读者参与护理科普期刊定稿决策的研究进展

从分析当前编辑决策的现状入手，阐述了读者参与的必要性和可行性，以及读者参与的方式，并提出设想。     

第22例 老年女性颈部肿物一例

欢迎读者对以上病例进行分析讨论,并将诊断结果发送至编辑部,本刊将在下期刊登参与讨论的读者来信、专家点评及正确答案。参与讨论的读者将获得本刊赠送的当期杂志一册。     

第19例月经不规律，左下腹附件区触及包块

编者按欢迎读者对以上病例进行分析讨论并将诊断结果发送至编辑部，本刊将在下期刊登参与讨论的读者来信、专家点评及正确答案。参与讨论的读者将获得本刊赠送的当期杂志一册。     

欢迎广大读者参与评审“韩济生疼痛医学论文奖”

<正>根据"韩济生疼痛医学论文奖"章程实施细则,入选论文的提名将由专家评审委员会评审和读者投票产生,我刊读者可以参与"韩济生疼痛医学论文奖"入选论文提名;入选论文的评分中,读者推荐人数将占有相应     

中华医学超声杂志(电子版)2011年评选优秀论文的通知

1.参评条件:凡在本刊2010年发表的论文均可参与评选。2.评选方法:参与评选的读者或作者可通过邮件或信函的形式将优秀论文评     

中华医学超声杂志(电子版)评选优秀论文的通知

1.参评条件:凡在本刊2010年发表的论文均可参与评选。2.评选方法:参与评选的读者或作者可通过邮件或信函的形式将优秀论文评     

《中华物理医学与康复杂志》继续医学教育答题注意事宜

自从本刊2006年开展“读杂志,获学分”继续医学教育活动以来,有众多读者积极参与,踊跃答题,已收到大量的回馈信息。在此我们向广大忠实读者对我刊的大力支持致以衷心的感谢!出于管理上的考虑,我们将于2007年1月一次性邮寄学分证书(全年答题者可获12分),并代为收取学分证书工本费上缴中华医学会。所有参与答题的读者均已给予回执,未收到回执者可通过电话或电子邮件与编辑部联系。期待您的继续参与!联系电话:027-83662874;E-mail:cjpmr@tih．tjmu．edu．cn。     

《上海护理》诚邀您参与读者调查

正[本刊讯] 2019年9月24-27日,第四届上海国际护理大会期间,《上海护理》期刊特设展位,回顾杂志发展历程、展示优秀文章、倾听读者心声,并同时开展了在线读者调查,以进一步了解读者需求、提升期刊服务内涵。设展期间,得到参会人员的积极关注和参与。为了     

病人决策行为研究进展

病人参与医疗决策是一个相对新的概念和行为 ,重点介绍它的内涵、产生背景、相关理论以及研究进展 ,目的在于提供一个框架给对此感兴趣的读者。     

中华医学超声杂志(电子版)评选优秀论文的通知

1.参评条件:凡在本刊2010年发表的论文均可参与评选。2.评选方法:参与评选的读者或作者可通过邮件或信函的形式将优秀论文评选推荐表投至本刊编辑部。经本刊编委会专家评审后拟于2011年第10期刊登     

护士对老年轻度认知障碍患者参与临床决策认知的质性研究

目的 深入了解长期护理轻度认知障碍（mild cognitive impairment,MCI）患者的护士对老年MCI患者参与临床决策的认知和建议,为促进医患共享决策提供参考。 方法 运用现象学研究法,于2020年11月—2021年2月选取13名长期护理MCI患者的护士进行半结构式深入访谈,采用Colaizzi 7步分析法对访谈资料进行分析。 结果 护士对老年MCI患者参与临床决策的认知可归纳为5个主题：①患者参与临床决策是尊重患者意愿的体现;②患者参与临床决策是综合提升护理质量的保障;③患者参与临床决策受其决策能力所限;④情绪消极应对状况影响患者参与临床决策;⑤患者参与临床决策在临床实施受阻。护士对老年MCI患者参与临床决策的建议可归纳为3个主题：①进一步激发患者的决策意识;②呼吁家属支持;③期望改善实施条件。 结论 医患共享决策具有重要的实践意义,但在临床实施中存在一定的阻碍。今后仍需加强患者的决策意识,培养护士的决策能力,完善医患共享决策的实施条件,以充分发挥护士的引导作用。     

