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Purpose: To construct humanistic nursing practice guidelines suitable for stroke patients. Design: This study was a development and validation study of guidelines using multiple methods, including literature review, qualitative research, questionnaire survey, thematic discussion, and Delphi expert consultation. Methods: Twenty-five experts from seven provinces and municipalities in China were interviewed over two rounds from December 2020 to February 2021. The first-level index was scored for importance and rationality, while the second-level index was scored for importance and feasibility using a five-point Likert scale. Delphi data was collected via a paper version of the questionnaire. The coefficients of variation and coordination were used to represent the degree of dispersion of expert opinions. Findings: In the two rounds of letter consultation, the questionnaire's recovery and effective rates were both 100%, while the opinion submission rates of the two rounds were 84 and 52%, respectively. Moreover, the expert authority coefficient was 0.91, and the coordination coefficients of expert opinions in the first round were as follows: importance of 0.03 and rationality of 0.07 for the first-level index; importance of 0.09 and feasibility of 0.11 for the secondary index. In round two, the coordination coefficients of expert opinions were as follows: importance of 0.04 and rationality of 0.05 for the first-level indicators; importance of 0.12 and feasibility of 0.10 for the secondary index. The results for the secondary index were P < 0.001 for the two rounds. The humanistic nursing practice guidelines for stroke patients that were ultimately formed included five first-level indicators (physiological care, safety care, emotional care, dignity care, and rehabilitation needs) and 46 s-level indicators. Conclusion: Our results show that the "Practice Guidelines for Humanistic Nursing for Stroke" established by experts adopts Maslow's hierarchy of needs as its structural framework. It meets people's basic needs and can provide a reference for the construction of a humanistic nursing specialty practice for stroke patients. Clinical relevance: Humanistic nursing guidelines for stroke could provide a reference for the construction of humanistic nursing practice in the stroke specialty. Clinical resources: Copeptin and long-term risk of recurrent vascular events after transient ischemic attack and ischemic stroke: population-based study https://pubmed.ncbi.nlm.nih.gov/26451023/. Effectiveness and usage of a decision support system to improve stroke prevention in general practice: a cluster randomized controlled trial https://pubmed.ncbi.nlm.nih.gov/28245247/. Guidelines for adult stroke rehabilitation and recovery: a guideline for healthcare professionals from the American Heart Association/American Stroke Association https://pubmed.ncbi.nlm.nih.gov/27145936/.
Asunto(s)
Derivación y Consulta , Accidente Cerebrovascular , Adulto , China , Técnica Delphi , Humanos , Accidente Cerebrovascular/terapia , Encuestas y Cuestionarios , Estados UnidosRESUMEN
Background: As a special patient group, stroke patients have a significant attachment to humanistic care. However, multiple problems remain in clinical practice. Medical staff in stroke wards are the primary providers of humanistic care. Finding out the opinions of the staff that provide these medical services is vitally important for stroke patients that need access to curative and humanistic care. Objective: The aim of the study is to explore the psychological experiences of doctors, nurses, and physiotherapists during the implementation of humanistic care in stroke wards. Method: This is a qualitative phenomenological study. Medical staff (i.e., doctors, nurses, and physiotherapists) were selected from stroke wards in general hospitals (minimum level two) from 13 cities within six provinces in China. A purposive sampling method was used until saturation (n = 18). Face-to-face or video call semi-structured interviews were conducted by using a phenomenological research method. The average interview length was 60 min (range 30-90 min). The Colaizzi seven-step method was used for analysis. Results: Four themes and 12 sub-themes were extracted from the qualitative interviews of the medicine, nursing and technology staff, as follows. â The ward staff reported that the behaviors of the stroke patients gradually improved when they assisted with stroke treatment idea changes, when they paid attention to solving the patients' existing problems, and when they took the initiative to create a caring atmosphere; â when humanistic care in the stroke wards was carried out with consciousness and ability improvement (including proactive caring behaviors in which vocational value was not strong and in which the whole-person rehabilitation was given attention, not just implementation), the patients' behaviors improved; â the stroke wards themselves were improved (the gap between the current management and the needs of medical institutions and the gap between the rehabilitation conditions and the patients' needs were addressed); and â the urgent needs of the staff in the implementation of humanistic care in stroke wards were considered (the addition of full-time posts, the effective training of humanistic care, and the construction of a more harmonious doctor-patient relationship). Conclusion: In implementing humanistic care in stroke wards, the consciousness and ability of the medical staff need to be improved. In addition, the practical problems and contradictions affecting the development of humanistic care must be addressed. To improve the level of humanistic care in stroke wards, attention should be paid to the overall improvement of the personal qualities of the medical staff and the integration of a humanistic management mode.
