Objective:This study aimed to explore the readiness for advance care planning(ACP)among older adults in Macao’s day service centers and investigate the influencing factors.Methods:A cross-sectional study was conducte...Objective:This study aimed to explore the readiness for advance care planning(ACP)among older adults in Macao’s day service centers and investigate the influencing factors.Methods:A cross-sectional study was conducted from October to December 2022 using a convenience sampling method.A total of 312 older adults were selected from 13 day service centers for older adults in Macao,China.The Advance Care Planning Acceptance Questionnaire and the Family Adaptation,Partnership,Growth,Affection,Resolve(APGAR)Scale were used to survey the older adults.Results:A total of 306 older adults completed the survey.The score for advance care planning readiness was 65.55±10.69,and 59.5%of participants(n=182)were willing to participate in ACP.The family function score was 7.24±2.51,while 70.3%of participants were from a highly functional family.The higher family function indicating a higher readiness for advance care planning(r=0.396,P<0.001).The multiple linear regression analysis indicated that the variables“age,”“knowledge of ACP,”“experience with ACP,”and“received resuscitation of yourself,relatives or friends”combined with“family function”can influence advance care planning readiness among older adults(R^(2)=0.317,F=27.898,P<0.001).Conclusions:Older adults in Macao’s day service centers were willing to engage in ACP.The importance of family involvement is highlighted in the ACP readiness.Health education and improved family communication are vital for promoting ACP,which ensures individuals receive care when they lack the capacity to make that choice.Additionally,healthcare professionals should enhance communication and education with older adults during the medical care process.展开更多
Objective:This study aimed to describe the implementation of advance care planning(ACP)in patients with stroke.Methods:A scoping review was conducted according to the Arksey and O'Malley framework.Accordingly,we s...Objective:This study aimed to describe the implementation of advance care planning(ACP)in patients with stroke.Methods:A scoping review was conducted according to the Arksey and O'Malley framework.Accordingly,we searched for articles published in ScienceDirect,PubMed,Scopus,ProQuest,and Medline.The inclusion criteria were original research on ACP among adult or elderly stroke patients,hospital-or community-based studies,and those published in English or Indonesian.Qualitative analysis was then used to identify keywords,categories,and themes.Results:Among the 1,050 articles identified,only 8 satisfied the inclusion criteria,indicating that limited studies were available for ACP interventions among stroke patients.Four themes were ultimately identified:the strategy implementation of AC,the challenges of ACP implementation,the benefits of ACP,and the factors influencing ACP.Strategy ACP implementation included the ACP method,the communication style,participation role,media used,and ACP documentation.Lack of information about ACP,facilities,incapacitated patients,and reluctance to implement have become challenges to implementation in stroke.The benefits of ACP,particularly the outcomes of the ACP program,included awareness of ACP engagement,patients can express their wishes,and increased advance directive(AD)documentation.The factors influencing ACP included patient condition,knowledge,and appropriate ACP methods.Conclusion:ACP has not been widely used when providing interventions for stroke patients.The implementation of ACP in stroke patients is full of challenges due to various patient conditions.Effective strategies are needed to improve ACP in stroke patients.It is necessary to develop an ACP for stroke patients'method that involves interprofessional collaboration,and studies on AcP in stroke patients need to be further conducted through interprofessional collaboration.展开更多
This paper systematically reviews the research progress of Advance Care Planning(ACP)in the field of lung cancer,and discusses its implementation status,key influencing factors and future development direction,includi...This paper systematically reviews the research progress of Advance Care Planning(ACP)in the field of lung cancer,and discusses its implementation status,key influencing factors and future development direction,including deepening of theoretical research,innovation of practice mode,optimization of policy support and cultural adaptation research.展开更多
<strong>Purpose:</strong> Disease-related Stigma is negative emotions, attitudes, stereotypes, and beliefs about diseases. Cancer is one of the diseases that can be exposed to stigma. Regarding the effects...<strong>Purpose:</strong> Disease-related Stigma is negative emotions, attitudes, stereotypes, and beliefs about diseases. Cancer is one of the diseases that can be exposed to stigma. Regarding the effects of stigma on the quality of life;admission and adherence to treatment, and considering stigma as a barrier to health promotion and cancer screening, the aim of this study was to provide a care plan for reducing stigma in cancer. <strong>Methods:</strong> This research was carried out during three phases of qualitative, quantitative studies and a review of the literature. The qualitative phase was conducted by conventional content analysis to find effective factors on the reduction of stigma through face to face semi-structured interviews. The quantitative phase was a cross-sectional descriptive study to measure the level of stigma. By using both quantitative and qualitative findings, and a review of the literature, a comprehensive care plan to reduce stigma in families with cancer patients was developed. <strong>Results:</strong> The results showed two categories of data;1) reducing stigma at the individual or family level which needs increasing awareness, teaching coping skills, and support, as well as counseling;and 2) stigma reduction at the community level and policy rules which involve public education and cultural changes. <strong>Conclusion:</strong> Implementation of a care plan for reducing stigma can increase the physical and psychological health outcomes of people influenced by cancer, and at the community level, improves the attitude toward cancer and the success of screening programs, and ultimately reduces disability and mortality of the disease.展开更多
Lathosterolosis is a very rare autosomal recessive cholesterol metabolism disorder. The disease manifests itself with developmental and mental delays, learning disabilities, microcephaly, facial dysmorphism, bilateral...Lathosterolosis is a very rare autosomal recessive cholesterol metabolism disorder. The disease manifests itself with developmental and mental delays, learning disabilities, microcephaly, facial dysmorphism, bilateral cataracts, and skeletal defects. It is caused by the deficiency of the enzyme sterol-C5-desaturase, which is involved in cholesterol biosynthesis. This deficiency prevents the synthesis of cholesterol, which acts as a precursor for lipid, bile acids, and steroid hormones. Until 2020, only 7 cases had been reported. In this case report, it was aimed to plan and implement the nursing care of a 2-year-old boy diagnosed with lathosterolosis with the diagnoses of the North American Nursing Diagnostic Association (NANDA).展开更多
