Interprofessional primary care: Patients' perspectives

Closer working relationships between social workers and general practitioners (GPs) have been encouraged in the UK for a number of years, but the passage of the National Health Service and Community Care Act 1990 has given a greater impetus and focus to these recommendations. This paper considers the potential benefits and pitfalls in the location of social workers within general practice, within the context of community care. The literature on the links between social work and general practice is reviewed, in order to identify the most important factors to consider when establishing a project to locate a social worker within general practice. Drawing on the author's direct involvement with three related projects, the Significance of these factors is discussed, leading to conclusions regarding the most effective way to plan and implement such change.     

脑卒中患者的社会支持状况调查分析及护理对策

目的 :了解脑卒中患者的社会支持状况 ,分析出社会支持较低的弱势群体。方法 :应用肖水源的“社会支持评定量表” ,调查分析 10 5例脑卒中患者所获得的社会支持状况。结果 :脑卒中患者获得的社会支持总分为 3 4.0 6± 7.44 ,与正常人总分3 6.94± 7.15比较 ,差异有统计学意义 (P <0 .0 1) ,有获得低水平社会支持的危险。老年和丧偶的脑卒中患者获得的社会支持更低 ,是社会支持较低的弱势群体。结论 :护士通过运用整体护理手段 ,加强脑卒中患者的社会支持 ,可帮助患者适应疾病过程 ,提高其生存质量     

Application of social ecological model to Taiwanese end-of-life communication and healthcare planning

BackgroundCultural and social backgrounds shape how people regard health, illness and death, and also play a significant role in end-of-life (EOL) decision-making in the face of uncertainty and distress. EOL communication and planning can be complex in a society where families play an important role in decision-making for EOL care in Taiwan.AimThis study aimed to identify the significance of cultural, community, interpersonal and individual determinants of EOL communication and healthcare planning.MethodsA social ecological model was applied to underpin the study. A random sample of 2000 adults aged 20 years or above was selected from the electoral roll in a metropolitan area in southern Taiwan. Adults were told that if they did not wish to participate in the study, they could either return a non-participation form or not complete the questionnaires. Hierarchical multiple regression analyses were used to determine the significance of different societal levels of factors on EOL communication and healthcare planning.FindingsFour hundred and seventy-four valid questionnaires were returned. Hierarchical multiple regression analyses revealed that the models of modified Measures of Public Preferences (p < .0001) were significant, with 22.7% of variance in facilitation, 81.9% of variance in content and 22.9% of variance in support being explained by variables at cultural, community, interpersonal and intrapersonal levels. The model of Advance Directives Attitude Survey (p < .0001) was significant with 25.6% of variance being explained by variables at cultural, community, interpersonal and intrapersonal levels.DiscussionThis study offers empirical evidence embedded within a social ecological perspective of the significance of cultural, social and contextual factors on individuals’ preferences for EOL communication and healthcare planning.ConclusionSuch information is important to enable health professionals to prepare individuals and their families for dealing with challenges related to EOL communication and healthcare.     

实施药学服务促进合理用药降低综合医疗费用的研究

随着社会的进步,医疗服务已逐渐变成一种产业,医院不再仅仅是治疗疾病的场所,更多成为一个为患者提供医疗服务的场所。卫生服务(patient care)包括医疗保健(m ed ical care)、护理(nursing care)和药学服务(pharm aceutical care)[1]。在上述的三个环节中,药学服务在国内还是一     

“优质护理服务示范病房”试点临床体会

目的以病人为中心,提供优质护理服务,提高患者的满意度。方法学习领会＂优质护理服务示范工程＂精神,结合我们的工作特点,推行＂优质护理服务示范病房＂,注重人文关怀,细化基础护理的内容,提供温馨服务。结果自2010年6月开展＂优质护理服务示范病房＂活动以来,提高了患者对护理工作的满意度,提高了社会影响力。结论推行＂优质护理服务示范病房＂,可以提高患者满意度。     

森田疗法对社交恐怖症的康复效果评价

目的:研究森田疗法对社交恐怖症的社会康复作用。方法:将41例社交恐怖症患者随机分为两组,森田疗法组22例,健康教育组19例,均于干预前、干预后、治疗结束半年后做社交回避及苦恼量表(SAD)和效果评定。结果:干预后及半年后随访,森田疗法组SAD总分与健康教育组相比,均呈显著性下降(P<0.01);明尼苏达多项人格测查表(MMPI)显示干预后森田疗法组临床量表(神经症量表)减分率显著高于健康教育组。结论:社区护理中采用森田疗法干预社交恐怖症,疗效好,能促进患者社会康复。     

The impact of volunteer befriending services for older people at the end of life: Mechanisms supporting wellbeing

Introduction: Older people at the end of life are particularly vulnerable to social isolation and loneliness, the associated health effects of which are significant. Increasingly, charitable organizations are offering befriending services for people at the end of life. However, there is little research evidence around the mechanisms by which befriending facilitates wellbeing at the end of life. The aim of the study was to explore the mechanisms by which befriending facilitates wellbeing in older people at the end of life.

