Thematic analysis

专题分析
  • 文章类型: Journal Article
    重症监护病房为一组先前存在的共病患者提供护理。重点已转移到改善与健康相关的生活质量,使更多的患者出院后幸存下来。评估随访干预措施的随机对照试验,为了改善身体恢复,没有表现出与健康相关的生活质量益处。定性研究可以提供背景,以了解重症监护幸存者在解决身体限制的后续护理期间的经历。
    综合定性研究并探索重症监护幸存者在后续护理背景下的身体症状的经验和观点。
    对电子数据库的系统搜索(MEDLINE,护理和相关健康文献的累积指数,WebofScience,应用社会科学索引和摘要,进行了OvidNursing和OvidEmcare)以确定同行评审的主要定性研究。未应用日期参数。纳入/排除标准指导筛选过程。
    来自符合条件的主要研究研究的数据被提取到NVivo(v12)中。
    关键评估是使用JoannaBriggs关键评估工具完成的。专题分析,布劳恩和克拉克(2022)告知数据综合。
    来自2457项研究,纳入了10项相关研究。确定了两个主要主题:1.恢复不确定;概述了重症监护病房幸存者在恢复期间所经历的不确定性。这个主题涉及系统级因素(医疗保健专业人员的作用和信息提供),为提供后续护理提供了背景。2.自我决定恢复;概述了确定恢复的个体特征,这些特征是由患者水平因素概念化的(动机,支持网络和健康感知)。
    对于重症监护幸存者,康复轨迹不确定,出院后急性期信息提供存在差距.患者自我决定康复是确保后续护理满足个体患者需求的重要考虑因素。预先存在的合并症和从随访护理中获益的患者亚组的影响仍然不确定。
    PROSPERO注册号。CRD420223555711。
    患者接受院后随访护理以改善重症监护幸存者身体康复的经验:定性研究的系统评价。
    UNASSIGNED: Intensive care units deliver care to a heterogeneous group of patients with pre-existing co-morbid disease. Focus has shifted to improving health related quality of life with more patients surviving beyond hospital discharge. Randomised controlled trials evaluating follow-up interventions, to improve physical recovery, have not demonstrated a health-related quality of life benefit. Qualitative research may provide the context to understand the experiences of intensive care survivors during follow-up care addressing physical limitations.
    UNASSIGNED: To synthesise qualitative studies and explore Intensive Care survivors\' experiences and perspectives of physical symptoms in the context of follow-up care.
    UNASSIGNED: A systematic search of electronic databases (MEDLINE, Cumulative Index of Nursing and Allied Health Literature, Web of Science, Applied Social Sciences Index and Abstracts, Ovid Nursing and Ovid Emcare) was conducted to identify peer-reviewed primary qualitative studies. No date parameters were applied. Inclusion/exclusion criteria guided the screening process.
    UNASSIGNED: The data from eligible primary research studies was extracted into NVivo (v12).
    UNASSIGNED: Critical appraisal was completed using the Joanna Briggs Critical Appraisal Tool. Thematic analysis, guided by Braun and Clarke (2022), informed the data synthesis.
    UNASSIGNED: From 2457 studies, ten relevant studies were included. Two main themes were identified: 1. Recovery as uncertain; which outlines the uncertainty experienced by intensive care unit survivors during recovery. This theme pertained to system-level factors (role of healthcare professional and information provision) which provides the context for delivering follow-up care. 2. Self-determination of recovery; outlines individual characteristics in determining recovery which is conceptualised by patient-level factors (motivation, support network and perception of health).
    UNASSIGNED: For intensive care survivors, the recovery trajectory is uncertain with a gap in information provision during the acute phase following hospital discharge. Patients\' self-determination of recovery is an important consideration to ensure follow-up care addresses the needs of individual patients. The impact of pre-existing co-morbid disease and subgroups of patients deriving benefit from follow-up care remains uncertain.
