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Melissa J. Bloomer Mari Botti Fiona Runacres Peter Poon Jakqui Barnfield Alison M. Hutchinson 《Collegian (Royal College of Nursing, Australia)》2019,26(1):165-170
Aim
To explore the impact of cultural factors on the provision of end-of-life care in a geriatric inpatient rehabilitation setting.Background
Australia’s ageing population is now also one of the most culturally diverse. Individuals from culturally and linguistically diverse backgrounds may have specific care needs at the end of life according to various aspects of their culture.Design
A mixed method approach using a retrospective audit of existing hospital databases, deceased patients’ medical records, and in-depth interviews with clinicians.Findings
Patients’ and families’ cultural needs were not always recognised or facilitated in end-of-life care, resulting in missed opportunities to tailor care to the individual’s needs. Clinicians identified a lack of awareness of cultural factors, and how these may influence end-of-life care needs. Clinicians expressed a desire for education opportunities to improve their understanding of how to provide patient-specific, culturally sensitive end-of-life care.Conclusion
The findings highlight that dying in geriatric inpatient rehabilitation settings remains problematic, particularly when issues of cultural diversity further compound end-of-life care provision. There is a need for recognition and acceptance of the potential sensitivities associated with cultural diversity and how it may influence patients’ and families’ needs at the end of life. Health service organisations should prioritise and make explicit the importance of early referral and utilisation of existing support services such as professional interpreters, specialist palliative care and pastoral care personnel in the provision of end-of-life care. Furthermore, health service organisations should consider reviewing end-of-life care policy documents, guidelines and care pathways to ensure there is an emphasis on respecting and honouring cultural diversity at end of life. If use of a dying care pathway for all dying patients was promoted, or possibly mandated, these issues would likely be addressed. 相似文献3.
Ibrahim M. Alananzeh Cannas Kwok Lucie Ramjan Janelle V. Levesque Bronwyn Everett 《Collegian (Royal College of Nursing, Australia)》2019,26(1):40-48
Background
Arab cancer survivors and their caregivers often have high levels of unmet information needs. However, whether these information needs are the same for cancer survivors living in Arab speaking countries compared to Arab migrants is not clear.Objective
To identify the information needs and information sources among Arab cancer survivors and their caregivers.Methods
Arab cancer survivors (n = 143) in Jordan and Australia were surveyed to explore their information needs and information sources. Interviews with cancer survivors and their caregivers, and focus groups with health care providers were conducted in both countries.Findings
While lack of information about cancer, its treatment and side effects were common to both groups, Arab Australian cancer survivors expressed greater need for information about managing their illness (P = .027), receiving explanations about tests (P = .016) and the benefits and side-effects of treatments before making choices (P = .041) than Jordanian cancer survivors. Qualitative findings revealed preferences for spoken rather than written information, and the provision of diagrams and drawings. Although information provided by doctors was a trusted source, almost half the participants indicated they used the Internet for information. Despite the use of interpreters, Australian health care providers expressed concern at whether the information they provided had been delivered and understood.Conclusion
Arab cancer survivors and their caregivers have unmet cancer information needs resulting in them seeking information from potentially unreliable sources such as the Internet. Arab migrants may need additional assistance to ensure they receive information relevant to their disease and are linked with the most trusted source of information. 相似文献4.
Camila Teixeira Vaz Rosana Ferreira Sampaio Fernanda Saltiel Elyonara Mello Figueiredo 《Revista brasileira de fisioterapia (S?o Carlos (S?o Paulo, Brazil))》2019,23(2):116-124
Background
Although the efficacy of pelvic floor muscle training (PFMT) and bladder training are well established, there is a paucity of patient centered models using these interventions to treat women with UI at primary level of health assistance in Brazil.Objective
To investigate the effectiveness of a physical therapy intervention to treat women with UI in primary health centers.Methods
Pragmatic non-randomized controlled trial in which women with UI from the community participated in a supervised physical therapy program consisting of bladder training plus 12 weeks of PFMT, performed either at home or in the health center. Outcome measures were amount and frequency of urine loss measured by the 24-h pad-test and the 24-h voiding diary; secondary outcome was the impact of UI on quality of life measured by the ICIQ-SF. Outcomes were measured at baseline, at the 6th and 12th weeks of the intervention and 1 month after discharge.Results
Interventions reduced the amount (pad-test, p = 0.004; d = 0.13, 95% CI = ?0.23 to 0.49) and frequency of urine loss (voiding diary, p = 0.003; d = 0.51, 95%CI = 0.14 to 0.87), and the impact of UI on quality of life (ICIQ-SF, p < 0.001; d = 1.26, 95%CI = 0.87 to 1.66) over time, with positive effects from the 6th week up to 1 month for both intervention setting (home and health center), and no differences between them.Conclusion
Interventions were effective, can be implemented in primary health centers favoring the treatment of a greater number of women who do not have access to specialized physical therapy.Trial registration: RBR-8tww4y. 相似文献5.
