'It is predicted that the total output of China’s health care industry in 2010, 2015, and 2020 will respectively realize such market sizes of 960, 2,480, and 5,720 billion yuan, with an annual growth rate of 20%,...'It is predicted that the total output of China’s health care industry in 2010, 2015, and 2020 will respectively realize such market sizes of 960, 2,480, and 5,720 billion yuan, with an annual growth rate of 20%, leaving huge room for development.' said展开更多
Introduction: Stroke may have a negative impact on mental health and behavior. Cognitive disorders are common after stroke. They are rarely assessed in current clinical practice, particularly in our context. They cons...Introduction: Stroke may have a negative impact on mental health and behavior. Cognitive disorders are common after stroke. They are rarely assessed in current clinical practice, particularly in our context. They constitute a real “invisible” handicap. In sub-Saharan Africa, we are not aware of any studies specifically assessing executive functions. These functions are at the heart of all adaptation processes to new or complex situations. This prompted the authors to carry out this study at the Ibrahima Pierre Ndiaye Neuroscience Department of the Fann National University Hospital Centre (Senegal). Objective and Methodology: The aim of this study was to assess and characterize post-stroke alterations in executive functions in our context. We conducted a descriptive cross-sectional study. It took place over a 4-month period from April 1 to August 31, 2021. Patients were matched to controls according to age, gender and educational level. Executive functions were assessed using the Frontal Assessment Battery (FAB). Results: A total of 30 patients with stroke were enrolled. These patients were matched to controls. The mean age of the patients was 46.87 ± 17.65 years. For the control group, it was 39.27 ± 12.33 years. The prevalence of executive function disorders was 20% in post-stroke patients. The majority of executive functions assessed were impaired. Sensitivity to interference and environmental autonomy were the only ones preserved. Conclusion: Impaired executive functions are common after stroke. They should be systematically assessed in all stroke patients to ensure optimal management.展开更多
We describe the case of a 73-year-old man with left shoulder paresis caused by a herpes zoster infection of the left C5 dermatomes. The patient had been affected by pain for 10 days, a skin rash on his left shoulder a...We describe the case of a 73-year-old man with left shoulder paresis caused by a herpes zoster infection of the left C5 dermatomes. The patient had been affected by pain for 10 days, a skin rash on his left shoulder and back for 5 days, and weakness of his left shoulder for 2 days before admission. Eiectromyography revealed denervation discharges from the left supraspinatus, infraspinatus and deltoid muscles, which was compatible with radiculopathy showing after zoster infection. The patient was examined in accordance with the International Classification of Functioning, Disability and Health, and treated with range-of-movement and strengthening exercises as well as activities of daily living and social participation. At 14 months after the onset of the condition, muscle strength had returned to normal. Electromyography revealed that motor unit action potentials were largely normal. These results indicate that the rehabilitation of paresis caused by herpes zoster can obtain positive results with suitable movement training.展开更多
Transgender people sometimes use cross-sex hormones without medical supervision. The use of cross-sex hormones, as well as the functional health and mental well-being, among male-to-female transgendered people （＇kat...Transgender people sometimes use cross-sex hormones without medical supervision. The use of cross-sex hormones, as well as the functional health and mental well-being, among male-to-female transgendered people （＇kathoeys＇） in Chiang Mai, Thailand, was studied. Sixty kathoeys were interviewed regarding their use of cross-sex hormones and their familyrelationships. Individuals also completed the Life Orientation Test Revised （LOT-R） to assess dispositional optimism, the Social Functioning Questionnaire （SFQ） and the Short Form Health Survey 36 （SF-36）. Three categories were established as follows： those who never cross-dress, those who sometimes cross-dress and those who always cross-dress in public. Of the 60 subjects, 44 had used hormones for prolonged periods （9.7＋6.1 years）. Their use was related to the permanence of cross-dressing but unrelated to functional health and mental well-being. Fifty percent of subjects had overdosed on commonly used oral contraceptives. Three people used injectable oestrogen in a higher-than-recommended dose. Self-acceptance was high or reasonably good （83%） compared to no acceptance （17%）, and neither was related to the permanence of cross-dressing. Their acceptance by parents and siblings was also relatively high （85% and 89%, respectively）. The permanence of cross-dressing had no effect on the scores of optimism, SF-36 scores and social functioning. Acceptance by oneself or one＇s parents did not seem to affect most aspects of functional health and mental well-being, but non-acceptance by siblings generated lower scores on the social functioning and general mental health subscales. Stressors tended to include physical rather than social factors. In conclusion, the unsupervised use of cross-sex hormones was common among kathoeys, and 50% of the sample had overdosed on them. Acceptance was relatively good, except by siblings. New strategies are needed for a more responsible use of cross-sex hormones.展开更多