    UNASSIGNED: PROSPERO Registration no. CRD42022355711.
    UNASSIGNED: Patients\' experiences of post-hospital follow-up care to improve physical recovery for intensive care survivors: A Systematic Review of Qualitative Research.
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  • 文章类型: Journal Article
    背景:本研究利用对临床医学物理学家的访谈来调查当前每周图表检查工作流程的自我报告缺陷和改进机会。
    方法:招募了19名医学物理学家进行30分钟的半结构化访谈,特别关注图像审查,并在每周检查中使用自动工具进行图像审查。调查类型的问题用于收集有关图表检查实践的定量信息,以及减少图表检查工作量与提高图表检查有效性的重要性。开放式问题用于调查受访者当前的每周图表检查工作流程,对每周图表检查和感知缺点的价值的看法,以及实施自动化图表检查工具的障碍和促进者。主题分析用于在访谈中制定共同主题。
    结果:物理学家对减少每周图表检查时间的价值进行了高度评价(从1到10的平均6.3分),但更重视提高检查的有效性,在1-10量表上平均为9.2。确定了四个主要主题:(1)每周的图表检查需要适应电子记录和验证图表环境,(2)物理学家可以通过分析图像为患者护理增加价值,而不重复医生所做的工作,(3)每周检查需要对趋势分析提供更大的支持,(4)自动化有可能增加物理检查的价值。
    结论:这项研究从临床医学物理学家的角度确定了当前每周图表检查过程的几个关键缺点。我们的结果表明,为每周检查工作流程的自动化组件提供了强有力的支持,以便允许更有效的检查,强调后续行动,趋势,故障模式和影响分析,并允许将时间花在其他更高价值的任务上,以提高患者的安全性。
    BACKGROUND: This study utilizes interviews of clinical medical physicists to investigate self-reported shortcomings of the current weekly chart check workflow and opportunities for improvement.
    METHODS: Nineteen medical physicists were recruited for a 30-minute semi-structured interview, with a particular focus placed on image review and the use of automated tools for image review in weekly checks. Survey-type questions were used to gather quantitative information about chart check practices and importance placed on reducing chart check workloads versus increasing chart check effectiveness. Open-ended questions were used to probe respondents about their current weekly chart check workflow, opinions of the value of weekly chart checks and perceived shortcomings, and barriers and facilitators to the implementation of automated chart check tools. Thematic analysis was used to develop common themes across the interviews.
    RESULTS: Physicists ranked highly the value of reducing the time spent on weekly chart checks (average 6.3 on a scale from 1 to 10), but placed more value on increasing the effectiveness of checks with an average of 9.2 on a 1-10 scale. Four major themes were identified: (1) weekly chart checks need to adapt to an electronic record-and-verify chart environment, (2) physicists could add value to patient care by analyzing images without duplicating the work done by physicians, (3) greater support for trending analysis is needed in weekly checks, and (4) automation has the potential to increase the value of physics checks.
    CONCLUSIONS: This study identified several key shortcomings of the current weekly chart check process from the perspective of the clinical medical physicist. Our results show strong support for automating components of the weekly check workflow in order to allow for more effective checks that emphasize follow-up, trending, failure modes and effects analysis, and allow time to be spent on other higher value tasks that improve patient safety.