Advance care planning is a process of discussion in which patients can communicate their end-of-life care preferences to family members and health care providers for consideration.Readiness for advance care planning i...Advance care planning is a process of discussion in which patients can communicate their end-of-life care preferences to family members and health care providers for consideration.Readiness for advance care planning is a patient's preparedness to engage in advance care planning.This review aims to develop the conceptual framework for advance care planning readiness for Chinese older people.The current knowledge from the published studies was identified and synthesized by an integrative review.The conceptual framework was developed based on the social-ecological model and the theory of planned behavior.The factors from the social environment/community,health care professionals,and individual/family layers were defined.These factors may influence an individual's medical decision-making,which in turn triggers individual behavioral mechanisms that arise from interactions between motivations,attitudes,and beliefs.Relevant factors should be considered when assessing the behavior of personnel engaged in advance care planning or formulating appropriate intervention measures to improve advance care planning par ticipation in China.This framework can be used to guide studies that explore how the social/familial/individual factors predict the readiness for advance care planning among Chinese older people,and to design intervention studies to test the effect of family function on the readiness for advance care planning.展开更多
Objective:The objective of this study is to explore the clinical effects of structured skin care plan of integrated Chinese and Western medicine in intervening elderly patients with incontinence-associated dermatitis(...Objective:The objective of this study is to explore the clinical effects of structured skin care plan of integrated Chinese and Western medicine in intervening elderly patients with incontinence-associated dermatitis(IAD).Materials and Methods:Totally,66 elderly patients with IAD were randomly divided into the experiment group(32 cases)and control group(34 cases).The control group was given routine nursing care,while the experiment group was given a structured skin care plan.The observational course was 2 weeks.The treatment efficiency and healing time were compared between the two groups.Results:After 2-week intervention,the total effective rate of the experiment group was higher than that of the control group(97.1%vs.78.1%,X^(2)=3.913,P=0.048).The skin assessment tool score of the experiment group was lower than that of the control group(0.56±1.58 vs.1.75±2.46,Z=−−2.401,P=0.016).The healing time of the experiment group was shorter than that of the control group(7.29±4.76 days vs.10.69±6.36 days,Z=−2.280,P=0.026).Conclusion:The structured skin care plan of integrated Chinese and Western medicine showed a good effect in elderly IAD patients,and provided a reference for clinical treatment and care of elderly patients with IAD.展开更多
Background:Using a pilot randomised controlled trial(RCT),to assess the short-term effectiveness of a structured diabetic retinopathy(DR)-specific,intensive,and personalised care planning(DR-IPCP)intervention on diabe...Background:Using a pilot randomised controlled trial(RCT),to assess the short-term effectiveness of a structured diabetic retinopathy(DR)-specific,intensive,and personalised care planning(DR-IPCP)intervention on diabetes control outcomes in Singaporeans with poorly controlled type 2 diabetes.Methods:Eighteen individuals with mild-moderate DR and poor glycemic control[HbA1c≥64 mmol/mol(≥8.0%)over two consecutive 6-month readings]were randomized to DR-IPCP(n=9)or usual care(UC,n=9).The intervention included a physician consultation,an initial personalised eye consultation with a experienced diabetes nurse educator,and three behaviour change follow-up calls.HbA1c(primary outcome),lipids and blood pressure were assessed at baseline and three months post-intervention.Participant feedback regarding the DR-IPCP program was collected at three months via a semi-structured telephone interview.Results:While no significant between-group differences were observed,DR-IPCP participants experienced significant within-group reductions in HbA1c,total cholesterol,and low density lipoprotein at follow-up compared to baseline[7 mmol/mol(−0.8%),−0.64 mmol/L,and−0.66 mmol/L,respectively].No significant within-group changes in these parameters were observed in the UC group.Following the DR-IPCP intervention,participants reported a clearer understanding of the link between diabetes management;the development and progression of DR.Conclusions:DR-IPCP provides an effective short-term improvement in diabetes control parameters in DR patients with poor diabetes control.An adequately powered and longitudinal RCT is warranted to assess the clinical,patient-centred and economic potential of this programme in this population.展开更多
The aim was to explore the implementation of individual care plans in municipal elderly care in relation to characteristics of staff. Data regarding characteristics of staff were derived through a questionnaire distri...The aim was to explore the implementation of individual care plans in municipal elderly care in relation to characteristics of staff. Data regarding characteristics of staff were derived through a questionnaire distributed to all staff working in the care for older people, (N = 908, n = 245) in four municipalities in Sweden. The number of care plans established during a one-year period was collected through a contact person in each municipality. In total 47 individual care plans were established during the study year. Significantly more staff in the municipality that had the most number of established individual care plans agreed that there had been sufficient education (p = 0.017), sufficient time (p = 0.002) and routines established regarding individual care plans (p = 0.014) and had a significantly better job satisfaction (p = 0.001), compared to staff in the other municipalities. Implementation leaders may need to take the working conditions and the perception of available resources among staff into consideration in the on-going process of implementing individual care plans.展开更多
