Effect of sexual diary keeping and self-evaluation on female sexual function and depression: A pilot study

Objectives The aim of the trial was to assess the effect of self-evaluation and sexual diary keeping on female sexual function and depressive symptoms in women diagnosed with sexual dysfunction.

Methods A single-arm non-randomised trial included 30 women (53 ± 7 years of age) with female sexual dysfunction (Female Sexual Function Index [FSFI] < 27) and a stable partnership duration of 5–40 years. Female sexual function was assessed by sexual, psychological and gynaecological history taking and validated questionnaires including the FSFI, Female Sexual Distress Scale (FSDS) and Hamilton Depression Scale (HDS), before and after 4 weeks of sexual diary keeping.

Results A subjective improvement in communication of sexual problems was reported by 60% of participants; no participants reported any worsening of communication. FSFI and FSDS scores were, respectively, 18.0 ± 7.7 and 22.0 ± 10.0 at baseline and 20.2 ± 7.2 and 20.6 ± 11.5 after 4 weeks. HDS score decreased from 6.0 ± 4.0 at baseline to 4.4 ± 2.7 after 4 weeks (p = 0.042).

Conclusions Self-evaluation and sexual diary keeping may improve aspects of sexual life, such as couple communication, without a direct effect on variables measured with validated questionnaires on different domains of sexual function.     

基于医护一体化有效沟通的移动视频探视在PICU中的应用

目的：探讨在儿童重症监护病房(PICU)利用移动视频探视系统结合医护一体化的有效沟通实施的方法和效果。方法选择2014年8月至2015年1月在PICU住院的120名患儿家属为对照组,2015年2月至2015年7月在PICU住院的131名患儿家属为观察组。对照组采用单一的视频探视方法,观察组在视频探视的基础上,评估患儿家属的需求,组成医护协同小组,完善“沟通—探视—沟通”工作制度,制定探视指引,确认探视流程,实施医护一体化的有效沟通,反馈探视沟通效果。采用焦虑自评量表和EMPATIC-30PICU患儿家属满意度测评量表对两组患儿家属进行问卷调查。结果对照组均发放120份问卷,收回115份,有效回收率为95.8%;观察组均发放131份问卷,收回128份,有效回收率为97.7%。观察组患儿家属焦虑程度为(49.4±5.9)分,明显低于对照组的(57.3±6.8)分,差异有统计学意义(P<0.05)。满意度调查结果显示,观察组家属对治疗照护、专业态度、父母参与、组织和信息5个维度的满意度分别为(4.9±0.7)分、(4.7±0.6)分、(5.0±1.2)分、(4.3±0.9)分和(5.0±1.1)分,均高于对照组的(3.2±0.9)分、(3.4±1.0)分、(3.1±0.8)分、(3.0±0.7)分和(3.2±0.8)分,差异均有统计学意义(P<0.05)。结论在PICU进行移动视频探视,结合医护一体化有效的沟通,动态了解患儿家属的心理需求,提供心理支持,缓解了家属的焦虑情绪,体现人文关怀,提高患儿家属的满意度,改善就医感受,有利于构建和谐的护患关系。     

Lessons from an online vaccine communication project

Most members of the general public use the internet to research health topics. However, the quality of vaccine-related material available online is mixed and internet search engines often bring web users to low-quality anti-vaccine websites.We present a case study of a pro-vaccine information hub launched in 2011. Vaccines Today provides high-quality information about vaccines and diseases, expert interviews, answers to frequently asked questions, parent/patient stories and videos/infographics. Twitter, Facebook, YouTube and Instagram are used to share this content and to engage with various online audiences.This Commentary outlines what works in online communication about vaccines and offers proposals for improving the impact of online vaccine advocacy. The value of networking to boost visibility and search engine ranking is emphasised. Furthermore, we present the case for the sharing and application of best practice in online communication.     