Methods: Semi-structured interviews were held with 12 recipients and family of a UK befriending service for older people at the end of life. Interviews explored experience of the befriending service, and the impact on wellbeing. Interviews were analysed using a process of thematic analysis.

Results: The data indicate that the befriending service had a multi-dimensional impact on a range of outcomes including emotional and psychological wellbeing, and reduced social isolation. Other outcomes included practical support, and family carer support.

Discussion: The mechanisms by which befriending facilitates wellbeing in older people at the end of life are complex. The unique issues faced by people approaching the end of life mean further research is required to explore dimensions of befriending in more depth and further develop theory.     

Is there a relationship between nursing students’ smartphone use,their fear of missing out and their care-related behaviour?

AimThis study aims to determine the relationship between smartphone use among intern nursing students, fear of missing out and their care-related behaviour.BackgroundToday, smartphone use is common and fear of missing out is a prominent issue in our society; this behaviour and issue are linked and may lead to adverse consequences. Design: The study is conducted as a cross-sectional design.MethodsThe target population in this research consists of senior nursing students (n = 101). There was no sampling selection and the study was completed with 97 students who agreed to participate in the research. Data were collected with introductory questionnaire forms, the Smartphone Addiction Scale (SAS), the Fear of Missing Out Scale (FoMOs) and the Caring Assessment Questionnaire (Care-Q). The valid and reliable SAS, FoMOs and Care-Q were transformed into online forms and the link was distributed to the participants via online Google forms.ResultsBased on the results of the study, the mean scores were 83.30 ± 2.21 of SAS, 21.56 ± 6.42 for FOMOs and 5.54 ± 0.87 for Care-Q scale. There were statistically significant differences between gender and Care-Q score and between the duration of smartphone use, daily smartphone usage time and SAS score (p < 0.05). There was a weak positive relationship between SAS and FoMOs scale scores, along with a weak negative relationship between the accessibility and comfort sub-dimensions of the SAS and Care-Q scale. Also, the SAS score explains 0.4% of the comfort subscale of the Care-Q scale (p < 0.05).ConclusionsFurther research focusing on nursing students is recommended to identify potential adverse effects created by the use of smartphones and the fear of missing out. In addition, educators are recommended to develop guidelines and prepare new policies for smartphone use to minimise the potential negative effects of smartphone use and fear of missing out on student care behaviour.     

造血干细胞移植出院患者社会支持状况调查分析

目的调查造血干细胞移植出院患者的社会支持现状,寻求相应的护理对策,帮助患者保持较高的社会支持水平。方法选择2007年9月2009年3月在层流病房进行造血干细胞移植的患者48例,采用肖水源的社会支持评定量表,进行住院期间和出院3个月后的问卷调查,并进行统计学分析。结果患者住院期间社会支持总分为（41.40±5.60）分,出院3个月后社会支持总分为（38.19±3.65）分,比较具有统计学意义（P〈0.05）。结论造血干细胞移植患者出院后社会支持水平降低,护士应加强对造血干细胞移植患者出院后的指导,拓宽造血干细胞移植出院患者社会支持渠道,帮助患者保持较高的社会支持水平,从而促进患者的康复。     

社区糖尿病健康教育的效果分析

目的：为提高社区糖尿病患自我保健的意识技能。方法对１０３例社区糖尿病患通过多学合作的“社区糖尿病患保健活动”、“糖尿病咨询门诊”进行健康教育,并选４１例社区糖尿病患作为对照组进行观察。结果教育组教育后的空腹血糖、糖化血红蛋白、糖尿病知识掌握水平３项指标与教育与教育前对照组的比较均有显差异（Ｐ〈０．００１）;对照组观察前后３项指标变化均无显差异（Ｐ〉０．０５）。结论这种以糖尿病知识教育为     

