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| 1 | 加拿大PICU和NICU临床医生的道德困境显示文摘目的量化NICU和PICU临床医生的道德困境,并确认相关因素。设计对在NICU或PICU中工作的临床医生进行全国性横断面调查。采用道德困境量表修订版(Moral Distress Scale-Revised,MDS-R)和自我评定法评价道德困境程度。采用Maslach职业倦怠问卷子量表评定去人格化。受访者报告参加6项可能有助于缓解一线员工道德困境的医院支持活动中每一项的具体情况。通过分析受试者特征比较预后,通过分层线性回归评估个体、ICU、医院和地区的影响。场所入组ICUs为加拿大的PICUs和三级NICUs。对象入组受访者已在参与研究的ICUs内工作3个月以上。干预措施无测量方法和主要结果从31家医院中确定了54个符合纳入标准的ICUs。49个(91%)加拿大NICUs和PICUs提供了2852份完整回复,应答率为45.2%。多数受访者为护士(64.9%)或来自NICU(66.5%)。中位MDS-R评分为79(52,113)分,997例(34.2%)的受访者MDS-R得分≥100分,234例(8.3%)受访者强烈认同工作引起的严重道德困境。护士的中位MDS-R评分为85(57,121)分,比内科医生高19分,比呼吸治疗师高8分(P<0.001)。ICU工作年限<1年者MDS-R评分为53(35,79)分,工作30年以上者MDS-R评分升至83(54,120)分(P<0.001);22.5%的受访者报告高度去人格化,这与道德困境有关(P<0.001)。MDS-R评分的变异性个体因素占92%,医院因素占5%,ICU影响占1%。参与可能有缓解作用的医院支持活动的频率对MDS-R平均值影响很小(<10分)。结论道德困境常见于儿童ICUs临床医生。解决道德困境需要针对高危群体的个体化干预措施。 | Dryden-Palmer K Moore G McNeil C 方伯梁(译) 钱素云(校) | 2021 | 中国小儿急救医学2021，28，2： | 2 |
| 2 | Behavior of Phenolics in Coal Liquefaction:Adduction Tendency and Coal Conversion Capability显示文摘 | McNeil R I Cronauer D C | 1984 | Fuel Processing Technology1984，9，1： | 1 |
| 3 | Annual cancer statistics report raises key questions 显示文摘 | McNeil C | 2006 | J Natl Cancer Inst2006，98，22： | 1 |
| 4 | K-Ras mutations are changing practice in advanced colorectal cancer显示文摘 | McNeil C | 2008 | J Natl Cancer Inst2008，100，23： | 1 |
| 5 | $100 Calgranulins in inflammatory arthritis 显示文摘 | Perera C McNeil H P Geczy C L | 2010 | Immunol Cell Biol2010，88，1： | 1 |
| 6 | Intermediates and products of the biohydrogenation of linoleic acid by bu- :yrivibriofibrisolvens 显示文摘 | Kepler C R Hirons K P McNeil J J | 1966 | The Journal of Biological chemis- Lry1966，241，6： | 1 |
| 7 | A descriptive analysis of occupational health exposures in an urban emergency medical services system: 2007 - 2009 显示文摘 | E1 Sayed M Kue R McNeil C | 2011 | Prehospital E- mergency Care2011，15，4： | 1 |
| 8 | Mechanisms of vanadium action: insulin-mimetic or insulin-enhancing agent?显示文摘 | Cam M C Brownsey R W McNeil] J H | 2000 | Can J Physiol Pharmacol2000，78，： | 1 |
| 9 | Effects of testosterone on coronary vasomotor regulation in men with coronary heart disease显示文摘 | Webb C M McNeil J G Hayward C S | 1999 | Circulation1999，100，： | 1 |
| 10 | Staphylococcus aureus infections in pediatric oncology patients: high rates of antimicrobial resistance, antiseptic tolerance and complications 显示文摘 | McNeil J C Hulten K G Kaplan S L | 2013 | Pediatr Infect Dis J2013，32，2： | 1 |
| 11 | Annual cancer statistics report raises key questions显示文摘 | McNeil C | 2006 | J Natl Cancer Inst2006，98，22： | 1 |
| 12 | A point process approach to value-at-risk estimation显示文摘 | Chavez-Demoulin V Davison A C Mcneil A J | 2005 | Quantitative Finance2005，5，2： | 1 |
| 13 | Annual cancer statistics report raises key questions显示文摘 | McNeil C | 2006 | J Natl Cancer Inst2006，98，22： | 1 |
| 14 | Kinetic model and thermal properties of a thermally cured thermosetting polycarbonate 显示文摘 | Delgado R Mcneil D M Hawley M C | 1994 | Polymer Engineering and Science1994，34，9： | 1 |
| 15 | Antiphospholipid antibodies are directed against a complex antigen that includes a lipid binding inhibitor of coagulation: beta-2 glycoprotein-I 显示文摘 | McNeil H P Simpson R J Chesterman C N | 1990 | Proceed Natl Acad Sci USA1990，87，11： | 1 |
| 16 | Maca:An Andean crop with muhi-pharmacological functions显示文摘 | WANG Y L WANG Y C MCNEIL B | 2007 | Food Res Int2007，40，： | 1 |
| 17 | Annual cancer statistics report raises key questions 显示文摘 | McNeil C | 2006 | J Natl Cancer Inst2006，98，22： | 1 |
| 18 | Cell cycle machinery:links with genesis and treatment of breast cancer显示文摘 | Butt A J Caldon C E McNeil C M | 2008 | Adv Exp Med Biol2008，630，： | 1 |
| 19 | Cytoplasmic localization of beta-catenin is a marker of poor outcome in breast cancer patients显示文摘 | López-Knowles E Zardawi S J McNeil C M | 2010 | Cancer Epidemiol Biomarkers Prev2010，19，1： | 1 |
| 20 | Enhanced saturation lithium composition in ball-milled single-walled carbon nanotubes显示文摘 | GAO B BOWER C LORENTZEN J D FLEMING L KLEINHAMMES A TANG X P MCNEIL L E WU Y ZHOU O | | 0，，1： | 1 |
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