Objective:This study aims to discuss the caregiving practices developed by Long-term Care Facilities(LTCFs)during the COVID-19 pandemic and analyze the daily care practices in long-term institutions for older adults i...Objective:This study aims to discuss the caregiving practices developed by Long-term Care Facilities(LTCFs)during the COVID-19 pandemic and analyze the daily care practices in long-term institutions for older adults in Brazil,all in light of the PCC framework.Methods:This is a mixed methods study in which data were collected through interviews with managers from 10 LTCFs.The qualitative discussion was carried out through the PCC framework divided into 5 categories:leisure,accommodation,food,hygiene and comfort,and clinical care.The quantitative data collected were analyzed in a descriptive way,being discussed in the light of the literature.Results:Analyzed LTCFs are unaware of our present difficulties in the implementation of PCC,with a greater presence of the traditional biomedical model being recognized.Given the vulnerabilities that the LTCFs present,PCC is an important alternative for LTCFs to promote the quality of life and autonomy of residents.Deconstructing the vision of LTCFs as a last resort of care and investing in the quality of care is an urgent and essential imperative for dignified and comprehensive care.Conclusions:This study highlights the need for a change in culture and understanding of the LTCFs not only as a place to provide healthcare,but also as a residents’home that fosters their autonomy,and feeling of belonging.Thus,it is essential to ensure that healthcare teams in LTCFs know about PCC and that further studies investigate the impact on the costs of PCC for institutionalized older adults.展开更多
This article addresses the issue of‘diversity culture’in social services with the purpose of re-conceptualizing person-centered social services theory and practice.The increased participation of women,minorities,and...This article addresses the issue of‘diversity culture’in social services with the purpose of re-conceptualizing person-centered social services theory and practice.The increased participation of women,minorities,and people of different nationalities and cultures in the business world is outlining a transformation of the workforce.In parallel,there is also a diversification and heterogeneity of customers,social service users’needs,and markets and consumers’styles.The paper analyzes main groups of theories that inform social services techniques-psychological theories,cognitive behavioral theories,systemic theories,humanistic theories,and constructionist theories-with the aim of re-thinking models and practices to address the challenges that the social services are facing in responding to needs of cultural,gender,action potential,and age diversity.Specifically,social workers and the social services system are required to adapt to the changing circumstances of the social,economic,cultural and communicative environment.展开更多
目的:探讨Guided Care护理模式在不孕症体外受精-胚胎移植(In vitro fertilization and embryo transfer,IVFET)助孕患者中的应用效果。方法:选取2022年12月至2024年12月于本院接受IVF-ET助孕治疗的92例不孕症患者作为研究对象,采用随...目的:探讨Guided Care护理模式在不孕症体外受精-胚胎移植(In vitro fertilization and embryo transfer,IVFET)助孕患者中的应用效果。方法:选取2022年12月至2024年12月于本院接受IVF-ET助孕治疗的92例不孕症患者作为研究对象,采用随机数字表法分为对照组和观察组,各46例。对照组患者接受常规护理,观察组患者接受Guided Care护理模式,两组均持续护理2 m。比较两组心理状态、治疗依从性、生活质量以及护理满意度。结果:护理后,观察组抑郁-焦虑-压力量表(Depression Anxiety Stress Scales,DASS)各项评分均较对照组低,Morisky改良版服药依从性量表(Morisky Medication Adherence Scale,MMAS-8)评分、(The Mos 36-item Short Form Health Survey,SF-36)评分及护理满意度均高于对照组(P<0.05)。结论:Guided Care护理模式能够有效改善不孕症患者接受IVF-ET治疗期间的焦虑、抑郁情绪,增强其治疗依从性,对于顺利妊娠具有积极意义,从而获得更高的护理满意度。展开更多
Objectives This study aimed to evaluate the effectiveness of the stepped self-care program on the self-care,self-efficacy,and quality of life of stroke survivors.Methods This quasi-experimental study allocated 110 str...Objectives This study aimed to evaluate the effectiveness of the stepped self-care program on the self-care,self-efficacy,and quality of life of stroke survivors.Methods This quasi-experimental study allocated 110 stroke survivors from two neurology wards into an intervention group(n=55)who received the stepped self-care program and a control group(n=55)who received usual care from June to December 2023.The Self-Care of Stroke Inventory,Stroke Self-Efficacy Questionnaire,and the short version of the Stroke Specific Quality of Life Scale were administered at baseline(T0),immediately post-intervention(T_(1)),and at 1-month(T_(2))and 3-month(T_(3))follow-ups.Data were analyzed using repeated measures analyses of variance,and generalized estimating equations.Results A total of 48 participants in the intervention group and 50 participants in the control group completed the study.No statistically significant differences were observed at T0 in any of the measured indicators(all P>0.05).The study showed significant group,time,and group×time interaction effects across the assessed outcomes(all P<0.05).Follow-up between-group comparisons at T_(1),T_(2),and T_(3) indicated that the intervention group had significantly higher scores in self-care maintenance,self-care monitoring,self-care management,self-efficacy,and quality of life than the control group(all P<0.001).Conclusions The stepped self-care program significantly improved self-care behaviors,self-efficacy,and quality of life among stroke survivors.These findings support the broader implementation of this approach in post-discharge home self-care.展开更多
Objectives This study aimed to explore and clarify the concept of reflective supervision as a professional self-care strategy to create a positive Intensive Care Unit(ICU)practice environment.Methods Walker and Avant...Objectives This study aimed to explore and clarify the concept of reflective supervision as a professional self-care strategy to create a positive Intensive Care Unit(ICU)practice environment.Methods Walker and Avant’s eight-step concept analysis approach was utilized to identify and define the attributes,antecedents,and consequences of reflective supervision in the ICU.An extensive literature search was conducted across various databases,including Google Scholar,CINAHL,PubMed.Articles published from 2005 to 2025 were identified.We followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses(PRISMA)2020 statement to indicate the included articles and extract related data based on relevance.Results Forty articles were included in the analysis.The identified attributes included the supervisor-supervisee relationship,effective communication,teamwork,collaborations,reflection,competencies,feedback,continuous support,and autonomous choice.The identified antecedents included participation,supportive supervision,flexibility,open-door policy,training,and motivation.Consequences impacting the success of reflective supervision were identified as promotion of resiliency,autonomy,work-life balance,self-awareness,increased self-esteem,professional development,critical thinking,increased job satisfaction,and enhanced commitment.Conclusions Reflective supervision is a complex professional self-care strategy that enhances ICU practice,by promoting nurses’well-being,self-awareness,therapeutic skills,and professional development.展开更多