The nurse's role in day surgery: a literature review

AIM: This paper reports a literature review to synthesize the evidence on day surgery, demonstrating its usefulness for innovative nurses. BACKGROUND: Day surgery growth has developed rapidly in recent years. Such a rapid growth has triggered a shift in nursing roles and interventions. Nursing roles are taking shape within modern day surgical units but have not been widely reviewed in developing countries. METHODS: The RCN library, BNI, CINAHL and Medline databases were searched using the terms 'day surgery and technological advantages', 'financial/economic benefits', 'patient experiences/satisfaction', 'day surgery/international comparisons', 'day surgery and developing countries'. Only papers in the English language from 1990 to 2005 were reviewed, with a predominantly adult focus. The papers examined mainly used research techniques and some opinion papers, policy documents and textbooks were examined for additional information. FINDINGS: The key strengths of day surgery are cost-effectiveness, increased patient satisfaction and low infection rates. Patients indicated that effective information provision and psychological preparation helped them cope with the experience. The use of music, story telling and distraction reduced pre-operative anxiety. Contrastingly, the deficits included poor information giving and psychological preparation resulting in high anxiety levels. Many patients encountered variable pain and nausea management and education strategies. CONCLUSION: This review highlights the importance of adequate preparation and continuous psychological support for patients undergoing day surgery. The challenges faced by practitioners involved with innovation are also emphasized.     

Using the DISC system to motivate dental patients

BACKGROUND: Dentists report that motivating patients to accept treatment plans and adopt behaviors that will improve their oral health is a significant challenge in their practices. According to the DISC system, which was developed by William Moulton Marston, people can be classified as having a "dominant" (D), "influencing" (I), "steady" (S) or "cautious" (C) behavioral style. Dentists and dental team members who recognize patients' DISC styles and tailor their communication accordingly may have greater success in motivating patients. CONCLUSIONS: Practitioners cannot classify all patients easily into one of the four DISC styles, and patients may have multiple reasons for rejecting treatment plans and resisting behavioral changes. However, the DISC system provides a set of useful principles for motivating many patients. Practice Implications. The benefits of using the DISC system may include an increase in the rate of treatment plan acceptance and an improvement in patients' behavior necessary for optimal oral health.     

Outcomes and safety of electronic consult use in vascular surgery

ObjectiveThe objective of this study was to determine how electronic consults (eConsults) are used in vascular surgery in a veterans health care setting and whether their use is safe for patients.MethodsA retrospective review was performed of all eConsults completed by the vascular surgery service at the Ann Arbor Veterans Affairs Healthcare System between October 10, 2012 and November 15, 2013. Patients' demographics and comorbidities were collected. eConsult recommendations and patient and provider compliance with recommendations were collected. Data on adverse outcomes up to 1 year after consultation and data on all-cause mortality at 1 year and 5 years were collected.ResultsBetween October 10, 2012 and November 15, 2013, of 350 eConsults completed, 123 (35%) were for peripheral artery disease, 93 (27%) for carotid stenosis, and 57 (16%) for abdominal aortic aneurysm. Unique recommendations were made for 291 consults (83%). Medication recommendations were made in 140 consults (40%). The most commonly recommended medication was cilostazol. Compliance with medication recommendations ranged from 30% to 61%. Noninvasive imaging was recommended in 220 consults (60.3%). Procedures overall were recommended in only six consults (1.7%). Five-year all-cause mortality for categorized diagnoses ranged from 8.3% for nonabdominal aneurysm to 28.1% for abdominal aortic aneurysm.ConclusionsWithin the Veterans Affairs vascular surgery service, eConsults provide a safe and effective means of triaging and providing recommendations for patients with vascular disease. eConsults used to augment traditional consultations may provide an important means of reducing clinic congestion for providers and reducing time and cost for patients.     

Patients’ perspectives on care,communication, and teamwork in the emergency department

BackgroundThe work of healthcare professionals (HCPs) in the emergency department (ED) involves effective communication and efficient teamwork, which may be perceived differently by patients and HCPs. Therefore, it is important to explore patient perspectives of information exchange and clinical assessment.AimTo evaluate experiences of care, communication, and teamwork from ED patients’ perspectives.MethodsSemi-structured interviews were conducted with 17 patients who were assessed in a Swedish ED during Spring 2021. Thematic analysis was used.ResultsParticipants’ experiences reflected the complex environment of the ED. Findings emphasize the importance of information exchange in relation to a caring approach. Three themes emerged: the need for a caring approach by HCPs towards patients’; the need for dialogue between patient and HCPs; and the need for information on ED environment constraints.ConclusionsPatients felt comforted when they experienced a caring empathic approach from the HCPs. For example, patients valued an individual holistic approach rather than feeling that they were being objectified by their medical conditions. This was important in coping with the anxiety caused by a stressful ED environment. There is a critical need for effective exchange of information between patients and HCPs.     

