前列腺癌根治术后患者延续护理服务需求的调查

目的调查前列腺癌根治术后患者延续护理服务需求情况,为制定个性化护理措施提供理论和实践依据。方法采用自行设计的调查问卷对96例前列腺癌根治术后患者的延续护理服务需求内容和方式进行调查。结果在延续护理服务内容上,前列腺癌患者对术后切口护理(96.9%)、术后并发症预防(93.8%)、活动锻炼(96.9%)、出院后复诊及预约(91.7%)、后续治疗(96.9%)、复发及预后信息咨询(96.9%)的服务内容有较高的需求;在延续护理服务方式上,99.0%患者选择医院专科门诊随访,81.3%患者选择电话、短信、网络咨询疾病的康复知识,仅有8.3%患者选择到社区医疗服务部门复诊。结论前列腺癌根治术后患者有较多延续性护理服务需求,医护人员应根据患者疾病及需求提供针对性延续护理服务。     

App在肿瘤科患者延续护理中的应用效果研究

目的构建延续护理App,探讨App在延续护理中的应用及效果。方法成立延续护理App项目小组,构建App功能模块,在肿瘤科延续护理中试运行,并对182名下载了App的患者或家属使用情况进行效果评价。结果在使用App 1个月期间,延续护理团队对每位使用App的患者均发送了延续护理服务内容,完成率为100.00%,但医患之间的交流较少,除96人(52.75%)通过App完成了复诊预约登记,其他模块使用率不足50%。患者本人对App的使用较积极,168名(92.31%)患者本人下载了App,只有14名(7.69%)患者家属下载了App。使用App完成延续护理服务的患者在复诊依从性方面明显优于未使用App的患者(P0.01)。结论 App运用于延续护理有效提高了患者复诊依从性,提供了高效便捷的延续护理服务,促进医患、护患、患患之间的交流,推进了延续护理信息化发展。     

口腔癌患者局部化疗间歇期健康教育需求情况调查

目的:调查口腔癌患者在局部灌注化疗间歇期的健康教育需求情况,为建立有效健康教育模式以及提高患者生存质量提供依据。方法:以问卷的方式调查2011年7月~2012年6月在我院口腔颌面外科行颞浅动脉灌注化疗的36例口腔癌患者健康教育需求情况。结果:按患者健康教育需求程度依次为不良反应的护理(100.00%)、心理指导(94.44%)、复诊相关事项指导(88.89%)、饮食指导(86.11%)、用药相关知识讲解(81.06%)、用药指导(75.00%)、口腔卫生指导(75.00%)、化疗费用告知(69.44%)、功能锻炼(66.67%)、家属指导(61.11%)。结论:患者健康教育需求较高,应根据患者需求开展有针对性的健康教育活动,使患者顺利度过化疗间歇期。     

山东省临床护士移动护理类APP功能需求及使用意愿的现状调查

[目的]调查山东省医院护士移动护理类应用程序(APP)功能需求及使用意愿的现状,为进一步开展移动护理类APP临床使用提供依据。[方法]采用方便抽样,对山东省1207名护士进行问卷调查,问卷内容包括一般资料、移动护理类APP知晓情况调查表、移动护理类APP功能需求调查表、移动护理类APP使用意愿调查表。[结果]参与调查的护士群体中,有289名(23.94%)护士使用过移动护理类APP,769名(63.71%)护士知晓移动护理类APP;护士对移动护理类APP的“病人端口药物提醒”及“护士端口健康护理”功能需求最高;护士对移动护理类APP使用意愿平均分为(4.16±0.69)分。[结论]护士对移动护理类APP的知晓度好、功能需求高,同时有较强的使用意愿。护理管理者应重视护士及病人双方对移动护理类APP的软件功能需求及使用心理,以期促进移动护理类APP更好地满足于护理服务。     

