patient-centered care

以患者为中心的护理
  • 文章类型: Journal Article
    可穿戴技术已经成为医疗保健领域的强大工具,在传统临床环境之外提供持续监测和个性化见解。这些设备因其改变患者护理和改善预后的潜力而在心血管医学中引起了极大的关注。这篇全面的综述概述了可穿戴技术的发展,进步,以及在心血管医学中的应用。我们研究传感器的小型化,集成人工智能(AI),以及远程患者监测解决方案的激增。主要发现包括可穿戴设备在早期发现心血管疾病中的作用,个性化健康跟踪,和远程患者管理。数据隐私问题和监管障碍等挑战也得到了解决。可穿戴技术的采用有望将医疗保健从被动转变为主动,实现精确诊断,治疗优化,和预防策略。医疗保健利益相关者之间的合作对于充分发挥可穿戴设备在心血管医学领域的潜力和开创个性化的新时代至关重要。积极的医疗保健。
    Wearable technologies have emerged as powerful tools in healthcare, offering continuous monitoring and personalized insights outside traditional clinical settings. These devices have garnered significant attention in cardiovascular medicine for their potential to transform patient care and improve outcomes. This comprehensive review provides an overview of wearable technologies\' evolution, advancements, and applications in cardiovascular medicine. We examine the miniaturization of sensors, integration of artificial intelligence (AI), and proliferation of remote patient monitoring solutions. Key findings include the role of wearables in the early detection of cardiovascular conditions, personalized health tracking, and remote patient management. Challenges such as data privacy concerns and regulatory hurdles are also addressed. The adoption of wearable technologies holds promise for shifting healthcare from reactive to proactive, enabling precision diagnostics, treatment optimization, and preventive strategies. Collaboration among healthcare stakeholders is essential to harnessing the full potential of wearables in cardiovascular medicine and ushering in a new era of personalized, proactive healthcare.
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  • 文章类型: Journal Article
    一致性的概念及其用法表明了以患者为中心的医疗保健,这鼓励患者和临床医生之间的公平合作。然而,在理解一致性方面缺乏清晰度,对这个概念进行分析是有必要的。
    本文旨在探索医疗保健背景下的一致性概念的本质。
    采用了Walker和Avant的八步概念分析方法。使用一致性和一致性作为CINAHL的关键词进行文献检索,MEDLINE,PubMed,ProQuest,Cochrane数据库,和ScienceDirect数据库,2006年至2022年出版。
    协调的属性包括通信过程,治疗伙伴关系,并就治疗方案达成一致。一致性的前提包括提供者与病人的关系,病人的信念,医疗保健提供者的特征,以及治疗计划的复杂性。后果是提高依从性和合规性,改善临床结果,和更好的生活质量。
    本文通过介绍其前身来澄清一致性,属性,和后果。这些发现是制定评估和护理干预措施以促进患者和谐的基础。护士可以利用这些发现,通过在健康遭遇期间建立一种信任的关系来鼓励和谐,这种关系尊重患者的信念,并有效地进行沟通,以提高患者在处理复杂治疗计划时的理解。
    UNASSIGNED: The concept of concordance and its usage are indicative of patient-centered healthcare, which encourages an equitable collaboration between patients and clinicians. However, there is a lack of clarity in understanding concordance, and an analysis of this concept is warranted.
    UNASSIGNED: This paper seeks to explore the essence of the concordance concept in the healthcare context.
    UNASSIGNED: Walker and Avant\'s eight-step method of concept analysis was applied. A literature search was conducted using concordance AND concord as keywords on CINAHL, MEDLINE, PubMed, ProQuest, Cochrane database, and ScienceDirect databases, published between 2006 and 2022.
    UNASSIGNED: The attributes of concordance include communication process, therapeutic partnership, and agreement on treatment regimens. Antecedents of concordance comprise provider-patient relationship, patients\' beliefs, healthcare providers\' characteristics, and complexity of treatment plans. Consequences are improved adherence and compliance, improved clinical outcomes, and better quality of life.