This paper summarizes the nursing experience of a child with acute fulminant myocarditis.Key nursing measures include establishing a multidisciplinary team to jointly formulate diagnosis and treatment plans;implementi...This paper summarizes the nursing experience of a child with acute fulminant myocarditis.Key nursing measures include establishing a multidisciplinary team to jointly formulate diagnosis and treatment plans;implementing refined volume management,anticoagulation management,and ventilator management during extracorporeal membrane oxygenation;providing personalized nutritional support for the child;and strengthening the prevention and management of complications.After active treatment and nursing care,the child recovered well and was successfully transferred out of the intensive care unit.展开更多
Take care of your hair to help it stay clean,strong and healthy.Wash your hair when it gets dirty,but not too often.For most people,that means every two to three days.People with oily hair wash it every one to two day...Take care of your hair to help it stay clean,strong and healthy.Wash your hair when it gets dirty,but not too often.For most people,that means every two to three days.People with oily hair wash it every one to two days.Use a brush or comb to keep your hair neat and smooth.It's also important to be gentle so you don't pull or break your hair.Never go to bed with wet hair.It can break easily when you sleep.Dry it before bed!展开更多
AIM To describe the development and implementation of a person-centered endoscopy safety checklist and to evaluate the effects of a "checklist intervention".METHODS The checklist,based on previously publishe...AIM To describe the development and implementation of a person-centered endoscopy safety checklist and to evaluate the effects of a "checklist intervention".METHODS The checklist,based on previously published safety checklists,was developed and locally adapted,taking patient safety aspects into consideration and using a person-centered approach. This novel checklist was introduced to the staff of an endoscopy unit at a Stockholm University Hospital during half-day seminars and team training sessions. Structured observations of the endoscopy team's performance were conducted before and after the introduction of the checklist. In addition,questionnaires focusing on patient participation,collaboration climate,and patient safety issues were collected from patients and staff. RESULTS A person-centered safety checklist was developed and introduced by a multi-professional group in the endoscopy unit. A statistically significant increase in accurate patient identity verification by the physicians was noted(from 0% at baseline to 87% after 10 mo,P < 0.001),and remained high among nurses(93% at baseline vs 96% after 10 mo,P = nonsignificant). Observations indicated that the professional staff made frequent attempts to use the checklist,but compliance was suboptimal: All items in the observed nurse-led "summaries" were included in 56% of these interactions,and physicians participated by directly facing the patient in 50% of the interactions. On the questionnaires administered to the staff,items regarding collaboration and the importance of patient participation were rated more highly after the introduction of the checklist,but this did not result in statistical significance(P = 0.07/P = 0.08). The patients rated almost all items as very high both before and after the introduction of the checklist;hence,no statistical difference was noted.CONCLUSION The intervention led to increased patient identity verification by physicians-a patient safety improvement. Clear evidence of enhanced person-centeredness or team work was not found.展开更多
<strong>Objective:</strong><span style="font-family:;" "=""><span style="font-family:Verdana;"> In 2012, we initiated a new person-centred model, integrated &...<strong>Objective:</strong><span style="font-family:;" "=""><span style="font-family:Verdana;"> In 2012, we initiated a new person-centred model, integrated </span><b><span style="font-family:Verdana;">P</span></b><span style="font-family:Verdana;">alliative advanced home ca</span><b><span style="font-family:Verdana;">RE</span></b><span style="font-family:Verdana;"> and heart </span><b><span style="font-family:Verdana;">F</span></b><span style="font-family:Verdana;">ailur</span><b><span style="font-family:Verdana;">E</span></b><span style="font-family:Verdana;"> ca</span><b><span style="font-family:Verdana;">R</span></b><span style="font-family:Verdana;">e (PREFER), to integrate specialised palliative home care with heart failure care. Natriuretic peptide</span></span><span style="font-family:Verdana;">-</span><span style="font-family:Verdana;">guided treatment is valuable for younger patients (age < 75 years), but its usefulness in palliative care is uncertain. We explored whether patients in PREFER reduced mean level of N-terminal pro B-type natriuretic peptide (NT-proBNP) more than the control group.</span><span style="font-family:Verdana;"> </span><b><span style="font-family:Verdana;">Design:</span></b><span style="font-family:Verdana;"> A pre-specified, exploratory substudy, analysed within the prospective, randomised PREFER study, which had an open, non-blinded design.</span><span style="font-family:Verdana;"> </span><b><span style="font-family:Verdana;">Participants:</span></b><span style="font-family:Verdana;"> Patients in palliative care with chronic heart failure, New York Heart Association class III-IV were randomly assigned to an intervention (n = 36;26 males, 10 females, mean age:</span><span style="font-family:Verdana;"> </span><span style="font-family:Verdana;">81</span><span style="font-family:Verdana;">.