Nurses' Perceptions of Patient Participation in the Postanesthesia Care Unit—A Qualitative Focus Group Study

PurposeTo explore postanesthesia care unit (PACU) nurses' experiences and perception of patient participation during PACU care.DesignQualitative focus group study based on a phenomenological hermeneutic approach.MethodsWe conducted three focus group interviews with 18 nurses from three different PACUs. Themes were created based on interpretive theory inspired by Ricoeur.FindingsFour themes and 11 subthemes were found. Patients’ clinical condition and situation, time management, ethical aspects, and the patient-nurse relationship all had a high impact on postanesthesia nursing practice and conditions for involving patients.ConclusionsPACU nurses want patients to participate in their own treatment and care in the PACU; however, nurses perceive patient participation differently. Nurses experience challenges including patients’ impaired autonomy, absence of a holistic approach, and lack of time and resources. Nurses highlight that these barriers should not become an excuse for noninvolvement.     

The value of values: shared decision-making in person-centered,value-based oral health care

In order to provide care that is truly person-centered, dental practitioners must incorporate the informed preferences of our patients into clinical treatment decisions. Shared decision making provides the necessary framework to accomplish this goal, especially in an era of value-based care.     

Participation, characteristics and retention rates of HIV-positive immigrants in the Swiss HIV Cohort Study

Objective

Data from observational cohorts may be influenced by population structure and loss to follow‐up (LTFU). Quality of care may be associated with participation in cohort networks. We aimed to study the participation, characteristics and retention rates of immigrants in the Swiss HIV Cohort Study (SHCS).

Methods

We compared enrolment over time (1996–1999, 2000–2003 and 2004–2008) and LTFU between individuals from different geographical regions. In 2008, we performed a cross‐sectional survey to investigate the proportion of individuals not participating in the SHCS but who were in care at SHCS institutions. Predictors for LTFU were analysed using Cox proportional hazard models, and those for nonparticipation using logistic regression.

Results

A total of 7840 individuals entered the SHCS during the observation period. The proportion of immigrants increased over time, especially the proportion of women from sub‐Saharan Africa, which increased from 21 to 48% during the observation period. Overall LTFU was 3.76 [95% confidence interval (CI) 3.58–3.95]/100, with the highest hazard ratio in men from sub‐Saharan Africa (2.82/100 patient‐years; 95% CI 2.30–3.46/100), compared with men from northwestern countries. Other predictors for LTFU were age <30 years, lower education, injecting drug use, and higher baseline CD4 cell counts. Participants taking antiretroviral therapy had reduced LTFU. The survey showed that 84% of HIV‐infected patients in care at SHCS institutions were enrolled in the cohort. Nonparticipation was more likely among men from non‐European regions (odds ratio 2.73; 95% CI 2.29–3.24), women from sub‐Saharan Africa (odds ratio 3.01; 95% CI 2.40–3.77) and women from Latin America/Caribbean (odds ratio 2.10; 95% CI 1.30–3.39).

Conclusions

Numbers of HIV‐infected immigrants are increasing but they are underrepresented in the SHCS, and immigrants are more likely to be lost to follow‐up.     

家属互补式健康教育护理模式对小儿发热康复效果观察

目的：探讨家属互补式健康教育护理模式对小儿发热的康复效果。方法将80例发热患儿按照随机数表法分为观察组和对照组各40例,对照组给予常规护理,观察组采用家属互补式健康教育护理模式进行护理干预,比较两组患儿的康复效果和家长满意度。结果两组患儿治疗效果比较差异无统计学意义（ P＞0.05）;观察组患儿家属发热初期处理、小儿发热正确知识、合理选择退热药物、合理采取降温措施、体温测量方法掌握程度均高于对照组,差异有统计学意义（ P＜0.05）;观察组患儿在治疗24 h后体温为（37.41±0.48）℃,显著低于对照组的（37.73±0.55）℃,两组比较有统计学意义（P＜0.05）;观察组患儿家属总体满意度为95.00％,显著高于对照组的80.00％,两组比较差异有统计学意义（ P＜0.05）。结论家属互补式健康教育护理有助于提高发热患儿家属健康知识掌握程度,缩短患儿退热时间。     

