Person-centred

以人为本
  • 文章类型: Journal Article
    背景:规范实践和提高患者安全性的一种方法是引入临床护理路径;但是,这些途径通常旨在协助临床医生和医疗机构进行循证实践。许多痴呆症护理途径存在,没有商定的护理途径版本,也没有关于其使用或结果的经验的数据。审查的目的是:(1)确定痴呆症护理途径的目的,用于部署路径的方法,和预期的用户类型;(2)识别护理路径的核心组件,预期结果,和对痴呆症患者及其护理伙伴的影响;(3)确定痴呆症患者和/或其护理伙伴参与发展的程度,实施,并评估护理途径。
    方法:我们在2023年9月利用Arskey和O\'Malley的范围审查框架,系统地搜索了六个文献数据库,以获取英语发表的文献。
    结果:来自痴呆症护理途径(n=13)的发现证明了临床医生对痴呆症诊断和管理实践的帮助,并在临床环境中提供了结构化护理流程。出于这个原因,这些途径强调评估和介入诊断后支持,较少强调以社区为基础的综合痴呆症护理。
    结论:未来的痴呆症护理途径发展可以寻求痴呆症患者和护理伙伴参与设计,实施和评估这些途径,确保结果衡量标准正确反映对有痴呆症患者及其护理伙伴的影响。
    BACKGROUND: One way of standardizing practice and improving patient safety is by introducing clinical care pathways; however, such pathways are typically geared towards assisting clinicians and healthcare organizations with evidence-based practice. Many dementia care pathways exist with no agreed-upon version of a care pathway and with little data on experiences about their use or outcomes. The objectives of the review were: (1) to identify the dementia care pathway\'s purpose, methods used to deploy the pathway, and expected user types; (2) to identify the care pathway\'s core components, expected outcomes, and implications for persons with dementia and their care partners; and (3) determine the extent of involvement by persons with dementia and/or their care partners in developing, implementing, and evaluating the care pathways.
    METHODS: We systematically searched six literature databases for published literature in the English language in September 2023 utilizing Arskey and O\'Malley\'s scoping review framework.
    RESULTS: The findings from the dementia care pathways (n = 13) demonstrated assistance in dementia diagnostic and management practices for clinicians and offered structured care processes in clinical settings. For this reason, these pathways emphasized assessment and interventional post-diagnostic support, with less emphasis on community-based integrated dementia care.
    CONCLUSIONS: Future dementia care pathway development can seek the involvement of persons with dementia and care partners in designing, implementing and evaluating such pathways, ensuring that outcome measures properly reflect the impact on persons with lived dementia experience and their care partners.
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  • 文章类型: Journal Article
    背景:以人为中心的护理是提供高质量医疗服务的组成部分,尽管概念各不相同,文献也很复杂。衡量以人为本的从业者技能的经过验证的仪器,和协商中的行为,有很多原因需要,包括培训方案。我们的目标是通过对现有的验证研究的综述进行系统的综述,以评估以人为中心的从业者技能和咨询行为。目标是对这些审查进行批判性评估,并总结可用的验证工具和支持它们的证据。
    方法:对Medline的系统搜索,EMBASE,PsycINFO和CINAHL于2020年9月进行。包括测量个体从业者以人为本的咨询技能或报告测量特性的行为的仪器的验证研究的系统评价。使用JoannaBriggs研究所关键评估清单对审查质量进行了评估,以进行系统审查和研究综合。评论的细节,包括的验证研究,仪器本身是列表的,包括心理测量数据,并提供了评论的叙述概述。
    结果:有4条评论符合纳入条件。这些使用了以人为中心的不同概念化和针对性不同,有时是相互排斥的,从业者和设置。四项审查包括68项独特的验证研究,检查了42种仪器,但重叠很少。批判性评估表明,需要改进这一领域的审查设计。这些审查中包含的工具尚未经过广泛的验证研究。
    结论:有许多工具可以用来衡量医疗保健从业人员以人为本的技能,这项研究为研究人员和研究用户提供了一个指南。已经开发的最相关和最有前途的工具,或其中的物品,应该进一步严格研究。需要对现有材料进行验证研究,而不是制定新措施。
    BACKGROUND: Person-centred care is integral to high-quality health service provision, though concepts vary and the literature is complex. Validated instruments that measure person-centred practitioner skills, and behaviours within consultations, are needed for many reasons, including in training programmes. We aimed to provide a high-level synthesis of what was expected to be a large and diverse literature through a systematic review of existing reviews of validation studies a of instruments that measure person-centred practitioner skills and behaviours in consultations. The objectives were to undertake a critical appraisal of these reviews, and to summarise the available validated instruments and the evidence underpinning them.