</span><span style="font-family:Verdana;">9 years) or control group (n = 36;25 males, 11 females, mean age:</span><span style="font-family:;" "=""></span><span style="font-family:Verdana;">76</span><span style="font-family:Verdana;">.</span><span style="font-family:Verdana;">5 years). The intervention group received the PREFER intervention for 6 months. The control group received care as usual at a primary health care centre or heart failure clinic at the hospital. NT-proBNP was measured at the start and end of study.</span><span style="font-family:Verdana;"> </span><b><span style="font-family:Verdana;">Results:</span></b><span style="font-family:Verdana;"> Plasma levels of NT-proBNP differed significantly between groups at baseline. By the end of the study, no significant difference was found between the groups. The mean value for NT-proBNP decreased by 35% in the PREFER group but was not statistically significant (P = 0.074);NT-proBNP increased 4% in the control group.</span><span style="font-family:Verdana;"> </span><b><span style="font-family:Verdana;">Conclusions</span></b><b><span style="font-family:Verdana;">:</span></b><b><span style="font-family:Verdana;"> </span></b><span style="font-family:Verdana;">We found no statistically significant reductions of NT-proBNP levels neither between nor within the PREFER and the control group at the end of the study.</span>展开更多
Community volunteers were recruited and trained to deliver person-centred care to patients with dementia or delirium in an acute hospital setting, in a small rural Australian hospital. The volunteer program was ground...Community volunteers were recruited and trained to deliver person-centred care to patients with dementia or delirium in an acute hospital setting, in a small rural Australian hospital. The volunteer program was grounded in action research methodology, and modelled on a previous research project. As a form of evaluation, interviews were conducted with nursing staff eight weeks after implementation of the volunteer program to explore their opinions. Data were analysed through a collaborative process and findings revealed strong benefits from the perspectives of the nursing staff. These benefits included overall improved patient care and improved time management for nursing tasks.展开更多
Background and Objective The development of modern palliative care in China began in the 1980s and is currently in an accelerating phase.However,inconsistencies in terminology and concepts have hindered policy-making,...Background and Objective The development of modern palliative care in China began in the 1980s and is currently in an accelerating phase.However,inconsistencies in terminology and concepts have hindered policy-making,clinical practice,and academic research.The Terminology of Clinical Medicine(2023 edition)has determined huan-he-yi-liao(缓和医疗)and an-ning-liao-hu(安宁疗护)as the formal terms of"palliative care"and"hospice care",respectively.To align with these terms,this study aims to establish expert consensus definitions tailored to the Chinese context.Methods We systematically retrieved and collected domestic and international literature and policy documents related to the definition of palliative care,then deconstructed and analyzed the relevant conceptual elements of these definitions.Core expert panel built the initial recommended definition upon the conceptual elements and consensus definition of palliative care by the International Association for Hospice and Palliative Care(IAHPC)through two rounds of online discussions.After nomination and selection,61 professionals in the field of palliative care in China were invited to participate in the consensus expert group.Two rounds of Delphi consultation were conducted among the consensus experts,who were asked to score their agreement using Likert scale to the items in the initial recommended definition and the definition statements of palliative care and hospice care.Agreement rate of over 80%was considered as reaching consensus for each items.The core expert panel revised the items and the statements of recommended definitions based on the results from Delphi surveys.The final recommended definitions were formulated after feedback from patient and public involvement(PPI)group members.Results The response rates for the first and second round of Delphi surveys were 83.6%and 100.0%,respectively.The agreement rates of the items and statements of the recommended definitions exceeded 90%.Accordingly,the definitions based on Chinese expert consensus are recommended.Palliative care is an active holistic approach aimed at patients of all ages suffering from life-threatening illness and their families and caregivers.It seeks to improve their quality of life by preventing,assessing,and relieving physical,psychological,social,and spiritual suffering.Hospice care is an integral part of palliative care,focusing on holistic care for patients at the end of life and their families and caregivers.Its goal is to help patients to maintain dignity and achieve a good death by alleviating physical,psychological,social,and spiritual distress without intentionally hastening or postponing death,meanwhile improve the quality of life for families and caregivers.Conclusions This study has established the Chinese expert consensus definitions of palliative care and hospice care in China,as well as the relationship between the two.The definitions highlight the holistic nature of palliative care,providing a foundation for discipline development,clinical practice,and public communication.展开更多
This paper reviews the research progress of “person-centered” nursing,and provides reference for the development of “person-centered” nursing in China.Currently,foreign scales have been developed to measure “pers...This paper reviews the research progress of “person-centered” nursing,and provides reference for the development of “person-centered” nursing in China.Currently,foreign scales have been developed to measure “person-centered” nursing,such as Individualized Care Scale,P-CA,Assess Health Care Providers’ Implementation of Patient-Cen,Person-centered Critical Care Nursing and Human-based Perioperative Care Scale.The “Person-centered” nursing model has been widely used in clinical nursing and nursing management.Studies have shown that “person-centered” nursing can improve patient satisfaction and promote the physical and mental health of patients.At the same time,the combination of “person-centered” nursing and teaching promotes the innovation of medical education medicine,and its combination with architecture promotes the progress of hospital construction.Future research should focus on the overall layout of hospitals and wards,use more holistic means of psychosomatic medicine to set up more comprehensive humanistic concepts such as accompanying family members area,improve the breadth and depth of humanistic nursing field,and promote the development of humanistic nursing in China.展开更多