Backgroud:To provide a reference for the further development of the field of the advance care planning(ACP),through the visual analysis of the related literature on the ACP.Methods:Taking the core collection database ...Backgroud:To provide a reference for the further development of the field of the advance care planning(ACP),through the visual analysis of the related literature on the ACP.Methods:Taking the core collection database of Web of ScienceTM as data sources,the method of subject word retrieval is adopted.Literature metrology and CiteSpaceⅤinformation visualization software were used to analyze the literature on ACP published from inception to September 2019.Results:A total of 1,981 literature were included.The number of ACP studies increased,USA published the most literature in the world,followed by Australia,Britain,Canada and the Netherlands and so on.The most leading published journal was the Journal of Palliative Medicine,and the highest impact factor was Palliative Medicine(4.956).Sudore,Rebecca L and Hillary D Lum are the key researcher networks with the largest amount of articles published in ACP field.The research content mainly included the definition,implementation process and implementation effect of ACP.Research focused on palliative care,hospice care,decision-making,communication,patient preference and so on.Conclusion:The studies on ACP is on the rise,the research content is deepening,which suggests that we can learn from the research results of foreign countries in this field and continue to deepen the research in the field of ACP in China.展开更多
Aim:To comprehensively synthesize and compare the effect of advance care planning for dementia patients.Design:Systematic review and meta-analysis.Methods:Ten electronic databases will be searched:the Cochrane Library...Aim:To comprehensively synthesize and compare the effect of advance care planning for dementia patients.Design:Systematic review and meta-analysis.Methods:Ten electronic databases will be searched:the Cochrane Library,PubMed,Medline,Embase,PsycINFO,CINAHL PLUS,Scopus,Web of Science,British Nursing Index,clinical Trials,and grey literature sources.Individually or cluster randomized controlled trials that evaluated advance care planning in people with dementia will be incorporated.The research screening flow diagrams will be detailed in the PRISMA flow chart.Data extraction will be carried out in Microsoft Excel 2019 independently by two researchers,any disagreements will be discussed with the third researcher and resolved.We will use the Cochrane Risk of Bias tool to assess the methodological quality.Review Manager 5.3 Software will be used for data synthesis.If sufficient data from studies are available,we will conduct a subgroup analysis of the main outcomes.Conclusion:The systematic review will combine existing trials which may contribute to more convincing conclusions,providing new ideas for medical workers to implement palliative therapy in dementia patients,and further promoting the application of advance care planning for dementia patients.展开更多
Background:The goal of this study was to conduct a meta-synthesis of advanced cancer patients’and their relatives’experiences with advanced care planning(ACP)and to provide evidence-based guidance for the developmen...Background:The goal of this study was to conduct a meta-synthesis of advanced cancer patients’and their relatives’experiences with advanced care planning(ACP)and to provide evidence-based guidance for the development and implementation of ACP in advanced cancer patients.Methods:We searched databases including China Knowledge Network,Wanfang database,VIP database,China Biomedical Literature Database,PubMed,Web of Science,Embase,Cochrane Library,and Cinahl from inception to April 2022 to collect qualitative studies on advanced cancer patients and families'experience about ACP.We use Joanna Briggs Institute Critical Appraisal Checklist for Qualitative Research to evaluate the quality of literature.After quality assessment,meta-synthesis was used to summarize and explain the results.Results:Eleven qualitative studies were included involving 29 results and ten categories.Three integrated themes were extracted:facilitators and barriers to the implementation of advanced medical care programs as perceived by patients and families with advanced cancer;attitudes of patients with advanced cancer and their families towards pre-existing medical care programs;suggestions from patients with advanced cancer and their families on the implementation elements of the pre-existing medical care program.Conclusion:ACP is a complex social process and influenced by many factors.It requires joint efforts of different stakeholders to achieve high-quality and successful ACP.展开更多
Objective:To assess the ACP acceptance among patients with malignant tumor in China and factors affecting adoption and timing.Methods:Quantitative study:The convenience sampling method was adopted from October 2020 to...Objective:To assess the ACP acceptance among patients with malignant tumor in China and factors affecting adoption and timing.Methods:Quantitative study:The convenience sampling method was adopted from October 2020 to October 2021 to investigate 200 oncology patients by a general information questionnaire,patient's advance care planning acceptance questionnaire(ACPQ).Multiple linear stepwise regression was used to analyze the influencing factors of ACP acceptance.Qualitative study:A purposive sampling method was used to select 31 oncology patients and 13 clinical nurses for semi-structured interviews.The data were analyzed using Colaizzi's seven steps.Results:The quantitative study revealed that patients with malignancy had an upper-middle acceptance score of(66.15±7.684)for ACP,with attitude(11.26±2.064),feelings(36.64±4.208),and intention(18.25±3.275)scores.Multiple linear regression analysis showed that religious beliefs,education,monthly income,bereavement experience and notification of condition were independent risk factors for acceptance of ACP(P<0.05).The qualitative study showed that(1)oncology patients have low awareness,high demand,and low acceptability of ACP intervention;(2)they preferred to discuss ACP when medical condition or treatment plan changes;(3)family members were usually involved in ACP discussions,followed by medical personnel;(4)economy,environment,companion,and doctor-patient relationship will all influence ACP implementation.As for nurses,they(1)were unsure about the dynamic changes of ACP content and its optimal timing;(2)had limited ACP knowledge;(3)were affected by environmental factors and nurse-patient relationships;(4)were prone to have disagreements due to inadequate organization department assistance.Conclusions:clinical practitioners should discuss ACP with patients in specific conditions to increase patient acceptance.ACP development requires updated legislation,professional training,and a standardized ACP system.展开更多
Objective:To explore the impact of the application and implementation of risk-based cancer care planning in patients with cervical cancer radiotherapy on the complications and self-care ability of patients.Method:This...Objective:To explore the impact of the application and implementation of risk-based cancer care planning in patients with cervical cancer radiotherapy on the complications and self-care ability of patients.Method:This study recruited selected patients who came for cervical cancer radiotherapy in a tertiary hospital in Xianyang City,Shaanxi Province from November 2020 to November 2021.One hundred patients were recruited.Nursing management was carried out,and cancer care planning under the concept of conventional care and risk were applied.The effects of different nursing methods on patients were compared and analyzed.Results:The patients in the experimental group had higher scores of self-care ability and lower complication rate.All data were significantly different from those of the control group(P<0.05),and the nursing effect on the experimental group was better.Conclusion:The application and implementation of the risk-based cancer care planning in patients who received cervical cancer radiotherapy has significant clinical effects,which is beneficial to reduce the incidence of patients’adverse reactions and promote patient recovery.展开更多