Patient involvement in the health care process has been documented as a critical component of successful disease management. However, inadequate functional health literacy among patients is a well-known barrier to eff...Patient involvement in the health care process has been documented as a critical component of successful disease management. However, inadequate functional health literacy among patients is a well-known barrier to effective doctor-patient communication, which has an adverse effect on health outcomes. This study aimed at investigating the association of functional health literacy and doctor-patient communication among HIV/AIDS patients in Homa Bay County, Kenya. It was a cross-sectional hospital-based survey conducted among 362 HIV/AIDS patients receiving care at the eight sub-county hospitals of Homa Bay county. Data was collected using a self-administered structured questionnaire. Cronbach’s alpha and confirmatory factor analysis tests were used to ascertain the reliability and validity of study instruments, while Logistic regression logistic analysis was used to measure the association between functional health literacy and doctor-patient communication. 51% of the respondents were females, and the majority (30.9%) of respondents fell in the age group of 45 years and above. The respondents’ functional health literacy levels were inadequate at weighted means scores of 3.23 [SD 1.31]. The study further established that functional health literacy significantly influenced doctor-patient communication [Nagelkerke R square = 0.318]. There is, therefore, a need to document the determinants of functional health literacy to improve it and make doctor-patient interaction an enjoyable and meaningful experience.展开更多
Introduction: Brazil leads the production of sugarcane and its derived commodities, sugar and ethanol. The fact that it is predominantly manually harvested exposes the workers to a variety of health hazards. Since the...Introduction: Brazil leads the production of sugarcane and its derived commodities, sugar and ethanol. The fact that it is predominantly manually harvested exposes the workers to a variety of health hazards. Since the harvest is a labor activity that exacts from the worker a heavy physical toll, involving the exertion of quick, repetitive movements that intensely overburden both one’s muscles and skeletal frame. Objective: To assess the health profile and functional independence in former workers who operated in a biofuel plant in Bahia. Methods: This is a descriptive, exploration-oriented study conducted with 42 workers formerly employed as cane cutters, both male and female and over 18 years old, all of them living in the town of Amélia Rodrigues (BA). The self-administered Nottingham Health Profile (NHP) was used to measure their quality of life, based on the World Health Organization’s classification of disabilities;the Functional Independence Measure (FIM) metrics was employed to keep track of functional independence. The FIM focuses on two aspects, motile and cognitive, subdivided further into categories designed to assess individual independence in tackling basic activities effectively and satisfactorily. Results: 42 individuals were assessed, most of them men (54.8%), predominantly adults (73.8%) of African descent (61.9%). Evidence, along with the correlation coefficient to analyze the FIM and the NHP, presents a significance level of 0.05 in the categories: Total NHP, Energy Level, Pain and Physical Abilities. Conclusion: This study found that there is harm to the health of former cane cutters as far as their sleep, energy levels and physical abilities are concerned. With these remarks, the authors expect to motivate health surveillance efforts regarding the risks in those work environments and the associated health issues, so that preventive and interventive public health measures can be implemented.展开更多
