BACKGROUND & AIMS: :This cross-sectional study surveyed a random sample of 129 nurse educators teaching in 61 U.S. schools of nursing. After the educators indicated their desire to participate, the survey instrument was e-mailed to them for completion; a 37.6% response rate was obtained. Demographically, the typical respondent was a healthy, 52-year-old, Caucasian female with a PhD in nursing. Outcomes reflected that respondents' mean anticipated age of retirement was 64.4; however, the optimal age of retirement desired by respondents was younger (62.4). The most influential factor affecting the timing of retirement was financial status. Workplace issues, personal and family health, and attitudes about retirement were other factors that affected participants' retirement decisions. The study findings indicate that nurse educators, as a group, do not plan to work beyond age 65.

背景与目标： ：这项横断面研究随机抽取了美国61所护理学校中129名教学教师的随机样本。在教育工作者表示希望参加之后，将调查工具通过电子邮件发送给他们，以供他们填写。获得了37.6％的响应率。人口统计学上，典型的受访者是健康的52岁白人女性，具有护理学博士学位。结果表明，受访者的平均预期退休年龄为64.4。然而，受访者期望的最佳退休年龄是年轻的（62.4）。影响退休时间的最有影响的因素是财务状况。工作场所问题，个人和家庭健康以及对退休的态度是影响参与者退休决定的其他因素。研究结果表明，护士教育者作为一个整体，不打算在65岁以上工作。

BACKGROUND & AIMS: :This paper examines factors that have lead to increasing internationalisation in nursing workforce and nursing education and contends that education and support for nurse managers and nurse academics is required in order to better prepare them for the challenges they will face. There are many benefits to be gained from internationalisation of nursing, the most significant being greater cross-cultural understanding and improved practices in workplaces across countries. However, the way in which nursing and nurses contribute to the international agenda is crucial to maintaining standards of education and nursing care in Australia and in countries with whom Australians collaborate. Internationalisation poses numerous challenges that need to be carefully thought through. This paper seeks to unravel and scrutinize some of the issues central to internationalisation in nursing, particularly in the Australian context.

背景与目标： ：本文探讨了导致护理人员队伍和护理教育国际化的因素，并认为需要对护士管理者和护士学者进行教育和支持，以便更好地为他们准备应对挑战。护理国际化将带来许多好处，其中最重要的是在各国之间提高对跨文化的了解和改进工作场所的实践。但是，护理和护士为国际议程做出贡献的方式对于维持澳大利亚以及与澳大利亚人合作的国家的教育和护理标准至关重要。国际化提出了许多挑战，需要仔细考虑。本文旨在探讨和审查护理国际化中的一些重要问题，特别是在澳大利亚的情况下。

BACKGROUND & AIMS: OBJECTIVE:To understand general practitioners' experiences of managing patients with chronic leg ulceration, thus informing future strategies to improve leg ulcer care in general practice, Australia. DESIGN:Qualitative study using phenomenology and in-depth interviewing. PARTICIPANTS AND SETTING:Maximum variation sample of 12 GPs working in the Perth and Hills Division of General Practice between September and December 2004. MAIN OUTCOME MEASURE:Themes in participants' experiences of leg ulcer care. FINDINGS:Participants regarded leg ulcer management as an integral part of general practice. They expressed a desire to maintain their involvement, yet relied on nursing assistance. They perceived that ulcer care was usually straightforward and successful. Approaches to management appeared to differ significantly from that outlined in current guidelines. Instead, participants valued accessibility of care for the patient, awareness of patient context and regular review. Occasional problems with non-healing ulcers were experienced, and, in these situations, specialist opinion was appreciated. CONCLUSION:This study highlights fundamental differences between GP and specialist conceptualisation of leg ulcer care. For GPs, it identifies key areas of ulcer management that could be improved. For specialists, it suggests that widespread implementation of traditional guidelines may not be appropriate or acceptable. New approaches to leg ulcer management in general practice are likely to need a combination of education, human resources and practical support.

背景与目标： 目的：了解澳大利亚全科医生治疗慢性腿部溃疡患者的经验，从而为将来在澳大利亚全民实践中改善腿部溃疡护理的策略提供参考。
设计：使用现象学和深度访谈进行定性研究。
参与者和背景：2004年9月至2004年12月在珀斯和希尔斯普通科工作的12名全科医生的最大变异样本。
主要观察指标：参加者腿部溃疡护理经验的主题。
结果：参加者认为腿部溃疡的治疗是普通做法不可或缺的一部分。他们表达了继续参与的愿望，但仍依靠护理援助。他们认为溃疡治疗通常是直接有效的。管理方法似乎与当前准则中概述的方法大不相同。相反，参与者重视对患者的护理可及性，对患者情境的了解和定期检查。偶尔会出现溃疡不愈的问题，在这种情况下，应征询专家的意见。
结论：本研究强调了GP和腿部溃疡护理专家概念的根本区别。对于全科医生，它确定了可以改善的溃疡管理关键领域。对于专家来说，这表明传统准则的广泛实施可能是不合适或不可接受的。一般实践中腿部溃疡治疗的新方法可能需要教育，人力资源和实践支持的结合。

