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    《护理与健康研究》总第39.3期
    日期:2016-06-06 09:05:53    来源:ISPN 周老师
    《护理与健康研究》2016年6月总第39卷第3期
    Research in Nursing & Health
    June 2016
    Volume 39, Issue 3 Pages 133–205
     
    Issue Information - TOC
    Issue Information - TOC (page 133)
     
    Editorial
    Under-Appreciated Steps in Instrument Development, Part II: Ending With Validity(pages 135–138)
    器械开发中重视不够的步骤,第二部分:以有效性告终
     
    SNRS News
    Our Community of Practice—Advancing Nursing Research: Message from the President (pages 139–141)
    我们的执业社区 – 促进护理研究:总裁消息
     
    Research Reports
    Empowering Change Agents in Hierarchical Organizations: Participatory Action Research in Prisons (pages 142–153)
    向等级森严组织中的变迁推动者授权:参与式行动研究在监狱的实施
    Participatory action research (PAR) approaches harness collaborative partnerships to stimulate change in defined communities. The purpose of this article is to illustrate key methodological strategies used in the application of PAR methods in the particularly challenging environment of a hierarchical organization. A study designed to promote sustainable, insider-generated system-level changes in the provision of end-of-life (EOL) care in the restrictive setting of six state prisons is used as an exemplar of the application of three cardinal principles of PAR. First, development of a collaborative network with active partnership between outsider academic researchers and insider co-researchers began with careful attention to understanding the culture and processes of prisons and gaining the support of organizational leadership, using qualitative data gathering and trust-building. During the implementation phase, promoting co-ownership of change in EOL care through the co-construction of knowledge and systems to enhance sustainable change required carefully-orchestrated strategies to maximize the collaborative spirit of the project. Co-researchers were empowered to examine their worlds and capture opportunities for change using new leadership skills role-modeled by the research team. Third, their local knowledge of the barriers inherent in the contextual reality of prisons was translated into achievable system change by production of a toolkit of formalized and well-rehearsed change strategies that collaborative teams were empowered to enact within their hierarchical prison environment. © 2016 Wiley Periodicals, Inc.
    Bidirectional Relationships Between Fatigue and Everyday Experiences in Persons Living With HIV (pages 154–163)
    HIV携带者疲劳与日常经历之间的双向关系
    疲劳可以预测多项日常生活调查变量结果,包括压力和社会支持。压力和支持反过来又可预示以后的疲劳,表明相互间存在一种自我促全的循环模式,同时也提示了可能的干预途径。
    Fatigue symptoms are very common among persons living with HIV (PLWH). Fatigue is related to functional and psychological problems and to treatment nonadherence. Using secondary data from ecological momentary assessment, we examined fatigue as a predictor of PLWH everyday experiences. In bidirectional analyses based on the shape shifters model, we also examined these experiences as predictors of fatigue. Data were examined from 67 PLWH who completed daily surveys on a handheld computer. Brief validated scales were used to assess participants’ control beliefs, mood, stress, coping, social support, experience of stigma, and motivation. At the beginning and end of the study, fatigue was measured with two CES-D items that have been used in past HIV symptom research. Multilevel models and logistic regression were used to test reciprocal predictive relationships between variables. Moderate to severe fatigue affected 45% of PLWH in the study. Initial fatigue predicted PLWH subsequent overall level of control beliefs, mood, stress, coping, and social support, all p < .05. These state variables remained relatively constant over time, regardless of participants’ initial fatigue. In tests for reciprocal relationships with 33 PLWH, average daily stress, OR = 4.74, and stigma, OR = 4.86, also predicted later fatigue. Fatigue predicted several daily survey variables including stress and social support. Stress and support in turn predicted fatigue at a later time, suggesting a self-perpetuating cycle but also a possible avenue for intervention. Future studies should examine daily variation in fatigue among PLWH and its relation to other everyday experiences and behaviors. © 2016 Wiley Periodicals, Inc.