AIM To determine the relationship between chronic kidney disease(CKD) awareness(CKD-A), self-management behaviors(CKD-SMB) knowledge, performance of CKDSMBs, health literacy(HL) and kidney function. METHODS Participan...AIM To determine the relationship between chronic kidney disease(CKD) awareness(CKD-A), self-management behaviors(CKD-SMB) knowledge, performance of CKDSMBs, health literacy(HL) and kidney function. METHODS Participants were eligible patients attending an outpatient nephrology clinic. Participants were administered: Newest Vital Sign to measure HL, CKD self-managementknowledge tool(CKD-SMKT) to assess knowledge, past performance of CKD-SMB, CKD-A. Estimated GFR(e GFR) was determined using the MDRD-4 equation. Duration of clinic participation and CKD cause were extracted from medical charts. RESULTS One-hundred-fifty patients participated in the study. e GFRs ranged from 17-152 m L/min per 1.73 m2. Majority(83%) of respondents had stage 3 or 4 CKD, low HL(63%), and were CKD aware(88%). Approximately 40%(10/25) of patients in stages 1 and 2 and 6.4%(8/125) in stages 3 and 4 were unaware of their CKD. CKD-A differed with stage(P < 0.001) but not by HL level, duration of clinic participation, or CKD cause. Majority of respondents(≥ 90%) correctly answered one or more CKD-SMKT items. Knowledge of one behavior, "controlling blood pressure" differed significantly by CKD-A. CKD-A was associated with past performance of two CKD-SMBs, "controlling blood pressure"(P = 0.02), and "keeping healthy body weight"(P = 0.01). Adjusted multivariate analyses between CKD-A and:(1) HL; and(2) CKD-SMB knowledge were nonsignificant. However, there was a significant relationship between CKD-A and kidney function after controlling for demographics, HL, and CKD-SMB(P < 0.05). CONCLUSION CKD-A is not associated with HL, or better CKD-SMBs. CKD-A is significantly associated with kidney function and substantially lower e GFR, suggesting the need for focused patient education in CKD stages 1.展开更多
In China, with the restructuring of health care system moving forward, private community health facilities have been playing a complementary but increasingly important role in providing public health and basic medical...In China, with the restructuring of health care system moving forward, private community health facilities have been playing a complementary but increasingly important role in providing public health and basic medical care services in urban areas. However, only limited evidence is available con-cerning the service functions of private community health facilities in China. The aim of this study was to explore the functions of private community health stations (PCHSs) to provide evidence-based rec-ommendations for policy-making and practice in the development of urban community health services systems. A total of 818 PCHSs and 4320 government-sponsored community health stations (GCHSs) located in 28 cities of China were investigated in 2008. The percentages of stations that provided health services and the annual workload per community health worker (CHW) were compared between the two types of institutions. The results showed that the percentages of PCHSs providing public health services were significantly higher than those of GCHSs (P<0.05); but no significant differences were found in the percentages of basic medical services providing between PCHSs and GCHSs (P>0.05). The annual workloads of all the public health services and basic medical services per CHW in PCHSs were lighter than those in GCHSs (P<0.05), except for resident health records establishment and health education materials distribution (P>0.05). At present, the GCHSs are still the mainstream in urban China, which will last for a long period in future. However, our findings showed that the annual workloads of CHWs in PCHSs were no heavier than those in GCHSs, and the PCHSs were willing to provide public health services. In view of current inadequacy of health resources in China, it is feasible to further develop PCHSs under the guidance of the government, given that PCHSs can perform the basic functions of community health services, which is useful for the formation of public-private partnerships (PPP) and the improvement of community health services.展开更多
The increase in chronic diseases in childhood highlights the need for a biopsychosocial approach to deal with the complexity of these health conditions. The International Classification of Functioning, Disability, and...The increase in chronic diseases in childhood highlights the need for a biopsychosocial approach to deal with the complexity of these health conditions. The International Classification of Functioning, Disability, and Health (ICF) results from the need to implement new explanatory evaluative and therapeutic models. Thus, the present systematic review aims to identify published studies on the use of the ICF in chronic childhood diseases. As a secondary objective, to map the themes that have already been studied in the area to support the discussion on the expansion of the use of this classification in health services. The systematic review followed the PRISMA protocol, and the model was the PICO acronym, where Population was children and adolescents with chronic diseases, Intervention/Exposure was evaluation based on ICF concepts, Comparator was any tool, instrument, or intervention, and outcome was direct or indirect use of the ICF. We selected eight articles, five of which used the ICF as a conceptual tool and three as a classification system, divided into the following themes: quality of life, evaluation of patients (without using coding) and mapping the inclusion of the activity’s results and participation in clinical trials. Thus, use of the ICF in clinical practice is still incipient, although it has been recommended in guidelines. Further studies are necessary to expand the number of contributions by the ICF and to develop the necessary approaches for understanding the classification’s use.展开更多
