药学服务与全程化药学服务

药学服务是药师所提供的以提高病人生活质量为目的，以合理药物治疗为中心的相关服务。全程化约学服务是在整个医疗卫生保健过程中，在任何场所，在预防保健、药物治疗之前和过程中以及愈后恢复等任何时期，围绕提高生活质量这一既定目标，直接为公众提供的负责任的、与药物相关的服务。该服务不仅由药师个人实施，而且更需要通过集体合作完成。本文对药学服务的产生、发展、特点、要求，及其与临床药学的关系进行了介绍。通过对我国药学服务现状和影响因素的分析，详细阐述了全程化药学服务的内涵，以促进我国临床药师的培养和药学服务的发展。     

人性化护理与传统护理应用于手术室护理的临床比较

目的：对比手术室传统护理与人性化护理的应用特点和效果。方法取2011年1月~2012年6月本院接受手术治疗患者共60例,随机分为两组,每组30例。观察组给予人性化护理,对照组给予传统手术护理,对比两组护理效果。结果观察组护理质量评分、护理后焦虑评分优于对照组（P〈0.05）。观察组护理满意度为100%显著高于对照组的86.7%（P〈0.05）。结论手术室开展人性化护理服务,可有效调节患者心态、提高整体的护理质量和临床效果。     

Hope and care

This paper is intended to document, through an overview of the historical and cultural development of medicine, the main statements contained in a conference on nursing held by Luigi Giussani, the late Italian priest and founder of the Catholic movement, Communion and Liberation. The invitation of Giussani “to put the heart in their (nurses) profession” is commented through a critical review of the evolution of the concepts of health and disease from Hippocrates to the modern definition of health provided by the World Health Organization. In particular the role of Christian faith in the origin of hospitals and in the care of patients with apparently incurable diseases is emphasised. Cultural and ethical implications for modern medical and nursing professions are proposed.     

Simultaneous care: integration between medical oncology and supportive care

The simultaneous care setting is the early incorporation of supportive care for patients being treated for malignancies. With this therapeutic approach the best choice of treatment for individual patients can be shared with other professionals, and patient’s quality of life and family distress can be dramatically improved.     

Technology and health care

The invasion of technology, both in society and health care, asks for critical assessment of efficacy and safety. In a greying population hospital care will be substituted by home care in the treatment of chronic diseases. Continuity of care, between hospital and home, requires good communication between physician, patient and family. The hospital pharmacy has an essential role in providing treatment material in renal dialysis, chemotherapy or parenteral nutrition, the instruction of patients and the quality control of diagnostic tests and new devices for drug administration. The surveillance of complex medication, especially in the elderly, is an important part of that consultancy. The hospital pharmacist, in order to take up his place in the treatment team, should become familiar with new and technical aspects of drug administration in home care setting and the safety of its transfer from hospital to home.     

Technology and health care

The invasion of technology, both in society and health care, asks for critical assessment of efficacy and safety. In a greying population hospital care will be substituted by home care in the treatment of chronic diseases. Continuity of care, between hospital and home, requires good communication between physician, patient and family. The hospital pharmacy has an essential role in providing treatment material in renal dialysis, chemotherapy or parenteral nutrition, the instruction of patients and the quality control of diagnostic tests and new devices for drug administration. The surveillance of complex medication, especially in the elderly, is an important part of that consultancy. The hospital pharmacist, in order to take up his place in the treatment team, should become familiar with new and technical aspects of drug administration in home care setting and the safety of its transfer from hospital to home.     

Osteoporosis and pharmaceutical care

The increasing prevalence of osteoporosis is causing a substantial health burden. Compliance and adherence to osteoporosis management are of high priority, having a significant effect on the cost effectiveness of therapy. In this study, we aimed to summarize the literature on patient compliance in osteoporosis. Our findings indicate that 60% of the patients have some medication related problem, in particular, it is difficult to influence the patients to play an active role in their disease management and to keep a high level of persistence. Pharmaceutical care could help to reach optimal cooperation between patients and the heath care professional, as one of its main objective is to improve the rate of patient adherence in long-term drug therapy.     

Clinimetrics and epilepsy care

In order to study the practicability of rating scales in the regular care of people with epilepsy, indices have been developed and tested on their validity. These indices consist of the Index of Seizures, representing seizure activity, and the Composite Index of Impairment concerning the severity of impairment caused by the seizure type and frequency and the side-effects of anti-epileptic drug treatment. The indices have been applied in a retrospective quantitative evaluation of anti-epileptic drug therapy. The medical records of 250 randomly selected patients registered at an adult out-patient clinic have been reviewed. Their seizures have been classified as generalized tonic-clonic, simple partial and/or complex partial. The distribution of this population according to these indices has been studied, which leads us to the following conclusions:

Integrating palliative care into primary care

Patients with serious illnesses are living longer and with greater disabilities. Palliative-care interventions have been shown to increase quality of life, lower costs, and improve survival. In order to meet the palliative-care needs of patients, it is crucial for primary-care clinicians to understand how they can provide primary palliative care and when they should refer to palliative-care specialists. By working together, many more patients and families will receive the comprehensive, individualized, coordinated care and support that both primary care and palliative care offers to patients. This article will review literature illustrating the benefits of palliative care; discuss why primary-care clinicians are ideally suited to incorporate palliative care into their practice; and provide guidance to primary-care clinicians regarding how and when to access palliative-care specialist services, how to gain more training in palliative care, and how to be reimbursed for palliative-care visits. Mt Sinai J Med 79:579-585, 2012. ? 2012 Mount Sinai School of Medicine.     

Measuring and monitoring health care

The era of assessment and accountability is upon us. The health care system is being asked to measure and monitor medical care in terms that are meaningful to patients and society. Hopefully, this effort will allow us to construct a medical care system that will achieve the safe, efficient, effective, and appropriate use of medical resources in the most cost-effective and humane manner possible. Pharmacists must become familiar with the technology and terminology of outcomes measurement. Quality of life and functional status will become an integral part of our everyday practice as we expand our definition of the therapeutic goal for drug therapy. Isolated physiologic goals such as DBP or cardiac output are neither broad enough nor meaningful in terms of what our patients expect from treatment. If we have not changed their lives through the relief of symptoms, prevention of complications, and increased longevity, is it a favorable outcome? This new era creates a new set of expectations for technology assessment and standards development that has implications for pharmacy. Eddy suggests that any medical policy statement, whether in a journal, national meeting, or pharmacy and therapeutics committee be accompanied by the following information: a list of the medical and economic outcomes considered in implementation of such a policy or standards, an estimate of what will happen to the above outcomes if the policy or standards are followed, and all supporting empiric evidence for such estimates.     

糖尿病患者抑郁情绪的护理干预

目的:探讨护理干预对糖尿病患者抑郁情绪的影响。方法:选取伴有抑郁情绪的糖尿病患者150例,随机分为护理干预组(实验组)75例和对照组75例,其中对照组给予常规护理,实验组在常规护理基础上针对抑郁情绪给予有针对性的护理干预。结果:经过护理干预后实验组患者SDS评分明显低于对照组(P<0.01),且实验组患者治疗总有效率亦明显高于对照组(P<0.01)。结论:针对不同病程,不同性别、年龄的糖尿病患者合并抑郁情绪时采取有针对性的护理干预可以有效改善糖尿病患者的抑郁情绪,提高患者生存质量。