Management of patients with acute hemorrhage requires addressing the source of bleeding,replenishing blood volume,and addressing any coagulopathy that may be present.Assessing coagulopathy and predicting blood require...Management of patients with acute hemorrhage requires addressing the source of bleeding,replenishing blood volume,and addressing any coagulopathy that may be present.Assessing coagulopathy and predicting blood requirements in real-time in patients experiencing ongoing bleeding can pose substantial challenges.In these patients,transfusion concepts based on ratios do not effectively address coagulopathy or reduce mortality.Moreover,ratio-based concepts do not stop bleeding;instead,they just give physicians more time to identify the bleeding source and plan management strategies.In clinical practice,standard laboratory coagulation tests(SLCT)are frequently used to assess various aspects of blood clotting.However,these tests may not always offer a comprehensive under-standing of clinically significant coagulopathy and the severity of blood loss.Furthermore,the SLCT have a considerable turnaround time,which may not be ideal for making prompt clinical decisions.In recent years,there has been a growing interest in point-of-care viscoelastic assays like rotational thromboelast-ometry,which provide real-time,dynamic information about clot formation and dissolution.展开更多
BACKGROUND The need for an emergency upgrade of a hospitalized trauma patient from the floor to the trauma intensive care unit(ICU)is an unanticipated event with possible life-threatening consequences.Unplanned ICU ad...BACKGROUND The need for an emergency upgrade of a hospitalized trauma patient from the floor to the trauma intensive care unit(ICU)is an unanticipated event with possible life-threatening consequences.Unplanned ICU admissions are associated with increased morbidity and mortality and are an indicator of trauma service quality.Two different types of unplanned ICU admissions include upgrades(patients admitted to the floor then moved to the ICU)and bounce backs(patients admitted to the ICU,discharged to the floor,and then readmitted to the ICU).Previous studies have shown that geriatric trauma patients are at higher risk for unfavorable outcomes.AIM To analyze the characteristics,management and outcomes of trauma patients who had an unplanned ICU admission during their hospitalization.METHODS This institutional review board approved,retrospective cohort study examined 203 adult trauma patients with unplanned ICU admission at an urban level 1 trauma center over a six-year period(2017-2023).This included 134 upgrades and 69 bounce backs.Analyzed variables included:(1)Age;(2)Sex;(3)Comorbidities;(4)Mechanism of injury(MOI);(5)Injury severity score(ISS);(6)Glasgow Coma Scale(GCS);(7)Type of injury;(8)Transfusions;(9)Consultations;(10)Timing and reason for unplanned admission;(11)Intubations;(12)Surgical interventions;(13)ICU and hospital lengths of stay;and(14)Mortality.RESULTS Unplanned ICU admissions comprised 4.2%of total ICU admissions.Main MOI was falls.Mean age was 70.7 years,ISS was 12.8 and GCS was 13.9.Main injuries were traumatic brain injury(37.4%)and thoracic injury(21.7%),and main reason for unplanned ICU admission was respiratory complication(39.4%).The 47.3%underwent a surgical procedure and 46.8%were intubated.Average timing for unplanned ICU admission was 2.9 days.Bounce backs occurred half as often as upgrades,however had higher rates of transfusions(63.8%vs 40.3%,P=0.002),consultations(4.8 vs 3.0,P<0.001),intubations(63.8%vs 38.1%%,P=0.001),longer ICU lengths of stay(13.2 days vs 6.4 days,P<0.001)and hospital lengths of stay(26.7 days vs 13.0 days,P<0.001).Mortality was 25.6%among unplanned ICU admissions,31.9%among geriatric unplanned ICU admissions and 11.9%among all trauma ICU patients.CONCLUSION Unplanned ICU admissions constituted 4.2%of total ICU admissions.Respiratory complications were the main cause of unplanned ICU admissions.Bounce backs occurred half as often as upgrades,but were associated with worse outcomes.展开更多
Objective:To clarify the concept of in-home respite care in dementia care and identify changes in the service content over time to help providers and users better understand this sustainable service.Method:A literatur...Objective:To clarify the concept of in-home respite care in dementia care and identify changes in the service content over time to help providers and users better understand this sustainable service.Method:A literature search was conducted through Chinese databases China National Knowledge Infrastructure(CNKI),Wanfang,VIP,and SinoMed,as well as English databases PubMed,the Cochrane Library,Web of Sciences,and Embase.Articles published from January 1980 to December 2024 were identified.Rogers’conceptual analysis of evolution was used for this concept analysis,including six steps:identifying the concept and its context,selecting appropriate databases,determining relevant literature,identifying the concept’s attributes,antecedents,and consequences,choosing a concept exemplar if appropriate,and defininghypotheses and implications for further concept development.Results:Thirty-one articles were included.This conceptual analysis revealed the evolution of in-home respite care service content over time and summarized three key attributes.The antecedents included factors related to people with dementia,family caregivers,and the social environment(aging society,government support).The consequences of in-home respite services include delayed institutional placement and reduced security risk events for people with dementia.For family caregivers,consequences include reduced caregiving stress,improved quality of life,and perceived benefitsfrom rest periods.Conclusion:In-home respite care can be interpreted as family-centered home care that provides temporary relief from family caregivers’responsibilities in caring for people with dementia to reduce caregiver burden.The trend of service specialization and attention on dementia families’needs in service provision are future research focus.展开更多
基金supported by the Mentored Undergraduate Summer Experience and SEED Money Grant of The College of New Jersey.
