advocacy

倡导
  • 文章类型: Journal Article
    背景:护士最重要但未被重视的角色之一是患者的倡导。为了有效地为患者辩护,护士应该对病人的倡导有良好的态度。尽管如此,在埃塞俄比亚,护士对患者倡导的态度是未知的。因此,本研究旨在评估东Gojjam区公立医院护士对患者宣传的态度及其相关因素,2023年西北。
    方法:自2023年3月1日至4月30日,在EastGojjamZone公立医院的385名护士中进行了基于机构的横断面研究设计。使用简单随机抽样技术从11家公立医院中选择了护士。数据以自我管理的方式收集。采用二元logistic回归进行数据分析。将双变量逻辑回归中P值<0.25的所有独立变量拟合到多变量逻辑回归中。95%置信区间的AOR用于识别关联的强度,0.05的p值用于在最终模型中声明其具有统计学意义。
    结果:共有385名护士参与了这项研究,反应率为91%。其中,49.9%的护士持不利态度。在基层医院工作[AOR=2.3;95%CI:(1.4-3.8)],护士合作不力[AOR=1.7;95%CI:(1.1-2.8)],对工作不满意[AOR=1.7;95%CI:(1.1-2.7)],工作监督能力差[AOR=6.2;95%CI:(3.7-9.8)]是与护士对患者倡导态度相关的因素.
    结论:对患者倡导持不利态度的护士人数较多。在基层医院工作,与他人合作不良,对工作不满意,对工作监督有不利的看法是与护士对患者倡导的不利态度相关的因素。建议所有医院更好地支持护士,以提高他们的工作满意度,并对护士的活动进行良好的监督。
    BACKGROUND: One of the most important but underappreciated roles of nurses is patient advocacy. To advocate for patients effectively, the nurses should have a favorable attitude towards patient advocacy. Despite this fact, the nurses\' attitude towards patient advocacy was not known in Ethiopia. Thus, this study aimed to assess nurses\' attitude towards patient advocacy and its associated factors in East Gojjam Zone Public Hospitals, Northwest in 2023.
    METHODS: Institutional-based cross-sectional study design was conducted among 385 nurses in East Gojjam Zone Public Hospitals from March 1 to April 30, 2023. Nurses were selected using simple random sampling techniques from 11 public hospitals. The data were collected in a self-administered way. Binary logistic regression was used for data analysis. All independent variables having a P value of < 0.25 in the bivariable logistic regression were fitted into a multivariable logistic regression. The AOR at a 95% confidence interval was used to identify the strength of the association, and a p value of 0.05 was used to declare it statistically significant at the final model.
    RESULTS: A total of 385 nurses participated in the study, for a 91% response rate. Among these, 49.9% of nurses had an unfavorable attitude. Being working in a primary hospital [AOR = 2.3; 95% CI: (1.4-3.8)], poor cooperation of nurses [AOR = 1.7; 95% CI: (1.1-2.8)], being unsatisfied with the job [AOR = 1.7; 95% CI: (1.1-2.7)], and poor perceived supervision of work [AOR = 6.2; 95% CI: (3.7-9.8)] were factors associated with nurses\' attitudes towards patient advocacy.
    CONCLUSIONS: The number of nurses who had an unfavorable attitude towards patient advocacy was high. Working in a primary hospital, poor cooperation with others, being dissatisfied with the job, and having an unfavorable perception towards the supervision of work were the factors associated with the unfavorable attitude of nurses towards patient advocacy. It is recommended that all hospitals better support the nurses to increase their job satisfaction and have good supervision of the nurses\' activities.
