共查询到20条相似文献,搜索用时 740 毫秒
1.
2.
Jinjiao Wang PhD RN Jenny Y. Shen MD Yeates Conwell MD Eric J. Podsiadly BA Thomas V. Caprio MD MPH MS Kobi Nathan PharmD Fang Yu PhD RN GNP-BC FGSA FAAN Erika E. Ramsdale MD Donna M. Fick PhD FAAN Amanda S. Mixon MD MS MSPH Sandra F. Simmons PhD 《Health services research》2023,58(Z1):123-138
Objective
To assess how age-friendly deprescribing trials are regarding intervention design and outcome assessment. Reduced use of potentially inappropriate medications (PIMs) can be addressed by deprescribing—a systematic process of discontinuing and/or reducing the use of PIMs. The 4Ms—“Medication”, “Mentation”, “Mobility”, and “What Matters Most” to the person—can be used to guide assessment of age-friendliness of deprescribing trials.Data Source
Published literature.Study Design
Scoping review.Data Extraction Methods
The literature was identified using keywords related to deprescribing and polypharmacy in PubMed, EMBASE, Web of Science, ProQuest, CINAHL, and Cochrane and snowballing. Study characteristics were extracted and evaluated for consideration of 4Ms.Principal Findings
Thirty-seven of the 564 trials identified met the review eligibility criteria. Intervention design: “Medication” was considered in the intervention design of all trials; “Mentation” was considered in eight trials; “Mobility” (n = 2) and “What Matters Most” (n = 6) were less often considered in the design of intervention. Most trials targeted providers without specifying how matters important to older adults and their families were aligned with deprescribing decisions. Outcome assessment: “Medication” was the most commonly assessed outcome (n = 33), followed by “Mobility” (n = 13) and “Mentation” (n = 10) outcomes, with no study examining “What Matters Most” outcomes.Conclusions
“Mentation” and “Mobility”, and “What Matters Most” have been considered to varying degrees in deprescribing trials, limiting the potential of deprescribing evidence to contribute to improved clinical practice in building an age-friendly health care system. 相似文献3.
4.
The use of haematopoietic stem cell transplantation in Fanconi anaemia patients: a survey of decision making among families in the US and Canada
下载免费PDF全文
![点击此处可从《Health expectations》网站下载免费的PDF全文](/ch/ext_images/free.gif)
Sadie P. Hutson PhD RN WHNP BC Paul K. J. Han MD MA MPH Jada G. Hamilton PhD MPH Sean C. Rife MA Mohamad M. Al‐Rahawan MD MPH Richard P. Moser PhD Seth P. Duty RN BSN Sheeba Anand MPH Blanche P. Alter MD MPH 《Health expectations》2015,18(5):929-941
Background
Fanconi anaemia (FA) is a rare genetic disorder associated with bone marrow failure (BMF), congenital anomalies and cancer susceptibility. Stem cell transplantation (SCT) offers a potential cure for BMF or leukaemia, but incurs substantial risks. Little is known about factors influencing SCT decision making.Objective
The study objective was to explore factors influencing patients' with FA and family members' decision making about SCT.Design
Using a mixed‐methods exploratory design, we surveyed US and Canadian patients with FA and family members who were offered SCT.Main variables studied
Closed‐ended survey items measured respondents' beliefs about the necessity, risks and concerns regarding SCT; multivariable logistic regression was used to examine the association between these factors and the decision to undergo SCT. Open‐ended survey items measured respondents' perceptions of factors important to the SCT decision; qualitative analysis was used to identify emergent themes.Results
The decision to undergo SCT was significantly associated with greater perceived necessity (OR = 2.81, P = 0.004) and lower concern about harms of SCT (OR = 0.31, P = 0.03). Qualitative analysis revealed a perceived lack of choice among respondents regarding the use of SCT, which was related to physician influence and respondent concerns about patients' quality of life.Conclusions
Overall, study results emphasize the importance of the delicate interplay between provider recommendation of a medical procedure and patient/parental perceptions and decision making. Findings can help providers understand the need to acknowledge family members' perceptions of SCT decision making and offer a comprehensive discussion of the necessity, risks, benefits and potential outcomes. 相似文献5.