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  • 文章类型: Journal Article
    背景:数字健康技术(dHT)提供了一个独特的机会来解决全球医疗保健系统面临的一些主要挑战。然而,dht的实施引起了一些关注,例如对它们对卫生系统和人民福祉的实际影响的了解有限,或者使用它们带来的潜在风险。在这种情况下,卫生技术评估(HTA)是卫生系统可以用来评估证据和确定给定dHT值的主要工具之一。然而,由于dHTs的性质,专家强调需要重新考虑传统HTA中使用的框架。
    目的:本范围审查(ScR)旨在确定全球范围内用于数字健康技术评估(dHTA)的方法学框架;确定正在考虑的领域;并生成,通过主题分析,基于文献中最常描述的领域的方法论框架的建议。
    方法:根据PRISMA-ScR指南中建立的指南进行ScR。我们检索了7个数据库,收集2011年1月至2021年12月期间发表的同行评议和灰色文献。检索到的研究由两名独立作者以单盲方式使用Rayyan进行筛选,并使用ATLAS提取数据。ti软件。使用相同的软件进行专题分析。
    结果:系统检索到3061篇研究(n=2238,73.1%,独特),其中26项(0.8%)研究纳入.从这些,我们确定了102个为dHTA设计的方法框架。这些框架由于其不同的结构而揭示了它们之间的巨大异质性,方法,以及dHTA中要考虑的项目。此外,我们确定了用于指代类似概念的不同措辞。通过专题分析,我们减少了这种异质性。在分析的第一阶段,出现了176个与不同评估项目有关的临时代码。在第二阶段,这些代码被分为86个描述性主题,which,反过来,在第三阶段分为61个分析主题,并通过3个级别的垂直层次结构进行组织:由13个领域组成的1级,由38个维度形成的2级,和由11个子维度组成的3级。从这61个分析主题中,我们提出了一个dHTA方法框架的建议。
    结论:需要调整用于dHTA的现有框架或创建新框架以更全面地评估不同类型的dHT。通过这个ScR,我们确定了26项研究,包括102项dHTA方法学框架和工具.对这26项研究的主题分析导致了12个领域的定义,38个维度,以及在dHTA中应考虑的11个子维度。
    BACKGROUND: Digital health technologies (dHTs) offer a unique opportunity to address some of the major challenges facing health care systems worldwide. However, the implementation of dHTs raises some concerns, such as the limited understanding of their real impact on health systems and people\'s well-being or the potential risks derived from their use. In this context, health technology assessment (HTA) is 1 of the main tools that health systems can use to appraise evidence and determine the value of a given dHT. Nevertheless, due to the nature of dHTs, experts highlight the need to reconsider the frameworks used in traditional HTA.
    OBJECTIVE: This scoping review (ScR) aimed to identify the methodological frameworks used worldwide for digital health technology assessment (dHTA); determine what domains are being considered; and generate, through a thematic analysis, a proposal for a methodological framework based on the most frequently described domains in the literature.
    METHODS: The ScR was performed in accordance with the guidelines established in the PRISMA-ScR guidelines. We searched 7 databases for peer reviews and gray literature published between January 2011 and December 2021. The retrieved studies were screened using Rayyan in a single-blind manner by 2 independent authors, and data were extracted using ATLAS.ti software. The same software was used for thematic analysis.
    RESULTS: The systematic search retrieved 3061 studies (n=2238, 73.1%, unique), of which 26 (0.8%) studies were included. From these, we identified 102 methodological frameworks designed for dHTA. These frameworks revealed great heterogeneity between them due to their different structures, approaches, and items to be considered in dHTA. In addition, we identified different wording used to refer to similar concepts. Through thematic analysis, we reduced this heterogeneity. In the first phase of the analysis, 176 provisional codes related to different assessment items emerged. In the second phase, these codes were clustered into 86 descriptive themes, which, in turn, were grouped in the third phase into 61 analytical themes and organized through a vertical hierarchy of 3 levels: level 1 formed by 13 domains, level 2 formed by 38 dimensions, and level 3 formed by 11 subdimensions. From these 61 analytical themes, we developed a proposal for a methodological framework for dHTA.
    CONCLUSIONS: There is a need to adapt the existing frameworks used for dHTA or create new ones to more comprehensively assess different kinds of dHTs. Through this ScR, we identified 26 studies including 102 methodological frameworks and tools for dHTA. The thematic analysis of those 26 studies led to the definition of 12 domains, 38 dimensions, and 11 subdimensions that should be considered in dHTA.