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  • 文章类型: Editorial
    暂无摘要。
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  • 文章类型: Journal Article
    倡导是心血管造影和介入学会(SCAI)的核心使命。SCAI代表介入心脏病学家和我们的患者倡导。本文件为介入心脏病学家的基层宣传提供了基础信息和工具包。文件的前半部分总结了医疗保健法律是如何制定的,医疗器械是如何被批准的,以及如何确定程序报销。文件的后半部分是宣传战略的剧本:立法宣传,司法倡导,与监管机构和付款人的倡导,在媒体上宣传,以及参与SCAI倡导倡议,例如政府关系委员会和SCAI政治行动委员会。配备了这个工具箱,介入心脏病学家必须增加我们与政府的宣传活动,付款人,和工业。
    Advocacy is a core mission of the Society for Cardiovascular Angiography & Interventions (SCAI). SCAI advocates on behalf of interventional cardiologists and our patients. This document provides foundational information and a toolkit for grassroots advocacy by interventional cardiologists. The first half of the document summarizes how health care laws are made, how medical devices are approved, and how procedure reimbursement is determined. The second half of the document is a playbook of advocacy strategies: legislative advocacy, judicial advocacy, advocacy with regulators and payors, advocacy in the media, and participation in SCAI advocacy initiatives, such as the Government Relations Committee and SCAI Political Action Committee. Equipped with this toolbox, interventional cardiologists must increase our advocacy activities with government, payors, and industry.
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  • 文章类型: Journal Article
    目的:倡导者-乳房项目的目的是通过教育和以患者为中心的研究来研究和改善乳腺癌(BC)患者的体验。
    方法:2021年12月,一项电子REDCap调查分发给了在梅奥诊所乳腺疾病登记处登记的6,918名BC幸存者(0-4阶段)。问卷询问了对BC护理服务的满意度,教育和支持获得(d)关于不列颠哥伦比亚省相关的关注。患者还对质量改进(QI)建议进行排名。
    结果:调查收到2,437份回复。18%患有导管原位癌,81%患有早期乳腺癌(EBC),即1-3期,2%患有转移性乳腺癌(MBC)。平均年龄为64岁(SD11.8),自诊断以来的平均时间为93个月(SD70.2)。69.3%的患者在梅奥诊所接受了所有护理。整体护理体验良好(>90%)。第一年回忆的主要严重症状是脱发,眉毛/睫毛变薄,潮热,性功能障碍,和认知问题。回顾的主要问题是担心BC复发/传播;亲人应对;害怕死亡,和情绪健康。患者对有关性功能障碍的信息最不满意,眉毛/睫毛变薄,周围神经病变,以及免疫治疗/靶向治疗的副作用。排名最高的QI项目是:i)终身访问简明的教育资源;ii)MBC的整体支持计划和iii)EBC和MBC的健康计划。
    结论:早期和晚期BC患者渴望心理支持,简明的教育资源,和整体护理。
    结论:这些领域的重点研究和QI举措将改善BC患者的体验。
    OBJECTIVE: The aims of the Advocate-BREAST project are to study and improve the breast cancer (BC) patient experience through education and patient-centered research.
    METHODS: In December 2021, an electronic REDCap survey was circulated to 6,918 BC survivors (stage 0-4) enrolled in the Mayo Clinic Breast Disease Registry. The questionnaire asked about satisfaction with BC care delivery, and education and support receive(d) regarding BC linked concerns. Patients also ranked Quality Improvement (QI) proposals.
    RESULTS: The survey received 2,437 responses. 18% had Ductal Carcinoma in Situ, 81% had early breast cancer (EBC), i.e. stage 1-3, and 2% had metastatic breast cancer (MBC). Mean age was 64 (SD 11.8), and mean time since diagnosis was 93 months (SD 70.2). 69.3% of patients received all care at Mayo Clinic. The overall experience of care was good (> 90%). The main severe symptoms recalled in year 1 were alopecia, eyebrow/eyelash thinning, hot flashes, sexual dysfunction, and cognitive issues. The main concerns recalled were fear of BC recurrence/spread; loved ones coping; fear of dying, and emotional health. Patients were most dissatisfied with information regarding sexual dysfunction, eyebrow/eyelash thinning, peripheral neuropathy, and on side effects of immunotherapy/targeted therapies. Top ranking QI projects were: i) Lifetime access to concise educational resources; ii) Holistic support programs for MBC and iii) Wellness Programs for EBC and MBC.
    CONCLUSIONS: Patients with early and advanced BC desire psychological support, concise educational resources, and holistic care.
    CONCLUSIONS: Focused research and QI initiatives in these areas will improve the BC patient experience.
