首页 | 本学科首页   官方微博 | 高级检索  
相似文献
 共查询到20条相似文献,搜索用时 244 毫秒
1.
目的了解患者对《侵权责任法》相关医疗法律法规的认知程度及其对目前医患关系相关问题的看法,为医疗安全及医疗立法提出建议。方法随机抽取2013年7月-9月6所医院的605例住院患者,利用自行设计的问卷对其进行调查,并对资料进行统计分析。结果共回收有效问卷542份,伤口患者对侵权责任法及相关医疗法规的认知程度不高,313例(57.7%)对侵权责任法一点也不了解;多数患者(50.6%)认为目前的医患关系更紧张,且平均月收入和付费方式不同的人群对医患关系紧张程度的认知存在差异;患者认为经济因素是影响患者群体就医行为选择的首要原因,不同收入的人群选择的就医行为也不相同;对于医疗纠纷解决方式,56.5%的患者不清楚医学会鉴定与司法鉴定的区别;仅有32.3%的患者相信第三方调解机构的协调意见。结论应通过多种渠道加大对大众的普法力度,使其明白自己在医疗行为的权利和义务;进一步建立健全医疗保障制度和完善医患纠纷解决方式,依然是构建和谐医患关系的关键所在。  相似文献   

2.
[目的]调查了解临床一线医生与护士对医患沟通与医患关系两者相关性的认知,为医护人员提高沟通能力提供有效方法。[方法]采用自制问卷对工作1年以上的120名医生和176名护士进行调查。[结果]医护双方在人际沟通相关知识获取途径、两者关系及主要影响因素3方面6项指标不同。[结论]医患沟通是影响医患关系、医疗质量、医院形象的重要因素,需引起广泛重视和加强,并采取有效措施加以改进和提高。  相似文献   

3.
医患共享决策是“以患者为中心”理念的拓展和延伸,强调医护患之间在进行决策过程中的沟通与协作,以患者需求为重点,加强医患之间沟通与交流,提高患者在医疗决策中的地位。近年来医患共享决策受到学者的广泛关注,被运用于多种领域。该文对医患共享决策的概念、国内外研究概况、优点及在髋膝关节置换术中的应用等方面进行综述,并对未来研究方向进行讨论,以期为医患共享决策在国内髋膝关节置换术中的应用提供参考。  相似文献   

4.
共享决策作为“以患者为中心的护理”的核心,是医患之间通过参考现有的最佳临床证据并考虑患者的价值观和偏好,协同合作制订决策的过程。共享决策通过促进患方参与决策,并增强其对预后和治疗护理措施的理解,来制订更加明智的决策。该文介绍共享决策在ICU的实施意义及应用情况,针对患者/家属因素、医疗相关人员因素和评估工具因素3个方面的影响因素进行分析,提出了共享决策在ICU实施的建议,以期为共享决策在ICU中的应用提供参考。  相似文献   

5.
目的:调查晚期肿瘤患者照顾者疲劳的发生情况并分析相关因素,为临床干预提供依据。方法采用便利抽样方法选择110例肿瘤晚期患者照顾者,采用疲劳自评量表对其疲劳状况进行调查。结果共发放调查问卷110份,回收110份,回收率为100%。剔除2份不合格问卷后,有效问卷108份。晚期肿瘤患者照顾者疲劳发生率为100%,其中51.9%在中度水平以上;62%的照顾者能通过休息、睡眠缓解疲劳;100%的照顾者的疲劳受环境影响;77.8%家属的疲劳程度有明显的时间变化规律,严重程度尤以晚上为重。结论晚期肿瘤患者照顾者的疲劳发生率高,程度较重,受环境影响明显,应引起临床关注。  相似文献   

6.
张渊 《协和医学杂志》2019,10(6):679-684
循证医学提倡医务人员应用证据并考虑患者价值和偏好作出决策。医患共同决策基于医患双方均为"专家"的理念, 即医生作为医学专家提供医学专业意见, 而患者作为了解自身偏好的专家, 双方在充分讨论后共同作出医学决策。在此过程中, 医务人员应同时具备获取最佳证据以及应用决策辅助系统实现医患共同决策的能力。本文通过比较不同医学决策模式, 讨论医患共同决策的理论与实践, 并列举与中国医疗环境相关的、医患共同决策可能面临的挑战与障碍因素, 以期为临床作出合理决策以及提高医疗服务质量提供借鉴。  相似文献   

