healthcare outcomes

医疗保健结果
  • 文章类型: Journal Article
    这项研究的目的是系统地回顾良性妇科疾病患者的低健康素养与患者报告结局之间的关系。在这个特定的人群中,我们还试图确定目前报告的低健康素养患病率,检查可能与低健康素养有关的人口统计学特征,并整理文献中描述的任何健康素养干预措施。MEDLINE(医学文献分析与检索系统)的系统搜索,Embase,科克伦图书馆,WebofScience,PubMed,和clinicaltrials.gov于2021年7月12日进行,并于2023年10月13日重复了与健康素养相关的术语,具体的健康素养措施,和良性妇科疾病。有语言或出版期限的限制。纳入需要主要文献来报告健康素养和患者报告的结果之间的关联。使用经过验证的工具来定量测量每一个,在患有良性妇科疾病的成年女性中。标题筛选,抽象筛选,并使用Covidence软件进行全文审查(墨尔本,澳大利亚)协助审查进程。在使用我们的搜索策略返回的18,701项研究中,选择25人进行全文审查。其中,没有研究符合纳入标准,并且报告了健康素养与患者报告结局之间的关联.这项研究在文献中发现了很大的差距。未来的工作应旨在评估良性妇科中健康素养与患者报告结果之间的关联,以告知以患者为中心的干预措施和护理提供。
    The objective of this study was to systematically review the relationship between low health literacy and patient-reported outcomes in patients with benign gynecologic conditions. In this specific population, we also sought to determine the current reported prevalence of low health literacy, examine demographic characteristics that may be related to low health literacy, and collate any health literacy interventions described in the literature. A systematic search of MEDLINE (Medical Literature Analysis and Retrieval System Online), Embase, The Cochrane Library, Web of Science, PubMed, and clinicaltrials.gov was performed on July 12, 2021, and repeated on October 13, 2023, for terms related to health literacy, specific health literacy measures, and benign gynecologic conditions. There were language or publication period restrictions. Inclusion required primary literature to report associations between health literacy and patient-reported outcomes, using validated tools to quantitatively measure each, in adult women with benign gynecologic conditions. Title screening, abstract screening, and full-text review were conducted with Covidence software (Melbourne, Australia) assisting with the review process. Of the 18,701 studies returned using our search strategy, 25 were selected for full-text review. Of these, no studies met inclusion criteria and reported an association between health literacy and patient-reported outcomes. This study identified a large gap in the literature. Future work should be directed at evaluating the association between health literacy and patient-reported outcomes in benign gynecology to inform patient-centered interventions and care provision.
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  • 文章类型: Journal Article
    大部分镰状细胞病(SCD)患者被确定为黑人或非裔美国人(AA)。如果不考虑种族/文化认同的影响,就不可能探索SCD儿童医疗保健结果中的社会偏见和污名。社会经济地位(SES),和地理。重要的是要了解当前社会运动的影响,扩大医疗保险覆盖面,在考虑SCD患者的医疗结果时,这些变量的远程医疗。这项研究的目的是确定种族认同的作用,SES,和地理在美国SCD儿童儿科人群的医疗保健结果(US)。本研究是根据系统审查和荟萃分析(PRISMA)指南的首选报告项目进行的范围审查。使用的数据库包括Cochrane,CINHAL,Medline,和护理和联合健康收藏,全部通过EBSCO信息服务访问。研究符合以下纳入标准:以英语出版,居住在美国的儿科患者,并在2017年至2022年之间发布。搜索词包括“镰状细胞”和“儿科”,然后将其与“少数民族”或“种族”或“农村”或“城市”或“贫困”或“收入”或“社会经济地位”相结合。最初的搜索产生了635篇独特的文章,17篇文章符合完全纳入标准。总的来说,很明显,有种族积极影响的例子,低SES,和农村地理位置对积极健康结果的影响,尽管大量研究在显示负相关或根本没有关联之间摇摆不定。护理SCD患者的障碍是多方面的,这使得难以分离和分析单个变量的影响。许多研究证明了家庭的重要性,社区,和机构关系作为对SCD患者的积极支持。这篇综述强调了对患者/家族支持小组的医疗保健结果益处进行额外研究的必要性,目的是将具有种族经验和SCD诊断的患者聚集在一起,无论SES和地理位置如何。
    A large proportion of patients with sickle cell disease (SCD) identify as Black or African American (AA). Social bias and stigma in healthcare outcomes for children with SCD are impossible to explore without considering the impact of racial/cultural identity, socioeconomic status (SES), and geography. It is important to understand the current influences of social movements, expanded health insurance coverage, and telehealth on these variables when considering healthcare outcomes for patients with SCD. The objective of this study was to determine the roles of racial identity, SES, and geography in healthcare outcomes for the pediatric population of children with SCD in the United States (US). This study is a scoping review following Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines. The databases utilized included Cochrane, CINHAL, Medline, and Nursing and Allied Health Collection, all accessed through the EBSCO Information Services. Studies met the following inclusion criteria: published in English, pediatric patients residing in the US, and published between 2017 and 2022. Search terms included \"sickle cell\" AND \"pediatric\", which were then combined with \"minority\" OR \"racial\" OR \"rural\" OR \"urban\" OR \"poverty\" OR \"income\" OR \"socioeconomic status\". The initial search yielded 635 unique articles, with 17 articles meeting full inclusion criteria. Overall, it was clear that there are examples of positive effects of race, low SES, and rural geographic location on positive health outcomes, though a large number of studies oscillated between showing negative associations or no association at all. Barriers to care for patients with SCD are multifaceted, making it difficult to isolate and analyze the impact of individual variables. Many studies demonstrated the significance of family, community, and institutional relationships as positive support for patients with SCD. This review highlights the need for additional research on the healthcare outcome benefits of patient/familial support groups aiming to bring together patients who share racial experience and SCD diagnosis regardless of SES and geography.