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  • 文章类型: Journal Article
    背景:卫生和社会部门组织越来越多地合作,以减轻其社区内的社会经济逆境。我们试图了解动机,经验,以及参与这些合作的组织的观点。
    方法:我们进行了半结构化,在2021年1月至4月期间,对来自25个卫生和社会部门组织的34位领导人进行了60分钟的采访。面试探讨了动机,好处和挑战,以及卫生部门组织如何最有效地应对社区一级的社会经济逆境。访谈是录音和转录的;主题是使用Dedoose软件编码的。
    结果:伙伴关系主要是由任务驱动的组织和主要卫生部门领导人推动的,他们有兴趣解决健康不良的根本原因;诸如需求证明法和基于价值的护理激励措施等政策使社区一级的投资与卫生部门组织的财务利益保持一致,从而促进了这些努力。虽然伙伴关系大多被视为增加影响(对卫生部门)和资源获取(对社会部门)的互利途径,社会部门组织对期望过高表示沮丧,不可持续的兴趣,以及缺乏卫生部门合作者的伙伴关系。尽管有这些挫折,卫生和社会部门的受访者都支持卫生部门继续参与社区层面的社会经济举措以及扩大政策和系统努力。
    结论:跨部门,社区层面的社会经济举措是互利的,但是社会部门组织经历了更多的挫折。卫生部门的政策和组织变革可以进一步动员和维持对这些努力的支持。
    BACKGROUND: Health and social sector organizations are increasingly working together to mitigate socioeconomic adversity within their communities. We sought to learn about the motivations, experiences, and perspectives of organizations engaged in these collaborations.
    METHODS: We conducted semi-structured, 60-minute interviews with 34 leaders from 25 health and social sector organizations between January-April 2021. Interviews explored motivations, benefits and challenges, and ways in which health sector organizations can most effectively address community-level socioeconomic adversity. Interviews were audio recorded and transcribed; themes were coded using Dedoose software.
    RESULTS: Partnerships were primarily motivated by mission-driven organizations and key health sector leaders who were interested in addressing root causes of poor health; policies such as certificate of need laws and value-based care incentives that aligned community-level investments with health sector organizations\' financial interests facilitated these efforts. While partnerships were mostly regarded as mutually beneficial ways to increase impact (for the health sector) and resource access (for the social sector), social sector organizations voiced frustrations regarding the outsized expectations, unsustained interest, and lack of partnership from their health sector collaborators. Despite these frustrations, both health and social sector interviewees supported the health sector\'s continued involvement in community-level socioeconomic initiatives and expansion of policy and systems efforts.
    CONCLUSIONS: Cross-sector, community-level socioeconomic initiatives were mutually beneficial, but social sector organizations experienced more frustrations. Policy and organizational changes within the health sector can further mobilize and sustain support for these efforts.
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  • 文章类型: Journal Article
    儿科肺科医师具有专业知识,可以在影响儿童呼吸健康的许多领域成为倡导者。本文概述了与健康公平相关的选定倡导主题,并提供了可以在临床中改善儿童呼吸健康的关键示例。
    Pediatric pulmonologists have the expertise to be advocates in many areas that affect the respiratory health of children. This article provides an overview of selected advocacy topics related to health equity and provides key examples that can improve child respiratory health in the clinical encounter and beyond.
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  • 文章类型: Journal Article
    背景:只有有限的基于证据的数据来指导≥80岁(P80+)乳腺癌(BC)患者的治疗建议。确定和解决未满足的需求至关重要。
    目的:Advocate-BREAST80+比较了P80+与患者<80岁(P80-)。
    方法:在2021年12月12日,REDCap调查以电子方式传阅了在梅奥诊所乳腺疾病登记处注册的6918人。调查询问了对BC护理多个方面的关注和满意度。
    结果:总体而言,2437名参与者回答(35%的应答率);202名(8.3%)为P80+。P80+不太可能接受局部区域和全身治疗。P80-(p<0.01)。值得注意的是,P80对BC疗法的短期和长期副作用以及管理毒性的信息明显不满意。P80+也不太可能参与临床试验(p<0.001)或将来希望这样做(p=0.0001)。
    结论:尽管与P80-相比,P80+经历的焦虑和症状相关的困扰较少,他们对BC治疗的副作用及其管理方面的信息明显不满意.P80+参加临床试验或愿意考虑这一选择的可能性显著降低。未来的研究应解决与P80+研究参与的副作用和障碍有关的教育需求。
    BACKGROUND: There are limited evidence-based data to guide treatment recommendations for breast cancer (BC) patients ≥80 years (P80+). Identifying and addressing unmet needs are critical.