患者对化疗相关性恶心呕吐管理的智能手机应用程序需求调查

目的:调查化疗患者对化疗相关性恶心呕吐(Chemotherapy-Induced Nausea and Vomiting,CINV)管理应用程序(App)的需求,从而为智能手机CINV应用程序功能设计和开发提供理论参考依据,提高随访的效率和质量。方法:采用自行设计的智能手机CINV应用程序功能需求调查问卷,对北京市2所三级甲等医院住院的335例诊断为恶性肿瘤且行化疗的患者进行调查。结果:335例化疗患者对CINV应用程序的需求总均分为(4.10±1.12)分,得分较高的前3位的模块分别是:使用功能(4.36±1.02)分、专业咨询(4.28±1.61)分、用药指导(4.14±1.10)分。不同教育程度、职业、主要照顾者的患者对CINV手机应用程序的需求差异具有统计学意义(P0.05)。结论:患者对化疗相关性恶心呕吐手机软件的使用功能有较高的需求,希望在化疗间歇期得到更专业的指导,不同教育程度、职业、主要照顾者的患者对于CINV手机应用程序的设计要兼顾不同背景患者的需求,做到差异性照护,才能使移动护理得到持续改进,从而不断提高随访的效率和质量。     

乳腺癌患者对疾病管理手机APP的需求情况的调查与分析

目的通过对乳腺癌患者进行调查,了解不同特征的患者对乳腺癌疾病管理手机APP的需求,探讨在本院开展乳腺癌疾病管理手机APP使用的必要性及其对医疗护理工作的意义,并为指导日后该平台的使用提供依据。方法采用自行设计的调查问卷,随机抽取广州某三甲医院收治的乳腺癌患者130例进行问卷调查。应用SPSS 20.0系统对调查结果进行分析。结果 (1)患者对乳腺癌管理手机APP需求较高,达85%。(2)所有患者表示对手机APP"咨询"功能的设计有需求。(3)不同年龄、学历、经济收入、居住类型和病程的患者对手机APP设计功能的需求有显著差异(P0.05)。结论患者对乳腺癌疾病管理手机APP的需求较高,有必要在院内根据不同特征患者情况,面向患者开展手机APP的使用,以帮助更多患者实现疾病自我管理,协助医护人员完善疾病治疗。     

移动医疗App应用于鼻咽癌患者延续护理的实践

目的评价移动医疗App应用于鼻咽癌患者延续护理的效果。方法将80例鼻咽癌患者按出院时间顺序分为对照组和观察组各40例,对照组采用常规延续护理,观察组采用移动医疗App进行延续护理,包括教会患者应用APP,推送鼻咽癌相关知识,医患、患患互动,健康状况分析和复查提醒等。结果干预3个月后观察组患者鼻塞、口干的发生率和严重程度均低于对照组(P0.01或P0.05);自我护理能力和希望水平评分均高于对照组(P0.01或P0.05)。结论应用移动医疗App进行延续护理,有助于减轻鼻咽癌患者放疗毒副反应,提高患者的自我护理能力和希望水平。     

移动医疗App+微信群在冠心病PCI术后患者延续护理中的应用

目的 :调查应用移动医疗同心管家App+微信群,对冠心病经皮冠状动脉介入治疗(PCI)术后患者进行延续护理的效果。方法 :选取我院2015年1-3月60例冠心病PCI术后患者,分为干预组和对照组,每组30例。对照组进行常规出院宣教及出院后的电话回访,干预组在此基础上应用移动医疗App+微信群进行延续护理。比较两组患者出院时及出院后3个月对冠心病PCI治疗相关知识认知、服药依从性、焦虑、抑郁程度等方面的差异。结果 :出院3个月后,干预组对冠心病PCI治疗相关知识认知及服药依从性评分高于对照组,干预组焦虑自评量表(SAS)和抑郁自评量表(SDS)评分低于对照组,差异均有统计学意义(P0.05)。结论 :应用移动医疗App+微信群对冠心病PCI术后患者进行延续护理的效果较好,值得推广和借鉴。     

