首页 | 本学科首页   官方微博 | 高级检索  
文章检索
  按 检索   检索词:      
出版年份:   被引次数:   他引次数: 提示:输入*表示无穷大
  收费全文   1069篇
  免费   53篇
  国内免费   5篇
儿科学   6篇
妇产科学   4篇
基础医学   189篇
临床医学   372篇
内科学   143篇
皮肤病学   9篇
神经病学   31篇
特种医学   1篇
外科学   34篇
综合类   131篇
预防医学   137篇
药学   60篇
  1篇
中国医学   3篇
肿瘤学   6篇
  2023年   20篇
  2022年   100篇
  2021年   94篇
  2020年   106篇
  2019年   79篇
  2018年   59篇
  2017年   54篇
  2016年   44篇
  2015年   34篇
  2014年   101篇
  2013年   79篇
  2012年   73篇
  2011年   78篇
  2010年   52篇
  2009年   48篇
  2008年   31篇
  2007年   25篇
  2006年   7篇
  2005年   14篇
  2004年   8篇
  2003年   4篇
  2002年   2篇
  2000年   4篇
  1999年   2篇
  1998年   4篇
  1997年   1篇
  1996年   1篇
  1993年   2篇
  1990年   1篇
排序方式: 共有1127条查询结果,搜索用时 15 毫秒
21.
《中国现代医生》2019,57(26):153-157
目的改善精神分裂症患者的自我管理能力,提高精神分裂症的康复效果。方法随机将我院精神分裂症患者分为观察组和对照组。对照组住院期间进行药物维持治疗、心理支持、健康教育、病情观察的干预,出院后实施以健康教育为主导的QQ、微信、电话的互联网+模式和家庭随访的院外康复护理。观察组住院期间在对照组干预方法基础上,加以自我决定理论为指导的自我管理理念教育和实践训练,出院后实施微信咨询和家庭随访。用PANSS、PSP、SSMIS测评分析两组干预前后的康复效果。结果精神症状:干预末,两组PANSS的总分及各因子分值均下降,两组间比较差异有统计学意义(t=2.99、3.93、2.17、3.16,P均0.05);社会功能:干预末,两组PSP分值均升高,但观察组比对照组升高快,两组间比较,差异有统计学意义(t=5.71,P0.05)。自我管理:干预末,两组SSMIS分值均升高,但观察组比对照组升高快,两组间比较,差异有统计学意义(t=4.65,P0.05)。结论自我决定理论能让患者了解并接受自我管理是改善精神分裂症疾病的需要,是改善患者社会功能的需求,在这种认知的基础上,能够促使患者自觉接受自我管理理念教育和实践训练。研究结果证明基于自我决定理论下的自我管理能够帮助患者改善精神分裂症自我管理能力,促进康复。  相似文献   
22.
ObjectiveSelf-management is a core theme within chronic care and several evidence-based interventions (EBIs) exist to promote self-management ability. However, these interventions cannot be adapted in a mere copy-paste manner. The current study describes and demonstrates a planned approach in adapting EBI’s in order to promote self-management in community-dwelling people with chronic conditions.MethodsWe used Intervention Mapping (IM) to increase the intervention’s fit with a new context. IM helps researchers to take decisions about whether and what to adapt, while maintaining the working ingredients of existing EBI’s.ResultsWe present a case study in which we used IM to adapt EBI’s to the Flemish primary care context to promote self-management in people with one or more chronic disease. We present the reader with a contextual analysis, intervention aims, and content, sequence and scope of the resulting intervention.ConclusionIM provides an excellent framework in providing detailed guidance on intervention adaption to a new context, while preserving the essential working ingredients of EBI’s.Practice ImplicationsThe case study is exemplary for public health researchers and practitioners as a planned approach to seek and find EBI’s, and to make adaptations.  相似文献   
23.
ObjectivesTo explore which dimensions of the person-centered approach (PCA) are adopted in self-management interventions, how they are applied, and its outcomes.MethodsA review team carried out a scoping review using the methodology of Arksey and O’Malley on diabetes mellitus type 2, person-centered care, and self-management.ResultsOf the 364 titles identified, 22 articles were included in this review. No study contained all five dimensions described by the person-centered framework. Some dimensions seemed difficult to assess, mainly having a sympathetic presence and engagement. The application of the five PCA dimensions are presented. Although the authors claimed their intervention to be person-centered, none used a specific tool to measure person-centered care in a holistic way.ConclusionAlthough the guidelines recommend a PCA to professionals, there is a gap with practice, professionals having difficulty adopting and measuring this approach.Practice implicationsSome strategies to facilitate the adoption of a PCA with people living with type 2 diabetes are proposed. These can help researchers and clinicians develop a PCA, by identifying the care delivery processes necessary to provide it. It seems important for researchers to measure whether their intervention is truly person-centered, using holistic tools and combining different methods (observation, questionnaire, interview).  相似文献   
24.
