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  • 文章类型: Journal Article
    背景:产科背景下的最新研究表明,患者参与住院患者安全具有附加价值。尽管有这些好处,产科最近的研究表明,患者参与对患者安全的四种不同的负面影响已经出现。然而,目前缺乏从患者参与患者安全的角度解决这些负面影响的方法.出于这个原因,本研究的目的是概述可以采取的措施,以减轻患者参与产科患者安全的负面影响.
    方法:本研究在某三级学术中心的产科进行。一项探索性定性访谈研究包括对专业人士(N=8)和患者(N=8)的16次访谈。减轻患者参与患者安全的负面影响的行动,使用演绎方法进行了分析和分类。
    结果:发现18项措施减轻了患者参与产科患者安全的负面影响。这些行动分为五个主题:\'结构\',\'文化\',\'教育\',\'情感\',和“物理和技术”。这五个类别反映了当前改善患者安全的方法,主要是从专业人员而不是患者的角度来看。
    结论:大多数确定的行动与改变文化有关,以产生更多的以患者为中心的护理并改变当前的现实。这主要是从专业人士的角度来看,而从患者的角度来看太少。此外,建议的行动都不符合第六个预期类别,即,\'政治\'。未来的研究应该探索基于这些行动实施以患者为中心的护理方法的方法。通过这样做,空间,必须创造金钱和时间来阐述这些行动,并将它们整合到组织结构中,文化和实践。
    BACKGROUND: Recent research within the context of Obstetrics shows the added value of patient participation in in-hospital patient safety. Notwithstanding these benefits, recent research within an Obstetrics department shows that four different negative effects of patient participation in patient safety have emerged. However, the approach to addressing these negative effects within the perspective of patient participation in patient safety is currently lacking. For this reason, the aim of this study is to generate an overview of actions that could be taken to mitigate the negative effects of patient participation in patient safety within an Obstetrics department.
    METHODS: This study was conducted in the Obstetrics Department of a tertiary academic center. An explorative qualitative interview study included sixteen interviews with professionals (N = 8) and patients (N = 8). The actions to mitigate the negative effects of patient participation in patient safety, were analyzed and classified using a deductive approach.
    RESULTS: Eighteen actions were identified that mitigated the negative effects of patient participation in patient safety within an Obstetrics department. These actions were categorized into five themes: \'structure\', \'culture\', \'education\', \'emotional\', and \'physical and technology\'. These five categories reflect the current approach to improving patient safety which is primarily viewed from the perspective of professionals rather than of patients.
    CONCLUSIONS: Most of the identified actions are linked to changing the culture to generate more patient-centered care and change the current reality, which looks predominantly from the perspective of the professionals and too little from that of the patients. Furthermore, none of the suggested actions fit within a sixth anticipated category, namely, \'politics\'. Future research should explore ways to implement a patient-centered care approach based on these actions. By doing so, space, money and time have to be created to elaborate on these actions and integrate them into the organizations\' structure, culture and practices.
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  • 文章类型: Journal Article
    健康素养和疾病认知在应对心脏代谢疾病流行中起着至关重要的作用。我们的目标是比较态度,知识,自我感知的风险和采取的行动,在有和没有代谢危险因素(MFs)的个体之间。
    从2022年6月5日至10月5日,邀请公众参与者填写一份自我管理的问卷。MF状态被定义为高血压的存在,高脂血症,糖尿病和/或当前/先前吸烟。参与者根据四个类别进行评估(基于知识的,基于态度,感知风险,和基于行动的)与四种心脏代谢疾病有关的问题-糖尿病,高血压,高脂血症,和非酒精性脂肪性肝病。
    共有345名参与者注册,其中34.5%的人至少有一个MF。与没有MF的相比,MFs参与者的知识得分较低,但所有心脏代谢疾病的感知风险评分更高。最大的知识差距与高血压相关的问题有关。调整后,线性回归表明,MFs的存在(β:2.752,95CI:0.772-4.733,p=0.007)和较高的知识得分(β:0.418,95CI:0.236-0.600,p<0.001)与较高的感知风险相关。尽管那些有MF的人的感知风险增加,这转化为很少的自我报告的预防措施,与没有MF的相比,即红肉/加工食品消费量的减少(p=0.045)和水果/蔬菜消费量的增加(p=0.009)。
    这项研究确定了一个患有MF的脆弱亚群,具有较高的感知风险,以及知识水平和采取的预防措施不一致。应在全国范围内努力解决知识到行动的差距。
    UNASSIGNED: Health literacy and illness perception play crucial roles in tackling the cardiometabolic disease epidemic. We aim to compare the attitudes, knowledge, self-perceived risks and actions taken, between individuals with and without metabolic risk factors (MFs).
