Interdisciplinary collaboration

跨学科合作
  • 文章类型: Journal Article
    有多个复杂问题的家庭经常与多个专业人员和组织打交道以寻求支持。综合社会护理据说可以防止经常出现的护理分散。我们确定了接受综合社会护理的家庭以及提供综合社会护理的专业人士所经历的促进者和障碍。
    我们根据Arksey和O\'Malley的框架进行了范围审查,使用以下数据库:PsycINFO,WebofScience核心合集,心理学与行为科学合集,CINAHL,PubMed,Medline此外,进行了专题分析。结果分为综合社会护理的促进因素和障碍。
    我们确定了278项研究,最终将16项纳入我们的范围审查。我们确定了主持人,包括:将正式护理与非正式网络联系起来,促进专业人员之间的合作,例如,成对工作,专业人员的自主权。我们确定了障碍,包括:时间限制,专业人员之外的任务,以及对组织间综合协作的抵制。这些发现可以促进社会综合护理的发展,作为支持面临多重复杂问题的家庭的一种有希望的方法。
    为了赋予家庭权力,综合社会关怀需要基于信任的系统方法。它涉及协调护理,共同决策,非正式网络和所有家庭成员的参与,包括孩子。
    UNASSIGNED: Families with multiple and complex problems often deal with multiple professionals and organizations for support. Integrated social care supposedly prevents the fragmentation of care that often occurs.We identified facilitators and barriers experienced by families receiving integrated social care and by the professionals who provide it.
    UNASSIGNED: We performed a scoping review following Arksey and O\'Malley\'s framework, using the following databases: PsycINFO, Web of Science Core Collection, Psychology and Behavioral Sciences Collection, CINAHL, PubMed, and Medline. Furthermore, conducted a thematic analysis. The results were divided into facilitators and barriers of integrated social care.
    UNASSIGNED: We identified 278 studies and finally included sixteen in our scoping review. We identified facilitators, including: linking formal care with informal networks, promoting collaboration among professionals e.g., working in pairs, and professionals autonomy. We identified barriers, including: time constraints, tasks outside professionals\' expertise, along with resistance to integrated collaboration among organizations. These findings can enhance the advancement of social integrated care as a promising approach to support families facing multiple and complex problems.
    UNASSIGNED: To empower families, integrated social care requires a systematic approach based on trust. It involves coordinated care, shared decision-making, informal networks and the participation of all family members, including children.
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  • 文章类型: Journal Article
    这篇综述文章评估了减少衰弱和痴呆住院老年人跌倒的策略的有效性和局限性。它探讨了现有的跌倒预防策略对急性容易跌倒和跌倒相关后果的队列的有效性。在MEDLINE进行了系统的文献检索,Embase,CINAHL,和PsycINFO,采用医学主题词(MeSH)确定2013年至2023年发表的关于患有痴呆和虚弱的住院老年人跌倒预防策略的研究.最初的643条记录被提炼成八篇文章,结构化跨学科床边回合(SIBR)作为一种值得注意的干预措施。SIBR通过促进改进的跨学科交流和护理计划,证明了跌倒的减少。然而,连续会议期间家庭参与的下降表明需要采取策略来维持家庭参与.研究结果提倡以患者为中心的干预措施,以解决该老年人群面临的认知和功能挑战。这篇综述提倡在医院环境中进行全面和包容性的研究,以改善虚弱的老年痴呆症患者的跌倒预防策略。
    This review article assesses the effectiveness and limitations of strategies to reduce falls among hospitalized older adults with frailty and dementia. It explores the efficacy of existing fall prevention strategies for a cohort that is acutely susceptible to falls and fall-related consequences. A systematic literature search was conducted across MEDLINE, Embase, CINAHL, and PsycINFO, employing Medical Subject Headings (MeSH) to identify studies on fall prevention strategies in hospitalized older adults with both dementia and frailty published from 2013 to 2023. The initial 643 records were distilled to eight articles, with Structured Interdisciplinary Bedside Rounds (SIBR) emerging as a notable intervention. SIBR demonstrated a reduction in falls by fostering improved interdisciplinary communication and care planning. However, a decline in family engagement during consecutive sessions suggests a need for strategies to sustain familial involvement. The findings advocate for patient-centered interventions that address the cognitive and functional challenges faced by this cohort of older adults. This review advocates for comprehensive and inclusive research in hospital environments to improve fall prevention strategies for frail older adults with dementia.
