Family

家庭
  • 文章类型: Journal Article
    评估睡眠行为中的亲子关系对于促进学龄前儿童的睡眠指南依从性的改变很重要。这项研究的目的是检查3-8岁儿童家庭中加速度计测量的睡眠数量和质量,并调查父母对儿童睡眠的影响。数据来自捷克横截面FAMIly体力活动,久坐行为和睡眠(FAMIPASS)研究,最终样本为374个家庭。2022年3月至2023年5月期间,通过在幼儿园/小学招收子女招募家庭。使用腕部佩戴的ActiGraph加速度计评估睡眠时间窗口和总睡眠时间。参与者在连续7天的时间内连续24小时/天佩戴该装置。人口统计数据和潜在的相关性是通过父母填写的问卷获得的。使用逻辑回归和独立样本Mann-WhitneyU检验完成统计分析。总之,65.5%的儿童(60%的男孩,70.9%的女孩)和58.3%的父母(52.4%的父亲,64.3%的母亲)达到了建议的睡眠持续时间。女孩/母亲的睡眠质量和睡眠时间更高,与男孩/父亲相比。如果他们的母亲(而不是父亲)符合睡眠建议,并且他们的母亲没有受过更高的教育水平,那么学龄前儿童更有可能遵守睡眠指南。坚持儿童睡眠指南也与儿童的女性性别有关,卧室里没有屏幕设备,变得更加活跃。鉴于母婴睡眠量的高一致性,在整个家庭中促进健康的睡眠行为很重要。
    Assessing parent-child relationship in sleep behaviours is important for facilitating changes in the sleep guideline compliance in preschool age children. The aim of this study was to examine accelerometer-measured sleep quantity and quality in families with children aged 3-8 years and investigate the parents\' influence on the child\'s sleep. The data were obtained from the Czech cross-sectional FAMIly Physical Activity, Sedentary behaviour and Sleep (FAMIPASS) study, with a final sample of 374 families. Families were recruited through the enrolment of their children in kindergartens/primary schools between March 2022 and May 2023. The sleep time window and total sleep time were assessed using a wrist-worn ActiGraph accelerometer. Participants wore this device continuously for 24 h/day over a period of 7 consecutive days. Demographic data and potential correlates were obtained via questionnaires completed by parents. Statistical analyses were completed using logistic regression and independent-samples Mann-Whitney U test. In all, 65.5% of children (60% boys, 70.9% girls) and 58.3% of parents (52.4% fathers, 64.3% mothers) achieved the recommended sleep duration. Greater sleep quantity and duration in good-quality sleep were significantly higher in girls/mothers, compared to boys/fathers. Preschoolers were more likely to comply with sleep guidelines if their mother (but not father) met the sleep recommendation and their mothers did not have a higher education level. Adhering to sleep guidelines in children was also associated with children\'s female gender, absence of screen device in the bedroom, and being more active. Given the high concurrence in mother-child sleep quantity, it is important to promote healthy sleep behaviours in the whole family.
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  • 文章类型: Journal Article
    暂无摘要。
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  • 文章类型: Journal Article
    目标:在临终癌症治疗中,10-20%的失去亲人的家庭成员经历不利的心理健康影响,包括长期的悲伤障碍。尽管付出了巨大的努力,支持其悲伤过程和幸福感的循证建议通常未成功用于常规临床护理。这项研究使用实施科学方法确定了促进者和障碍。
    方法:来自瑞士四家医院和三家家庭护理服务机构的81名癌症护理注册护士评估了他们目前在临终关怀和丧亲关怀方面的家庭支持做法。然后,他们评估了他们的机构的组织属性和他们自己的个人特征和技能,关于潜在相关的基于文献的因素。使用分数逻辑回归确定基于指南的家庭支持的促进者和障碍。
    结果:姑息治疗服务专业化,一种支持变革的文化,家庭支持指南的可用性,丧亲支持服务的账单/报销,个人对家庭支持和技能的了解与更多采用基于指南的家庭支持实践相关。家庭缺乏隐私和培训不足是重大障碍。
    结论:虽然文献中出现了一些潜在的相关因素,某些组织和个人决定因素实际上是根据生命末期癌症护理护士的经验预测基于指南的家庭支持,一些决定因素比其他决定因素具有更强的影响。这为通过量身定制的策略集中质量改进和实施工作提供了至关重要的指导,尤其是在资源稀缺的情况下。此外,领养的丧亲护理低于临终关怀,建议特别需要支持性的组织文化,包括特定的培训和计费/报销选项。
    OBJECTIVE: In end-of-life cancer care, 10-20% of bereaved family members experience adverse mental health effects, including prolonged grief disorder. Despite great efforts, evidence-based recommendations to support their grieving process and well-being are often not successfully adopted into routine clinical care. This study identified facilitators and barriers using implementation science methodology.