    UNASSIGNED: From 5 June to 5 October 2022, participants of the general public were invited to complete a self-administered questionnaire. MF status was defined as the presence of hypertension, hyperlipidemia, diabetes mellitus and/or current/previous smoking. Participants were assessed based on four categories (knowledge-based, attitude-based, perceived risk, and action-based) of questions pertaining to four cardiometabolic diseases - diabetes mellitus, hypertension, hyperlipidemia, and non-alcoholic fatty liver disease.
    UNASSIGNED: A total of 345 participants were enrolled, of whom 34.5% had at least one MF. Compared to those without MFs, participants with MFs had lower knowledge scores, but higher perceived risk scores across all cardiometabolic diseases. The largest knowledge gap pertained to hypertension-related questions. After adjustment, linear regression demonstrated that the presence of MFs (β:2.752, 95%CI: 0.772-4.733, p = 0.007) and higher knowledge scores (β:0.418, 95%CI: 0.236-0.600, p < 0.001) were associated with higher perceived risk. Despite increased perceived risk in those with MFs, this translated to only few increased self-reported preventive actions, when compared to those without MFs, namely the reduction in red meat/processed food consumption (p = 0.045) and increase in fruits/vegetables consumption (p = 0.009).
    UNASSIGNED: This study identified a vulnerable subpopulation living with MFs, with high perceived risks, and discordant levels of knowledge and preventive actions taken. Nationwide efforts should be channeled into addressing the knowledge-to-action gap.
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  • 文章类型: Journal Article
    父母对身体残疾的孩子的参与有至关重要的影响。这项研究的目的是了解父母自己的日常行为,挑战,需要在家里抚养身体残疾的孩子的同时,在学校,在社区中。这项研究的另一个目标是完善先前在范围审查中确定的初步主题框架。
    基于使用7天的日记来收集数据,进行了定性研究询问。为了系统地将数据组织成结构化格式,在现有的初步主题框架的指导下,使用归纳推理和演绎推理进行了内容分析。
    对符合条件的日记的分析表明,47名父母提到的行动描述了通过使用以下方法来提高身体残疾子女的参与度的几种努力:启用,或者改变社会和物质环境,或通过支持他们的孩子执行或从事有意义的活动。这些父母的行为主要是由于社会和物质环境的限制所造成的挑战。强调了父母的回答,最重要的是,需要为所有人设计的环境。根据调查结果,提出了重新定义的主题框架。
    父母的行动,挑战,和需求主要针对社会或/和物理环境。提出的主题框架可以为从业者提供知识,以支持父母。需要做更多的工作来提供量身定制的方法。儿科康复可能需要解决环境对身体残疾儿童参与的重要性。
    Parents have a vital influence on the participation of their child with a physical disability. The aim of this study is to gain insight into parents\' own daily actions, challenges, and needs while supporting their child with a physical disability at home, at school, and in the community. An additional objective of this study is to refine the preliminary thematic framework previously identified in a scoping review.
