关于病证结合的思考

在护理这样一个女性为主导的职业,社会偏见、传统观念的影响是导致男护士产生职业困惑的主要原因。从社会性别视角分析了这种原因的产生是由于社会性别定义与分工模式被内化的结果,并依此提出了加强护理宣传与护理教育改革、护理分工合理化等对策。     

一起四级医疗事故引发的几点思考

目前,规范护士执业范围的法律、法规存在着盲区。作者通过对一起四级医疗事故的护理责任及护士执业范围的合法性进行分析探讨,认为应当尽快出台与《护士条例》配套的实施细则,以明确规范护士的执业范围及合法性,保障护士执业的安全。     

Ethics,Brain Injuries,and Sports: Prohibition,Reform, and Prudence

Abstract

In this paper, we explore the issue of the elimination of sports, or elements of sports, that present a high risk of brain injury. In particular, we critically examine two elements of Angelo Corlett’s and Pam Sailors’ arguments for the prohibition of football and Nicholas Dixon’s claim for the reformation of boxing to eliminate blows to the head based on (a) the empirical assumption of an essential or causal connection between brain injuries incurred in football and the development of a degenerative brain disease known as chronic traumatic encephalopathy (CTE); and (b) John Stuart Mill’s rejection of consensual domination (ie voluntary enslavement). We present four arguments to contest the validity of Corlett, Dixon’s and Sailor’s positions. Specifically, we argue that (i) certain autonomy-based arguments undermine paternalist arguments for reform; (ii) the nature of the goods people pursue in their lives might justify their foregoing (degrees of) future autonomy; (iii) Mill’s argument against consensual domination draws on ambiguous and arbitrary distinctions; (iv) the lack of consensus and empirical evidence regarding CTE arising from brain injuries in sport underdetermines calls for reform. We conclude that these proposals for reforming or eliminating sports with high risks of brain injuries are not well founded.     

糖尿病专科护士在2型糖尿病防治中的作用与地位

当前我们对糖尿病防治措施和手段可以说是无所不先进,但患者血糖、血脂、血压达标情况仍旧令人担忧。防治领域的相关人员都在竭尽全力探讨其原因,结果令人失望。但是糖尿病作为慢性终生性习惯性疾病,当前几乎所有的有意义的研究均指向良好的生活习惯（饮食控制、增加体育锻炼）有利于减少糖尿病发病。糖尿病专科医生作为疾病防治的三级层面,很...     

Intervention Models for Mothers and Children at Risk for Injuries

We review risk factors commonly associated with childhood unintentional injuries and highlight adolescent mothers and their young children as a high risk group. Several intervention models of injury, including the epidemiological model, Peterson and Brown's working model, and the socioecological model have been proposed to explain the events that lead to injuries. Discussion of these models is provided and a synthesis of the adolescent parenting model and the socioecological model of injury is suggested as way to address the complex variables that lead to an injury causing event for adolescent mothers and their young children. Finally, we suggest areas of future investigation and their implications for prevention and treatment.     

Natural sequence of recovery from child post-traumatic amnesia: A retrospective cohort study

The aim of this study was to determine the sequence of skills recovery during post-traumatic amnesia (PTA) in children with moderate to severe traumatic brain injuries (TBIs). Setting: Fifty children aged 8 to 15 years consecutively admitted to a children’s hospital with TBI and PTA>24 were tested in a retrospective cohort study where the main measure was the Westmead PTA Scale (WPTAS). The group analyses show that orientation to time took longer to recover than orientation to person and place, but not memory, while the individual analyses revealed that when orientation to time was grouped with memory, 94% of children recovered orientation to person and place before orientation to time and memory (examiner and pictures). Correlation coefficients between age and the number of days taken to recover skills were not found to be significant. It was established that, in terms of the natural sequence of skills recovery in children aged 8 to 15 years following moderate to severe TBI, recovery of orientation to time is more closely aligned to memory than to orientation to person and place. It was also established that WPTAS items are developmentally appropriate for children aged 8 to 15 years who have sustained TBI. These findings are clinically important because monitoring recovery from PTA both impacts the rehabilitation offered to individuals during acute care and aids discharge planning.     

Corporeal illusions in chronic spinal cord injuries

While several studies have investigated corporeal illusions in patients who have suffered from a stroke or undergone an amputation, only anecdotal or single case reports have explored this phenomenon after spinal cord injury. Here we examine various different types of bodily misperceptions in a comparatively large group of 49 people with spinal cord injury in the post-acute and chronic phases after the traumatic lesion onset. An extensive battery of questionnaires concerning a variety of body related feelings was administered and the results were correlated to the main clinical variables. Six different typologies of Corporeal Illusion emerged: Sensations of Body Loss; Body-Part Misperceptions; Somatoparaphrenia-like sensations; Disownership-like sensations; Illusory motion and Misoplegia. All of these (with the exception of Misoplegia) are modulated by clinical variables such as pain (visceral, neuropathic and musculoskeletal), completeness of the lesion, level of the lesion and the length of time since lesion onset. In contrast, no significant correlations between bodily illusions and personality variables were found. These results support data indicating that at least some cognitive functions (in particular the body, action and space representations) are embodied and that somatosensory input and motor output may be necessary to build and maintain a typical self-body representation.     

护士道德勇气研究进展

当护士拥有道德勇气时能履行对病人的道德责任等多种作用。本文对国内外护士道德勇气的研究进行梳理,列举了中西方学者对于道德勇气概念的定义,并且从质性和量性研究两方面分析护士道德勇气的研究现况,总结了人口学因素、组织伦理氛围、道德困境、道德敏感性与道德韧性等影响护士道德勇气的相关因素。本文有助于更全面的理解这一护士美德,未来可通过结合中国国情进一步探索并构建干预方案以提高护士的道德勇气,保障患者享受高质量护理。

     

Development of a Career Stress Scale for Hospital Nurses: Implications for Workplace Counseling

The author performed 3 studies to investigate the construct validation and applicability of a Career Stress Scale for hospital nurses. After conducting an exploratory factor analysis on a sample of 141 nurses in the 1st study, the author examined divergent and convergent validity in the 2nd study, and performed a confirmatory factor analysis to test the hypothesized model on a sample of 284 teaching hospital nurses. The final study aimed to expand the findings, and the author used multigroup structural equation modeling to examine the measurement invariance of the Career Stress Scale for a district hospital, in a sample of 166 nurses. Recommendations for future studies and workplace counseling are discussed.