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《Research in social & administrative pharmacy》2020,16(3):267-276
BackgroundThe scope and roles of pharmacists worldwide are undergoing dramatic change. Patient-focused care aimed at caring for people that seek medical assistance in dying is among the newest roles. While pharmacists have been involved in medically assisted dying in some international jurisdictions for over two decades, little is known about their actual lived experiences.ObjectiveTo map the literature concerning pharmacy practice in the assisted dying domain to clarify apparent research gaps.MethodsA mapping review was preformed following a systematic search of Medline, CINAHL and IPA to locate academic papers and reports relating to pharmacists’ involvement in assisted dying published between 1990 and 2019. Searches included articles in English, French, and Dutch. References and citations of articles were searched to identify additional articles.ResultsA total of 43 articles were selected, including commentaries (n = 26), reports (n = 2), a scoping literature review (n = 1), and empirical studies (n = 14). Most commentaries centered on pharmacists' roles, ethico-legal and moral challenges, and educational concerns in relation to participation. Of the 14 empirical studies, 12 studies were designed around surveys that focused on pharmacists' attitudes, and opinions concerning assisted dying. Other methodologies included thematic analysis of moral dilemmas, experimental design identifying attitudes to sedation at end of life, and analysis of documents such as guidelines, position statements, and standards of practice. Two studies utilized a qualitative research approach. A significant gap was found with respect to research exploring the actual experience of pharmacists’ practice in medically assisted dying.ConclusionThere is an absence of studies exploring pharmacists’ actual experiences in assisted dying practice. Research involving pharmacists that participate in legally sanctioned assisted dying will facilitate a meaningful understanding of the lived experience of pharmacy practice in this domain. 相似文献
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目的探讨援外医疗救助"爱心行"项目中,针对柬埔寨医务人员不同培养形式初步结果。方法 2017年12月-2019年3月,横断面调查方法。近5年卫生人力资源培养相关文献查询,参加"爱心行"项目中国柬埔寨政府多部门,中国援外医疗队员,柬埔寨西部大学教授,参加培养柬埔寨卫生管理及医疗卫生人员等为访谈对象。半结构式访谈收集培养时间、内容类型及过程,分析比较长短期不同培训形式优缺点及初步结果。结果 7种形式共培养柬埔寨医生167人,来自柬埔寨4个省及金边市。其中硕士1名;长期进修(3月及以上)2名,会议及培训40名,与柬大学联合短期培训24名学员,来华现场培训实习5名,中国援外医疗队现场带教33人,中国流动医疗车现场带教培训70名。培训内容包括项目管理组织,筛查技能,心脏B超检查,Intensive Care Unit(ICU),心导管,经皮介入治疗结构性心脏病及车载心电图机,X线,生化分析仪使用等。结论援外项目应长短期培养相结合,多种培养形式有利于兼顾项目实施现场需求及长期项目影响。 相似文献
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《The journal of sexual medicine》2020,17(10):2067-2076
BackgroundMultiple options of genital gender-affirming surgery are available to transmen. The transman should be able to weigh these options based on the outcomes, risks, and consequences that are most important to him. For this reason, a decision aid for genital surgery in transmen (DA-GST) was developed. It aims to support the transman in making thoughtful choices among treatment options and facilitate shared decision-making between the healthcare professionals and the transindividual.AimThe aim of this study was to evaluate the newly developed DA-GST.MethodsThis was a cross-sectional study using mixed methods. Transmen considering to undergo genital surgery were eligible to partake in the study. The questionnaires used in this study were developed by adapting the validated Dutch translation of the “Decisional Conflict Scale,” the “Measures of Informed Choice,” and the “Ottawa Preparation for Decision-Making Scale.” Qualitative interviews were conducted querying their subjective experience with the DA-GST. The data from the questionnaires were statistically analyzed, and the data from the interviews were thematically analyzed.OutcomesThe main outcome measures were decisional conflict and decisional confidence measured via self-report items and qualitative data regarding the use of the DA-GST via interviews.ResultsIn total, 51 transmen participated in the questionnaires study, 99 questionnaires were analyzed, and 15 interviews were conducted. Although confident in their decision, most transmen felt responsible to collect the necessary information themselves. The ability to go through the decision aid independently aided