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  • 文章类型: Journal Article
    在美国,大多数英语水平有限(LEP)的人都是外国出生的,创造了复杂的语言交集,社会经济,以及医疗服务获取和取得良好成果的政策障碍。绘制研究文献是解决LEP如何与医疗保健相交的关键。此范围审查遵循PRISMA-ScR指南,包括PubMed/MEDLINE,CINAHL,社会学文摘,EconLit,和学术搜索总理。研究选择包括自2000年以来的定量研究,其结果指定为居住在美国的LEP成年人与医疗保健服务获取或定义的健康结果有关。包括医疗费用。共有137篇文章符合纳入标准。主要结果包括门诊护理,住院治疗,筛选,具体条件,和一般健康。总的来说,文献发现,与精通英语的人群相比,LEP人群在多种模式下获得和利用医疗保健方面存在差异,结果较差.当前的研究包括对LEP种群的不一致定义,主要是横断面研究,小样本量,以及同质的语言和区域样本。当前的法规和实践不足以解决LEP个人在获得医疗保健和结果方面面临的障碍。需要对EMR和其他数据收集进行更改,以一致地包括LEP状态和更严格的方法研究,以解决LEP个人的医疗保健差异。
    A majority of individuals with limited English proficiency (LEP) in the U.S. are foreign-born, creating a complex intersection of language, socio-economic, and policy barriers to healthcare access and achieving good outcomes. Mapping the research literature is key to addressing how LEP intersects with healthcare. This scoping review followed PRISMA-ScR guidelines and included PubMed/MEDLINE, CINAHL, Sociological Abstracts, EconLit, and Academic Search Premier. Study selection included quantitative studies since 2000 with outcomes specified for adults with LEP residing in the U.S. related to healthcare service access or defined health outcomes, including healthcare costs. A total of 137 articles met the inclusion criteria. Major outcomes included ambulatory care, hospitalization, screening, specific conditions, and general health. Overall, the literature identified differential access to and utilization of healthcare across multiple modalities with poorer outcomes among LEP populations compared with English-proficient populations. Current research includes inconsistent definitions for LEP populations, primarily cross-sectional studies, small sample sizes, and homogeneous language and regional samples. Current regulations and practices are insufficient to address the barriers that LEP individuals face to healthcare access and outcomes. Changes to EMRs and other data collection to consistently include LEP status and more methodologically rigorous studies are needed to address healthcare disparities for LEP individuals.
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  • 文章类型: Journal Article
    研究人员和政策制定者之间正在就如何使透明度成为医疗保健系统的强大工具进行辩论。这项研究探讨了有关普通人群的医疗服务信息的可用性和可及性如何影响俄罗斯的医疗保健结果。根据系统审查和荟萃分析(PRISMA)指南的首选报告项目进行系统审查和报告。还审查了世界上最有效的医疗保健系统中使用的卫生设施的透明度指标。尽管提高俄罗斯医疗系统的透明度被认为是提高效率的工具,在提高实际透明度方面做得很少。俄罗斯医疗保健系统的现有制度细节对可接受的透明度水平施加了严重限制。在回顾的俄罗斯实证研究中,透明度通常被简单地视为医疗机构网站上提供的信息或与强制性医疗统计报告的可访问指标数量有关的问题。这项研究的新颖之处在于(a)审查有关该主题的最新研究,以及(b)在分析中包括俄语研究。我们详细阐述了改善俄罗斯医疗系统透明度驱动成果的一般和具体政策含义。
    There is an ongoing debate among researchers and policy-makers on how to make transparency a powerful tool of healthcare systems. This study addresses how the availability and accessibility of information about medical services to the general population affects healthcare outcomes in Russia. A systematic review was conducted and reported according to the Preferred Reporting Items for Systematic Reviewing and Meta-Analysis (PRISMA) guidelines. Transparency indicators of health facilities used in the world\'s most efficient healthcare systems are also reviewed. Although the increase of transparency in the Russian healthcare system is considered as a tool for improving its efficiency, very little has been done to improve the actual level of transparency. The existing institutional specifics of the Russian healthcare system impose serious restrictions on acceptable levels of transparency. In the reviewed empirical Russian studies, transparency is often viewed simplistically as either information available on the websites of medical organizations or issues related to the amount of accessible indicators of compulsory medical statistical reporting. The novelty of this study consists in (a) reviewing the most recent studies on the topic and (b) including studies in Russian in the analysis. We elaborate on general and specific policy implications for improving transparency-driven outcomes in the Russian healthcare system.
