM) in patients with hepatitis B virus (HBV) infection. Methods Clinical data were collected from HBV-infected patients treated at the Zhoukou City Infectious Disease Hospital (Zhoukou City Tuberculosis Prevention and Control Institute)between January 2024 and May 2025. A total of 95 patients were included in the study, Patients were grouped based on the presence or absence of T2DM following HBV infection. Patients with T2DM were included in the T2DM group (n=21), while those without T2DM were included in the control group (n=74). Baseline characteristics and laboratory test data were compared between the two groups, and logistic regression analysis was performed to identify factors associated with the development of T2DM in HBV-infected patients. Results The age, body mass index (BMI), and triglycerides (TG) in the intervention group were higher than those in the control group (P < 0.05); The proportion of cases with age ≥45 years, obese BMI, HBV infection duration ≥6 months, TG ≥1.7 mmol/L, smoking, hepatitis B surface antigen (HBsAg) positivity, and a FIB-4 score ≥2.67 was higher than that in the control group (P < 0.05). Age ≥ 45 years [OR = 21.599 (95% CI: 2.875–162.262)], BMI (obesity) [OR = 16.729 (95% CI: 1.443–193.981)], duration of HBV infection ≥ 6 months [OR = 6.199 (95% CI: 1.101–34.904)], smoking [OR=9.429 (95% CI: 1.344–66.141)], and TG ≥ 1.7 mmol/L [OR=71.834 (95% CI: 7.060–730.897)] were risk factors for T2DM in patients with HBV infection (P < 0.05). Conclusion The development of T2DM in patients with HBV infection is influenced by a combination of demographic factors (age and BMI), clinical course (duration of HBV infection), comorbid dyslipidemia, and lifestyle factors (smoking).
论著

自发性脑出血患者静脉血栓栓塞症的危险因素及预防措施

Spontaneous intracerebral hemorrhage and venous thromboembolism:Risk factors and preventive strategies

:214-220
 
       目的 探讨自发性脑出血(SICH)患者静脉血栓栓塞症(VTE)的独立危险因素,并评估针对性分层预防措施的有效性及安全性, 为临床优化防治策略提供依据。方法 回顾性纳入2022年1月—2025年1月收治的86例SICH患者, 根据下肢深静脉超声结果分为深静脉血栓(DVT)组(n=16)与非DVT组(n=70)。采集患者基线资料、临床特征及实验室指标, 采用单因素及多因素Logistic回归分析VTE危险因素, 并基于独立危险因素制定分层预防方案。结果 多因素分析显示, 体质指数(BMI)升高(OR=1.22, 95%CI:1.06~1.41)、中心静脉置管(OR=5.23, 95%CI:1.37~19.95)、止血药物使用(OR=4.80, 95%CI:1.21~19.01)及NIHSS评分升高(OR=1.20, 95%CI:1.02~1.42)是VTE的独立危险因素(均P<0.05)。因此需针对SICH患者进行针对性干预, 包括基于BMI的个体化干预、中心静脉置管的精细化管控、止血药物的动态调控及神经功能保护与早期康复。结论 SICH患者VTE发生与代谢、医源性及神经功能损伤多因素交互作用密切相关, 应针对患者构建基于BMI、中心静脉管理及凝血监测的分层预防策略。
       Objective To explore the independent risk factors for venous thromboembolism(VTE)in patients with spontaneous intracerebral hemorrhage(SICH)and to assess the effectiveness and safety of targeted stratified prophylaxis to provide a basis for optimizing prevention and treatment strategies in the clinic.Methods A retrospective analysis was conducted on 86 SICH patients admitted between January 2022 and January 2025.Based on lower-extremity venous ultrasound findings, patients were divided into a deep venous thrombosis(DVT)group(n=16)and a non-DVT group(n=70).Baseline characteristics, clinical features, and laboratory indicators were collected.Univariate and multivariate Logistic regression analyses were performed to identify VTE risk factors, and a stratified prevention protocol was developed based on independent risk factors.Results Multivariate analysis revealed that elevated body mass index(BMI)(OR=1.22, 95%CI:1.06-1.41), central venous catheterization(OR=5.23, 95%CI:1.37-19.95), hemostatic drug use(OR=4.80, 95%CI:1.21-19.01), and higher NIHSS scores(OR=1.20, 95%CI:1.02-1.42)were independent risk factors for VTE(all P<0.05).Consequently, targeted nursing interventions should be implemented for SICH patients, including BMI-based personalized care, refined management of central venous catheters, dynamic regulation of hemostatic drugs, and neuroprotective early rehabilitation.Conclusions VTE in SICH patients is closely associated with the interplay of metabolic, iatrogenic,and neurological injury factors.A stratified prevention strategy incorporating BMI monitoring, central venous catheter management, and coagulation surveillance is critical for reducing thrombotic risk while ensuring safety.
论著

老年脆性骨折患者术前衰弱前期、衰弱现状调查及影响因素分析

Status of preoperative weakness and influencing factors in elderly patients with osteoporotic fracture

:188-194
 
       目的 调查老年脆性骨折患者术前衰弱现况,并分析影响因素。方法 采用便利抽样法, 2024年11月—2025年3月, 选取于广州市某三甲医院骨科住院的207例老年脆性骨折患者, 使用一般资料调查表、简易衰弱评估量表、简版流调中心抑郁量表、广泛性焦虑量表和营养风险筛查量表2002开展问卷调查。采用有序分类Logistic回归, 分析老年脆性骨折患者术前衰弱的影响因素。结果 207例老年脆性骨折患者的术前衰弱前期占48.3%, 衰弱发生率为23.2%。有序分类Logistic 回归分析结果显示年龄(OR=1.131)、睡眠差(OR=2.557)、合并3种及以上慢性病(OR=3.990)、抑郁(OR=3.296)、营养不良风险(OR=4.005)为老年脆性骨折患者术前衰弱的危险因素,BMI正常(OR=0.206)是保护因素(均P<0.05)。结论 老年脆性骨折患者年龄, 睡眠情况, 多种共病,抑郁, 存在营养不良风险及BMI影响其术前衰弱水平, 重视衰弱的筛查及早期干预, 提升患者治疗效果和生活质量。
       Objective To explore the preoperative frailty status and influencing factors in elderly patients with osteoporotic fractures.Methods Using convenience sampling, 207 elderly patients with osteoporotic fractures admitted to the orthopedic department of a tertiary hospital in Guangzhou from November 2024 to March 2025 were selected.Data were collected using a general information questionnaire, the Frail Scale, the 10-item Center for Epidemiologic Studies Depression Scale(CES-D-10), the Generalized Anxiety Disorder Scale(GAD-7), and the Nutritional Risk Screening 2002(NRS-2002).Logistic regression was used to analyze factors influencing preoperative frailty.Results Among 207 elderly patients with osteoporotic fractures, the incidence of early stages of frailty was 48.3%, and the incidence of frailty was 23.2%.Logistic regression analysis revealed the following risk factors for preoperative frailty:age(OR=1.131), poor sleep quality(OR=2.557), multiple chronic comorbidities(OR=3.990), depression(OR=3.296), nutritional risk(OR=4.005).Normal body mass index(OR=0.206)was a protective factor.Conclusions Advanced age,poor sleep quality, multiple chronic comorbidities, depression, nutritional risk and body mass index are associated with frailty in elderly osteoporotic fracture patients.Health care providers should pay attention to frailty screening and early intervention, which can reverse or delay the progression of frailty and improve the treatment effect and quality of life of patients.
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.
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.
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