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  • 文章类型: Journal Article
    背景:COVID-19大流行给儿童保护专业人员(CPP)的工作带来了新的挑战和障碍,并加剧了家庭和儿童的现有困境,增加儿童虐待的风险。随着世界各国政府实施新的限制和预防措施来阻止病毒传播,CPP必须适应远程工作的新现实。然而,有限的研究调查了远程工作如何影响CPP和儿童保护工作,以及CPP如何处理这种替代工作方式。
    目的:这篇综述旨在弥补研究中的空白,以揭示CPPs为克服COVID-19带来的挑战而开发的创造性和有效的方法,COVID-19被定义为CPPs的“积极遗产”,特别是在适应远程工作的挑战。
    方法:本综述是使用范围审查进行的,随后进行两轮专题分析。范围审查以六种语言进行:希伯来语,阿拉伯语,法语,葡萄牙语,西班牙语,和英语。
    结果:第一轮主题分析发现了18篇与本综述相关的文章。第二轮提取了两个主要主题:1)远程工作的挑战和2)克服无接触的挑战。
    结论:本综述的结果可用于为未来大流行期间的儿童保护策略提供信息。它们还为重新思考儿童保护工作与技术的关系提供了机会,以系统地改革当前和未来的保护政策和做法,包括在大流行之外。
    BACKGROUND: The COVID-19 pandemic created new challenges and barriers for the work of child protection professionals (CPPs) and intensified existing hardships for families and children, increasing the risk of child maltreatment. As new restrictions and precautions were implemented by governments worldwide to stop the virus from spreading, CPPs had to adapt to a new reality of working remotely. However, limited research has investigated how remote work impacted CPPs and child protection work and how CPPs handled this alternative work style.
    OBJECTIVE: This review aims to address gaps in the research to reveal the creative and effective approaches CPPs developed to overcome the challenges presented by COVID-19, defined as the \'positive legacy\' of CPPs, particularly in adapting to remote work challenges.
    METHODS: This review was conducted using a scoping review, followed by two rounds of thematic analysis. The scoping review was conducted in six languages: Hebrew, Arabic, French, Portuguese, Spanish, and English.
    RESULTS: The first round of thematic analysis found 18 articles relevant to this review. The second round extracted two main themes: 1) the challenges of remote work and 2) overcoming the challenges of no contact.
    CONCLUSIONS: The findings of this review may be used to inform future strategies for child protection during a pandemic. They also provide an opportunity to rethink the relationship child protection work has with technology to systematically reform current and future protection policies and practices, including outside of a pandemic.
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  • 文章类型: Journal Article
    由于社会经济不平等是获取和利用2型糖尿病(T2D)服务的关键因素,本次范围审查的目的是确定减少T2D社会经济不平等的解决方案.
    使用PubMed对2000年及以后的科学文章进行了范围审查,WebofScience(WOS),Scopus,Embase,ProQuest数据库使用Arksey和O\'Malley框架进行范围审查,文章被提取,一丝不苟地阅读,并进行了主题分析。
    从审查的数据库中确定了总共7204篇文章。删除重复和不相关的文章后,最终纳入并分析了117篇文章。从最终制品中提取了许多溶液和通道。减少T2D社会经济不平等的解决方案分为12种主要解决方案和63种通道。
    建议在糖尿病政策和干预措施中应用确定的解决方案,以减少T2D的社会经济不平等。此外,可以将通道作为切入点,以帮助更好地实施糖尿病政策。
    UNASSIGNED: As socioeconomic inequalities are key factors in access and utilization of type 2 diabetes (T2D) services, the purpose of this scoping review was to identify solutions for decreasing socioeconomic inequalities in T2D.
    UNASSIGNED: A scoping review of scientific articles from 2000 and later was conducted using PubMed, Web of Science (WOS), Scopus, Embase, and ProQuest databases. Using the Arksey and O\'Malley framework for scoping review, articles were extracted, meticulously read, and thematically analyzed.