    METHODS: A systematic search of Medline, EMBASE, PsycINFO and CINAHL was conducted in September 2020. Systematic reviews of validation studies of instruments measuring individual practitioner person-centred consultation skills or behaviours which report measurement properties were included. Review quality was assessed with the Joanna Briggs Institute Critical Appraisal Checklist for Systematic Reviews and Research Syntheses. Details of the reviews, the included validation studies, and the instruments themselves are tabulated, including psychometric data, and a narrative overview of the reviews is provided.
    RESULTS: Four reviews were eligible for inclusion. These used different conceptualisations of person-centredness and targeted distinct, sometimes mutually exclusive, practitioners and settings. The four reviews included 68 unique validation studies examining 42 instruments, but with very few overlaps. The critical appraisal shows there is a need for improvements in the design of reviews in this area. The instruments included within these reviews have not been subject to extensive validation study.
    CONCLUSIONS: There are many instruments available which measure person-centred skills in healthcare practitioners and this study offers a guide to what is available to researchers and research users. The most relevant and promising instruments that have already been developed, or items within them, should be further studied rigorously. Validation study of existing material is needed, not the development of new measures.
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  • 文章类型: Journal Article
    本系统综述旨在根据最近发布的ReAble定义及其对日常生活活动(ADL)的影响,概述康复干预措施。此外,确定了这些康复干预措施中最常见和最有希望的特征.检索了四个电子书目数据库。在2002年至2020年之间发表的文章中,其中描述了与ReAble定义的标准相匹配的康复干预的随机或临床对照试验。并具有ADL功能作为结果。使用雪球采样和专家完成来检测其他出版物。两名研究人员筛选并提取了已确定的文章,并评估了方法学质量;第三位研究人员通过讨论和仲裁解决了差异。纳入了来自8个国家的20项相关研究。其中10项研究有效改善ADL功能。识别有希望的特征是具有挑战性的,因为包括了等量的有效和无效的干预措施。内容描述往往缺乏,研究质量为中低。然而,有迹象表明,使用更多样化的跨学科团队,标准化评估和目标设定方法以及四个或更多干预组件(即ADL培训,身体和/或功能锻炼,教育,功能障碍的管理)可以改善日常功能。无法得出有关ADL功能有效性的结论。确定的共同要素可以在制定重新能力计划时提供指导。干预方案和过程评估应更经常地使用报告指南发布。从重新启用专家那里收集更多数据可以帮助解开重新启用的黑匣子。
    This systematic review aimed to provide an overview of reablement interventions according to the recently published ReAble definition and their effect on Activities of Daily Living (ADL). In addition, the most common and promising features of these reablement interventions were identified. Four electronic bibliographic databases were searched. Articles were included when published between 2002 and 2020, which described a Randomised or Clinical Controlled Trial of a reablement intervention matching the criteria of the ReAble definition, and had ADL functioning as an outcome. Snowball sampling and expert completion were used to detect additional publications. Two researchers screened and extracted the identified articles and assessed methodological quality; discrepancies were resolved by discussion and arbitration by a third researcher. Twenty relevant studies from eight countries were included. Ten of these studies were effective in improving ADL functioning. Identifying promising features was challenging as an equal amount of effective and non-effective interventions were included, content descriptions were often lacking, and study quality was moderate to low. However, there are indications that the use of more diverse interdisciplinary teams, a standardised assessment and goal-setting method and four or more intervention components (i.e. ADL-training, physical and/or functional exercise, education, management of functional disorders) can improve daily functioning. No conclusions could be drawn concerning the effectiveness on ADL functioning. The common elements identified can provide guidance when developing reablement programmes. Intervention protocols and process evaluations should be published more often using reporting guidelines. Collecting additional data from reablement experts could help to unpack the black box of reablement.