J. Morel C. Herlin B. Amara C. Mauri H. Rouays C. Verollet I. Almeras N. Frasson A. Dupeyron C. Jourdan J.-P. Daures A. Gelis 《Annals of physical and rehabilitation medicine》2019,62(2):77-83
Background
Flap surgery for deep pelvic pressure ulcers (PPUs) has been found effective, but the recurrence rate remains high and few risk factors have been identified.Objective
We evaluated risk factors for PU recurrence after primary flap surgery in people with spinal cord injury (SCI).Patients and methods
This observational retrospective study based on medical charts included all individuals with SCI who underwent primary flap surgery for a PPU in the Hérault department in France between 2006 and 2014. Overall, 100 biomedical, psychological, socioeconomic and care management factors were studied. The primary outcome was PPU recurrence (surgical site and/or other pelvic site). The secondary outcome was recurrence at the surgical site. Cox proportional hazards regression was used to determine associated factors, estimating hazard ratios (HRs) and 95% confidence intervals (CIs).Results
We included 85 patients. Half had a PPU recurrence, and in one-third, the recurrence was at the surgical site. On multivariate analysis, global PPU recurrence was associated with colostomy (HR = 2.79) and living with a partner (HR = 2.29). Non-traumatic SCI and sacral wound were associated with PPU recurrence (HR = 3.39, HR = 0.48) and recurrence at the surgical site (HR = 3.3, HR = 0.3).Conclusion
Risk factors of PPU recurrence are based on both biomedical and social models. After primary flap surgery, the risk of recurrence justifies regular follow-up and strict monitoring. 相似文献6.
Ruben Barakat Ignacio Refoyo Javier Coteron Evelia Franco 《Revista brasileira de fisioterapia (S?o Carlos (S?o Paulo, Brazil))》2019,23(2):148-155
Background
Excessive gestational weight gain is associated with several adverse events and pathologies during pregnancy.Objective
The purpose of this study was to examine the effects of an exercise program throughout pregnancy on maternal weight gain and prevalence of gestational diabetes.Method
A randomized controlled trial was designed that included an exercise intervention group (EG) and standard care control group (CG). The exercise intervention included moderate aerobic exercise performed three days per week (50–55 minutes per session) for 8–10 weeks to 38–39 weeks gestation.Results
594 pregnant women were assessed for eligibility and 456 were included (EG n = 234; CG n = 222). The results showed a higher percentage of pregnant women gained excessive weight in the CG than in the EG (30.2% vs 20.5% respectively; odds ratio, 0.597; 95% confidence interval, 0.389–0.916; p = 0.018). Similarly, the prevalence of gestational diabetes was significantly higher in the CG than the EG (6.8% vs 2.6% respectively; odds ratio, 0.363; 95% confidence interval, 0.138–0.953; p = 0.033).Conclusion
The results of this trial indicate that exercise throughout pregnancy can reduce the risk of excessive maternal weight gain and gestational diabetes. 相似文献7.