Background: Patient records should both transfer and create knowledge about patients and their health care. A standardized care plan could be a way to implement evidence-based care directly in practice and improve the...Background: Patient records should both transfer and create knowledge about patients and their health care. A standardized care plan could be a way to implement evidence-based care directly in practice and improve the documentation in patient records. The aim of this study is to investigate and compare the development and implementation process of a standardized care plan in hospital and primary health care. A further aim is to evaluate the effects on the quality of documentation and the care given in two contexts. Methods and Analysis: Realistic evaluation will be used as a framework to investigate the implementation process. According to this framework, possible contexts, mechanisms, and outcomes in the study will be considered. The study will be performed in two contexts: an orthopedic clinic and primary health care centers. In both contexts, the two key mechanisms will be the same: the implementation process will be driven by internal facilitators (practitioners at the units) and the process will be guided by the Rules and Regulations for interoperability in the Health and Social Care specification, “National information structure for standardized care plans”. Two outcomes of the study will be studied: to investigate the development and implementation process by an evaluation of fidelity and to evaluate how a standardized care plan affects the quality of documentation and the use of evidence-based care. Discussion: Implementation of the SCP will probably meet the same resistance as implementation of guidelines. Documentation of care is an important but resource-consuming requirement in health care, a more standardized method of documenting is requested by health professionals. This project can provide insight into the complex process of developing and implement an SCP in different contexts, which will be useful in further implementation processes.展开更多
Introduction: In the context of end-of-life care, interest in advance care planning (ACP) has increased as an approach that allows a person to live in the manner of his or her choosing until the end. ACP is a process ...Introduction: In the context of end-of-life care, interest in advance care planning (ACP) has increased as an approach that allows a person to live in the manner of his or her choosing until the end. ACP is a process of discussion among the elderly persons, family members, and medical staff. However, preparations necessary for starting ACP are not clear. In this study, we aim to clarify the readiness of ACP focusing on the elderly who are the center of end-of-life care. Methods: We reviewed the literature on the subject in the CINAHL and PubMed databases. The keywords used were “advance care planning” and “readiness”. Results: Twelve articles were selected for the final analysis. ACP readiness was broadly divided into preparations on the part of the elderly themselves, family members, and medical professionals. Conclusion: The most frequently reported factor in readiness for ACP was elderly people informing their families and physicians of their intentions. In addition, the establishment of communicative relationships among elderly persons, their family members, and medical professionals was considered readiness for commencing ACP. It was suggested that enhancing these types of readiness would help reduce the barriers to ACP, thereby facilitating its practice.展开更多
This study aimed to examine the effects of empowerment and education intervention to promote Advance Care Planning (ACP) for residents in a highly aged and depopulated region. The study utilized a single-group pre- an...This study aimed to examine the effects of empowerment and education intervention to promote Advance Care Planning (ACP) for residents in a highly aged and depopulated region. The study utilized a single-group pre- and post-test design and was conducted in Osakikamijima, Hiroshima, Japan. The researchers and town officials together formed an ACP committee and created an intervention framework. An ACP workshop was held for the participants and a self-administered questionnaire was carried out before, immediately after, and 3 months after the workshop. A total of 125 residents participated in the workshop and 87 of them completed more than 80% of the questionnaire items, whose responses were analyzed as valid responses. The number of participants who completed the AD increased significantly three months after the workshop (p = 0.008). There was a slight increase in the frequency of consultation with the family, but no change was observed in terms of consultation with healthcare providers. The educational intervention in-creased the respondents’ awareness and knowledge of ACP but did not affect the autonomous decision-making process regarding end-of-life care. This strategic process of ACP empowered the residents’ awareness and attitude towards end-of-life care with an increased completion rate of AD. On the other hand, cognitive barriers remained toward communication and decision-making shared with healthcare providers. Insufficient consultation with family members also became evident. Therefore, a new intervention strategy which helps increase communication with healthcare providers needs to be formulated and guidelines for consultation with the family and others need to be prepared.展开更多
A nursing care planning system that automatically generated nursing summaries from information entered into the Psychiatric Outcome Management System (PSYCHOMS?, Tanioka et al.), was developed to enrich the content of...A nursing care planning system that automatically generated nursing summaries from information entered into the Psychiatric Outcome Management System (PSYCHOMS?, Tanioka et al.), was developed to enrich the content of nursing summaries at psychiatric hospitals, thereby reducing the workload of nurses. Preparing nursing summaries entails finding the required information in nursing records that span a long period of time and then concisely summarizing this information. This time consuming process depends on the clinical experience and writing ability of the nurse. The system described here automatically generates the text data needed for nursing summaries using an algorithm that synthesizes patient information recorded in electronic charts, the Nursing Care Plan information or the data entered for North American Nursing Diagnosis Association (NANDA) 13 domains with predetermined fixed phrases. Advantages of this system are that it enables nursing summaries to be generated automatically in real time, simplifies the process, and permits the standardization of useful nursing summaries that reflect the course of the nursing care provided and its evaluation. Use of this system to automatically generate nursing summaries will allow more nursing time to be devoted to patient care. The system is also useful because it enables nursing summaries that contain the required information to be generated regardless of who prepares them.展开更多
