health professional

健康专业
  • 文章类型: Journal Article
    背景:自COVID-19大流行以来,在许多国家,初级保健中视频咨询(VC)的使用已大大扩展。VC和其他远程医疗格式经常被吹捧为改善医疗保健访问的解决方案,大量研究表明,卫生专业人员和患者对这种护理形式的满意度很高。然而,患者对VC满意度的操作和测量在研究中各不相同,并且通常缺乏对动态上下文因素的考虑(例如,便利性,易用性,或隐私)和可能影响患者满意度的医患关系变量。
    目的:我们的目标是开发一个全面的、以证据为基础的问卷,用于评估一般实践中患者对VC的满意度。
    方法:vCare患者满意度问卷(vCare-PSQ)是根据COSMIN(基于共识的健康测量仪器选择标准)指南制定的。为了实现我们的总体目标,我们追求三个目标:(1)对现有患者满意度量表(PS-14)进行验证分析,(2)评估可能影响患者满意度的外在环境因素,以及(3)对相关内在满意度和关系满意度的评估(例如,健康焦虑,信息技术素养,信任全科医生,或便利性)。出于验证目的,问卷是由188名参加过至少1次VC的丹麦成年人的便利样本填写的.
    结果:我们对丹麦人群中PS-14的验证分析产生了可靠的结果,表明PS-14是丹麦患者人群中患者对VC满意度的适当衡量标准。将情境和医患关系因素回归到患者满意度上进一步表明,患者满意度取决于PS-14无法衡量的几个因素。这些包括信息技术素养和患者对全科医生的信任,以及几个上下文的利弊。
    结论:将PS-14与情境和医患关系因素的动态测量相结合,可以更全面地了解患者对VC的满意度。因此,vCare-PSQ可能有助于增强方法学方法来评估患者对VC的满意度。我们希望vCare-PSQ格式可能对未来在一般实践环境中有关VC的研究和实施工作有用。
    BACKGROUND: Since the COVID-19 pandemic, the use of video consultation (VC) in primary care has expanded considerably in many countries. VC and other telehealth formats are often touted as a solution to improved health care access, with numerous studies showing high satisfaction with this care format among health professionals and patients. However, operationalization and measurement of patient satisfaction with VC varies across studies and often lacks consideration of dynamic contextual factors (eg, convenience, ease-of-use, or privacy) and doctor-patient relational variables that may influence patient satisfaction.
    OBJECTIVE: We aim to develop a comprehensive and evidence-based questionnaire for assessing patient satisfaction with VC in general practice.
    METHODS: The vCare Patient-Satisfaction Questionnaire (the vCare-PSQ) was developed according to the COSMIN (Consensus-Based Standards for the Selection of Health Measurement Instruments) guidelines. To achieve our overall objective, we pursued three aims: (1) a validation analysis of an existing patient-satisfaction scale (the PS-14), (2) an assessment of extrinsic contextual factors that may impact patient satisfaction, and (3) an assessment of pertinent intrinsic and relational satisfaction correlates (eg, health anxiety, information technology literacy, trust in the general practitioner, or convenience). For validation purposes, the questionnaire was filled out by a convenience sample of 188 Danish adults who had attended at least 1 VC.
    RESULTS: Our validation analysis of the PS-14 in a Danish population produced reliable results, indicating that the PS-14 is an appropriate measure of patient satisfaction with VC in Danish patient populations. Regressing situational and doctor-patient relational factors onto patient satisfaction further suggested that patient satisfaction is contingent on several factors not measured by the PS-14. These include information technology literacy and patient trust in the general practitioner, as well as several contextual pros and cons.
    CONCLUSIONS: Supplementing the PS-14 with dynamic measures of situational and doctor-patient relational factors may provide a more comprehensive understanding of patient satisfaction with VC. The vCare-PSQ may thus contribute to an enhanced methodological approach to assessing patient satisfaction with VC. We hope that the vCare-PSQ format may be useful for future research and implementation efforts regarding VC in a general practice setting.