Time to delivery: Transfers for threatened preterm labour and prelabour rupture of membranes in Western Australia
下载免费PDF全文
![点击此处可从《The Australian journal of rural health》网站下载免费的PDF全文](/ch/ext_images/free.gif)
Jade Hollingworth MBBS BSc Rachel Pietsch MBBS BSc Mathias Epee‐Bekima MD MRCOG FRANZCOG Elizabeth Nathan M.Biostat 《The Australian journal of rural health》2018,26(1):42-47
Objective
To describe the outcomes of patients transferred to King Edward Memorial Hospital (KEMH) with signs of labour at preterm gestations.Design
A retrospective observational study of the 69 cases transferred to KEMH during 2015.Setting
Patient transfers from all locations across Western Australia (WA) to the sole tertiary perinatal centre in Perth.Participants
Pregnant women within WA with threatened or actual preterm labour (PTL) or preterm prelabour rupture of membranes (PPROM) between 23 and 32 weeks gestation.Main outcome measures
The occurrence of delivery during the admission and time‐to‐delivery as well as length of admission and association between clinical factors and time‐to‐delivery.Results
The percentage of the study population delivered during the admission following transfer was 72.5%. Eighty‐six per cent of those who delivered did so within 72 hours of transfer. The median time from transfer to delivery was 1 day. Sixty‐three per cent of those who did not deliver during the admission progressed to 36 weeks gestation. Patients transferred with PPROM were less likely to deliver during the admission compared to those with uterine activity (50% versus 19.6%, P = 0.007) and nulliparas were more likely to deliver (93.5% versus 55.3%, P < 0.001).Conclusion
The majority of women transferred with signs of PTL progress to delivery during the same admission with the highest risk of delivery being the first 72 hours following transfer. If the pregnancy is ongoing at 72 hours, there is a reasonable chance of progression to late preterm gestation supporting the return of woman to their place of origin for antenatal care following discharge. 相似文献6.
Evaluation of a protocol for eliciting narrative accounts of pediatric inpatient experiences of care
Steven C. Martino PhD Kerry A. Reynolds PhD Rachel Grob PhD Alina I. Palimaru PhD Sarah Zelazny MPH Mary E. Slaughter PhD Lise Rybowski MBA Andrew M. Parker PhD Sara L. Toomey MD MPhil MPH Mark A. Schuster MD PhD Mark Schlesinger PhD 《Health services research》2023,58(2):271-281
7.
8.
Objective
The objective of this study was to identify nutritional indicators that predict MNA (mini nutritional assessment) classification in hospitalized elderly patients. 相似文献9.
A. Brett Hauber Ateesha F. Mohamed F. Reed Johnson Olatoye Oyelowo Bradley H. Curtis Cheryl Coon 《Quality of life research》2010,19(5):701-709
Purpose
Our objective was to estimate preference-based weights for the IWQOL-Lite that reflect the relative importance overweight and obese people place on the domains included in the instrument. 相似文献10.
11.
Background
The objective of this study was to develop scales measuring personal and environmental factors that affect dietary fat intake behavior, physical activity, and stress management in low-income mothers. 相似文献12.
Kiss P De Meester M Kruse A Chavée B Braeckman L 《International archives of occupational and environmental health》2012,85(2):197-206
Purpose
The aim of this study was to identify easy to assess occupational factors that are associated with the presence of neck and shoulder complaints (NSC) in computer workers. 相似文献13.
Chelminski PR Ives TJ Felix KM Prakken SD Miller TM Perhac JS Malone RM Bryant ME DeWalt DA Pignone MP 《BMC health services research》2005,5(1):3
Background
Chronic non-cancer pain is a common problem that is often accompanied by psychiatric comorbidity and disability. The effectiveness of a multi-disciplinary pain management program was tested in a 3 month before and after trial. 相似文献14.
Background
The purpose of this constructivist grounded theory study was to develop a theoretical model that explains women's processes of managing diagnosed depression when pregnant. 相似文献15.