    METHODS: 81 registered nurses working in cancer care from four hospitals and three home care services in Switzerland assessed their current family support practices in end-of-life care and bereavement care. They then assessed organisational attributes of their institution and their own individual characteristics and skills regarding literature-based factors of potential relevance. Facilitators and barriers to guideline-based family support were determined using fractional logistic regression.
    RESULTS: Service specialisation in palliative care, a culture that supports change, the availability of family support guidelines, billing/reimbursement of bereavement support services, and individual knowledge of family support and skill were systematically associated with higher adoption of guideline-based family support practices. Lack of privacy with families and insufficient training acted as significant barriers.
    CONCLUSIONS: While several potentially relevant factors have emerged in the literature, certain organisational and individual determinants actually empirically predict guideline-based family support according to nurses in end-of-life cancer care, with some determinants having much stronger implications than others. This provides crucial guidance for focussing quality improvement and implementation efforts through tailored strategies, especially with scarce resources. Furthermore, adoption is lower in bereavement care than in end-of-life care, suggesting a particular need for supportive organisational cultures including specific training and billing/reimbursement options.
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  • 文章类型: Systematic Review
    背景:患有危及生命和限制生命的疾病的儿童可能由于多种痛苦症状而经历高水平的痛苦,这些症状导致生活质量差,并增加其家庭成员长期痛苦的风险。所有这些儿童及其家庭都需要高质量的症状治疗,在生命的尽头更是如此。在本文中,我们为儿科姑息治疗患者的症状治疗提供循证建议,以优化护理.
    方法:建立了一个由56名儿科姑息治疗专家和9名(失去亲人)父母组成的多学科小组,以制定有关儿科姑息治疗中症状治疗的建议,包括焦虑和抑郁。谵妄,呼吸困难,血液学症状,咳嗽,皮肤投诉,恶心和呕吐,神经症状,疼痛,死亡拨浪鼓,疲劳,儿科姑息镇静和放弃水合和营养。建议是基于系统文献检索的证据,其他文献来源(如指南),临床专业知识,以及耐心和家庭价值观。我们使用等级方法进行证据评估。父母被纳入指南小组,以确保患者和家庭价值观的代表性。
    结果:我们共纳入了18项研究,这些研究报告了特定(非)药物干预措施在儿科姑息治疗中治疗症状的效果。其中一些干预措施在症状缓解方面显着改善。该证据只能(部分)回答27个临床问题中的8个。我们包括29个指南和两个教科书作为补充文献来处理缺乏证据。总的来说,我们根据证据制定了221项关于儿科姑息治疗中症状治疗的建议,其他文献,临床专业知识,以及耐心和家庭价值观。
    结论:尽管与症状相关的儿科姑息治疗干预措施的现有证据有所增加,儿科姑息治疗的证据仍然很少。我们敦促国际多学科多机构合作,以进行高质量的研究,并为全世界所有儿童的姑息治疗中症状缓解的优化做出贡献。
    BACKGROUND: Children with life-threatening and life-limiting conditions can experience high levels of suffering due to multiple distressing symptoms that result in poor quality of life and increase risk of long-term distress in their family members. High quality symptom treatment is needed for all these children and their families, even more so at the end-of-life. In this paper, we provide evidence-based recommendations for symptom treatment in paediatric palliative patients to optimize care.