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  • 文章类型: Journal Article
    女同性恋,同性恋,双性恋,变性人,酷儿,双性恋和无性(LGBTQIA+)的人努力寻找一个了解他们的问题和需求的医疗服务。此外,医疗保健专业人员也发现很难照顾LGBTQIA+,因为很少有人研究或听说过管理。本文提出了一项试点研究的协议,旨在为健康科学专业人员开发LGBTQIA护理课程。该研究包括第一阶段:基于LGBTQIA+个人之间的文献综述和焦点小组讨论的课程开发,第二阶段:LGBTQIA+护理课程的试点测试。研究结果将反映医疗保健专业人员对LGBTQIA+护理知识的改进。
    Lesbian, Gay, Bisexual, Transgender, Queer, Intersex and Asexual (LGBTQIA+) people struggle to identify a healthcare service that understands their problems and needs. Additionally, healthcare professionals also find it difficult to care for LGBTQIA+ as very little is studied or heard about management. The article presents a protocol for a pilot study aimed at the development of an LGBTQIA+ care curriculum for health science professionals. The study includes Phase I: The development of a curriculum based on a literature review and focus group discussion among LGBTQIA+ individuals, and Phase II: Pilot testing of LGBTQIA+ care curriculum. The study outcome will reflect the improvement in the knowledge of healthcare professionals on LGBTQIA+ care.
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  • 文章类型: Journal Article
    背景:护士在对抗抗菌素耐药性(AMR)中起着关键作用。然而,地方和国家AMR遏制努力的成功取决于知识,态度,护理人员和本科生的实践(KAP)。目的:本研究旨在探讨护士KAP对AMR的影响因素,提供见解,以控制耐药病原体的出现和传播。方法:这种横断面,涉及意大利护士的多中心调查,护生,和医疗保健专业人员进行了一个匿名的在线调查问卷,重点是AMR。中位数12分作为“良好KAP”的截止值。“研究变量与良好KAP之间的关联使用卡方或t检验进行评估,其次是多变量logistic回归分析,具有统计学意义(p<0.05)。调查结果:在848名参与者中,61.9%(n=525)是学生,39.6%(n=336)的人得分为“低KAP”。“高KAP与女性和独立研究AMR有关。相反,生活在意大利南部并接受制药公司的AMR培训与低KAP有关。结论:在意大利护士中,AMR意识依赖于那些自学成才并受性别和地区影响的人。意大利大学缺乏关于AMR管理的讲座,需要做很多工作来提高非医疗卫生工作者对抗菌药物管理的认识。
    Background: Nurses play a pivotal role in combating antimicrobial resistance (AMR). However, the success of local and national AMR containment efforts hinges on the knowledge, attitude, and practice (KAP) of nursing staff and undergraduate students. Objectives: This study aims to explore the determinants of nurses\' KAP regarding AMR, offering insights to control the emergence and spread of drug-resistant pathogens. Methods: This cross-sectional, multicenter survey involving Italian nurses, nursing students, and healthcare professionals was conducted administering an anonymous online questionnaire focusing on AMR. The median score of 12 was taken as the cutoff for \"good KAP.\" The association between study variables and good KAP was assessed using chi-square or t-tests, followed by multivariable logistic regression analysis for statistically significant (p < 0.05) variables. Findings: Among 848 participants, 61.9% (n = 525) were students, and 39.6% (n = 336) scored as having \"low KAP.\" High KAP was associated with being female and studying AMR independently. Conversely, living in southern Italy and receiving AMR training from pharmaceutical companies were associated with low KAP. Conclusions: Among Italian nurses, AMR awareness relies on those who have studied AMR as self-taught and is affected by gender and region. Italian universities lack in lectures on AMR management, and much needs to be done to improve awareness of antimicrobial stewardship among nonmedical health workers.