    UNASSIGNED: This paper offers clarification of concordance by presenting its antecedents, attributes, and consequences. The findings serve as a basis for developing assessments and nursing interventions to promote patient concordance. Nurses can use the findings to encourage concordance by establishing a trusty relationship during health encounters that respects patients\' beliefs and effectively communicating to improve patients\' understanding in dealing with complex treatment plans.
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  • 文章类型: Journal Article
    有效的沟通在护理中至关重要,影响患者安全,满意,和护理质量。AIDET框架是一种行之有效的工具,可减少患者的焦虑并增强他们的体验。然而,菲律宾护理学生与AIDET的看法和经验仍未探索。
    这项研究探索了菲律宾护理专业学生对AIDET的使用,注重效益,挑战,和改进。
    定性的,采用了马丁·海德格尔哲学的解释性现象学方法。这项2023年的研究,在安吉利斯市的一所大学进行,菲律宾,探索菲律宾护理学生与AIDET沟通框架的经验。根据半结构化访谈指南,有目的地选择了30名参与者参加便利的讨论。对转录录音的主题内容分析确定了他们叙述中反复出现的主题,专注于他们使用AIDET的经历所赋予的含义。
    出现了四个主题:(a)简化的护士与患者的互动(组织沟通,融洽的建筑,缓解焦虑,承认,和赋权作为子主题),(b)加强以病人为中心的护理(同情和同情,改善患者体验作为子主题),(c)特定患者人群的挑战(患者偏好、语言障碍,患者状况,承认文化差异为子主题),(d)AIDET在护理教育中通过实践加强应用,优化频率和定时,促进更深入的理解,加强反馈机制)作为学生护士的建议。
    AIDET在护理教育中的早期整合对于学生护士加强沟通至关重要,提高患者满意度,并提供以患者为中心的护理,为他们提供宝贵的沟通技巧。
    UNASSIGNED: Effective communication is vital in nursing, influencing patient safety, satisfaction, and care quality. The AIDET framework is a proven tool for reducing patient anxiety and enhancing their experience. However, perceptions and experiences of Filipino nursing students with AIDET remain unexplored.
    UNASSIGNED: This study explored Filipino nursing students\' use of AIDET, focusing on benefits, challenges, and improvements.
    UNASSIGNED: A qualitative, interpretive phenomenological approach informed by the philosophy of Martin Heidegger was employed. This 2023 study, conducted at a university in Angeles City, Philippines, explored Filipino nursing students\' experiences with the AIDET communication framework. Thirty participants were purposefully selected to participate in facilitated discussions following a semi-structured interview guide. Thematic content analysis of the transcribed audio recording identified recurring themes in their narratives, focusing on the meanings they ascribed to their experiences using AIDET.
    UNASSIGNED: Four themes emerged: (a) Streamlined nurse-patient interaction (organizes communication, rapport building, alleviate anxiety, acknowledgment, and empowerment as sub-themes), (b) Enhances patient-centered care (empathy and compassion, improved patient experience as sub-topics), (c) Challenges with specific patient populations (patient preferences, language barrier, patient condition, acknowledgment of cultural differences as sub-themes), and (d) AIDET in nursing education strengthening application through practice, optimizing frequency and timing, promoting deeper understanding, enhancing feedback mechanism) as student nurses\' recommendations.
    UNASSIGNED: Early integration of AIDET in nursing education is essential for student nurses to enhance communication, improve patient satisfaction, and deliver patient-centered care, equipping them with valuable communication skills.
