Patient experience

患者体验
  • 文章类型: Journal Article
    研究在心脏手术前告知患者视频对重症监护经验的影响。
    这项随机对照试验于2021年12月至2022年12月在一家公立医院的心血管外科诊所进行,有90名患者(实验组45名患者-对照组45名患者)参加。患者信息表和重症监护经历量表用于研究数据。实验组患者在心脏手术前通过视频告知重症监护。
    发现实验组的ICES总分(74.5±3.9)明显高于对照组(63.9±6.4)(p<0.001)。感知环境的子维度(20.8±1.7),可怕的经历(18.6±1.0),发现实验组的经验回忆率(18.5±1.5)和护理满意度(16.7±1.4)在统计学上明显高于实验组,高于对照组子维度得分(p<0.001)。
    发现通过视频告知患者有关心脏手术前的重症监护设置和过程对重症监护体验具有积极作用。注意:这项研究是从硕士论文中产生的,没有提出。所有参与者都同意这项研究,他们的匿名性得到了保留。试用登记号:NCT05255887。
    UNASSIGNED: To study the effect of informing patients with video before cardiac surgery on intensive care experience.
    UNASSIGNED: This randomized controlled trial was conducted between December 2021 and December 2022 in the cardiovascular surgery clinic of a public hospital with the participation of 90 patients (45 patients in experimental group - 45 patients in control group) who were scheduled to undergo cardiac surgery. Patient Information Form and Intensive Care Experiences Scale were used for study data. Patients in experimental group were informed with video about the intensive care before cardiac surgery.
    UNASSIGNED: It was found that the total score on ICES of the experimental group (74.5±3.9) was statistically and significantly higher than that of the control group (63.9±6.4) (p<0.001). The sub-dimension of awareness of surroundings (20.8±1.7), the frightening experiences (18.6±1.0), and the recall of experience (18.5±1.5) and satisfaction with care (16.7±1.4) were found to be statistically significantly higher in the experimental group, than in the control group sub-dimension scores (p<0.001).
    UNASSIGNED: It was found that informing patients with video about the intensive care setting and process before cardiac surgery had a positive effect on the intensive care experience. Note: The study was produced from a master\'s thesis and was not presented. All participants gave informed consent for the study, and that their anonymity was preserved.Trial Registration NO.: NCT05255887.
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  • 文章类型: Journal Article
    患者参与临床试验对于医疗保健的发展至关重要。在招募患有急性疾病的试验参与者方面存在一些挑战。基于注册表的随机DAPA-MI临床试验招募了住院期间因心肌梗死的患者,并提供了带有智能瓶盖的研究药物,该瓶盖使用无线技术传输监测数据。这项访谈研究旨在调查患者参与临床试验的经验以及他们对新瓶盖技术的态度。
    参与DAPA-MI试验的一部分患者来自瑞典的四家医院。进行了半结构化访谈,并使用清单内容分析进行了分析。
    视频访谈包括21名患者(4名女性和17名男性)。中位年龄为59岁(范围44-80)。确定了四类患者的经历。贡献的意愿包括患者对参与的积极态度以及参与开发和研究的一部分。对信息的感知强调了口头信息的价值以及反思时间的重要性。处于脆弱状态,突显了在急性医疗条件下感知和记忆能力的受损。对新技术的适应描述了智能瓶盖评估依从性的总体积极经验。
    患者参与试验的经历总体上是积极的,但在急性心肌梗死中发现了一些挑战。智能瓶盖被广泛接受,尽管有些处理困难。
    UNASSIGNED: The participation of patients in clinical trials is crucial for the development of healthcare. There are several challenges in the recruitment of trial participants with acute medical conditions. The registry-based randomized DAPA-MI clinical trial recruited patients during hospitalization for myocardial infarction and provided study drugs in bottles with smart caps that used wireless technology to transmit monitoring data. This interview study aimed to investigate patients\' experience of participation in a clinical trial and their attitude to the new bottle cap technology.