    METHODS: A multidisciplinary panel of 56 experts in paediatric palliative care and nine (bereaved) parents was established to develop recommendations on symptom treatment in paediatric palliative care including anxiety and depression, delirium, dyspnoea, haematological symptoms, coughing, skin complaints, nausea and vomiting, neurological symptoms, pain, death rattle, fatigue, paediatric palliative sedation and forgoing hydration and nutrition. Recommendations were based on evidence from a systematic literature search, additional literature sources (such as guidelines), clinical expertise, and patient and family values. We used the GRADE methodology for appraisal of evidence. Parents were included in the guideline panel to ensure the representation of patient and family values.
    RESULTS: We included a total of 18 studies that reported on the effects of specific (non) pharmacological interventions to treat symptoms in paediatric palliative care. A few of these interventions showed significant improvement in symptom relief. This evidence could only (partly) answer eight out of 27 clinical questions. We included 29 guidelines and two textbooks as additional literature to deal with lack of evidence. In total, we formulated 221 recommendations on symptom treatment in paediatric palliative care based on evidence, additional literature, clinical expertise, and patient and family values.
    CONCLUSIONS: Even though available evidence on symptom-related paediatric palliative care interventions has increased, there still is a paucity of evidence in paediatric palliative care. We urge for international multidisciplinary multi-institutional collaboration to perform high-quality research and contribute to the optimization of symptom relief in palliative care for all children worldwide.
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  • 文章类型: Journal Article
    背景:慢性精神疾病有很长时间,反复出现,并需要持续的护理以及综合和协作的方法来组织护理。本文的目的是总结适应临床实践指南以家庭为中心的慢性精神疾病患者的协作护理所需的最重要步骤。
    方法:由于该研究将是一项探索性混合方法研究,该设计将作为一项序贯定性-定量研究(QUALQUAN)进行,由三个阶段组成,9个模块,和24个连续步骤,这是基于准则国际网络,以适应准则手册。在第一阶段,建立了适应临床指南的先决条件.在第二阶段,收集证据,将进行一项定性研究(半结构化访谈),以从患者的角度探讨慢性精神障碍患者及其家人的护理需求的维度和组成部分,看护者,和医疗保健提供者。此外,将进行文献综述以提取相关的临床指南和文章。一个专家小组将筛选和评估潜在的临床指南,并将制定一项准则草案。
    结论:预计这些发现将通过在伊朗的社会文化背景下提供综合护理和改善协作护理来满足精神疾病患者及其护理人员的需求。
    BACKGROUND: Chronic mental illnesses have long periods, are recurring, and require continuous care as well as an integrated and collaborative approach to organize the care. The purpose of this article is to summarize the most important steps necessary for adapting a clinical practice guideline for family-centered collaborative care of patients with chronic mental illnesses referring to the medical centers.
    METHODS: As the study will be an exploratory mixed methods study, the design will be carried out as a sequential qualitative-quantitative study (QUAL quan), consisting of 3 phases, 9 modules, and 24 sequential steps, which is based on the Guidelines International Network to adapt the guideline manual. In the first phase, the prerequisites for adaptation of the clinical guideline were established. In the second phase, to collect evidence, a qualitative study (semi-structured interview) will be conducted to explore the dimensions and components of the care needs of patients with chronic mental disorders and their families from the perspectives of patients, caregivers, and healthcare providers. Additionally, a literature review to extract relevant clinical guidelines and articles will be done. A panel of experts will screen and evaluate potential clinical guidelines, and a draft guideline will be developed.
    CONCLUSIONS: It is expected that these findings will meet the needs of patients with mental illness and their caregivers by providing integrated care and improving collaborative care within the sociocultural context of Iran.