BACKGROUND & AIMS: BACKGROUND:General practitioners' (GPs) negative beliefs about smoking cessation services may act as barriers to them recommending such services to smokers motivated to stop smoking. METHODS:In Study 1, 25 GPs from 16 practices across London were interviewed in this qualitative study. Framework analysis was used to identify key themes in GPs' beliefs about smoking cessation services. In Study 2, a convenience sample of 367 GPs completed an internet-based survey. Path-analysis was used to examine relationships between beliefs identified in Study 1 and intentions to recommend smoking cessation services. RESULTS:In Study 1, GPs felt that smoking cessation assistance was best provided by others. GPs favoured local services (i.e. practice nurses offering stop smoking support) over central services (i.e. offered through the Primary Care Trust), mainly because these were seen as more personalised and accessible for patients. These beliefs appeared to influence GPs' beliefs about the effectiveness of services. In Study 2, GPs' beliefs had a large effect on their intentions to recommend both central services, (f2 = .79) and local services, (f2 = 1.04). GPs' beliefs about effectiveness and cost-effectiveness were key predictors their intentions to recommend central services and local services. Beliefs about the level of personalisation offered and smokers' likelihood of attending services had indirect effects on intentions to recommend services operating via beliefs about effectiveness. CONCLUSION:GPs vary in their perceptions of the effectiveness of smoking cessation services and their intentions to recommend these services vary in line with these beliefs. Interventions aimed at increasing the likelihood with which GPs recommend these services may therefore be more effective if they addressed these beliefs.

背景与目标： 背景：全科医生对戒烟服务的消极信念可能会阻碍他们向有志于戒烟的吸烟者推荐此类服务。
方法：在这项定性研究中，研究1采访了伦敦16家医院的25名全科医生。框架分析用于确定全科医生对戒烟服务的信念中的关键主题。在研究2中，一个367名GP的便利样本完成了一项基于Internet的调查。路径分析用于检验研究1中确定的信念与推荐戒烟服务的意图之间的关系。
结果：在研究1中，家庭医生认为其他人最好提供戒烟帮助。全科医生相对于中央服务（即通过初级保健基金会提供的服务）偏爱本地服务（即提供戒烟支持的执业护士），主要是因为这些服务被视为对患者更具个性化和可及性。这些信念似乎影响了全科医生对服务有效性的信念。在研究2中，GP的信念对推荐中央服务（f2 = .79）和本地服务（f2 = 1.04）的意图产生了很大影响。全科医生对有效性和成本效益的信念是他们打算推荐中央服务和本地服务的主要预测指标。关于提供的个性化水平的信念以及吸烟者参加服务的可能性，通过对有效性的信念对推荐服务的意图产生了间接影响。
结论：全科医生对戒烟服务有效性的看法各不相同，因此推荐这些服务的意图也因这些信念而异。因此，如果他们解决了这些信念，旨在增加全科医生推荐这些服务可能性的干预措施可能会更加有效。

BACKGROUND & AIMS: INTRODUCTION:Telecommunication infrastructure is being rolled out across Australia with little knowledge about the uptake by health professionals in remote areas. Computer mediated communication has the potential to offer educational support to remote practitioners; however, the viability of this is uncertain. The aim of this research was to establish and evaluate an internet-based resource library targeting the needs of remote area maternity service providers. METHODS:A participatory action research (PAR) approach was used to involve remote area maternity service providers in the Northern Territory of Australia. The evaluation of the resource library included its performance on reach, agency affiliation and richness, factors identified to affect the sustainability and utility of such a resource. An additional component of the evaluation framework documented the facilitators of and barriers to using an information technology strategy to reduce the isolation of remote area maternity service providers. RESULTS:Overall, the evaluation of the resource library was very positive. Feedback from the PAR team described the resource as contemporary, useful and relevant. Practitioners in leadership and education positions identified the resource library as a valuable tool that enabled them to access professional knowledge, which could then be distributed to any remote-based practitioners, who experienced difficulties with access themselves. The evaluation found that logistical issues were a major problem for potential users. Hardware inadequacies, access difficulties, unfamiliarity with computers, and a lack of management support for nursing and midwifery staff to utilise the resource, were all identified barriers. Remote-area practitioners highlighted education, training and 24 hour support as key priorities. CONCLUSIONS:Results from this research clearly showed the potential of web-based resources to offer educational support through access to clinical guidelines, reports and research, thus reducing the isolation of the remote practitioner. However, it highlighted the need for clear strategic direction at policy level, whereby all stakeholders unite to synchronise the rollout of information technology infrastructure with the necessary education, training and support as an integral component.