Objective: To review, categorise, and synthesise findings from literature on health information technology (HIT) functionalities, HIT use, and the impact of HIT on hospital performance. Materials and Methods: We condu...Objective: To review, categorise, and synthesise findings from literature on health information technology (HIT) functionalities, HIT use, and the impact of HIT on hospital performance. Materials and Methods: We conducted a systematic integrative literature review based on a compre-hensive database search. To organise, categorise and synthesise the ex-isting literature, we adopted the affordance actualization theory. To align the literature with our research framework, we used four categories: 1) the functionalities of HIT and how these functionalities are measured;2) use and immediate outcomes of HIT functionalities;3) different perfor-mance indicators and how HIT functionalities affect them;and 4) what hospital characteristics influence the outcome of hospital performance. Results: Fifty-two studies were included. We identified four types of HIT. Only ten studies (19.2%) define the use of HIT by explicitly meas-uring the use rate of HIT. We identified five dimensions of hospital per-formance indicators. Every dimension showed mixed results;however, in general, HIT has a positive impact on mortality and patient readmis-sions. We found several hospital characteristics that may affect the rela-tionship between HIT and hospital-level outcomes. Discussion: Further efforts should focus on embedded research on HIT functionalities, use and effects of HIT implementations with more performance indicators and adjusted for hospital characteristics. Conclusion: The proposed framework could help hospitals and researchers make decisions regard-ing the functionalities, use and effects of HIT implementation in hospi-tals. Given our research outcomes, we suggest future research opportuni-ties to improve understanding of how HIT affects hospital performance. .展开更多
目的探讨老年脑卒中患者认知功能对口腔健康相关生活质量(oral health-related quality of life,OHRQoL)评估的影响及作用机制。方法采用横断面研究设计,采用便利抽样的方法于2015年10月至2020年1月从宣武医院、天坛医院、大兴区西红门...目的探讨老年脑卒中患者认知功能对口腔健康相关生活质量(oral health-related quality of life,OHRQoL)评估的影响及作用机制。方法采用横断面研究设计,采用便利抽样的方法于2015年10月至2020年1月从宣武医院、天坛医院、大兴区西红门医院和北京口腔医院门诊招募符合纳入和排除标准的老年脑卒中患者247例。根据蒙特利尔认知功能量表评分分为中重度认知障碍组111例(≤20分),轻度认知障碍组95例(21~25分),认知功能正常组41例(≥26分)。采用口腔健康影响程度量表简版(oral health impact prole-14,OHIP-14)评估OHRQoL,并进行标准化口腔临床检查及口腔情况认知功能测试。通过Mann-Whitney U检验比较不同认知功能组间差异,并构建结构方程模型进行路径分析。结果中重度认知障碍组OHIP-14评分中疼痛与不适维度及总分显著低于轻度认知障碍组(P<0.05)。路径分析显示,认知功能通过口腔情况认知功能的完全中介作用间接影响OHRQoL评估。结论中重度认知障碍的老年脑卒中患者可能因其口腔情况认知功能下降,造成其OHRQoL评估不准确。展开更多
文摘'It is predicted that the total output of China’s health care industry in 2010, 2015, and 2020 will respectively realize such market sizes of 960, 2,480, and 5,720 billion yuan, with an annual growth rate of 20%, leaving huge room for development.' said
文摘Introduction: Stroke may have a negative impact on mental health and behavior. Cognitive disorders are common after stroke. They are rarely assessed in current clinical practice, particularly in our context. They constitute a real “invisible” handicap. In sub-Saharan Africa, we are not aware of any studies specifically assessing executive functions. These functions are at the heart of all adaptation processes to new or complex situations. This prompted the authors to carry out this study at the Ibrahima Pierre Ndiaye Neuroscience Department of the Fann National University Hospital Centre (Senegal). Objective and Methodology: The aim of this study was to assess and characterize post-stroke alterations in executive functions in our context. We conducted a descriptive cross-sectional study. It took place over a 4-month period from April 1 to August 31, 2021. Patients were matched to controls according to age, gender and educational level. Executive functions were assessed using the Frontal Assessment Battery (FAB). Results: A total of 30 patients with stroke were enrolled. These patients were matched to controls. The mean age of the patients was 46.87 ± 17.65 years. For the control group, it was 39.27 ± 12.33 years. The prevalence of executive function disorders was 20% in post-stroke patients. The majority of executive functions assessed were impaired. Sensitivity to interference and environmental autonomy were the only ones preserved. Conclusion: Impaired executive functions are common after stroke. They should be systematically assessed in all stroke patients to ensure optimal management.