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  • 文章类型: Journal Article
    这项研究调查了加纳KomfoAnokye教学医院的高级护理计划(ACP)对慢性肾脏疾病(CKD)患者生活质量的影响。它专门调查了患者对ACP准备情况的看法。利用定性的描述性设计,在肾脏诊所对CKD患者进行了一对一的访谈,采用半结构化访谈指南对音频数据进行主题分析。研究结果揭示了CKD患者之间的理解差距,参与者承认他们容易患肾衰竭,通常与糖尿病和高血压病史有关。尽管认识到潜在的结果,如透析依赖或死亡,一些患者保留了治愈的希望,依靠信仰。最初的肾衰竭诊断引起休克和痛苦,导致许多患者更喜欢舒适和熟悉的家庭护理,包括透析.同时,少数人赞成医院护理,以保护他们的孩子免受心理创伤。大多数患者认为法律准备是不必要的,以资产有限或对死后遗产执行缺乏担忧为由。这些见解强调了在ACP中进行有针对性的教育和支持的必要性,以提高患者在慢性肾脏病护理和临终计划中的预后。
    This study examined the impact of advance care planning (ACP) on the quality of life for patients with chronic kidney disease (CKD) at Komfo Anokye Teaching Hospital in Ghana. It specifically investigated patients\' perspectives on their readiness for ACP. Utilizing a qualitative descriptive design, one-on-one interviews were conducted with CKD patients at the renal clinic, employing a semi-structured interview guide for thematic analysis of audio data. The findings revealed a gap in understanding among CKD patients, with participants acknowledging their vulnerability to renal failure, often linked to a medical history of diabetes and hypertension. Despite recognizing potential outcomes such as dialysis dependency or death, some patients retained hope for a cure, relying on faith. The initial kidney failure diagnosis induced shock and distress, leading many patients to prefer the comfort and familiarity of home-based care, including dialysis. Meanwhile, a minority favored hospital care to protect their children from psychological trauma. Most patients deemed legal preparations unnecessary, citing limited assets or a lack of concern for posthumous estate execution. These insights emphasize the necessity for targeted education and support in ACP to enhance patient outcomes in chronic kidney disease care and end-of-life planning.
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  • 文章类型: Editorial
    暂无摘要。
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  • 文章类型: Journal Article
    背景:基于体验的协同设计(EBCD)是一个多阶段参与行动研究过程,最初是为了增加患者对服务改进计划的参与而开发的。这篇观点文章是对研究人员经验的反思,侧重于参与性方法的应用和可行性,特别是共同设计,在早期临床试验的特定背景下。
    方法:我们反思了在肿瘤学早期临床试验的新背景下应用EBCD的机遇和挑战,其中实验性治疗越来越被视为一种治疗选择,在某些情况下,它们的有效性可能会导致加速批准,从而促进更快地整合到标准护理中。
    结果:我们建议在此类试验中应用EBCD的机会在于改善以人为中心的护理的交付,护理协调,在从实验到标准护理的过渡过程中提供支持。讨论了在早期临床试验中应用EBCD时的三个潜在挑战,这些挑战涉及:试验过程中标准化的需求;在高度不确定性的背景下规划EBCD;和患者人群的脆弱性。
    结论:将EBCD纳入早期肿瘤学试验为加强以人为中心的护理提供了机会,并可导致护理过程和治疗发展的同步改善。
    本文是与一位患者合作伙伴合作开发的,该合作伙伴在我们正在进行的EBCD研究的早期临床试验中担任顾问委员会成员。
    BACKGROUND: Experience-Based Co-Design (EBCD) is a multi-stage participatory action research process which was developed originally to increase patient involvement in service improvement initiatives. This viewpoint article serves as a reflection on the researchers\' experiences, focusing on the application and feasibility of participatory approaches, particularly co-design, in the specific context of early-phase clinical trials.
    METHODS: We reflect on the opportunities and challenges of applying EBCD in a new context of early-phase clinical trials in oncology where experimental treatments are increasingly perceived as a therapeutic option and, in certain instances, their efficacy may lead to accelerated approval facilitating a swifter integration into standard care.
    RESULTS: We propose that the opportunity of applying EBCD in such trials lies in improving the delivery of person-centered care, care coordination, and support during the transition from experimental to standard care. Three potential challenges when applying EBCD in early-phase clinical trials are discussed related to: the need for standardization in trial processes; planning EBCD in a context of high uncertainty; and vulnerability of patient populations.
    CONCLUSIONS: Integrating EBCD into early-phase oncology trials presents an opportunity to enhance person-centered care and can lead to simultaneous improvements in care processes and therapeutic development.
    UNASSIGNED: This article has been developed with the collaboration of a patient partner who serves on the advisory board of our ongoing EBCD study in early clinical trials.