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  • 文章类型: Journal Article
    脑震荡是体育运动中的一个严重问题,有可能造成短期和长期的健康后果。这些担忧凸显了将脑震荡管理指南转化为现实体育环境的必要性。这项定性研究探讨了社区橄榄球运动员的脑震荡经历,这是新西兰橄榄球的脑震荡管理途径的一部分。
    对36名橄榄球运动员进行了半结构化访谈(35名男性和1名女性;22名在学校比赛,14名在俱乐部级别比赛;平均年龄19.8±4.8)利用主题分析来分析数据。
    确定了四个主题,i)症状之旅,Ii)专门的脑震荡管理途径在塑造球员体验中的作用,iii)教练和物理治疗师的影响,和iv)橄榄球文化。作为脑震荡管理途径的一部分获得的支持,来自参与脑震荡之旅的个人,深刻地影响了他们的整体体验。然而,玩家在返回学校/工作时发现指导不足。有时,这项运动的集体文化价值观使得运动员难以制定积极的脑震荡管理行为。
    研究结果强调了明确的管理途径对支持玩家恢复的重要性。解决橄榄球集体主义文化的负面影响对于最佳脑震荡管理和康复仍然至关重要。
    UNASSIGNED: Concussion is a serious concern in sport, with the potential to cause short- and long-term health consequences. These concerns highlight the need for the translation of concussion management guidelines into use in real-world sports settings. This qualitative study explores community rugby players\' concussion experiences as part of New Zealand Rugby\'s concussion management pathway.
    UNASSIGNED: Semi-structured interviews were conducted with 36 rugby players (35 males and 1 female; 22 played at school and 14 at club-level; mean age 19.8 ± 4.8) Thematic analysis was utilized to analyze data.
    UNASSIGNED: Four themes were identified i) the symptom journey, ii) the role of a dedicated concussion management pathway in shaping players\' experiences, iii) the influence of coaches and physiotherapists, and iv) rugby culture. Support received as part of the concussion management pathway, and from individuals who were part of players\' concussion journey, deeply impacted their overall experience. However, players identified insufficient guidance while returning to school/work. At times, the sport\'s collective cultural values made it difficult for players to enact positive concussion management behavior.
    UNASSIGNED: The findings highlight the importance of a defined management pathway to support players\' recovery. Addressing negative aspects of rugby\'s collectivist culture remains critical for optimal concussion management and recovery.
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  • 文章类型: Journal Article
    放射治疗(RT)的未充分利用导致了全球癌症的巨大负担,研究发现实际利用率显着低于基于证据的最佳利用率。归因因素差异很大,从患者偏好,引荐者偏见,地理差异。本范围审查的目的是绘制和综合有关影响全球RT利用的障碍和促进因素的最新文献报告。四个在线数据库;Medline,Embase,Scopus和CINAHL确定了1993年至2023年之间的文章。研究资格包括RT服务报告,特别是对RT利用的障碍和影响。标题和摘要筛选,随后按照PRISMA指南进行全文审查.提取变量并将其分类为患者,卫生专业人员(HP)和部门层面的影响。总的来说,340项研究纳入范围审查。在225篇(66%)论文中报告了HP影响(包括在此特定综述中),其中最普遍的HP影响是转诊(n=187;83%)。在惠普的论文中,114人(51%)认为知识和教育对RT利用有影响。随后,角色解读,描述全科医生作为患者倡导者所承担的角色,教育家,在89项(40%)研究中确定了管理者或护理人员。此范围审查显示了影响RT利用率的因素范围。结果表明,引荐者的知识和理解差距会影响国际上的RT利用。需要对推荐RT教育进行未来的研究和干预,以限制此类影响的影响。
    The underutilisation of radiation therapy (RT) is contributing to the significant global burden of cancer with studies identifying actual utilisation rates are significantly lower than evidence-based optimal utilisation rates. Attributing factors vary considerably, ranging from patient preference, referrer bias, to geographic variations. The aim of this scoping review is to map and synthesise the current literature reporting on barriers and facilitators influencing utilisation of RT globally. Four online databases; Medline, Embase, Scopus and CINAHL identified articles dated between 1993 and 2023. Study eligibility included reporting on RT services, specifically barriers and influences on utilisation of RT. Title and abstract screening, followed by full text review was performed as per PRISMA guidelines. Variables were extracted and categorised into patient, health professional (HP) and department level influences. In total, 340 studies were included in the scoping review. HP influences (included in this specific review) were reported in 225 (66 %) papers with the most prevalent HP influence being referral (n = 187; 83 %). Of the HP papers, 114 (51 %) identified knowledge and education as an influence on RT utilisation. Subsequently, role interpretation, describing the assumed role adopted by the General Practitioner as the patients advocate, educator, manager or carer was identified in 89 (40 %) studies. This scoping review demonstrates the range of factors impacting RT utilisation. The results suggest referrer knowledge and understanding gaps impact RT utilisation internationally. Future research and intervention into referrer RT education is required to limit the impact of such influences.