文摘Objective:This study aims to discuss the caregiving practices developed by Long-term Care Facilities(LTCFs)during the COVID-19 pandemic and analyze the daily care practices in long-term institutions for older adults in Brazil,all in light of the PCC framework.Methods:This is a mixed methods study in which data were collected through interviews with managers from 10 LTCFs.The qualitative discussion was carried out through the PCC framework divided into 5 categories:leisure,accommodation,food,hygiene and comfort,and clinical care.The quantitative data collected were analyzed in a descriptive way,being discussed in the light of the literature.Results:Analyzed LTCFs are unaware of our present difficulties in the implementation of PCC,with a greater presence of the traditional biomedical model being recognized.Given the vulnerabilities that the LTCFs present,PCC is an important alternative for LTCFs to promote the quality of life and autonomy of residents.Deconstructing the vision of LTCFs as a last resort of care and investing in the quality of care is an urgent and essential imperative for dignified and comprehensive care.Conclusions:This study highlights the need for a change in culture and understanding of the LTCFs not only as a place to provide healthcare,but also as a residents’home that fosters their autonomy,and feeling of belonging.Thus,it is essential to ensure that healthcare teams in LTCFs know about PCC and that further studies investigate the impact on the costs of PCC for institutionalized older adults.
文摘This article addresses the issue of‘diversity culture’in social services with the purpose of re-conceptualizing person-centered social services theory and practice.The increased participation of women,minorities,and people of different nationalities and cultures in the business world is outlining a transformation of the workforce.In parallel,there is also a diversification and heterogeneity of customers,social service users’needs,and markets and consumers’styles.The paper analyzes main groups of theories that inform social services techniques-psychological theories,cognitive behavioral theories,systemic theories,humanistic theories,and constructionist theories-with the aim of re-thinking models and practices to address the challenges that the social services are facing in responding to needs of cultural,gender,action potential,and age diversity.Specifically,social workers and the social services system are required to adapt to the changing circumstances of the social,economic,cultural and communicative environment.
文摘目的:探讨Guided Care护理模式在不孕症体外受精-胚胎移植(In vitro fertilization and embryo transfer,IVFET)助孕患者中的应用效果。方法:选取2022年12月至2024年12月于本院接受IVF-ET助孕治疗的92例不孕症患者作为研究对象,采用随机数字表法分为对照组和观察组,各46例。对照组患者接受常规护理,观察组患者接受Guided Care护理模式,两组均持续护理2 m。比较两组心理状态、治疗依从性、生活质量以及护理满意度。结果:护理后,观察组抑郁-焦虑-压力量表(Depression Anxiety Stress Scales,DASS)各项评分均较对照组低,Morisky改良版服药依从性量表(Morisky Medication Adherence Scale,MMAS-8)评分、(The Mos 36-item Short Form Health Survey,SF-36)评分及护理满意度均高于对照组(P<0.05)。结论:Guided Care护理模式能够有效改善不孕症患者接受IVF-ET治疗期间的焦虑、抑郁情绪,增强其治疗依从性,对于顺利妊娠具有积极意义,从而获得更高的护理满意度。
基金The National Natural Science Foundation of China[72174184]provided policy and financialsupport for this research.
文摘Objectives This study aimed to evaluate the effectiveness of the stepped self-care program on the self-care,self-efficacy,and quality of life of stroke survivors.Methods This quasi-experimental study allocated 110 stroke survivors from two neurology wards into an intervention group(n=55)who received the stepped self-care program and a control group(n=55)who received usual care from June to December 2023.The Self-Care of Stroke Inventory,Stroke Self-Efficacy Questionnaire,and the short version of the Stroke Specific Quality of Life Scale were administered at baseline(T0),immediately post-intervention(T_(1)),and at 1-month(T_(2))and 3-month(T_(3))follow-ups.Data were analyzed using repeated measures analyses of variance,and generalized estimating equations.Results A total of 48 participants in the intervention group and 50 participants in the control group completed the study.No statistically significant differences were observed at T0 in any of the measured indicators(all P>0.05).The study showed significant group,time,and group×time interaction effects across the assessed outcomes(all P<0.05).Follow-up between-group comparisons at T_(1),T_(2),and T_(3) indicated that the intervention group had significantly higher scores in self-care maintenance,self-care monitoring,self-care management,self-efficacy,and quality of life than the control group(all P<0.001).Conclusions The stepped self-care program significantly improved self-care behaviors,self-efficacy,and quality of life among stroke survivors.These findings support the broader implementation of this approach in post-discharge home self-care.