Objective
To measure foot sensitivity and blood glucose levels among diabetic patients as measures of improvement pre and post Apiyu massage.Method
Quasi experimental research was employed to measure foot sensitivity and blood glucose levels before and after APIYU massage for fifty-five (55) purposive sampled consented adult patients with diabetes from Rejosari and Langsat Health Centers in Pekanbaru Riau, Indonesia. The intervention was given about three times in a week for thirty (30) minutes.Result
Revealed that there were significant differences between measures before and after massage using the Apiyu tool on: (a) mean sensitivity levels for pre-tests and post-tests on the right foot (pre-test 9.49, post-test 9.64; p-value = 0.011) and the left foot (pre-test 9.55, post-test 9.80; p-value = 0.004), and (b) blood glucose levels (pre-test 271.6, post-test 220.7; p-value = 0.001).Conclusion
The APIYU massage was proven effective for improving foot sensitivity and reducing blood glucose among diabetic patients. 相似文献8.
Background
Entering the paediatric intensive care unit with a critically ill child is a stressful experience for parents. In addition to fearing for their child’s well-being, parents must navigate both a challenging environment and numerous new relationships with healthcare staff. How parents form relationships with staff and how they perceive both their own and the healthcare providers’ roles in this early stage of their paediatric intensive care journey is currently unknown.Purpose
This paper explores bereaved parents’ perceptions of their role and their relationships with healthcare providers when their child is admitted to the intensive care unit, as part of a larger study exploring their experiences when their child dies in intensive care.Methods
A constructivist grounded theory approach was utilised to recruit 26 bereaved parents from 4 Australian intensive care units. Parents participated in audio-recorded, semi-structured interviews lasting 90–150 min. All data were analysed using the constant comparative analysis processes, supported by theoretical memos.Results
Upon admission, parents viewed healthcare providers as experts, both of their child’s medical care and of the hospital system. This expertise was welcomed, with the parent–healthcare provider relationship developing around the child’s need for medical care. Parents engaged in 2 key behaviours in their relationships with staff: prioritising survival, and learning ‘the system’. Within each of these behaviours are several subcategories, including ‘Stepping back’, ‘Accepting restrictions’ and ‘Deferring to medical advice’.Conclusions
The relationships between parents and staff shift and change across the child’s admission and subsequent death in the paediatric intensive care unit. However, upon admission, this relationship centres around the child’s potential survival and their need for medical care, and the parent’s recognition of the healthcare staff as experts of both the child’s care and the hospital system. 相似文献9.
Cheryl Ross Cath Rogers Christine King 《Collegian (Royal College of Nursing, Australia)》2019,26(1):1-7
Background
Nursing workload remains an issue in current health care contexts. The use of quantitative methodologies, methods and tools to measure workload has not produced adequate data to inform workforce policy to resolve workforce concerns about workload.Objective
This study aimed to identify the influence of both culture and climate as factors in nursing workload.Methods
This research used an overall critical ethnographic methodology to investigate the real lifeworkload issues of nurses. Methods included fieldwork observations and informal discussions over a 3 year period and 11 in-depth interviews.Results
The study identifies the impact of safety mandates on nursing workload as an invisible phenomenon within current workload methodologies. Such mandates add to nursing roles and routines, and become a ‘taken-for-granted’ activity that is not always directly related to patient care, nor is a visible factor in workload measurement.Conclusion
Given that workload measurements are formulated on direct patient care activities, indirect and unrecognised activities may create additional nursing workload. 相似文献10.
Objective
This study aims to determine the effectiveness of health education through audiovisual media on improving family knowledge in the prevention of dengue fever (DHF).Method
This study used a Quasi Experiment research design with a research design of Non-Equivalent Control Group. The study was conducted in the community with a sample of 40 people, consisting of 20 for experimental group and 20 for control group. The samples were selected using purposive sample collection method. The measuring instrument used is a questionnaire that has been tested for validity and reliability. The analysis was done through univariate analysis and bivariate analysis using t-independent test.Result
This study found that the showed a significant increase in changes in the level of attitudes and actions of families in the prevention of dengue fever by using audiovisual media, (p = 0.000), (p = 0.000).Conclusion
It is recommended that the health workers should provide health education by using audiovisual media in the prevention of dengue fever. 相似文献11.