背景与目标： 简介：电信基础设施正在澳大利亚各地推广，对偏远地区的卫生专业人员的使用了解甚少。计算机介导的交流有可能为远程从业者提供教育支持；但是，这种方法的可行性尚不确定。这项研究的目的是建立和评估针对偏远地区孕妇服务提供商需求的基于互联网的资源库。
方法：采用参与式行动研究（PAR）的方法，使澳大利亚北领地的偏远地区产妇服务提供者参与进来。对资源库的评估包括其在覆盖范围，代理机构的隶属关系和丰富性方面的绩效，已确定的影响该资源可持续性和实用性的因素。评价框架的另一个组成部分记录了使用信息技术战略来减少偏远地区产妇服务提供者的隔离的促进因素和障碍。
结果：总的来说，对资源库的评价是非常积极的。 PAR团队的反馈认为该资源具有当代性，实用性和相关性。担任领导和教育职务的从业人员认为资源库是使他们能够访问专业知识的宝贵工具，然后可以将其分发给在访问方面遇到困难的任何远程工作者。评估发现，后勤问题是潜在用户的主要问题。硬件不足，访问困难，对计算机不熟悉以及对护理人员和助产人员缺乏利用资源的管理支持，这些都是障碍。偏远地区的从业者强调教育，培训和24小时支持是关键重点。
结论：这项研究的结果清楚地表明了基于Web的资源通过访问临床指南，报告和研究提供教育支持的潜力，从而减少了远程医生的孤立感。但是，它强调需要在政策一级制定明确的战略方向，所有利益相关者团结起来，将信息技术基础设施的部署与必要的教育，培训和支持作为一个不可或缺的组成部分进行同步。

BACKGROUND & AIMS: OBJECTIVE:Nurse educators need an enhanced understanding of factors contributing to nursing student success to decrease attrition and increase retention. Improved understanding of factors related to successful nurse preparation could improve educational processes and facilitate student success, thereby addressing the worldwide nursing shortage as well as increasing the competence and expertise of new graduates. Student-faculty trust and related characteristics have been identified as factors associated with student success (Applebaum, 1995). Research investigating trust in communications and education has been conducted with students in other disciplines but not with nursing students. This research investigated the complex relationships between students' trust in faculty, the students' mood states, and students' educational performance and outcomes. METHOD:The study utilized a quantitative, cross-sectional, descriptive, and correlational design. Student volunteers were recruited from a baccalaureate nursing education program located in the southwest United States. Participants completed three instruments: the Health Sciences Reasoning Test (HSRT), Profile of Mood States (POMS), and Interpersonal Trust Scale (ITS). The resulting scores were compared and contrasted along with selected demographic variables. RESULTS:The study identified a significant relationship between total mood disturbance and interpersonal trust. The trends in the POMS subscales of Anger and Confusion are of particular interest, as the two factors strongly influenced shifts in Total Mood Disturbance. As students progressed through the nursing program, experiences of Anger and Confusion increased with each progressive semester and were accompanied by corresponding decreases in trust. CONCLUSIONS:The results complement established findings relating mood and cognitive function. Alterations in the student's level of trust potentially could share relationships with cognition and critical thinking, although perhaps not in a direct and linear fashion.

背景与目标： 目的：护士教育者需要对有助于护理学生成功的因素有更深入的了解，以减少损耗和增加保留率。更好地理解与成功的护士准备相关的因素，可以改善教育过程并促进学生的成功，从而解决全球范围内的护理短缺问题，并提高新毕业生的能力和专业知识。学生与教师之间的信任和相关特征已被确定为与学生成功相关的因素（Applebaum，1995）。已经与其他学科的学生进行了调查研究，以研究对交流和教育的信任，但没有与护生一起进行。这项研究调查了学生对教师的信任，学生的情绪状态以及学生的教育表现和成果之间的复杂关系。
方法：本研究采用定量，横断面，描述性和相关性设计。学生志愿者是从位于美国西南部的学士学位护理教育计划招募的。参与者完成了三项工具：健康科学推理测验（HSRT），情绪状态简介（POMS）和人际信任量表（ITS）。将所得分数与选定的人口统计学变量进行比较和对比。
结果：该研究确定了总情绪障碍与人际信任之间的显着关系。愤怒和混乱的POMS子量表的趋势特别受关注，因为这两个因素强烈影响了总情绪干扰的变化。随着学生逐步完成护理计划，每学期的学期中，愤怒和困惑的经历就会增加，随之而来的是信任的减少。
结论：该结果补充了有关情绪和认知功能的既定发现。学生信任度的改变可能会与认知和批判性思维共享关系，尽管可能不是直接和线性的方式。

