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81.
抓取“微医网”医患评论数据,对其中时滞与患者满意度进行关联分析,并对评论内容进行主题挖掘,提取不同时滞区间内患者重点关注的内容。通过对患者评论文本不同时滞区间内容的分析,寻找满意度提升策略,以缓解医患关系。使用K-means将患者反馈数据根据就诊后时长反馈分为“短期”和“长期”,通过LDA主题提取模型,对满意度划分后的患者评论文本挖掘不同时滞区间内患者所关注的重点内容,将其差异进行对比分析发现,患者就诊满意度随着时滞呈现趋高现象,不同时滞文本显示患者评论维度大致相同,但随着时滞区间的转移,患者所关注的就诊体验内容也有所变化。 相似文献
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83.
Hong-Sheng Zhang Qian Liu Chun-Mei Piao Yan Zhu Qiang-Qiang Li Jie Du Hong Gu 《The Canadian journal of cardiology》2019,35(12):1851-1856
BackgroundThe relationship between clinical outcomes and gene mutations in Chinese pediatric patients with idiopathic and heritable pulmonary arterial hypertension (PAH) is unclear.MethodsWe retrospectively studied the clinical characteristics and outcomes of pediatric patients who visited Beijing Anzhen Hospital from September 2008 to December 2018.ResultsEighty-two pediatric patients were included. Forty-two gene mutations were identified in 41 patients (50%), including 25 mutations in BMPR2, 5 mutations in ACVRL1, 3 mutations each in ABCA3 and NOTCH3, 2 mutations each in KCNK3 and HTR2B, 1 mutation in ENG, and 1 mutation in EIF2AK4. The mean age at diagnosis of PAH was 86.4 ± 55.1 months. Forty-eight patients (twenty-eight mutation carriers) underwent cardiac catheterization examinations, with acute vasodilator testing performed simultaneously. Results showed that mutation carriers demonstrated a higher pulmonary vascular resistance index (P = 0.037). Patients with gene mutations responded poorly to vasodilators (P = 0.001). The 1-, 2-, and 3-year survival rates of mutation noncarriers were 95.1%, 87.8%, and 82.5% respectively; while for mutation carriers, the proportions were 86.6% (P = 0.216), 63.8% (P = 0.021), and 52.2% (P = 0.010), respectively. Cardiac index was an independent predictor of death (P = 0.005; odds ratio [OR] 2.16, 95% confidence interval [CI] 1.258-3.704), as well as RAP (P = 0.01; OR 1.26, 95% CI 1.056-1.503).ConclusionsIn our cohort of Chinese pediatric patients, those with an identified gene mutation demonstrated worse clinical outcomes. Therefore, early gene screening for pediatric patients with idiopathic and heritable PAH is recommended, and more aggressive treatment for mutation carriers may be advisable. 相似文献
84.
《Archives of physical medicine and rehabilitation》2019,100(11):2032-2038
ObjectiveTo explore attitudes and practices of physicians relating to accessible medical diagnostic equipment in serving patients with mobility disability.DesignOpen-ended individual telephone interviews, which reached data saturation. Interview recordings were transcribed verbatim for qualitative conventional content analysis.SettingMassachusetts, the United States, October 2017-January 2018.ParticipantsPracticing physicians from 5 clinical specialties (N=20).InterventionsNot applicable.Main Outcome MeasuresCommon themes concerning physical accessibility.ResultsMean ± SD time in practice was 27.5±12.5 years; 14 practices had height-adjustable examination tables; and 7 had wheelchair-accessible weight scales. The analysis identified 6 broad themes: height-adjustable examination tables have advantages; height-adjustable examination tables have drawbacks; transferring patients onto examination tables is challenging; rationale for examining patients in their wheelchairs; perceptions of wheelchair-accessible weight scales; and barriers and facilitators to improving physical accessibility. Major barriers identified by participants included costs of equipment, limited space, and inadequate payment for extra time required to care for persons with disability. Even physicians with accessible examination tables sometimes examined patients seated in their wheelchairs.ConclusionsEven if physicians have accessible equipment, they do not always use it in examining patients with disability. Future efforts will need to consider ways to eliminate these access barriers in clinical practice. Given small sample size, results are not generalizable to physicians nationwide and globally. 相似文献
85.