    UNASSIGNED: A subset of patients participating in the DAPA-MI trial were recruited from four hospitals in Sweden. Semi-structured interviews were conducted and analysed using manifest content analysis.
    UNASSIGNED: Video interviews were performed including 21 patients (four women and 17 men). The median age was 59 years (range 44-80). Four categories of patients\' experiences were identified. A willingness to contribute consisted of patients\' positive attitudes to participation and to be a part of development and research. The perception of information emphasized the value of the oral information as well as the importance of time for reflection. Be in a vulnerable condition highlighted the impaired ability to perceive and remember in the acute medical condition. Adaptation to a new technology described the overall positive experiences of the smart bottle cap to evaluate adherence.
    UNASSIGNED: Patients\' experiences of trial participation were in general positive but some challenges in the acute setting of a myocardial infarction were revealed. The smart bottle cap was well accepted, despite some handling difficulties.
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  • 文章类型: Journal Article
    目的:我们试图探索患有由蜱虫引起的衰弱症状复合物(DSCATT)的患者的生活经验,以指导潜在治疗干预措施的发展。
    方法:我们进行了一对一的深入,对受DSCATT影响的澳大利亚13人进行半结构化访谈。使用主题分析对访谈进行转录和分析。
    结果:尽管参与者将疾病的起源归因于蜱叮咬,并非所有人都坚称他们患有莱姆病。传统医疗保健中的负面经验被标记,据报道会加剧疾病的影响并影响心理健康。Further,这些负面经历促使参与者寻求未经批准的治疗(根据澳大利亚标准).在参与者组中,对疾病的确认和病原体的识别的愿望是明显的。
    结论:DSCATT患者在澳大利亚因蜱引起的慢性症状引起的有争议的医疗保健环境中面临重大挑战。我们的研究结果表明需要善解人意,该队列的支持性和以患者为中心的治疗。
    结论:DSCATT导致受影响人群在多个领域的负担相当大。医疗保健方面的负面经历加剧了澳大利亚DSCATT患者的痛苦。承认DSCATT患者患病经历的新方法,除了基于证据的治疗方法,包括生物心理社会护理模式,需要解决这种衰弱的状况。
    OBJECTIVE: We sought to explore the lived experience of people with Debilitating Symptom Complexes Attributed to Ticks (DSCATT) to inform the development of a potential treatment intervention.
    METHODS: We conducted one-to-one in-depth, semi-structured interviews with 13 people living in Australia affected by DSCATT. Interviews were transcribed and analysed using thematic analysis.
    RESULTS: Although participants attributed the origin of their illness to tick bites, not all were adamant they had Lyme disease. Negative experiences in conventional healthcare were marked and were reported to exacerbate the impact of the illness and affect mental health. Further, these negative experiences propelled participants to seek unapproved treatments (by Australian standards). The desire for the illness to be acknowledged and causative agents identified was pronounced among the participant group.
    CONCLUSIONS: Individuals with DSCATT experience significant challenges amid a contentious healthcare landscape surrounding chronic symptoms attributed to ticks in Australia. Our findings suggest the need for empathetic, supportive and patient-centred treatments for this cohort.
    CONCLUSIONS: DSCATT results in a considerable burden across multiple domains for those affected. Negative experiences with healthcare exacerbate the suffering of people with DSCATT in Australia. New approaches that acknowledge the illness experience of people with DSCATT, alongside evidence-based treatments that encompass biopsychosocial models of care, are needed to tackle this debilitating condition.