    UNASSIGNED: A total of 7204 articles were identified from the reviewed databases. After removing duplicate and nonrelevant articles, 117 articles were finally included and analyzed. A number of solutions and passways were extracted from the final articles. Solutions for decreasing socioeconomic inequalities in T2D were categorized into 12 main solutions and 63 passways.
    UNASSIGNED: Applying identified solutions in diabetes policies and interventions would be recommended for decreasing socioeconomic inequalities in T2D. Also, the passways could be addressed as entry points to help better implementation of diabetic policies.
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  • 文章类型: Journal Article
    使用人工智能(AI),可以模仿人类智能并增强临床结果,由于数字化效应和COVID-19大流行,医疗保健决策的发展有所增长。这项研究的目的是确定AI工具在医疗服务交付网络决策过程中的应用范围。
    本研究采用定性方法对现有综述进行了系统综述。在PubMed中搜索了2000年至2024年之间以英语发表的评论文章,Scopus,ProQuest,和Cochrane数据库。CASP(关键评估技能计划)系统审查清单用于评估文章的质量。根据资格标准,最终的文章由2名作者独立进行,数据提取.最后,使用主题分析方法对从所选文章中提取的数据进行分析。
    在14219条确定的记录中,18篇评论文章符合条件,并包括在分析中,涵盖了其他669篇文章的调查结果。所有评论文章的质量评估得分较高。And,对数据的主题分析确定了3个主要主题,包括临床决策,组织决策,和共同决策;它起源于8个子主题。
    这项研究表明,人工智能工具已应用于医疗保健决策的各个方面。使用AI可以提高质量,效率,和医疗服务的有效性,通过提供准确的,及时,和个性化信息来支持决策。需要进一步的研究来探索在医疗保健决策中实施AI的最佳实践和标准。
    UNASSIGNED: The use of artificial intelligence (AI), which can emulate human intelligence and enhance clinical results, has grown in healthcare decision-making due to the digitalization effects and the COVID-19 pandemic. The purpose of this study was to determine the scope of applications of AI tools in the decision-making process in healthcare service delivery networks.
    UNASSIGNED: This study used a qualitative method to conduct a systematic review of the existing reviews. Review articles published between 2000 and 2024 in English-language were searched in PubMed, Scopus, ProQuest, and Cochrane databases. The CASP (Critical Appraisal Skills Programme) Checklist for Systematic Reviews was used to evaluate the quality of the articles. Based on the eligibility criteria, the final articles were selected and the data extraction was done independently by 2 authors. Finally, the thematic analysis approach was used to analyze the data extracted from the selected articles.
    UNASSIGNED: Of the 14 219 identified records, 18 review articles were eligible and included in the analysis, which covered the findings of 669 other articles. The quality assessment score of all reviewed articles was high. And, the thematic analysis of the data identified 3 main themes including clinical decision-making, organizational decision-making, and shared decision-making; which originated from 8 subthemes.
    UNASSIGNED: This study revealed that AI tools have been applied in various aspects of healthcare decision-making. The use of AI can improve the quality, efficiency, and effectiveness of healthcare services by providing accurate, timely, and personalized information to support decision-making. Further research is needed to explore the best practices and standards for implementing AI in healthcare decision-making.
