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Nan Fang Yi Ke Da Xue Xue Bao ; 39(3): 364-368, 2019 Mar 30.
Artigo em Chinês | MEDLINE | ID: mdl-31068313


OBJECTIVE: To analyze the clinical features of chronic myeloid leukemia (CML) with T315 I mutation (CML-T315I) and compare the effectiveness of different treatments. METHODS: We retrospectively analyzed the clinical data and outcomes of 19 patients with CML-T315I receiving different treatments. The T315 I mutations in these patients were detected by examination of BCR-ABL kinase domain (KD) mutation by RTQ-PCR and Sanger sequencing. The relapse following the treatments, defined as hematological, cytogenetic and molecular biological recurrences, were analyzed in these patients. RESULTS: Of the 19 patients with CML-T315I, 14 (73.7%) were in CML-CP stage at the initial diagnosis, and 13 (81.2%) were high-risk patients based on the Sokal scores. All the 19 patients were treated with TKI after the initial diagnosis, and during the treatment, 15 (78.9%) patients were found to have additional chromosomal aberrations, and 10 (52.6%) had multiple mutations; 13 (68.4%) of the patients experienced disease progression (accelerated phase/blast crisis) before the detection of T315I mutation, with a median time of 40 months (5-120 months) from the initial diagnosis to the mutation detection. After detection of the mutation, 12 patients were treated with ponatinib and 7 were managed with the conventional chemotherapy regimen, and their overall survival rates at 3 years were 83.3% and 14.2%, respectively (P < 0.001). CONCLUSIONS: CML patients resistant to TKI are more likely to have T315I mutations, whose detection rate is significantly higher in the progressive phase than in the chronic phase. These patients often have additional chromosomal aberrations and multiple gene mutations with poor prognoses and a high recurrence rate even after hematopoietic stem cell transplantation. Long-term maintenance therapy with ponatinib may improve the prognosis and prolong the survival time of the patients.

Leucemia Mielogênica Crônica BCR-ABL Positiva , Resistencia a Medicamentos Antineoplásicos , Proteínas de Fusão bcr-abl , Humanos , Imidazóis , Mutação , Piridazinas , Estudos Retrospectivos
J Clin Nurs ; 28(13-14): 2669-2680, 2019 Jul.
Artigo em Inglês | MEDLINE | ID: mdl-30938905


AIMS AND OBJECTIVES: This study examines the impacts of mentor-mentee rapport on willingness to mentor/be mentored, self-efficacy, outcome expectations, career interest and subsequently on nurses' professional turnover intention. BACKGROUND: Workplace relationships, whether positive or negative, influence nurse turnover within an organisation. Yet little is known about the effects of mentoring on nurses' intentions to leave the nursing profession. DESIGN: A cross-sectional, survey-based research design was used to collect data from a large medical centre in Northern Taiwan. METHODS: Study concepts were measured using scales from social capital theory (SCT), social cognitive career theory (SCCT) and the nursing literature. Partial least square structural equation modelling was used to test all study hypotheses. The STROBE statement was chosen as the EQUATOR checklist. RESULTS: For mentors, rapport was positively related to willingness to mentor, which was positively related to outcome expectations, and further, positively related to career interest and negatively related to professional turnover intention. For mentees, rapport was positively related to willingness to be mentored, which was positively related to self-efficacy, outcome expectations and ultimately to career interest. Career interest was negatively related to professional turnover intentions. CONCLUSIONS: Rapport between mentors and mentees may be an important means to retain nurses in the profession. RELEVANCE TO CLINICAL PRACTICE: Managers should consider taking steps to enhance rapport between mentors and mentees. In doing so, managers improve nurse retention, a critical component of providing high-quality patient care.

Satisfação no Emprego , Tutoria , Mentores/psicologia , Reorganização de Recursos Humanos , Autoeficácia , Adulto , Atitude do Pessoal de Saúde , Estudos Transversais , Humanos , Intenção , Masculino , Capital Social , Inquéritos e Questionários , Taiwan
J Nurs Manag ; 24(8): 1098-1108, 2016 Nov.
Artigo em Inglês | MEDLINE | ID: mdl-27477168


AIMS: The purpose of this study is to examine how the interaction between nurse openness and work experience is related to patient safety. BACKGROUND: No study has yet examined the interactions between these, and how openness and work experience jointly impact patient safety. METHODS: This study adopts a cross-sectional design, using self-reported work experience, perceived time pressure and measures of patient safety, and was conducted in a major medical centre. The sample consisted of 421 full-time nurses from all available units in the centre. Proportionate random sampling was used. Patient safety was measured using the self-reported frequency of common adverse events. Openness was self-rated using items identified in the relevant literature. RESULTS: Nurse openness is positively related to the patient safety construct (B = 0.08, P = 0.03). Moreover, work experience reduces the relation between openness and patient safety (B = -0.12, P < 0.01). CONCLUSIONS: The relationship between openness, work experience and patient safety suggests a new means of improving patient care in a health system setting. IMPLICATIONS FOR NURSING MANAGEMENT: Nurse managers may enhance patient safety by assessing nurse openness and assigning highly open nurses to duties that make maximum use of that trait.

Acontecimentos que Mudam a Vida , Enfermeiras e Enfermeiros/psicologia , Segurança do Paciente/normas , Local de Trabalho/psicologia , Adulto , Estudos Transversais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Cultura Organizacional , Análise de Regressão , Autorrelato , Inquéritos e Questionários , Gerenciamento do Tempo/psicologia , Local de Trabalho/normas