Objective To construct a framework and relevant evaluation items for evaluating the core competence of clinical nursing teachers. Methods We explored the whole frame of competence structure and established behavior items for evaluating competences with corresponding level-marking standards through theory analysis, literature study, expert consultation and a small sample test. We also investigated 237 nursing managers, teachers, and students from six medical schools in China using a 5-point Likert-type scale. Item analysis and factor analysis were performed to reveal competence construction and connotation, and the evaluation model for core competence of clinical nursing teachers were constructed. Results Content, structure and internal consistency coefficient were checked for validity. Cronbach＇s alpha of the total system was 0. 9109 and of each domain ranged from 0. 6064 to 0. 8474. Results of Split-half Reliability demonstrated that of total system was 0. 8765 and of each domain ranged from 0. 634 2 to 0. 8369. Conclusions The evaluation model for core competence of clinical nursing teachers is composed of three parts： competence domains, behavior items and their corresponding grade standards. Core competence of clinical nursing teachers consist of four domains：leadership ability, problem-solving ability, teaching ability and nursing ability, each of which contains several behavior items and corresponding four grades standards reflecting different abilities.
目的:观察护理干预对脑瘫患儿生活自理能力训练的影响。方法:80例脑瘫患儿随机分为2组,常规组40例,实施常规护理;观察组40例,在常规护理基础上对患儿和家长给予护理干预,两组患儿治疗前后均进行日常生活自理动作评定。结果:治疗后,2组患儿ADL评分较治疗前有明显提高(Plt;0.05),与常规组比较,观察组患儿改善更明显(Plt;0.01)。结论:护理干预对脑瘫患儿生活自理能力的训练有促进作用。
ObjectiveTo investigate the effects of melatonin (MT) on bone mass and serum inflammatory factors in rats received ovariectomy (OVX) and to investigate the effects of MT on the levels of inflammatory factors in culture medium and osteogenic ability of bone marrow mesenchymal stem cells (BMSCs) stimulated by lipopolysaccharide. Methods Fifteen 12-week-old Sprague Dawley (SD) rats were randomly divided into 3 groups. The rats in Sham group only received bilateral lateral abdominal incision and suture, the rats in OVX group received bilateral OVX, and the rats in OVX+MT group received 100 mg/(kg·d) MT oral intervention after bilateral OVX. After 8 weeks, the levels of serum inflammatory factors [interleukin-1β (IL-1β), IL-6, and tumor necrosis factor α (TNF-α)] were detected using ELISA assay. Besides, the distal femurs were detected by Micro-CT to observe changes in bone mass and microstructure, and quantitatively measured bone volume fraction, trabecular thickness, and trabecular number. The BMSCs were extracted from the femurs of three 3-week-old SD rats using whole bone marrow culture method and passaged. The 3rd-5th passage BMSCs were cultured with different concentrations of MT (0, 1, 10, 100, 1 000 µmol/L), and the cell viability was then detected using cell counting kit 8 (CCK-8) to select the optimal concentration of MT for subsequent experiments. Cells were devided into osteogenic induction group (group A) and osteogenic induction+1/5/10 μg/mL lipopolysaccharide group (group B-D). The levels of inflammatory factors (IL-1β, IL-6 and TNF-α) in cell culture medium were detected using ELISA assay after corresponding intervention. According to the results of CCK-8 method and ELISA detection, the cells were intervened with the most significant concentration of lipopolysaccharide for stimulating inflammation and the optimal concentration of MT with osteogenic induction, defining as group E, and the cell culture medium was collected to detect the levels of inflammatory factors by ELISA assay. After that, alkaline phosphatase (ALP) staining and alizarin red staining were performed respectively in groups A, D, and E, and the expression levels of osteogenic related genes [collagen type Ⅰ alpha 1 chain (Col1a1) and RUNX family transcription factor 2 (Runx2)] were also detected by real time fluorescence quantitative PCR (RT-qPCR). ResultsELISA and Micro-CT assays showed that compared with Sham group, the bone mass of the rats in the OVX group significantly decreased, and the expression levels of serum inflammatory factors (IL-1β, IL-6, and TNF-α) in OVX group significantly increased (P<0.05). Significantly, the above indicators in OVX+MT group were all improved (P<0.05). Rat BMSCs were successfully extracted, and CCK-8 assay showed that 100 µmol/L was the maximum concentration of MT that did not cause a decrease in cell viability, and it was used in subsequent experiments. ELISA assays showed that compared with group A, the expression levels of inflammatory factors (IL-1β, IL-6, and TNF-α) in the cell culture medium of groups B-D were significantly increased after lipopolysaccharide stimulation (P<0.05), and in a concentration-dependent