以患者需求为导向的延续护理模式在重型颅脑损伤患者中的应用和效果评价

目的:探讨以患者需求为导向的延续护理模式在重型颅脑损伤患者中的应用和效果评价。方法:将2013年1月~2016年6月我院出院的86例重型颅脑损伤患者作为研究对象。参考卫生部医院研究所"延续护理服务需求调查问卷",结合本院神经外科患者的特点,自编本科室"患者出院后对延续护理服务的需求调查问卷",针对患者调查问卷结果并建立所有重型颅脑损伤患者的健康档案。通过构建以患者需求为导向的延续护理模式,修订完善重型颅脑损伤延续护理相关内容指引,规范对患者进行延续护理服务的流程。比较实施前、实施后1个月、实施后3个月患者生活质量和健康知识知晓的情况。结果:对患者进行延续护理后,患者生活质量和对健康知识知晓等方面较出院前有明显提高,差异有统计学意义(P0.05))。结论:对重型颅脑损伤患者实施以患者需求为导向的延续护理,通过专业医学帮助、指导,可以提高患者的生活质量和健康知识知晓率,同时提升患者满意度,促进患者康复。     

慢加急性肝衰竭患者出院后延续护理需求调查

目的:调查慢加急性肝衰竭(ACLF)患者出院后延续护理需求。方法:选取2014年1月~2015年10月北京市某三甲医院肝衰竭中心收治的422例ACLF患者,采用自行设计的问卷分别对出院后护理需求内容和需求方式进行调查。结果:调查共回收问卷422份,有效回收率100.00%。ACLF患者均有出院后护理需求,需求率为100.00%,其中护理需求内容中患者最需要率(96.45%)和总需要率(100.00%)最高的均为用药指导;在出院后护理方式需求中,患者最满意率(91.49%)和总满意率(98.34%)最高的均为电话随访。结论:ACLF患者对出院后护理有着迫切的需求,包括多项护理内容,而随访方式需求差异较大,显示为传统方式与网络和移动技术相结合的特征。     

Outcomes of National Institutes of Health peer review of clinical grant applications.

PURPOSE: We previously reported that National Institutes of Health (NIH) peer review outcomes in 2002 were slightly but significantly less favorable for grant applications for clinical research than for laboratory research. The present analysis was undertaken to determine if factors related to the review process might contribute to this difference. METHODS: The impact of each of the following factors on median priority scores and funding rates for clinical and nonclinical R01 grant applications was evaluated: (1) the percentage of clinical applications assigned for review to a study section, (2) the requested direct costs, and (3) the clinical research experience of the reviewers. RESULTS: Confirming our previous observation, in both 1994 and 2004, median priority scores and funding rates for R01 applications were less favorable for clinical research. In 1994, clinical applications did not fare as well in study sections reviewing relatively low percentages of clinical applications. This was not the case in 2004. Although requested direct costs were greater for clinical than for nonclinical R01 applications, median priority scores within each category were actually more favorable for applications requesting greater funding. Assignment of priority scores was not different for reviewers with or without experience conducting clinical research. CONCLUSION: These data do not support the hypothesis that the less favorable review outcomes for clinical applications are related to these review factors. We suggest that peer review outcomes for clinical research will benefit from the recent refinement of NIH review criteria, emphasizing the unique contributions of clinical investigation, and from increased training opportunities for clinical investigators.     

Biological Gene Delivery Vehicles: Beyond Viral Vectors

Gene therapy covers a broad spectrum of applications, from gene replacement and knockdown for genetic or acquired diseases such as cancer, to vaccination, each with different requirements for gene delivery. Viral vectors and synthetic liposomes have emerged as the vehicles of choice for many applications today, but both have limitations and risks, including complexity of production, limited packaging capacity, and unfavorable immunological features, which restrict gene therapy applications and hold back the potential for preventive gene therapy. While continuing to improve these vectors, it is important to investigate other options, particularly nonviral biological agents which include bacteria, bacteriophage, virus-like particles (VLPs), erythrocyte ghosts, and exosomes. Exploiting the natural properties of these biological entities for specific gene delivery applications will expand the repertoire of gene therapy vectors available for clinical use. Here, we review the prospects for nonviral biological delivery vehicles as gene therapy agents with focus on their unique evolved biological properties and respective limitations and potential applications. The potential of these nonviral biological entities to act as clinical gene therapy delivery vehicles has already been shown in clinical trials using bacteria-mediated gene transfer and with sufficient development, these entities will complement the established delivery techniques for gene therapy applications.     