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  • 文章类型: Journal Article
    背景:利尿肾图是一种核医学检查,可以区分阻塞性和非阻塞性尿路病变。Renography之前已经被调查过,但不是从病人的角度来看。这项研究的目的是通过利尿肾图过程获得患者经验的知识和理解。
    方法:该研究采用了定性的描述性设计;数据是通过对最近接受利尿症肾图检查的17名成年患者的半结构化访谈收集的。使用归纳定性内容分析对转录本进行分析,以确定其明显和潜在内容。
    结果:确定了一个主要主题:但仍然在良好的手中\'。参与者了解进行肾脏描记术的必要性,尽管存在令人担忧的因素,但仍忍受了检查。他们被利尿作用困扰,担心放射性,在成像过程中感到孤立。技术人员的关怀和信息方法缓解了他们的经验。从三个子主题中确定了主要主题:\'我遇到了不便\',\'我很担心\'和\'我感到安全\'。
    结论:参与者在整个肾图过程中都经历了担忧,但仍然对检查感到满意,主要是因为技术人员参与其中。患者和技术人员之间的沟通和互动对于创造良好的体验很重要。在康复期间,对患者经历的更多知识可用于开发患者信息,并提高技术人员对患者可能经历的麻烦因素的认识。
    结论:本研究描述了导致消极和积极经历的问题。提高对这些问题的专业意识和知识可以促进患者信息和专业接触的发展,并可能改善患者的依从性和整体体验。
    BACKGROUND: Diuresis renography is a nuclear medicine examination that can distinguish between obstructive and non-obstructive uropathy. Renography has been investigated before, but not from a patient perspective. The aim of this study was to gain knowledge and understanding of patient experiences with the diuresis renography process.
    METHODS: The study had a qualitative descriptive design; data was collected through semi-structured interviews with 17 adult patients that had recently undergone diuresis renography. The transcripts were analysed using inductive qualitative content analysis to identify their manifest and latent content.
    RESULTS: One main theme was identified: \'Not smooth all the way through, but still in good hands\'. The participants understood the necessity of the performed renography and endured the examination despite its worrying elements. They were bothered by diuretic effects, worried about radioactivity and felt isolated during the imaging. The technologists\' caring and informative approach eased their experience. The main theme was identified from three subthemes: \'I experienced inconvenience\', \'I was worried\' and \'I felt safe\'.
    CONCLUSIONS: The participants experienced worry throughout the renography process but were still satisfied with the examination, mostly because of the technologists being involved. Communication and interaction between patient and technologist are important for creating a good experience. Improved knowledge of patient experiences during renographies could be used to develop patient information and increase technologists\' awareness of factors patients may experience as troubling.
    CONCLUSIONS: This study describes issues that contribute to both negative and positive experiences. Improved professional awareness and knowledge about these issues can contribute to the development of patient information and professional encounters, and may improve patients\' compliance and overall experience.
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  • 文章类型: Journal Article
    目的:纤维瘤是一种罕见且复杂的疾病,其特征是形式多样性很大,本地化,和预后。疾病和治疗都会对患者的生活质量产生重大影响。鉴于这种疾病的复杂性和罕见性,关于患者对这种疾病的经验的文献很少。这项研究的目的是调查患有硬纤维瘤的参与者的疾病表征和主观体验。
    方法:在18岁以上的法国患者中使用电话半指导性访谈,诊断为硬纤维瘤。通过一般归纳法对数据进行分析,以识别参与者话语中出现的一般主题。
    结果:参与者(8名女性,7名男性)在这项研究中年龄在27到71岁之间。分析揭示了与疾病和治疗有关的八个主要主题,与疾病生活在一起,疾病对与他人关系的影响,疾病和医疗途径,以及疾病引起的身份变化。两个最突出的主题是疾病和治疗表现以及疾病的生活。本研究选择了这些主题。
    结论:这些结果为患者纤维瘤的表现和经验提供了新的见解。它为开发更广泛的系统研究的必要性提出了论据,以在所有疾病途径中探索更大样本中的这些变量。的确,这个人群遇到了特殊的问题,呼吁发展特定的社会心理支持。
    OBJECTIVE: Desmoid tumors are a rare and complex disease characterized by a great diversity in its forms, localizations, and prognosis. Both the disease and the treatment can have a significant impact on quality of life in patients. Given the complexity of the disease and its rarity, the literature on patients\' experience with the disease scarce. The purpose of this study is to investigate illness representations and subjective experience in participants affected with desmoid tumors.
