• 【获得ART治疗的社会经济差异以及增加消费者成本的政策的不同影响。】 复制标题 收藏 收藏
    DOI:10.1093/humrep/det302 复制DOI
    作者列表:Chambers GM,Hoang VP,Illingworth PJ
    BACKGROUND & AIMS: STUDY QUESTION:What was the impact on access to assisted reproductive technology (ART) treatment by different socioeconomic status (SES) groups after the introduction of a policy that increased patient out-of-pocket costs? SUMMARY ANSWER:After the introduction of a policy that increased out-of-pocket costs in Australia, all SES groups experienced a similar percentage reduction in fresh ART cycles per 1000 women of reproductive age. Higher SES groups experienced a progressively greater reduction in absolute numbers of fresh ART cycles due to existing higher levels of utilization. WHAT IS KNOWN ALREADY:Australia has supportive public funding arrangements for ARTs. Policies that substantially increase out-of-pocket costs for ART treatment create financial barriers to access and an overall reduction in utilization. Data from the USA suggests that disparities exist in access to ART treatment based on ethnicity, education level and income. STUDY DESIGN, SIZE, DURATION:Time series analysis of utilization of ART, intrauterine insemination (IUI) and clomiphene citrate by women from varying SES groups before and after the introduction of a change in the level of public funding for ART. PARTICIPANTS/MATERIALS, SETTING, METHODS:Women undertaking fertility treatment in Australia between 2007 and 2010. MAIN RESULTS AND THE ROLE OF CHANCE:Women from higher SES quintiles use more ART treatment than those in lower SES quintiles, which likely reflects a greater ability to pay for treatment and a greater need for ART treatment as indicated by the trend to later childbearing. In 2009, 10.13 and 5.17 fresh ART cycles per 1000 women of reproductive age were performed in women in the highest and lowest SES quintiles respectively. In the 12 months after the introduction of a policy that increased out-of-pocket costs from ∼$1500 Australian dollars (€1000) to ∼$2500 (€1670) for a fresh IVF cycle, there was a 21-25% reduction in fresh ART cycles across all SES quintiles. The absolute reduction in fresh ART cycles in the highest SES quintile was double that in the lowest SES quintile. LIMITATIONS, REASONS FOR CAUTION:In this study, SES was based on the average relative socioeconomic advantage and disadvantage of small geographic areas, and therefore may not reflect the SES of an individual. Additionally, the policy impact was limited to the 12 months following its introduction, and may not reflect longer term trends in ART treatment. WIDER IMPLICATIONS OF THE FINDINGS:While financial barriers are an important obstacle to equitable access to ARTs, socioeconomic differences in utilization are likely to persist in countries with supportive public funding, due in part to differences in childbearing patterns and treatment seeking behaviour. Policy makers should be informed of the impact that changes in the level of cost subsidization have on access to ART treatment by different socioeconomic groups. STUDY FUNDING/COMPETING INTEREST(S):G.M.C. receives grant support to her institution from the Australian Government, Australian Research Council (ARC) Linkage Grant No LP1002165; ARC Linkage Grant Partner Organisations are IVFAustralia, Melbourne IVF and Queensland Fertility Group. V.P.H. is employed as an Economics Research Associate on the same grant. P.J.I. is Medical Director of the IVF Clinic, IVFAustralia and has a financial interest in the parent group, Virtus. TRIAL REGISTRATION NUMBER:N/A.
    背景与目标:
  • 【Trittans早期治疗偏头痛发作: 提高疗效和患者满意度的策略?】 复制标题 收藏 收藏
    DOI:10.1586/14737175.6.7.1087 复制DOI
    作者列表:D'Amico D,Moschiano F,Bussone G
    BACKGROUND & AIMS: :Treating migraine attacks early with triptans may be more effective than late triptan administration. However, in published studies, the definition of 'early' varied (in terms of time, pain intensity or presence of allodynia) or was unclear. Therefore, clear clinical indications have not been established. Appropriately designed trials to address this issue remain a priority. Early triptan treatment may also have disadvantages, including inadvertent treatment of tension-type headaches and danger of medication overuse. At present, only those migraineurs with rapid pain worsening, high pain recurrence rate and clinical indications of allodynia should be encouraged to take triptans as quickly as possible. This recommendation implies a requirement for patient education and the need to carefully tailor treatment to individual needs.
