Factors for Effective Identification of Patients at Nutritional Risk in Clinical Practice: Thematic Analysis of Qualitative Research

IntroductionDespite the high prevalence of malnutrition in patients at all levels of healthcare, early prevention and treatment of malnourished patients are often neglected and overlooked in clinical practice. The aim of this systematic literature review was to identify the factors considered most important by healthcare professionals in the identification and treatment of malnourished patients or those at risk of malnutrition.MethodsA systematic literature review of qualitative research was conducted. Documents published in scientific journals in English from 2011 to 2021 were searched in the PubMed (MEDLINE), CINAHL and ProQuest databases. The results were analysed with a thematic analysis of qualitative research findings.ResultsFrom the search set of 1010 results, 7 sources were included in the final analysis. Factors identified by health professionals as important in the identification and treatment of malnourished patients in clinical practice were grouped into five themes: unclear organizational structure; indefinite structure of nutritional care; poor continuity of nutritional care; lack of knowledge and skills of health professionals; lack of time and human resources.ConclusionsHealth policy must provide resources for nutritional care for patients at all levels of health care on the initiative of the highest professional bodies at the state level. To improve the nutritional care of patients in clinical practice, the management of health care institutions must promote and enable the professional and organizational establishment of clinical nutrition as a regular medical activity of the institution, develop clinical nutritional pathways, and promote evidence-based clinical practice and interprofessional collaboration.     

护理人员对慢性病移动健康管理体验的Meta整合

目的 系统评价护理人员利用移动健康进行慢性病管理的体验,为改善移动健康管理服务提供依据。方法 计算机检索Medline (Ovid)、Embase、Cochrane Library、Web of Science、CINAHL、中国知网、万方数据库和维普数据库,检索有关护理人员利用移动健康进行慢性病管理体验的质性研究,检索时限为建库至2023年2月。依据JBI质性研究质量评价标准评价文献质量,采用Meta整合方法对原始研究结果进行整合。结果 共纳入8篇文献,提炼出66个原始研究结果,归纳为10个新类别,综合为2个整合。护士使用移动健康进行慢性病管理感知益处;护士使用移动健康进行慢性病管理感知障碍。结论 移动健康有助于护理人员进行慢性病管理,但其使用仍存在一些障碍,应从移动健康的易用性、移动健康与传统管理手段的融合、健全相关制度保障等方面完善。     

OSCE考核模本在护生急救技能评价体系中的应用

目的评估在护理学生急救护理技能考核评价中引入OSCE模本的应用效果。方法选取2020年10月—2021年10月期间在本院急诊科轮转的98名实习护生为研究对象,在急救考核中应用OSCE模本,通过四个考站的考核,考核和评价护生在各考站的急救技能和综合能力、急诊常见疾病的预检分诊、护生急诊急救临床能力、转运过程及突发事件的应对,并让护生在参加考核后完成问卷调查。结果 OSCE考核成绩(73.36±6.57)分,考试成绩总体上基本服从正态分布,校标关联效度系数(r=0.66,P <0.05),难度系数为0.70,区分度为0.56,护生对OSCE考核模本在护生急救技能评价体系中的应用认可度和满意度分别为84.21%和78.95%。结论可在原有的基础上进一步完善OSCE考核模式,使其更基础更广泛地应用于护生教学和考核中应用中。     

微信公众平台在手术室护理带教中的应用效果

目的 微信公众平台在手术室护理带教中的应用效果。方法 选取226名在我院手术室进行实习的护生进行调研,本次调查时间在2019年1月—2020年9月。根据随机形式将实习护生分为2组,每组均分得113名。在本次调查中,对比组所采用的带教模式为传统常规带教。研究组所采用的带教模式为微信公众平台带教模式。分析两组最终护理结果。结果 （1）对比组实习护生操作成绩与研究组相比明显较低,两组差异有统计学意义,P <0.05;(2)对比组实习护生理论成绩与研究组相比明显较低,两组差异有统计学意义,P <0.05;(3)对比组实习护生SRSSDL得分结果与研究组相比明显较低,两组差异有统计学意义,P <0.05;(4)对比组：参与调查的113名实习护生,通过收集113份有效调查问卷,总结护理满意评分结果证实,本组实习护生对于本次护理带教均表示满意;研究组：参与调查的113名实习护生,通过收集113份有效调查问卷,总结护理满意评分结果证实,本组实习护生对于本次护理带教均表示十分满意,对比组实习护生带教满意得分结果与研究组相比明显较低,两组差异有统计学意义,P <0.05。结论 在手...     

