Psychological and clinical effects of renal biopsy performed using sedation

.A sedation regimen using sequential oral trinepazine, intravenous Pethco (pethidine, chlorpromazine and promethazine) and diazemuls was evaluated in children having native kidney (n = 17) and transplant kidney (n = 17) biopsies. Biopsy was successful in all cases, with no serious side effects. A self-reported scale of memory recall and pain perception showed the optimal time for biopsy to be between 30 and 90 min after the intravenous Pethco. The child’s level of distress was measured by a self-reported scale, a parent-reported scale and an observational scale for doctors and nurses; 45% of children rated themselves highly distressed prior to the procedure, their parents being the best assessors of this distress. Younger children and those undergoing native kidney biopsy had less understanding of the procedure. Children’s worries could be clearly categorised into procedural and outcome issues: those undergoing transplant biopsy were more worried about outcome, whereas those undergoing native kidney biopsy were more worried about the procedure. Received April 3, 1995; received in revised form and accepted April 17, 1996     

Patient involvement and language barriers: Problems of agreement or understanding?

ObjectiveThis study aims to explicate efforts for realizing patient-centeredness (PCC) and involvement (SDM) in a difficult decision-making situation. It investigates what communicative strategies a physician used and the immediate, observable consequences for patient participation.MethodsFrom a corpus of videotaped hospital encounters, one case in which the physician and patient used Norwegian as lingua franca was selected for analysis using conversation analysis (CA). Secondary data were measures of PCC and SDM.ResultsThough the physician did extensive interactional work to secure the patient’s understanding and acceptance of a treatment recommendation, his persistent attempts did not succeed in generating the patient’s participation. In ratings of PCC and SDM, this case scored well above average.ConclusionDespite the fact that this encounter displays some of the ‘best actual practice’ of PCC and SDM within the corpus, our analysis of the interaction shows why the strategies were insufficient in the context of a language barrier and possible disagreement.Practice implicationsWhen facing problems of understanding, agreement and participation in treatment decision-making, relatively good patient centered skills may not suffice. Knowledge about the interactional realization of key activities is needed for developing training targeted at overcoming such challenges.     

Understanding falls in progressive supranuclear palsy

IntroductionProgressive supranuclear palsy (PSP) is characterized by frequent falls which worsen with disease progression, causing substantial morbidity and mortality. Few studies have investigated which factors contribute to falls in PSP, and all have involved few participants, thus lacking necessary statistical power. The aim of this study was to identify clinical parameters most significantly associated with increasing falls in PSP, using the largest sample of patients to date.MethodsComprehensive clinical data were collected from 339 not demented PSP patients meeting the NINDS-SPSP criteria, who were divided into two groups – Infrequent Fallers (IF; n = 118) with rare falls, and Frequent Fallers (FF; n = 221) who fell occasionally to multiple times a day. Of 198 clinical parameters, we hypothesized 38 to be correlated with an increasing risk of falls. These 38 parameters were analyzed via univariate regression analysis to determine the strength of their association with fall frequency. Unit odds ratios identified the magnitude with which each parameter resulted in an increasing risk of falls.ResultsTwenty-five of 38 parameters analyzed were significantly associated with fall frequency based on univariate analysis. Symptom duration, clinical measures of disease severity, and several motoric and oculomotor clinical parameters were associated with FF. Examined cognitive parameters and slowing of vertical saccades were not.ConclusionsThe clinical parameters identified as associated with increased frequency of falls improve our understanding of why they occur and may help identify not demented PSP patients at risk for increasing falls.     

Do parents understand the medical information provided in paediatric emergency departments? A prospective multicenter study

Aim: We evaluated the extent to which parents understood the medical information about hospitalization of their child in an emergency department and looked for characteristics likely to increase the risk of poor comprehension. Methods: Prospective multicenter study in thirteen paediatric emergency departments. The parents and doctors completed questionnaires based on closed‐ended questions with a common core of four items: reasons of hospitalization, diagnosis, treatment and seriousness of child condition. We evaluated concordance between parents and doctor answers for these items by comparing their responses. Results: This study included 380 parents. Percentage of concordance was 55% for the reason of hospitalization, 78% for the diagnosis, 92% for the treatment, 48% for the seriousness of the condition and 19% for all four items. The mean number of concordant items was 2.76 (CI 95%, 2.66–2.86). Parents whose children seemed not in pain and parents who received additional information from the nurse showed significantly slightly higher levels of concordance with doctor’s answers (2.98 vs 2.66, p = 0.006 and 2.89 vs 2.60, p = 0.004, respectively). Conclusion: This study shows that improvements are required in the clarity of the information delivered to the parents. The assistance of nurses and optimal pain management may help to improve communication.     