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  • 文章类型: Journal Article
    背景:来自医学和心理领域不同专业的卫生专业人员在饮食失调(ED)的诊断和治疗中发挥着重要作用。这项研究旨在找出有关诊断的知识差距,病因学,和ED的管理,并评估卫生专业人员对这些疾病的态度。
    方法:开发并验证了新的问卷。在涉及ED管理的学科中工作的居民和顾问(即,内科,全科医生,精神病区,心理领域,和手术区)完成问卷。通过单向ANCOVA和卡方检验比较了研究组之间的知识和态度。
    结果:问卷的最终版本包括54个项目,评估以下方面:污名,治疗,身体并发症,诊断,和ED的病因。对于所有卫生专业人员来说,最缺乏的领域是病因,而最好的是身体并发症的管理。所有医疗专业人员在病因学方面的知识都比精神科医生少,诊断,和ED的治疗。缺乏关于循证心理治疗的知识,一般精神病理学,和家庭成员在ED管理中的角色出现在所有卫生专业人员中。在非心理健康专业人员中发现了污名,他们认为这些患者与其他人不同,并对他们的异常饮食行为负责。
    结论:澄清卫生专业人员在ED知识和对这些人的态度方面出现的具体差距,可能会为教育计划提供信息,以改善ED的早期发现和管理。
    本文调查了卫生专业人员对饮食失调(ED)患者的态度以及对这些疾病的诊断和管理的了解。诊断知识的空白,病因,治疗首先出现在非心理健康专业人员中。心理治疗的有效性和家庭成员在治疗过程中的作用没有得到充分承认,导致ED发作的一般心理因素未被识别。态度受损主要在外科医生中观察到,尽管所有卫生专业人员都认为这些疾病与其他人不同,并认为这些人对他们的异常饮食行为负责。这些发现概述了与卫生专业人员有关的对ED的污名,并可能损害早期诊断和恢复。教育计划应旨在提供持续教育,以更新和提高卫生专业人员的ED知识。
    BACKGROUND: Health professionals from different specialties in medical and psychological areas play an important role in diagnosis and treatment of eating disorders (EDs). This study aimed to identify gaps in knowledge about the diagnosis, etiology, and management of EDs and to assess health professionals\' attitudes towards these illnesses.
    METHODS: A new questionnaire was developed and validated. Residents and consultants working in disciplines involved in the management of EDs (namely, internal medicine, general practitioners, psychiatric area, psychological area, and surgical area) completed the questionnaire. Knowledge and attitudes were compared among the study groups through one-way ANCOVA and chi-square tests.