The role of electronic medical records in improving health care quality: A quasi-experimental study

The Teleprimary Care—Oral Health Clinical Information System (TPC-OHCIS) is an updated electronic medical record (EMR) that has been applied in Malaysian primary healthcare. Recognizing the level of patient satisfaction following EMR implementation is crucial for assessing the performance of health care services. Hence, the main objective of this study was to compare the level of patient satisfaction between EMR-based clinics and paper-based clinics.The study was a quasi-experimental design that used a control group and was conducted among patients in 14 public primary healthcare facilities in the Seremban district of Malaysia from May 10, to June 30, 2021. Patient satisfaction was assessed using the validated Short-Form Patient Satisfaction Questionnaire, which consisted of 7 subscales. All data were analyzed using the IBM Statistical Package for Social Sciences version 21.A total of 321 patients consented to participate in this study, and 48.9% of them were from EMR clinics. The mean score for the communication subscale was the highest at 4.08 and 3.96 at EMR-adopted clinics and paper-based record clinics. There were significant differences in general satisfaction and communication subscales, with higher patient satisfaction found in clinics using EMR.With the utilization of EMR, patient satisfaction and communication in delivering healthcare services have improved.     

早期帕金森病患者多巴胺能药物与夜间睡眠的相关性探讨

目的探索帕金森病（PD）患者多巴胺能药物与夜间主观和客观睡眠之间的关系。方法收集本院2010年10月至2013年6月门诊诊疗的帕金森病患者的人口学特征和疾病信息,所有患者行整夜视频多导睡眠图、完成PD睡眠量表（SCOPA-SLEEP）,采集用药信息,包括服药与就寝时间,转化为左旋多巴当量。结果共有41例男性、20例女性患者纳入研究,中位年龄63．6岁,中位病程5年。经过年龄、性别、疾病严重程度和病程校正,更高的左旋多巴等效剂量（LED4H）与更高的SCOPA-NS（P〈0．05）及入睡后觉醒时间（P〈0．05）相关。更高剂量就寝前多巴胺能药物摄人与快速动眼（REM）睡眠时间百分比减少相关（P〈0．05）。结论就寝前服用更高剂量多巴胺能药物与更少的REM睡眠及更差的睡眠质量相关。尽管PD患者睡眠质量不佳由多种因素引起,但仍建议将睡前服药剂量和时间纳入帕金森病患者管理当中。     

针刺对照激素治疗贝尔麻痹急性期疗效比较系统评价

目的：比较针刺与激素治疗贝尔麻痹急性期临床疗效及安全性。方法：检索PubMed、Cochrane图书馆、CBM数据库、CNKI数据库等收集针灸治疗贝尔麻痹急性期的临床随机对照试验,以Cochrane系统评价手册4.26结合Jadad进行质量评价,统计学分析采用RevMan 4.2.6。结果：4篇文献符合纳入标准,共316例患者。Meta分析显示针刺治疗贝尔麻痹急性期对照激素为主治疗,组间比较差异无统计学意义。合并RR[随机效应模型]=1.11,95%CI（0.99,1.25）,Z=1.80,P=0.07。结论：针刺较激素予贝尔麻痹急性期治疗治愈率尚无差异,但可能有缩短疗程的趋势,需要高质量的证据进一步证明。     

南昌地区高校教师职业性喉病调查分析

目的了解高等院校一线教师职业性喉病发病情况并提出预防保健建议。方法对南昌地区两所高等院校428名一线教师与382名行政人员各类职业性喉病的发病情况进行对照分析,并分析高校教师职业性喉病发病的性别差异。结果高校教师各类职业性喉病的患病率显著高于对照组（P〈0．05或P〈0．01）,男女教师职业性喉病的患病率无显著性差异（P〉0．05）。结论高校教师各类职业性喉病的患病率高,应引起学校及教师本人的高度关注。     

口腔固有条件对全口义齿满意度的影响

目的探讨无牙颌患者口腔固有条件对全口义齿修复效果的影响及与全口义齿满意度的关系。方法随机选取97例行全口义齿修复的患者,根据口腔固有条件分成三组,修复后的1个月和6个月分别填写全口义齿满意度调查问卷,进行统计分析。结果戴用全口义齿1个月后,口腔固有条件Ⅰ级组Ⅱ级组较Ⅲ级组全口义齿满意度高,有统计学意义;戴用全口义齿6个月后,三组的满意度均有一定提高,三组间满意度无明显差异。结论无牙颌患者的口腔固有条件会部分影响全口义齿的修复效果。     

复方左旋多巴制剂的研究进展

左旋多巴治疗帕金森病有40多年的历史,一直是治疗帕金森病的主要药物。但长期应用左旋多巴后,会引起“开-关”现象和运动障碍等并发症,给患者带来极大的痛苦。提高临床疗效、减少并发症的发生,延缓帕金森病进程是治疗帕金森病的重点内容。现综述近年来复方左旋多巴制剂,包括目前临床使用中的药物和制药公司研发的药物的研究进展。