An outline of consumer participation in health

Awareness about the importance of consumers' participating in decision making in health is being increasingly advocated as a way of improving the safety and quality of health care. This article briefly describes some of the key international and national health directions and research that support a more active role for consumers in decision making in health. In addition, it proposes four key dimensions of consumer participation as a framework to describe the scope for consumers to participate in decision-making in individual care processes, health services and the broader health system. Finally, a new Commonwealth Government funded initiative, the National Resource Centre for Consumer Participation in Health, is described which aims to increase the access of service providers and consumer organisations to information about the various methods and models of consumer feedback and participation and provide support to enhance their application of the methods and models to practice.     

Shared decision making: evaluation of German medical students' preferences

Rationale Current medical student perceptions of patient centredness and the priorities of students for a change in medical care were investigated. Methods We conducted an observational study using questionnaires at the University of Leipzig in Germany. In total, 188 consecutive medical students attending the Department of General Medicine participated in this study. We investigated students’ priorities for an improvement in medical care related to aspects of the patient–doctor relationship and to aspects of organization. Results Receiving more information and undergoing the process of shared decision making was the most important choice; selected by 43.2% as their first priority. The second choice was found to be consultation time (16.2%) which also refers to the patient–doctor relationship. Shorter queues for tests, also considered important for more patient autonomy, were ranked third (14.6%). Medical students participating in this study were least interested in access to specialists, cost of medications and continuity of care. Conclusion For the first time, it is shown that shared decision making, in addition to its many benefits, is not only a patients’, but also a prospective doctors’ top priority. Consequently, medical student training programmes might incorporate shared decision‐making training as an important element of patient centredness.     

Unmet needs in information flow between breast cancer patients,their spouses,and physicians

This study focused on the needs and sources of disease information of breast cancer patients and their spouses during early disease in two settings: at the department of oncology (AD) and on a rehabilitation course (RC). The aim was to characterize those patients and spouses who are not content with average information. Eighty percent of AD and 31% of RC patients were content with the available information (p<0.001) and 75% of AD spouses and 43% of RC spouses reported similarly (p=0.008). Higher education, younger age, and shorter time (<1 year) since diagnosis indicated a greater need for information among patients, whereas among spouses, only education level was associated with it. More information was needed on prognosis, cancer as a disease, its influence on daily life, and treatment effects. In both groups, the same proportion of patients reported to have felt involved in decision making sufficiently (60%), inadequately (27%), and 19% versus 16% did not want to be actively participating in decision making. The patients were mostly satisfied with participation in decision making, but they expressed unsatisfactory needs on information during early years of breast cancer. Similarly, their spouses were not content with available information.     

Changes in intensive care unit nurse involvement in end of life decision making between 1999 and 2016: Descriptive comparative study

ObjectiveComparison of nurse involvement in end of life decision making in European countries participating in ETHICUS I- 1999 and ETHICUS II- 2015.MethodologyThis was a prospective observational study of 22 European ICUs included in the ETHICUS-II and I. Data were collected as per the ETHICUS-I and ETHICUS-II protocols. Four questions within the ETHICUS protocols related to nurse involvement in end of life decision making were analyzed. This is a comparison of changes in nurse involvement in end of life decisions from 1999 to 2015.SettingInternational e-based questionnaire completed by an intensive care clinician when an end of life decision was performed on any patient.SubjectsIntensive care physicians and nurses, no interventions were performed.MeasurementsA 20 question survey was used to describe the decision making process, on what basis was the decision made, who was involved in the decision making process, and what precise decisions were made.ResultsA total of 4592 cases from 22 centres are included. While there was more agreement between nurses and physicians in ETHICUS-I compared to ETHICUS-I, fewer discussions with nurses occurred in ETHICUS-II. The frequency of end of life decisions that were discussed with nurses decreased in all three regions between ETHICUS-I and ETHICUS-II.ConclusionBased on the results of the current study, nurses should be further encouraged to increase their involvement in end of life decision-making, especially those in southern Europe.     

