The needs of patients with post–intensive care syndrome: A prospective,observational study

BackgroundThe needs of critical illness survivors and how best to address these are unclear.ObjectivesThe objective of this study was to identify critical illness survivors who had developed post–intensive care syndrome and to explore their use of community healthcare resources, the socioeconomic impact of their illness, and their self-reported unmet healthcare needs.MethodsPatients from two intensive care units (ICUs) in Western Australia who were mechanically ventilated for 5 days or more and/or had a prolonged ICU admission were included in this prospective, observational study. Questionnaires were used to assess participants' baseline health and function before admission, which were then repeated at 1 and 3 months after ICU discharge.ResultsFifty participants were enrolled. Mean Functional Activities Questionnaire scores increased from 1.8 out of 30 at baseline (95% confidence interval [CI]: 0–3.5) to 8.9 at 1 month after ICU discharge (95% CI: 6.5–11.4; P = <0.001) and 7.0 at 3 months after ICU discharge (95% CI: 4.9–9.1; P = < 0.001). Scores indicating functional dependence increased from 8% at baseline to 54% and 33% at 1 and 3 months after ICU discharge, respectively. Statistically significant declines in health-related quality of life were identified in the domains of Mobility, Personal Care, Usual Activities, and Pain/Discomfort at 1 month after ICU discharge and in Mobility, Personal Care, Usual Activities, and Anxiety/Depression at 3 months after ICU discharge. An increase in healthcare service use was identified after ICU discharge. Participants primarily identified mental health services as the service that they felt they would benefit from but were not accessing. Very low rates of return to work were observed, with 35% of respondents at 3 months, indicating they were experiencing financial difficulty as a result of their critical illness.ConclusionsStudy participants developed impairments consistent with post–intensive care syndrome, with associated negative socioeconomic ramifications, and identified mental health as an area they need more support in.     

山东省临床护士移动护理类APP功能需求及使用意愿的现状调查

[目的]调查山东省医院护士移动护理类应用程序(APP)功能需求及使用意愿的现状,为进一步开展移动护理类APP临床使用提供依据。[方法]采用方便抽样,对山东省1207名护士进行问卷调查,问卷内容包括一般资料、移动护理类APP知晓情况调查表、移动护理类APP功能需求调查表、移动护理类APP使用意愿调查表。[结果]参与调查的护士群体中,有289名(23.94%)护士使用过移动护理类APP,769名(63.71%)护士知晓移动护理类APP;护士对移动护理类APP的“病人端口药物提醒”及“护士端口健康护理”功能需求最高;护士对移动护理类APP使用意愿平均分为(4.16±0.69)分。[结论]护士对移动护理类APP的知晓度好、功能需求高,同时有较强的使用意愿。护理管理者应重视护士及病人双方对移动护理类APP的软件功能需求及使用心理,以期促进移动护理类APP更好地满足于护理服务。     

医养结合机构失能老人服务供需匹配问卷的研制

目的编制医养结合机构失能老人服务供需匹配问卷。方法于2019年4—5月,在文献研究、半结构访谈和专家咨询的基础上拟定问卷初稿,通过德尔菲法对14名专家进行2轮函询。根据专家函询结果对问卷进行修改和完善,形成最终版问卷。计算专家积极系数、专家权威系数、专家意见集中程度、专家意见协调系数。结果2轮专家函询问卷的有效回收率分别为93.3%和100.0%,专家权威系数为0.92。第2轮函询中,维度及条目的专家意见协调系数分别为0.638和0.407(P<0.001),变异系数均<20%。最终确立的医养结合机构失能老人服务供需匹配问卷包括5个维度,30个条目。结论医养结合机构失能老人服务供需匹配问卷的科学性和可靠性较好,内容全面,可作为有利的调查工具进行失能老人服务供需匹配研究,为制订医养结合照护服务供给方案提供参考依据。     

Household characteristics affecting where mothers deliver in rural Kenya

Data from a household survey were used to analyse the distribution of newborn deliveries in a rural area of Kenya. It was found that 52% of deliveries occurred at home or with traditional birth attendants. Using regression techniques, the most significant predictors of choosing an informal delivery setting are the household's distance from the nearest maternity bed and whether a household member has insurance. The results suggest that travel time is an important barrier to access. Therefore, quality improvements at existing facilities may not result in greater use of modern sector delivery, particularly if improvements are partially offset by user fees.     

济南市老年人医养护一体化社区居家养老健康服务需求的质性研究

目的 了解济南市老年人医养护一体化社区居家养老健康服务需求,为构建以需求为导向的社区居家养老体系提供理论依据。方法 采用最大差异抽样法抽取15名老年人进行访谈,采用 Colaizzi 现象学分析法进行分析。结果 根据访谈资料最终归纳为8个主题,对养老的态度和养老方式的选择、对医养护一体化的态度和看法、对专业医疗和护理服务的需求、生活照料需求、健康管理需求、精神文化需求、中医养生需求、政府政策支持需求。结论 老年人医养护一体化社区居家养老健康服务需求强烈,发展医养护一体化养老服务,能够满足社区老年人健康养老需求。     

饮用水中耗氧量测量不确定度的评定

目的通过不确定度评定对水中耗氧量测定结果临界值进行判断.方法根据JJF1059-1999《测量不确定度评定与表示》对《生活饮用水卫生规范》(2001)中耗氧量的酸性高锰酸钾滴定法的测量不确定度进行分析评定.结果水中耗氧量测定的A类相对标准不确定度为0.584%,B类不确定度为0.781%.其中,使用25ml滴定管引入的相对标准不确定度分项为0.708%,水样体积引入的相对标准不确定度分项为0.056%,校正高锰酸钾标准溶液引入的不确定度分项为0.325%;合成相对标准不确定度为0.975%,扩展不确定度为1.95%.结论根据不确定度评定结果[(3.08±0.06)mg/L]可以判定受污染的水样中耗氧量超标,25 ml滴定管的使用对不确定度贡献最大.     

人口老龄化对农村医疗卫生服务的新要求

在我国未富先老的情况下,农村人口老龄化水平高于全国平均水平和城市水平,大多数农村社会保障制度尚未建全,为老年人提供的医疗卫生保健服务发展严重滞后,现有的农村医疗模式难以满足越来越多的老年人医疗卫生服务需求.为此,提出健全农村基层卫生服务网络体系,大力培养全科医学人才,充分利用中医药,加大健康教育力度、做好预防工作,重视老年医学的教育和科学研究,以满足人口老龄化对农村医疗服务提出的新要求.     

教学医院智慧图书馆服务模式创新及满意度分析

采用在线问卷调查形式,针对读者对教学医院图书馆了解及利用情况、用户体验及满意度进行调查分析,为进一步提升图书馆服务水平提出建议,包括营造舒适的馆舍环境和学术氛围,增强馆藏资源丰富性和易获取性,提高馆员专业素质等。     

基于IPv6的分级诊疗平台设计

分析IPv6环境下分级诊疗平台多元化需求以及资源和网站管理安全性需求,介绍分级诊疗转诊信息平台整体设计,包括整体架构、用户管理和上下转诊等具体功能实现。实践证明该平台在资源、用户和管理3个方面具有安全性和可靠性等优点。