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  • 文章类型: Journal Article
    种植体周围疾病,包括种植体周围粘膜炎和种植体周围炎,在种植牙科中提出了越来越大的挑战。这篇全面的综述探讨了假体设计因素与种植体周围疾病发展之间的复杂相互作用。通过分析假体组件对微生物定植的影响,机械应力,和软组织健康,该审查强调了它们在疾病预防和管理中的关键作用。此外,它强调了维护协议的重要性,假肢调整,和患者教育,以确保有利的长期结果。审查强调了假肢设计未来进步的潜力,包括创新材料和数字技术,并强调跨学科合作在优化患者护理方面的重要性。总的来说,该综述强调了假体设计在解决种植体周围疾病复杂性方面的关键作用,为临床医生和研究人员提供见解,以提高植入物支持修复体的成功率和寿命。
    Peri-implant disease, encompassing peri-implant mucositis and peri-implantitis, presents a growing challenge in implant dentistry. This comprehensive review explores the intricate interplay between prosthetic design factors and the development of peri-implant disease. By analyzing the impact of prosthetic components on microbial colonization, mechanical stress, and soft tissue health, the review highlights their crucial role in disease prevention and management. Additionally, it emphasizes the significance of maintenance protocols, prosthetic adjustments, and patient education in ensuring favorable long-term outcomes. The review underscores the potential for future advancements in prosthetic design, including innovative materials and digital technologies, and stresses the importance of interdisciplinary collaboration in optimizing patient care. Overall, the review underscores the critical role of prosthetic design in addressing the complexities of peri-implant disease, offering insights for clinicians and researchers to enhance the success and longevity of implant-supported restorations.
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  • 文章类型: Journal Article
    这篇全面的综述导航肝脏评分系统的景观为肝硬化的诊断和预后。肝硬化,慢性进行性肝病,对其诊断和管理提出了重大挑战。审查开始定义和提供肝硬化的概述,强调其临床意义。强调肝脏评分系统的重要性,包括Child-Pugh评分,终末期肝病,白蛋白-胆红素(ALBI)评分,和纤维化-4(FIB-4)指数,本研究探讨了它们在评估肝功能障碍严重程度和预测预后方面的作用.细致的分析确定了这些评分系统的优点和局限性,为临床医生提供有价值的见解。建议强调将这些工具纳入常规临床实践中,以进行早期干预和个性化治疗计划。强调跨学科合作对于肝硬化管理的整体方法至关重要。结论呼吁未来的研究来完善现有的评分系统,探索新兴的生物标志物和成像技术,并进行前瞻性研究以提高精确度。通过接受这些建议,医学界可以提高对肝硬化的认识和管理,最终改善患者的结果和革命性的肝病方法。
    This comprehensive review navigates the landscape of liver scoring systems for the diagnosis and prognosis of cirrhosis. Cirrhosis, a chronic and progressive liver disease, presents significant challenges in its diagnosis and management. The review begins by defining and providing an overview of cirrhosis, emphasizing its clinical implications. Highlighting the significance of liver scoring systems, including the Child-Pugh score, end-stage liver disease, albumin-bilirubin (ALBI) score, and fibrosis-4 (FIB-4) index, the study explores their role in assessing liver dysfunction severity and predicting outcomes. A meticulous analysis identifies the strengths and limitations of these scoring systems, offering valuable insights for clinicians. The recommendations emphasize incorporating these tools into routine clinical practice for early intervention and personalized treatment plans. Interdisciplinary collaboration is underscored as crucial for a holistic approach to cirrhosis management. The conclusion calls for future research to refine existing scoring systems, explore emerging biomarkers and imaging techniques, and conduct prospective studies to enhance precision. By embracing these recommendations, the medical community can advance the understanding and management of cirrhosis, ultimately improving patient outcomes and revolutionizing liver disease approaches.