Objective To evaluate and overview the experience of quality care of family planning of China.Methods The framework of quality care of China was summarized and analyzed, that was clients, technology and management tri...Objective To evaluate and overview the experience of quality care of family planning of China.Methods The framework of quality care of China was summarized and analyzed, that was clients, technology and management triangle program system.Results The 8fundamental elements of quality care in China were presented： 1） policy environment of QoC, 2） comprehensive services, 3） choice of method, 4） IEC to policy-makers and providers, 5） technical competence, 6） interpersonal communications, 7） institutional guideline and regulation, 8） appropriate constella- tion of service.Conclusion FP sectors should prepare different constellations of service to meet their individual reproductive health need for different clients and develop institutional guide- line and regulation for FP service to follow up in practice. QoC should be a kind of standardized service process.展开更多
文摘Objective:This study aimed to explore the readiness for advance care planning(ACP)among older adults in Macao’s day service centers and investigate the influencing factors.Methods:A cross-sectional study was conducted from October to December 2022 using a convenience sampling method.A total of 312 older adults were selected from 13 day service centers for older adults in Macao,China.The Advance Care Planning Acceptance Questionnaire and the Family Adaptation,Partnership,Growth,Affection,Resolve(APGAR)Scale were used to survey the older adults.Results:A total of 306 older adults completed the survey.The score for advance care planning readiness was 65.55±10.69,and 59.5%of participants(n=182)were willing to participate in ACP.The family function score was 7.24±2.51,while 70.3%of participants were from a highly functional family.The higher family function indicating a higher readiness for advance care planning(r=0.396,P<0.001).The multiple linear regression analysis indicated that the variables“age,”“knowledge of ACP,”“experience with ACP,”and“received resuscitation of yourself,relatives or friends”combined with“family function”can influence advance care planning readiness among older adults(R^(2)=0.317,F=27.898,P<0.001).Conclusions:Older adults in Macao’s day service centers were willing to engage in ACP.The importance of family involvement is highlighted in the ACP readiness.Health education and improved family communication are vital for promoting ACP,which ensures individuals receive care when they lack the capacity to make that choice.Additionally,healthcare professionals should enhance communication and education with older adults during the medical care process.
基金funded by the Center for Education Financial Service(Puslapdik)and the Indonesia Endowment Fund for Education(LPDP)(Grant number:02651/J5.2.3/BPI.06/9/2022).
文摘Objective:This study aimed to describe the implementation of advance care planning(ACP)in patients with stroke.Methods:A scoping review was conducted according to the Arksey and O'Malley framework.Accordingly,we searched for articles published in ScienceDirect,PubMed,Scopus,ProQuest,and Medline.The inclusion criteria were original research on ACP among adult or elderly stroke patients,hospital-or community-based studies,and those published in English or Indonesian.Qualitative analysis was then used to identify keywords,categories,and themes.Results:Among the 1,050 articles identified,only 8 satisfied the inclusion criteria,indicating that limited studies were available for ACP interventions among stroke patients.Four themes were ultimately identified:the strategy implementation of AC,the challenges of ACP implementation,the benefits of ACP,and the factors influencing ACP.Strategy ACP implementation included the ACP method,the communication style,participation role,media used,and ACP documentation.Lack of information about ACP,facilities,incapacitated patients,and reluctance to implement have become challenges to implementation in stroke.The benefits of ACP,particularly the outcomes of the ACP program,included awareness of ACP engagement,patients can express their wishes,and increased advance directive(AD)documentation.The factors influencing ACP included patient condition,knowledge,and appropriate ACP methods.Conclusion:ACP has not been widely used when providing interventions for stroke patients.The implementation of ACP in stroke patients is full of challenges due to various patient conditions.Effective strategies are needed to improve ACP in stroke patients.It is necessary to develop an ACP for stroke patients'method that involves interprofessional collaboration,and studies on AcP in stroke patients need to be further conducted through interprofessional collaboration.
基金Supported by National Natural Science Foundation of China(71774049).
文摘This paper systematically reviews the research progress of Advance Care Planning(ACP)in the field of lung cancer,and discusses its implementation status,key influencing factors and future development direction,including deepening of theoretical research,innovation of practice mode,optimization of policy support and cultural adaptation research.
文摘<strong>Purpose:</strong> Disease-related Stigma is negative emotions, attitudes, stereotypes, and beliefs about diseases. Cancer is one of the diseases that can be exposed to stigma. Regarding the effects of stigma on the quality of life;admission and adherence to treatment, and considering stigma as a barrier to health promotion and cancer screening, the aim of this study was to provide a care plan for reducing stigma in cancer. <strong>Methods:</strong> This research was carried out during three phases of qualitative, quantitative studies and a review of the literature. The qualitative phase was conducted by conventional content analysis to find effective factors on the reduction of stigma through face to face semi-structured interviews. The quantitative phase was a cross-sectional descriptive study to measure the level of stigma. By using both quantitative and qualitative findings, and a review of the literature, a comprehensive care plan to reduce stigma in families with cancer patients was developed. <strong>Results:</strong> The results showed two categories of data;1) reducing stigma at the individual or family level which needs increasing awareness, teaching coping skills, and support, as well as counseling;and 2) stigma reduction at the community level and policy rules which involve public education and cultural changes. <strong>Conclusion:</strong> Implementation of a care plan for reducing stigma can increase the physical and psychological health outcomes of people influenced by cancer, and at the community level, improves the attitude toward cancer and the success of screening programs, and ultimately reduces disability and mortality of the disease.
