ICU患者外出检查风险分析与对策

为了探讨ICU危重患者外出检查风险的原因,从而降低ICU危重患者外出检查风险,本文通过对312例ICU患者外出检查风险因素进行讨论分析,研究降低风险的对策,即在规范ICU患者外出检查流程、做好检查前准备和注意途中安全及返回后的护理,结果提示285例患者无意外发生,安全返回病房,其余27例患者存在一定风险,但在相应处理措施下均安全返回病房。     

Experimental manipulation of maternal proximity during short sequences of sleep and infant calming response

This study aimed to understand how different mother-infant sleeping arrangements impact infants’ self-regulation, particularly their calming response. Thus this study investigated the effect of three prevalent mother-infant sleeping arrangements, co-sleeping (CS), sleeping beyond arm’s length from their mother (BAL), and solitary sleeping (SS), on infants’ physiological calming through self-regulation during a nap session in 24 infants (50% female, M = 1.85 months SD = 0.93 months), who were identified as either regular co-sleepers with their mothers, infants who slept in the BAL sleeping arrangement from their mother, and infants who are solitary sleepers (SS). The effect of all three sleeping conditions amongst all the three types of infants with different habitual sleeping arrangements was assessed. All infants spent 10 min (2 × 5 min sessions) in each sleeping condition (CS, BAL, SS) during which electrocardiographic recordings were collected to obtain interbeat intervals (IBI) and rMSSD, a measure of heart rate variability (HRV) an index of physiological calming, maintained by the parasympathetic pathway involved in self-regulation. Infants who regularly co-slept with their mothers had the highest IBI, indicating greater physiological calming and self-regulation across all sleeping arrangement conditions (CS, BAL, SS), followed by infants who regularly slept in the BAL sleeping arrangement from their mothers. IBI was lowest amongst regular solitary sleepers, potentially indicating physiological stress due to mother-infant separation. However, HRV indices during the sleeping arrangements (especially across regular solitary sleepers) were inconclusive as to whether the lack of change in HRV across all sleeping conditions was due to physiological stress responses or greater physiological regulation. This study is the first to investigate the effect of manipulated and habitual mother-infant sleeping arrangements on infant physiological calming.     

汉语口语词汇产生的音韵编码单元：内隐启动范式的ERP研究

本研究中选择英语水平低的汉语母语者,排除作为二语的英语音韵编码单元(音素)可能对汉语口语词汇产生过程的影响后,运用事件相关电位技术,考察了汉语口语产生过程中音节和音素效应的时间进程。实验采用内隐启动范式,要求被试看到提示词之后说出对应的目标词。事件相关电位分析结果发现,音节效应出现在线索词呈现后的100～400 ms之间,音素效应出现在500～600 ms之间,波形表现为相关条件比无关条件的波形更正。这表明在词汇选择之后的音韵编码阶段讲话者首先提取的单元是音节,而音素效应出现的时间窗口可能是音韵编码阶段后期或者是语音编码阶段,结果验证了合适编码单元假说的观点。     

预立医疗照护计划在重症医学科中的应用研究进展

基于目前我国医疗压力较大,过度治疗现象突出等问题,站在现代医学观念和辩证思维角度来思考如何合理且有效地利用现有的医疗资源,减少不必要且增加患者痛苦的治疗,减轻患者家庭负担,让患者有尊严地离开。同时,借鉴国外经验结合我国文化背景对预立医疗照护计划的可行性和必要性进行阐述,对国内外预立医疗照护计划实施的现状进行对比,并分析国内外预立医疗照护计划实施差异的原因,提出针对性的措施,以期为我国重症医学科推行预立医疗照护计划提供建议,促进安宁疗护的进一步发展。     

ICU生命末期患者死亡质量量表的汉化及信效度评价

为了翻译并修订重症监护病房生命末期患者死亡质量量表(QODD-3.2A),形成中文版QODD-3.2A,并对其进行信效度检验,先采用Brislin翻译模式对QODD-3.2A进行翻译、回译、专家咨询、预调查后形成中文版QODD-3.2A,之后采用便利抽样方法,对湖北省两所综合医院182例死亡患者的死亡质量进行调查并评价其信效度。通过分析,中文版QODD-3.2A量表有6个维度,共24个条目,累计方差贡献率为67.47%,总量表的Cronbach'sα值为0.891,折半系数为0.801,量表水平的内容效度指数为0.94。中文版QODD-3.2A具有较好的信效度,可作为国内ICU生命末期患者死亡质量的评估工具。     

从道家“复归婴儿”看《红楼梦》心理精神疾病

道家“复归婴儿”认为发展健全的人格及保养身体应学习“婴儿”淳朴、凝聚、无欲等饱满的精神状态。此思想可以帮助分析《红楼梦》中人物的心理精神疾病的死亡原因与施治手段。通过林黛玉、王熙凤及贾瑞之死分析其不良的精神状态与心理欲望对健康的影响,结合道家所提倡的六种婴儿状态:“营魄抱一”、“涤除玄鉴”、“见素抱朴”、“绝学弃智”、“知足知止”以及“知和知常”分别对此三人的心理疾病提出解决方案。     

产科医护人员在围产期死亡事件中不良体验的应对进展

围产期死亡是一个全球性问题,在对丧亲家庭造成影响的同时,也对产科医护人员带来很多不良体验和深远影响。围绕个人相关因素和文化背景因素对产科医护人员在围产期死亡照护体验的影响进行分析,概括分析了产科医护人员在围产期死亡事件中的情绪创伤等不良身心体验,从产科相关专业的教育培训内容与培训方式、针对性的政策制定与制度保障、多层面的社会支持等论述产科医护人员应对围产期死亡事件的最新进展,为我国该领域实践和研究提供参考。     

建立“社区卒中单元”的必要性

"社区卒中单元"是以社区医疗机构为支撑,以患者家庭为中心,以此二者双向互动为轴线,以提高卒中患者的生活质量为目的。"社区卒中单元"与通常意义上的"医院卒中单元"不同。在这一模式中,患者及其家属的康复自助的积极性、主动性具有决定意义。