    METHODS: Telephonic semi-directive interviews were used in French patients over 18 years, diagnosed with desmoid tumor. Data were analyzed through a general inductive method to identify emergent general themes in participants\' discourse.
    RESULTS: Participants (8 women, 7 men) in this study were aged between 27 and 71. The analysis revealed eight major themes relative to representations of illness and treatment, live with the illness, the impact of illness on relationships with others, the illness and medical pathways, and the identity changes caused by the illness. The two most salient themes were illness and treatment representations and life with the illness. Those themes were chosen for this study.
    CONCLUSIONS: The results provide new insights on representation of and experience with desmoid tumors in patients. It brings arguments for the necessity of development wider systematic study to explore those variables in a larger sample during all the illness pathway. Indeed, this population meets particular issues appealing for the development of a specific psychosocial support.
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  • 文章类型: Journal Article
    对受试者有什么了解?:持续观察通常用于心理健康病房,以支持服务使用者的安全,在那里,他们将不断受到工作人员的关注。有证据表明,连续的观察可能是无益的和限制性的,但对实践或改进它的最佳方法知之甚少。这篇论文对现有知识有什么帮助?:这项评估整合了服务用户的观点,非正式护理人员和工作人员探索当前的持续观察经验,并告知未来的改进。虽然先前的研究强调了治疗参与的重要性,这项研究还强调了观察程序如何适应个人需求.实践的含义是什么?:如果连续观察是治疗性的,可能会更有益,与风险水平成正比,并与服务用户共同开发,非正式的照顾者和工作人员。关于沟通的进一步培训可以支持工作人员的参与,观察过程可以正规化,以确保定期进行协作审查。
    介绍:连续观察是管理精神科病房高风险的常用工具。然而,关于它在实践中的使用,以前的研究很少。
    目的:本定性服务评估旨在探索服务用户的持续观察体验,当地NHS心理健康信托基金的非正式护理人员和工作人员,告知对当前实践的未来改进建议。
    方法:五个服务用户,三名非正式护理人员和七名医护人员完成了半结构化面试,对其进行了主题分析,以创建四个主题。
    结果:积极的互动和参与活动对于观察的治疗方法至关重要,支持服务用户和员工,以尽量减少可能出现的非生产性行为。在安全与隐私之间取得平衡的困难可能表明,为每个服务用户制定相称和量身定制的观察程序的重要性。确保服务用户和非正式护理人员的声音仍然是有关护理的决策的核心,可以进一步改善观察体验。
    结论:本研究强调治疗,按比例和共同产生的观察结果作为改进实践的关键特征。观察过程的进一步培训和形式化可以促进文化变革,朝着更长期的风险管理方法发展。
    WHAT IS KNOWN ON THE SUBJECT?: Continuous observation is often used in mental health wards to support the safety of service users, where they will be constantly watched by a member of staff. Evidence suggests that continuous observations may be unhelpful and restrictive, but not enough is known about the practice or the best ways to improve it. WHAT THIS PAPER ADDS TO EXISTING KNOWLEDGE?: This evaluation integrates the perspectives of service users, informal carers and staff to explore current continuous observation experiences and inform future improvements. While previous research highlights the importance of therapeutic engagement, this study additionally emphasizes how the observation procedure could be adapted to individual needs. WHAT ARE THE IMPLICATIONS FOR PRACTICE?: Continuous observations could be more beneficial if they are therapeutic, proportional to the level of risk and co-developed with the service user, informal carer and staff. Further training about communication could support staff engagement and the observation process could be formalized to ensure regular collaborative reviews.
    UNASSIGNED: INTRODUCTION: Continuous observation is a frequently used tool to manage high levels of risk on psychiatric wards. However, there is little previous research on its use in practice.