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  • 文章类型: Systematic Review
    背景:土著和托雷斯海峡岛民(澳大利亚的土著人民)和与癌症相关的非土著澳大利亚人之间存在持续的差异,原住民和托雷斯海峡岛民经历了更长的治疗时间,发病率较高,和更高的死亡率。本系统综述旨在调查文献中有关澳大利亚原住民和托雷斯海峡岛民癌症患者的经验和支持性护理需求的发现和建议。
    方法:采用专题分析法进行系统评价。在CINAHL中进行了数据库搜索,提供信息,MEDLINE,ProQuest,Scopus,和WebofScience在2000年1月至2021年12月之间发表的文章。共有91项纳入研究,使用混合方法评估工具进行评估。纳入的研究报告了土著和托雷斯海峡岛民人群的癌症经历和支持性护理需求。
    结果:确定了六个关键主题:文化,家庭,和社区;癌症结果;心理困扰;获得医疗保健;癌症教育和认识;缺乏适当的数据。文化被视为实现最佳癌症护理的潜在促进者,纳入的研究强调了对文化安全的癌症服务的需求,以及在医疗机构中常规收集原住民和托雷斯海峡岛民的身份。
    结论:未来的工作应该利用这些发现,鼓励在医疗机构中整合文化,以提高治疗完成度,并为患有癌症的原住民和托雷斯海峡岛民提供积极的经验。
    BACKGROUND: Persistent disparities exist between Aboriginal and Torres Strait Islander peoples (the Indigenous peoples of Australia) and non-Indigenous Australians associated with cancer, with Aboriginal and Torres Strait Islander peoples experiencing a longer time to treatment, higher morbidity rates, and higher mortality rates. This systematic review aimed to investigate findings and recommendations in the literature about the experiences and supportive care needs of Aboriginal and Torres Strait Islander peoples with cancer in Australia.
    METHODS: A qualitative systematic review was conducted using thematic analysis. Database searches were conducted in CINAHL, Informit, MEDLINE, ProQuest, Scopus, and Web of Science for articles published between January 2000 and December 2021. There were 91 included studies which were appraised using the Mixed Methods Appraisal Tool. The included studies reported on the experiences of cancer and supportive care needs in Aboriginal and Torres Strait Islander populations.
    RESULTS: Six key themes were determined: Culture, family, and community; cancer outcomes; psychological distress; access to health care; cancer education and awareness; and lack of appropriate data. Culture was seen as a potential facilitator to achieving optimal cancer care, with included studies highlighting the need for culturally safe cancer services and the routine collection of Aboriginal and Torres Strait Islander status in healthcare settings.
    CONCLUSIONS: Future work should capitalize on these findings by encouraging the integration of culture in healthcare settings to increase treatment completion and provide a positive experience for Aboriginal and Torres Strait Islander peoples with cancer.
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  • 文章类型: Journal Article
    全世界,移动设备通常使用基于产品的商业模式进行分发,在向用户提供设备的情况下,并在用户有问题返回诊所时进行维修或更换。转向基于服务的业务模型可以为用户提供持续和定制的支持,并为临床医生和制造商提供更好的数据来做出决策。本研究回顾了有关基于辅助技术服务的商业模式的论文,以及设计这种模式以优化经济和社会价值的考虑因素。然后,它将发现应用于移动设备空间。
    在PubMed进行了系统的文献检索,WebofScience,和OVID数据库,以分析讨论用于提供辅助产品的服务交付模式的研究。归纳主题分析确定了主题,与提供服务相关的促进者和障碍。调查结果适用于移动设备服务提供。
    29篇相关论文的主题分为四类:获取(可负担性/可用性/教育),实用程序(可定制性/可用性/适应性),诚信(质量/可持续性/影响),和合规性(政策/隐私/安全)。最常见的主题是可定制性,负担能力,可用性,和教育。需要基于服务的交付模式来取代传统的基于产品的模式,和许多考虑因素来优化他们的设计。没有出版物讨论了使用现代传感器的基于服务的移动设备供应模型的设计和实现。软件和其他数字技术来优化服务。使用现代数字技术的基于服务的模型是移动设备领域的新技术,但是从其他领域可以学到很多东西。
    利用现代数字技术的基于服务的商业模式可能会改善正在进行的个人康复,但是它们对于移动设备领域来说是新的,目前缺乏研究和循证实践。系统评价发现,传感器等现代数字技术,应用程序,和人工智能可能有助于为辅助产品的用户提供持续支持和更个性化的康复。为最终用户提供持续支持,辅助产品基于服务的商业模式的成功设计应该是可访问的,无论是物质上还是经济上,以及易于定制和适应随着时间的推移。
    UNASSIGNED: Throughout the world, mobility devices are usually distributed using product-based business models, where a device is provided to a user, and serviced or replaced when the user returns to the clinic with an issue. Moving to a service-based business model can provide continuous and customised support for the user, and provide the clinicians and manufacturers with better data to base their decisions on. This study reviews papers on assistive technology service-based business models and considerations in designing such a model to optimise economic and social value. It then applies the findings to the mobility device space.
