Preference for patient-centered communication among the citizens of the Visegrad countries

ObjectivesThe aim of the study was to investigate and compare the preferences that citizens of four Visegrad countries hold concerning the communication between patient and provider.MethodsThe patient-practitioner orientation scale was used on a general population in our research, which consists of the Sharing and Caring subscales and assesses patient-centered or doctor-centered orientation toward communication. The statistical analysis included 4000 respondents of citizens from the Czech Republic, Slovakia, Poland and Hungary. When comparing the various demographic data and the four countries with each other univariate and multivariate logistic regressions were performed.ResultsBeing female, middle aged, having a higher education and a poor health status were associated with significantly higher Sharing and Caring scores. Also, Hungarian citizens had a significantly higher Caring score compared to the other three countries.ConclusionsKey demographic variables were identified that affect how citizens perceive the communication between patient and provider. With the exception of Caring among Hungarian citizens, no differences were observed among the Visegrad countries.Practice implicationsThese findings have potential implications for understanding the preferences of the citizens and thus better promote a more patient-centered communication.     

Evaluation of nasal obstruction in lowlander males in high altitude

Background

Nasal symptoms are a major problem affecting the quality of life of lowlanders deployed at high altitude. Study was carried out in fresh male inductees inducted in high altitude of 11,500 ft (3500 m) above sea level to evaluate the nasal obstruction using the subjective Nasal obstruction and symptom evaluation (NOSE) score and rhinomanometry during the stay in high altitude.

PTEN基因多态性与抑郁症风险的相关性研究

正抑郁症患者的临床特征主要包括持续缓慢的思维、抑郁情绪以及认知障碍,对日常生活活动的兴趣下降~([1])。抑郁症的发病机制复杂,与多种因素有关,如年龄、性别、婚姻状况、种族、教育、环境和遗传因素等,其中遗传因素是目前研究者们关注的热点之一。PTEN基因(gene of phosphate and tension homology deleted on chrom-some ten,PTEN)是一种肿瘤抑制     

What is the factor that most influences QOL among rheumatoid arthritis patients?

We attempted to elucidate the factors which affect the quality of life (QOL) among patients with rheumatoid arthritis (RA). Ninety-five patients who satisfied the American Rheumatism Association criteria for RA were asked to fill in a modified arthritis impact measurement scale, version 2 (AIMS2) and complete a Lorish's face scale (FS) test. The same questionnaire and FS test were completed by 75 healthy persons as controls. We used Lorish's FS for our assessment of QOL. The investigation was undertaken to analyze the relationship between FS and each item on the questionnaire. For average FS score, there was no significant difference between the RA group and the controls. However, RA group scores covered a wider range than those of the controls. From the correlation analysis, physical stress, pain factors, and some of the activities of daily living (ADL) factors showed a strong correlation with FS. ADL factors which strongly correlated with FS were those related to activities of the lower limbs. Other ADL factors were moderately correlated with FS. Socioeconomic factors were not significantly correlated with FS. There was no significant difference between the QOL of RA patients and that of healthy controls. The QOL was correlated with pain and stress factors rather than with ADL factors among patients with RA. Received: June 9, 2000 / Accepted: October 23, 2000     

老年住院患者衰弱综合征现状及影响因素

 目的  老年住院患者衰弱综合征现状, 探讨其影响因素。方法  采用方便抽样法选取上海市某三甲医院外科、内科、老年科老年住院患者279例, 采用一般资料调查表、衰弱问卷式评分表(Frail scale)、基础疾病调查表研究衰弱的发生情况, 分析临床资料与衰弱程度的关系。结果  65岁以上住院老年人群衰弱前期的发生率为41.2%, 衰弱发生率为34.4%; 衰弱前期与衰弱期的高发年龄分别为65～70岁(27.0%)和86～90岁(34.4%)。衰弱程度与年龄、文化程度、家庭人均月收入、握力的比较差异具有统计学意义(P<0.01)。有序Logistic回归分析显示, 关节炎、脑卒中、慢性肺疾病与衰弱程度比较的结果具有统计学意义(P<0.05), 关节炎、脑卒中、慢性肺疾病患者的衰弱发生率通常是无关节炎、脑卒中、慢性肺疾病患者的6. 9、6. 0、2. 7倍。结论  老年住院患者衰弱综合征受多种因素影响, 与多种不良结局相关, 可作为医护人员提高老年护理质量的参考依据。     

Risk of bacterial infection associated with allogeneic blood transfusion among patients undergoing hip fracture repair

BACKGROUND: The relationship between allogeneic blood transfusion and bacterial infection remains uncertain. An increased risk of bacterial infection would represent the most important risk of allogeneic transfusion, because viral disease transmission has become so rare. STUDY DESIGN AND METHODS: A retrospective cohort study of 9598 consecutive hip fracture patients at least 60 years old who underwent surgical repair was performed. The primary outcome was serious bacterial infection, defined as bacteremia, pneumonia, deep wound infection, or septic arthritis or osteomyelitis. Secondary outcomes included two individual infections, pneumonia and urinary tract infection (UTI), and the cost of infection. Hospital cost of infection was assessed by linking the study population to Medicare data. RESULTS: Fifty-eight percent of patients received at least one transfusion. Serious bacterial infection occurred in 437 patients (4.6%); 28.8 percent of this group died during the hospital stay. Pneumonia occurred in 361 patients (3.8%) and UTI occurred in 1157 patients (12.1%). The adjusted risk of serious bacterial infection associated with transfusion was 1.35 (95% CI, 1.10-1.66). The adjusted risk for pneumonia was 1.52 (95% CI, 1.21-1.91), and that for UTI was 1.03 (95% CI, 0.91-1.17). A dose-response relationship was present for serious bacterial infection (p = 0.001) and pneumonia (p = 0.001). The cost of hospitalization was $14,000 greater for patients with serious infection than for patients without infection. CONCLUSION: Blood transfusion is associated with a 35-percent greater risk of serious bacterial infection and a 52-percent greater risk of pneumonia. Postoperative infections are costly. The risk of bacterial infection may be the most common life-threatening adverse effect of allogeneic blood transfusion.     