Developing and testing a brief clinic‐based lung cancer screening decision aid for primary care settings
下载免费PDF全文
![点击此处可从《Health expectations》网站下载免费的PDF全文](/ch/ext_images/free.gif)
Karen Kane McDonnell PhD RN OCN Scott M. Strayer MD MPH Erica Sercy MSPH Callie Campbell BA Daniela B. Friedman PhD Kathleen B. Cartmell PhD MPH Jan M. Eberth PhD 《Health expectations》2018,21(4):796-804
Background
Cancer screening‐related decisions require patients to evaluate complex medical information in short time frames, often with primary care providers (PCPs) they do not know. PCPs play an essential role in facilitating comprehensive shared decision making (SDM).Objective
To develop and test a decision aid (DA) and SDM strategy for PCPs and high‐risk patients.Design
The DA was tested with 20 dyads. Each dyad consisted of one PCP and one patient eligible for screening. A prospective, one‐group, mixed‐method study design measured fidelity, patient values, screening intention, acceptability and satisfaction.Results
Four PCPs and 20 patients were recruited from an urban academic medical centre. Most patients were female (n = 14, 70%), most had completed high school (n = 15, 75%), and their average age was 65 years old. Half were African American. Patients and PCPs rated the DA as helpful, easy to read and use and acceptable in terms of time frame (observed t = 11.6 minutes, SD 2.7). Most patients (n = 16, 80%) indicated their intent to be screened. PCPs recommended screening for most patients (n = 17, 85%).Conclusions
Evidence supports the value of lung cancer screening with LDCT for select high‐risk patients. Guidelines endorse engaging patients and their PCPs in SDM discussions. Our findings suggest that using a brief, interactive, plain‐language, culturally sensitive, theory‐based DA and SDM strategy is feasible, acceptable and may be essential to effectively translate and sustain the adoption of LDCT screening recommendations into the clinic setting. 相似文献16.
Aucouturier J Isacco L Thivel D Fellmann N Chardigny JM Duclos M Duché P 《Clinical nutrition (Edinburgh, Scotland)》2011,30(6):780-785
Background & aims
Exercise induces adaptations in fat metabolism favourable to the treatment of obesity. However, time interval between meal and exercise alters substrate bioavailability and oxidation during exercise. The aim of this study was therefore to investigate the effect of time interval between food intake and exercise on substrate oxidation rates in obese and lean children.Methods
The metabolic responses to exercise of nine obese children (10.3 ± 1.8 years; %body fat: 36.1 ± 6.1) and seven lean children (9.2 ± 1.6 years; %body fat: 22.2 ± 4.1) were compared 1 h (time interval 1, TI1) and 3 h (TI3) after a standardized breakfast.Results
Despite significantly lower plasma glucose and insulin concentrations and large effect size suggesting a higher plasma FFA availability (lean, 1.43, obese 0.98), fat oxidation was not significantly increased in TI3 compared to TI1 in both lean and obese children. Fat oxidation contributed marginally to energy expenditure during exercise (<20%) in both conditions and groups but was moderately increased during TI3 compared to TI1 in lean children (effect size: 0.54).Conclusions
The low contribution of fat oxidation to energy expenditure during exercise in obese and lean children fed 3 h before exercise questions the efficacy of moderate intensity exercise to favourably affect fat balance. 相似文献17.
Background
The purpose of this study was to test the hypothesis that racial differences in satisfaction can be found among OB/GYN patients on a US naval base. 相似文献18.
Background
The prevalence of smoking in nursing personnel remains high. The aim of this study was to identify work factors that predict smoking cessation among nurses' aides. 相似文献19.
Panagiotis Papastergiou George Rachiotis Konstantina Polyzou Christos Zilidis Christos Hadjichristodoulou 《BMC public health》2008,8(1):297
Background
Mortality differences at national level can generate hypothesis on possible causal association that could be further investigated. The aim of the present study was to identify regions with high mortality rates in Greece. 相似文献20.
Silje Steinsbekk Thomas Jozefiak R?nnaug ?deg?rd Lars Wichstr?m 《Quality of life research》2009,18(9):1159-1167