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中华护理学会精神卫生专业委员会 《中华护理杂志》2022,57(18):2181-2185
目的 形成《精神科住院抑郁症患者自杀预防及护理干预措施专家共识》,规范精神科住院抑郁症患者自杀护理干预措施。 方法 运用循证方法及文献分析法提取住院抑郁症患者自杀护理干预措施推荐建议和研究结论,形成共识初稿,通过2轮专家函询及2次专家论证会,结合专家意见,对初稿进行调整、修改和完善,形成共识终稿。 结果 2轮函询专家积极系数均为100%,专家权威系数均为0.924,各指标重要性赋值均数均>3.5分,且变异系数均<0.25,专家肯德尔和谐系数分别为0.182和0.260(均P<0.01)。最终对精神科住院抑郁症患者自杀护理干预操作性定义、自杀风险评估、干预形式、干预时间、干预理论基础、干预一般原则、自杀意念的干预措施、自杀行为的干预措施、特殊人群自杀护理干预要点、干预效果评价及出院后的健康教育计划共11个部分的内容达成一致意见。 结论 该共识为精神科住院抑郁症患者自杀护理干预措施提供指导依据,使精神科住院抑郁症患者的自杀护理干预更规范。 相似文献
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Tau Ming Liew 《Journal of the American Medical Directors Association》2019,20(8):1054.e11-1054.e20
ObjectivesEarly diagnosis of cognitive impairment is increasingly emphasized in the literature to facilitate timely preventive interventions. Although bedside cognitive tests such as the Montreal Cognitive Assessment (MoCA) are widely used for such early diagnostic purposes, they may not have comparable performance to a full neuropsychological battery (FNB) in diagnosing early cognitive impairment. This study investigated whether a small subset of neuropsychological tests can be added on to MoCA to match its performance to that of the FNB in discriminating mild cognitive impairment and dementia (MCI/dementia) from normal cognition.DesignCross-sectional diagnostic study.SettingAlzheimer's Disease Centers across the United States.ParticipantsOlder participants (≥50 years) who completed MoCA and the FNB (N = 9187).MeasuresThe study sample was split into two: the derivation sample (n = 1837) was used to develop a brief neuropsychological battery that best discriminated MCI/dementia (using the best-subset approach with 10-fold cross-validation); while the validation sample (n = 7350) verified its actual performance in discriminating MCI/dementia.ResultsA 3-item neuropsychological battery was identified, comprising MoCA, Benson Complex Figure Recall, and Craft Story 21 Delayed Recall. It had excellent performance in discriminating MCI/dementia from normal cognition (area under the receiver operating characteristic curve [AUROC] 90.0%, 95% confidence interval [CI] 89.2%-90.7%), which was comparable to that of the FNB (AUROC 88.4%, 95% CI 87.6%-89.2%). By contrast, MoCA alone had significantly worse AUROC (86.9%, 95% CI 86.0%-87.7%) than that of the FNB.Conclusions/ImplicationsUsing rigorous methods, this study developed a brief neuropsychological battery that maintained the brevity of a bedside cognitive test, while rivaling the diagnostic performance of an FNB in early cognitive impairment. This brief battery offers a viable alternative when the FNB is needed but cannot be feasibly administered in nonspecialty clinics. It can have a wider health systems effect of improving patients’ access to accurate diagnosis in early cognitive impairment and facilitating timely interventions to delay the progression of cognitive impairment. 相似文献
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目的研究在精神科护理中采用标准化护理管理体系的临床效果,为临床提供可靠的参考依据。方法选取在2018年1—12月期间来该院精神科进行治疗的190例患者作为研究对象,并按照不同的护理方式随机分为两组,对照组给予常规护理模式,研究组采用标准化护理管理体系,然后对比两组患者的护理质量。结果对照组在专科护理、基础护理、护理文书、用药护理、健康教育、病区安全等护理质量指标与研究组比较,明显低于研究组,差异有统计学意义(P<0.05)。对照组患者满意度为80.00%,护理人员满意度为80.00%,研究组患者满意度为95.79%,护理人员满意度为96.00%,研究组患者满意度及护理人员满意度均高于对照组,两组间进行对比,差异有统计学意义(P<0.05),经过对比,对照组患者在护理过程中不良事件的发生情况(如暴力行为、吞食异物、自残、跌倒、噎食、外走等)均多于研究组,两组间进行对比,差异有统计学意义(P<0.05)。结论标准化护理管理体系在精神科中具有很高的临床应用价值,不仅能提高护理质量,还能降低不良事件的发生,患者与护理工作人员的满意度高,值得在临床中广泛推广。 相似文献
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《L'Encéphale》2022,48(3):254-264
BackgroundRecent changes in psychiatric care and teaching that limit patient contact for medical students can be overcome in part by simulation-based education. Understanding the learning processes of medical students involved in psychiatric simulation-based programmes could usefully inform efforts to improve this teaching. This study explored the learning processes of medical students the first time they role-play in psychiatry.MethodsWe used constructivist grounded theory to analyse semi-structured interviews of 13 purposively sampled medical students and the six psychiatrists who trained them. To improve the triangulation process, the results of this analysis were compared with those of the analyses of the role-play video and the debriefing audio-tapes.ResultsFive organising themes emerged: improving the students’ immediate perception of patients with mental disorders; cultivating clinical reasoning; managing affect; enhancing skills and attitudes and fostering involvement in learning psychiatry.ConclusionResults suggest that psychiatric role-playing can improve students’ progressive understanding of psychiatry through the development of intuition and by allaying affects. Emotional elaboration and student involvement appear to be key features. 相似文献
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《Annales médico-psychologiques》2022,180(7):702-706
The use of digital technologies in medicine is constantly growing. The adoption of digital technologies in the clinical practice in psychiatry seems to be a question of when, not if. How can we use those tools effectively? To address those issues, this short review discusses three of the major contributions of digital psychiatry: 1/the assistance and improvement of current care; 2/the development of new treatments; 3/the production of scientific and medical knowledge. 相似文献