    背景与目标: : 早期用曲坦治疗偏头痛发作可能比晚期服用曲坦更有效。然而,在已发表的研究中,“早期” 的定义有所不同 (在时间,疼痛强度或异常性疼痛的存在方面) 或不清楚。因此,尚未建立明确的临床适应症。解决这一问题的适当设计的试验仍然是一个优先事项。早期曲坦治疗也可能有缺点,包括无意中治疗紧张型头痛和药物过度使用的危险。目前,只有那些疼痛迅速恶化,疼痛复发率高且有异常性疼痛的临床指征的偏头痛患者才应鼓励尽快服用曲普坦斯。此建议意味着需要对患者进行教育,并且需要根据个人需求精心定制治疗方法。
  • 【脊柱裂患者尿道清洁间歇导管插入术的并发症和患者满意度: 比较涂层导管与未涂层导管。】 复制标题 收藏 收藏
    DOI:10.1016/j.jpurol.2019.10.001 复制DOI
    作者列表:Burki T,Abasher A,Alshahrani A,Al Hams AW,Ibrahim H,Albadawe H,Al Modhen F,Jamalalail Y,Al Shammari A
    BACKGROUND & AIMS: INTRODUCTION:Many types of catheters are available in market for clean intermittent catheterization (CIC). Each company claim superiority of their products, but strong evidence is lacking. PURPOSE:To assess the complications due to CIC in spina bifida children and its possible relationship to hydrophilic-coated catheter (HCC) or uncoated catheters (UCCs), with a view to decrease catheter related complications, and improve patients experience and compliance. MATERIALS AND METHODS:The authors retrospectively reviewed the spina bifida patients aged between 0 and 16 years, who had no surgical intervention, and were performing CIC urethrally for at least 6 months. General information was recorded from electronic patient record, followed by telephonic/outpatient interview. Patients were divided into two groups: UCC or HCC. Patients in both groups had also used catheter from the other group at times. This study recorded the type/size of catheter used, its duration, complications, and their possible relation to type of catheter. Carer/patients overall satisfaction was recorded on a scale of 1-10 and their preference about the type of catheter they wish. The data were analyzed using SPSS (P-value < 0.05 as significant). RESULTS:One hundred one patients were included in the study: 53 UCC and 48 HCC. There was no significant difference between gender/associated conditions/age at start of CIC or duration of CIC. The mean time taken to perform the procedure was similar in both groups: UCC 9.7 min vs HCC 8.8 min. Difficulty in insertion was felt in 20, UCC 12 vs HCC 8 (P = 0.15), recurrent UTIs UCC 12 vs HCC 17 (P = 0.09), median patient satisfaction UCC 8/10 (3-10) and HCC 10/10 (7-10) (P = 0.63). Request for change of catheter was made by 10 from UCC group to HCC vs none from HCC (P ≤ 0.05).When given a choice, 28/53 (52.8%) in UCC and none (0%) in HCC group (P ≤ 0.0001) preferred to change to the other type of catheter, mainly for convenience of use of the product. Per year per patient cost was UCC US$ 389 vs HCC US$ 2820. DISCUSSION:Many un-modifiable factors contribute to the outcome of CIC. Despite claims of superiority by manufactures of some catheters over others, strong evidence is lacking especially in children. This study has shown no difference in the complications between UCC and HCC. CONCLUSION:There is no significant difference in complication rates with urethral CIC in patients using either UCC or HCC. A significant majority would prefer to use HCC mainly because of convenience of use of the product though at a seven times higher cost.