Update on personal digital assistant applications for the healthcare provider

OBJECTIVE: To review the common general drug information applications and specialty drug information applications available for personal digital assistants (PDAs). DATA SOURCES: The literature was accessed through MEDLINE (2003-June 2004). Other information was obtained through secondary sources, such as Web sites describing common PDA applications as well as actual product trials. The key search terms used were handheld, PDA, personal digital assistants, drug information, pharmacokinetics, medical information, and medical applications. STUDY SELECTION AND DATA EXTRACTION: Articles or studies that provided a review of drug information references for the PDA since 2002 were included. Data pertaining to cost and application size were obtained from product or vendor Web sites. DATA SYNTHESIS: There are numerous medical applications available for the PDA including general drug information references, specialty drug information references (eg, pediatrics, cardiology, infectious diseases, oncology, psychology, herbals), diagnostic applications, medical calculators, nursing references, and patient tracking databases. Due to the huge array of programs, as well as factors such as cost and memory requirements, the healthcare provider must be selective in the medical applications that are placed on the PDA. CONCLUSIONS: There are many excellent PDA drug information applications that provide fast and accurate drug information and other features that assist the healthcare provider.     

Opportunities and Challenges for the Clinical Utilization of Functional Electrical Stimulation

Clinical applications of electrical stimulation for effecting change in the damaged or disabled nervous system are in their infancy. This technique is extremely powerful, because any neural structure that is electrically excitable can potentially be affected. Although early attempts to apply electrical stimulation were limited by insufficient physiological knowledge and undeveloped technology, developments over the past two decades now provide a strong base for clinical applications. Clinical systems for bladder control and respiration have been in use for many years. Some applications of FES to restore hand function and walking are in multicenter testing, whereas many others are being studied for clinical feasibility at single sites. Applications are focusing on safety and efficacy, as well as on clinical outcome measures to address the issues posed by the regulatory and reimbursement processes. As clinical systems become more routine, issues of multiple system applications will need to be addressed. Present and future applications of functional electrical stimulation may be expected to significantly enhance independence and improve the quality of life for individuals with central nervous system dysfunction.     

Recent progress in the applications of silica-based nanoparticles

Functionalized silica nanoparticles (SiO₂ NPs) have attracted great attention due to their promising distinctive, versatile, and privileged physiochemical characteristics. These enhanced properties make this type of functionalized nanoparticles particularly appropriate for different applications. A lack of reviews that summarizes the fabrications of such nanomaterials and their different applications in the same work has been observed in the literature. Therefore, in this work, we will discuss the recent signs of progress in the fabrication of functionalized silica nanoparticles and their attractive applications that have been extensively highlighted (advanced catalysis, drug-delivery, biomedical applications, environmental remediation applications, and wastewater treatment). These applications have been selected for demonstrating the role of the surface modification step on the various properties of the silica surface. In addition, the current challenges in the applications of functionalized silica nanoparticles and corresponding strategies to discuss these issues and future perspectives for additional improvement have been addressed.

Functionalized silica nanoparticles (SiO₂ NPs) have attracted great attention due to their promising distinctive, versatile, and privileged physiochemical characteristics.     

Opportunities and challenges for the clinical utilization of functional electrical stimulation

Clinical applications of electrical stimulation for effecting change in the damaged or disabled nervous system are in their infancy. This technique is extremely powerful, because any neural structure that is electrically excitable can potentially be affected. Although early attempts to apply electrical stimulation were limited by insufficient physiological knowledge and undeveloped technology, developments over the past two decades now provide a strong base for clinical applications. Clinical systems for bladder control and respiration have been in use for many years. Some applications of FES to restore hand function and walking are in multicenter testing, whereas many others are being studied for clinical feasibility at single sites. Applications are focusing on safety and efficacy, as well as on clinical outcome measures to address the issues posed by the regulatory and reimbursement processes. As clinical systems become more routine, issues of multiple system applications will need to be addressed. Present and future applications of functional electrical stimulation may be expected to significantly enhance independence and improve the quality of life for individuals with central nervous system dysfunction.     

Web applications for total quality management.