BACKGROUND & AIMS: BACKGROUND:The NHS plan proposes up to 1000 general practitioners with a special interest (GPwSIs) by 2004.1,2 Following a meeting organised by the General Practice Airways Group (GPIAG) Williams et al, in their discussion document3 outlined the possible roles of a GPwSI, using respiratory medicine as a model. A GPIAG working party then met up with the representatives of the Royal College of General Practitioners (RCGP) and produced a draft working document which could give guidance to primary care organisations (PCO's) about the the possible role of a GPwSI in respiratory medicine together with the core competencies needed to fulfil such a role. This stated that the role of a GpwSI in respiratory medicine is primarily one of leadership and service development (i.e as a GP lead in respiratory medicine within a PCO). This is contrast to other specialities such as ENT or dermatology where the GPwSI has a predominantly clinical role. In addition the draft document envisaged that the "gold standard" qualification for a GPwSI would be a Diploma in Respiratory Medicine. The GPIAG draft document was modified after consultation with the British Thoracic Society, Royal College of Physicians, Royal College of Nursing, National Asthma Campaign, National Respiratory Training Centre and the Respiratory Education Training Centre and submitted to the RCGP. The resultant framework, published in this issue (pp38-41), is a chimera of a generic RCGP framework (for example, certain competencies such as negotiating skills will be common to all specialities) with the respiratory disease specific framework of the GPIAG draft document.

背景与目标： 背景：NHS计划在2004年之前提议多达1000名具有特殊兴趣的全科医生（GPwSI）。1,2在美国通用航空集团（GPIAG）组织的一次会议之后，威廉姆斯（Williams）等人在讨论文件3中概述了GPwSI的可能作用。 ，以呼吸道医学为模型。 GPIAG工作组随后会见了皇家全科医师学院（RCGP）的代表，并产生了一份工作文件草案，该文件可为GPwSI在呼吸内科中的可能作用以及对初级保健组织（PCO）的指导。履行这一职责所需的核心能力。这表明，GpwSI在呼吸内科中的作用主要是领导力和服务开发之一（即作为PCO中呼吸内科的GP主管）。这与其他专业（例如ENT或皮肤科）相反，在这些专业中GPwSI主要发挥临床作用。此外，文件草案还设想GPwSI的“金标准”资格将是呼吸医学文凭。在与英国胸科协会，皇家内科医学院，皇家护理学院，国家哮喘运动，国家呼吸训练中心和呼吸教育训练中心协商后，对GPIAG文件草案进行了修改，并提交给RCGP。结果框架在本期（pp38-41）中发布，是通用RCGP框架（例如，谈判技巧等技能对于所有专业都是通用的）与GPIAG文件草案中针对呼吸系统疾病的框架的嵌合体。 。

BACKGROUND & AIMS: Background:Since 1985, nurse-run asthma clinics have been developing and are now widespread in the United Kingdom, having been greatly stimulated by the New Contract for General Practice (1990). To date, there have been few definitive studies evaluating such clinics. This study, in two adjacent general practices in semi-rural Somerset, evaluates the effect of nurse-run clinics on patients' symptoms, pulmonary function, and healthcare utilisation over a four-month period. Methods:One hundred and twenty-nine subjects, aged 2-79 years, were recruited from the two practices over a one-year period (1991-1992). All patients identified in either practice who had used preventive therapy in the preceding 12 months were eligible and were included if they had a positive exercise or reversibility (20%) test and had not previously received formal asthma education. A pre- and post-experimental study design was used. Subjects' symptoms, pulmonary function, and health care in the preceding eight weeks were assessed at intake and at 16 weeks; the nurse education being delivered at intake, one and four weeks. Results:Both mean number of days off work/school and mean number of nights on which waking occurred fell (p < 0.001). Peak expiratory flow rates and forced expiratory volumes improved during the study period (p < 0.001 and p < 0.01 respectively). Use of antibiotics, oral steroids, and rescue bronchodilator use all improved significantly (p < 0.001). Physician attendances were also reduced. Conclusions:A nurse-run asthma clinic in general practice is an effective way to improve symptoms, pulmonary function, and health care utilisation for asthmatic patients.

背景与目标： 背景：自1985年以来，由护士执照的哮喘诊所一直在发展，并在英国得到广泛应用，这受到《新通用合同》（1990年）的大力推动。迄今为止，很少有明确的研究评估此类诊所。这项研究是在半农村萨默塞特郡的两个相邻常规实践中，评估了四个月内护士经营的诊所对患者症状，肺功能和医疗保健利用率的影响。
方法：在一年的时间里（1991-1992），从这两种实践中招募了129名2-79岁的受试者。两种做法中确定的在过去12个月中均使用过预防性治疗的所有患者均符合资格，并且如果他们的运动或可逆性测试阳性（20％）并且先前未接受过正规的哮喘教育，则将其包括在内。实验之前和之后的研究设计被使用。在进食时和第16周评估受试者在前八周的症状，肺功能和医疗保健；入学时分一，四个星期进行护士教育。
结果：平均下班天数/上学时间和平均醒来晚数均下降（p <0.001）。在研究期间，峰值呼气流速和强制呼气量有所改善（分别为p <0.001和p <0.01）。抗生素，口服类固醇和急救支气管扩张剂的使用均显着改善（p <0.001）。医师出勤率也有所降低。
结论：一般由护士经营的哮喘诊所是改善哮喘患者症状，肺功能和医疗保健利用率的有效方法。