    OBJECTIVE: Advocate-BREAST80+ compared the needs of P80+ vs. patients < 80 years (P80-).
    METHODS: In 12/2021, a REDCap survey was electronically circulated to 6918 persons enrolled in the Mayo Clinic Breast Disease Registry. The survey asked about concerns and satisfaction with multiple aspects of BC care.
    RESULTS: Overall, 2437 participants responded (35% response rate); 202 (8.3%) were P80+. P80+ were less likely to undergo local regional and systemic therapies vs. P80- (p < 0.01). Notably, P80+ were significantly less satisfied with information about the short and long-term side effects of BC therapies and managing toxicities. P80+ were also less likely to have participated in a clinical trial (p < 0.001) or to want to do so in the future (p = 0.0001).
    CONCLUSIONS: Although P80+ experienced less anxiety and symptom-related distress compared with P80-, they were significantly less satisfied with information regarding the side effects of BC therapies and their management. P80+ were significantly less likely to have participated in a clinical trial or be open to considering this option. Future studies should address educational needs pertaining to side effects and barriers to research participation in P80+.
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  • 文章类型: Journal Article
    背景:营销对全球青年赌博的正常化具有重大影响。这包括塑造对赌博的积极态度,以及增加对赌博的社会和文化接受度-特别是与体育等有价值的活动相一致。正因为如此,公共卫生专家认为,赌博营销对青少年的健康和福祉构成重大风险。虽然年轻人越来越多地接触到,并受到赌博产品营销的影响,很少就政策问题和选择咨询他们。这项研究旨在探索澳大利亚年轻人对当前赌博广告政策反应的看法。他们是否认为年轻人应该参与关于赌博营销法规的讨论和决定,以及他们对政府保护年轻人免受赌博业营销策略之害的责任的看法。
    方法:定性焦点小组(n=22)在澳大利亚维多利亚州和新南威尔士州,n=64,12-17岁。参与者被要求反思当前的赌博政策,特别是关于市场营销,他们认为赌博营销应该做些什么,以及是否以及如何将年轻人纳入对赌博的公共卫生对策中。使用了解释性的“大Q”方法进行反身性主题分析。
    结果:年轻人强调需要围绕赌博营销的内容和频率制定更有效的法规。他们还希望看到赌博的负面影响的更现实的表现,以对抗持续的积极商业营销信息。大多数人认为,由于他们独特的经历,年轻人应该有机会对赌博的反应发表意见。与会者确定了增加年轻人参与决策的机制,例如与各级政府的直接沟通渠道,参与研究,多样化的参与方式。具体建议包括更多的监管行动,例如禁止赌博广告。
    结论:创建正式结构,促进将年轻人的观点纳入有关赌博的决策中,可以产生更多创新和有效的策略,以防止赌博行业产品的危害,促销,和实践。
    BACKGROUND: Marketing has a significant impact on the normalisation of gambling for youth across the globe. This has included shaping positive attitudes towards gambling, as well as increasing the social and cultural acceptance of gambling - particularly aligned with valued activities such as sport. Because of this, public health experts argue that gambling marketing poses a significant risk to the health and wellbeing of youth. While young people are increasingly exposed to, and impacted by marketing for gambling products, they are rarely consulted about policy issues and options. This study aimed to explore young Australians\' perceptions of current policy responses to gambling advertising, whether they thought young people should be involved in discussions and decisions about gambling marketing regulations, and their perceptions of the duty of governments to protect young people from gambling industry marketing strategies.
    METHODS: Qualitative focus groups (n = 22) were held with n = 64, 12-17 year olds in the Australian states of Victoria and New South Wales. Participants were asked to reflect on current gambling policies, particularly relating to marketing, what they thought should be done about gambling marketing, and if and how young people should be included in public health responses to gambling. An interpretivist \'Big Q\' approach to reflexive thematic analysis was used.
