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61.
Fetal Movement Counting—Maternal Concern and Experiences: A Multicenter,Randomized, Controlled Trial
Eli Saastad CNM MHSc Brita A. Winje RN MPH Pravin Israel PhD J. Frederik Frøen MD PhD 《分娩》2012,39(1):10-20
Abstract: Background: Fetal movement counting may improve timely identification of decreased fetal activity and thereby contribute to prevent adverse pregnancy outcomes, but it may also contribute to maternal concern. This study aimed to test whether fetal movement counting increased maternal concern. Methods: In a multicenter, controlled trial 1,013 women with a singleton pregnancy were randomly assigned either to perform daily fetal movement counting from pregnancy week 28 or to follow standard Norwegian antenatal care where fetal movement counting is not encouraged. The primary outcome was maternal concern, measured by the Cambridge Worry Scale. Analysis was by intention-to-treat. Results: The means and SDs on Cambridge Worry Scale scores were 0.77 (0.55) and 0.90 (0.62) for the intervention and the control groups, respectively, a mean difference between the groups of 0.14 (95% CI: 0.06–0.21, p < 0.001). Decreased fetal activity was of concern to 433 women once or more during pregnancy, 45 and 42 percent in the intervention and control groups, respectively (relative risk = 1.1, 95% CI: 0.9–1.2). Seventy-nine percent of the women responded favorably to the use of counting charts. Conclusions: Women who performed fetal movement counting in the third trimester reported less concern than those in the control group. The frequency of maternal report of concern about decreased fetal activity was similar between the groups. Most women considered the use of a counting chart to be positive. (BIRTH 39:1 March 2012) 相似文献
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Rick Penciner MD CCFP Sanam Siddiqui Hon BSc Shirley Lee MD MHSc CCFP 《Academic emergency medicine》2007,14(8):727-731
Background Tracking medical student clinical encounters is now an accreditation requirement of medical schools. The use of handheld computers for electronic logging is emerging as a strategy to achieve this.
Objectives To evaluate the technical feasibility and student satisfaction of a novel electronic logging and feedback program using handheld computers in the emergency department.
Methods This was a survey study of fourth-year medical student satisfaction with the use of their handheld computers for electronic logging of patient encounters and procedures. The authors also included an analysis of this technology.
Results Forty-six students participated in this pilot project, logging a total of 2,930 encounters. Students used the logs an average of 7.6 shifts per rotation, logging an average of 8.3 patients per shift. Twenty-nine students (63%) responded to the survey. Students generally found it easy to complete each encounter (69%) and easy to synchronize their handheld computer with the central server (83%). However, half the students (49%) never viewed the feedback Web site and most (79%) never reviewed their logs with their preceptors. Overall, only 17% found the logging program beneficial as a learning tool.
Conclusions Electronic logging by medical students during their emergency medicine clerkship has many potential benefits as a method to document clinical encounters and procedures performed. However, this study demonstrated poor compliance and dissatisfaction with the process. In order for electronic logging using handheld computers to be a beneficial educational tool for both learners and educators, obstacles to effective implementation need to be addressed. 相似文献
Objectives To evaluate the technical feasibility and student satisfaction of a novel electronic logging and feedback program using handheld computers in the emergency department.
Methods This was a survey study of fourth-year medical student satisfaction with the use of their handheld computers for electronic logging of patient encounters and procedures. The authors also included an analysis of this technology.
Results Forty-six students participated in this pilot project, logging a total of 2,930 encounters. Students used the logs an average of 7.6 shifts per rotation, logging an average of 8.3 patients per shift. Twenty-nine students (63%) responded to the survey. Students generally found it easy to complete each encounter (69%) and easy to synchronize their handheld computer with the central server (83%). However, half the students (49%) never viewed the feedback Web site and most (79%) never reviewed their logs with their preceptors. Overall, only 17% found the logging program beneficial as a learning tool.
Conclusions Electronic logging by medical students during their emergency medicine clerkship has many potential benefits as a method to document clinical encounters and procedures performed. However, this study demonstrated poor compliance and dissatisfaction with the process. In order for electronic logging using handheld computers to be a beneficial educational tool for both learners and educators, obstacles to effective implementation need to be addressed. 相似文献
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Desley G Hegney RN BA PhD Elizabeth Patterson BSc MHSc PhD Diann S Eley MSc PhD Rosemary Mahomed MComHlthPrac PhD Jacqui Young RN BN MN 《International journal of nursing practice》2013,19(1):54-59
This was the first Australian study investigating the acceptability, feasibility and sustainability of a nurse‐led model of chronic disease management in general practice. A concurrent mixed‐methods design was used within a 12‐month intervention of nurse‐led care in three general practices. Adult patients with type 2 diabetes, hypertension and/or stable ischaemic heart disease were randomized into nurse‐led or standard care. Semi‐structured interviews explored perceptions of key stakeholders towards this model including patients in the nurse‐led arm, and all practice staff pre‐ and posttrial. The data were thematically analysed and the emergent themes were: importance of time; collaborative relationships; nurse job satisfaction, confidence and competence; patient self‐management and choice. Our findings showed that nurses provided chronic disease management that was acceptable, feasible and sustainable. The collaborative involvement of doctors was intrinsic to patient acceptability of nurse‐led care that facilitated job satisfaction, and therefore retention and growth within this nursing speciality. 相似文献
66.
Sarah M. Perman MD MS Anna Marie Chang MD Judd E. Hollander MD David F. Gaieski MD Stephen Trzeciak MD MPH Robert Birkhahn MD Ronny Otero MD Tiffany M. Osborn MD Eugene Moretti MD MHSc H. Bryant Nguyen MD Kyle J. Gunnerson MD David Milzman MD Munish Goyal MD Charles B. Cairns MD Long Ngo PhD Emanuel P. Rivers MD MPH Nathan I. Shapiro MD MPH 《Academic emergency medicine》2011,18(2):219-222
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