    OBJECTIVE: This qualitative service evaluation aims to explore the continuous observation experiences of service users, informal carers and staff in a local NHS Mental Health Trust, informing suggested future improvements to current practice.
    METHODS: Five service users, three informal carers and seven healthcare staff completed semi-structured interviews, which were thematically analysed to create four themes.
    RESULTS: Positive interaction and engagement in activities were critical for a therapeutic approach to observations, supporting service users and staff to minimize the unproductive behaviours that can arise. Difficulties balancing safety with privacy could suggest the importance of proportionate and tailored observation procedures for each service user. Ensuring the voices of service users and informal carers remain central to decisions regarding care could further improve the observation experience.
    CONCLUSIONS: This study highlights therapeutic, proportionate and co-produced observations as key characteristics to improve practice. Further training and formalization of the observation process could foster cultural changes towards more long-term approaches to risk management.
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  • 文章类型: Journal Article
    该研究旨在探索患者在内镜手术各个阶段的体验和看法,并检查以患者为中心的沟通与患者体验之间的关联。共有191名患者接受了询问恐惧和疼痛的术前和术后调查,患者对提供给他们的信息的满意度,感知和经验。疼痛与术后恐惧相关(r=0.63,p<0.01),与访视结束时报告的患者体验呈负相关(r=-0.17,p<0.01)。从之前提供的信息(r=0.47,p<0.01)和手术后提供的信息(r=0.51,p<0.001)中发现患者体验与满意度之间存在显着的正相关。一个预测模型发现,对医生的看法,对出院前提供的信息的满意度,和信任感是患者体验的预测因子(F=44.9,R2=0.61,p<0.001)。患者对手术前后提供的信息的满意度可以积极影响患者的体验,导致恐惧和焦虑的减少,并增加对医疗建议的依从性。应该以参与的方式制定和设计PCC治疗内镜患者的策略,考虑到与患者体验相关的各个方面。
    The study aimed to explore patients\' experiences and perceptions throughout the various stages of endoscopic procedures and examine the association between patient-centered communication and the patient\'s experience. A total of 191 patients responded to pre- and post-procedure surveys that inquired about fear and pain, patients\' satisfaction regarding the information provided to them, perceptions and experience. Pain was associated with post-procedure fear (r = 0.63, p < 0.01) and negatively associated with reported patient experience at the end of the visit (r = -0.17, p < 0.01). Significant positive associations were found between patient experience and satisfaction from the information provided before (r = 0.47, p < 0.01) and the information provided after the procedure (r = 0.51, p < 0.001). A predictive model found that perceptions toward the physicians, satisfaction from information provided before discharge, and feelings of trust are predictors of the patient experience (F = 44.9, R2 = 0.61, p < 0.001). Patients\' satisfaction with information provided before and after the procedure can positively affect the patients\' experience, leading to a decrease in fear and anxiety and increasing compliance with medical recommendations. Strategies for PCC with endoscopic patients should be developed and designed in a participatory manner, taking into account the various aspects associated with the patient experience.
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  • 文章类型: Journal Article
    目的:持续气道正压通气(CPAP)被认为是治疗中重度阻塞性睡眠呼吸暂停(OSA)的有效方法。临床医生通过每24小时使用CPAP的小时数来衡量对治疗的依从性。很少有研究检查患者CPAP的生活经验和使用障碍。这项研究检查了OSA患者的经历,COVID-19期间CPAP的使用和治疗。
    方法:这项CPAP患者经历定性研究是一个更大项目的一部分。总体研究是一项三臂非盲随机对照试验,对CPAP患者使用标准护理或两种远程医疗干预之一治疗OSA。已完成RCT研究的患者被邀请通过电话接受采访,关于他们的OSA诊断,CPAP经验,他们使用远程医疗的经验和SARS-CoV-2(COVID-19)的影响。
    结果:15名患者(每个试验组5名)参加了半结构化访谈。专题分析确定了三个主题:日常生活、标准的医院护理与远程医疗管理以及通过COVID-19和CPAP的生活。
    结论:所有参与者在诊断前都描述了由OSA引起的显著症状。虽然CPAP治疗经常被描述为具有挑战性,患者讨论了治疗后症状的改善。关于虚拟约会有不同的意见,然而,使用远程医疗支持CPAP治疗的共识得到了好评.COVID-19似乎对患者的体验影响不大。
    OBJECTIVE: Continuous positive airway pressure (CPAP) is considered effective treatment for moderate-severe obstructive sleep apnea (OSA). Clinicians measure compliance to treatment by the number of hours CPAP is used per 24 hours. There have been very few studies examining the patients\' lived experience of CPAP and the barriers to use. This study examined the patients\' experience of OSA, CPAP use and treatment during COVID-19.