BACKGROUND & AIMS: BACKGROUND:Evidence suggests that behavioral, social, and environmental factors may modify the effects of life stress on health and performance of new nurses as they transition to hospitals. OBJECTIVES:The aim of this study was to describe the methods of a project designed to investigate the role of social, behavioral, and environmental factors in modifying the adverse effects of stress on new nurses and to discuss demographic, health, and life stress characteristics of the cohort at baseline. METHODS:A prospective cohort design was used to conduct a comprehensive assessment of health endpoints, life stress, behaviors, personal traits, social factors, indicators of engagement and performance, and environmental exposures in nursing students. Adjusted odds ratios and analyses of covariance were used to examine associations between these factors at baseline. RESULTS:Health indicators in the cohort were comparable or better than in the broader United States population, and lifetime stress exposure was lower than among students from other majors. Exposure to more lifetime stressors was associated with greater risk for various health conditions, including hypertension, diabetes, and depression. Conversely, better social, environmental, behavioral, and personal profiles were associated with protective effects for the same health conditions. DISCUSSION:These data comprehensively summarize the lives of predominately Hispanic nursing students and highlight risk and resilience factors associated with their health and well-being. The findings are timely, as the nursing field diversifies in preparation to care for a diverse and aging population. Comprehensively assessing stress-health relationships among student nurses ought to inform the policies, practices, and curricula of nursing schools to better prepare nurses to thrive in the often-strenuous healthcare environment.

背景与目标： 背景：证据表明，行为，社会和环境因素可能会改变生活压力对新护士过渡到医院时的健康和绩效的影响。
目的：本研究的目的是描述一个项目的方法，该项目旨在研究社会，行为和环境因素在减轻压力对新护士的不良影响中的作用，并讨论人口统计学，健康状况和生活压力特征。基线时的同类群组。
方法：采用前瞻性队列设计，对护理专业学生的健康终点，生活压力，行为，个人特质，社会因素，参与度和绩效指标以及环境暴露进行了综合评估。调整后的优势比和协方差分析用于检查基线时这些因素之间的关联。
结果：该队列中的健康指标与美国更广泛的人群相当或更好，并且终身压力暴露低于其他专业的学生。暴露于更多终生应激源与各种健康状况（包括高血压，糖尿病和抑郁症）的更大风险相关。相反，在相同的健康状况下，更好的社交，环境，行为和个人形象与保护作用相关。
讨论：这些数据全面总结了主要是西班牙裔护生的生活，并突出了与他们的健康和福祉相关的风险和适应力因素。由于护理领域的多样化，为照顾多样化和老龄化的人群做准备，因此发现是及时的。全面评估学生护士之间的压力与健康的关系，应告知护理学校的政策，做法和课程，以更好地为护士做好准备，使其在经常艰苦的医疗环境中壮成长。

BACKGROUND & AIMS: BACKGROUND:Adequate physical activity (PA) is considered essential in diabetes management. However, evidence on the best method of promoting PA within diabetes care is inconclusive. The current work identifies perceptions on the acceptability of Intervention Group Participants (IGP) and Project Officers (POs) about the "MOVEdiabetes" intervention programme aimed at increasing PA in adults with type 2 diabetes in Oman (a retrospectively registered trial). METHODS:The "MOVEdiabetes" programme (PA consultations, pedometers and WhatsApp messages) was delivered by the POs (primary health care practitioners) in four primary care centres within a one-year cluster randomised control trial. Recruitment and retention were measured from trial attendance records. Programme satisfaction, appropriateness, and content suitability were assessed using exit surveys for both the IGP (interview based) and POs (self-administered). Open text questions on perceptions to the study programme were also included. RESULTS:Participants were randomised to an intervention group (IG, n = 122) or comparison group (CG, n = 110). The overall retention rate at three and 12 months was 92.7% [110(90.2%) IG vs 105(95.5%) CG] and 75% [82(67.2%) IG vs 92(83.6%) CG] respectively. Most (n = 14, 87.5%) POs and more than half (n = 49, 59.8%) IGP perceived the programme as very appropriate and many reported that they were "quite/ very satisfied" with the programme (n = 16, 100% PO's and n = 71, 86.6% IGP). Two thirds (n = 55, 66.0%) of IGP were very/quite likely to recommend the programme to others. PA consultations, use of pedometers and Whatsapp messages were well perceived by all. Participants recommended the inclusion of dietary advice and PA promotion for the general public. Exploring PA facilities within the community was suggested by POs. CONCLUSIONS:The "MOVEdiabetes" programme achieved a high retention rate and was perceived as satisfactory and appropriate. Results from this study suggest that it is worthwhile exploring the use of the "MOVEdiabetes" programme in clinical practice and further community links. TRIAL REGISTRATION:International Standard Randomised Controlled Trials No: ISRCTN14425284. Registered retrospectively on 12th April 2016.