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  • 文章类型: Journal Article
    根据推荐的隔离指南评估2019年冠状病毒病患者的依从性水平。
    方法:在卡拉奇进行了基于电话的横断面调查,在获得陶氏健康科学大学伦理审查委员会批准后,从2020年3月至10月,卡拉奇,包括两种性别的患者,这些患者被测试为阳性,并由于感染的轻度/无症状性质而被建议家庭隔离。根据美国国立卫生研究院发布的指南,使用预先设计的42项问卷收集数据,伊斯兰堡,巴基斯坦。使用SPSS20对数据进行分析。
    结果:在接受治疗的450名患者中,305(68%)回应;176(57.7%)女性和129(41.1%)男性。总体平均年龄为35.16±14.15岁(范围:13-78岁)。在总数中,9名(2.95%)患者根本没有孤立自己,51(16.7%)与其他人接触,75(24.6%)打破了家庭隔离,69(22.6%)与其他家庭成员共享房间。总的来说,260名(85.2%)参与者通过传统和社交媒体不断更新指南的变化。
    结论:建议家庭隔离的2019年冠状病毒病患者遵守了部分但不是全部建议。
    UNASSIGNED: To assess compliance level of coronavirus disease-2019 patients with recommended isolation guidelines.
    METHODS: The cross-sectional phone-based survey was conducted in Karachi, from March to October 2020 after approval from the ethics review board of Dow University of Health Sciences, Karachi, and comprised patients of either gender who had been tested positive and were advised home isolation due to mild/asymptomatic nature of their infection. Data was collected using a predesigned 42-item questionnaire in the light of the guidelines issued by the National Institutes of Health, Islamabad, Pakistan. Data was analysed using SPSS 20.
    RESULTS: Of the 450 patients approached, 305(68%) responded; 176(57.7%) females and 129(41.1%) males. The overall mean age was 35.16±14.15 years (range: 13-78 years). Of the total, 9(2.95%) patients did not isolate themselves at all, 51(16.7%) came into contact with other people, 75(24.6%) broke the home isolation and 69(22.6%) were sharing their rooms with other family members. Overall, 260(85.2%) participants were keeping themselves updated with the changes in the guidelines through conventional and social media.
    CONCLUSIONS: Coronavirus disease-2019 patients who were advised home isolation adhered to some but not all of the recommendations.
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  • 文章类型: Journal Article
    当父母死于艾滋病毒/艾滋病相关原因时,孩子们经常经历情绪不稳定,并被赋予额外的义务,比如照顾兄弟姐妹。年轻人的反应可能多种多样,包括增加酒精消费,他们与兄弟姐妹的关系可能会发生积极或消极的变化。
    本文的目的是研究年轻人在失去家庭成员后管理自己的生活经验,并为护士提供制定的指南,以建议年轻人在失去家庭成员后进行自我管理。
    Khayelitsha,西开普省,南非。
    遵循本研究的描述性现象学设计。研究人员对参与者进行了11次半结构化访谈。这项研究是针对年龄在18至25岁之间的年轻人进行的。
    该研究表明,家庭供养者的死亡对于留守青年来说很难应对日常生活的变化。
    研究结果表明,家庭成员的死亡对家庭有重大影响。一位更资深的家庭成员必须承担起责任,并保持坚强,以帮助他们的兄弟姐妹专注于未来。家庭成员的死亡可能导致一连串的强迫变化,需要新的行为来维持稳定。
    本研究基于背景的数据集中在社区卫生中心(CHC)如何在家庭提供者死于艾滋病毒/艾滋病后帮助年轻人管理自己,使用制定的指导方针。
    UNASSIGNED: When parents die from HIV/AIDS-related causes, children often experience emotional instability and are given additional obligations, such as caring for siblings. Youths may react in a variety of ways, including increasing alcohol consumption, and their relationships with their siblings may be altered positively or negatively.
    UNASSIGNED: The purpose of this article is to examine the lived experiences of youths in managing themselves after losing a family member to HIV/AIDS and suggest developed guidelines for nurses to advise youths on self-management after losing a family member to HIV/AIDS.