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  • 文章类型: Journal Article
    本系统综述旨在根据最近发布的ReAble定义及其对日常生活活动(ADL)的影响,概述康复干预措施。此外,确定了这些康复干预措施中最常见和最有希望的特征.检索了四个电子书目数据库。在2002年至2020年之间发表的文章中,其中描述了与ReAble定义的标准相匹配的康复干预的随机或临床对照试验。并具有ADL功能作为结果。使用雪球采样和专家完成来检测其他出版物。两名研究人员筛选并提取了已确定的文章,并评估了方法学质量;第三位研究人员通过讨论和仲裁解决了差异。纳入了来自8个国家的20项相关研究。其中10项研究有效改善ADL功能。识别有希望的特征是具有挑战性的,因为包括了等量的有效和无效的干预措施。内容描述往往缺乏,研究质量为中低。然而,有迹象表明,使用更多样化的跨学科团队,标准化评估和目标设定方法以及四个或更多干预组件(即ADL培训,身体和/或功能锻炼,教育,功能障碍的管理)可以改善日常功能。无法得出有关ADL功能有效性的结论。确定的共同要素可以在制定重新能力计划时提供指导。干预方案和过程评估应更经常地使用报告指南发布。从重新启用专家那里收集更多数据可以帮助解开重新启用的黑匣子。
    UNASSIGNED:在线版本包含补充材料,可在10.1007/s10433-022-00693-3获得。
    This systematic review aimed to provide an overview of reablement interventions according to the recently published ReAble definition and their effect on Activities of Daily Living (ADL). In addition, the most common and promising features of these reablement interventions were identified. Four electronic bibliographic databases were searched. Articles were included when published between 2002 and 2020, which described a Randomised or Clinical Controlled Trial of a reablement intervention matching the criteria of the ReAble definition, and had ADL functioning as an outcome. Snowball sampling and expert completion were used to detect additional publications. Two researchers screened and extracted the identified articles and assessed methodological quality; discrepancies were resolved by discussion and arbitration by a third researcher. Twenty relevant studies from eight countries were included. Ten of these studies were effective in improving ADL functioning. Identifying promising features was challenging as an equal amount of effective and non-effective interventions were included, content descriptions were often lacking, and study quality was moderate to low. However, there are indications that the use of more diverse interdisciplinary teams, a standardised assessment and goal-setting method and four or more intervention components (i.e. ADL-training, physical and/or functional exercise, education, management of functional disorders) can improve daily functioning. No conclusions could be drawn concerning the effectiveness on ADL functioning. The common elements identified can provide guidance when developing reablement programmes. Intervention protocols and process evaluations should be published more often using reporting guidelines. Collecting additional data from reablement experts could help to unpack the black box of reablement.
    The online version contains supplementary material available at 10.1007/s10433-022-00693-3.
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  • 文章类型: Journal Article
    建议将体力活动作为慢性疼痛的首选治疗方法。目的是描述以人为本的健康计划的内容和看法,并评估患者日常生活中健康计划的执行情况。
    对133名参与者的以人为中心的健康计划进行了描述性回顾性审查,以支持身体活动。定量内容分析用于分析健康计划的内容。关于身体活动以及健康计划的实施和感知的问卷调查,并进行了体能测试。
    参与者的目标与身体功能有关(n=118),一般健康状况(n=90),活动和参与(n=80)和症状(n=35)。参与者确定了个人(n=174),社会(n=69)和物质资源(n=36)。他们确定了与健康问题相关的恐惧和障碍(n=95),很难完成它(n=41),相互竞争的优先事项(n=19)和环境因素(n=12)。参与者确定需要外部支持(n=110)。在研究的前6个月,参与者的身体活动水平和身体能力显著增加。
    以人为中心的方法似乎有助于增强实现既定目标的动力,并增强身体活动中的自我效能感,同时也受到身体活动和身体能力增加的支持。对康复的影响以人为中心的方法有助于增强实现既定目标的动力和进行体育锻炼时管理症状的自我效能。个人健康计划的共享文档有助于可视化资源,以促进定期的身体活动以及实现既定目标的替代方法。共同创建的健康计划抓住了参与者的目标,资源,恐惧和需要支持,帮助参与者克服挑战,并支持参与者进行身体活动。
    Physical activity is recommended as first-choice treatment in chronic pain conditions. The aim was to describe the content and perceptions of person-centred health plans, and to evaluate patients\' implementation of the health plan in their everyday life.