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  • 文章类型: Journal Article
    正在收集越来越多的关于一个人的日常功能的数据,它拥有信息来彻底改变以人为本的医疗保健。然而,关于日常运作的数据的全部潜力还不能被利用,因为它大多以非结构化和不可访问的方式存储。这些数据的整合,从而加快了知识发现,通过引入功能组学作为补充“组学”倡议是可能的,拥抱数据科学的进步。功能组学是研究一个人的日常功能的高通量数据,可以通过国际功能分类来实施,残疾与健康(ICF)。使功能组学具有可操作性的先决条件是FAIR(Findable,可访问,互操作,和可重用)原则。本文说明了FAIR原理的逐步应用,使功能组学数据机器可读和可访问,在严格认证的条件下,在一个实际的例子中。建立更多的FAIR功能组学数据存储库,使用联合数据基础设施进行分析,使新一代知识能够改善健康和以人为中心的医疗保健。一起,作为一个联合健康和医疗保健研究社区,我们需要考虑采用这里提出的方法。
    An ever-increasing amount of data on a person\'s daily functioning is being collected, which holds information to revolutionize person-centered healthcare. However, the full potential of data on daily functioning cannot yet be exploited as it is mostly stored in an unstructured and inaccessible manner. The integration of these data, and thereby expedited knowledge discovery, is possible by the introduction of functionomics as a complementary \'omics\' initiative, embracing the advances in data science. Functionomics is the study of high-throughput data on a person\'s daily functioning, that can be operationalized with the International Classification of Functioning, Disability and Health (ICF).A prerequisite for making functionomics operational are the FAIR (Findable, Accessible, Interoperable, and Reusable) principles. This paper illustrates a step by step application of the FAIR principles for making functionomics data machine readable and accessible, under strictly certified conditions, in a practical example. Establishing more FAIR functionomics data repositories, analyzed using a federated data infrastructure, enables new knowledge generation to improve health and person-centered healthcare. Together, as one allied health and healthcare research community, we need to consider to take up the here proposed methods.
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  • 文章类型: Journal Article
    尽管人们越来越担心避孕方面的胁迫,很少有研究描述了它的频率和表现。Further,没有确定的定量方法来测量这种结构。我们开始通过详细说明避孕胁迫经历的细微差别并测试一种新颖的措施来填补这一空白:避孕护理清单中的胁迫。在2023年初,我们调查了美国生育年龄的人,他们在出生时被分配给女性,了解他们的避孕护理。我们在样本中描述了避孕胁迫的频率(N=1197),并使用开放式描述来证明这些经验中的细微差别。最后,我们首次发布了检查表,并提供了心理测试结果。在曾经与医疗保健提供者谈论避孕的人中,超过六分之一(18.46%)的参与者报告说,在他们上次的避孕咨询中经历了胁迫,超过三分之一(42.27%)的人在他们一生的某个时候报告了这一情况。使用或继续使用避孕药是患者报告的最常见的胁迫形式(终生频率为14.62%)。因子分析支持避孕护理清单中强制的双因素维度。项目间相关性有统计学意义(p<0.001),提供可靠性的证据。该清单还与计划生育护理的质量指标有关(向下胁迫:t[1194]=7.54,p<0.001;向上胁迫:t[1194]=14.76,p<0.001)和医疗保健中的歧视(向下胁迫:t[1160]=-14.77,p<0.001;向上胁迫:t[1160]=-18.27,p<0.001),提供结构效度的证据。研究结果提供了有关避孕胁迫的频率和表现的关键信息。心理测试揭示了避孕护理清单中强制性有效性的证据,可靠性,和维度,同时也为未来的测试和改进提供了途径。
    Despite growing concerns over coercion in contraceptive care, few studies have described its frequency and manifestations. Further, there is no established quantitative method of measuring this construct. We begin to fill this gap by detailing nuance in contraceptive coercion experiences and testing a novel measure: the Coercion in Contraceptive Care Checklist. In early 2023, we surveyed reproductive-aged people in the United States who were assigned female at birth about their contraceptive care. We describe the frequency of contraceptive coercion in our sample (N = 1197) and use open-ended descriptions to demonstrate nuances in these experiences. Finally, we debut our checklist and present psychometric testing results. Among people who had ever talked to a healthcare provider about contraception, over one in six participants (18.46%) reported experiencing coercion during their last contraceptive counseling, and over one in three (42.27%) reported it at some point in their lifetime. Being made to use or keep using birth control pills was the most common form of coercion reported by patients (14.62% lifetime frequency). Factor analysis supported the two-factor dimensionality of the Coercion in Contraceptive Care Checklist. Inter-item correlations were statistically significant (p < 0.001), providing evidence of reliability. The checklist was also related to measures of quality in family planning care (downward coercion: t[1194] = 7.54, p < 0.001; upward coercion: t[1194] = 14.76, p < 0.001) and discrimination in healthcare (downward coercion: t[1160] = -14.77, p < 0.001; upward coercion: t[1160] = -18.27, p < 0.001), providing evidence of construct validity. Findings provide critical information about the frequency and manifestations of contraceptive coercion. Psychometric tests reveal evidence of the Coercion in Contraceptive Care Checklist\'s validity, reliability, and dimensionality while also suggesting avenues for future testing and refinement.