Effectiveness of INROADS into pain management, a nursing educational intervention

Nurses play a critical role in managing a patient's pain, from initial evaluation to ongoing patient education. However, little information exists on current gaps in nurses' knowledge and their pain-related decision making. To this end, an educational intervention-the INROADS initiative-was designed to improve the knowledge of nurses involved in patient management as well as to guide them toward practices that are consistent with currently available evidence. The results from an evaluation of this intervention show that nurses participating in the INROADS program were 52% more likely to make evidence-based care choices for their patients, compared with a control group of demographically similar nurses. The effect of this program may reinforce it as a model for the design of future interventions for pain management.     

Critical appraisal of the literature on economic evaluations of substitution of skills between professionals: a systematic literature review

Objective  Substitution of skills has been introduced to increase health service efficiency, but little evidence is available about its cost-effectiveness. This systematic review aims to identify economic evaluations of substitution between professionals, to assess the quality of the study methods applied and to value the results for decision making.
Methods  Publications between January 1996 and November 2006 were searched in Medline, Cochrane, Cinahl, database of Health Technology Assessments, EPOC and Embase. Randomized controlled trials (RCTs), cost–benefit analysis, interrupted time series design and systematic reviews were selected. The methodological quality of the papers was reviewed, using the critical appraisal of Drummond and the EPOC list.
Results  Eleven studies were finally included of 7605 studies: three cost-effectiveness studies, three cost-minimization studies and five studies related to partial economic evaluations. Small numbers of participating professionals and several limitations in the cost valuation and the measurement of costs were identified.
Conclusions  Several potential limitations influence the validity and generalizability. Full economic evaluations per se are of limited value for making decisions about substitution of skills. The tenuous relationship between structural, process and outcome variables is not sufficient investigated. For meaningfully placing the costs and consequences of substitution of skills in the context of health care and generating relevant data for decision making, it is strongly recommended to combine an economic evaluation (RCT) with an observational longitudinal study.     

Substance use disorder and compulsory commitment to care: a care‐ethical decision‐making framework

In the era of deinstitutionalisation of psychiatric patients, steady or even increasing rates of compulsory commitment to care (CCC ) are an intriguing phenomenon to analyse. From a clinical, legal and ethical perspective, CCC continues to be a controversial practice in psychiatry, and perhaps even more so when applied to patients with severe substance use disorder (SUD ). Several reasons make it controversial. The lack of consensus about the benefits of CCC and professional disagreement about what mental illness and autonomy mean in the case of SUD make it difficult to apply ethically sound clinical decision‐making in CCC . Also, the medico‐legal framework underlying CCC use sometimes appears to foster the use of reductionist clinical evaluation. Layered on top of these issues is how stakeholders view coercion. There is a discrepancy between clinicians’ and patients’ perception of coercion, which leads to clinician–patient differences on whether CCC is necessary. Moreover, the way in which the evaluation is typically carried out influences patients’ perception of coercion and subsequently their motivation for participating fully in treatment. In this article, we explore the value of care ethics, often applied to care practices such as nursing, when applied to more procedural medical practices, such as decision‐making regarding CCC . The care‐ethical approach views decision‐making as part of a dynamic care process, within which the lived experience, interpretative dialogue and promotion of dignity are core features. Embracing this new framework means a paradigm shift in when the therapeutic relationship begins, namely, investing in it occurs while conducting an evaluation for a possible CCC procedure. Unlike in current typical evaluations, early cultivation of the therapeutic relationship enables the patient to participate in the definition of his needs, reduces perceived coercion and negative emotions and enhances treatment motivation. Finally, implications of this novel approach for clinical practice are formulated and discussed.     

Parental treatment decision making in pediatric oncology

OBJECTIVE: To review progress and future plans for a research program about parents' making treatment decisions for their children with cancer. DATA SOURCES: Theoretical papers, review articles, and research reports. CONCLUSION: Three important questions need to be addressed to achieve the goal of supporting parents in treatment decision making: 1) Whatfactors predict a parent's preferred role iln decision making? 2) What are the critical outcomes from parental decision making that nurses could help to improve? 3) Is it role choice, actual role assumed, or congruence between preferred and actual role in decision making that predicts decision outcomes for the parents? IMPLICATIONS FOR NURSING PRACTICE: Research-based responses to the remaining questions about parent treatment decision making will help nurses develop and test interventions designed to support parents in their decision making experiences.