    Inter-Rater Agreement of Pressure Ulcer Risk and Prevention Measures in the National Database of Nursing Quality Indicators® (NDNQI) (pages 164–174)
    国家护理质量指标数据库®(NDNQI)压力性溃疡风险的评判一致性和预防措施
    In this descriptive multi-site study, we examined inter-rater agreement on 11 National Database of Nursing Quality Indicators® (NDNQI®) pressure ulcer (PrU) risk and prevention measures. One hundred twenty raters at 36 hospitals captured data from 1,637 patient records. At each hospital, agreement between the most experienced rater and each other team rater was calculated for each measure. In the ratings studied, 528 patients were rated as “at risk” for PrU and, therefore, were included in calculations of agreement for the prevention measures. Prevalence-adjusted kappa (PAK) was used to interpret inter-rater agreement because prevalence of single responses was high. The PAK values for eight measures indicated “substantial” to “near perfect” agreement between most experienced and other team raters: Skin assessment on admission (.977, 95% CI [.966–.989]), PrU risk assessment on admission (.978, 95% CI [.964–.993]), Time since last risk assessment (.790, 95% CI[.729–.852]), Risk assessment method (.997, 95% CI [.991–1.0]), Risk status (.877, 95% CI [.838–.917]), Any prevention (.856, 95% CI [.76–.943]), Skin assessment (.956, 95% CI [.904–1.0]), and Pressure-redistribution surface use (.839, 95% CI [.763–.916]). For three intervention measures, PAK values fell below the recommended value of ≥.610: Routine repositioning (.577, 95% CI [.494–.661]), Nutritional support (.500, 95% CI [.418–.581]), and Moisture management (.556, 95%CI [.469–.643]). Areas of disagreement were identified. Findings provide support for the reliability of 8 of the 11 measures. Further clarification of data collection procedures is needed to improve reliability for the less reliable measures. © 2016 Wiley Periodicals, Inc.
    Relationship of Maternal Psychological Distress Classes to Later Mother–Infant Interaction, Home Environment, and Infant Development in Preterm Infants (pages 175–186)
    早产儿产妇心理压力等级与产后母婴互动、家庭环境和婴儿发育的关系
    Latent class analyses can be used early in the postpartum period to identify mothers of preterm infants experiencing similar patterns of psychological distress symptoms, but whether these classes of mothers also differ in parental responses to their infants or in their infants’ development is largely unknown. In this longitudinal multisite-repeated measures study, we evaluated the usefulness of three psychological distress classes (low distress, high depressive and anxiety symptoms, and extreme distress) in predicting mother–infant interactions, quality of home environment, and infant development in 229 mother-preterm infant pairs. Mothers completed psychological distress questionnaires at study entry; parent-infant interaction was recorded at 2 and 6 months of age corrected for prematurity; and infant developmental data were collected 12 months corrected age. Mothers in the extreme distress class engaged in more developmental stimulation at 2 months (β = .99, p < 0.01) and at 6 months (β = 1.38, p < .01) than mothers in the other classes and had better quality of home environment at 2 months (β = 2.52, p = .03). When not controlling for neurological insult, infants of mothers in the extreme distress class had poorer cognitive (β = −10.28, p = .01) and motor (β = −15.12, p < .01) development scores at 12 months corrected age than infants of mothers in the other distress classes, but after controlling for infant neurological insult, there were no differences in cognitive, motor, and language development based on maternal psychological distress class. © 2016 Wiley Periodicals, Inc.
    “I Lost My Image, the Image Others Know Me By”: Findings From a Hermeneutic Phenomenological Study of Patients Living With Treatment-Induced Cutaneous Toxicities (pages 187–196)
    Andreas Charalambous and Melanie Charalambous
    “我丧失了形象,别人心目中的形象”:治疗诱导性皮肤毒性患者的解释性现象学研究成果
    Comparison of Unit-Level Patient Turnover Measures in Acute Care Hospital Settings (pages 197–203)
    急症保健医院病房病人周转措施比较
     
    Issue Information - Author Guidelines
    Issue Information - Author Guidelines (pages 204–205)
     




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