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In Hong Kong, compulsory admission is governed by the Mental Health Ordinance Section 31 (detention of a patient under observation), Section 32 (extension of period of detention for such a patient), Section 36 (detention of certified patients), and the sections in Part IV for hospital order, transfer order, and removal order. Mental health professionals adopt both legal criteria and practice criteria for compulsory admission. The present study discusses the harm principle, the patient\'s decision-making capacity, the multi-axial framework for compulsory admission, and the balance between paternalism and patient liberty.

BACKGROUND: The HONEYPOT trial failed to establish the superiority of exit-site application of Medihoney compared with nasal mupirocin prophylaxis for the prevention of peritonitis in peritoneal dialysis (PD) patients. This study aimed to assess the representativeness of the patients in the HONEYPOT trial to the Australian and New Zealand PD population.
METHODS: This study compared baseline characteristics of the 371 PD patients in the HONEYPOT trial with those of 6,085 PD patients recorded on the Australia and New Zealand Dialysis and Transplant (ANZDATA) Registry.
RESULTS: Compared with the PD population, the HONEYPOT sample was older (standardized difference [d] = 0.19, p = 0.003), more likely to be treated with automated PD (d = 0.58, p < 0.001), had higher residual renal function (d = 0.26, p < 0.001) and a higher proportion of participants with end-stage kidney disease due to polycystic kidney disease (d = 0.17) and lower proportion due to diabetes (d = -0.17) and glomerulonephritis (d = -0.18) (p < 0.001), and lower proportions of indigenous people (d = -0.17, p < 0.001), current smokers (d = -0.10, p < 0.001), and people with prior histories of hemodialysis (d = -0.16, p < 0.001), diabetes mellitus (d = -0.18, p < 0.001), and coronary artery disease (d = -0.15, p < 0.001).
CONCLUSIONS: HONEYPOT trial participants tended to be healthier than the Australian and New Zealand PD patient population. Although the differences between the groups were generally modest, it is possible that their cumulative effect may have had some impact on external generalizability, which is not an uncommon occurrence in clinical trials.

The role of nurses as patient advocates is well recognised by healthcare professionals, yet the processes and practices involved in patient advocacy are not clearly understood. A suboptimal level of advocacy is often apparent in the literature, encompassing paternalistic concepts of protecting patients from harm. This article examines the concept of patient advocacy and its relevance to nursing, associated goals and outcomes of advocacy and the processes and practices involved. It provides insights into how nurses practise patient advocacy in healthcare settings and how they may develop this role further, through formal education, workplace learning, role modelling by expert nurses and promoting an organisational culture conducive to patient advocacy.

CONCLUSIONS: The polyclinics debate should recognise the need to balance the benefits of long-term personal doctor-patient relationship with the broader improved health outcomes from evidence based inputs from multidisciplinary teams in primary care. There is increasing evidence from the international health literature that a focus on integrated health systems is the key to better health outcomes both at the individual and population levels, in addition to being more cost effective. Although there is some evidence that other healthcare professionals such as nurse practitioners can deliver equally high health outcomes for patients, the GP role is not an anachronism and even seems increasingly more important in the 21st century given the increasing complexity of primary care and long term conditions.

OBJECTIVE: To explicate nurses\' role and the underlying processes involved in advocating for safe practice in hospitals.
BACKGROUND: Nurses\' role as patient advocates in safeguarding patients\' interests and well-being is constantly upheld. As previous studies have fallen short in delineating the processes of how and in what conditions the patient advocate role is operationalized, this study was conducted to fill the evidence gap through examining nurses\' advocacy role and practices in real clinical contexts.
METHODS: A field study approach that involved multiple methods of data collection was adopted.
METHODS: This study was conducted from February 2010-March 2011 in four medical units in two public hospitals in Hong Kong. Empirical data were generated from weekly field observations, review of relevant documents and individual semi-structured interviews with 28 nurses and were then analysed through a comparative analysis process.
RESULTS: Nurses play an integral role in ensuring safe practice in hospitals through mitigating risk arising from sudden changes in patients\' health conditions and the hospitalization process and correcting near-misses for co-workers to prevent harm. The modelling of expert nurses and team-based learning emerged as essential factors facilitating the development of nurses\' advocacy role and practices. The state of \'limited advocacy\', as characterized by the adoption of disempowering and coercive measures to ensure patient safety, clearly indicates a need to re-examine the concept of advocacy in contemporary health care.
CONCLUSIONS: The findings contribute to a more complete understanding of nurses\' advocacy role and practices, which have a significant bearing on patient safety.

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OBJECTIVE: This study aimed to explore patient perception of the meaning of family involvement in elective surgery decision making in Taiwan.
BACKGROUND: Informed consent is based on respecting patient autonomy. However in cultures where family plays a key role in medical decision making, a patient\'s perspective of family involvement has not been fully investigated.
METHODS: Based on a phenomenological approach, this study conducted semistructured interviews to elicit the experiences of 10 elective surgery patients in southern Taiwan who had family present during their surgery decision making. An adapted version of Colaizzi\'s (1978) method was used to analyse narratives.
RESULTS: Three themes emerged from the elective surgery patients\' perception of the meaning of family involvement in their surgery decision-making process: (1) Primacy of family well-being, (2) family as information broker, and (3) family as patient advocate. Patients articulated reciprocal relationships amongst family members, and they expressed overall family well-being as their ultimate concern when making their treatment decision. The essence of the elective surgery patients\' perception of the meaning of family involvement in decision making was \'family as a whole\'.
CONCLUSIONS: Patients\' concern for overall family well-being and their perspective that family plays a supportive role in transmitting information and acting as patient advocate during the decision-making process may both enhance and restrict individual patient autonomy. In cultures where family is central in decision making, appropriately involving the family in medical decisions should not be overlooked.
CONCLUSIONS: Understanding and acknowledging the important roles of family in medical decision making from the patients\' perspective can enable health professionals to more effectively communicate with patients and their family. Then, health professionals can empower the individual who is making the medical decision based on his or her own needs.

This paper explores the way that patient participation has increased in dentistry in recent years and introduces the two concepts of \'quality of life\' and \'patient satisfaction\' and examines their relevance to everyday clinical dental practice.