manner. Moreover, the expression levels of inflammatory factors in group D were significantly higher than those in groups B and C (P<0.05). After MT intervention, the expression levels of inflammatory factors in group E were significantly lower than those in group D (P<0.05). ALP staining, alizarin red staining, and RT-qPCR assays showed that compared with group A, the percentage of positive area of ALP and alizarin red and the relative mRNA expressions of Col1a1 and Runx2 in group D significantly decreased, while the above indicators in group E significantly improved after MT intervention (P<0.05). ConclusionMT may affect the bone mass of postmenopausal osteoporosis by reducing inflammation in rats; MT can reduce the inflammation of BMSCs stimulated by lipopolysaccharide and weaken its inhibition of osteogenic differentiation of BMSCs.
ObjectiveTo understand the status and risk factors of care ability among main caregivers of stroke patients.MethodsA total of 395 stroke patients and their main caregivers were enrolled in the Department of Neurology, West China Hospital, Sichuan University from August 2017 to February 2018. General data of the patients and their main caregivers were collected. The caring ability of the main caregivers was assessed by the family care test inventory. Connor- Davision Resilience Scale and Mishel Uncertainty in Illness Scale-Family Member Form were used to assess the psychological resilience and uncertainty illness of caregivers. Single factor analysis and multiple linear regression analysis were all used to explore the risk factors.ResultsThe care ability of the main caregivers of stroke patients was basically at a high level. Multivariate analysis showed that patients’ age [non-standardized partial regression coefficient (b)=−0.051, 95% confidence interval (CI) (−0.079, −0.024), P<0.001], family income [b=−0.455, 95%CI (−0.770, −0.141), P=0.005], and activities of daily living ability at admission [b=−0.017, 95%CI (−0.029, −0.006), P=0.003], and caregivers’ sleeping status [b=0.636, 95%CI (0.340, 0.932), P<0.001], scores of resilience [b=−0.143, 95%CI (−0.202, −0.083), P<0.001] and illness uncertainty [b=−0.127, 95%CI (−0.153, −0.100), P<0.001] were influencing factors of caregivers’ care ability.ConclusionsThe main caregivers of stroke patients have good care ability. The older the patients are, the higher the family income is, and the better the ability of activities of daily living at admission is, the better the caregivers’ care ability they have. The better the caregivers’ sleep is, and the stronger the caregivers’ psychological resilience and uncertainty of disease are, the better the caring ability they have. It is suggested that we should pay more attention to the physical and mental status of caregivers, raise their awareness of stroke, teach them relevant knowledge and care skills, so as to lighten the physical and mental burden of caregivers, improve the prognosis of patients and finally improve the quality of life of patients and their caregivers.
Objective To explore the teaching ability of the neurology refresher doctors by case teaching method combined with flipped classroom teaching mode. Methods The refresher doctors who were studying in the infection group of Department of Neurology, Xuanwu Hospital Capital Medical University between March 2019 and September 2020 were selected. According to the time of admission, the enrolled refresher doctors were divided into control group (grade 2019) and observation group (grade 2020). The control group adopted the traditional teaching mode, and the observation group adopted the case teaching method combined with the flipped classroom teaching mode. A self-designed questionnaire was used to compare the teaching ability of the two groups of refresher doctors. Results A total of 44 refresher doctors were included. Among them, there were 24 refresher doctors in the control group and 20 refresher doctors in the observation group. The self-evaluation of the teaching ability of the two groups of refresher doctors and the evaluation of their teaching ability by the teachers showed that, except for the item “enthusiasm for teaching and willingness to spend enough time to participate in the evaluation of teaching work” of humanistic quality (P>0.05), the observation group was better than the control group in professional knowledge, teaching ability, teaching methods and humanistic quality (P<0.05). Conclusions Through the case teaching method combined with flipped classroom teaching mode, the teaching ability of refresher doctors can be cultivated, which is helpful for training more high-quality doctors for the country and promoting the sustainable and coordinated development of medical education. However, the awareness and enthusiasm of the refresher doctors to teaching work need to be improved.