    RESULTS: The final version of the questionnaire consisted of 54 items assessing the following areas: stigma, treatment, physical complications, diagnosis, and aetiopathogenesis of EDs. For all health professionals the area of most deficiency was the aetiopathogenesis, while the best one was the management of physical complications. All medical professionals showed less knowledge than psychiatrists in terms of etiology, diagnosis, and treatment of EDs. A lack of knowledge about evidence-based psychotherapies, general psychopathology, and family members\' role in the management of EDs emerged among all health professionals. Stigma was found among non-mental health professionals who considered these patients to be different from others and responsible for their abnormal eating behaviors.
    CONCLUSIONS: Clarifying the health professionals\' specific gaps occurring in the knowledge of EDs and in the attitudes towards these individuals may inform educational programs to improve early detection and management of EDs.
    This article investigated attitudes towards individuals with eating disorders (EDs) and knowledge of the diagnosis and management of these illnesses among health professionals. A gap in the knowledge of diagnosis, aetiopathogenesis, and treatment emerged above all in non-mental health professionals. Psychotherapy effectiveness and the role of family members in the therapeutic process were not sufficiently acknowledged, and general psychological factors contributing to the onset of EDs were not recognized. Impaired attitudes were primarily observed among surgeons, although all health professionals considered these disorders as distinct from others and viewed these individuals as responsible for their abnormal eating behaviors. These findings outline a type of stigma towards EDs that is associated with health professionals and may impair early diagnosis and recovery. Educational programs should aim to provide continuous education to update and improve the knowledge of EDs among health professionals.
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  • 文章类型: Journal Article
    关于登革热的卫生统计几乎不存在,尽管该病毒在多哥传播。这项研究旨在评估知识,态度,卡拉卫生区卫生专业人员的实践(KAP)。
    于2022年3月至6月进行了一项横断面研究,其中使用详尽的招募方法选择了在多哥北部卡拉地区工作的医疗保健专业人员。数据是由训练有素的住院医生通过标准化的面对面访谈收集的,基于世卫组织2009年登革热指南的预测试问卷。三个多元回归模型被用来调查与知识相关的因素,态度和,和实践。
    共有464名受访者(37.1%为女性),中位年龄35岁,包括四分位间距(29-43年)。只有(3.0%)的参与者接受过登革热诊断培训,过去三年的治疗和预防,10.3%的人在他们的医院接受了登革热快速诊断测试。半数受访者(49.1%)对登革热有良好的认识,30.0%的人有积极的态度。共有256名专业人士在执业中遇到登革热个案,只有24例(9.4%)有适当的登革热诊断和治疗方法.在多变量分析中,参加持续登革热培训的医疗保健专业人员更有可能有足够的登革热诊断和治疗实践aOR=8.1;CI95%=[1.7-36.0].
    通过持续的培训和提供登革热诊断测试来加强医疗保健专业人员的登革热相关技能,可以帮助改善多哥登革热的早期发现和管理。
    UNASSIGNED: Health statistics on dengue are virtually non-existent, despite the fact that the virus is circulating in Togo. This study aimed to assess the knowledge, attitudes, and practices (KAP) of health professionals in the Kara health region.
    UNASSIGNED: A cross-sectional study was conducted from March to June 2022 among healthcare professionals who had worked in the Kara region of northern Togo were selected using an exhaustive recruitment method. Data were collected by trained resident doctors with a face-to-face interview using a standardized, pretested questionnaire based on the WHO 2009 dengue guide. Three multivariate regression models were utilized to investigate factors associated with knowledge, attitudes and, and practices.
    UNASSIGNED: A total of 464 respondents (37.1% female), median age 35 years, interquartile range (29-43 years) were included. Only (3.0%) of the participants had received training on dengue fever diagnosis, treatment and prevention in the last 3 years, and 10.3% had dengue rapid diagnostic tests available at their hospital. Half of the respondents (49.1%) had good knowledge of dengue fever, compared with 30.0% who had positive attitudes. Of a total of 256 professionals who had encountered a case of dengue fever in their practice, only 24 (9.4%) had appropriate practices for diagnosing and treating dengue fever. In multivariate analysis, the healthcare professionals who had taken part in ongoing training on dengue fever were more likely to have adequate dengue diagnosis and treatment practice aOR = 8.1; CI 95% = [1.7-36.0].