ObjectiveTo explore the views of primary care teams about the provision of self-management support to patients with common health problems.MethodsSemi-structured interviews were conducted with twenty-one members of the primary care team from thirteen general practices. Interviews were transcribed verbatim, and analysed using the ‘Framework’ approach.ResultsThree categories and six sub-categories illustrating different self-management support activities across common health problems were identified from the analysis of interviews, and contributed to one major theme and one cross-cutting theme. Referral and signposting were frequently used to facilitate patient engagement with external services and resources. Practitioners faced some challenges in balancing medical management and psychosocial support and motivating patients to engage with self-management.ConclusionsPrimary care teams described providing a wide range of self-management support activities, but the pattern of use varied for different types of health problem. These patterns may have been influenced, in part, by general practices focusing upon achieving financially incentivised quality improvement goals.Practice implicationsTo improve self-management support, practitioners need a digital repository of services/resources, motivational interviewing skills, an understanding of the optimum duration and pattern of consultations, and incentivised targets that match a biopsychosocial model of care.  相似文献   
25.
目的探讨机械心脏瓣膜术后患者行为的自我管理。方法将168例机械心脏瓣膜术后患者随机分为干预组86例和对照组82例。干预组患者在常规药物治疗的同时给予有针对性的自我管理教育,而对照组患者在常规药物治疗的同时则行常规健康教育,分别于治疗护理1年后采用“自我管理行为量表”对两组患者进行测定,评估两组患者的自我管理行为,并应用中文版SF-36量表对两组患者进行评价,比较两组患者的生活质量(QOL)。结果治疗护理1年后,干预组患者的自我管理行为量表及SF-36量表的各项评分均明显高于对照组,两组比较差异均有统计学意义(P〈0.01)。结论自我管理教育可帮助患者建立良好的健康行为模式,能提高患者自我管理疾病的能力,减少并发症的发生,从而促进康复,达到提高机械心脏瓣膜术后患者生活质量的目的。  相似文献   
26.
BackgroundSelf-management may be a lifelong task for patients with chronic back pain. Research suggests that chronic pain self-management programmes have beneficial effects on patients’ health outcome. Contemporary pain management theories and models also suggest that a good patient–professional partnership enhances patients’ ability to self-manage their condition.Objectives(1) To investigate whether there is a reciprocal relationship between self-management of chronic back pain and health-related quality of life (HRQoL); (2) to examine the impact of a good patient–professional partnership on HRQoL, either directly, or indirectly via change in the ability to self-manage pain.Design and settingThis quasi-experimental study was designed to take place during routine service appointments and conducted in a community-based pain management service in the United Kingdom. A patient–professional partnership was established in which patients were actively involved in setting up goals and developing individualised care plans. Through this, health professionals undertook patients’ health needs assessment, collaborated with patients to identify specific problems, provided written materials and delivered individualised exercise based on patients’ life situation. Patients were recruited following initial consultation and followed up three months later.ParticipantsA total of 147 patients (65% female) with a mean age of 48 years (standard deviation (SD): 14 years) were enrolled in the study. Of these, 103 subjects completed the study. Patients were included if they were aged 18 and over, suffered from chronic back pain, had opted in to the clinic and had sufficient ability to read and understand English. Patients were excluded if they opted out this service after the initial assessment, suffered from malignant pain or required acute medical interventions for their pain relief.MethodsSelf-reported measures of HRQoL, patient–professional partnerships and self-management ability were collected at baseline and three months later. Pathways proposed were depicted using structural equation modelling.ResultsThere was no association between patients’ self-management ability and HRQoL at baseline. However, a positive direct effect was detected at three months (−0.38, p < 0.01). A patient–professional partnership was not found to be beneficial for patients’ HRQoL through a direct pathway, but via an indirect pathway where self-management was a mediator (−19.09, p < 0.01).ConclusionsThis study suggests that the increase in patients’ self-management ability may lead to improvement in HRQoL after pain management support provided in a partnership with health professionals. A good patient–professional partnership appears to be beneficial as an augmentation to self-management practice for patients with chronic back pain.  相似文献   
27.

