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41.
Kinta Beaver PhD MRes BA DPSN RGN David Jones MD FRCS † Shabbir Susnerwala MD FRCR ‡ Olive Craven MSc RGN RM Onc.Cert § Mary Tomlinson BA RGN ¶ Gary Witham BA RGN Onc.Cert PG.Cert Karen A Luker PhD BNurs FMedSci †† 《Health expectations》2005,8(2):103-113
OBJECTIVES: To explore patient views on participation in treatment, physical care and psychological care decisions and factors that facilitate and hinder patients from making decisions. DESIGN: Qualitative study using semi-structured interviews with patients. SETTING AND PARTICIPANTS: Three NHS Trusts in the north-west of England. Theoretical sampling including 41 patients who had been treated for colorectal cancer. RESULTS: For patients, participation in the decision-making process was about being informed and feeling involved in the consultation process, whether patients actually made decisions or not. The perceived availability of treatment choices (surgery, radiotherapy, chemotherapy) was related to type of treatment. Factors that impacted on whether patients wanted to make decisions included a lack of information, a lack of medical knowledge and trust in medical expertise. Patients perceived that they could have a more participatory role in decisions related to physical and psychological care. CONCLUSION: This study has implications for health professionals aiming to implement policy guidelines that promote patient participation and shared partnerships. Patients in this study wanted to be well informed and involved in the consultation process but did not necessarily want to use the information they received to make decisions. The presentation of choices and preferences for participation may be context specific and it cannot be assumed that patients who do not want to make decisions about one aspect of their care and treatment do not want to make decisions about other aspects of their care and treatment. 相似文献
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Bilateral congenital eventration of the diaphragm almost uniformly presents in infancy with respiratory compromise and is associated with a high mortality rate. Delayed presentation of diaphragmatic eventration in older children and adults may be associated with acute gastric volvulus. Thus, any patient with abdominal pain, vomiting, or nonspecific gastrointestinal symptoms in association with abnormal diaphragmatic findings on chest x-ray should undergo further diagnostic workup with upper gastrointestinal series or computed tomography (CT) scan. Treatment of gastric volvulus requires immediate surgical repair to prevent subsequent necrosis and perforation. The authors describe a case report of bilateral congenital diaphragmatic eventration complicated by a perforated gastric volvulus in a 13-year-old boy. Emergent reduction of the volvulus, closure of the perforated stomach, plication of the diaphragm, and placement of gastrostomy was performed successfully. 相似文献
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This study provides a comprehensive multivariate analysis of drug use disclosure among arrestees interviewed between 2000 and 2001 at 37 sites across the U.S. served by the Arrestee Drug Abuse Monitoring (ADAM) Program. Rates varied widely by drug and across sites. The marijuana disclosure rate varied from 68% in Fort Lauderdale to 93% in Spokane. The cocaine/crack disclosure rate varied from 28% in Chicago to 70% in Kansas City. Moreover, covariates of disclosure differed across drugs. This wide variation in disclosure suggests extreme caution be used when comparing self-reports of prevalence across drugs, locations, and individual characteristics - certainly at least for arrestees. 相似文献
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Using action research to develop midwives’ skills to support women with perinatal mental health needs
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Patricia Leahy‐Warren PhD MSc BSc Hdip PHN RPHN RM RGN Mary Rose Day DN MA BSc Hdip PHN RPHN RM RGN Kari Glavin PhD M.Sc PHN RN MEANS Edith Roth Gjevjon PhD MSc RN MEANS Anne Kjersti Myhrene Steffenak PhD MSc PHN RN Live S. Nordhagen MSc PHN RN Hilde Egge MSc PHN RN Elizabeth Healy MSc PHN RGN 《Public health nursing (Boston, Mass.)》2018,35(4):307-316