背景与目标： 背景：足够的体育锻炼（PA）被认为是糖尿病治疗中必不可少的。但是，关于在糖尿病护理中促进PA的最佳方法的证据尚无定论。当前的工作确定了干预团体参与者（IGP）和项目官员（PO）对于旨在提高阿曼2型糖尿病成年人PA的“ MOVEdiabetes”干预计划的接受性的看法（一项回顾性注册试验）。
方法：“ MOVEdiabetes”计划（PA咨询，计步器和WhatsApp消息）由PO（初级卫生保健从业者）在为期一年的整群随机对照试验中在四个初级保健中心提供。招聘和保留是根据试听记录进行的。使用IGP（基于面试）和PO（自行管理）的退出调查评估计划的满意度，适当性和内容的适用性。还包括有关对学习计划的看法的公开文本问题。
结果：参与者被随机分为干预组（IG，n = 122）或对照组（CG，n = 110）。三个月和12个月时的总保留率分别为92.7％[110（90.2％）IG与105（95.5％）CG]和75％[82（67.2％）IG与92（83.6％）CG]。大多数（n = 14，87.5％）PO和超过一半（n = 49，59.8％）IGP认为该计划非常合适，许多人报告他们对该计划“非常/非常满意”（n = 16，100 ％的PO和n ＝ 71，IGP为86.6％）。 IGP的三分之二（n = 55，占66.0％）很可能会向其他人推荐该计划。所有人都很好地了解了PA咨询，计步器的使用和Whatsapp消息。与会者建议为一般公众包括饮食建议和PA推广。采购员建议在社区内探索公共广播设施。
结论：“运动糖尿病”计划获得了很高的保留率，被认为是令人满意和适当的。这项研究的结果表明，有必要探索“ MOVEdiabetes”计划在临床实践中的使用以及进一步的社区联系。
试验注册：国际标准随机对照试验编号：ISRCTN14425284。于2016年4月12日进行追溯注册。

BACKGROUND & AIMS: BACKGROUND:Coronary artery disease is a major cause of morbidity and mortality among adults worldwide, including China. After a hospital stay, transitional care could help to ensure improved patient care and outcomes, and reduce Medicare costs. Nevertheless, the results of the existing transitional care are not always satisfactory and our knowledge of how to perform effective transitional care for patients with coronary artery disease is limited in mainland China. OBJECTIVES:To examine the effectiveness of a nurse-led transitional care program on clinical outcomes, health-related knowledge, and physical and mental health status among Chinese patients with coronary artery disease. DESIGN:Randomized controlled trial. METHODS:The Omaha system and Pender's health promoting model were employed in planning and implementing this nurse-led transitional care program. The sample was comprised of 199 Chinese patients with coronary artery disease. The experimental group (n=100) received nurse-led transitional care intervention in addition to routine care. The nurse-led transitional care intervention included a structured assessment and health education, followed by 7 months of individual teaching and coaching (home visits, telephone follow-up and group activity). The control group (n=99) received a comparable length routine care and follow-up contacts. Evaluations were conducted at baseline and completion of the interventions using the perceived knowledge scale for coronary heart disease, the medical outcomes study 36-item short-form health survey and clinical measures (blood pressure, blood glucose, lipids, body mass index). Data were collected between March and October 2014. RESULTS:Compared with the control group, participants in the experimental group showed significant better clinical outcomes (systolic blood pressure, t=5.762, P=0.000; diastolic blood pressure, t=4.250, P=0.000; fasting blood glucose, t=2.249, P=0.027; total cholesterol, t=4.362, P=0.000; triglyceride, t=3.147, P=0.002; low density lipoprotein cholesterol, t=2.399, P=0.018; and body mass index, t=3.166, P=0.002), higher knowledge scores for coronary artery disease (total knowledge score, t=-7.099, P=0.000), better physical health status (t=-2.503, P=0.014) and mental health status (t=-2.950, P=0.004). CONCLUSIONS:This study provides evidence for the value of a nurse-led transitional care program using both the Omaha system and Pender's health promoting model as its theoretical framework. The structured interventions in this nurse-led transitional care program facilitate the use of this program in other settings.

背景与目标： 背景：冠状动脉疾病是包括中国在内的世界各地成年人发病和死亡的主要原因。住院后，过渡护理可以帮助确保改善患者护理和结局，并降低医疗保险成本。然而，现有的过渡治疗的结果并不总是令人满意的，在中国大陆，我们对如何为冠心病患者进行有效的过渡治疗的知识是有限的。
目的：探讨由护士主导的过渡护理计划对中国冠心病患者的临床结局，健康相关知识以及身心健康状况的有效性。
设计：随机对照试验。
方法：奥马哈系统和Pender的健康促进模型被用于计划和实施由护士主导的过渡护理计划。样本包括199名中国冠心病患者。除常规护理外，实验组（n = 100）还接受了护士主导的过渡护理干预。由护士主导的过渡护理干预包括结构化评估和健康教育，然后是7个月的个人教学和辅导（上门拜访，电话随访和小组活动）。对照组（n = 99）接受了相当长度的常规护理和随访。在基线和干预措施完成时使用已知的冠心病知识量表，医学成果研究36个项目的简短健康调查和临床指标（血压，血糖，血脂，体重指数）进行评估。数据是在2014年3月至2014年10月之间收集的。
结果：与对照组相比，实验组参与者表现出明显更好的临床结局（收缩压，t = 5.762，P = 0.000；舒张压，t = 4.250，P = 0.000；空腹血糖，t = 2.249 ，P = 0.027；总胆固醇，t = 4.362，P = 0.000；甘油三酸酯，t = 3.147，P = 0.002；低密度脂蛋白胆固醇，t = 2.399，P = 0.018；体重指数，t = 3.166，P = 0.002），对冠心病的知识得分更高（总知识得分，t = -7.099，P = 0.000），更好的身体健康状况（t = -2.503，P = 0.014）和心理健康状况（t = -2.950，P = 0.004）。
结论：本研究提供了以奥马哈体系和彭德健康促进模型为理论框架的护士主导的过渡护理计划的价值的证据。该由护士主导的过渡护理计划中的结构化干预措施有助于在其他环境中使用该计划。