文摘Lathosterolosis is a very rare autosomal recessive cholesterol metabolism disorder. The disease manifests itself with developmental and mental delays, learning disabilities, microcephaly, facial dysmorphism, bilateral cataracts, and skeletal defects. It is caused by the deficiency of the enzyme sterol-C5-desaturase, which is involved in cholesterol biosynthesis. This deficiency prevents the synthesis of cholesterol, which acts as a precursor for lipid, bile acids, and steroid hormones. Until 2020, only 7 cases had been reported. In this case report, it was aimed to plan and implement the nursing care of a 2-year-old boy diagnosed with lathosterolosis with the diagnoses of the North American Nursing Diagnostic Association (NANDA).
文摘Advance care planning is a process of discussion in which patients can communicate their end-of-life care preferences to family members and health care providers for consideration.Readiness for advance care planning is a patient's preparedness to engage in advance care planning.This review aims to develop the conceptual framework for advance care planning readiness for Chinese older people.The current knowledge from the published studies was identified and synthesized by an integrative review.The conceptual framework was developed based on the social-ecological model and the theory of planned behavior.The factors from the social environment/community,health care professionals,and individual/family layers were defined.These factors may influence an individual's medical decision-making,which in turn triggers individual behavioral mechanisms that arise from interactions between motivations,attitudes,and beliefs.Relevant factors should be considered when assessing the behavior of personnel engaged in advance care planning or formulating appropriate intervention measures to improve advance care planning par ticipation in China.This framework can be used to guide studies that explore how the social/familial/individual factors predict the readiness for advance care planning among Chinese older people,and to design intervention studies to test the effect of family function on the readiness for advance care planning.
基金This study is supported by the Young Teacher Project of Beijing University of Chinese Medicine(No.:2018-JYB-JS134).
文摘Objective:The objective of this study is to explore the clinical effects of structured skin care plan of integrated Chinese and Western medicine in intervening elderly patients with incontinence-associated dermatitis(IAD).Materials and Methods:Totally,66 elderly patients with IAD were randomly divided into the experiment group(32 cases)and control group(34 cases).The control group was given routine nursing care,while the experiment group was given a structured skin care plan.The observational course was 2 weeks.The treatment efficiency and healing time were compared between the two groups.Results:After 2-week intervention,the total effective rate of the experiment group was higher than that of the control group(97.1%vs.78.1%,X^(2)=3.913,P=0.048).The skin assessment tool score of the experiment group was lower than that of the control group(0.56±1.58 vs.1.75±2.46,Z=−−2.401,P=0.016).The healing time of the experiment group was shorter than that of the control group(7.29±4.76 days vs.10.69±6.36 days,Z=−2.280,P=0.026).Conclusion:The structured skin care plan of integrated Chinese and Western medicine showed a good effect in elderly IAD patients,and provided a reference for clinical treatment and care of elderly patients with IAD.
基金This study was supported by Singapore Health Services Pte Ltd.Prof Ecosse L.Lamoureux received the funding under the SingHealth Research Strategic Hires Scheme,STH-1202-SERI.The grant body had no roles in design,conduct or data analysis of the study.
文摘Background:Using a pilot randomised controlled trial(RCT),to assess the short-term effectiveness of a structured diabetic retinopathy(DR)-specific,intensive,and personalised care planning(DR-IPCP)intervention on diabetes control outcomes in Singaporeans with poorly controlled type 2 diabetes.Methods:Eighteen individuals with mild-moderate DR and poor glycemic control[HbA1c≥64 mmol/mol(≥8.0%)over two consecutive 6-month readings]were randomized to DR-IPCP(n=9)or usual care(UC,n=9).The intervention included a physician consultation,an initial personalised eye consultation with a experienced diabetes nurse educator,and three behaviour change follow-up calls.HbA1c(primary outcome),lipids and blood pressure were assessed at baseline and three months post-intervention.Participant feedback regarding the DR-IPCP program was collected at three months via a semi-structured telephone interview.Results:While no significant between-group differences were observed,DR-IPCP participants experienced significant within-group reductions in HbA1c,total cholesterol,and low density lipoprotein at follow-up compared to baseline[7 mmol/mol(−0.8%),−0.64 mmol/L,and−0.66 mmol/L,respectively].No significant within-group changes in these parameters were observed in the UC group.Following the DR-IPCP intervention,participants reported a clearer understanding of the link between diabetes management;the development and progression of DR.Conclusions:DR-IPCP provides an effective short-term improvement in diabetes control parameters in DR patients with poor diabetes control.An adequately powered and longitudinal RCT is warranted to assess the clinical,patient-centred and economic potential of this programme in this population.
文摘The aim was to explore the implementation of individual care plans in municipal elderly care in relation to characteristics of staff. Data regarding characteristics of staff were derived through a questionnaire distributed to all staff working in the care for older people, (N = 908, n = 245) in four municipalities in Sweden. The number of care plans established during a one-year period was collected through a contact person in each municipality. In total 47 individual care plans were established during the study year. Significantly more staff in the municipality that had the most number of established individual care plans agreed that there had been sufficient education (p = 0.017), sufficient time (p = 0.002) and routines established regarding individual care plans (p = 0.014) and had a significantly better job satisfaction (p = 0.001), compared to staff in the other municipalities. Implementation leaders may need to take the working conditions and the perception of available resources among staff into consideration in the on-going process of implementing individual care plans.