    UNASSIGNED: Strengthening healthcare professionals\' dengue-related skills through ongoing training and the provision of dengue diagnostic tests could help improve early detection practices and management of dengue fever in Togo.
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  • 文章类型: Journal Article
    背景:压力性溃疡(PU)是在医疗机构中不动的患者中常见且严重的并发症。护士在预防PU方面发挥着重要作用;然而,新手护士缺乏临床经验。虚拟现实(VR)非常有利于以临床和程序为重点的培训,因为它有助于模拟。
    目的:我们旨在探索针对新手护士使用头戴式显示器的新型PU管理VR模拟(PU-VRSim)计划的可行性,并调查不同类型的学习材料(即,VR或基于视频的讲座)影响学习成果和体验。
    方法:PU-VRSim是在Unity3D平台中创建的。这项混合方法试点准实验研究包括35名新手护士,分为实验组(n=18)和对照组(n=17)。实验组使用VR应用PU-VRSim程序,而对照组接受了基于视频的讲座。PU知识测试,批判性思维倾向测量工具,在干预前后对两组进行了朝鲜语版本的一般自我效能量表的评估。干预之后,使用临床判断规则对实验组进行了进一步评估,并进行了访谈以评估他们使用PU-VRSim的经验.
    结果:干预前后比较结果显示,实验组(P=.001)和对照组(P=.005)的PU知识均有显著改善。两组的自我效能感和批判性思维没有显着差异。实验组在临床判断上平均得分为3.23(SD0.44)分(完成),使用4分量表进行评估。实验组访谈表明,VR模拟是现实的,有助于学习PU管理。
    结论:结果表明,PU-VRSim可以提高新手护士在现实环境中对PU管理的学习。建议新手护士使用VR进行临床培训的进一步研究。
    BACKGROUND: Pressure ulcers (PUs) are a common and serious complication in patients who are immobile in health care settings. Nurses play a fundamental role in the prevention of PUs; however, novice nurses lack experience in clinical situations. Virtual reality (VR) is highly conducive to clinical- and procedure-focused training because it facilitates simulations.
    OBJECTIVE: We aimed to explore the feasibility of a novel PU management VR simulation (PU-VRSim) program using a head-mounted display for novice nurses and to investigate how different types of learning materials (ie, VR or a video-based lecture) impact learning outcomes and experiences.
    METHODS: PU-VRSim was created in the Unity 3D platform. This mixed methods pilot quasi-experimental study included 35 novice nurses categorized into the experimental (n=18) and control (n=17) groups. The PU-VRSim program was applied using VR in the experimental group, whereas the control group received a video-based lecture. The PU knowledge test, critical thinking disposition measurement tool, and Korean version of the General Self-Efficacy Scale were assessed before and after the intervention in both groups. After the intervention, the experimental group was further assessed using the Clinical Judgment Rubric and interviewed to evaluate their experience with PU-VRSim.
    RESULTS: The results compared before and after the intervention showed significant improvements in PU knowledge in both the experimental group (P=.001) and control group (P=.005). There were no significant differences in self-efficacy and critical thinking in either group. The experimental group scored a mean of 3.23 (SD 0.44) points (accomplished) on clinical judgment, assessed using a 4-point scale. The experimental group interviews revealed that the VR simulation was realistic and helpful for learning about PU management.
    CONCLUSIONS: The results revealed that PU-VRSim could improve novice nurses\' learning of PU management in realistic environments. Further studies using VR for clinical training are recommended for novice nurses.