文摘We describe the case of a 73-year-old man with left shoulder paresis caused by a herpes zoster infection of the left C5 dermatomes. The patient had been affected by pain for 10 days, a skin rash on his left shoulder and back for 5 days, and weakness of his left shoulder for 2 days before admission. Eiectromyography revealed denervation discharges from the left supraspinatus, infraspinatus and deltoid muscles, which was compatible with radiculopathy showing after zoster infection. The patient was examined in accordance with the International Classification of Functioning, Disability and Health, and treated with range-of-movement and strengthening exercises as well as activities of daily living and social participation. At 14 months after the onset of the condition, muscle strength had returned to normal. Electromyography revealed that motor unit action potentials were largely normal. These results indicate that the rehabilitation of paresis caused by herpes zoster can obtain positive results with suitable movement training.
文摘Transgender people sometimes use cross-sex hormones without medical supervision. The use of cross-sex hormones, as well as the functional health and mental well-being, among male-to-female transgendered people （＇kathoeys＇） in Chiang Mai, Thailand, was studied. Sixty kathoeys were interviewed regarding their use of cross-sex hormones and their familyrelationships. Individuals also completed the Life Orientation Test Revised （LOT-R） to assess dispositional optimism, the Social Functioning Questionnaire （SFQ） and the Short Form Health Survey 36 （SF-36）. Three categories were established as follows： those who never cross-dress, those who sometimes cross-dress and those who always cross-dress in public. Of the 60 subjects, 44 had used hormones for prolonged periods （9.7＋6.1 years）. Their use was related to the permanence of cross-dressing but unrelated to functional health and mental well-being. Fifty percent of subjects had overdosed on commonly used oral contraceptives. Three people used injectable oestrogen in a higher-than-recommended dose. Self-acceptance was high or reasonably good （83%） compared to no acceptance （17%）, and neither was related to the permanence of cross-dressing. Their acceptance by parents and siblings was also relatively high （85% and 89%, respectively）. The permanence of cross-dressing had no effect on the scores of optimism, SF-36 scores and social functioning. Acceptance by oneself or one＇s parents did not seem to affect most aspects of functional health and mental well-being, but non-acceptance by siblings generated lower scores on the social functioning and general mental health subscales. Stressors tended to include physical rather than social factors. In conclusion, the unsupervised use of cross-sex hormones was common among kathoeys, and 50% of the sample had overdosed on them. Acceptance was relatively good, except by siblings. New strategies are needed for a more responsible use of cross-sex hormones.
文摘Patient involvement in the health care process has been documented as a critical component of successful disease management. However, inadequate functional health literacy among patients is a well-known barrier to effective doctor-patient communication, which has an adverse effect on health outcomes. This study aimed at investigating the association of functional health literacy and doctor-patient communication among HIV/AIDS patients in Homa Bay County, Kenya. It was a cross-sectional hospital-based survey conducted among 362 HIV/AIDS patients receiving care at the eight sub-county hospitals of Homa Bay county. Data was collected using a self-administered structured questionnaire. Cronbach’s alpha and confirmatory factor analysis tests were used to ascertain the reliability and validity of study instruments, while Logistic regression logistic analysis was used to measure the association between functional health literacy and doctor-patient communication. 51% of the respondents were females, and the majority (30.9%) of respondents fell in the age group of 45 years and above. The respondents’ functional health literacy levels were inadequate at weighted means scores of 3.23 [SD 1.31]. The study further established that functional health literacy significantly influenced doctor-patient communication [Nagelkerke R square = 0.318]. There is, therefore, a need to document the determinants of functional health literacy to improve it and make doctor-patient interaction an enjoyable and meaningful experience.