    RESULTS: Young people highlighted the need for more effective regulations around the content and frequency of gambling marketing. They also wanted to see more realistic representations of the negative impacts of gambling to counter persistent positive commercial marketing messages. Most thought that young people should be given an opportunity to have a say about responses to gambling due to their unique experiences. Participants identified mechanisms to increase young people\'s engagement in decision making, such as direct lines of communication to different levels of government, involvement in research, and diversifying ways of engagement. Specific recommendations included more regulatory action such as bans on gambling advertising.
    CONCLUSIONS: Creating formal structures that facilitate the inclusion of young people\'s perspectives in decisions made about gambling can result in more innovative and effective strategies to prevent the harms from gambling industry products, promotions, and practices.
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  • 文章类型: Journal Article
    本文报告了关于为SRHR宣传和运动建设提供捐助者资金的圆桌对话,由性与生殖健康事务(SRHM)与AmplifyChange合作于2022年9月14日至15日组织。它探讨了关于SRHR倡导和运动建设的变化格局的当前情景,并从讨论中提出了一些关键要点。圆桌会议审查了当前的筹资架构,借鉴参与者的不同观点,包括资助者,并提出了关键问题,即当前的供资模式是否旨在帮助或阻碍推进变革性的SRHR宣传议程,以有效地应对对SRHR收益的反对和回滚。它提供了对当前监测成功和影响的方法的见解,反过来,制定未来的筹资战略和优先事项,并为前进的道路提供初步建议和解决方案。文章最后呼吁在SRHR倡导和运动建设资金环境中注入一套新的共同商定的价值观,植根于人和以运动为中心的方法中的原则和战略,作为确保不仅更多而且更好的资金的一种方式。
    The article reports on a roundtable dialogue on Donor Funding for SRHR Advocacy and Movement Building, organised by Sexual and Reproductive Health Matters (SRHM) in collaboration with AmplifyChange on 14-15 September 2022. It explores the current scenario about the changing landscape for advocacy and movement building for SRHR and presents some key takeaways from the discussion. The roundtable examined the current funding architecture, drawing on the diverse perspectives of participants, including funders, and raises critical questions on whether current funding patterns are geared to help or hinder advancing a transformative SRHR advocacy agenda that can effectively counter opposition to and rollback of SRHR gains. It provides insights into current approaches to monitoring success and impact that, in turn, shape future funding strategies and priorities and offers preliminary suggestions and solutions for a way forward. The article ends with a call to infuse the SRHR advocacy and movement-building funding landscape with a new set of mutually agreed values, principles and strategies that are embedded in people and movement-centred approaches as a way to ensure not just more but better funding.
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  • 文章类型: Journal Article
    2023年的产品召回描述了儿童摄入水珠的发病率和死亡率的风险。我们旨在描述美国的水珠暴露和管理趋势。从2013年到2023年,我们使用了国家电子伤害监测系统(NEISS)来识别水珠伤害。纳入标准为0-17岁,摄入物体/异物的诊断,和叙述词(S)建议水珠(S)。NEISS提供了权重和方差变量来生成国家估计。有226例水珠受伤(摄入66%)。2岁以下儿童占受伤人数的29%。56%的病例涉及多个水珠。2020年后水珠伤害频率有明显上升趋势。16例(7%)需要升级护理。水珠伤害正在上升,似乎会影响所有年龄段的儿童。5岁以下的儿童似乎最脆弱。
    A 2023 product recall has described the risk for morbidity and mortality for children ingesting water beads. We aimed to describe water bead exposure and management trends in the United States. We used the National Electronic Injury Surveillance System (NEISS) to identify water bead injuries from 2013 to 2023. Inclusion criteria were ages 0-17 years, diagnosis of ingested object/foreign body, and the narrative word(s) suggested water bead(s). NEISS supplied weights and variance variables to generate national estimates. There were 226 water bead injuries (66% ingestion). Children under age 2 years comprised 29% of injuries. Multiple water beads were involved in 56% of cases. There was a significant uptrend in water bead injury frequency after 2020. Sixteen (7%) cases required escalation of care. Water bead injuries are rising and appear to affect children of all ages. Children aged less than 5 years appear most vulnerable.
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