    背景与目标:
  • 【促进姑息治疗中的消费者声音: 探索使用消费者影响声明的可能性。】 复制标题 收藏 收藏
    DOI:10.1111/hex.12118 复制DOI
    作者列表:McConigley R,Shelby-James T,Currow DC
    BACKGROUND & AIMS: BACKGROUND:It can be difficult to engage consumers in health decision making. This is particularly so in the area of palliative care, where consumers are very unwell and are unlikely to become involved in long-term programmes that promote consumer input. This paper explores the possibility of using 'Consumer Impact Statements' to facilitate the inclusion of the viewpoint of people at the end of life in the process of policy and decision making, particularly in the area of subsidy of pharmaceuticals used in palliative care. SEARCH STRATEGY:A broad search was conducted to find information about the use of impact statements in any health field. The health literature and grey literature were searched to explore the use of Consumer Impact Statements to date. RESULTS:No papers were found describing the use of Consumer Impact Statements in the palliative care setting. Health impact assessment is used in the areas of environmental health and community health. Impact statements are less commonly used in other areas of health, especially policy development, and no formal description of a Consumer Impact Statement was found. DISCUSSION:There is considerable scope for developing the use of Consumer Impact Statements to promote the consumer viewpoint in health decision making, because it will allow people who are otherwise unlikely to contribute to the public debate to have their views heard by decision makers. CONCLUSION:The use of Consumer Impact Statements is particularly suited to palliative care, given that consumers are often otherwise unable to contribute to the public debate.
    背景与目标:
  • 【护理工作环境、离职意向、工作倦怠和护理质量: 工作满意度的调节作用。】 复制标题 收藏 收藏
    DOI:10.1111/jnu.12528 复制DOI
    作者列表:Al Sabei SD,Labrague LJ,Miner Ross A,Karkada S,Albashayreh A,Al Masroori F,Al Hashmi N
    BACKGROUND & AIMS: PURPOSE:The purpose of this study was twofold: (a) to assess predictors of the turnover intention, burnout, and perceived quality of care among nurses working in Oman, and (b) to examine the potential moderating role of job satisfaction on the relationship between work environment and nurse turnover intention. DESIGN:A cross-sectional design was used to collect data from a sample of 207 nurses working in a public hospital in Muscat, Oman. METHODS:An electronic survey was used to assess nurses' perceptions of work environment, burnout, job satisfaction, turnover intention, and quality of care. FINDINGS:Participation in hospital affairs, a foundation for quality of care, and staffing adequacy were predictors of burnout among nurses and perceived quality of care. Logistic regression analysis revealed that working in a favorable environment was associated with less turnover intention, but only when job satisfaction was high. CONCLUSIONS:Improving nurse job satisfaction is a mechanism through which future interventions could enhance working conditions and promote better nurse retention. CLINICAL RELEVANCE:Organizational strategies are needed to increase nurse job satisfaction by empowering nurses to take more active roles in hospital affairs as a strategy to reduce turnover intention and enhance the quality of patient care.
    背景与目标:
  • 【与分割厚度皮肤移植相比,较低的供体部位发病率和较高的患者对表皮移植的满意度: 一项随机对照试验 (EPIGRAAFT试验)。】 复制标题 收藏 收藏
    DOI:10.1016/j.bjps.2020.03.006 复制DOI
    作者列表:Kanapathy M,Bystrzonowski N,Hachach-Haram N,Twyman L,Becker DL,Richards T,Mosahebi A
    BACKGROUND & AIMS: BACKGROUND:Split thickness skin grafting (SSG) is an important modality for wound coverage; however, it leads to donor site morbidity. Epidermal grafting (EG) is a promising option for autologous skin grafting which offers minimal donor site morbidity, though it is not known if EG is an effective clinical alternative for SSG. This study compared the efficacy of EG as an alternative to SSG in terms of wound healing outcomes, donor site morbidity, patient satisfaction and adverse events. METHODS:EPIGRAAFT is a Phase 2, randomized, open-label trial with two parallel groups: EG and SSG. Patients referred for skin grafting with a healthy granulating wound bed were included. The co-primary endpoints were the proportion of wounds healed and donor site healing time. The secondary endpoints include donor site morbidity measured using Vancouver Scar Scale, mean time for complete wound healing, patient satisfaction assessed using a validated skin grafting questionnaire and incidence of adverse events. RESULTS:Of the 61 patients screened, 44 patients were randomized. There was no difference in the proportion of wounds healed at 6 weeks (p=0.366) and 3 months(p=0.24) as well as the mean time for wound healing (p=0.12). EG resulted in lower donor site morbidity (p=0.001), faster donor site healing time (EG: 4.86 days vs. SSG: 21.32 days) (p<0.0001), and higher overall satisfaction (p<0.001). There were no adverse events reported. CONCLUSION:This study demonstrated that EG has superior donor site outcomes with faster donor site healing and lower morbidity compared to SSG, while having comparable wound healing outcomes. Patients receiving EG also experienced higher donor site satisfaction compared to SSG. ClinicalTrials.gov identifier: NCT02535481.