糖尿病社区护理干预效果的综合评估

对８２例Ⅱ型糖尿病患者实施两个月的社区护理干预，帮助患者提高自我保健能力，增加社会支持。效果评估：患者除血糖降低外，生活质量提高，疾病对社会活动的影响减少，抑郁和焦虑减轻，住院天数缩短，用药量减少，社会经济效益增加     

Comparative efficacy of social media delivered health education on glycemic control: A meta-analysis

ObjectiveTo compare outcomes associated with patient education about glycemic control via group chat versus patient education as usual among individuals with diabetes in China.MethodsWe searched the following databases both in English and in Chinese languages: PubMed, CNKI, Wanfang database, VIP database, and CBM for articles published up to Jan 1, 2018. The studies were screened by two independent reviewers. Using criteria from the risk of bias assessment tool developed by Cochrane Collaboration to assess the risk of bias of eligible studies. A meta-analysis of studies was performed using comprehensive meta-analysis version 3.0.ResultsTwenty-five unique randomized clinical trials, including 2,838 patients, were identified. The education delivered via group chat had large overall pooled effect sizes in improving glucose control measured by hemoglobin A1c [Hedges’ g = −0.81, 95% CI: (−0.98, −0.64)], fasting blood glucose [Hedges’ g = −1.11, 95% CI: (−1.37, −0.85)], and 2 h postprandial blood glucose [Hedges’ g = −0.98, 95% CI: (−1.20, −0.76)]. Additionally, patient education delivered via group chat has shown consistently superior outcomes in glucose control in short-term (0–3 months), mid-term (3–6 months) and longer-term (6–12 months).ConclusionsEducational interventions via group chat had a superior outcome in blood glucose control compared to education as usual in China. Educational interventions via group chat had superior short-term, mid-term, and longer-term outcomes in blood glucose control compared to education as usual in China.     

多学科医疗照护行为对精神分裂症患者康复的影响

目的探讨多学科医疗照护行为改善精神分裂症患者的社会功能和生活质量的效果。方法将212例临床痊愈出院的首发精神分裂症患者随机分为研究组和对照组各106例,出院后两组患者均给予抗精神药物维持治疗,研究组在此基础上,延续医院治疗护理,实施多学科医疗照护行为,由医院抽调专业人员定期深入家庭进行康复指导,纠正错误,调整康复训练方法,时间为1年。干预前后,采用简明精神病评定量表（BPRS）、社会功能缺陷筛查量表（SDSS）、生活质量评定表（WHO—QOL）进行效果评估。结果干预前两组各项评分差异无统计学意义（P〉0．05）;干预后研究组BPRS（24．89±6．77）分、SDSS（8．13±3．12）分,均低于对照组（29．79±7．68）分、（16．46±4．22）分,差异有统计学意义（t=3．06,9．10;P〈0．01）;WHO-QOL研究组（5．95±2．19）分高于对照组（3．54±1．62）分,差异有统计学意义（t=9．27,P〈0．01）。结论多学科医疗照护行为能够有效地延续医院治疗护理,对于维持精神分裂症患者的病情,改善社会功能以及提高其生活质量均具有积极的作用。     

Influence of organizational context on nursing home staff burnout: A cross-sectional survey of care aides in Western Canada

PurposeOur study examined care aide characteristics, organizational context, and frequency of dementia-related resident responsive behaviours associated with burnout. Burnout is the experience of emotional exhaustion, cynicism, and professional inefficacy. Care aide burnout has implications for turnover, staff health, and quality of care.Design and methodsWe used surveys collected from 1194 care aides from 30 urban nursing homes in three Western Canadian provinces. We used a mixed-effects regression analysis to assess care aide characteristics, dementia-related responsive behaviours, unit and facility characteristics, and organizational context predictors of care aide burnout. We measured burnout using the Maslach Burnout Inventory, Short Form.ResultsWe found that care aides were at high risk for emotional exhaustion and cynicism, but report high professional efficacy. Statistically significant predictors of emotional exhaustion included English as a second language, medium facility size, organizational slack-staff, organizational slack-space, health (mental and physical) and dementia-related responsive behaviours. Statistically significant predictors of cynicism were care aide age, English as a second language, unit culture, evaluation (feedback of data), formal interactions, health (mental and physical) and dementia-related responsive behaviours. Statistically significant predictors of professional efficacy were unit culture and structural resources. Greater care aide job satisfaction was significantly associated with increased professional efficacy.ImplicationsThis study suggests that individual care aide and organization features are both predictive of care aide burnout. Unlike care aide or structural characteristics of the facility elements of the organizational context are potentially modifiable, and therefore amenable to intervention.