赋能教育模式对血液透析患者钙磷代谢及营养状态的影响

目的观察赋能教育模式对血液透析伴矿物质及骨代谢异常患者钙磷代谢及营养状态的影响。方法组建赋能教育模式团队,选择2015年6月至2016年6月我院透析中心维持性血液透析(maintenance hemodialysis,MHD)患者60例,赋能教育模式干预12周后,采用自身前后对照的方法,比较患者血钙、血磷、钙磷乘积、全段甲状旁腺激素(intact parathyroid hormone,i PTH)、血红蛋白(hemoglobulin,Hb)、血浆白蛋白(albumin,Alb)、前白蛋白(pre albumin PAB)、肱三头肌皮褶厚度(triceps skinfold thickness,TSF)和上臂中段肌肉周径(mid-arm muscle circumference,MAMC)。结果赋能教育模式后患者血钙、血磷、钙磷乘积、赋能教育模式后患者血钙(t=0.017,P=0.002)、血磷(t=0.368,P=0.005)、钙磷乘积(t=3.089,P≤0.001)、i PTH降低(t=4.216,P=0.004),Hb(t=-1.267,P=0.039)、Alb升高(t=-1.051,P=0.045),TSF升高(t=-2.546,P=0.009),MAMC有升高趋势,但差异尚无统计学意义(t=-1.056,P=0.736)。结论赋能教育模式可改善血液透析伴矿物质及骨代谢异常患者钙磷代谢及营养状态。国家自然科学基金项目(No:71403232);;厦门市科技计划项目(No:3502Z20174037

急危重症患者并发电解质紊乱及酸碱失衡连续性血液净化的护理

总结26例电解质紊乱及酸碱失衡急危重症患者连续性血液净化的护理。准确监测电解质、酸碱平衡及血糖变化,严格遵医嘱配置置换液;液体平衡管理,精确统计各种出入量数据,准确设置置换液和超滤液速度,并及时纠正偏差;营养支持个体化,供氮和热能分别以0.025g/kg与21kJ/kg的速度逐渐调整,直至达到预期目标。本组患者治疗后,有效纠正了水、电解质、酸碱失衡,清除炎性介质

血液透析室护士身心健康状况与应对方式的关系研究

目的通过对血液透析室护士身心健康状况与应对方式的调查研究,促进护士心理行为良性发展,提高其身心健康水平。方法采用一般资料调查表、康奈尔健康问卷、简易应对方式量表对269名血液透析室护士进行问卷调查。结果血液透析室护士最常见的躯体健康问题是眼和耳(24.67%),其次是消化系统(18.26%),最常见的心理健康问题是不适应(19.42%),身心健康阳性率为15.61%,心理健康阳性率为7.43%。年龄越大、工作年限越长,护士的心理健康水平越高,消极应对得分明显高于常模,消极应对得分与身心健康状况得分呈正相关(P<0.01)。结论血液透析室护士身心健康状况不容乐观,既要提高工作能力也要注重心理调节能力的培养,促进护士形成积极的心理反应模式,尤其是年轻护士,应学会和运用积极的应对策略,保持良好的身心健康状况。厦门市科技计划项目(3502Z20144041

Construction and practice of Internet-Plus hierarchical nursing training scheme based on ADDIE teaching model (基于ADDIE教学模型的“互联网+”护士层级培训方案的构建与实践)

Objective To explore the application effectiveness of the Internet-Plus hierarchical nursing training program based on the analysis-design-development-implementation-evaluation(ADDIE) teaching model in the training of Traditional Chinese Medicine nurses. Methods From October 2022 to May 2023, 400 nurses from a tertiary Traditional Chinese Medicine hospital in Shenzhen were selected as study subjects and randomly divided into an experimental group and a control group, with 200 subjects in each group. During the training process, the control group received traditional training methods, while the experimental group received the Internet-Plus hierarchical nursing training program based on the ADDIE teaching model. Specialist competence, job competency, and training satisfaction were compared before and after training in both groups. Results After the nursing training program, nurses in the experimental group achieved higher scores of theoretical and practical tests compared with those in the control group (P＜0. 01). Scores of help role ability, education-guidance ability, valuation and judgment ability, nursing intervention ability and quality evaluation ability in the experimental group were higher than those in the control group(P＜0. 05). Scores of satisfaction with training arrangement, training method and training benefits in the experimental group were higher than those in the control group(P＜0. 01). Conclusion Applying the Internet-Plus hierarchical nursing training program based on the ADDIE teaching model in nursing training helps nurses enhance their specialist competence and job competency. (目的 探究基于分析、设计、开发、实施和评价(ADDIE)教学模型的“互联网+”护士层级培训方案在中医院护士培训中的应用效果。方法 选取2022年10月—2023年5月深圳市某三甲中医院的400名护士为研究对象, 采用随机数字表法分为试验组和对照组, 每组各200例。在培训过程中, 对照组采用传统培训方案, 试验组采用基于ADDIE教学模型的“互联网+”护士层级培训方案。比较两组培训前后专科能力、岗位胜任力及培训满意度。结果 培训结束后, 试验组护士专科能力考核中理论成绩和技能成绩均高于对照组, 差异有统计学意义(P＜0. 01); 试验组护士胜任力量表(NCS)中帮助角色、教育指导、诊断能力、诊疗干预和确保质量核心能力评分均高于对照组, 差异有统计学意义(P＜0. 05); 试验组在培训安排、培训方式和培训收益维度的满意度认同高于对照组, 差异有统计学意义(P＜0. 01)。结论 将基于ADDIE教学模型的“互联网+”护士层级培训方案应用于护理培训中, 有利于增强护士的专科能力和岗位胜任力。

1995～2011年CERN土壤环境元素含量数据集

土壤环境是地球环境的重要组成部分。目前土壤环境问题的关注重点在于土壤污染。我国土壤污染以无机污染为主。中国生态系统研究网络(Chinese Ecosystem Research Network,CERN)自1988年组建以来,在中国主要农田、森林、草原、荒漠、湿地生态系统中,按统一的规范,对与土壤环境状况有关的铁、锰、铜、锌、硼、钼、镉、铬、铅、镍、汞、砷、硒元素进行了长期定位监测。通过对CERN典型生态样地表层土壤环境元素监测数据进行加工处理,获得1995～2011年中国陆地生态系统土壤环境元素含量数据集。本数据集中13种土壤环境元素指标测定的相对误差平均为6.55%,重复测定的相对偏差为7.70%。同时附有完整的背景信息,保证了数据在空间和时间上的一致性。本数据集可以为全国和区域土壤环境质量评估、土壤污染风险评价以及环境土壤学研究等工作提供数据基础

Determination of the number of ψ(3686) events taken at BESIII

The number of ψ(3686) events collected by the BESIII detector during the 2021 run period is determined to be (2259.3±11.1)×106 by counting inclusive ψ(3686) hadronic events. The uncertainty is systematic and the statistical uncertainty is negligible. Meanwhile, the numbers of ψ(3686) events collected during the 2009 and 2012 run periods are updated to be (107.7±0.6)×106 and (345.4±2.6)×106, respectively. Both numbers are consistent with the previous measurements within one standard deviation. The total number of ψ(3686) events in the three data samples is (2712.4±14.3)×10^