the decision-making process by providing information and highlighting their subjective priorities. Suggested additions are pictures of postoperational outcomes and personal statements from experienced transmen.Clinical TranslationThe DA-GST could be implemented as an integral part of transgender health care. Clinicians could take the individual personal values into account and use it to accurately tailor their consult. This would ultimately improve the doctor-patient relationship and decrease decisional regret by enhancing effective shared decision-making.Strengths & LimitationsThis mixed-method design study confirmed the use of the DA-GST while taking a broad range of decisional factors into account. Limitations include the absence of a baseline analysis and the limited power for the comparison of treatment groups.ConclusionsThis study suggests that the DA-GST helped transmen feel more prepared for their personal consult with the surgeon, reduced decisional conflict, and increased their decisional confidence.Mokken SE, Özer M, van de Grift TC, et al. Evaluation of the Decision Aid for Genital Surgery in Transmen. J Sex Med 2020;17:2067–2076. 相似文献
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目的:探讨心脏骤停患者的急救措施和临床分析。方法回顾性分析2008年10月~2013年10月70例心脏骤停患者的资料。患者入院后立即对其实施抢救,抢救主要包括心肺复苏术、辅助给氧、电除颤等,同时严格监控患者的各项生理指标。根据患者心脏骤停时间将其分为3组分别为A组1~5 min,B组6~10 min,C组>10 min。结果 A、B、C 组抢救成功50、6、2例患者,抢救成功率分别为96.15%、75.00%、20.00%,A组抢救成功率明显高于B、C组,差异有统计学意义(P〈0.05)。结论及时有效的早期复苏术和抢救处理对于患者的复苏至关重要,可以明显提高患者的生存概率。 相似文献
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Biesma R Makoa E Mpemi R Tsekoa L Odonkor P Brugha R 《Social science & medicine (1982)》2012,74(3):381-389
One of the biggest challenges in scaling up health interventions in sub-Saharan Africa for government recipients is to effectively manage the rapid influx of aid from different donors, each with its own requirements and conditions. However, there is little empirical evidence on how governments absorb knowledge from new donors in order to satisfy their requirements. This case study applies Cuellar and Gallivan's (2006) framework on knowledge absorptive capacity (AC) to illustrate how recipient government organisations in Lesotho identified, assimilated and utilised knowledge on how to meet the disbursement and reporting requirements of Lesotho's Round 5 grant from the Global Fund to Fight AIDS, TB and Malaria (Global Fund). In-depth topic guided interviews with 22 respondents and document reviews were conducted between July 2008 and February 2009. Analysis focused on six organisational determinants that affect an organisation's absorptive capacity: prior-related knowledge, combinative capabilities, motivation, organisational structure, cultural match, and communication channels. Absorptive capacity was mostly evident at the level of the Principal Recipient, the Ministry of Finance, who established a new organisational unit to meet the requirements of Global Fund Grants, while the level of AC was less advanced among the Ministry of Health (Sub-Recipient) and district level implementers. Recipient organisations can increase their absorptive capacity, not only through prior knowledge of donor requirements, but also by deliberately changing their organisational form and through combinative capabilities. The study also revealed how vulnerable African governments are to loss of staff capacity. The application of organisational theory to analyse the interactions of donor agencies with public and non-public country stakeholders illustrates the complexity of the environment that aid recipient governments have to manage. 相似文献
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《Journal of medical engineering & technology》2013,37(4):180-183
The education of biomedical engineers in Canada is discussed, with reference to the Canadian health care system and related industry. Information on specific educational programmes, with enrolment data, is presented. The paper concludes with brief comments on the certification of clinical engineers in Canada. 相似文献
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目的 评价以问题为基础的教学法(problem-based learning,PBL)对提高护理专业实习生应急能力的效果.方法 将64名护理专业实习生随机分为两组,每组32名.对照组采用传统教学法,试验组采用PBL教学法.比较两组实习生理论、操作及临床应急能力的考核成绩,并由试验组实习生对PBL教学法的效果进行评价.结果 试验组实习生理论、操作及临床应急能力考核成绩好于对照组(P<0.01),对PBL教学法的效果评价积极,认为能提高急危重症抢救时的应对能力,93.75%的学生希望继续使用这种模式.结论 应用PBL教学法能激发实习生的求知积极性,培养他们综合分析和处理问题的能力,进而提高应急能力. 相似文献