文摘Objectives This study aimed to explore and clarify the concept of reflective supervision as a professional self-care strategy to create a positive Intensive Care Unit(ICU)practice environment.Methods Walker and Avant’s eight-step concept analysis approach was utilized to identify and define the attributes,antecedents,and consequences of reflective supervision in the ICU.An extensive literature search was conducted across various databases,including Google Scholar,CINAHL,PubMed.Articles published from 2005 to 2025 were identified.We followed the Preferred Reporting Items for Systematic Reviews and Meta-Analyses(PRISMA)2020 statement to indicate the included articles and extract related data based on relevance.Results Forty articles were included in the analysis.The identified attributes included the supervisor-supervisee relationship,effective communication,teamwork,collaborations,reflection,competencies,feedback,continuous support,and autonomous choice.The identified antecedents included participation,supportive supervision,flexibility,open-door policy,training,and motivation.Consequences impacting the success of reflective supervision were identified as promotion of resiliency,autonomy,work-life balance,self-awareness,increased self-esteem,professional development,critical thinking,increased job satisfaction,and enhanced commitment.Conclusions Reflective supervision is a complex professional self-care strategy that enhances ICU practice,by promoting nurses’well-being,self-awareness,therapeutic skills,and professional development.
文摘This paper summarizes the nursing experience of a child with acute fulminant myocarditis.Key nursing measures include establishing a multidisciplinary team to jointly formulate diagnosis and treatment plans;implementing refined volume management,anticoagulation management,and ventilator management during extracorporeal membrane oxygenation;providing personalized nutritional support for the child;and strengthening the prevention and management of complications.After active treatment and nursing care,the child recovered well and was successfully transferred out of the intensive care unit.
文摘Take care of your hair to help it stay clean,strong and healthy.Wash your hair when it gets dirty,but not too often.For most people,that means every two to three days.People with oily hair wash it every one to two days.Use a brush or comb to keep your hair neat and smooth.It's also important to be gentle so you don't pull or break your hair.Never go to bed with wet hair.It can break easily when you sleep.Dry it before bed!
文摘AIM To describe the development and implementation of a person-centered endoscopy safety checklist and to evaluate the effects of a "checklist intervention".METHODS The checklist,based on previously published safety checklists,was developed and locally adapted,taking patient safety aspects into consideration and using a person-centered approach. This novel checklist was introduced to the staff of an endoscopy unit at a Stockholm University Hospital during half-day seminars and team training sessions. Structured observations of the endoscopy team's performance were conducted before and after the introduction of the checklist. In addition,questionnaires focusing on patient participation,collaboration climate,and patient safety issues were collected from patients and staff. RESULTS A person-centered safety checklist was developed and introduced by a multi-professional group in the endoscopy unit. A statistically significant increase in accurate patient identity verification by the physicians was noted(from 0% at baseline to 87% after 10 mo,P < 0.001),and remained high among nurses(93% at baseline vs 96% after 10 mo,P = nonsignificant). Observations indicated that the professional staff made frequent attempts to use the checklist,but compliance was suboptimal: All items in the observed nurse-led "summaries" were included in 56% of these interactions,and physicians participated by directly facing the patient in 50% of the interactions. On the questionnaires administered to the staff,items regarding collaboration and the importance of patient participation were rated more highly after the introduction of the checklist,but this did not result in statistical significance(P = 0.07/P = 0.08). The patients rated almost all items as very high both before and after the introduction of the checklist;hence,no statistical difference was noted.CONCLUSION The intervention led to increased patient identity verification by physicians-a patient safety improvement. Clear evidence of enhanced person-centeredness or team work was not found.