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The complete mol-ecule of the title compound, C(28)H(24)N(6), is generated by inversion symmetry with the inversion centre located at the mid-point of the central C-C bond of the butanediyl unit. The benzimidazole and pyridine rings are almost coplanar, the dihedral angle between their mean planes being 6.86â (11)°.
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In the title compound, [Cu(2)(C(6)H(8)O(4))Cl(2)(C(15)H(11)N(3))(2)]·4H(2)O, the dinuclear copper complex is located on a crystallographic inversion centre. Each Cu atom is in a distorted square-pyramidal coordination environment, with one O atom of an adipate dianion and three N atoms from the 2,2':6',2''-terpyridine ligand occupying the basal plane, and one chlorine in the apical site. In addition, there is weak Cu-O inter-action opposite of the chlorine with a distance of 2.768â (1)â Å. The adipate ligand adopts a gauche-anti-gauche conformation. The inter-stitial water mol-ecules form hydrogen-bonded tertramers that are connected to the complexes via O-Hâ¯O and O-Hâ¯Cl hydrogen bonds, thus leading to the formation of tightly hydrogen-bonded layers extending perpendicular to the b-axis direction.
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In the title compound, [Cu(C(7)H(5)O(2))(2)(C(3)H(4)N(2))(2)(H(2)O)]·H(2)O, the Cu(II) atom is in a distorted square-pyramidal environment. The mol-ecules are assembled into double chains extending along [010] by N-Hâ¯O hydrogen bonds. These double chains are linked by O-Hâ¯O hydrogen bonds, forming layers parallel to (02); the layers are linked into a three-dimensional network by van der Waals inter-actions.
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In the title compound, [Cd(HCOO)(2)(C(10)H(8)N(2))](n), the Cd(II) ion, located on a position with 2.22 site symmetry, is surrounded by two 4,4'-bipyridine ligands and four formate ligands in a distorted octahedral CdN(2)O(4) coordination. The 4,4'-bipyridine ligands bridge the metal ions, forming one-dimensional chains along different directions, which are further connected by formate ligands into a topologically (10(10).12(4).14)(10)(3) three-dimensional network.
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In the title salt, (C(10)H(9)N(2))(2)[Fe(C(8)H(2)NO(6))(C(8)H(3)NO(6))]·3H(2)O, the Fe(III) atom is O,N,O'-chelated by dianionic and trianionic ligands in a slightly distorted octa-hedral coordination geometry. The cations and ferrate anions are linked into a layered structure; the layers are connected through the uncoordinated water mol-ecules into a hydrogen-bonded three-dimensional supra-molecular structure. One of the uncoordinated water molecules is disordered around an inversion centre and was refined with half-occupancy for each position.
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Seven new glutaric acid complexes, Co(H 2O) 5L 1, Na 2[CoL 2] 2, Na 2[L(H 2L) 4/2] 3, {[Co 3(H 2O) 6L 2](HL) 2}.4H 2O 4, {[Co 3(H 2O) 6L 2](HL) 2}.10H 2O 5, {[Co 3(H 2O) 6L 2]L 2/2}.4H 2O 6, and Na 2{[Co 3(H 2O) 2]L 8/2].6H 2O 7 were obtained and characterized by single-crystal X-ray diffraction methods along with elemental analyses, IR spectroscopic and magnetic measurements (for 1 and 2). The [Co(H 2O) 5L] complex molecules in 1 are assembled into a three-dimensional supramolecular architecture based on intermolecular hydrogen bonds. Compound 2 consists of the Na (+) cations and the necklace-like glutarato doubly bridged [ C o L 4 / 2 ] 2 - infinity 1 anionic chains, and 3 is composed of the Na (+) cations and the anionic hydrogen bonded ladder-like [ L ( H 2 L ) 4 / 2 ] 2 - infinity 1 anionic chains. The trinuclear {[Co 3(H 2O) 6L 2](HL) 2} complex molecules with edge-shared linear trioctahedral [Co 3(H 2O) 6L 2] (2+) cluster cores in 4 and 5 are hydrogen bonded into two-dimensional (2D) networks. The edge-shared linear trioctahedral [Co 3(H 2O) 6L 2] (2+) cluster cores in 6 are bridged by glutarato ligands to generate one-dimensional (1D) chains, which are then assembled via interchain hydrogen bonds into 2D supramolecular networks. The corner-shared linear [Co 3O 16] trioctahedra in 7 are quaternate bridged by glutarato ligands to form 1D band-like anionic {[Co 3(H 2O) 2]L 8/2} (2+) chains, which are assembled via interchain hydrogen bonds into 2D layers, and between them are sandwiched the Na (+) cations. The magnetic behaviors of 1 and 2 obey the Curie-Weiss law with chi m = C/( T - Theta) with the Curie constant C = 3.012(8) cm (3) x mol (-1) x K and the Weiss constant Theta = -9.4(7) K for 1, as well as C = 2.40(1) cm (3) x mol (-1) x K and Theta = -2.10(5) K for 2, indicating weak antiferromagnetic interactions between the Co(II) ions.
