探讨ICU获得性肺部感染的病因分析

目的探讨ICU院内获得性肺部感染的病因。方法183例危重病患者均来自于2004年1月~2006年4月入住怀化医学高等专科学校附属医院暨怀化市第三人民医院ICU的患者。结果183例危重病患者中发生院内获得性肺部感染47例,感染率25.68%。年龄愈大、住院时间愈长、采用手术治疗、气管插管或切开的患者,肺部感染率愈高。结论ICU院内获得性肺部感染率较高,应引起临床医务人员的高度重视。     

慎独精神在提高ICU护理质量中应用的体会

慎独,出自《礼记.中庸》中的＂莫见乎隐,莫见乎微,故君子慎其独也＂,属于中国伦理思想史上一个特有的范畴,是我国儒家倡导的一种修身养性的方法,是道德修养的较高境界。慎独是指一个人在无人监管、没有舆论影响的情况下,仍能坚持道德信念,谨慎从事,坚持原则,不做任何违反道德和规范的事,     

中华猕猴桃的防癌作用——(七)阻断慢性萎缩性胃炎病人体内N-亚硝基脯氨酸合成

本文报导了中华猕猴桃汁阻断慢性萎缩性胃炎(CAG)病人体内N-亚硝基脯氨酸(NPRO)合成的作用。在11名CAG病人的自身对照研究中,病人食入300mg NaNO_3和500mg脯氨酸后,尿中NPRO从本底值26.3nmol升至63.9nmol;同时服4.1ml浓缩猕猴桃汁后,多数人尿中NPRO明显下降,阻断率达94.4％。此外,有2人体内NPRO合成水平很高,提示可能有较高的癌变危险性。     

“邵氏保肺功”对肺癌术后老年患者生活质量影响的临床研究

目的 研究“邵氏保肺功”配合耳穴贴压对肺癌术后老年患者生活质量的影响。方法 选取符合纳入标准的肺癌术后老年患者96例,采用分层区组设计,将患者按自主意愿分入治疗组与对照组,剔除脱落病例后每组42例。治疗组采取“邵氏保肺功”功法锻炼共12周,对照组不进行功法锻炼。分别于入组时、干预12周后以及入组1年后对患者进行肺癌患者生活质量量表(FACT-L)、中医证候积分评估。结果 两组生活质量量表评分比较P<0.05,差异有统计学意义,治疗组在生活质量方面的改善优于对照组。两组中医证候评分比较P<0.05,差异有统计学意义,治疗组在中医证候评分的改善优于对照组。结论 邵氏保肺功可明显提高肺癌术后患者的生活质量,具有长期疗效,临床使用副作用少,治疗成本低,易于推广应用。     

READ-BACK在综合ICU临床检验危急值管理中的应用及效果观察

危急值即当这种结果出现时说明患者可能正处于危险边缘状态,此时如果临床医师能及时得到检验信息,给予患者干预措施或治疗,就可能挽救患者生命,否则将可能出现不良后果,特别是综合 ICU的住院患者[1].临床实验室危急值报告制度最早在中国医院协会发布的《2007年度患者安全目标》被正式提出,2015年由国家卫计委出台的15项质...     

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.     

Including the voice of paediatric patients: Cocreation of an engagement game

BackgroundEngaging patients in health care, research and policy is essential to improving patient‐important health outcomes and the quality of care. Although the importance of patient engagement is increasingly acknowledged, clinicians and researchers still find it difficult to engage patients, especially paediatric patients. To facilitate the engagement of children and adolescents in health care, the aim of this project is to develop an engagement game.MethodsA user‐centred design was used to develop a patient engagement game in three steps: (1) identification of important themes for adolescents regarding their illness, treatment and hospital care, (2) evaluation of the draft version of the game and (3) testing usability in clinical practice. Adolescents (12–18 years) were engaged in all steps of the development process through focus groups, interviews or a workshop. These were audio‐recorded, transcribed verbatim and analysed in MAXQDA.Results(1) The important themes for adolescents (N = 15) were included: visiting the hospital, participating, disease and treatment, social environment, feelings, dealing with staff, acceptation, autonomy, disclosure and chronically ill peers. (2) Then, based on these themes, the engagement game was developed and the draft version was evaluated by 13 adolescents. Based on their feedback, changes were made to the game (e.g., adjusting the images and changing the game rules). (3) Regarding usability, the pilot version was evaluated positively. The game helped adolescents to give their opinion. Based on the feedback of adolescents, some last adjustments (e.g., changing colours and adding a game board) were made, which led to the final version of the game, All Voices Count.ConclusionsWorking together with adolescents, All Voices Count, a patient engagement game was developed. This game provides clinicians with a tool that supports shared decision‐making to address adolescents'' wishes and needs.Patient or Public ContributionPaediatric patients, clinicians, researchers, youth panel of Fonds NutsOhra and patient associations (Patient Alliance for Rare and Genetic Diseases, Dutch Childhood Cancer Organization) were involved in all phases of the development of the patient engagement game—from writing the project plan to the final version of the game.     

Improving diversity in study participation: Patient perspectives on barriers,racial differences and the role of communities

IntroductionThe lack of racial/ethnic diversity in research potentially limits the generalizability of findings to a broader population, highlighting the need for greater diversity and inclusion in clinical research. Qualitative research (i.e., focus groups) was conducted to identify (i) the potential motivators and barriers to study participation across different races and ethnicities; (ii) preferred delivery of education and information to support healthcare decision‐making and the role of the community.MethodsPatient focus groups were conducted with 26 participants from the sponsor''s Patient Engagement Research Councils selected through subjective sampling. Recruitment prioritized adequate representation across different race/ethnic groups. Participation was voluntary and participants underwent a confidential interview process before selection. Narrative analysis was used to identify themes and draw insights from interactions. Experienced research specialists identified emerging concepts, and these were tested against new observations. The frequency of each concept was examined to understand its importance.ResultsBased on self‐selected race/ethnicity, participants were divided into five focus groups (Groups: African American/Black: 2; Hispanic/Latino, Asian American, and white: 1 each) and were asked to share their experiences/opinions regarding the stated objectives. Barriers to study participation included: limited awareness of opportunities to participate in research, fears about changes in standard therapy, breaking cultural norms/stigma, religion‐related concerns and mistrust of clinical research. Participants identified the importance of transparency by pharmaceutical companies and other entities to build trust and partnership and cited key roles that communities can play. The perceptions of the African American group regarding diversity/inclusion in research studies appeared to be different from other groups; a lack of trust in healthcare providers, concerns about historical instances of research abuse and the importance of prayer were cited.ConclusionThis study provided insights into barriers to study participation, and also highlighted the need for pharmaceutical companies and other entities to authentically engage in strategies that build trust within communities to enhance recruitment among diverse populations.Patient or Public ContributionThe data collected in the present study was provided by the participants in the focus groups.