Patient mobilisation in the intensive care unit and evaluation of a multifaceted intervention including Facebook groups: A quasi-experimental study

AimsTo describe prevalence and time to mobilisation in intensive care unit patients defined as a minimum sitting in an upright position in bed, and evaluate the impact of a multifaceted quality improvement campaign on likelihood of patients being mobilised.Research methodology/designQuality improvement project using a quasi-experimental study design, comparing patient cohorts before (Before) and after (Intervention) a campaign including educational sessions, audit and feedback of intensive care unit quality indicators via closed Facebook-groups and e-mail and local opinion leaders. Secondary analysis of mobilisation data from adult intensive care patient stays extracted from electronical medical charts. Likelihood of being mobilised was analysed with Multivariate Cox-regression model and reported as Sub-hazard Ratio (SHR).SettingFour intensive care units in a university hospital.Main outcome measuresPrevalence and time to first documented mobilisation, defined as at least “sitting in bed” during the intensive care unit stay.ResultsOverall, 929 patients were analysed, of whom 710 (76 %) were mobilised; 73 % (356/ 489) in Before vs 81 % (354/ 440) in Intervention (p = 0.007). Median time to mobilisation was 69.9 (IQR: 30.0, 149.8) hours; 71.7 (33.9, 157.9) in Before and 66.0 (27.1, 140.3) in Intervention (p = 0.104). Higher SAPS II-scores were associated with lower likelihood (SHR 0.98, 95 % CI 0.97–0.99), whereas admissions due to gastroenterological failure (SHR 2.1, 95 % CI 1.4–3.0), neurological failure (SHR 1.5, 95 % CI 1.0–2.2) and other causes (intoxication, postoperative care, haematological-, and kidney failure) (SHR 1.7, 95 % CI 1.13–2.6) were associated with higher likelihood of mobilisation vs respiratory failure.ConclusionA quality improvement campaign including use of Facebook groups is feasible and may improve mobilisation in intensive care unit patients. Most patients were mobilised within 72 hours following intensive care unit admission, and SAPS II scores and causes for intensive care unit admission were both associated with likelihood of being mobilised.     

Integration of Smartphones into clinical pharmacy practice: An evaluation of the impact on pharmacists׳ efficiency

BackgroundPersonal smartphones are used frequently by healthcare practitioners in hospitals to assist in the provision of care. Island Health is one of the first health authorities in Canada to endorse the iPhone^®smartphone as a potentially valuable tool for clinical practice.ObjectiveTo measure smartphones effect on pharmacists׳ efficiency, to assess pharmacist acceptance of corporate smartphones, and to investigate how these devices are being utilized.MethodsThis multi-center time-trial, survey, and observational prospective study enrolled 90 pharmacists across eight hospitals on Vancouver Island. Participants performed a time-trial of 22 situational drug information questions before and after receiving an iPhone^®. They also completed demographic and satisfaction surveys. A subset of 14 of the 90 pharmacists participated in a pre- and post- iPhone^® implementation eight hour direct observation study. Lastly, communication data from the phone service provider was collected and analyzed.ResultsSmartphone use was associated with a faster median response time of approximately six minutes for all situational time-trial questions combined (48 min:15 s pre-iPhone^® vs. 42 min:18 s post-iPhone^®) (p=0.039). Smartphone use did not significantly influence time spent walking to obtain a resource, time spent using computers, or time spent answering of clinical questions during observation. Almost half of pharmacists reported that using the smartphone increased their confidence and competence to resolve drug therapy problems.ConclusionsPharmacists readily accepted smartphones into their practice and felt positively about using them. Smartphones did not improve direct observation measures of workflow, but they did improve pharmacists׳ efficiency in the answering of hypothetical drug information questions (p=0.039). This study indicates that if smartphones are incorporated into pharmacy practice in a structured, organized manner with supports and training in place, smartphone uptake will occur and pharmacists will adapt and incorporate this technology into their daily routine with no predicted deterioration in the quality of their work. The impact of improved efficiency on patient care resulting from an increased reliance on technology and time spent on devices needs to be further assessed.