    背景与目标:
  • 【急诊医学临床药师对护理满意度的影响】 复制标题 收藏 收藏
    DOI:10.1007/s11096-019-00927-y 复制DOI
    作者列表:Treu CN,Llamzon JL,Acquisto NM,Lazar JD
    BACKGROUND & AIMS: BACKGROUND:In the United States, emergency medicine clinical pharmacists have become more common over the last several decades. Despite being a vital component of the emergency department interdisciplinary team, there is very limited information published regarding the direct impact emergency medicine clinical pharmacists have on other emergency department-based professions. OBJECTIVE:To determine if the addition of an emergency medicine clinical pharmacist improves nursing satisfaction with pharmacy services. SETTING:The study was conducted at a 422-bed urban teaching hospital consisting of approximately 60 emergency medicine nurses. METHODS:This was a prospective study that evaluated nursing satisfaction prior to the initiation of an emergency medicine clinical pharmacist and one year after implementation. The survey consisted of 29 questions and was designed to assess three areas of pharmacy: general pharmacy, pharmacy information technology, and emergency medicine clinical pharmacy services. For the majority of questions, a 5-point Likert scale ranging from 1 representing strongly disagree to 5 representing strongly agree was utilized. Responses for the 5 point Likert scale were further tabulated into either positive or negative responses. All emergency department nurses employed during the study period (September 2015 and 2016) were eligible to participate anonymously. MAIN OUTCOME MEASURE:The main outcome assessed was the difference in satisfaction scores between study periods. RESULTS:A total of 52 surveys were returned over the course of the study (22 [36.7%] in the pre-intervention group versus 30 [50%] in the post-intervention group). All general pharmacy questions were improved at one year with timely resolution of pharmacy related issues, medication procurement, and satisfaction with pharmacy services achieving statistical significance. Pharmacy information technology questions were significantly improved with respect to satisfaction with the automated medication dispensing system inventory, prevention and resolution of medication stock outs, and ease of medication removal compared to baseline. The perceived impact of emergency medicine clinical pharmacy services in the pre-intervention group was validated after the one-year implementation period. CONCLUSION:An emergency medicine clinical pharmacist increases nursing satisfaction with central pharmacy and pharmacy technology services and was able to maintain the nurses' perceived expected role of the clinical pharmacist.
    背景与目标:
  • 【[西班牙南部农村和城市青少年坚持地中海饮食,生活满意度,人体测量学以及身体和久坐活动]。】 复制标题 收藏 收藏
    DOI:10.3305/nh.2013.28.4.6486 复制DOI
    作者列表:Grao-Cruces A,Nuviala A,Fernández-Martínez A,Porcel-Gálvez AM,Moral-García JE,Martínez-López EJ
    BACKGROUND & AIMS: BACKGROUND:The Mediterranean diet is one of the healthier diet models. Mediterranean food patterns are suffering a deterioration that can especially affect children and adolescents. OBJECTIVE:Determine adherence to the Mediterranean diet in adolescents of southern Spain and its relationship with the residence area, sex, age, life satisfaction, anthropometry, and habits of physical activity and sedentary activities. METHODOLOGY:A total of 1973 adolescents (11-18 years) of southern Spain participated in this descriptive cross-sectional study. Cut-off value between rural and urban locations was 10000 inhabitants. Adherence to the Mediterranean diet was calculated from the KIDMED questionnaire. Life satisfaction, physical activity, and sedentary activities also were measured through valid and reliable questionnaires. Body mass index and % body fat were measured using the TANITA BC-420-S body analyzer. RESULTS:30.9% of the adolescents reported an optimal quality diet, percent higher in rural locations (P < 0.05). Adherence was lower in older adolescents (P < 0.001), it was not different between sexes or according to anthropometric variables. Adolescents more satisfied with their lives (P < 0.001), more active (P < 0.001), more studious (P < 0.001), and less sedentary in front of a screen (P < 0.001) showed greater adherence to the Mediterranean food pattern. CONCLUSION:The majority of adolescents need to improve their nutritional quality. Compared with these subjects, the adolescents most adherent to the Mediterranean diet had a healthier lifestyle and they showed greater life satisfaction. :Introducción: La dieta mediterránea es uno de los modelos más saludables de dieta. Los patrones alimentarios mediterráneos están sufriendo un deterioro que puede afectar especialmente a niños y adolescentes. Objetivo: Determinar la adherencia a la dieta mediterránea de los adolescentes del sur de España y su relación con el área de residencia, sexo, edad, satisfacción con la vida, características antropométricas y hábitos de actividad física y sedentaria. Métodos: Un total de 1.973 adolescentes (11-18 años) del sur de España participaron en este estudio descriptivo transversal. El punto de corte entre poblaciones rurales y urbanas fue 10.000 habitantes. La adherencia a la dieta mediterránea fue calculada a partir del cuestionario KIDMED. Satisfacción con la vida, actividad física y sedentarismo también mediante cuestionarios fiables y válidos. Índice de masa corporal y % de grasa corporal fueron medidos utilizando el analizador corporal TANITA BC-420-S. Resultados: El 30,9% de los adolescentes reportó una dieta de calidad óptima, porcentaje superior en poblaciones rurales (P < 0,05). La adherencia fue menor en los adolescentes de mayor edad (P < 0,001), sin diferir entre sexos ni según las variables antropométricas. Los adolescentes más satisfechos con sus vidas (P < 0,001), más activos (P < 0,001), más estudiosos (P < 0,001) y menos sedentarios delante de una pantalla (P < 0,001) mostraron mayor adherencia al patrón alimentario mediterráneo. Conclusión: La mayoría de adolescentes necesitan mejorar su calidad nutricional. En comparación con estos sujetos, los más adheridos a la dieta mediterránea llevaban un estilo de vida más saludable y mostraron mayor satisfacción con sus vidas.
    背景与目标:
  • 【在美国,直接面向消费者的广告对他汀类药物使用的影响。】 复制标题 收藏 收藏
    DOI:10.1097/MLR.0000000000000752 复制DOI
    作者列表:Chang HY,Murimi I,Daubresse M,Qato DM,Emery SL,Alexander GC
    BACKGROUND & AIMS: IMPORTANCE:The value of direct-to-consumer advertising (DTCA) of prescription drugs is widely debated, as is the effect of DTCA on prescription sales and health care utilization. OBJECTIVE:We examined the association between DTCA intensity for statin medications and prescription sales and cholesterol-related health care utilization. DESIGN, SETTING, AND PARTICIPANTS:We conducted an ecological study for 75 designated market areas from 2005 to 2009 in the United States using linked data regarding televised DTCA volume, non-DTCA marketing and promotion, retail, mail order and long-term care prescription drug sales, prescription drug and ambulatory care health care utilization, and contextual factors such as health care density and socioeconomic status. Main outcomes and measures were volume of sales, number of dispensed prescriptions, and high cholesterol-related outpatient visits. Analyses were conducted in 2016. RESULTS:The intensity of rosuvastatin and atorvastatin ad exposures per household varied substantially across designated market areas. After adjustment for socioeconomic, demographic, and clinical characteristics, each 100-unit increase in advertisement viewership was associated with a 2.22% [95% confidence interval (CI), 0.30%-4.19%] increase in statin sales. Similar patterns were observed between DTCA and statin dispensing among the commercially insured. DTCA was associated with increases in high cholesterol-related outpatient visits among adults 18-45 years of age (3.15% increase in visits per 100-unit increase in viewership, 95% CI, 0.98%-5.37%) but not among those 46-65 years of age (0.51%, 95% CI, -1.49% to 2.55%). CONCLUSION:DTCA for statins is associated with increases in statin utilization and hyperlipidemia-related outpatient visits, especially for young adults.