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  • 文章类型: Journal Article
    目的:成人严重和持久饮食失调的治疗模式侧重于减少伤害和改善生活质量。然而,在这方面,儿科文献存在明显的差距。本研究旨在评估卫生专业人员对年轻人临床护理的看法(例如,年龄10-25岁)患有严重和持久的饮食失调,并探索对这些演示文稿的适当治疗方案的看法。
    方法:卫生专业人员被邀请通过加拿大和澳大利亚专业饮食失调网络完成一项关于他们在儿科饮食失调临床护理方面经验的两阶段在线调查。调查1包括有关他们在支持具有严重和持久陈述的个人方面的经验的问题。完成调查2的参与者回顾了临床插图,并分享了他们对治疗建议和护理模式的看法。包括一个严肃而持久的演讲。
    结果:共有85名临床医生回答了调查1中关于严重和持久的进食障碍表现的问题。这些受访者中的一部分(n=25)也参加了调查2。调查1的大多数受访者报告为儿科严重和持久的饮食失调表现提供临床护理。在调查2的受访者中,受访者对临床护理的共识较低,最适合患有严重和持久饮食失调的年轻人。调查2的回应提出了儿科环境中严重和持久的护理模式的许多挑战,临床医生分享了他们对生活质量模型的认识。同时也引起了人们对这些模式适合年轻人的担忧。
    结论:这项研究的初步结果表明,大多数临床医生报告说,他们已经为表现严重和持久的年轻人提供了护理。显然需要为在儿科饮食失调环境中工作的临床医生建立指导,以关注生活质量的护理模式。与感兴趣的各方接触,包括那些有生活经验的人,可以澄清儿童饮食失调的严重和持久表现的术语和临床路径的发展。
    治疗模式侧重于减少伤害和生活质量(而不是饮食失调恢复)可用于患有严重和持久饮食失调的成年人。然而,这些模式并不广泛适用于年轻人。事实上,关于儿科人群中严重和持久的饮食失调表现的研究非常有限。我们评估了卫生专业人员对患有严重和持久饮食失调的年轻人的临床护理的看法,并向专业人士询问哪些治疗方案可能最适合这些演示。大多数参与者报告说,为儿科严重和持久的饮食失调表现提供了临床护理。然而,临床医生对最适合年轻人出现严重和持久的饮食失调的治疗有不同的看法.需要与临床医生和有经验的人进行进一步的研究和参与,以澄清儿科饮食失调的严重和持久表现的术语和临床路径。
    OBJECTIVE: Models of treatment for adults with severe and enduring eating disorders focus on harm reduction and improving quality of life. However, there is a notable gap in the pediatric literature in this area. The current study set out to assess the perspectives of health professionals regarding clinical care for young people (e.g., ages 10-25 years) with severe and enduring eating disorders, and to explore perceptions about appropriate treatment options for these presentations.
    METHODS: Health professionals were invited to complete a two-stage online survey about their experiences with clinical care for pediatric eating disorders through Canadian and Australian professional eating disorder networks. Survey 1 included questions about their experiences in supporting individuals with severe and enduring presentations. Participants who completed Survey 2 reviewed clinical vignettes and shared their perspectives about treatment recommendations and models of care, including for a severe and enduring presentation.
    RESULTS: A total of 85 clinicians responded to questions on Survey 1 about severe and enduring eating disorder presentations. A portion of these respondents (n = 25) also participated in Survey 2. The majority of respondents to Survey 1 reported providing clinical care for pediatric severe and enduring eating disorder presentations. Amongst respondents to Survey 2, there was low consensus amongst respondents for the clinical care that would be most appropriate for young people with a severe and enduring eating disorder presentation. Numerous challenges in models of care for severe and enduring presentations in pediatric settings were raised in responses on Survey 2, with clinicians sharing their awareness of models focusing on quality of life, while also raising concerns about the appropriateness of these models for young people.