A. Sampath Kumar Arun G. Maiya B.A. Shastry K. Vaishali N. Ravishankar Animesh Hazari Shubha Gundmi Radhika Jadhav 《Annals of physical and rehabilitation medicine》2019,62(2):98-103
Background
Insulin resistance is a determining factor in the pathophysiology of type 2 diabetes mellitus (T2DM). Exercise is known to improve insulin resistance, but a systematic review of the literature is lacking.Objective
This systematic review and meta-analysis focused on identifying evidence for the effectiveness of a structured exercise intervention program for insulin resistance in T2DM.Methods
We searched MEDLINE via PubMed, CINHAL, Scopus and Web of Science, and the Cochrane Central Register of Controlled Trials for reports of studies on fasting insulin, homeostatic model assessment for insulin resistance (Homa-IR), fasting blood sugar, glycated hemoglobin and body mass index in patients with T2DM and healthy controls that were published between 1990 and 2017. Data are reported as the standardized mean difference or mean difference with 95% confidence intervals (CIs).Results
Among 2242 records retrieved, only 11 full-text articles were available for meta-analysis. Data for 846 participants were analyzed, 440 in the intervention group, and 406 in the control group. The mean difference for fasting insulin level was ?1.64 (95% CI; ?3.38 to 0.10), Homa-Ir 0.14 (?1.48 to 1.76), fasting blood sugar ?5.12 (?7.78 to ?2.45), hemoglobin A1c 0.63 (?0.82 to 2.08) and body mass index ?0.36 (?1.51 to 0.79).Conclusion
The evidence highlights the effectiveness of a structured exercise intervention program for insulin resistance in T2DM with a moderate level 2 of evidence. 相似文献12.
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Objectives
this study aimed to identify the influence of health education about HIV/AIDS towards enhancing knowledge and HIV prevention efforts in household wives.Method
A quasy experimental design with pretest and posttest nonequivalent control group study was conducted among housewives in Rumbai Pekanbaru, Riau Province from March to August 2018. A systematic random sampling technique was used to select 144 housewives. A total of 72 intervention groups and 72 control groups. The intervention group was given health education with videos and leaflets. A questionnaire that it tested for validity and reliability has been applied. The Paired-Samples T-Test and Independent Samples T-Test were applied to analyze data.Results
There were differences in pretest and posttest preventive knowledge and prevention behavior scores on HIV in the intervention group (p-value = 0.000). However, there was no significant difference in prevention behavior in the control group (p-value = 0.0120). Based on this results, it can be concluded that health education can increase the knowledge and behavior of prevention of HIV/AIDS in household wives (p-value = 0.000).Recommendation
The health education on HIV/AIDS counseling and testing are key interventions for reducing number of HIV/AIDS cases. It is recommended that housewives to conduct HIV status on health services, and for HIV program holders are expected to increase the frequency of health education by using attractive media and VCT mobile services in order to reach more housewives. 相似文献16.
M. González-Rincón P. Díaz de Herrera-Marchal M.L. Martínez-Martín 《Enfermería intensiva / Sociedad Espa?ola de Enfermería Intensiva y Unidades Coronarias》2019,30(2):78-91
Objective
Analyze the role of the nurse at the end of the life of a critically ill patient.Method
Bibliographic review from a search of the health science databases such as PubMed, CINAHL, Cuiden, Scopus, Cochrane, as well as specialized platforms, general and thematic browsers. The limits were language (English or Spanish) and publication date (2005-2015).Results
180 articles met the inclusion criteria, and 16 of them were selected for analysis. The main results were grouped into three categories of analysis: direct patient care, family-focussed care and the nurse's role within the team.Conclusions
the described roles place the nurse as a key element in humanising death in the ICU and so nurses can and must lead change, playing an active role in creating strategies that really promote the integration of a palliative care approach in ICU. 相似文献17.