Difficulties in obtaining a sample of young adult cleft lip and palate subjects and their relatives

Abstract Families of individuals aged 15–24 yr born with cleft lip, with or without cleft palate, and suitable control families were required for a study of inherited predisposition to the malformation. Cleft patients were identified through hospital discharge listings, but the overall yield of participating patients was only 8% of the cases listed. An attempt to recruit control subjects by the same method, using patients who had been hospitalized for dissection tonsillectomy, yielded only 4% of those identified as suitable in the discharge listings. The results highlight the value of specialized, regularly updated disease registers in the recruitment of subjects for research purposes.     

Predicting preferences: a neglected aspect of shared decision-making

In recent years, shared decision-making between patients and doctors regarding choice of treatment has become an issue of priority. Although patients' preferences lie at the core of the literature on shared decision-making, there has not been any attempt so far to link the concept of shared decision-making with the extensive behavioural literature on people's self-predictions of their future preferences. The aim of the present review is to provide this link. First, we summarize behavioural research that suggests that people mispredict their future preferences and feelings. Secondly, we provide the main psychological accounts for people's mispredictions. Thirdly, we suggest three main empirical questions for inclusion in a programme aimed at enriching our understanding of shared decision-making and improving the procedures used for putting it into practice.     

Scientific rigor and community participation in health promotion research: are they compatible?

An important challenge for those conducting health promotionresearch is to reconcile the competing demands of scientificrigor and community participation. To develop further the theoreticaland empirical basis for health promotion, research needs tobe scientifically rigorous in every aspect of conceptualization,design, implementation, analysis and interpretation. Anotherwidely held perspective in health promotion research is thatit should be based on widespread community participation invarious stages of the process. These two compelling forces arecompeting to the extent that they create questions about controlof the research questions, methods used and relevance. The natureof this dilemma is discussed in this paper, along with an exampleof how one community-based research unit is dealing with theseissues     

Individual and neighbourhood determinants of social participation and social capital: a multilevel analysis of the city of Malmö, Sweden

The aim of this study was to analyse the impact of neighbourhood on individual social capital (measured as social participation). The study population consisted of 14,390 individuals aged 45–73 that participated in the Malmö diet and cancer study in 1992–1994, residing in 90 neighbourhoods of Malmö, Sweden (population 250,000). A multilevel logistic regression model, with individuals at the first level and neighbourhoods at the second level, was performed. The study analysed the effect (intra-area correlation and cross-level modification) of the neighbourhood on individual social capital after adjustment for compositional factors (e.g. age, sex, educational level, occupational status, disability pension, living alone, sick leave, unemployment) and, finally, one contextual migration factor. The prevalence of low social participation varied from 23.0% to 39.7% in the first and third neighbourhood quartiles, respectively. Neighbourhood factors accounted for 6.3% of the total variance in social participation, and this effect was reduced but not eliminated when adjusting for all studied variables (−73%), especially the occupational composition of the neighbourhoods (−58%). The contextual migration variable further reduced the variance in social participation at the neighbourhood level to some extent. Our study supports Putnam's notion that social capital, which is suggested to be an important factor for population health and possibly for health equity, is an aspect that is partly contextual in its nature.     

肿瘤化疗病人参与护理计划工作的研究

目的　探索有效的护理方法,提高肿瘤化疗病人的护理效果。方法　84例肿 瘤化疗住院病人随机分为观察组(44例)和对照组(40例),观察组病人参与护理计划工作,对 照组进行常规护理。入院后1周和3周分别进行生活质量评分。结果　3周后观察组生活质 量评分优于对照组(P<0.05),特别是在食欲、睡眠、精神、家庭理解与配合、对癌症的认识、 对治疗的态度、日常生活情况及面部表情方面;而疲乏、疼痛、同事的理解配合及治疗的副作用 上无差异(P>0.05)。结论　护患共同参与护理计划工作对肿瘤化疗病人的康复有益;生活 质量评估表可指导护理工作。