    背景与目标:
  • 【抢劫暴露对创伤后压力与工作满意度之间关系的调节作用。】 复制标题 收藏 收藏
    DOI:10.2486/indhealth.2019-0096 复制DOI
    作者列表:Montani F,Sommovigo V,Setti I,Giorgi G,Argentero P
    BACKGROUND & AIMS: :Research has disregarded the boundary conditions of the effects of post-traumatic stress symptoms (PTSS) at work. Addressing this issue, the present study examines the moderating impact of the (shared vs. isolated) exposure to robbery on the relationship between PTSS and employee job satisfaction. Drawing on the conservation of resources theory, we argue that PTSS would positively affect employee job satisfaction when the robbery is experienced collectively. To test our predictions, we conducted a two-wave study-with a lag of two months between measurements-on 140 employees from a national bank in Italy. Results from hierarchical regression analyses supported our prediction: the exposure to robbery moderated the relationship between PTSS and job satisfaction. While within the "isolated exposure" group the job satisfaction score was higher among less symptomatic victims, within the "shared exposure" group those with high PTSS reported higher job satisfaction levels than those with low PTSS. We discuss the implications of these findings for theory and practice.
    背景与目标: : 研究忽略了创伤后应激症状 (PTSS) 在工作中的影响的边界条件。针对这一问题,本研究探讨了抢劫 (共享与孤立) 暴露对PTSS与员工工作满意度之间关系的调节影响。根据资源守恒理论,我们认为,当集体经历抢劫时,PTSS会对员工的工作满意度产生积极影响。为了检验我们的预测,我们对意大利一家国家银行的140名员工进行了两波研究-两次测量之间间隔了两个月。分层回归分析的结果支持了我们的预测: 抢劫的暴露减轻了PTSS与工作满意度之间的关系。在 “孤立暴露” 组中,症状较少的受害者的工作满意度得分较高,而在 “共享暴露” 组中,具有高PTSS的人报告的工作满意度水平高于具有低PTSS的人。我们讨论了这些发现对理论和实践的影响。
  • 【护士从业者和管理式护理: 患者满意度和坚持护士从业者护理计划的意图。】 复制标题 收藏 收藏
    DOI:10.1111/j.1745-7599.2007.00245.x 复制DOI
    作者列表:Hayes E
    BACKGROUND & AIMS: PURPOSE:To explore patient satisfaction, intention to adhere to nurse practitioner (NP) plan of care, and the impact of managed care on NPs' patients in multiple settings, the final phase of a three-part study of NPs and managed care. DATA SOURCES:Postvisit questionnaires and narrative comments about patient satisfaction with NP communication, overall satisfaction with visit, recall of plan of care, intention to adhere to NP's recommendations, and impact of managed care on ease of obtaining healthcare resources. CONCLUSIONS:Patients were very satisfied with NP communication and with their healthcare visit. They mostly intended to adhere to the NP-recommended plan of care but less so to recommended lifestyle changes. Patients trusted their NPs, valued their expertise, were confident in the NPs' care, and believed that the NPs considered their best interests. They appreciated that the NPs took time to listen to their concerns and helped them to obtain healthcare resources. Most patients were not greatly impacted by managed care and obtained needed healthcare resources with little difficulty. IMPLICATIONS FOR PRACTICE:Although the first two phases of this study found that many NPs had strong negative attitudes toward managed care, these attitudes were not conveyed toward patients in this sample. NPs, however, will continue to face new challenges as third-party payers attempt to reduce healthcare costs, further testing NP adaptability and resourcefulness.
    背景与目标:
  • 【护士对血液透析单位工作环境的看法与护士离职,患者满意度和住院之间的关系。】 复制标题 收藏 收藏
    DOI: 复制DOI
    作者列表:Gardner JK,Thomas-Hawkins C,Fogg L,Latham CE
    BACKGROUND & AIMS: :While the nephrology nursing shortage persists despite the continued growth of the population of individuals with Stage 5 chronic kidney disease, there is a paucity of empirical data regarding nephrology nurses' perceptions of their work environments. Moreover, there are no studies that have examined the relationship of work environment attributes to patient and nurse outcomes in dialysis settings. The purpose of this study was to examine the relationships between staff nurses' perceptions of dialysis work environments, nurses' intentions to leave their current jobs, nurse turnover, patient satisfaction, and patient hospitalization rates. A descriptive, correlational design was used. Nurse level and facility level data were obtained. The sample for nurse-level data consisted of 199 registered nurses in staff nurse roles in 56 dialysis facilities of a national dialysis company. The sample for facility-level analysis consisted of 46 dialysis facilities, and nurse-level data were aggregated for facility-level analysis. The Practice Environment Scale-Nursing Work Index (PES-NWI) was used to measure nurses' perceptions of the dialysis work environment. Nurses' intention to leave their jobs and facility-level turnover rates were the nurse outcomes examined in this study. Facility-level patient satisfaction and hospitalization rates were the patient outcomes examined. Correlation coefficients were computed to measure the relationships between study variables, and independent t-tests were performed to examine subgroup differences in work environment perceptions. Overall, nurses rated the work environment somewhat favorably. Nurses who expressed intention to leave their jobs rated the work environment more negatively compared to nurses who intended to stay. Significant correlations were found between nurses' perceptions of the dialysis work environment, nurses' intention to leave their jobs, nurse turnover rates, and patient hospitalizations. Study findings suggest that nurses' perceptions of the dialysis work environment are important for nurse and patient outcomes in dialysis settings. Further research is needed to explore the predictive ability of the work environment for nurse and patient outcomes in hemodialysis units.
