AIDET沟通联合六西格玛管理在改善床边快速血糖疼痛感中的应用

目的 观察AIDET 沟通联合六西格玛管理在改善床边快速血糖疼痛感中的应用效果。方法 选取2019 年1—6 月在本院内分泌科住院的糖尿病患者94 例，运用AIDET 沟通模式联合六西格玛管理方法作为改善工具，改善前患者为对照组，纳入48 例，改善后患者为观察组，纳入46 例，比较两组患者即时疼痛评分、24 h 后疼痛评分、左右手疼痛评分、各手指疼痛评分的情况及改善前后患者主观资料的变化。结果 观察组患者床边快速血糖的即时及24 h 后NRS 评分均低于对照组，差异有统计学意义（P<0.05）；与即时相比，两组患者24 h 后左右手NRS评分比较，差异均有统计学意义（P＜0.05）；观察组患者24 h 后的NRS 评分明显低于对照组，差异有统计学意义（P＜0.05）。两组患者主观资料中的知识、无想法比例比较，差异有统计学意义（P<0.05）。结论 运用AIDET 沟通联合六西格玛管理模式改善床边快速血糖疼痛感，可以有效的减轻患者疼痛感，体现了优质护理中人文关怀的理念。     

Palliative and hospice care in gynecologic cancer: A review

Despite the increasing availability of palliative care, oncology providers often misunderstand and underutilize these resources. The goals of palliative care are relief of suffering and provision of the best possible quality of life for both the patient and her family, regardless of where she is in the natural history of her disease. Lack of understanding and awareness of the services provided by palliative care physicians underlie barriers to referral. Oncologic providers spend a significant amount of time palliating the symptoms of cancer and its treatment; involvement of specialty palliative care providers can assist in managing the complex patient. Patients with gynecologic malignancies remain an ideal population for palliative care intervention. This review of the literature explores the current state of palliative care in the treatment of gynecologic cancers and its implications for the quality and cost of this treatment.     

Priority-setting and rationing in healthcare: Evidence from the English experience

In a context of ever increasing demand, the recent economic downturn has placed further pressure on decision-makers to effectively target healthcare resources. Over recent years there has been a push to develop more explicit evidence-based priority-setting processes, which aim to be transparent and inclusive in their approach and a number of analytical tools and sources of evidence have been developed and utilised at national and local levels. This paper reports findings from a qualitative research study which investigated local priority-setting activity across five English Primary Care Trusts, between March and November 2012. Findings demonstrate the dual aims of local decision-making processes: to improve the overall effectiveness of priority-setting (i.e. reaching ‘correct’ resource allocation decisions); and to increase the acceptability of priority-setting processes for those involved in both decision-making and implementation. Respondents considered priority-setting processes to be compartmentalised and peripheral to resource planning and allocation. Further progress was required with regard to disinvestment and service redesign with respondents noting difficulty in implementing decisions. While local priority-setters had begun to develop more explicit processes, public awareness and input remained limited. The leadership behaviours required to navigate the political complexities of working within and across organisations with differing incentives systems and cultures remained similarly underdeveloped.