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  • 文章类型: Journal Article
    背景:痴呆症护理管理是一种基于证据的护理模式。它已证明其功效和成本效益,并已应用于不同的环境和不同的目标群体。然而,它在德国的日常护理中是不可用的。科学证据影响了国家痴呆症战略,其中一项措施是检查将其实施为常规护理的可能性和要求。这项研究的目的是在德国选定的地区将痴呆症护理管理纳入常规护理中,并评估对参与者的影响。
    方法:为期12个月,n=90名患有认知障碍的患者及其非正式护理人员在初级保健的不同常规环境中招募(综合医院,医生网络,门诊护理服务,咨询服务)由初级保健伙伴提供。他们使用参与式方法接受适应特定环境的痴呆症护理管理(DeCM)。DeCM由专门合格的痴呆症护理管理人员提供,包括对医疗保健需求的全面评估,然后在医疗保健计划中提供基于算法和基于人员的支持。实施和监测。干预的持续时间为6个月,并且在(基线)之前进行数据评估,在结束时(随访1,FU1)和干预结束后6个月(随访2,FU2)。主要结果是FU1和FU2的未满足需求。次要结果是抗痴呆药物治疗,FU1和FU2的神经精神症状和照顾者负担。进一步的结果是认知,虚弱和健康相关的生活质量。一个单独的过程评估伴随着实施。
    背景:大学医学伦理委员会Greifswald,德国,已审查并批准该研究(注册号BB110/22)。所有参与者在参与前提供书面知情同意书。结果将在区域讲习班上传播,按,在线媒体和谈话。它们将提交给国际同行评审的科学期刊发表,并在科学会议上发表。此外,结果将与资助者讨论,并提交给国家痴呆症战略指导委员会。
    背景:NCT05529277。
    BACKGROUND: Dementia Care Management is an evidence-based model of care. It has proven its efficacy and cost-effectiveness and has been applied to different settings and different target groups. However, it is not available in routine care in Germany. The scientific evidence has influenced the National Dementia Strategy, in which one measure is to examine the possibility and requirements to implement it into routine care. The aim of this study is to implement Dementia Care Management into routine care in a selected region in Germany and evaluate the effect on participants.
    METHODS: For the duration of 12 months, n=90 patients and their informal caregivers with cognitive impairment are recruited in different routine settings in primary care (general hospital, physicians\' network, ambulatory nursing service, counselling service) by partners in primary care. They receive an adapted Dementia Care Management (DeCM) to the specific setting using participatory methods. DeCM is delivered by specifically qualified dementia care managers and consists of a comprehensive assessment of healthcare needs followed by algorithm-based and person-based support in healthcare planning, implementing and monitoring. The duration of the intervention is 6 months and data assessments are conducted prior to (baseline), at the end of (follow-up 1, FU1) and 6 months after the end of the intervention (follow-up 2, FU2). Primary outcomes are unmet needs at FU1 and FU2. Secondary outcomes are antidementia drug treatment, neuropsychiatric symptoms and caregiver burden at FU1 and FU2. Further outcomes are cognition, frailty and health-related quality of life. A separate process evaluation accompanies the implementation.