    UNASSIGNED: Khayelitsha, Western Cape province, South Africa.
    UNASSIGNED: A descriptive phenomenological design for this study was followed. The researcher conducted 11 semi-structured interviews with participants. The study was conducted with participants that were youth aged between 18 and 25 years.
    UNASSIGNED: The study revealed that the death of a family provider can be difficult for the youth left behind to deal with the changes in their daily lives.
    UNASSIGNED: The findings demonstrated that the death of a family member has a significant impact on the family. One of the more senior family members must assume charge and remain strong to help their siblings focus on the future. The death of a family member might result in a cascade of forced changes that necessitate new behaviours to maintain stability.
    UNASSIGNED: This study\'s context-based data focuses on how the Community Health Centre (CHC) may assist young people in managing themselves after a family provider has died from HIV/AIDS, using the developed guidelines.
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  • 文章类型: English Abstract
    With the deepening of clinical research, the management of neonatal respiratory distress syndrome (RDS) needs to be optimized and improved. This article aims to introduce the 2022 European guideline on the management of neonatal RDS, focusing on its key updates. The guide has optimized the management of risk prediction for preterm birth, maternal referral, application of prenatal corticosteroids, application of lung protective ventilation strategies, and general care for infants with RDS. The guideline is mainly applicable to the management of RDS in neonates with gestational age greater than 24 weeks.
    随着临床研究的深入,新生儿呼吸窘迫综合征(respiratory distress syndrome,RDS)的管理需优化和改进。该文旨在介绍2022年欧洲新生儿RDS管理指南,重点介绍其更新要点。该指南对早产风险预测、产妇转诊、产前糖皮质激素的应用、肺保护性通气策略的应用,以及RDS患儿的一般护理等方面的管理进行了优化。该指南主要适用于胎龄>24周新生儿RDS的管理。.
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  • 文章类型: Journal Article
    背景:利益相关者的价值观和偏好在指南的制定中至关重要。
    目的:本研究的目的是调查利益相关者对中国适应性身体约束指南草案的价值观和偏好。
    方法:这项调查研究是在东部的四家大学附属综合医院进行的,中央,西方,2022年1月5日至30日,中国东北地区。分发了一份48项自我报告问卷,价值观和偏好以10点Likert量表进行评估。单向方差分析用于比较利益相关者之间的价值和偏好得分。作为效应大小的衡量标准,对于方差分析结果,报告了部分η2和科恩的f值。
    结果:共有1155名利益相关者参加了研究。46项建议草案的平均值和偏好得分高于7。Therewaseithersignificantdifferenceinthevaluesandpreferencesofthestakeholdersforthedraftrecommendationsortherewasasignificantdifference(pvaluerangefrom<0.001~.048),但效应大小很小或很小(部分η2值范围为0.011~.044;科恩的f值范围为0.101~.214)。患者的网络治疗和早期气管切开相关项目的平均得分分别为6.84和6.60,低于家庭成员,决策者,和卫生保健专业人员,具有统计学意义(p<0.001)。效应大小的部分η2和科恩f值分别为0.083/0.062和0.302/0.256,这表明差异是中等的。
    结论:这些建议符合利益相关者的价值观和偏好。患者更支持实施网络治疗或催眠治疗以进行疼痛管理,但不支持早期气管切开术以减少机械通气的持续时间。指南小组可以使用价值和偏好信息来修订和认可重症监护中适应的身体约束指南的建议。
    结论:从业者应根据利益相关者的价值观和偏好实施建议。
    The values and preferences of stakeholders are crucial in the development of guidelines.
    The aim of this study was to investigate stakeholders\' values and preferences regarding draft recommendations for adapted physical restraint guidelines in China.
    This survey research was carried out at four university-affiliated comprehensive hospitals based in the eastern, central, western, and north eastern zones of China from January 5-30, 2022. A 48-item self-report questionnaire was distributed, and values and preferences were assessed on a 10-point Likert scale. One-way ANOVA was used to compare values and preference scores among stakeholders. As effect-size measures, partial η2 and Cohen\'s f values are reported for ANOVA results.