7.
目的了解经口甲状腺切除术后患者医疗决策参与满意度水平和医患关系得分水平,并分析两者的相关性。方法于2020年2-4月采用一般资料调查表、患者对医疗决策参与的满意度调查问卷和医患关系问卷,对已接受经口甲状腺切除术后的355例患者进行调查。结果经口甲状腺切除术后患者医疗决策满意度总得分为(87.73±12.70)分,医患关系总得分为(60.19±5.65)分;Spearman相关性分析结果显示,医疗决策满意度与医患关系呈较强正相关(r=0.675,P0.01)。结论患者对医疗决策参与的满意度以及医患关系得分均处于较高水平,建议临床医务工作者合理运用医患共同决策模式,重视与患者的沟通交流,提高患者参与医疗决策的满意度,进一步改善医患关系。  相似文献   

8.
目的 对共享决策在癌症领域相关研究进行可视化分析,以期为我国研究提供借鉴。方法 检索1998年1月1日至2021年5月12日Web of Science核心合集中共享决策在癌症领域研究的相关文献,应用CiteSpace软件对文献中的国家、机构、关键词进行可视化分析。结果 共纳入文献1684篇,发文量最多的国家为美国,发文量最多的机构为阿姆斯特丹大学;研究热点为乳腺癌、前列腺癌、信息、沟通、患者参与、生存质量等。发展趋势为基于循证的高质量系统评价、指南和以患者为中心的姑息护理临床实践。结论 共享决策在癌症领域相关研究呈逐年上升趋势,但主要集中在发达国家;未来可基于国际热点前沿,结合我国国情,探讨有效方法促进医患间的共享决策。  相似文献   

9.
医患共享决策是当下医疗服务发展的主流趋势。文章介绍了问题提示列表的概述和特征,并对问题提示列表在患者及家属决策参与中的应用进行综述,旨在为临床应用提供参考,促进共享决策。  相似文献   

10.
冯馨  李斌 《解放军护理杂志》2011,28(22):22-24,58
目的探讨医患双方对医疗知情同意书的意见,以期为修改医疗知情同意书提供参考依据。方法收集不同等级医院的医疗知情同意书进行分析。采用自制的调查问卷对某医院100名医生和100名患者进行医疗知情同意书意见的调查。结果医患双方在医疗知情同意书的性质、过程、签署及改进方面的差异均有统计学意义(均P<0.05)。结论临床现行医疗知情同意书仍有许多方面不能达到医生及患者的要求,且绝大部分的医生及患者均认同知情同意书应采取全国统一格式。  相似文献   

11.
OBJECTIVE: To analyze the effects of informational support, desire for behavioral involvement in health decision-making (behavioral involvement), opportunities to make decisions, and independence on subjective health status in surgical patients. A theoretical model of self-determination was applied and tested. METHODS: The data were collected by structured questionnaires with a sample of 1,454 surgical patients in five European countries. LISREL analyses were used to test the theoretical causal model of self-determination. RESULTS: Patients' perceptions of informational support received from nursing professionals and their desired involvement in health decision-making affected patients' opportunities to make decisions and further their independence level, which in turn affected patients' subjective health status. CONCLUSIONS: Understanding of factors that increase self-determination in patients can help health care professionals to promote patients' well-being.  相似文献   

12.
目的了解高护生职业生涯规划的现状及职业决策困难程度,为更好地开展高护生职业生涯教育提供理论依据。方法采用《高护生职业生涯规划问卷》和《大学生职业决策困难问卷》量表对300名护理专科生进行随机分层调查。结果不同年级、不同性别的高护生个人职业生涯规划评分差异有统计学意义(P〈0.05),职业决策困难评分差异无统计学意义(P〉0.05)。结论高护生职业规划能力较差,职业决策存在一定困难,大学二年级和男护生更明显。高护生职业生涯规划教育应体现年级及性别的特点,应重点加强男护生职业规划教育。  相似文献   