文摘Introduction: Brazil leads the production of sugarcane and its derived commodities, sugar and ethanol. The fact that it is predominantly manually harvested exposes the workers to a variety of health hazards. Since the harvest is a labor activity that exacts from the worker a heavy physical toll, involving the exertion of quick, repetitive movements that intensely overburden both one’s muscles and skeletal frame. Objective: To assess the health profile and functional independence in former workers who operated in a biofuel plant in Bahia. Methods: This is a descriptive, exploration-oriented study conducted with 42 workers formerly employed as cane cutters, both male and female and over 18 years old, all of them living in the town of Amélia Rodrigues (BA). The self-administered Nottingham Health Profile (NHP) was used to measure their quality of life, based on the World Health Organization’s classification of disabilities;the Functional Independence Measure (FIM) metrics was employed to keep track of functional independence. The FIM focuses on two aspects, motile and cognitive, subdivided further into categories designed to assess individual independence in tackling basic activities effectively and satisfactorily. Results: 42 individuals were assessed, most of them men (54.8%), predominantly adults (73.8%) of African descent (61.9%). Evidence, along with the correlation coefficient to analyze the FIM and the NHP, presents a significance level of 0.05 in the categories: Total NHP, Energy Level, Pain and Physical Abilities. Conclusion: This study found that there is harm to the health of former cane cutters as far as their sleep, energy levels and physical abilities are concerned. With these remarks, the authors expect to motivate health surveillance efforts regarding the risks in those work environments and the associated health issues, so that preventive and interventive public health measures can be implemented.
文摘AIM To determine the relationship between chronic kidney disease(CKD) awareness(CKD-A), self-management behaviors(CKD-SMB) knowledge, performance of CKDSMBs, health literacy(HL) and kidney function. METHODS Participants were eligible patients attending an outpatient nephrology clinic. Participants were administered: Newest Vital Sign to measure HL, CKD self-managementknowledge tool(CKD-SMKT) to assess knowledge, past performance of CKD-SMB, CKD-A. Estimated GFR(e GFR) was determined using the MDRD-4 equation. Duration of clinic participation and CKD cause were extracted from medical charts. RESULTS One-hundred-fifty patients participated in the study. e GFRs ranged from 17-152 m L/min per 1.73 m2. Majority(83%) of respondents had stage 3 or 4 CKD, low HL(63%), and were CKD aware(88%). Approximately 40%(10/25) of patients in stages 1 and 2 and 6.4%(8/125) in stages 3 and 4 were unaware of their CKD. CKD-A differed with stage(P < 0.001) but not by HL level, duration of clinic participation, or CKD cause. Majority of respondents(≥ 90%) correctly answered one or more CKD-SMKT items. Knowledge of one behavior, "controlling blood pressure" differed significantly by CKD-A. CKD-A was associated with past performance of two CKD-SMBs, "controlling blood pressure"(P = 0.02), and "keeping healthy body weight"(P = 0.01). Adjusted multivariate analyses between CKD-A and:(1) HL; and(2) CKD-SMB knowledge were nonsignificant. However, there was a significant relationship between CKD-A and kidney function after controlling for demographics, HL, and CKD-SMB(P < 0.05). CONCLUSION CKD-A is not associated with HL, or better CKD-SMBs. CKD-A is significantly associated with kidney function and substantially lower e GFR, suggesting the need for focused patient education in CKD stages 1.
基金supported by agrant from"The National Urban Community Health Service System Building Project"of the Ministry of Health of China(No.)
文摘In China, with the restructuring of health care system moving forward, private community health facilities have been playing a complementary but increasingly important role in providing public health and basic medical care services in urban areas. However, only limited evidence is available con-cerning the service functions of private community health facilities in China. The aim of this study was to explore the functions of private community health stations (PCHSs) to provide evidence-based rec-ommendations for policy-making and practice in the development of urban community health services systems. A total of 818 PCHSs and 4320 government-sponsored community health stations (GCHSs) located in 28 cities of China were investigated in 2008. The percentages of stations that provided health services and the annual workload per community health worker (CHW) were compared between the two types of institutions. The results showed that the percentages of PCHSs providing public health services were significantly higher than those of GCHSs (P<0.05); but no significant differences were found in the percentages of basic medical services providing between PCHSs and GCHSs (P>0.05). The annual workloads of all the public health services and basic medical services per CHW in PCHSs were lighter than those in GCHSs (P<0.05), except for resident health records establishment and health education materials distribution (P>0.05). At present, the GCHSs are still the mainstream in urban China, which will last for a long period in future. However, our findings showed that the annual workloads of CHWs in PCHSs were no heavier than those in GCHSs, and the PCHSs were willing to provide public health services. In view of current inadequacy of health resources in China, it is feasible to further develop PCHSs under the guidance of the government, given that PCHSs can perform the basic functions of community health services, which is useful for the formation of public-private partnerships (PPP) and the improvement of community health services.