延续性护理对昏迷患儿严重程度的影响研究

目的探讨延续性护理在脑电双频指数联合振幅整合脑电图判断患儿昏迷程度中的护理效果。方法选择2012年5月~2016年10月入院治疗的昏迷患儿140例,根据护理方法不同分为对照组70例和观察组70例。患儿均采用脑电双频指数联合振幅整合脑电图评估昏迷程度。对照组采用常规方法护理,观察组采用延续性护理,比较两组护理效果及对预后的影响。结果观察组护理后BIS及GCS评分,高于对照组(P0.05);两组护理前a EEG连续性、睡眠觉醒周期及下边缘振幅值评分比较,差异无统计学意义(P0.05);观察组护理后a EEG连续性、睡眠觉醒周期及下边缘振幅值评分,高于对照组(P0.05);观察组护理后康复率,高于对照组(P0.05);观察组护理后残疾、植物人及死亡率,低于对照组(P0.05)。结论采用脑电双频指数联合振幅整合脑电图能准确的评估患儿昏迷程度,评估时加强患儿延续性护理有助于提高护理质量,改善患儿预后,值得推广应用。     

Perceived pain during rapid maxillary expansion in children with different expanders:: A prospective study

ObjectivesTo evaluate and compare the intensity of pain caused by rapid maxillary expansion (RME) with two expanders: Hyrax and Haas type, in growing patients.Materials and MethodsThirty-nine patients (23 girls and 16 boys) with an average age of 9.3 years (SD = 1.39 years) were randomized into two groups and treated with Hyrax- and Haas-type expanders. In both groups, initial activation of the expander screw was one full turn on the first day followed by 2/4 of a turn two times a day (morning and night) for 7 days. Inclusion criteria were patients presenting with a posterior crossbite or maxillary atresia between 7 and 12 years old. To evaluate the intensity of pain during the active phase of the treatment, a combination of the Numerical Rating Scale and Wong-Baker Faces Pain Scale was used. Mann-Whitney test was used to compare the two treatment groups.ResultsThere was significant inverse correlation between days following insertion and pain. During the expansion period, 100% of the children reported some pain. Hyrax expander subjects reported greater pain than those treated with the Haas-type expander only on the first day. The level of pain remained greater in girls throughout treatment.ConclusionsPain was reported regardless of the type of expander and was higher in the Hyrax group only on the first day of activation.     

脑卒中后失能综合评估量表的汉化与信效度检验

目的 对脑卒中后失能综合评估量表进行汉化及信效度检验,探索该量表在国内的临床适用性。方法 采用Brislin双人直译-回译法、专家评议、预调查对量表进行文化调适,便利抽取203名脑卒中患者进行调查,对中文版量表进行项目分析,并验证其重测信度、评定者间信度、内容效度、效标关联效度。结果 脑卒中后失能综合评估量表重测信度相关性分析结果显示相关系数为0.988;评定者间信度Kappa系数为0.846（95%置信区间为0.793~0.899）,P<0.001;各条目内容效度指数均在0.833~1.000之间,量表内容效度指数为0.935;以改良Rankin量表为标准,效标关联效度系数为0.896。结论 中文版脑卒中后失能综合评估量表具有良好的信效度,可作为我国临床脑卒中失能评估工具。     

Clinical learning environment,supervision and nurse teacher (CLES+T) scale: Translation and validation of the Arabic version

AimThis study aimed to translate the Clinical Learning Environment, Supervision and Nurse Teacher (CLES + T) scale into Arabic and to evaluate its psychometric properties in the context of Morocco.BackgroundThe CLES + T scale is internationally valid and reliable instrument used to evaluate the quality of the clinical learning environment for students in the health professions.DesignTranscultural validation studyMethodsThe present study was carried out between March and May 2019 at two public nursing education institutions in Morocco. The sample included 1550 undergraduate students enrolled in the first, second and third year of nursing, midwifery and health-techniques degree program and who have just completed a course of clinical practicum in hospital ward or primary healthcare settings. The CLES + T scale was translated into Arabic and back-translated. Internal consistency reliability and construct validity using exploratory and confirmatory factor analysis were conducted.ResultsThe CLES+T scale showed alpha coefficients ranging from 0.71 to 0.92 and the five factors identified explained 55% of the variance, with “Role of nurse teacher” and “Supervisory relationship” as the two main factors explaining 41% of the variance. Confirmatory factor analysis approved the factor structure of the Arabic version of the instrument.ConclusionThe Arabic version of CLES+T displayed suitable psychometric properties for using it in evaluating the quality of clinical learning environment of nursing students in Morocco and likely in other Arabic speaking countries.