全方位参与 完善管理机制 是合作医疗可持续发展的关键

在合作医疗基本形成一个雏型后,要进一步办好合作医疗,使其保持持续发展,管理工作是关键。连续3年的上海市医学领先课题研究提示,只有调动三级医疗机构的积极性,调整三级合管会的功能,共同来参与合作医疗的管理,发挥各自的优势,才能保证合作医疗正常、平稳、持续地发展,为农村居民提供医疗、预防、保健、康复全方位的服务。     

Husserl and Heidegger: Exploring the disparity

Introduced as an alternative to empirical science, phenomenology offers nursing an insightful means for understanding nursing phenomena specifically in relation to lived experiences. However, not all phenomenologies were created equal, a point which has left many a nursing researcher not only confused. Furthermore, this confusion might result in the choosing of a philosophical framework that is neither cognizant with the research question nor the epistemological lens through which the researcher operates. Drawing on common nursing examples to illustrate concepts, the authors closely examine and debate the disparities between Husserl's transcendental phenomenology and Heidegger's hermeneutic approach to phenomenology. The aim of the article is to demystify the dense language used and present the fundamental beliefs of each philosopher in a format that is accessible to novice phenomenologists.     

The meaning of home for ageing women living alone: An evolutionary concept analysis

The concept of home to women ageing should be visited in the light of ongoing cultural, political, temporal and disciplinary evolutions. In part, to compliment policies increasing focus on supporting older adults to age in place and a growing attention on the home as a place where healthcare is designed and provided. The following concept analysis utilises Rodgers’ evolutionary method to inductively analyse literature in order to elicit the meaning and experience of home among older women who are ageing at home. Literature was collected over an 18‐month period during 2014–2015 and the sample was made up of 49 articles. The analysis led to the concept of home among women ageing in communities to be defined by four attributes. These attributes are home as (i) a resource, (ii) an attachment, (iii) the precariousness of maintaining and sustaining home and (iv) a cultural expectation. This analysis of the meaning and experience of home among women ageing at home has shed light on the needs for this group of women, while highlighting the need to continue to further clarify and define the concept through research.     

Fluoroscopically guided percutaneous radiological gastrostomy: Technique,metholodology and pitfalls

Fluoroscopically guided percutaneous gastrostomy tube placement is an uncommon but well‐established inter­‐ventional procedure. We present our experience of this procedure in a series of 23 patients, concentrating on the methodology, technique and pitfalls.     

The evolution of palliative care and the relevance to residential aged care: Understanding the past to inform the future

Improving the experience of dying in residential aged care units became a significant project of the Australian Government’s National Palliative Care Program in 2004. This initiative resulted in an expectation that residential aged care facilities would adopt the recommended palliative approach to underpin service delivery. Recognising palliative care as a specialist area of health care practice is a recent development which has influenced the expectations of community and government. This paper traces the global history of palliative care and how historical factors influenced its development in Australia. This discussion presents an overview of the positioning of dying and death within society, explaining how with the shifting emphasis on care of the dying accordingly has been the focus on palliative care specialists. Care of the dying in residential aged care units has largely been overlooked in the context of specialist involvement. This paper acknowledges dying and death as occurring in residential aged care facilities, illuminating the advantages of adopting a palliative approach and offers recommendations.