Background

Mild acquired cognitive impairment (MACI) is a new term used to describe a subgroup of patients with mild cognitive impairment (MCI) who are expected to reach a stable cognitive level over time. This patient group is generally young and have acquired MCI from a head injury or mild stroke. Although the past decade has seen a large amount of research on how to use information and communication technology (ICT) to support self-management of patients with chronic diseases, MACI has not received much attention. Therefore, there is a lack of information about what tools have been created and evaluated that are suitable for self-management of MACI patients, and a lack of clear direction on how best to proceed with ICT tools to support self-management of MACI patients.

Objective

This paper aims to provide direction for further research and development of tools that can support health care professionals in assisting MACI patients with self-management. An overview of studies reporting on the design and/or evaluation of ICT tools for assisting MACI patients in self-management is presented. We also analyze the evidence of benefit provided by these tools, and how their functionality matches MACI patients’ needs to determine areas of interest for further research and development.

Methods

A review of the existing literature about available assistive ICT tools for MACI patients was conducted using 8 different medical, scientific, engineering, and physiotherapy library databases. The functionality of tools was analyzed using an analytical framework based on the International Classification of Functioning, Disability and Health (ICF) and a subset of common and important problems for patients with MACI created by MACI experts in Sweden.

Results

A total of 55 search phrases applied in the 8 databases returned 5969 articles. After review, 7 articles met the inclusion criteria. Most articles reported case reports and exploratory research. Out of the 7 articles, 4 (57%) studies had less than 10 participants, 5 (71%) technologies were memory aids, and 6 studies were mobile technologies. All 7 studies fit the profile for patients with MACI as described by our analytical framework. However, several areas in the framework important for meeting patient needs were not covered by the functionality in any of the ICT tools.

Conclusions

This study shows a lack of ICT tools developed and evaluated for supporting self-management of MACI patients. Our analytical framework was a valuable tool for providing an overview of how the functionality of these tools matched patient needs. There are a number of important areas for MACI patients that are not covered by the functionality of existing tools, such as support for interpersonal interactions and relationships. Further research on ICT tools to support self-management for patients with MACI is needed.  相似文献   
28.
ObjectiveThe Self-Management of Well-being (SMW) group intervention for older women was implemented in health and social care. Our aim was to assess whether effects of the SMW intervention were comparable with the original randomized controlled trial (RCT). Furthermore, we investigated threats to effectiveness, such as participant adherence, group reached, and program fidelity.MethodsIn the implementation study (IMP) 287 and RCT 142 women participated. We compared scores on self-management ability and well-being of the IMP and RCT. For adherence, drop-out rates and session attendance were compared. Regarding reach, we compared participants’ baseline characteristics. Professionals completed questions regarding program fidelity.ResultsNo significant differences were found on effect outcomes and adherence between IMP and RCT (all p  0.135). Intervention effect sizes were equal (0.47–0.59). IMP participants were significantly less lonely and more likely to be married, but had lower well-being. Most professionals followed the protocol, with only minimal deviations.ConclusionThe effectiveness of the SMW group intervention was reproduced after implementation, with similar participant adherence, minimal changes in the group reached, and high program fidelity.Practice implicationsThe SMW group intervention can be transferred to health and social care without loss of effectiveness. Implementation at a larger scale is warranted.  相似文献   
29.
BackgroundSelf-management approaches are widely used to improve chronic care. In this context, health care professionals call for efficient tools to engage patients in managing their illness. Mobile health (mHealth), defined by WHO as medical and public health practice supported by mobile devices, is demonstrated to enhance self-management and health-coaching as an engaging tool in supporting behaviour change. Nevertheless, it is unclear how health-coaching and mHealth can benefit from each other.ObjectiveWe conducted a scoping review to provide a literature-overview and identify any existing gaps in knowledge of mHealth in combination with health-coaching interventions for improving self-management in patients with chronic diseases.Patient involvementNo patients were involved in the review process.MethodsThe five-stage framework by Arksey and O'Malley was used. The review surveys; PubMed, CINAHL, Embase, Scopus, and PsycInfo. Two independent reviewers performed review selection and characterization.ResultsThe review points at two approaches; (i) coaching used to support mHealth and (ii) mHealth as support for coaching. The findings suggest that patients prefer physical interactions to telecommunication. mHealth was primarily used to facilitate telecommunication and to monitor disease aspects.DiscussionWe found that mHealth and health-coaching interventions benefit from each other. The review report on a considerable unclarity in the coaching-methods and that the patients were more satisfied with physical interactions than mHealth. We suggest to prioritize human contact and to explore more personalized health technology.Practical valueThis scoping review can provide a framework for researchers and care providers to support discussion and introduction of new approaches and technology in self-management for patients with chronic diseases, thereby improving patients’ quality of life.  相似文献   
30.

Objective

About 800 of the 13,000 members of the German Tinnitus Association (DTL) are active in self-help groups (SHGs). This study analyzes whether SHG-participation is associated with tinnitus-related Health Literacy (HLit) and Quality of Life (QoL).

Methods

In a cross-sectional study 1108 tinnitus patients in- and outside of SHGs administered a questionnaire containing tinnitus-related burden, QoL, tinnitus knowledge, self-management, assessment of SHGs, and socio-demographics. Participants were divided into four subgroups: (1) active SHG-members (19.6%), (2) former SHG-members (10.6%), (3) DTL-members, but not in SHG (57.9%), (4) neither DTL- nor SHG-members (11.9%).

Results

Participant were 59.7% male and 61.3 years on average. SHG-attendees are on average 5 years older than non-attendees, and have a lower education, while there are no differences in gender-distribution. Regression analyses show significant associations between SHG-participation and tinnitus knowledge, coping and self-esteem. QoL, however, is not associated with SHG-participation. SHG-members report considerable further benefits from SHG-membership.

Conclusions

Despite the limitations through the cross-sectional design, it seems more likely that tinnitus-related HLit and other benefits are a result of SHG-participation than vice versa.

Practice implications

Health care providers should inform their patients about SHGs and encourage them to consider a SHG as a possible option for their self-management.  相似文献   
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