    UNASSIGNED: A systematic literature search was undertaken in PubMed, Web of Science, and OVID databases to analyse studies that discuss service delivery models used to provide assistive products. Inductive thematic analysis determined the themes, facilitators and barriers associated with providing a service. Findings were applied to mobility device service provision.
    UNASSIGNED: Themes from the 29 relevant papers were grouped into four categories: Access (affordability/availability/education), Utility (customisability/usability/adaptability), Integrity (quality/sustainability/impact), and Compliance (policy/privacy/security). The most common themes were customisability, affordability, availability, and education. There is a need for service-based delivery models to replace conventional product-based models, and many considerations to optimise their design. No publications discussed the design and implementation of a service-based model for mobility device provision that uses modern sensors, software and other digital technologies to optimise the service. Service-based models that use modern digital technologies are new for the mobility device field, but much can be learnt from other fields.
    Service-based business models that make use of modern digital technologies are likely to improve ongoing individual rehabilitation, but they are new for the mobility device field and currently lack research and evidence-based practice.The systematic review found that modern digital technologies like sensors, apps, and AI might be useful for providing ongoing support and more personalised rehabilitation for users of assistive products.To provide ongoing support for end-users, a successful design of service-based business model for assistive products should be accessible, both physically and financially, as well as easy to customise and adapt over time.
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  • 文章类型: Journal Article
    服务使用者及其家人对当前急性精神卫生服务提供中的安全性提出了担忧。尽管人们越来越意识到负面影响,但在精神卫生机构中常规使用限制性干预措施。资金不足和规避风险的管理实践是关键挑战。利用范围审查和专题分析方法,这篇综述探讨了现有的文献中的精神卫生工作者的观点在不同的设置(包括精神科病房和急诊科),关注他们限制性干预的经验。制定了四个主题:1.安全性(包括工作人员和患者);2.工作人员减少限制性干预的障碍;3.当前实践中的强度;4.更改建议。文献中的主要差距是紧急情况和危机临床医生的观点有限(尽管这些领域是使用限制性干预措施的环境)和联合卫生学科的观点有限(尽管他们在这些环境中担任临床医生)。它还注意到工作人员和患者安全之间的鸿沟,好像这些问题是相互排斥的,而不是共存的,这是经历过的现实。倡导机构,政府和媒体呼吁减少危机环境中的限制性干预。本研究综合认为,为了实现这一点,临床工作人员必须参与这一过程,并积极寻求和借鉴他们的观点,以实现改革。
    Service users and their families have raised concerns about safety in current acute mental health service delivery. Restrictive interventions are routinely used across mental health settings despite increasing awareness of the negative impacts. Underfunding and risk-averse management practices are implicated as key challenges. Utilizing a scoping review and thematic analysis method, this review explored the existing literature of mental health staff perspectives across various settings (including psychiatric wards and emergency departments), focusing on their experience of restrictive interventions. Four themes were developed: 1. Safety (both staff and patient); 2. Barriers to staff reducing their restrictive interventions; 3. Strength in current practice; 4. Recommendations for change. Key gaps in the literature were the limited perspectives of emergency and crisis clinicians (despite these areas being settings where restrictive interventions are utilized) and limited perspectives from allied health disciplines (despite their employment as clinicians in these settings). It also noted a divide between staff and patient safety, as though these concerns are mutually exclusive rather than cooccurring, which is the experienced reality. Advocacy bodies, governments and the media are calling for a reduction in restrictive interventions in crisis settings. This research synthesis proposes that, to achieve this, clinical staff must be involved in the process and their perspectives actively sought and drawn upon to enable reform.