    A qualitative research inquiry was performed based on using a diary over a 7-day period to gather data. To systematically organise data into a structured format, content analysis has been applied using both inductive and deductive reasoning guided by the existing preliminary thematic framework.
    Analysis of the eligible diaries shows that the actions mentioned by the 47 parents describe several efforts to enhance participation of their children with a physical disability by using, enabling, or changing the social and physical environment, or by supporting their child to perform or engage in meaningful activities. Those parents\' actions are primarily a result of challenges caused by restrictions in social and physical environments. Parental responses highlighted, above all, the need for environments designed for all people. Based on the findings a redefined thematic framework is presented.
    Parents\' actions, challenges, and needs are mainly directed towards the social or/and physical environment. The presented thematic framework can offer practitioners knowledge to support parents. More work is necessary to provide tailored approaches. Paediatric rehabilitation may need to address the importance of the environment on the participation of a child with a physical disability.
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  • 文章类型: Journal Article
    背景:在乌干达,难产仍然是孕产妇和围产期发病率和死亡率的主要原因,许多妇女独自在家分娩或由不熟练的助产士协助分娩。很少有人知道社区如何看待阻碍劳动,以及在这种并发症发生的情况下他们会采取什么行动。
    目的:本研究的目的是探索社区成员对乌干达西南部难产病例的理解和采取的行动。
    方法:使用扎根理论(GT)分析来自20个焦点小组讨论(FGD)的数据,10个女人,10个男人,在八个农村和两个城市社区进行。
    结果:基于社区成员对阻碍劳动的理解和采取的应对行动的概念模型被呈现为由女性“保护自身完整性”(核心类别)的愿望发起的途径。该途径包括与核心类别密切相关的其他六个类别,即:(1)“控制自己的生育过程”;(2)“达到极限-未能分娩”(个人水平);(3)“用尽传统选择”;(4)“合作伙伴负责”;(5)“面临具有挑战性的转诊条件”(社区水平);最后(6)“持久的无响应医疗保健系统”(医疗保健系统水平)。
    结论:有必要理解和承认妇女在分娩过程中不愿意让他人参与。然而,医疗保健系统应提供可接受的护理和更接近社区的功能转诊系统,从而支持社区寻求及时护理的能力,以应对阻碍的劳动。轻松访问移动电话可能会改善推荐系统。该区域基础设施的升级需要多部门方法。建议通过定量问卷测试概念模型。
    BACKGROUND: Obstructed labour is still a major cause of maternal and perinatal morbidity and mortality in Uganda, where many women give birth at home alone or assisted by non-skilled birth attendants. Little is known of how the community view obstructed labour, and what actions they take in cases where this complication occurs.
    OBJECTIVE: The objective of the study was to explore community members\' understanding of and actions taken in cases of obstructed labour in south-western Uganda.
    METHODS: Grounded theory (GT) was used to analyse data from 20 focus group discussions (FGDs), 10 with women and 10 with men, which were conducted in eight rural and two urban communities.
    RESULTS: A conceptual model based on the community members\' understanding of obstructed labour and actions taken in response is presented as a pathway initiated by women\'s desire to \'protecting own integrity\' (core category). The pathway consisted of six other categories closely linked to the core category, namely: (1) \'taking control of own birth process\'; (2) \'reaching the limit--failing to give birth\' (individual level); (3) \'exhausting traditional options\'; (4) \'partner taking charge\'; (5) \'facing challenging referral conditions\' (community level); and finally (6) \'enduring a non-responsive healthcare system\' (healthcare system level).
    CONCLUSIONS: There is a need to understand and acknowledge women\'s reluctance to involve others during childbirth. However, the healthcare system should provide acceptable care and a functional referral system closer to the community, thus supporting the community\'s ability to seek timely care as a response to obstructed labour. Easy access to mobile phones may improve referral systems. Upgrading of infrastructure in the region requires a multi-sectoral approach. Testing of the conceptual model through a quantitative questionnaire is recommended.
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