Adrienne P. Hudson Amy J. Spooner Natasha Booth Robyn A. Penny Louisa G. Gordon Tai-Rae Downer Patsy Yates Robyn Henderson Natalie Bradford Aaron Conway Christopher O’Donnell Alanna Geary Raymond J. Chan 《Collegian (Royal College of Nursing, Australia)》2019,26(1):110-117
Background
Nurse navigator roles aim to assist patients and their carers with navigating the healthcare system and accessing services to enable them to take a more active role in their own health care.Aim
The aim of this study was to explore patients’ and carers’ experiences of receiving care from a nurse navigator.Methods
This was a qualitative study involving semi-structured interviews with 12 patients (adults and children) and 13 carers receiving care from a nurse navigator in Queensland, Australia. Thematic analysis was conducted.Findings
The nurse navigator was a central contact person for patients and carers within the complex healthcare system. They were described as approachable, available and knowledgeable about the medical condition and the healthcare system, enabling patients to take a more active role in their own healthcare. The navigators played a pivotal role in navigating the seemingly insurmountable obstacles of accessing advice, services, equipment and appointments in a seamless way. However, further work is required to ensure that patients and carers are connected with a nurse navigator earlier in their healthcare journey.Discussion
The nurse navigators’ understanding of the complex healthcare system coupled with their global overview of patients and carers provided the participants with a sense of direction, options and more control over their own healthcare trajectory.Conclusions
The nurse navigator role has the ability to improve the care experience of patients and carers of varying ages and with varying medical conditions as explored in this study. 相似文献18.
Anne Mette Rustaden Lene Annette Hagen Haakstad Gøran Paulsen Kari Bø 《Revista brasileira de fisioterapia (S?o Carlos (S?o Paulo, Brazil))》2019,23(2):156-163
Background
Overweight and obesity are associated with musculoskeletal pain, particularly in the female population. However, regular resistance training may positively affect these complaints.Objective
The present study aimed to investigate between group differences in musculoskeletal pain in previously inactive women, allocated to three different resistance-training modalities available in health- and fitness clubs.Methods
This is secondary analysis from a single-blinded randomized controlled trial, including healthy women (aged 18–65) with a BMI (kg/m2) ≥25. The participants were allocated to 12 weeks (3 times/weekly) of either BodyPump (high-repetition low-load group session) (n = 24), heavy load resistance training with a personal trainer (n = 28), non-supervised heavy load resistance training (n = 19) or non-exercising controls (n = 21). Primary outcome was self-reported musculoskeletal pain in ten different body parts, measured with the Standardized Nordic Pain Questionnaire, at baseline and post-test. In addition, the study included sub-analyses of the participants when they were divided into high (≥28 of 36 sessions, n = 38) and low (≤27 of 36 sessions, n = 22) exercise adherence.Results
The analysis revealed no between group differences in musculoskeletal pain in any of the ten body parts. The results did not change when the participants were divided into high versus low adherence.Conclusions
Twelve weeks of BodyPump, heavy load resistance training with a personal trainer and non-supervised heavy load resistance training did not show any effect on self-reported musculoskeletal pain in overweight women.Clinical Trial registration number: NCT01993953.(https://clinicaltrials.gov/ct2/show/NCT01993953). 相似文献19.
Jane Currie Mary Chiarella Thomas Buckley 《Collegian (Royal College of Nursing, Australia)》2019,26(1):8-15
Background
Nurse practitioners (NPs) have been practising in Australia since 2001, predominantly in the public sector. To facilitate the expansion of NPs working in community and primary health care settings, legislative changes in 2010 led to privately practising NPs (PPNPs) being eligible to provide care subsidised through the Medicare Benefits Schedule (MBS) and the Pharmaceutical Benefits Scheme (PBS). To date, there has been little evaluation of PPNP services in Australia. Reported in this paper is the process through which national survey data enabled the refinement and development of theories on PPNP services in Australia.Aim
To describe the development and refinement of theories to answer the research question how, why and in which contexts PPNP services impact on patient access to care.Methods
The first part of a realist evaluation of privately practising nurse practitioner (PPNP) services in Australia has been conducted. A literature review and a national survey (n = 73) of PPNPs was undertaken to develop and refine preliminary realist theories and hypotheses.Findings
The theories developed relate to three broad aspects of PPNP practice activities: reimbursement, collaborative arrangements and scope of practice. National survey results support the preliminary theory that the current structure of the NP MBS items heavily influenced PPNPs’ reasoning processes in the design and delivery of patient services. Survey data also supports the theory that medical practitioners’ level of understanding of PPNPs’ roles and of collaborative arrangement legislation influences how they engage with PPNPs and the concomitant service outcomes.Conclusions
The national survey data confirmed the significance of theories about reimbursement, collaborative arrangements and scope of practice and how these have impacted on how PPNPs provide patient access to services. 相似文献20.