    A descriptive retrospective review was conducted of person-centred health plans to support physical activity in 133 participants. Quantitative content analysis was used to analyse the content of the health plans. Questionnaires on physical activity and on implementation and perception of the health plans, and a test of physical capacity were administered.
    Participants\' goals were found to be related to physical function (n = 118), general health (n = 90), activity and participation (n = 80) and symptoms (n = 35). Participants identified personal (n = 174), social (n = 69) and material resources (n = 36). They identified fears and obstacles related to health issues (n = 95), difficulties getting it done (n = 41), competing priorities (n = 19) and contextual factors (n = 12). Participants identified need for external support (n = 110). Participants\' level of physical activity and physical capacity increased significantly during the first 6 months of the study.
    The person-centred approach seems helpful in enhancing motivation to achieve set goals and strengthen self-efficacy in physical activity also supported by increased physical activity and physical capacity. Implications for rehabilitationA person-centred approach can be helpful to enhance motivation to achieve set goals and self-efficacy to manage symptoms when engaging in physical activity.Shared documentation of a personal health plan helps to visualize resources to promote regular physical activity as well as alternative ways to reach set goals.The co-created health-plan captures the participant\'s goals, resources, fears and need of support, helps the participant to overcome challenges, and supports the participant to be physically active.
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  • 文章类型: Journal Article
    自闭症患者经常接受磁共振成像检查。在这种环境下,通常会感到焦虑和被噪音淹没,灯光或其他人。狭窄的扫描仪,大声的声音和长时间的检查很容易引起恐慌。这篇综述旨在确定自闭症患者在没有镇静或麻醉的情况下进行磁共振成像扫描的任何适应。在筛选的4442篇文章中,评估了53个更相关的研究结果,最终将21个纳入本研究。自定义通信,不同的技术来改善环境,使用熟悉和分散注意力的技术已在以前的研究中使用。本研究结果可用于对如何改善磁共振成像实践和自闭症患者体验提出建议。它们还可以用于为使用磁共振成像扫描仪的医疗保健专业人员创建培训。
    Autistic patients often undergo magnetic resonance imaging examinations. Within this environment, it is usual to feel anxious and overwhelmed by noises, lights or other people. The narrow scanners, the loud noises and the long examination time can easily cause panic attacks. This review aims to identify any adaptations for autistic individuals to have a magnetic resonance imaging scan without sedation or anaesthesia. Out of 4442 articles screened, 53 more relevant were evaluated and 21 were finally included in this study. Customising communication, different techniques to improve the environment, using technology for familiarisation and distraction have been used in previous studies. The results of this study can be used to make suggestions on how to improve magnetic resonance imaging practice and the autistic patient experience. They can also be used to create training for the healthcare professionals using the magnetic resonance imaging scanners.
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  • 文章类型: Journal Article
    目的本研究旨在综合有关参与者如何参与支持就业(SE)干预措施的可用知识,已定义,概念化。我们还旨在根据我们的研究结果制定SE参与者参与的工作定义。方法本系统范围审查是在PRISMA扩展范围审查之后进行的。系统地搜索了以下数据库:EBSCO,Scopus,社会关怀在线,还有JSTOR.我们根据实证研究纳入了同行评审的英文出版物。结果16篇文献符合纳入标准,纳入最终分析。主题框架分析导致三个主题传达了参与者参与的概念:自主选择,赋权,和协作/工作联盟。我们建议参与者参与SE是一个积极的多方面过程,涉及参与者的赋权,参与者行使自我决定的知情选择,以及他们与SE从业者在工作联盟中的合作。结论参与者赋权,自主选择,和协作是参与者参与SE的重要方面。研究结果将吸引SE从业人员,并为更广泛的其他职业服务领域做出重大贡献,以支持人们(重新)进入竞争性劳动力市场。
    Purpose This study aimed to synthesise the available knowledge on how participant engagement in supported employment (SE) interventions is presented, defined, and conceptualised. We also aimed to develop a working definition of participant engagement in SE based on the results of our study. Methods This systematic scoping review was conducted following the PRISMA extension for scoping reviews. The following databases were systematically searched: EBSCO, SCOPUS, Social Care Online, and JSTOR. We included peer-reviewed publications in English based on empirical studies. Results Sixteen articles met the inclusion criteria and were included in the final analysis. Thematic framework analysis resulted in three themes conveying the concept of participant engagement: self-determined choice, empowerment, and collaboration/working alliance. We suggest that participant engagement in SE is an active multifaceted process that involves the empowerment of participants, participants\' exercise of self-determined informed choice, and their collaboration with SE practitioners in a working alliance. Conclusions Participant empowerment, self-determined choice, and collaboration are important aspects of participant engagement in SE. The study results will appeal to SE practitioners and make significant contributions to the broader field of other vocational services supporting people in (re-)entering the competitive labour market.