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  • 文章类型: Review
    背景:这篇综合综述旨在了解护理对阿片类药物使用障碍(OUD)患者健康结局的影响。
    方法:Whittemore和Knafl\(2005)的综合审查方法指导了审查过程。作者搜索PubMed,护理和相关健康文献累积指数(CINAHL),和OVID数据库供同行评审,英语文章描述了接受OUD药物治疗的人的护理。文献检索遵循系统评价和荟萃分析(PRISMA)指南的首选报告项目。
    结果:删除重复项后,通过数据库搜索确定了773篇文章;15篇文章符合纳入标准,并被纳入美国的最终审查,加拿大,爱尔兰,英格兰,和荷兰。出现了两个主题:(1)护士主导的护理对患者预后的影响;(2)护理角色和护理环境。研究强调了促进以患者为中心和患者满意度的护理方面。
    结论:注册护士在为接受OUD药物治疗的患者提供优质护理方面的重要性从文献综述中显而易见。审查中的研究强调了注册护士在影响接受OUD药物治疗的患者结局方面的重要作用,包括沟通和护理协调。
    结论:这篇综述强调了在OUD治疗环境中需要角色划分和进一步开发护士敏感指标的必要性。
    This integrative review aimed to understand the impact of nursing on the health outcomes of people with opioid use disorder (OUD).
    Whittemore and Knafl\'s (2005) integrative review methodology guided the review process. The authors searched PubMed, the Cumulative Index to Nursing and Allied Health Literature (CINAHL), and OVID databases for peer-reviewed, English language articles describing nursing care for people receiving medications for OUD. The literature search followed the Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guidelines.
    A total of 773 articles were identified through the database searches after duplicates were removed; 15 articles met inclusion criteria and were included in the final review from the United States, Canada, Ireland, England, and the Netherlands. Two themes emerged: (1) The effect of nurse-led care on patient outcomes and (2) Nursing roles and the environment of care. Studies emphasized the aspects of nursing care that promote patient-centeredness and patient satisfaction.
    The importance of the registered nurse in providing quality care for people receiving medications for OUD is clear from the literature reviewed. The studies in the review highlighted important aspects of the registered nurses\' role in affecting outcomes for people receiving medications for OUD including communication and care coordination.
    This review highlights the need for role delineation and further development of nurse-sensitive indicators in the OUD treatment setting.
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  • 文章类型: Journal Article
    BACKGROUND: Postoperative delirium is the most common complication of surgery particularly in older patients.
    OBJECTIVE: The current study aimed to summarize the commonly used delirium assessment tools in assessing postoperative delirium (POD) and to estimate the incidence rates of POD.
    METHODS: A systematic review that included empirical cohort studies reporting the use of delirium assessment tools in assessing POD between 2000 and 2019. Five core databases were searched for eligible studies. The methodological quality assessment of the included studies was undertaken using the Joanna Briggs Institute (JBI) critical appraisal checklist to examine the risk of bias. Pooled incidence estimates were calculated using a random effects model.
    RESULTS: Nineteen studies with a total of 3,533 postsurgery older patients were included in this review. The confusion assessment method (CAM) and CAM-ICU were the most commonly used tools to assess POD among older postoperative patients. The pooled incidence rate of POD was 24% (95% CI [0.20, 0.29]). The pooled incidence estimates for mixed (noncardiac) surgery, orthopedic surgery, and tumor surgery were 23% (95% CI [0.15, 0.31]), 27% (95% CI [0.20, 0.33]), and 19% (95% CI [0.15, 0.22]), respectively. More than 50% of included studies used CAM to assess POD in different types of postoperative patients. Using CAM to assess delirium is less time-consuming and it was suggested as the most efficient tool for POD detection.
    UNASSIGNED: We identified that CAM could be implemented in different settings for assessing POD. The incidence and risk factors for POD introduced can be used for future research to target these potential indicators. The incidence rate, risk factors, and predictors of POD explored can provide robust evidence for clinical practitioners in their daily practice.
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