    背景与目标: : 尽管患有5期慢性肾脏病的人群持续增长,但肾脏病护理短缺仍然存在,但有关肾脏病护士对其工作环境的看法的经验数据很少。此外,没有研究检查透析环境中工作环境属性与患者和护士结果之间的关系。这项研究的目的是研究护士对透析工作环境的看法,护士离职的意图,护士更替,患者满意度和患者住院率之间的关系。采用描述性、相关设计。获得护士级别和设施级别数据。护士级数据的样本由一家国家透析公司的56个透析设施中的199名担任护士角色的注册护士组成。用于设施级别分析的样本由46个透析设施组成,并汇总了护士级别的数据以进行设施级别分析。实践环境量表-护理工作指数 (pes-nwi) 用于衡量护士对透析工作环境的看法。护士离职的意图和机构级别的更替率是本研究中检查的护士结果。设施级别的患者满意度和住院率是检查的患者结局。计算相关系数以衡量研究变量之间的关系,并进行独立的t检验以检查工作环境感知的亚组差异。总体而言,护士对工作环境的评价有些不错。与打算留下的护士相比,表示打算离职的护士对工作环境的评价更为负面。在护士对透析工作环境的看法,护士离职的意愿,护士更替率和患者住院之间发现了显着的相关性。研究结果表明,护士对透析工作环境的看法对于透析环境中的护士和患者结果很重要。需要进一步的研究来探索血液透析单元中工作环境对护士和患者结果的预测能力。
  • 【门诊部用户满意度快速量表的效度和一致性。】 复制标题 收藏 收藏
    DOI:10.24875/GMM.19005144 复制DOI
    作者列表:García-Galicia A,Díaz-Díaz JF,Montiel-Jarquín ÁJ,González-López AM,Vázquez-Cruz E,Morales-Flores CF
    BACKGROUND & AIMS: Background:User satisfaction is key to define and assess the quality of care; however, there is no patient satisfaction rapid scale in Mexico. Our objective was to determine the validity and consistency of an outpatient department user satisfaction rapid scale (ERSaPaCE). Method:Comparative, observational, cross-sectional, prolective study. In phase 1, a rapid scale model was developed, which was submitted to experts in medical care for assessment; the instrument was pilot-tested in 10-patient groups, using as many rounds as required until it obtained 20 approvals. In phase 2, the resulting questionnaire and the Outpatient Service User Satisfaction (SUCE) scale were applied to outpatient department users. ERSaPaCE was reapplied by telephone 10 days later. Descriptive statistics, Cronbach's a, Spearman's correlation and intra-class correlation coefficient (ICC) were used. Results:Two-hundred patients were recruited, out of which 53 % were aged 31-60 years; 51.5 % were women and 48.5 % men, all of them users of the outpatient services from 13 specialties. Cronbach's a for ERSaPaCE was 0.608, whereas ICC was 0.98 (p = 0.000). Convergent validity was 0.681 (p = 0.000) using Spearman's rho. Conclusion:ERSaPaCE was a valid and consistent instrument for the assessment of outpatient department user satisfaction. Antecedentes:La satisfacción del usuario es clave para definir y valorar la calidad de la atención, sin embargo, no existe una escala rápida de satisfacción del paciente en México. El objetivo fue determinar la validez y consistencia de la Escala Rápida de Satisfacción del Paciente de Consulta Externa (ERSaPaCE). Método:Estudio comparativo, observacional, transversal, prolectivo. En la fase 1 se elaboró un modelo de escala rápida, que se sometió a la valoración de expertos en atención médica; se realizaron pruebas piloto con 10 pacientes por ronda, tantas veces como fuera necesario hasta lograr 20 aprobaciones. En la fase 2 se aplicó el cuestionario resultante y la escala de Satisfacción del Usuario de Consultas Externas (SUCE) a usuarios de consulta externa; la ERSaPaCE se reaplicó telefónicamente siete a 10 días después. Se utilizó estadística descriptiva, a de Cronbach, Spearman y coeficiente de correlación intraclase (CCI). Resultados:Se reclutaron 200 pacientes, 53 % con edad de 31 a 60 años, 51.5 % mujeres y 48.5 % hombres de la consulta externa de 13 especialidades; a de Cronbach de ERSaPaCE = 0.608, CCI = 0.98 (p = 0.000) y validez convergente = 0.681 (p = 0.000) por rho de Spearman. ­. Conclusiones:ERSaPaCE fue un instrumento válido y consistente para evaluar la satisfacción del usuario de consulta externa.