    METHODS: This CPAP patient experience qualitative study was part of a larger project. The overarching study was a three-armed nonblinded randomized controlled trial of patients on CPAP for treatment of OSA using standard care or one of two telemedicine interventions. Patients who had completed the RCT study were invited to be interviewed via telephone, about their OSA diagnosis, CPAP experiences, their experience of using telemedicine and the impact of SARS-CoV-2 (COVID-19).
    RESULTS: Fifteen patients (five from each arm of the trial) took part in a semi-structured interview. Thematic analysis identified three themes: day to day living, standard hospital care versus telemedicine management and living though COVID-19 with CPAP.
    CONCLUSIONS: All participants described significant symptoms caused by their OSA before diagnosis. While CPAP treatment was often described as challenging, patients discussed the improvement in their symptoms with treatment. There were differing opinions on virtual appointments, however the consensus was the use of telemedicine to support CPAP treatment was well received. COVID-19 appeared to have little effect on the patient experience.
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  • 文章类型: Journal Article
    文化谦逊是对自我评价的终身承诺,纠正医患关系中的权力失衡,发展相互信任的有益伙伴关系。
    本研究的目的是确定文化谦卑训练的可行性和有效性。
    从2020年7月到2021年3月,有133名医学生参加的90分钟教育研讨会,住院医师和医学教育教师包括1)干预前和干预后的调查;2)关于公平和文化谦逊原则的互动演示;3)参与者探索社会文化身份和权力;和4)反思小组讨论。
    从干预前到干预后的感知分数评估显着增加(3.89[SEM=0.04]对4.22[0.08],p<0.001)和知识分数(0.52[0.02]对0.67[0.02],p<0.001)。被认为随时间变化的最常见的身份参与者是个性=40%,外观=36%,年龄=35%。遭受压迫/征服的最常见身份是种族/民族=54%,性别=40%,宗教=28%;而经历特权的最常见身份是性别=49%,种族/民族=42%,外貌=25%。男性参与者的性别认同平均功率得分为73%,而女性参与者的平均功率得分为-8%(P<0.001)。非西班牙裔白人的种族认同感平均功率评分为62%,而非白人参与者为13%(p<0.001)。英语作为第二语言仅被美国以外出生的人视为受压迫/征服的身份(p<0.001)。
    互动教育研讨会可以增加参与者关于文化谦逊的知识和看法。参与者可以自我反思,以识别被压迫/征服或特权的社会文化身份。
    UNASSIGNED: Cultural humility is a lifelong commitment to self-evaluation, redressing power imbalances in patient-physician relationships and developing mutually trusting beneficial partnerships.
    UNASSIGNED: The objective of this study was to determine the feasibility and efficacy of cultural humility training.
    UNASSIGNED: From July 2020-March 2021, 90-minute educational workshops attended by 133 medical students, resident physicians and medical education faculty included 1) pre- and post- intervention surveys; 2) interactive presentation on equity and cultural humility principles; 3) participants explored sociocultural identities and power; and 4) reflective group discussions.