BACKGROUND & AIMS: PURPOSE:To explore patient satisfaction, intention to adhere to nurse practitioner (NP) plan of care, and the impact of managed care on NPs' patients in multiple settings, the final phase of a three-part study of NPs and managed care. DATA SOURCES:Postvisit questionnaires and narrative comments about patient satisfaction with NP communication, overall satisfaction with visit, recall of plan of care, intention to adhere to NP's recommendations, and impact of managed care on ease of obtaining healthcare resources. CONCLUSIONS:Patients were very satisfied with NP communication and with their healthcare visit. They mostly intended to adhere to the NP-recommended plan of care but less so to recommended lifestyle changes. Patients trusted their NPs, valued their expertise, were confident in the NPs' care, and believed that the NPs considered their best interests. They appreciated that the NPs took time to listen to their concerns and helped them to obtain healthcare resources. Most patients were not greatly impacted by managed care and obtained needed healthcare resources with little difficulty. IMPLICATIONS FOR PRACTICE:Although the first two phases of this study found that many NPs had strong negative attitudes toward managed care, these attitudes were not conveyed toward patients in this sample. NPs, however, will continue to face new challenges as third-party payers attempt to reduce healthcare costs, further testing NP adaptability and resourcefulness.

背景与目标： 目的：探讨患者满意度，遵守护士执业医师（NP）护理计划的意图，以及在多种情况下管理式护理对NPs患者的影响，NPs和管理式护理三部分研究的最后阶段。
数据来源：事后访问有关患者对NP交流满意度，对访视的总体满意度，召回护理计划，遵守NP建议的意愿以及管理式护理对获得医疗资源的难易程度的影响后的问卷调查和叙述性评论。
结论：患者对NP的交流和他们的医疗就诊感到非常满意。他们的主要目的是遵守NP推荐的护理计划，但不建议改变生活方式。患者信任他们的NP，重视他们的专业知识，对NP的护理充满信心，并相信NP认为他们的最大利益。他们赞赏国家警察花费时间倾听他们的担忧，并帮助他们获得医疗资源。大多数患者不受管理治疗的影响很大，并且几乎没有困难地获得所需的医疗资源。
实践的意义：尽管本研究的前两个阶段发现许多NP对管理式护理抱有强烈的消极态度，但这些态度并未在本样本中传达给患者。但是，随着第三方付款人试图降低医疗保健成本，进一步测试NP的适应性和足智多谋，NP将继续面临新的挑战。

BACKGROUND & AIMS: :While the nephrology nursing shortage persists despite the continued growth of the population of individuals with Stage 5 chronic kidney disease, there is a paucity of empirical data regarding nephrology nurses' perceptions of their work environments. Moreover, there are no studies that have examined the relationship of work environment attributes to patient and nurse outcomes in dialysis settings. The purpose of this study was to examine the relationships between staff nurses' perceptions of dialysis work environments, nurses' intentions to leave their current jobs, nurse turnover, patient satisfaction, and patient hospitalization rates. A descriptive, correlational design was used. Nurse level and facility level data were obtained. The sample for nurse-level data consisted of 199 registered nurses in staff nurse roles in 56 dialysis facilities of a national dialysis company. The sample for facility-level analysis consisted of 46 dialysis facilities, and nurse-level data were aggregated for facility-level analysis. The Practice Environment Scale-Nursing Work Index (PES-NWI) was used to measure nurses' perceptions of the dialysis work environment. Nurses' intention to leave their jobs and facility-level turnover rates were the nurse outcomes examined in this study. Facility-level patient satisfaction and hospitalization rates were the patient outcomes examined. Correlation coefficients were computed to measure the relationships between study variables, and independent t-tests were performed to examine subgroup differences in work environment perceptions. Overall, nurses rated the work environment somewhat favorably. Nurses who expressed intention to leave their jobs rated the work environment more negatively compared to nurses who intended to stay. Significant correlations were found between nurses' perceptions of the dialysis work environment, nurses' intention to leave their jobs, nurse turnover rates, and patient hospitalizations. Study findings suggest that nurses' perceptions of the dialysis work environment are important for nurse and patient outcomes in dialysis settings. Further research is needed to explore the predictive ability of the work environment for nurse and patient outcomes in hemodialysis units.