【摘要】 目的 观察悬吊运动系统治疗（sling exercise therapy， SET）联合神经发育疗法治疗对痉挛型脑性瘫痪儿童肌张力及日常生活活动能力（activities of daily living，ADL ）的影响。 方法 2008年8月-2009年3月收治的40例双下肢痉挛型脑性瘫痪儿童纳入研究。根据随机数字表法分为治疗组与对照组，每组各20例。对照组与治疗组均采用神经发育疗法进行康复训练，治疗组在神经发育疗法基础上配合悬吊运动系统治疗。观察两组患儿治疗1、3个月时肌张力与ADL变化。 结果 治疗1个月时，治疗组患儿肌张力缓解明显优于对照组（P＜0.05），3个月时，治疗组肌张力缓解程度明显优于对照组。两组ADL评分比较，治疗组ADL评分改善情况明显优于对照组（P＜0.05）。 结论 悬吊运动系统治疗联合神经发育疗法可明显缓解痉挛型脑性瘫痪患儿童肌张力，提高ADL。【Abstract】 Objective To observe the effects of sling exercise therapy (SET) combined with neurodevelopmental therapy on muscle tension and activities of daily living (ADL) of children with spastic cerebral palsy. Methods Forty children with spastic cerebral palsy on bilateral lower limb were selected in our study. The children were randomly divided into a treatment group and a control group, 20 children in each group. Both the two groups were accepted rehabilitation training by neurodevelopmental therapy, while the treatment group was received SET as cooperate cure based on the neurodevelopmental therapy. The changes of muscle tension and ADL on the one and three months after treatment were observed. Results On the one and three months after treatment, the remission of muscle tension and improvement of ADL score were better than those in the control group, the differences were statistically significant(Plt;0.01). Conclusion SET combined with neurodevelopmental therapy can relieve the muscle tension, and improve the ADL of children with spastic cerebral palsy.
Objective To evaluate the level of nursing professional competence of fulltime system graduated nurses in Sichuan province and determine its influencing factors, so as to provide references for nursing high-education reform and nursing human resource management. Methods With a self-designed questionnaire and stratified cluster sample method, both graduated nurses and their direct nursing managers were investigated and asked to evaluate nursing professional competence. Results The mean scores of nursing professional competence of the nurses’ self-evaluation and their managers’ evaluation were 69.90±10.27 and 68.96±11.33, respectively. Factors influencing nursing professional competence included individual interest in nursing, graduated institution, working position, and training provided by employer. Conclusion The professional competence of the nurses graduated with full-time bachelors of clinical nursing in Sichuan province is close to the intermediate level, and it still needs to be improved on the whole, especially in the aspects of nursing research and management. Besides, nursing institutions should further enhance the construction of inner teaching environment and the professional thoughts education of nurse students, while the employer should offer more professional development opportunities, so as to improve the professional self-identity and competence, and to finally lay the talent foundation for the development of nursing disciplines.
ObjectiveTo deeply discuss the home care experience of parents of children with epilepsy, analyzed the current status of care ability and the real influencing factors, and provide a basis to improve their care ability.MethodsDescriptive research was used to conduct in-depth interviews with parents of 14 children with epilepsy who were admitted to the Children's Hospital of Zhengzhou University from December 2019 to January 2020, and data analysis was performed by using the generic analysis method.ResultsThe home care experience of parents of children with epilepsy includes four themes: weak nursing ability, physical and mental fatigue, weak support system, and expectation of medical professional support.ConclusionMedical staffs should combine the needs of parents of children with epilepsy and the influencing factors of care ability to carry out health education guidance of online and offline epilepsy knowledge and care skills to improve their care ability.