文摘The increase in chronic diseases in childhood highlights the need for a biopsychosocial approach to deal with the complexity of these health conditions. The International Classification of Functioning, Disability, and Health (ICF) results from the need to implement new explanatory evaluative and therapeutic models. Thus, the present systematic review aims to identify published studies on the use of the ICF in chronic childhood diseases. As a secondary objective, to map the themes that have already been studied in the area to support the discussion on the expansion of the use of this classification in health services. The systematic review followed the PRISMA protocol, and the model was the PICO acronym, where Population was children and adolescents with chronic diseases, Intervention/Exposure was evaluation based on ICF concepts, Comparator was any tool, instrument, or intervention, and outcome was direct or indirect use of the ICF. We selected eight articles, five of which used the ICF as a conceptual tool and three as a classification system, divided into the following themes: quality of life, evaluation of patients (without using coding) and mapping the inclusion of the activity’s results and participation in clinical trials. Thus, use of the ICF in clinical practice is still incipient, although it has been recommended in guidelines. Further studies are necessary to expand the number of contributions by the ICF and to develop the necessary approaches for understanding the classification’s use.
文摘Objective: To review, categorise, and synthesise findings from literature on health information technology (HIT) functionalities, HIT use, and the impact of HIT on hospital performance. Materials and Methods: We conducted a systematic integrative literature review based on a compre-hensive database search. To organise, categorise and synthesise the ex-isting literature, we adopted the affordance actualization theory. To align the literature with our research framework, we used four categories: 1) the functionalities of HIT and how these functionalities are measured;2) use and immediate outcomes of HIT functionalities;3) different perfor-mance indicators and how HIT functionalities affect them;and 4) what hospital characteristics influence the outcome of hospital performance. Results: Fifty-two studies were included. We identified four types of HIT. Only ten studies (19.2%) define the use of HIT by explicitly meas-uring the use rate of HIT. We identified five dimensions of hospital per-formance indicators. Every dimension showed mixed results;however, in general, HIT has a positive impact on mortality and patient readmis-sions. We found several hospital characteristics that may affect the rela-tionship between HIT and hospital-level outcomes. Discussion: Further efforts should focus on embedded research on HIT functionalities, use and effects of HIT implementations with more performance indicators and adjusted for hospital characteristics. Conclusion: The proposed framework could help hospitals and researchers make decisions regard-ing the functionalities, use and effects of HIT implementation in hospi-tals. Given our research outcomes, we suggest future research opportuni-ties to improve understanding of how HIT affects hospital performance. .
文摘目的探讨老年脑卒中患者认知功能对口腔健康相关生活质量(oral health-related quality of life,OHRQoL)评估的影响及作用机制。方法采用横断面研究设计,采用便利抽样的方法于2015年10月至2020年1月从宣武医院、天坛医院、大兴区西红门医院和北京口腔医院门诊招募符合纳入和排除标准的老年脑卒中患者247例。根据蒙特利尔认知功能量表评分分为中重度认知障碍组111例(≤20分),轻度认知障碍组95例(21~25分),认知功能正常组41例(≥26分)。采用口腔健康影响程度量表简版(oral health impact prole-14,OHIP-14)评估OHRQoL,并进行标准化口腔临床检查及口腔情况认知功能测试。通过Mann-Whitney U检验比较不同认知功能组间差异,并构建结构方程模型进行路径分析。结果中重度认知障碍组OHIP-14评分中疼痛与不适维度及总分显著低于轻度认知障碍组(P<0.05)。路径分析显示,认知功能通过口腔情况认知功能的完全中介作用间接影响OHRQoL评估。结论中重度认知障碍的老年脑卒中患者可能因其口腔情况认知功能下降,造成其OHRQoL评估不准确。