    CONCLUSIONS: The preliminary results of this study demonstrate that the majority of clinicians report that they have provided care to young people with severe and enduring presentations. There is a clear need for establishing guidance for clinicians working in pediatric eating disorder settings around models of care focused on quality of life. Engagement with interested parties, including those with lived experience, can clarify the development of terminology and clinical pathways for severe and enduring presentations of pediatric eating disorders.
    Treatment models focusing on harm reduction and quality of life (as opposed to eating disorder recovery) are available for adults with severe and enduring eating disorders. However, these models are not widely available for young people. In fact, there is very limited research on severe and enduring eating disorder presentations in pediatric populations. We assessed the views of health professionals regarding clinical care for young people with severe and enduring eating disorder presentations, and asked professionals about what treatment options might be most appropriate for these presentations. Most participants reported providing clinical care for pediatric severe and enduring eating disorder presentations. However, clinicians had diverse views about the treatment that would be most appropriate for a severe and enduring eating disorder presentation in a young person. Further research and engagement with clinicians and those with lived experience is needed to clarify the terminology and clinical pathways for severe and enduring presentations of pediatric eating disorders.
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  • 文章类型: Journal Article
    背景:尽管跨专业学生主导的健康诊所已在全球范围内实施,这种模式的影响有待确认。
    目的:对跨专业学生主导诊所的文献进行批判性分析,以及利益相关者对可行性的看法以及实施的障碍和促进者。
    方法:范围审查,使用PRISMAScr进行证据综合和质量评价。从2003年到2023年搜索了八个数据库:Medline(Ovid),Embase(Ovid),CINAHL(EBSCO),科克伦,Scopus,ERIC,WebofScienceandInformitHealthCollection。使用定性描述性方法分析来自患者的数据,学生和教育工作者和归纳主题分析确定了紧急主题。
    结果:纳入了3140份出版物的46项研究。出现的一个关键主题是,患者认为他们的健康和福祉有所改善,并重视从学生主导的诊所获得健康信息。学生的经历大多是积极的,尽管有些人发现在跨专业团队中工作具有挑战性,而且角色并不总是很清楚。诊所使学生能够提高沟通技巧和自主性。临床教育工作者报告说,学生在跨专业环境中受益于体验式学习。诊所是可行的,只要有足够的资金,基础设施,人员和资源可用。实施的障碍包括缺乏资金,过多的等待时间和不结盟的学生时间表。临床前指导和现场临床教育工作者的支持促进了实施。
    结论:尽管实施跨专业学生主导诊所存在一些挑战,它们可以对学生学习和患者体验产生积极影响。
    BACKGROUND: Although interprofessional student led health clinics have been implemented worldwide, the impact of this model await confirmation.
    OBJECTIVE: To conduct a critical analysis of the literature on interprofessional student led clinics, and the views of stakeholders on feasibility and the barriers and facilitators to implementation.
    METHODS: A scoping review, evidence synthesis and quality appraisal were conducted using PRISMA Scr. Eight databases were searched from 2003 to 2023: Medline (Ovid), Embase (Ovid), CINAHL (EBSCO), Cochrane, Scopus, ERIC, Web of Science and Informit Health Collection. A qualitative descriptive approach was used to analyse data from patients, students and educators and inductive thematic analysis identified emergent themes.
    RESULTS: Forty-six studies were included from a yield of 3140 publications. A key theme to emerge was that patients perceived improvements in their health and wellbeing and valued gaining health information from student led clinics. Student experiences were mostly positive although some found it challenging to work in interprofessional teams and roles were not always clear. The clinics enabled students to improve communication skills and autonomy. Clinical educators reported that students benefited from experiential learning within an interprofessional context. The clinics were feasible, provided that sufficient funding, infrastructure, staff and resources were available. Barriers to implementation included lack of funding, excessive waiting times and non-aligned student timetables. Pre-clinic orientation and support from on-site clinical educators facilitated implementation.
    CONCLUSIONS: Despite some challenges with implementing interprofessional student led clinics, they can have a positive impact on student learning and patient experiences.
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