    UNASSIGNED: There were significant increases from pre to post intervention assessments for perception scores (3.89 [SEM= 0.04] versus 4.22 [0.08], p<0.001) and knowledge scores (0.52 [0.02] versus 0.67 [0.02], p<0.001). Commonest identities participants recognized as changing over time were personality = 40%, appearance = 36%, and age =35%. Commonest identities experienced as oppressed/subjugated were race/ethnicity = 54%, gender = 40% and religion = 28%; whilst commonest identities experienced as privileged were gender= 49%, race/ethnicity = 42% and appearance= 25%. Male participants assigned mean power score of 73% to gender identity compared to mean power score of -8% by female participants (P<0.001). Non-Hispanic Whites had mean power score for race identity of 62% compared to 13% for non-white participants (p<0.001). English as a second language was only acknowledged as an oppressed/subjugated identity by those born outside the United States (p<0.001).
    UNASSIGNED: An interactive educational workshop can increase participants\' knowledge and perceptions regarding cultural humility. Participants can self-reflect to recognize sociocultural identities that are oppressed/subjugated or privileged.
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  • 文章类型: Journal Article
    硬皮病的口腔和牙齿表现极为常见,然而,它们在风湿病学中经常被忽视,在牙科中却知之甚少。先前的研究表明,有必要了解硬皮病患者及其护理参与者的口腔和牙科经历。这项范围审查的目的是,第一次,全面绘制关于硬皮病口腔和牙齿表现的识别和管理的已知信息,硬皮病患者是如何经历这些的,并探索硬皮病良好口腔和牙齿护理的障碍和促成因素的关键特征。使用六个数据库(Embase,PubMed,心理信息,ASSIA,Scopus和SSCI),根据系统审查和荟萃分析的首选报告项目-范围审查的扩展。灰色文献也包括在内。如果全文和摘要以英文提供,则研究有资格纳入。2002年至2022年出版,重点关注成人硬皮病口腔和牙科护理的概念,无论是关于识别和管理,最佳实践的推动者和障碍,或者病人的经历和幸福。旨在了解患者生活经历的定性研究在文献中存在显着差距。同样,在风湿病中,对硬皮病的口腔和牙齿表现缺乏关注。确定了三个关键特征,这将促进研究和临床实践中的最佳实践:多学科护理的必要性;集中患者体验的必要性;以及减轻牙科护理障碍的必要性。我们得出的结论是,牙科领域对硬皮病的认识有所提高,并简化了牙科和风湿病学科之间的转诊程序,为了能够早期识别和管理硬皮病,是至关重要的。
    Oral and dental manifestations of scleroderma are extremely common, yet they are often overlooked within rheumatology and poorly understood within dentistry. Previous research has indicated the need to understand the oral and dental experiences of people living with scleroderma and those involved in their care. This scoping review aims, for the first time, to comprehensively map what is known regarding the identification and management of oral and dental manifestations of scleroderma, how these are experienced by people living with scleroderma, and to explore key characteristics of barriers and enablers to good oral and dental care in scleroderma. A scoping review was conducted using six databases (Embase, PubMed, PsychINFO, ASSIA, Scopus and SSCI), according to the Preferred Reporting Items for Systematic Reviews and Meta-analyses - extension for Scoping Review. Grey literature was also included. Studies were eligible for inclusion if the full text and abstract were available in English, published between 2002 and 2022, and focused on the concept of oral and dental care in adults with scleroderma, either relating to identification and management, enablers and barriers to best practice, or patient experiences and well-being. Qualitative research which seeks to understand patients\' lived experiences was a notable gap in the literature. Similarly, there was a significant lack of focus on the oral and dental manifestations of scleroderma in rheumatology. Three key features were identified which would facilitate best practice in research and clinical contexts: the necessity of multidisciplinary care; the necessity of centralising patient experience; and the necessity of mitigating barriers to dental care. We conclude that increased awareness of scleroderma within dentistry and streamlining referral procedures between the disciplines of dentistry and rheumatology, to enable the early identification and management of scleroderma, are crucial.
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