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  • 文章类型: Journal Article
    无家可归在美国是一个越来越令人担忧的问题,每年有350万人经历它,在任何给定的夜晚有60万人经历它。无家可归的人面临30天再次入院和更高死亡率的脆弱性。使医疗保健系统紧张,加剧现有的差距。本研究旨在通过回顾有关医疗喘息对30天再入院率影响的文献,向神经外科医生提供基于证据的策略,以降低无家可归患者的再入院率和死亡率。该研究旨在评估医疗喘息在减少再入院和改善无家可归者健康结果方面的功效。
    在PubMed进行了全面的文献检索,Embase/Medline,和Cochrane数据库,以及咨询国家医疗临时护理研究所和医疗保健获取和信息部门。从最初的296篇文章中选择了十篇文章,以研究喘息计划对无家可归患者的再入院率的影响。
    由于各种因素,无家可归患者的再入院率很高。诸如喘息计划和全面的医疗保健方法之类的干预措施可以降低这些比率。事实证明,医院和医疗部门之间的合作特别有效。
    无家可归者的医疗保健不足导致再次入院人数增加,住院时间更长,和更高的成本。医疗休息是一个可行的解决方案,但是有限的资源阻碍了它们的有效性。因此,促进医院之间的合作至关重要,喘息,和其他实体。未来的研究应集中在神经外科手术中的差异,并探索替代服务。跨学科方法是解决医疗保健不平等的关键。
    UNASSIGNED: Homelessness is a growing concern in the US, with 3.5 million people experiencing it annually and 600,000 on any given night. Homeless individuals face increased vulnerability to 30-day hospital readmissions and higher mortality rates, straining the healthcare system and exacerbating existing disparities. This study aims to inform neurosurgeons on evidence-based strategies to reduce readmission and mortality rates among homeless patients by reviewing the literature on the impact of medical respite on 30-day readmission rates. The study aims to gauge the efficacy of medical respite in reducing hospital readmissions and improving health outcomes for homeless individuals.
    UNASSIGNED: A comprehensive literature search was conducted across PubMed, Embase/Medline, and Cochrane databases, as well as consulting the National Institute for Medical Respite Care and the Department of Health Care Access and Information. Ten articles were chosen from an initial 296 to investigate the impact of respite programs on readmission rates among homeless patients.
    UNASSIGNED: Homeless patients experience high readmission rates due to various factors. Interventions such as respite programs and a comprehensive approach to healthcare can lower these rates. Collaboration between hospitals and medical respites has proven particularly effective.
    UNASSIGNED: Inadequate healthcare for homeless individuals leads to increased readmissions, longer hospital stays, and higher costs. Medical respites are a viable solution, but limited resources hamper their effectiveness. Therefore, it is crucial to facilitate cooperation between hospitals, respites, and other entities. Future research should focus on disparity in neurosurgical procedures and explore alternative services. An interdisciplinary approach is key to addressing healthcare inequalities.
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  • 文章类型: Journal Article
    这篇全面的综述深入探讨了人工智能(AI)在护理科学和医疗保健中的影响和挑战。人工智能已经在这些领域展示了其变革潜力,应用范围从个性化护理和诊断准确性到预测分析和远程医疗。然而,人工智能的整合有其复杂性,包括与数据隐私相关的担忧,伦理考虑,以及算法和数据集中的偏差。医疗保健的未来似乎充满希望,随着人工智能准备推进诊断,治疗,和医疗保健实践。然而,至关重要的是要记住,人工智能应该补充,不替换,医疗保健专业人员,保留护理的基本要素。为了最大限度地发挥人工智能在医疗保健领域的潜力,跨学科合作,道德准则,保护患者权利至关重要。这次审查以行动呼吁结束,强调需要持续的研究和集体努力,以确保人工智能有助于改善医疗保健成果,同时坚持最高标准的道德和以患者为中心的护理。
    This comprehensive review delves into the impact and challenges of Artificial Intelligence (AI) in nursing science and healthcare. AI has already demonstrated its transformative potential in these fields, with applications spanning from personalized care and diagnostic accuracy to predictive analytics and telemedicine. However, the integration of AI has its complexities, including concerns related to data privacy, ethical considerations, and biases in algorithms and datasets. The future of healthcare appears promising, with AI poised to advance diagnostics, treatment, and healthcare practices. Nevertheless, it is crucial to remember that AI should complement, not replace, healthcare professionals, preserving the essential human element of care. To maximize AI\'s potential in healthcare, interdisciplinary collaboration, ethical guidelines, and the protection of patient rights are essential. This review concludes with a call to action, emphasizing the need for ongoing research and collective efforts to ensure that AI contributes to improved healthcare outcomes while upholding the highest standards of ethics and patient-centered care.