基金supported by the Key Program of Tianjin Municipal Education Commission(171006301C),Nation Natural Science Foundation Program(81603565).
文摘Backgroud:To provide a reference for the further development of the field of the advance care planning(ACP),through the visual analysis of the related literature on the ACP.Methods:Taking the core collection database of Web of ScienceTM as data sources,the method of subject word retrieval is adopted.Literature metrology and CiteSpaceⅤinformation visualization software were used to analyze the literature on ACP published from inception to September 2019.Results:A total of 1,981 literature were included.The number of ACP studies increased,USA published the most literature in the world,followed by Australia,Britain,Canada and the Netherlands and so on.The most leading published journal was the Journal of Palliative Medicine,and the highest impact factor was Palliative Medicine(4.956).Sudore,Rebecca L and Hillary D Lum are the key researcher networks with the largest amount of articles published in ACP field.The research content mainly included the definition,implementation process and implementation effect of ACP.Research focused on palliative care,hospice care,decision-making,communication,patient preference and so on.Conclusion:The studies on ACP is on the rise,the research content is deepening,which suggests that we can learn from the research results of foreign countries in this field and continue to deepen the research in the field of ACP in China.
文摘Aim:To comprehensively synthesize and compare the effect of advance care planning for dementia patients.Design:Systematic review and meta-analysis.Methods:Ten electronic databases will be searched:the Cochrane Library,PubMed,Medline,Embase,PsycINFO,CINAHL PLUS,Scopus,Web of Science,British Nursing Index,clinical Trials,and grey literature sources.Individually or cluster randomized controlled trials that evaluated advance care planning in people with dementia will be incorporated.The research screening flow diagrams will be detailed in the PRISMA flow chart.Data extraction will be carried out in Microsoft Excel 2019 independently by two researchers,any disagreements will be discussed with the third researcher and resolved.We will use the Cochrane Risk of Bias tool to assess the methodological quality.Review Manager 5.3 Software will be used for data synthesis.If sufficient data from studies are available,we will conduct a subgroup analysis of the main outcomes.Conclusion:The systematic review will combine existing trials which may contribute to more convincing conclusions,providing new ideas for medical workers to implement palliative therapy in dementia patients,and further promoting the application of advance care planning for dementia patients.
文摘Background:The goal of this study was to conduct a meta-synthesis of advanced cancer patients’and their relatives’experiences with advanced care planning(ACP)and to provide evidence-based guidance for the development and implementation of ACP in advanced cancer patients.Methods:We searched databases including China Knowledge Network,Wanfang database,VIP database,China Biomedical Literature Database,PubMed,Web of Science,Embase,Cochrane Library,and Cinahl from inception to April 2022 to collect qualitative studies on advanced cancer patients and families'experience about ACP.We use Joanna Briggs Institute Critical Appraisal Checklist for Qualitative Research to evaluate the quality of literature.After quality assessment,meta-synthesis was used to summarize and explain the results.Results:Eleven qualitative studies were included involving 29 results and ten categories.Three integrated themes were extracted:facilitators and barriers to the implementation of advanced medical care programs as perceived by patients and families with advanced cancer;attitudes of patients with advanced cancer and their families towards pre-existing medical care programs;suggestions from patients with advanced cancer and their families on the implementation elements of the pre-existing medical care program.Conclusion:ACP is a complex social process and influenced by many factors.It requires joint efforts of different stakeholders to achieve high-quality and successful ACP.
基金supported by Zhou's Nursing Research Project(No.HLYJ-Z-2018-07).
文摘Objective:To assess the ACP acceptance among patients with malignant tumor in China and factors affecting adoption and timing.Methods:Quantitative study:The convenience sampling method was adopted from October 2020 to October 2021 to investigate 200 oncology patients by a general information questionnaire,patient's advance care planning acceptance questionnaire(ACPQ).Multiple linear stepwise regression was used to analyze the influencing factors of ACP acceptance.Qualitative study:A purposive sampling method was used to select 31 oncology patients and 13 clinical nurses for semi-structured interviews.The data were analyzed using Colaizzi's seven steps.Results:The quantitative study revealed that patients with malignancy had an upper-middle acceptance score of(66.15±7.684)for ACP,with attitude(11.26±2.064),feelings(36.64±4.208),and intention(18.25±3.275)scores.Multiple linear regression analysis showed that religious beliefs,education,monthly income,bereavement experience and notification of condition were independent risk factors for acceptance of ACP(P<0.05).The qualitative study showed that(1)oncology patients have low awareness,high demand,and low acceptability of ACP intervention;(2)they preferred to discuss ACP when medical condition or treatment plan changes;(3)family members were usually involved in ACP discussions,followed by medical personnel;(4)economy,environment,companion,and doctor-patient relationship will all influence ACP implementation.As for nurses,they(1)were unsure about the dynamic changes of ACP content and its optimal timing;(2)had limited ACP knowledge;(3)were affected by environmental factors and nurse-patient relationships;(4)were prone to have disagreements due to inadequate organization department assistance.Conclusions:clinical practitioners should discuss ACP with patients in specific conditions to increase patient acceptance.ACP development requires updated legislation,professional training,and a standardized ACP system.