13.
Decision-making in the ICU: perspectives of the substitute decision-maker   总被引:4,自引:4,他引:0  
OBJECTIVE: To describe the substitute decision-makers' perspectives related to decision-making in the intensive care unit (ICU) and to determine those variables associated with their overall satisfaction with decision-making. DESIGN: Prospective, multicenter, cohort study. SETTING: Six Canadian university-affiliated ICUs. PATIENTS AND PARTICIPANTS: We distributed a validated, self-administered questionnaire assessing 21 key aspects of communication and decision-making to substitute decision-makers of ICU patients who were mechanically ventilated for more than 48 h. INTERVENTION: None. MEASUREMENTS AND RESULTS: A group consisting of 1,123 substitute decision-makers received questionnaires; 789 were returned (70.3% response rate). Respondents were most satisfied with the frequency of communication with nurses and least satisfied with the frequency of communication with physicians. In terms of overall satisfaction with decision-making, 560 (70.9%) of the respondents were either completely or very satisfied. The majority (81.2%) of respondents preferred some form of shared decision-making process. Factors contributing the most to satisfaction with decision-making included: complete satisfaction with level of health care the patient received, completeness of information received, and feeling supported through the decision-making process. Satisfaction with decision-making varied significantly across sites. CONCLUSIONS: In this multicenter observational study, we found that most substitute decision-makers for ICU patients wanted to share decision-making responsibility with physicians and that, overall, they were satisfied with their decision-making experience. Adequate communication, feeling supported, and achieving the appropriate level of care for their family member were key determinants of satisfaction with decision-making in the ICU.  相似文献   

14.
In large clinical trials where outcome assessment is possible using questionnaires, it may be more cost-effective to mail them to patients than to conduct interviews in-person. However, nonresponse to mailed questionnaires reduces the effective sample size and can introduce bias. We conducted a systematic review and meta-analysis of randomized controlled trials evaluating the effect of questionnaire length on response rates. We searched 14 electronic bibliographic databases, the reference lists of relevant trials, and we contacted the authors of eligible trials to ask about unpublished data. For each trial identified, we used logistic regression to estimate the odds ratio for response per one page increase in the number of pages included in the questionnaire. We pooled the regression coefficients in a random effects meta-analysis. Heterogeneity among the coefficients was assessed using a chi-square test at a 5% significance level. We specified a priori that the reduction in the odds of response per one page increase would be greatest among trials comparing relatively short questionnaires. We used meta regression to examine the relationships between the regression coefficients, the length of the questionnaires used in each trial, and other study characteristics. A total of 38 randomized controlled trials were identified where participants were allocated to questionnaires of differing lengths and where the number of pages used was known. There was significant heterogeneity between the regression coefficients estimated from each trial. In meta regression, most of the heterogeneity was explained by variation in the length of the questionnaires used in each trial. Among trials in which the shortest questionnaire was a postcard, the odds of response were more than halved for each additional page used (0.39; 95% CI 0.34 to 0.45). In the remaining trials, pooled effect sizes were much smaller. In trials of one page compared with either two or three pages, the odds of response per one page increase was 1.01 (95% CI 0.82 to 1.24). For one page compared with four or more pages, and for two or more pages compared with longer alternatives, the odds ratios per one page increase were 0.90 (95% CI 0.83 to 0.98) and 0.98 (95% CI 0.96 to 0.99), respectively. There were no statistically significant associations between trial results and other study characteristics. It appears that response can be increased by using a shorter questionnaire. Moderate changes to the length of shorter questionnaires will be more effective than moderate changes to the length of longer questionnaires. If a choice of follow-up questionnaire exists for a clinical trial, the shorter one should be used. If a new follow-up questionnaire is to be designed, it should be made as short as possible without compromising the data collection requirements of the trial.  相似文献   

15.
Purpose: To determine what client factors predict allocation of an electric scooter and to determine what needs assessor and agency factors explain variation in decision-making by long-term care needs assessors concerning clients requesting electric scooters.

Method: Hypothetical case vignettes were sent to needs assessors allocating services for the elderly, and questionnaires were used to obtain organizational and individual needs assessor data. Multilevel logistic regression analysis provided random and fixed effects.

Results: The decision whether or not to allocate an electric scooter was influenced primarily by the clients' driving safety, their disabilities and whether or not there were possibilities to stall the electric scooter. Transportation goals and the clients' activity level were not taken into account. There was some random variation on the level of needs assessors.

Conclusions: A system whereby all clients who request an electric scooter, have disabilities that limit mobility, have shown to be safe drivers and have a shed to stall the scooter are allocated a scooter may be more appropriate in maintaining elderly persons' independence and preventing social isolation. Regular evaluation afterwards and extra driving lessons may prevent allocation of scooters to clients who do not use them.  相似文献   