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In the title compound, [Cu(2)(C(12)H(8)N(3)O(2))(2)(C(6)H(8)O(4))(H(2)O)(2)]·3H(2)O, both crystallographically independent Cu atoms are in similar distorted square-pyramidal coordination environments. The dinuclear complex mol-ecules are assembled into one-dimensional supra-molecular chains extending in the [100] direction by hydrogen bonds. Inter-chain hydrogen bonds further link these chains into layers perpendicular to [001].
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In the title compound, [Cu(C(8)H(7)O(2))(C(12)H(8)N(2))(2)](C(8)H(7)O(2))·6H(2)O, the Cu atom is in a distorted square-pyramidal coordination environment. The six crystallographically independent uncoordinated water mol-ecules are inter-connected by hydrogen bonds, completing dodeca-water (H(2)O)(12) clusters which are hydrogen bonded to the carboxyl-ate groups of phenyl-acetate anions, building up one-dimensional anionic chains propagating along [100]. Between the cationic and anionic chains are hydrogen bonds from water mol-ecules to the carboxyl-ate O atoms belonging to the phenyl-acetato ligands.
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In the title compound, [Cu(CHO(2))(C(12)H(8)N(2))(2)]CHO(2)·6H(2)O, the Cu atom is coordinated in a distorted trigonal-bipyramidal fashion by an O atom of the formate ligand and four N atoms of two phenanthroline ligands with Cu-O and Cu-N distances of 2.020â (3) and 1.978â (3)-2.177â (3)â Å, respectively. Hydrogen bonding O-Hâ¯O between water molecules and between water anions as well as π-π inter-actions [centroid-centroid distances between phen rings = 3.38â (7) and 3.40â (5)â Å] are responsible for the supra-molecular assembly.
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The title compound, [Co(C(10)H(8)N(2))(3)]Cl(3)·4H(2)O, contains discrete [Co(bpy)(3)](3+) cations (bpy is 2,2'-bipyridine), Cl(-) anions and water mol-ecules. The [Co(bpy)(3)](3+) complex cation exhibits C(2) symmetry with the twofold axis through the central Co atom and bis-ecting one bpy ligand and one of the Cl(-) anions. The four solvent water mol-ecules and the remaining two Cl(-) anions lie on a mirror plane. Hydrogen-bond inter-actions define a two-dimensional layer structure parallel to (100), which consists of seven-membered [Cl(2)(H(2)O)(5)], eight-membered [Cl(4)(H(2)O)(4)] and ten-membered [Cl(2)(H(2)O)(8)] rings.
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The central CuN(4)O(2) motif of the title compound, [Cu(ClO(4))(2)(C(8)H(6)N(4))(C(10)H(8)N(2))](n), exhibits a Jahn-Teller-distorted octa-hedral geometry around the metal centre, showing a considerably long Cu-O bond distance of 2.634â (4)â Å towards the second perchlorate group occupying the sixth coordination site, giving a (4+1+1)-type coordination mode. The 4,4'-bipyridine (bipy) ligands are highly twisted with respect to each other, the dihedral angle between the two pyridyl ring planes being 38.9â (2)°. The bipy ligands act as bridging ligands between [Cu(ClO(4))(2)(2,2'-bpym)] (2,2'-bpym is 2,2'-bipyrimidine) units, generating an infinite one-dimensional zigzag chain along [010]. Intra- and intermolecular C-Hâ¯O hydrogen bonds are present in the crystal structure.