    BACKGROUND: The Ethics Committee of University Medicine Greifswald, Germany, has reviewed and approved the study (registration number BB110/22). All participants provide written informed consent prior to participation. The results will be disseminated in regional workshops, press, online media and talks. They will be submitted to international peer-reviewed scientific journals for publication and presented at scientific meetings and conferences. Furthermore, results will be discussed with the funder and presented to the steering committee of the National Dementia Strategy.
    BACKGROUND: NCT05529277.
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  • 文章类型: Journal Article
    背景:心血管疾病仍然是全球死亡的主要原因。从心肌梗塞中恢复具有挑战性,因为症状的原因涵盖了健康的多个方面,而不仅仅是身体状况。证据表明,在临床环境中提供的方式与人的需求和偏好之间存在差距。实施以人为中心的护理(PCC)干预措施可以通过更好地了解患者的感知及其在整个康复过程中的作用来促进心肌梗死的恢复。这项研究旨在在文化上适应基于证据的PCC干预措施,以增强葡萄牙医疗保健背景下心肌梗死后患者的自我效能。
    方法:葡萄牙以人为中心的心肌梗死恢复期护理(P2MIR)干预措施将由循证干预措施发展而来。植根于PCC的伦理。PCC对急性冠脉综合征患者的干预,已在瑞典医疗保健环境中成功实施和评估的内容将得到验证,通过使用定性方法,在文化上适应和协调葡萄牙的医疗保健环境。为了评估其可接受性,适当性和可行性,利益相关者的样本,由医护人员样本和心肌梗塞患者样本组成,将从医院招募,包括住院部和门诊部。利益相关者将被邀请参加半结构化焦点小组讨论,旨在收集他们对P2MIR干预的看法,这将在之前提交给他们。数据分析将使用内容分析按照演绎归纳的方法进行,以进一步告知干预适应过程,以在葡萄牙医疗保健背景下进行最终干预。
    背景:该研究已获得里斯本中央医院健康伦理委员会的审查和批准,里斯本,葡萄牙(登记号20170700050)。结果将通过同行评审的期刊和会议介绍进行传播。
    BACKGROUND: Cardiovascular diseases remain a leading cause of death worldwide. Recovery from myocardial infarction is challenging as the causes of symptoms span multiple aspects of health not just physical conditions. Evidence has shown a gap between the waycare is provided in the clinical setting and the person\'s needs and preferences. The implementation of person-centred care (PCC) interventions can promote recovery from myocardial infarction by allowing a greater understanding of the person\'s perception and its role on the overall recovering process. This study aims to culturally adapt an evidence-based PCC intervention to enhance self-efficacy in patients after myocardial infarction within a Portuguese healthcare context.
    METHODS: The Portuguese person-centred care for myocardial infarction recovery (P2MIR) intervention is set to be developed from an evidence-based intervention, rooted in the ethics of PCC. An intervention of PCC for patients with acute coronary syndrome, which has been successfully implemented and evaluated in the Swedish healthcare context will be validated, culturally adapted and harmonised to the Portuguese healthcare context by using qualitative methods. To evaluate its acceptability, appropriateness and feasibility, a sample of stakeholders, consisting of a sample of healthcare professionals and a sample of people who suffered a myocardial infarction, will be recruited from a hospital, including both inpatient and outpatient departments. The stakeholders will be invited to semistructured focus group discussions, aiming to gather their perceptions about the P2MIR intervention, which will be previously presented to them. Data analysis will be conducted using content analysis following a deductive-inductive approach to further inform the intervention adaptation process to its final intervention in a Portuguese healthcare context.
    BACKGROUND: The study has been reviewed and approved by the Health Ethics\' Committees of the Centro Hospitalar Lisboa Ocidental, Lisbon, Portugal (registry number 20170700050). The results will be disseminated through peer-reviewed journals and conference presentations.
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