Total quality management involves the consideration of many quality subjects as part of the management, such as quality processes, quality education, quality assurance, quality planning, quality results and quality document management. But crucial quality elements are also communication, data management and information sharing. Web applications and other associated computer communication applications such as E-mail and newsgroups, for example, offer to the laboratory environment the best tools to achieve proper communication and data management/sharing. These applications, enabling the set-up of Internet and Intranet sites, are used to share the information in the form of simple text pages or of completely interactive pages, which could comprise audio and video files, web page formulae and web data management applications. These applications are being associated to several applications and also being integrated into the laboratory information system (LIS).     

Summary statements of the NIH Nursing Research Grant Applications

Summary statements from the Nursing Research Study Section, Division of Research Grants, NIH, between October, 1986 and June, 1988 were used to identify reasons for recommending approval or disapproval of grant applications with RO1 and R29 activity codes. The 917 comments (25 +/- 4 per critique), sorted into one of nine categories (Aims, Significance, Investigator, Budget, Resources, Design, Sample, Techniques, Data Analysis) for analysis, were classified as Strengths (positive comments) or Weaknesses (negative comments). The weaknesses of approved applications were confined mostly to the categories of Design and Techniques. Disapproved applications had few strengths and many weaknesses in Design, Sample, Techniques, and Data Analysis. Critiques of First Award (R29) and traditional research project grant applications (RO1) were similar. The approved applications addressed meaningful problems, had well-synthesized literature reviews, and were solvable by available techniques. The research plans were consonant with stated aims, and the methods sections reflected understanding of the principles underlying the techniques to be used. A supportive environment and adequate research resources, including access to the study population were common to these applications. Disapproved applications provided poor synthesis of the literature, methods inconsistent with the aims, and often reflected inadequate understanding of techniques to be used.     

Empirical determination of the need for rehabilitation

In Germany, members of social insurance (e.g., pension) schemes have to apply for medical rehabilitation. Usually, the applications are the expression of a subjective demand. If the applications are granted this leads to the actual supply of medical rehabilitation services. Formerly, long waiting lists were common. These have been replaced by a new balance between demand (amount of applications), "offer" (capacity of rehabilitation clinics) and the amount of granted applications. In addition to these notions, the article develops the concept of need for rehabilitation services based on sociomedical indications. Consequently, the need for medical rehabilitation can--to a certain degree--be objectified. The concept of need should not be mixed up with that of demand: not every member of a social insurance scheme who objectively is in need of medical rehabilitation realizes the need, not everybody who realizes a need will apply for rehabilitation, and not all applications will be granted. The article gives an overview of different ways of needs assessment.     

Graphitic carbon nitride nanotubes: a new material for emerging applications

We provide a critical review of the current state of the synthesis and applications of nano- and micro-tubes of layered graphitic carbon nitride. This emerging material has a huge potential for light-harvesting applications, including light sensing, artificial photosynthesis, selective photocatalysis, hydrogen storage, light-induced motion, membrane technologies, and can become a major competitor for such established materials as carbon and titania dioxide nanotubes. Graphitic carbon nitride tubes (GCNTs) combine visible-light sensitivity, high charge carrier mobility, and exceptional chemical/photochemical stability, imparting this material with unrivaled photocatalytic activities in photosynthetic processes, such as water splitting and carbon dioxide reduction. The unique geometric GCNT structure and versatility of possible chemical modifications allow new photocatalytic applications of GCNTs to be envisaged including selective photocatalysts of multi-electron processes as well as light-induced and light-directed motion of GCNT-based microswimmers. Closely-packed arrays of aligned GCNTs show great promise as multifunctional membrane materials for the light energy conversion and storage, light-driven pumping of liquids, selective adsorption, and electrochemical applications. These emerging applications require synthetic routes to GCNTs with highly controlled morphological parameters and composition to be available. We recognize three major strategies for the GCNT synthesis including templating, supramolecular assembling of precursors, and scrolling of nano-/microsheets, and outline promising routes for further progress of these approaches in the light of the most important emerging applications of GCNTs.

The current state of the synthesis and applications of nano- and micro-tubes of graphitic carbon nitride is critically reviewed.