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Association of Multimodal Pain Control with Patient-Reported Outcomes in Children Undergoing Surgery
《Journal of pediatric surgery》2023,58(6):1206-1212
IntroductionOur aim was to describe practices in multimodal pain management at US children's hospitals and evaluate the association between non-opioid pain management strategies and pediatric patient-reported outcomes (PROs).MethodsData were collected as part of the 18-hospital ENhanced Recovery In CHildren Undergoing Surgery (ENRICH-US) clinical trial. Non-opioid pain management strategies included use of preoperative and postoperative non-opioid analgesics, regional anesthetic blocks, and a biobehavioral intervention. PROs included perioperative nervousness, pain-related functional disability, health-related quality of life (HRQoL). Associations were analyzed using multinomial logistic regression models.ResultsAmong 186 patients, 62 (33%) received preoperative analgesics, 186 (100%) postoperative analgesics, 81 (44%) regional anesthetic block, and 135 (73%) used a biobehavioral intervention. Patients were less likely to report worsened as compared to stable nervousness following regional anesthetic block (relative risk ratio [RRR]:0.31, 95% confidence interval [CI]:0.11–0.85), use of a biobehavioral technique (RRR:0.26, 95% CI:0.10–0.70), and both in combination (RRR:0.08, 95% CI:0.02–0.34). There were no associations of non-opioid pain control modalities with pain-related functional disability or HRQoL.ConclusionUse of postoperative non-opioid analgesics have been largely adopted, while preoperative non-opioid analgesics and regional anesthetic blocks are used less frequently. Regional anesthetic blocks and biobehavioral interventions may mitigate postoperative nervousness in children.Level of evidenceIII. 相似文献
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收集2000年1月1日至2021年12月1日发表的以突发公共卫生事件中公众的信息需求为研究主题的中英文文献,探讨公众信息需求的动机、主题和特征,分析研究现状。在突发公共卫生事件中,信息需求的动机主要包括自我保护、缓解认知失调、缓解焦虑、维持社会关系;信息需求的主题为事件信息、疾病及治疗信息、健康防护知识、政府和专家权威信息;信息需求的特征表现为强烈而迫切,具有多样性和系统性。突发公共卫生事件中的公众信息需求相关研究主要针对普通群众和各种网络用户,关注老年人、高危工作人群等的信息需求是今后研究的重点。研究结果为突发公共卫生事件信息资源建设和科学决策提供了借鉴。 相似文献
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目的分析看图对话工具在妊娠期糖尿病(GDM)患者健康教育中的应用效果。方法选取2018年1月—2019年12月广西中医药大学附属瑞康医院收治的80例GDM患者,随机分为对照组和观察组,每组40例。对照组开展常规健康教育,观察组采用看图对话工具开展健康教育。比较两组健康教育前后的血糖指标和自护行为能力评分、自然分娩率。结果健康教育后,对照组患者空腹血糖、餐后2 h血糖及糖化血红蛋白水平分别为(6.62±1.24)mmol/L、(7.25±1.32)mmol/L及(6.84±1.26)%,观察组患者空腹血糖、餐后2 h血糖及糖化血红蛋白水平分别为(6.12±2.41)mmol/L、(7.92±1.25)mmol/L及(6.26±1.31)%,两组比较差异均有统计学意义(t=5.135、5.032、5.121,均P<0.05)。健康教育后,观察组患者自护行为能力评分均显著高于对照组(均P<0.05)。观察组自然分娩率为95.00%(38例),显著高于对照组(82.50%,33例),差异有统计学意义(χ2=5.314,P<0.05)。结论在GDM患者健康教育中应用看图对话工具取得了显著效果,不仅能控制患者的血糖水平,而且在提高自护行为能力评分和自然分娩率方面有显著优势。 相似文献
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目的 分析河南省老年人社会经济地位与精神健康的关系。方法 使用多阶段分层整群抽样方法,以河南省18个省辖市的5 570名60岁及以上老年人为研究对象,采用有序logistic回归模型分析社会经济地位对老年人精神健康的影响,探讨医疗保险和居住安排的中介效应。结果 河南省老年人精神健康受损1 999人,受损率35.89%。有序logistic回归分析显示社会经济地位的三个维度均对老年人精神健康有显著影响(均P<0.05),月收入水平(OR = 0.598,95%CI:0.446 ~ 0.801)和受教育程度(OR = 1.617,95%CI:1.004 ~ 2.604)越高,老年人精神健康水平越好;原来职业的层级越高(OR = 1.325,95%CI:1.155 ~ 1.520),老年人精神健康水平越差。影响路径分析显示,城镇职工医保对老年人精神健康有促进作用(低SES:OR = 0.609,95%CI:0.422 ~ 0.878;高SES:OR = 0.380,95%CI:0.248 ~ 0.582),城乡居民医保对高SES老年人精神健康有促进作用(OR = 0.285,95%CI:0.181 ~ 0.448);此外,与配偶/伴侣居住(OR = 0.610,95%CI:0.483 ~ 0.769)、与子女居住(OR = 0.646,95%CI:0.520 ~ 0.803)缓解了社会经济弱势地位对老年人精神健康的负面影响。结论 河南省老年人精神健康受损率较高,社会经济地位的三个维度影响老年人的精神健康水平,医疗保险和居住安排在社会经济地位与老年精神健康的关系中具有显著的中介效应。 相似文献
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《Research in social & administrative pharmacy》2022,18(9):3694-3698