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  • 文章类型: Systematic Review
    目的:探讨医护专业人员同情概念的含义。
    背景:同情心被普遍认为是医疗保健的基础,医疗机构的核心价值,对提供优质护理至关重要。尽管越来越多关于医疗保健中的同情心的研究,医疗保健专业人员如何理解同情仍不清楚。
    方法:根据PRISMA指南对定性研究进行了系统评价。
    方法:Medline,Emcare,PsychINFO和CINAHL被搜索到2021年11月,以英语进行定性研究,探索医疗保健专业人员对同情心的理解。在提取数据并进行主题分析之前,对纳入的研究进行了质量评估。
    结果:17篇论文符合纳入标准。一个总的主题,\“它是由价值观驱动的\”支撑着确定的四个主要主题:(1)\“它是关于人们并与他们一起工作\”:作为人类的同情心,(2)\'有这种感觉\':同情作为存在,(3)如果我不理解他们,我将无法帮助\':同情是理解,(4)“希望以某种方式提供帮助”:同情作为行动。
    结论:医疗保健专业参与者报告说,同情心是出于价值观和人文医疗保健实践固有的动机。描述的医疗保健专业的含义是多种多样的和上下文相关的。定性研究应进一步探索医疗从业者的同情经验,作为他们的实践的一部分,以告知卫生专业教育,政策,和实践。
    结论:以同情心实践,医疗保健专业人员需要支持和人性化的组织,尊重每个人的人性,并鼓励人们对彼此以及对患者具有同情心,他们的家人和/或照顾者。医疗保健专业人员需要反思同情对他们意味着什么,它是如何位于他们独特的实践背景下,以及同情心如何增强临床实践。
    本系统评价没有患者或公众贡献。
    OBJECTIVE: To explore the meaning ascribed to the concept of compassion by healthcare professionals.
    BACKGROUND: Compassion is universally regarded as the foundation of healthcare, a core value of healthcare organisations, and essential to the provision of quality care. Despite increasing research on compassion in healthcare, how healthcare professionals understand compassion remains unclear.
    METHODS: A systematic review of qualitative studies was conducted and is reported following PRISMA guidelines.
    METHODS: Medline, Emcare, PsychINFO and CINAHL were searched to November 2021 for qualitative studies in English that explored healthcare professionals\' understandings of compassion. Included studies were appraised for quality before data were extracted and thematically analysed.
    RESULTS: Seventeen papers met the inclusion criteria. An overarching theme, \'It\'s very values driven\' underpins the four main themes identified: (1) \'It\'s about people and working with them\': Compassion as being human, (2) \'There is this feeling\': Compassion as being present, (3) \'If I don\'t understand them, I won\'t be able to help\': Compassion as understanding, (4) \'Wanting to help in some way\': Compassion as action.
    CONCLUSIONS: Healthcare professional participants reported compassion as motivated by values and inherent to humanistic healthcare practice. The meanings healthcare professions described were varied and contextual. Qualitative research should further explore healthcare practitioners\' experiences of compassion as part of their practice to inform health professions education, policy, and practice.
    CONCLUSIONS: To practice with compassion, healthcare professionals require supportive and humanistic organisations that honour each person\'s humanity and encourage people to be human and compassionate to each other as well as to patients, their families and/or carers. Healthcare professionals need to reflect on what compassion means to them, how it is situated within their unique practice context, and how compassion can enhance clinical practice.
    UNASSIGNED: This systematic review had no patient or public contribution.
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