背景与目标： ：尽管尽管患有5期慢性肾脏病的人数持续增长，但肾科护理人员短缺仍然存在，但是关于肾科护士对其工作环境的看法的经验数据很少。此外，尚无研究检查透析环境中工作环境属性与患者和护士结局之间的关系。这项研究的目的是检验护士对透析工作环境的看法，护士离职的意图，护士离职率，患者满意度和患者住院率之间的关系。使用了描述性的相关设计。获得了护士级别和设施级别的数据。护士级数据的样本由199家在一家国家透析公司的透析设施中担任护士职位的注册护士组成。用于设施级分析的样本由46个透析设施组成，并且汇总了护士级数据以进行设施级分析。实践环境量表-护理工作指数（PES-NWI）用于衡量护士对透析工作环境的看法。护士离开工作的意图和机构级别的离职率是本研究中检查的护士结局。设施水平的患者满意度和住院率是检查的患者结局。计算相关系数以衡量研究变量之间的关系，并进行独立的t检验以检验工作环境感知中的亚组差异。总体而言，护士对工作环境的评价较高。与打算留下来的护士相比，打算离开工作的护士对工作环境的评价更为负面。在护士对透析工作环境的看法，护士离开工作的意愿，护士离职率和患者住院之间，发现了显着的相关性。研究结果表明，护士对透析工作环境的理解对于透析环境中的护士和患者结局非常重要。需要进一步的研究来探索工作环境对血液透析部门护士和患者结果的预测能力。

BACKGROUND & AIMS: :This discussion paper seeks to explore an approach that metal health nurses can adopt that ensures the patient is at the centre of training and professional development opportunities. Although nurse training and education is shaped by practice and theory, the lived experiences of the patients as an educational resource often become lost in the milieu of 'doing' nursing. We argue that in addition to theoretical knowledge and practice knowledge, there is the need to harness the equally important patient experience knowledge. Drawing upon Ptolemaic concepts, this paper explores the potential tensions for mental health nurses resulting from the imbalance in power when engaging in therapeutic relationships with patients. It is argued that in order for mental health nurses to become more effective, they need to learn how to relinquish some of their power, even where this gives rise to uncomfortable tensions for the nurse. Such tensions result from the centrality afforded to theoretical knowledge and ritualized practice that underpins nursing and the difficulties this may cause for many nurses in accepting the value of patient experience as a primary source of knowledge. The difficulties of adopting this approach point to a need for mental health nurses and nurse educationalists to take a more reflexive approach to their patient encounters and within their encounters with each other.

背景与目标： ：本讨论文件旨在探索金属保健护士可以采用的方法，以确保患者处于培训和专业发展机会的中心。尽管护士的培训和教育是由实践和理论决定的，但患者作为“教育”资源的生活经验常常在“做”护理的环境中迷失了。我们认为，除了理论知识和实践知识外，还需要利用同等重要的患者体验知识。借鉴托勒密主义的概念，本文探讨了与患者建立治疗关系时力量不平衡所导致的精神保健护士的潜在压力。有人认为，为了使精神保健护士更有效，他们需要学习如何放弃自己的一些力量，即使这会给护士带来不舒服的压力。这种紧张关系源于理论知识和仪式化实践的中心地位，这是护理的基础，而这可能会给许多护士带来困难，使他们难以接受患者经验作为主要知识来源的价值。采用这种方法的困难表明，心理健康护士和护士教育学家需要对患者的遭遇以及彼此之间的遭遇采取更自反的态度。

BACKGROUND & AIMS: :We conducted a literature review to assess the current status of general practitioner services in residential aged-care facilities (RACFs) in Australia and the impact of recent initiatives to enhance access by RACF residents to these services. Of 400 publications identified, 22 were selected as relevant to our study. We also analysed publicly available statistical data on GP services in RACFs. Recent initiatives to improve quality of care and facilitate access to GP services for RACF residents include the Aged Care GP Panels Initiative, the Enhanced Primary Care program, and an expanded role of palliative care. Despite these initiatives, many GPs still find RACF services unappealing due to a perceived poor level of remuneration for the effort involved. Further improvements in access to and quality of GP services to RACFs may require new models of care delivery and financing.

背景与目标： ：我们进行了文献综述，以评估澳大利亚住宅老年护理设施（RACF）中全科医生服务的当前状况，以及最近旨在增强RACF居民获得这些服务的举措的影响。在确定的400种出版物中，有22种与我们的研究相关。我们还分析了RACF中GP服务的公开统计数据。为提高护理质量并促进RACF居民获得全科医生服务而采取的最新举措包括老年护理全科医生小组倡议，增强的初级保健计划以及姑息治疗的作用扩大。尽管采取了这些举措，但由于认为所付出的努力的报酬水平很低，许多全科医生仍然没有发现RACF服务的吸引力。进一步改善RACF获得GP服务的质量和质量可能需要新的护理提供和融资模式。