Purpose
The objectives of the study were to identify the incidence and pattern of dry eye after phacoemulsification and manual small incision cataract surgeries.Methods
The study consisted of two groups of patients - Group 1 underwent manual small incision cataract surgery (SICS) and Group 2 underwent phacoemulsification. The dry eye-related data was collected preoperatively and at 1?week, 1?month and 3?months postoperatively. Ocular Surface Disease Index questionnaire, tear break-up time (TBUT) and Schirmer test – 1 were used to record the type of dry eye.Results
One hundred eyes of 96 patients, including 35 (36.5%) men and 61 (63.5%) women with the mean age of 63.1 (±8.3) years were studied. Dry eyes were found in 42% eyes (p?<?0.001) of patients at 1?week follow-up. Fifteen percent and 9% of the eyes were dry at 1?month and 3?months after surgery, respectively. There were 34 (53.1%) and 8 (22.2%) dry eyes in SICS and phacoemulsification groups, respectively at one week postoperative follow-up which was a statistically significant difference.Majority of eyes (27/42, 64.3%) had mild dryness. There were significant differences in TBUT at 1?week, 1?month and 3?months postoperatively. At 1?week review, the SICS group had mean TUBT of 10.0 (±0.55) sec as compared to 13.9 (±0.70) sec in phacoemulsification group (p?<?0.001).Conclusion
Incidence of dry eye is higher in SICS than phacoemulsification due to tear film instability. The clinicians should be conscious about dry eye symptoms and signs in an otherwise healthy eye after cataract surgery. 相似文献86.
Sabine Fuchs Britta Olberg Matthias Perleth Reinhard Busse Dimitra Panteli 《Health policy (Amsterdam, Netherlands)》2019,123(2):173-181
Objective
Medical devices (MDs) encompass a broad and heterogeneous range of technologies. While practices vary considerably across countries, MDs often find application in patient care with little or no evaluation of their effectiveness and safety following market approval. A recently proposed taxonomy of MDs considered devices from the viewpoint of Health Technology Assessment (HTA). The aim of the work presented here was to test its plausibility and applicability by considering real-world HTA practices.Methods
HTA reports on MDs from European institutions were collected in a systematic manner and the evaluated devices and/or related procedures were matched to a position on the taxonomy. Following this, representatives from 16 European HTA institutions were asked about the usefulness of the taxonomy in semi-structured interviews.Results
1237 HTA reports (2004–2015) from 33 European institutions were included in the sample. The majority of reports was on technologies from the taxonomic positions initially estimated as having high relevance. Most of the experts interviewed stated that they found the taxonomy useful, particularly regarding its potential to aid in selecting technologies for assessment and to highlight potential methodological particularities per taxonomic position.Conclusions
Overall, the distribution of identified reports on the matrix confirmed that the initial estimation of the relevance and necessity of HTA provided in the taxonomic model is plausible. In addition, interviews with representatives of European HTA institutions showed that the taxonomy could be useful. 相似文献87.
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89.
《Journal of Medical Imaging and Radiation Sciences》2019,50(3):365-368
There is no shortage of discussion surrounding the importance of achieving a highly engaged workforce in health care institutions. Despite the abundance of idealisms surrounding the importance of providing patient-centered care, some medical radiation technologists may consider this to be a contradiction, when they themselves do not feel valued or empowered by their employer. In addition, overwhelming evidence points to the fact that high employee engagement is directly linked to positive patient experiences and outcomes. Logically, it then follows that much attention should be paid to fully engaging health care teams. Highly engaged medical radiation technologists are more likely to provide personalized patient-centered care. Health care leaders can help to engage their teams by using effective behavioral and leadership styles that will be received favourably by most staff. With the evolution of the generations occupying the workplace, managers must adapt and vary their leadership styles, if they hope to effectively engage their teams and provide world-class patient-centered care. 相似文献
90.
Sakti Chakrabarti Jaskanwal Sara Ronstan Lobo Rachel Eiring Heidi Finnes Jessica Mitchell Mindy Hartgers Akiko Okano Thorvardur Halfdanarson Axel Grothey 《Clinical colorectal cancer》2019,18(1):52-57