医德医风教育与建设之我见

医德医风,事关民生,事关医疗卫生行业形象,事关党和政府与人民群众的血肉联系。我院主要从建立组织管理,完善制度建设,拓展监督渠道,强化服务考核四个方面,不断深化医德医风教育与建设。有效地提高了患者满意度和社会信誉度,树立了医院的良好形象。     

Early Intensive Family Intervention and Evidence of Effectiveness: Lessons from the South West Autism Programme

Intervention strategies in autistic spectrum disorder (ASD) have emanated from a range of theoretical perspectives with a consensus view that the greatest impact on children's subsequent development is likely to occur when this work is early, intensive and focuses on young children in the context of the family. Controversies in ASD intervention have arisen in relation to claims for effectiveness, particularly for versions of Applied Behavioural Analysis. Taking account of user perspectives, the evidence base for ASD intervention is considered, distinguishing between experimental work that identifies a treatment effect and research that establishes ecological validity. In order to move practice forward, research is required to address which programme components are helpful for which children and which families in which contexts. Drawing on current intervention research (South West Autism Programme), this paper concludes by outlining some of the factors that need to be considered in shaping future ASD research and ASD service provision.     

探讨创新管理理念下医院管理的方法与实践

目的分析创新管理理念下医院管理的方法与实践工作。方法对创新管理理念组和常规管理组进行回顾性分析,比较两组的医疗服务效果。结果创新管理理念组在医疗质量、医技水平、服务水平、就医环境、医风医德的总体评分以及医护人员满意度上均优于常规管理组。结论切合医院实际创新的内部管理理念,能够提升医院的服务质量,提高医院的竞争力。     

概述美国的药学服务实践流程变迁

摘 要 目的： 概述美国的药学服务实践流程变迁,为我国开展药学服务工作提供借鉴。方法: 查阅文献,对美国医院药学相关学会组织提出的药学服务实践流程进行总结、分析。结果与结论:美国药学从业者联合委员会提出的以患者为中心的药学服务完整总结了其实践流程,包括采集-评估-计划-实施-随访等步骤,强调与团队的沟通、合作、资源共享,适合任何工作环境对患者提供的药学服务。     

Prevalence and reliability of treatment-based classification for subgrouping patients with low back pain

Objectives: To observe the distribution of patients who presented with low back pain (LBP) and to determine the between therapists’ interrater reliability of assessments in a private outpatient setting using treatment-based classification (TBC) subgroups.

Methods: An observational and methodological study was conducted. Four hundred and twenty-nine patients (231 male; 198 female) presenting LBP symptoms and referred to conservative treatment were assessed by 13 physical therapists who conducted a 60-min examination process utilizing TBC subgroups. Interrater reliability analyses from six raters were assessed using Fleiss’ kappa and previously recorded data (n = 30).

Results: In this study, 65.74% of patients were classified in only one subgroup, the most prevalent being stabilization (21.91%), followed by extension (15.38%), traction (11.89%), flexion (10.96%), manipulation (5.13%), and lateral shift (0.47%). Approximately 20.98% of patients were classified in two subgroups, where the most frequent overlaps were flexion + stabilization (7.46%), extension + stabilization (6.06%), flexion + traction (4.20%), extension + manipulation (1.86%), and 13.29% of patients were not classified in any TBC subgroup. Analysis of interrater reliability showed a kappa value of 0.62 and an overall agreement of 66% between raters.

Discussion: LBP is a heterogeneous clinical condition and several classification methods are proposed in the attempt to observe better outcomes for patients. Eighty-five percent of patients assessed were able to be classified when using the TBC assessment and reliability analysis showed a substantial agreement between raters.

Level of Evidence: 2c.     

A scoping review of the progress of the evolution of the Doctor of Nursing Practice in the USA to inform consideration of future transformation of Nurse Practitioner education in Australia

Background

In 2004 a consensus was reached through a vote of membership of the American Association of Colleges of Nursing to move Nurse Practitioner education from the masters to the doctoral level by 2015.