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  • 文章类型: Journal Article
    乳腺癌,全球最常见的恶性肿瘤之一,其多样化的神经系统并发症构成了巨大的健康负担。这篇全面的综述探讨了乳腺癌神经系统影响的复杂景观,包括脑转移,非转移性并发症,以及它们对生活质量的深刻影响,预后,以及受影响个体的生存。机制,临床表现,探讨了脑转移的治疗方式以及跨学科合作在其管理中的关键作用。此外,我们解决非转移性神经系统并发症,包括副肿瘤综合征,治疗相关的副作用,脑膜癌,和辐射诱导的神经毒性,阐明他们面临的挑战以及认知和情感福祉的重要性。讨论了预后因素和生存率,强调影响患者预后的变量的复杂性。最后,我们强调协作护理在应对这些多方面挑战方面的重要作用,强调未来的研究方向和不断追求提高乳腺癌患者的生活质量。
    Breast cancer, one of the most prevalent malignancies globally, poses a substantial health burden with its diverse neurological complications. This comprehensive review examines the intricate landscape of breast cancer\'s neurological effects, encompassing brain metastases, non-metastatic complications, and their profound influence on the quality of life, prognosis, and survival of affected individuals. The mechanisms, clinical manifestations, and treatment modalities of brain metastasis and the critical role of interdisciplinary collaboration in their management are explored. Additionally, we address non-metastatic neurological complications, including paraneoplastic syndromes, treatment-related side effects, leptomeningeal carcinomatosis, and radiation-induced neurotoxicity, shedding light on the challenges they present and the importance of cognitive and emotional well-being. Prognostic factors and survival rates are discussed, emphasizing the complexity of variables impacting patient outcomes. Lastly, we underscore the vital role of collaborative care in addressing these multifaceted challenges, highlighting future research directions and the ongoing quest to enhance the quality of life for breast cancer patients.
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  • 文章类型: Journal Article
    脑瘫(CP)是一种复杂的神经系统疾病,其特征是影响全球数百万人的运动功能障碍。这项全面的审查探讨了评估在管理CP中的关键作用。从探索它的定义和背景开始,我们阐明了CP评估的不同目标,从诊断和目标设定到研究和流行病学。我们研究标准评估量表和工具,讨论CP评估固有的挑战,突出新兴趋势,包括集成技术,个性化医疗,和神经成像。CP评估在临床诊断中的应用,治疗计划,研究,强调教育。未来的建议包括标准化,跨学科合作,研究重点,和专业培训。总之,我们强调评估作为指导CP患者护理的指南针的重要性,呼吁采取行动,改进评估做法,为受这种情况影响的人塑造更光明的未来。
    Cerebral palsy (CP) is a complex neurological condition characterized by motor dysfunction affecting millions worldwide. This comprehensive review delves into the critical role of assessment in managing CP. Beginning with exploring its definition and background, we elucidate the diverse objectives of CP assessment, ranging from diagnosis and goal setting to research and epidemiology. We examine standard assessment scales and tools, discuss the challenges inherent in CP assessment, and highlight emerging trends, including integrating technology, personalized medicine, and neuroimaging. The applications of CP assessment in clinical diagnosis, treatment planning, research, and education are underscored. Recommendations for the future encompass standardization, interdisciplinary collaboration, research priorities, and professional training. In conclusion, we emphasize the importance of assessment as a compass guiding the care of individuals with CP, issuing a call to action for improved assessment practices to shape a brighter future for those affected by this condition.
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  • 文章类型: Systematic Review
    目的:系统地定位,评估和综合有关跨专业气管造口术团队在增加说话瓣膜使用和减少说话和拔管时间方面的有效性的证据,不良事件,住院时间(重症监护病房(ICU)和住院)和死亡率。此外,评估在医院环境中实施跨专业气管切开术团队的促进者和障碍。
    方法:使用系统评价和荟萃分析(PRISMA)的首选报告项目和约翰·霍普金斯大学护理循证实践模型的指导进行系统评价。
    方法:我们的临床问题:跨专业气管造口术团队是否增加了说话瓣膜的使用,减少了说话和拔管的时间,不良事件,住院时间和死亡率?包括成人气管造口术患者的主要研究。合格的研究由两名审稿人系统审查,并由另外两名审稿人验证。
    方法:MEDLINE,CINAHL和EMBASE。
    结果:14项研究符合资格标准;主要是干预前后队列研究。说话瓣膜使用率增加的百分比为14%-275%;语音中位天数减少的百分比为33%-73%,拔管中位天数减少的百分比为26%-32%;不良事件发生率减少的百分比为32%-88%;住院天数减少的百分比为18-40天;ICU总住院时间和死亡率无显著变化。促进者包括团队教育,覆盖范围,轮,标准化,通信,领导人员和自动化,病人跟踪;障碍是财政上的。
    结论:气管切开术的患者接受了专业的跨专业团队的护理,在一些临床结果方面表现出改善。
    结论:来自严格,有必要进行控制良好且动力充足的研究,以及促进更广泛采用跨专业气管造口术团队策略的实施策略。专业的气管造口术团队与提高安全性和护理质量相关。
    结论:综述证据为更广泛地实施跨专业气管造口术团队提供了依据。
    未经荟萃分析的PRISMA和合成(SWiM)。
    无。
    OBJECTIVE: To systematically locate, evaluate and synthesize evidence regarding effectiveness of interprofessional tracheostomy teams in increasing speaking valve use and decreasing time to speech and decannulation, adverse events, lengths of stay (intensive care unit (ICU) and hospital) and mortality. In addition, to evaluate facilitators and barriers to implementing an interprofessional tracheostomy team in hospital settings.