理解性学习对学科教学的启示

在药学专业学科教学中，基于理解性学习的教学理念和价值启示，采用构建框架、举一反三、找关键词、教学演示等方法指导高职学生掌握合适的学法，积极有效学习，提升理解力和学习力。     

高校学生对非处方药品说明书理解力调查

目的:了解在校大学生对非处方药(OTC)说明书的理解程度。方法:搜集国产OTC药品复方氯己定漱口水不同厂家的说明书8份,选取其中较为规范的主要项目作为测试内容制作测试问卷。对在校大学生进行问卷调查,应用SPSS 22.0进行统计分析。结果:共对370名大学生进行了问卷调查,有效问卷308份。对适应证的正确理解率最高为96.78%,其次是用法用量和药物相互作用,对不良反应的理解率最低为22.73%,全部理解错误率1.95%(95%CI:0.72%~4.19%),全部正确理解率13.64%(95%CI:10.00%~17.98%)。结论:大学生对药品说明书的理解力有待提高。应加强卫生宣教,提高消费者安全用药意识。在OTC药品被批准上市前进行目标用药人群的说明书理解力测试很有必要,建议尽早制定适于国情的说明书理解力研究指南。     

Toward a consensus on the nature of empathy: A review of reviews

ObjectiveThe objective was to provide a synthesis of already synthesized literature on empathy in order to identify similarities and differences among conceptualizations.MethodsA review of reviews was conducted to locate synthesized literature published between January 1980 and December 2019. Two authors screened and extracted data, and quality-appraised the sources. A total of 52 articles deemed relevant to this overview were synthesized using thematic analysis.ResultsThe analysis resulted in four themes found in most empathy conceptualizations. In empathy, the empathizer (1) understands, (2) feels, and (3) shares another person’s world (4) with self-other differentiation.ConclusionsMost writings about empathy begin by claiming that there is far from a consensus on how empathy should be defined. This article shows a developing consensus among neuroscientists, psychologists, medical scientists, nursing scientists, philosophers, and others that empathy involves understanding, feeling, sharing, and self-other differentiation.Practice implicationsA clarification of the content of empathy may assist practitioners and researchers in avoiding confusion regarding the meaning of the concept, as well as in developing and measuring the relevant aspects of the concept.     

领悟社会支持能力对高校护理专业女生焦虑的影响

目的：研究领悟社会支持能力对护理专业学生焦虑的影响,探讨影响焦虑的相关因素,为大学生进行健康教育和促进提供依据。方法整群抽取安徽省两所高校护理专业女生作为调查对象,采用领悟社会支持量表( PSSS)、焦虑自评量表( SAS)对学生进行问卷调查。结果发放调查问卷805份,回收有效问卷785份,有效率为97．5%。护理专业女生发生焦虑的比例较高,达34．78%。领悟社会支持得分与焦虑得分呈负相关关系(P<0．05)。领悟社会支持受到家庭经济状况、年级、学习成绩和是否适应集体生活影响,护理专业学生的焦虑与民族、是否适应集体生活、学习压力、积极标准分等有关。结论领悟社会支持是影响护理专业学生焦虑情绪的重要因素,提高学生领悟社会支持水平有助于减少护理专业学生的不良情绪。     

不同层次医务人员对抑郁症和老年期痴呆诊治技术了解情况的调查

目的调查医务人员对抑郁症和老年期痴呆诊治技术了解情况。方法选择浙江省10个地市的医务人员进行《抑郁症和老年期痴呆诊治问卷》调查,共发放问卷527份,回收521份,其中有效问卷512份。结果随着医院等级的提高,两种疾病技术的了解程度逐渐提高,但街道与社区卫生服务的基层医务人员对两种疾病的诊疗技术的了解程度较低（P＜0.01）。在社区卫生服务中心的医务人员不了解的人群远远高于了解的人群,除精神专科医务人员,其他专业的医务人员对抑郁症的精神访谈技术及心理测试技术（包括量表自评及他评）,不了解的人群基本上多于了解的人群（P＜0.01）。老年期痴呆的诊断、评估、治疗、康复管理等技术的医务人员不了解超过了解（P＜0.01）。综合医院和精神专科医院的医务人员对两种疾病的技术了解的人群高于不了解的人群,而在社区卫生服务中心的医务人员不了解的人群远远高于了解的人群（P＜0.01）。随着工作年限的增加,抑郁症识别技术、精神访谈技术、药物治疗、心理治疗技术及康复技术了解的人群要高于不了解的人群（P＜0.05或0.01）。结论基层医务人员作为精神疾病防控、康复的第一线,对相关知识的了解程度令人担忧,应该通过各种方式,把专业知识向基层进行传播。