16.
BACKGROUND: Death in modern societies is often preceded by medical end-of-life decisions. Empirical research on these end-of-life decisions focuses predominantly on the physicians' role. Little is known about the role of other health care workers, especially that of nurses. AIM: This paper reports the findings of a study that investigated how often nurses are consulted by physicians in the decision-making process preceding end-of-life decisions and how often nurses participate in administering lethal drugs in end-of-life decisions. METHOD: Data were collected within a nationwide cross-sectional retrospective death certificate study in Flanders, the Dutch-speaking part of Belgium. We selected 3999 deaths, a 20% random sample of all those occurring during the first 4 months of 1998. Anonymous questionnaires were mailed to the physicians who signed the death certificates. Several questions concerned the involvement of nurses in end-of-life decisions. RESULTS: We received 1925 valid questionnaires. For all reported end-of-life decisions (39.3% of all deaths in Flanders), physicians provided information about the involvement of nurses. Physicians consulted at least one nurse in 52% of end-of-life decisions cases occurring in institutions, compared with 21.4% of such cases at home. Nurses administered lethal drugs in 58.8% of euthanasia cases occurring in institutions and in 17.2% at home. For cases in which life was ended without the patient's explicit request because, predominantly, they were too ill to do so, these percentages were respectively 82.7% and 25.2%. In institutions, nurses mostly administered drugs without the attendance of a physician who had prescribed the drugs. CONCLUSIONS: Nurses in Belgium are largely involved in administering lethal drugs in end-of-life decisions, while their participation in the decision-making process is rather limited. To guarantee prudent practice in end-of-life decisions, we need clear guidelines, professionally supported and legally controlled, for the assignment of duties between physicians and nurses regarding the administration of lethal drugs to reflect current working practice. In addition, we need appropriate binding standards governing mutual communication about all end-of-life decisions.  相似文献   

17.
PurposeTo investigate the preferred and actual participation levels of colorectal cancer patients and their families in treatment decision-making.MethodsA cross-sectional survey was conducted using a questionnaire administered to colorectal cancer patients hospitalized in the general surgical wards in two of the upper first-class hospitals in Beijing between February and July 2013.ResultsA total of 113 questionnaires were analyzed. For the families of colorectal cancer patients, the concordance rate of their preferred and actual participation levels in treatment decision-making was 60.2% and 62.8% for the patients themselves. Patients with stoma and male patients preferred a passive role compared to those without stoma and female patients (x2 = 7.978, p < 0.05; x2 = 9.854, p < 0.05).ConclusionsOver 40% of colorectal cancer patients preferred a passive role in treatment decision-making. We suggest that communication between physicians and patients should be strengthened to accommodate the patient's desired level of involvement.  相似文献   

18.
肾移植术后患者治疗依从性及其影响因素分析   总被引:1,自引:0,他引:1  
目的 了解肾移植术后患者治疗依从性及其影响因素.方法 采用随机抽样方法 对肾移植术后门诊随访的220例患者进行调查.调查内容包括患者的基本情况、治疗依从性、肾移植相关知识水平、社会支持,并对其进行统计分析.结果 依从性总得分为(10.34±1.56)分,其中,生活方式依从得分最高,定期复查依从得分最低.影响肾移植术后患者依从性的因素为经济状况、肾移植相关知识、医疗费用支付方式、移植术后时间、社会支持.结论 肾移植术后患者的治疗依从性影响人/肾存活率及患者生活质量,应从加强患者健康教育及随访、提供多方位、多层次的社会支持等方面提高患者的治疗依从性.  相似文献   

19.

Purpose

Advance directives (AD) are becoming increasingly widespread. We examine the prevalence of AD and the factors associated with AD in tumor patients during radiotherapy.

Methods

A standardized questionnaire was handed out to all tumor patients on 9 random days with an interval of at least 12?weeks. The data were analyzed in a bivariate and multivariate way.

Results

Of 1,208 questionnaires, 658 were completed and returned (54.5%). Of respondents, 23.6% had already signed an AD, 53.3% thought they were likely to sign an AD, 9.0% did not want to sign an AD, and 4.9% were not familiar with advance directives. Patients who have signed an AD and those who are likely to sign one think that ADs facilitate the physician’s decision-making process (97.7% cf. 94.5%) and that they ease the burden on relatives (98.5% cf. 98.8%). Regardless of an AD having been signed, every second respondent was of the opinion that AD facilitates consultations rather than serving as a directive (55.1% cf. 57.3%). Patients likely to sign an AD are significantly younger compared to those unlikely to do so and have suffered from their tumor disease for a shorter period of time.

Conclusions

Of advance directives is widely accepted among the tumor patients surveyed. Advanced directives are not exclusively seen as instruments for surrogate decision making, but also as mediums to improve communication. Training of physicians and additional offers for patients could increase the actual number of ADs and perhaps improve physicians and relatives understanding of patients needs and wishes.  相似文献   

20.
设为首页 | 免责声明 | 关于勤云 | 加入收藏

Copyright©北京勤云科技发展有限公司  京ICP备09084417号