    METHODS: Systematic review using Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) and Johns Hopkins Nursing Evidence-Based Practice Model\'s guidance.
    METHODS: Our clinical question: Do interprofessional tracheostomy teams increase speaking valve use and decrease time to speech and decannulation, adverse events, lengths of stay and mortality? Primary studies involving adult patients with a tracheostomy were included. Eligible studies were systematically reviewed by two reviewers and verified by another two reviewers.
    METHODS: MEDLINE, CINAHL and EMBASE.
    RESULTS: Fourteen studies met eligibility criteria; primarily pre-post intervention cohort studies. Percent increase in speaking valve use ranged 14%-275%; percent reduction in median days to speech ranged 33%-73% and median days to decannulation ranged 26%-32%; percent reduction in rate of adverse events ranged 32%-88%; percent reduction in median hospital length of stay days ranged 18-40 days; no significant change in overall ICU length of stay and mortality rates. Facilitators include team education, coverage, rounds, standardization, communication, lead personnel and automation, patient tracking; barrier is financial.
    CONCLUSIONS: Patients with tracheostomy who received care from a dedicated interprofessional team showed improvements in several clinical outcomes.
    CONCLUSIONS: Additional high-quality evidence from rigorous, well-controlled and adequately powered studies are necessary, as are implementation strategies to promote broader adoption of interprofessional tracheostomy team strategies. Interprofessional tracheostomy teams are associated with improved safety and quality of care.
    CONCLUSIONS: Evidence from review provides rationale for broader implementation of interprofessional tracheostomy teams.
    UNASSIGNED: PRISMA and Synthesis Without Meta-analysis (SWiM).
    UNASSIGNED: None.
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  • 文章类型: Journal Article
    学校社会工作者是学校心理健康劳动力的组成部分,也是教育环境中领先的社会服务提供者。近几十年来,学校社会工作实践在很大程度上受到多层次支持系统(MTSS)方法的影响,生态系统观点,和促进循证实践。然而,现有的学校社会工作审查都没有审查学校社会工作服务的最新特点和成果。此范围审查分析并综合了学校社会工作者的重点和功能以及他们提供的最先进的社会和心理/行为健康服务。调查结果显示在过去的二十年里,世界各地的学校社会工作者对实践模式和兴趣有着共同的理解。大多数学校社会工作干预和服务针对高需求的学生,以改善他们的社会,精神/行为健康,和学术成果,其次是促进学校氛围的一级和二级预防活动,学校文化,老师,学生,和父交互,和父母的幸福。该综合还支持学校社会工作者的多种角色及其协作,服务学生的跨系统方法,家庭,和教育机构的工作人员。讨论了未来学校社会工作研究的意义和方向。
    School social workers are integral to the school mental health workforce and the leading social service providers in educational settings. In recent decades, school social work practice has been largely influenced by the multi-tiered systems of support (MTSS) approach, ecological systems views, and the promotion of evidence-based practice. However, none of the existing school social work reviews have examined the latest characteristics and outcomes of school social work services. This scoping review analyzed and synthesized the focuses and functions of school social workers and the state-of-the-art social and mental/behavioral health services they provide. Findings showed that in the past two decades, school social workers in different parts of the world shared a common understanding of practice models and interests. Most school social work interventions and services targeted high-needs students to improve their social, mental/behavioral health, and academic outcomes, followed by primary and secondary prevention activities to promote school climate, school culture, teacher, student, and parent interactions, and parents\' wellbeing. The synthesis also supports the multiple roles of school social workers and their collaborative, cross-systems approach to serving students, families, and staff in education settings. Implications and directions for future school social work research are discussed.
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