文摘<strong>Objective:</strong><span style="font-family:;" "=""><span style="font-family:Verdana;"> In 2012, we initiated a new person-centred model, integrated </span><b><span style="font-family:Verdana;">P</span></b><span style="font-family:Verdana;">alliative advanced home ca</span><b><span style="font-family:Verdana;">RE</span></b><span style="font-family:Verdana;"> and heart </span><b><span style="font-family:Verdana;">F</span></b><span style="font-family:Verdana;">ailur</span><b><span style="font-family:Verdana;">E</span></b><span style="font-family:Verdana;"> ca</span><b><span style="font-family:Verdana;">R</span></b><span style="font-family:Verdana;">e (PREFER), to integrate specialised palliative home care with heart failure care. Natriuretic peptide</span></span><span style="font-family:Verdana;">-</span><span style="font-family:Verdana;">guided treatment is valuable for younger patients (age < 75 years), but its usefulness in palliative care is uncertain. We explored whether patients in PREFER reduced mean level of N-terminal pro B-type natriuretic peptide (NT-proBNP) more than the control group.</span><span style="font-family:Verdana;"> </span><b><span style="font-family:Verdana;">Design:</span></b><span style="font-family:Verdana;"> A pre-specified, exploratory substudy, analysed within the prospective, randomised PREFER study, which had an open, non-blinded design.</span><span style="font-family:Verdana;"> </span><b><span style="font-family:Verdana;">Participants:</span></b><span style="font-family:Verdana;"> Patients in palliative care with chronic heart failure, New York Heart Association class III-IV were randomly assigned to an intervention (n = 36;26 males, 10 females, mean age:</span><span style="font-family:Verdana;"> </span><span style="font-family:Verdana;">81</span><span style="font-family:Verdana;">.</span><span style="font-family:Verdana;">9 years) or control group (n = 36;25 males, 11 females, mean age:</span><span style="font-family:;" "=""></span><span style="font-family:Verdana;">76</span><span style="font-family:Verdana;">.</span><span style="font-family:Verdana;">5 years). The intervention group received the PREFER intervention for 6 months. The control group received care as usual at a primary health care centre or heart failure clinic at the hospital. NT-proBNP was measured at the start and end of study.</span><span style="font-family:Verdana;"> </span><b><span style="font-family:Verdana;">Results:</span></b><span style="font-family:Verdana;"> Plasma levels of NT-proBNP differed significantly between groups at baseline. By the end of the study, no significant difference was found between the groups. The mean value for NT-proBNP decreased by 35% in the PREFER group but was not statistically significant (P = 0.074);NT-proBNP increased 4% in the control group.</span><span style="font-family:Verdana;"> </span><b><span style="font-family:Verdana;">Conclusions</span></b><b><span style="font-family:Verdana;">:</span></b><b><span style="font-family:Verdana;"> </span></b><span style="font-family:Verdana;">We found no statistically significant reductions of NT-proBNP levels neither between nor within the PREFER and the control group at the end of the study.</span>
文摘Community volunteers were recruited and trained to deliver person-centred care to patients with dementia or delirium in an acute hospital setting, in a small rural Australian hospital. The volunteer program was grounded in action research methodology, and modelled on a previous research project. As a form of evaluation, interviews were conducted with nursing staff eight weeks after implementation of the volunteer program to explore their opinions. Data were analysed through a collaborative process and findings revealed strong benefits from the perspectives of the nursing staff. These benefits included overall improved patient care and improved time management for nursing tasks.
文摘Background and Objective The development of modern palliative care in China began in the 1980s and is currently in an accelerating phase.However,inconsistencies in terminology and concepts have hindered policy-making,clinical practice,and academic research.The Terminology of Clinical Medicine(2023 edition)has determined huan-he-yi-liao(缓和医疗)and an-ning-liao-hu(安宁疗护)as the formal terms of"palliative care"and"hospice care",respectively.To align with these terms,this study aims to establish expert consensus definitions tailored to the Chinese context.Methods We systematically retrieved and collected domestic and international literature and policy documents related to the definition of palliative care,then deconstructed and analyzed the relevant conceptual elements of these definitions.Core expert panel built the initial recommended definition upon the conceptual elements and consensus definition of palliative care by the International Association for Hospice and Palliative Care(IAHPC)through two rounds of online discussions.After nomination and selection,61 professionals in the field of palliative care in China were invited to participate in the consensus expert group.Two rounds of Delphi consultation were conducted among the consensus experts,who were asked to score their agreement using Likert scale to the items in the initial recommended definition and the definition statements of palliative care and hospice care.Agreement rate of over 80%was considered as reaching consensus for each items.The core expert panel revised the items and the statements of recommended definitions based on the results from Delphi surveys.The final recommended definitions were formulated after feedback from patient and public involvement(PPI)group members.Results The response rates for the first and second round of Delphi surveys were 83.6%and 100.0%,respectively.The agreement rates of the items and statements of the recommended definitions exceeded 90%.Accordingly,the definitions based on Chinese expert consensus are recommended.Palliative care is an active holistic approach aimed at patients of all ages suffering from life-threatening illness and their families and caregivers.It seeks to improve their quality of life by preventing,assessing,and relieving physical,psychological,social,and spiritual suffering.Hospice care is an integral part of palliative care,focusing on holistic care for patients at the end of life and their families and caregivers.Its goal is to help patients to maintain dignity and achieve a good death by alleviating physical,psychological,social,and spiritual distress without intentionally hastening or postponing death,meanwhile improve the quality of life for families and caregivers.Conclusions This study has established the Chinese expert consensus definitions of palliative care and hospice care in China,as well as the relationship between the two.The definitions highlight the holistic nature of palliative care,providing a foundation for discipline development,clinical practice,and public communication.
文摘This paper reviews the research progress of “person-centered” nursing,and provides reference for the development of “person-centered” nursing in China.Currently,foreign scales have been developed to measure “person-centered” nursing,such as Individualized Care Scale,P-CA,Assess Health Care Providers’ Implementation of Patient-Cen,Person-centered Critical Care Nursing and Human-based Perioperative Care Scale.The “Person-centered” nursing model has been widely used in clinical nursing and nursing management.Studies have shown that “person-centered” nursing can improve patient satisfaction and promote the physical and mental health of patients.At the same time,the combination of “person-centered” nursing and teaching promotes the innovation of medical education medicine,and its combination with architecture promotes the progress of hospital construction.Future research should focus on the overall layout of hospitals and wards,use more holistic means of psychosomatic medicine to set up more comprehensive humanistic concepts such as accompanying family members area,improve the breadth and depth of humanistic nursing field,and promote the development of humanistic nursing in China.