In this paper, we argue that understanding and addressing the problem of poor-quality medical products requires a more interdisciplinary approach than has been evident to date. While prospective studies based on rigorous standardized methodologies are the gold standard for measuring the prevalence of poor-quality medical products and understanding their distribution nationally and internationally, they should be complemented by social science research to unpack the complex set of social, economic, and governance factors that underlie these patterns. In the following sections, we discuss specific examples of prospective quality surveys and of social science studies, highlighting the value of cross-sector partnerships in driving high-quality, policy-relevant research in this area. 相似文献
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《Research in social & administrative pharmacy》2022,18(9):3492-3500
BackgroundPolypharmacy is commonly related to poor drug adherence, decreased quality of life and inappropriate prescribing in eldery. Furthermore, this condition also leads to a higher utilization of health services resources, due to the increased risk of adverse drug events, length of stays in hospitals and readmissions rates after discharge.ObjectiveThis Systematic Review aimed to synthesize the current evidence that evaluates pharmaceutical services on polymedicated patients, from an economic perspective.MethodsSystematic searches were conducted in MEDLINE, SCOPUS and Cochrane Library databases to identify studies that were published until January 2021. Experimental and observational studies were included in this review, using strict inclusion/exclusion criteria and were assessed for quality using the following tools: RoB and ROBINS-I. Two independent reviewers selected the articles and extracted the data.Results3,662 articles were retrieved from the databases. After the screening, 18 studies were included: 9 experimental and 9 observational studies. The studies reported that the integration of the pharmacist as a member of the healthcare team provides an optimized use of pharmacotherapy to polymedicated patients and contributes to health promotion, providing reduction of spending on medication, reduction of expenses related to emergency care and hospitalizations and other medical expenses. The ECRs made cost-effectiveness or cost-benefit analysis, and most of the Non Randomized studies had statistically significant cost savings even considering the expenses of pharmaceutical assistance. Experimental studies reported a cost reduction varying between US$ 193 to US$ 4,966 per patient per year. Furthermore, observational studies estimated a cost reduction of varying from US$ 3 to US$ 2,505 per patient per year. The cost savings are related to decrease in emergency visits and hospitalizations, through pharmacist intervention (medication review and pharmacotherapy follow-up).ConclusionsConsidering the set of studies included, pharmaceutical care services directed to polymedicated patients may cooperate to save financial resources. Most of the interventions showed positive economic trends and also contributed to improving clinical parameters and quality of life. However, due to the majority of the studies having exploratory or qualitative methodology, it is essential to carry out more robust studies, based on full economic evaluation. 相似文献
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目的 探讨医院信息系统中增加住院陪护管理功能的应用效果。方法 基于互联网医院、智慧医院等信息系统,开发信息化住院陪护管理功能,包括流行病学史调查、免费核酸申请、电子陪护证办理、体温监测登记及上报和统计查询。该功能与医院智慧护理链接后全院应用。比较功能应用前和应用后的遵医嘱一患一陪达标率、有效陪护证达标率、体温监测并登记日上报达标率和陪护证使用追溯率,评价护士和管理者疫情防控管理的人均耗时以及对该管理功能的满意度。结果 应用信息化陪护管理功能后,一患一陪达标率、有效陪护证达标率、体温监测并登记日上报达标率和陪护证使用追溯率显著高于应用前(均P<0.05);护士陪护管理人均耗时从(554.13±30.77)s降至(311.67±21.54)s(P<0.05);护士和管理者对该信息化陪护管理功能的满意度显著提高(均P<0.05)。结论 信息化住院陪护管理功能的应用有效提升了疫情期间陪护的管理质量和管理效率,提高了一线护士和管理者的满意度。 相似文献