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  • 文章类型: Journal Article
    Background: Client-centred practice aims to involve the person in making decisions during the therapeutic intervention process, giving him or her a central and active role.Objectives: To analyze the effects of client-centred practice in occupational therapy on issues related to occupational performance and participation among people with stroke and traumatic brain injury.Material and methods: A systematic review of randomized clinical trials examining the effects of a client-centred practice carried out by occupational therapists in patients with stroke or traumatic brain injury aged over 18 years was conducted. PubMed, Web of Science, Scopus, OT Seeker, PsycINFO and EBSCO were used to retrieve potentially eligible publications.Results: Eight studies, from 294 identified, were included. The extracted data showed that the application of client-centred practice in occupational therapy improved satisfaction with occupational performance compared to conventional interventions. However, client-centred practice and conventional intervention had similar effects on functionality (Activities of Daily Living), life satisfaction and burden on caregivers.Conclusions and significance: Client-centred practice has the effect of achieving greater satisfaction with occupational performance. This suggests that client-centred practice in occupational therapy helps patients to accept the new limitations on their occupational performance. Further studies are needed to determine the effects of client-centred practice on other aspects.
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  • 文章类型: Journal Article
    OBJECTIVE: To evaluate the mechanism through which nursing leadership impacts patient safety.
    BACKGROUND: Patient safety has received considerable attention among policymakers, governments and public sectors with the emphasis in health care settings on minimizing the risk to patients. Claims are made leadership plays a crucial role in patient safety. However, the incidents of adverse events are consistently high in hospitals.
    RESULTS: Published English-only research articles that examine the mechanism by which nursing leadership impacts patient safety were selected from seven electronic databases and manual searches. Data extraction, quality assessments and analysis were completed for ten research studies.
    RESULTS: There is evidence of significant mediating effects between nursing leadership and decreased adverse patient outcomes specifically with regard to workplace empowerment, leader-nurse relationship and the quality of the care environment.
    CONCLUSIONS: The findings suggest that nursing leadership has a significant indirect impact on patient safety outcomes. From a person-centred perspective, the care environment requires workplace empowerment and effective relationships between leaders and nurses.
    CONCLUSIONS: To improve patient safety outcomes, managers must strive to emphasize workplace empowerment, leader-nurse relationship and the quality of the care environment. Managers must consider these domains as part of an effective workplace culture.
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  • 文章类型: Journal Article
    BACKGROUND: Microenterprises are very small businesses requiring little capital and can be an employment pathway for people with intellectual disabilities. This systematic review aims to identify the facilitators, barriers and outcomes from microenterprise.
    METHODS: Web of Science, Scopus, EconLit, PsycINFO and ProQuest were searched to identify peer-reviewed studies on microenterprises owned by people with intellectual disability published up to and including 1 October 2019.
    RESULTS: A total of 1080 papers were independently screened by two reviewers. Six papers met the inclusion criteria. Barriers included lack of access to business expertise and resources, and the tension between growing microenterprises and maintaining eligibility for welfare payments. Formal and informal supports were key facilitators. Outcomes experienced included additional income, skills development, increased confidence and engagement in meaningful activities.
    CONCLUSIONS: Additional research is required to develop an evidence base which may support investment in this employment pathway, making microenterprise more accessible to people with intellectual disabilities.
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