韩新民教授治疗小儿外感咳嗽经验

韩新民教授认为,肺属娇脏,小儿肺常不足,又易为六淫之邪所侵,故临床以外感咳嗽多见。因发病原因及年龄、体质等因素的不同,其临床证候各异。临床上对外感咳嗽提出早期以宣肺散邪为先;中期以清热化痰为主;过敏咳嗽重在抗敏肃肺。     

在校本科生实践经验获取途径的探索

高校毕业生就业难,与其“动手能力不强、缺乏实践经验”有一定关系。结合大学生的专业方向,就学生在校期间获取实践经验的途径进行了探索,指出遴选大二、大三学生参与科研活动是使在校大学本科生获取实践经验、培养创新能力投入少而又行之有效的途径,对缓解大学生“就业难”问题有所帮助。     

102例闭合性肝脾破裂保守治疗的护理体会

目的回顾性分析102例接受保守治疗闭合性肝脾破裂患者的临床资料,总结闭合性肝脾破裂保守治疗的护理体会。方法严格选择具适应证的患者,严密观察患者生命体征、腹部变化、输液量及速度、出入液量、药物的使用情况及效果,同时配合精心的生活护理。结果102例肝脾破裂患者经保守治疗,腹腔积血全吸收,73例肝脾损伤完全恢复,29例肝脾损伤基本恢复,残留少许直径2～3cm左右低密度区或机化灶,随访分别于1～3个月基本消失。结论保守治疗肝脾破裂是安全有效的,对于条件适合的患者可作为首选治疗方案在临床应用。     

谈谈如何办好中医皮肤性病学教育的六点体会

中医皮肤性病学是古代哲学、自然科学和临床经验融合一体的经验科学,笔者根据当前的教学现状和临床中医皮肤性病学的教学经历,谈六点体会:(1)融合多元教学方法,提高学生的综合素质;(2)改进教学手段,提高教学效果;(3)改进教学技巧、提高学生自主学习的能力;(4)强调中医皮肤性病学与临床学科的相关性;(5)开展网络教学,增加第二课堂;(6)抓好临床实习阶段的教学,培养新时代的人才。作为中医皮肤性病学的教育工作者,深感工作任重而道远,只有不断探索、改革,适应当前形势的变化,不断努力进取,向同仁学习,才有可能找到一条适合皮肤性病学教学特点的教学之路,为培养新时代的人才做出贡献。     

Comparison of Patients' Expectations and Experiences at Traditional Pharmacies and Pharmacies Offering Enhanced Advanced Pharmacy Practice Experiences

Objectives

To compare patients'' expectations and experiences at pharmacies offering traditional APPE learning opportunities with those offering enhanced APPEs that incorporate pharmaceutical care activities.

Methods

A survey of anchored measures of patient satisfaction was conducted in 2 groups of APPE- affiliated community pharmacies: those participating in an enhanced APPE model versus those participating in the traditional model. The enhanced intervention included preceptor training, a comprehensive student orientation, and an extended experience at a single pharmacy rather than the traditional 2 x 4-week experience at different pharmacies.

Results

While patient expectations were similar in both traditional and enhanced APPE pharmacies, patients in enhanced pharmacies reported significantly higher in-store satisfaction and fewer service gaps. Additionally, satisfaction was significantly higher for patients who had received any form of consultation, from either pharmacist or students, than those reporting no consultations.

Conclusion

Including provision of pharmaceutical care services as part of APPEs resulted in direct and measurable improvements in patient satisfaction.     

Mothers' experiences of having their newborn child in a neonatal intensive care unit

BACKGROUND: From birth the child has an ability to respond to the environment, which influences the interaction between mother and child. If this attachment is interrupted, the child's emotional development is negatively influenced. When the child needs care in a neonatal intensive care unit (NICU) it is difficult to establish contacts between mother and child. Separation from the child is found to be the most difficult aspect for mothers when their newborn child is hospitalized in a NICU. AIM: The aim of this study was to describe mothers' experiences when their full-term newborn child was cared for in a NICU during the postpartum maternity care period. METHOD: A phenomenological hermeneutic interview study was performed. Ten mothers were interviewed once, 6 months to 6 years after the experience. RESULTS: The essence of the experience is understood as an alternation between two opposite concepts, exclusion and participation, with emphasis on exclusion. A feeling of exclusion dominates when the new mother feels a lack of interaction and a sense of not belonging to either the maternity care unit or the NICU. This has a negative effect on her maternal feelings. On the contrary, when a feeling of participation dominates, a continuous dialogue exists and the mother is cared for as a unique person with unique needs. This supports her maternal feelings in a positive direction. The implication of the result for nurses is that it is important to decrease mothers' experience of exclusion and to increase their feeling of participation when their child is cared for in a NICU. A return visit to the responsible nurse to go through the treatment and experiences should be offered to all parents whose child has been cared for in a NICU.     

The experience of caring for someone over 75 years of age: results from a Scottish General Practice population

Aims and objectives. To understand the unpaid carers’ experiences of looking after someone aged over 75 at all stages of their caring career. Background. The role of, and support for, unpaid carers have become central in the debates surrounding community care in the UK. This paper presents the findings of a study to elicit the complexities of the caring role and inform the Primary Health Care Team to help support carers more effectively. Designs and methods. A quantitative research design was employed. Carers of people over 75 years of age in a General Practice, who had been previously identified from a screening questionnaire, were sent the Carers Assessment of Difficulties Index, the Carers Assessment of Satisfactions Index and Carers Assessment of Managing Index questionnaires which examine the experience of caring. Results. From a sample of 247 carers, a 70% response rate (n = 172) was achieved. Satisfactions lay in the quality of care provided; difficulties reflected the potential and actual family tensions generated; coping strategies included reframing difficulties, using humour and practical problem solving. The data show that caregivers’ reactions, such as feeling angry about the situation, or the consequences of their involvement, such as tensions within the family, cause them more difficulties than the actual care‐giving tasks they perform. Conclusion. This study adds to the understanding of carers’ roles by including carers across a range of situations, including those at an early stage of their caring career. Service providers are better able to support carers if they understand the complex interplay of difficulties, rewards and personal coping strategies associated with the caring role. Relevance to practice. The study helps illuminate the less obvious, but important, emotional aspects of carers’ difficulties and suggests strategies which service providers may find helpful in assessing carers’ needs and determining the appropriate interventions.     

It's like being in another world--patients' lived experience of magnetic resonance imaging

Aim. The aim of this study was to illuminate patients’ lived experience during magnetic resonance imaging. Background. Magnetic resonance imaging has increased in importance since the early 1980s and is today a common useful diagnostic tool. Although magnetic resonance imaging are non‐invasive and considered painless, many patients experience anxiety, sometimes so strong that the scan has to be terminated. Design and methods. The study had an inductive design and a hermeneutic phenomenological methodology was used. Results. The essential theme of going through magnetic resonance imaging was a feeling of being in another world. The strange environment and isolation inside the scanner made the participants’ experiences unusual, with varying degrees of difficulty dealing with it. Being in the other world caused a threat to the participants’ self‐control. There was a relation between threat to self‐control, effort and need for support in the sense that the magnitude of threat to self‐control had an impact on the effort it took to handle the situation and on the need for support, and conversely that the support received could affect the effort and threat to self‐control. Conclusions. The study shows that the information received and the interaction between patients and staff have a significant influence on patients’ lived experiences. Relevance to clinical practice. The individual experience of threat to self‐control requires the need for support to be individualized and care need to be adjusted for each patient.