文摘Management of patients with acute hemorrhage requires addressing the source of bleeding,replenishing blood volume,and addressing any coagulopathy that may be present.Assessing coagulopathy and predicting blood requirements in real-time in patients experiencing ongoing bleeding can pose substantial challenges.In these patients,transfusion concepts based on ratios do not effectively address coagulopathy or reduce mortality.Moreover,ratio-based concepts do not stop bleeding;instead,they just give physicians more time to identify the bleeding source and plan management strategies.In clinical practice,standard laboratory coagulation tests(SLCT)are frequently used to assess various aspects of blood clotting.However,these tests may not always offer a comprehensive under-standing of clinically significant coagulopathy and the severity of blood loss.Furthermore,the SLCT have a considerable turnaround time,which may not be ideal for making prompt clinical decisions.In recent years,there has been a growing interest in point-of-care viscoelastic assays like rotational thromboelast-ometry,which provide real-time,dynamic information about clot formation and dissolution.
文摘BACKGROUND The need for an emergency upgrade of a hospitalized trauma patient from the floor to the trauma intensive care unit(ICU)is an unanticipated event with possible life-threatening consequences.Unplanned ICU admissions are associated with increased morbidity and mortality and are an indicator of trauma service quality.Two different types of unplanned ICU admissions include upgrades(patients admitted to the floor then moved to the ICU)and bounce backs(patients admitted to the ICU,discharged to the floor,and then readmitted to the ICU).Previous studies have shown that geriatric trauma patients are at higher risk for unfavorable outcomes.AIM To analyze the characteristics,management and outcomes of trauma patients who had an unplanned ICU admission during their hospitalization.METHODS This institutional review board approved,retrospective cohort study examined 203 adult trauma patients with unplanned ICU admission at an urban level 1 trauma center over a six-year period(2017-2023).This included 134 upgrades and 69 bounce backs.Analyzed variables included:(1)Age;(2)Sex;(3)Comorbidities;(4)Mechanism of injury(MOI);(5)Injury severity score(ISS);(6)Glasgow Coma Scale(GCS);(7)Type of injury;(8)Transfusions;(9)Consultations;(10)Timing and reason for unplanned admission;(11)Intubations;(12)Surgical interventions;(13)ICU and hospital lengths of stay;and(14)Mortality.RESULTS Unplanned ICU admissions comprised 4.2%of total ICU admissions.Main MOI was falls.Mean age was 70.7 years,ISS was 12.8 and GCS was 13.9.Main injuries were traumatic brain injury(37.4%)and thoracic injury(21.7%),and main reason for unplanned ICU admission was respiratory complication(39.4%).The 47.3%underwent a surgical procedure and 46.8%were intubated.Average timing for unplanned ICU admission was 2.9 days.Bounce backs occurred half as often as upgrades,however had higher rates of transfusions(63.8%vs 40.3%,P=0.002),consultations(4.8 vs 3.0,P<0.001),intubations(63.8%vs 38.1%%,P=0.001),longer ICU lengths of stay(13.2 days vs 6.4 days,P<0.001)and hospital lengths of stay(26.7 days vs 13.0 days,P<0.001).Mortality was 25.6%among unplanned ICU admissions,31.9%among geriatric unplanned ICU admissions and 11.9%among all trauma ICU patients.CONCLUSION Unplanned ICU admissions constituted 4.2%of total ICU admissions.Respiratory complications were the main cause of unplanned ICU admissions.Bounce backs occurred half as often as upgrades,but were associated with worse outcomes.
基金supported by the Fundamental Research Funds for the Central Universities(lzujbky-2022-it36)。
文摘Objective:To clarify the concept of in-home respite care in dementia care and identify changes in the service content over time to help providers and users better understand this sustainable service.Method:A literature search was conducted through Chinese databases China National Knowledge Infrastructure(CNKI),Wanfang,VIP,and SinoMed,as well as English databases PubMed,the Cochrane Library,Web of Sciences,and Embase.Articles published from January 1980 to December 2024 were identified.Rogers’conceptual analysis of evolution was used for this concept analysis,including six steps:identifying the concept and its context,selecting appropriate databases,determining relevant literature,identifying the concept’s attributes,antecedents,and consequences,choosing a concept exemplar if appropriate,and defininghypotheses and implications for further concept development.Results:Thirty-one articles were included.This conceptual analysis revealed the evolution of in-home respite care service content over time and summarized three key attributes.The antecedents included factors related to people with dementia,family caregivers,and the social environment(aging society,government support).The consequences of in-home respite services include delayed institutional placement and reduced security risk events for people with dementia.For family caregivers,consequences include reduced caregiving stress,improved quality of life,and perceived benefitsfrom rest periods.Conclusion:In-home respite care can be interpreted as family-centered home care that provides temporary relief from family caregivers’responsibilities in caring for people with dementia to reduce caregiver burden.The trend of service specialization and attention on dementia families’needs in service provision are future research focus.