    背景与目标:
  • 【以消费者为基础的精神卫生教育人力源。】 复制标题 收藏 收藏
    DOI:10.1007/BF01411073 复制DOI
    作者列表:Signell KA
    BACKGROUND & AIMS: :This paper outlines a program for promoting mental health in the population by "giving away our skills" as mental health professionals. This kind of program can be started on a shoestring by a community mental health center, family service agency, or adult education program. It consists of teaching parent-child communication courses, with selected parents then becoming instructors to build a network of nonprofessional personpower. The paper explores strategies of setting up programs. It explores the shifting role of the professional toward a colleague relationship with nonprofessionals. Finally, it presents research on the program's effectiveness with parents and the impact on the lives and self-images of the nonprofessional instructors themselves.
    背景与目标: : 本文概述了通过 “放弃我们的技能” 作为精神卫生专业人员来促进人口精神卫生的计划。这种计划可以由社区精神卫生中心,家庭服务机构或成人教育计划开始。它包括教授亲子交流课程,然后由选定的父母成为讲师,以建立非专业的人格力量网络。本文探讨了项目设置的策略。它探讨了专业人员在与非专业人员建立同事关系方面的角色转变。最后,它介绍了该计划对父母的有效性以及对非专业教师本身的生活和自我形象的影响的研究。
  • 【压力生活事件,污名和生活满意度与精神病披露意愿之间的关系: 香港的一项社区研究。】 复制标题 收藏 收藏
    DOI:10.1111/eip.13008 复制DOI
    作者列表:Suen YN,Chan KWS,Siu LTT,Lo LHL,Cheung C,Hui LMC,Lee HME,Chang WC,Wong PS,Chen YHE
    BACKGROUND & AIMS: AIM:The preference of and potential barriers to disclosure of psychotic illness vary across cultures. Studying its patterns and correlates can guide the design of future culture-specific intervention and public education approaches to improve willingness to disclose and thereby reducing the duration of untreated psychosis (DUP). METHODS:A population-based, random telephone survey was conducted with a total of 1514 respondents in Hong Kong in January 2018. Cross-sectional data on willingness to disclose psychotic illness, life satisfaction, stigmatizing attitude and recent experience of stressful life events (SLEs) were analysed against age and gender using structural equation modelling (SEM). RESULTS:Unwillingness to disclose to anyone was reported by 12% of the participants. Family was reported as the preferred disclosure candidate by most respondents. Our model, which showed a good fit to the data demonstrated that stigmatizing attitude and life satisfaction were directly associated with willingness to disclose illness. Younger age was correlated with more recent experience of SLEs, lower life satisfaction and less willingness to disclose illness. Women's disclosure willingness was positively associated with their life satisfaction, which was sensitive to recent exposure to single SLE. In contrast, men's was negatively associated with their stigmatizing attitude, which increased significantly upon exposure to two or more recent SLEs. CONCLUSION:Encouraging the public to help their family to seek treatment should be a focal point of a successful mental health public education campaign. Cultural-specific and integrated interventions should be developed targeting the vulnerable groups including people with high recent life stress, particularly woman and those with younger age.
    背景与目标:

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