    A total of 1155 stakeholders were enrolled in the study. The mean value and preference scores were higher than seven for 46 draft recommendations. There was either no significant difference in the values and preferences of the stakeholders for the draft recommendations or there was a significant difference (p values ranged from <0.001 ∼ .048), but the effect size was small or very small (partial η2 value ranged from 0.011 ∼ .044; Cohen\'s f value ranged from 0.101 ∼ .214). The mean scores of patients for items related to cyber therapy and early tracheotomy were 6.84 and 6.60, respectively, which were lower than those of family members, policy-makers, and health care professionals and were statistically significant (p < 0.001). The partial η2 and Cohen\'s f values of the effect size were 0.083/0.062 and 0.302/0.256, respectively, which indicated that the differences were moderate.
    These recommendations were in line with the values and preferences of stakeholders. Patients were more supportive of implementing cyber therapy or hypnosis for pain management but did not support early tracheotomy to reduce the duration of mechanical ventilation. Guideline panels could use value and preference information to revise and endorse recommendations of adapted physical restraint guidelines in critical care.
    Practitioners should implement recommendations based on the values and preferences of stakeholders.
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  • 文章类型: Journal Article
    未经评估:有证据表明,家庭中心协作护理对已确定患有慢性精神疾病的个体是有用的。临床实践指南提供了主要基于待进行研究的具体建议,并且有利于为循证实践和指导命运研究提供信息。
    UNASSIGNED:确定当前的科学实践指南,包括针对双相情绪障碍患者的家庭中心协作护理建议,精神分裂症,并分析其方法学质量指南的选择。
    UNASSIGNED:对七个电子数据库(G-I-N)进行了系统搜索,(NICE),(卫生部),(标志),(WHO),(NIH)和(APA)以及其他来源。三名裁判独立审查了文章和入选标准的选定指南。随后,18名训练有素的评估师使用AGREEII独立评估了所有15条指南。
    UNASSIGNED:计算领域和总体质量的平均得分。对于指南的总体评估,60%达到质量阈值,领域得分为60%。这些指南的总体平均质量评分为58/29%。
    UNASSIGNED:指南的适用性需要改进,以提高其相关性和临床利用率。随着患有慢性精神疾病的人在他们的疾病过程中进展,家庭和医疗保健提供者在帮助他们方面发挥着至关重要的作用。有效康复技术的研究知识分析,包括家庭参与治疗,可以通过使用完善和适当的方法来增强。
    UNASSIGNED: Evidence suggests that family-center collaborative care is useful for individuals identified with chronic mental illness. Clinical practice guidelines offer specific recommendations primarily based on to be had studies and are beneficial in informing evidence-based practice and guiding destiny studies.
    UNASSIGNED: Identify current scientific practice guidelines including family-center collaborative care suggestions for individuals with Bipolar Mood Disorder, Schizophrenia, and Major Depressive Disorder and analyze the selection of guidelines for their methodological quality.
    UNASSIGNED: A systematic search was conducted on seven electronic databases (G-I-N), (NICE), (MOH), (SIGN), (WHO), (NIH) and (APA) and additional sources. Three referees independently reviewed articles and selected guidelines for inclusion criteria. Subsequently, 18 trained appraisers independently assessed all 15 guidelines using AGREE II.
    UNASSIGNED: The mean scores for domains and overall quality were computed. For the overall assessment of the guidelines, 60% reached the quality threshold with domain scores of 60%. The overall average quality rating for these guidelines was 58/29%.
    UNASSIGNED: The applicability of the guidelines needs to be improved in order to improve their relevance and clinical utilization. As individuals with chronic mental illnesses progress through their disease course, families and health care providers play a crucial role in helping them. The analysis of research knowledge on effective rehabilitation techniques, including the involvement of families in treatment, can be enhanced by using well-developed and appropriate methods.
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