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A new monoclinic polymorphic form of the title compound, [Cu(HCO(2))(2)(C(14)H(12)N(2))(H(2)O)], is described. It differs from the first ortho-rhom-bic polymorph [Pan, Lin & Zheng (2005 â¶). Z. Kristallogr. New Cryst. Struct.220, 495-496] in the deviation of the Cu atom relative to the plane of the 2,9-dimethyl-1,10-phenanthroline (dmp) ligand. In the present structure, the Cu atom is shifted from the mean plane of the dmp ligand by only 0.005â (1)â Å, compared with 0.318â (6)â Å in the ortho-rhom-bic form. Hydrogen-bonding and π-π stacking inter-actions (mean inter-planar distance of 3.59â Å in the title compound) in the two different polymorphs are both essential to the supra-molecular assembly.
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In the title compound, [CdCl2(C(18)H(12)N(6))].3H2O, the Cd atom has a distorted square-pyramidal coordination geometry. The solvent water molecules are hydrogen bonded to each other to form planar cyclic water hexamers, which, together with other hydrogen bonds, interlink the Cd complex molecules to give one-dimensional supramolecular ribbons that extend along the [111] direction. The chains are assembled into two-dimensional layers parallel to (111) by pi-pi stacking interactions. Furthermore, interlayer pi-pi stacking interactions and weak C-H...Cl hydrogen bonds complete the formation of a three-dimensional framework.
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The principal building units in the title compound, [Co3(C9H3O6)2(C10H8N2)4(H2O)10].C10H8N2.8H2O, are the linear centrosymmetric tricobalt(II) complex molecules resulting from two square-pyramidal [Co(btc)(bpy)(H2O)3]- entities (bpy is 4,4'-bipyridine and btc is the benzene-1,3,5-tricarboxylate trianion) bridged by one trans-[Co(bpy)2(H2O)4]2+ unit. The trinuclear complex molecules are assembled into infinite chains through intermolecular O-H...N hydrogen bonds and pi-pi stacking interactions between adjacent monodentate bpy ligands. The chains and uncoordinated bpy molecules are further assembled into two-dimensional open layers, which are stacked in a staggered manner to give a three-dimensional supramolecular architecture with the solvent water molecules in the cavities.
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In the title compound, [Ni2(C12H8O12)(C12H8N2)2]n, the 3,6-dicarboxycyclohexane-1,2,4,5-tetracarboxylate (H2chhc4-) anion has crystallographically imposed C(2) symmetry and bridges the six-coordinate Ni atoms to generate polymeric infinity1[Ni2(H2chhc)2/2(C12H8N2)2] chains extending in the [010] direction. The coordination polymer chains are linked into a three-dimensional framework by O-H...O and C-H...O hydrogen bonds.
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The title compound, [Co(C6H9O4)2(C12H12N2)(H2O)2]n, crystallizes in the space group P-1. The Co atom is on a center of symmetry and the 1,2-di-4-pyridylethane (bpe) ligand also sits across a crystallographic inversion center. The Co atom is octahedrally coordinated by two aqua ligands, two carboxylate O atoms and two pyridyl N atoms, and is bridged by the anti-bpe ligands to generate one-dimensional 1infinity{[Co(Hadip)2(H2O)2](bpe)2/2} chains (Hadip is 5-carboxypentanoate), which are further interlinked by O-H...O and C-H...O hydrogen bonds into two-dimensional layers.
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OBJECTIVE: To explore risk factors of injection-related sharp injury and to provide safety injection guidance to healthcare takers. METHODS: A cross-sectional survey and 1:1 case-control study was used to study the epidemiological features and risk factors of sharp injuries among 3010 clinical nurses and nurse students from 13 hospitals in Guangzhou. Logistic multiple factor analysis was used. RESULTS: Eighty-seven point five percent of nurses have suffered injuries at last once time. During the past month, 37.6% of the nurses have suffered injuries at least once time. The frequency of the injuries was 0.84 per person month. Through multiple logistic regression analysis, data showed that the risk factors leading to the sharp injuries in orders were: contacting the needle more frequently, subjectively thinking that the sharp injuries as unavoidable, the atmosphere in the nursing unit was not harmonious enough, recapping habit, carelessness at work, too many patients that not cooperating, breaking the ampule off without using carbasus, crowded and noisy working place, lack of acknowledge on prevention, lack of the awareness on how to avoiding the accident, having an initiative and creative personality etc. CONCLUSION: The results provided a foundation for the department of infection control in the hospital and sanitary administration department to constitute safety injection policies.