文摘Objective:To explore the impact of the application and implementation of risk-based cancer care planning in patients with cervical cancer radiotherapy on the complications and self-care ability of patients.Method:This study recruited selected patients who came for cervical cancer radiotherapy in a tertiary hospital in Xianyang City,Shaanxi Province from November 2020 to November 2021.One hundred patients were recruited.Nursing management was carried out,and cancer care planning under the concept of conventional care and risk were applied.The effects of different nursing methods on patients were compared and analyzed.Results:The patients in the experimental group had higher scores of self-care ability and lower complication rate.All data were significantly different from those of the control group(P<0.05),and the nursing effect on the experimental group was better.Conclusion:The application and implementation of the risk-based cancer care planning in patients who received cervical cancer radiotherapy has significant clinical effects,which is beneficial to reduce the incidence of patients’adverse reactions and promote patient recovery.
文摘Background: Patient records should both transfer and create knowledge about patients and their health care. A standardized care plan could be a way to implement evidence-based care directly in practice and improve the documentation in patient records. The aim of this study is to investigate and compare the development and implementation process of a standardized care plan in hospital and primary health care. A further aim is to evaluate the effects on the quality of documentation and the care given in two contexts. Methods and Analysis: Realistic evaluation will be used as a framework to investigate the implementation process. According to this framework, possible contexts, mechanisms, and outcomes in the study will be considered. The study will be performed in two contexts: an orthopedic clinic and primary health care centers. In both contexts, the two key mechanisms will be the same: the implementation process will be driven by internal facilitators (practitioners at the units) and the process will be guided by the Rules and Regulations for interoperability in the Health and Social Care specification, “National information structure for standardized care plans”. Two outcomes of the study will be studied: to investigate the development and implementation process by an evaluation of fidelity and to evaluate how a standardized care plan affects the quality of documentation and the use of evidence-based care. Discussion: Implementation of the SCP will probably meet the same resistance as implementation of guidelines. Documentation of care is an important but resource-consuming requirement in health care, a more standardized method of documenting is requested by health professionals. This project can provide insight into the complex process of developing and implement an SCP in different contexts, which will be useful in further implementation processes.
文摘Introduction: In the context of end-of-life care, interest in advance care planning (ACP) has increased as an approach that allows a person to live in the manner of his or her choosing until the end. ACP is a process of discussion among the elderly persons, family members, and medical staff. However, preparations necessary for starting ACP are not clear. In this study, we aim to clarify the readiness of ACP focusing on the elderly who are the center of end-of-life care. Methods: We reviewed the literature on the subject in the CINAHL and PubMed databases. The keywords used were “advance care planning” and “readiness”. Results: Twelve articles were selected for the final analysis. ACP readiness was broadly divided into preparations on the part of the elderly themselves, family members, and medical professionals. Conclusion: The most frequently reported factor in readiness for ACP was elderly people informing their families and physicians of their intentions. In addition, the establishment of communicative relationships among elderly persons, their family members, and medical professionals was considered readiness for commencing ACP. It was suggested that enhancing these types of readiness would help reduce the barriers to ACP, thereby facilitating its practice.
文摘This study aimed to examine the effects of empowerment and education intervention to promote Advance Care Planning (ACP) for residents in a highly aged and depopulated region. The study utilized a single-group pre- and post-test design and was conducted in Osakikamijima, Hiroshima, Japan. The researchers and town officials together formed an ACP committee and created an intervention framework. An ACP workshop was held for the participants and a self-administered questionnaire was carried out before, immediately after, and 3 months after the workshop. A total of 125 residents participated in the workshop and 87 of them completed more than 80% of the questionnaire items, whose responses were analyzed as valid responses. The number of participants who completed the AD increased significantly three months after the workshop (p = 0.008). There was a slight increase in the frequency of consultation with the family, but no change was observed in terms of consultation with healthcare providers. The educational intervention in-creased the respondents’ awareness and knowledge of ACP but did not affect the autonomous decision-making process regarding end-of-life care. This strategic process of ACP empowered the residents’ awareness and attitude towards end-of-life care with an increased completion rate of AD. On the other hand, cognitive barriers remained toward communication and decision-making shared with healthcare providers. Insufficient consultation with family members also became evident. Therefore, a new intervention strategy which helps increase communication with healthcare providers needs to be formulated and guidelines for consultation with the family and others need to be prepared.
文摘A nursing care planning system that automatically generated nursing summaries from information entered into the Psychiatric Outcome Management System (PSYCHOMS?, Tanioka et al.), was developed to enrich the content of nursing summaries at psychiatric hospitals, thereby reducing the workload of nurses. Preparing nursing summaries entails finding the required information in nursing records that span a long period of time and then concisely summarizing this information. This time consuming process depends on the clinical experience and writing ability of the nurse. The system described here automatically generates the text data needed for nursing summaries using an algorithm that synthesizes patient information recorded in electronic charts, the Nursing Care Plan information or the data entered for North American Nursing Diagnosis Association (NANDA) 13 domains with predetermined fixed phrases. Advantages of this system are that it enables nursing summaries to be generated automatically in real time, simplifies the process, and permits the standardization of useful nursing summaries that reflect the course of the nursing care provided and its evaluation. Use of this system to automatically generate nursing summaries will allow more nursing time to be devoted to patient care. The system is also useful because it enables nursing summaries that contain the required information to be generated regardless of who prepares them.
文摘Objective To evaluate and overview the experience of quality care of family planning of China.Methods The framework of quality care of China was summarized and analyzed, that was clients, technology and management triangle program system.Results The 8fundamental elements of quality care in China were presented： 1） policy environment of QoC, 2） comprehensive services, 3） choice of method, 4） IEC to policy-makers and providers, 5） technical competence, 6） interpersonal communications, 7） institutional guideline and regulation, 8） appropriate constella- tion of service.Conclusion FP sectors should prepare different constellations of service to meet their individual reproductive health need for different clients and develop institutional guide- line and regulation for FP service to follow up in practice. QoC should be a kind of standardized service process.
