• 【经医师营养专家培训后的家庭医师营养实践。】 复制标题 收藏 收藏
    DOI:10.1093/ajcn/65.6.2007S 复制DOI
    作者列表:Lazarus K
    BACKGROUND & AIMS: Although nutrition is an important part of medical care, nutrition education is not provided in most training programs for physicians in the United States, resulting in limited nutrition knowledge among physicians and limited nutritional care of patients. A nutrition education program was provided by a physician nutrition specialist in a family practice residency program. For 6 mo, the nutrition specialist provided the family physicians with recommendations for nutritional care for their patients. The effects of the education program on residents' and faculty physicians' nutrition knowledge and nutritional patient care, patients' perceptions of the importance of nutrition, and physicians' dietary patterns were determined by pre- and post-intervention nutrition exams for physicians and patients, patient questionnaires about attitudes toward nutrition, chart reviews, and physicians' diet records. The nutrition education program resulted in an increase in physicians' nutrition knowledge scores (P < 0.01) and an increase in the frequency with which physicians discussed nutrition and recommended diets for their patients (P < 0.05). This suggests that nutrition education by a physician nutrition specialist within a family practice residency program can be effective in increasing nutritional care provided to patients.

    背景与目标: 尽管营养是医疗保健的重要组成部分,但在美国大多数医师的培训计划中并未提供营养教育,这导致医师之间的营养知识有限,患者的营养保健也有限。营养保健教育计划是由医师营养专家在家庭执业驻留计划中提供的。营养专家在6个月内为家庭医生提供了有关为其患者提供营养护理​​的建议。通过干预前和干预后对医师和患者的营养检查来确定教育计划对住院医师和教职医师的营养知识和患者营养的影响,患者对营养重要性的看法以及医师的饮食方式的影响,有关营养态度的患者问卷调查表,图表评论以及医生的饮食记录。营养教育计划导致医师的营养知识得分增加(P <0.01),医师讨论营养和为患者推荐饮食的频率增加(P <0.05)。这表明在家庭执业住院医师计划中,由医生营养专家进行的营养教育可以有效地增加提供给患者的营养保健服务。

  • 【急诊医学教育奖学金的作者指南:教育创新(第3部分)。】 复制标题 收藏 收藏
    影响因子 :
    发表时间:2018-05-01
    来源期刊:CJEM
    DOI:10.1017/cem.2017.28 复制DOI
    作者列表:Hall AK,Hagel C,Chan TM,Thoma B,Murnaghan A,Bhanji F
    BACKGROUND & AIMS: OBJECTIVE:The scholarly dissemination of innovative medical education practices helps broaden the reach of this type of work, allowing scholarship to have an impact beyond a single institution. There is little guidance in the literature for those seeking to publish program evaluation studies and innovation papers. This study aims to derive a set of evidence-based features of high-quality reports on innovations in emergency medicine (EM) education. METHODS:We conducted a scoping review and thematic analysis to determine quality markers for medical education innovation reports, with a focus on EM. A search of MEDLINE, EMBASE, ERIC, and Google Scholar was augmented by a hand search of relevant publication guidelines, guidelines for authors, and website submission portals from medical education and EM journals. Study investigators reviewed the selected articles, and a thematic analysis was conducted. RESULTS:Our search strategy identified 14 relevant articles from which 34 quality markers were extracted. These markers were grouped into seven important themes: goals and need for innovation, preparation, innovation development, innovation implementation, evaluation of innovation, evidence of reflective practice, and reporting and dissemination. In addition, multiple outlets for the publication of EM education innovations were identified and compiled. CONCLUSION:The publication and dissemination of innovations are critical for the EM education community and the training of health professionals. We anticipate that our list of innovation report quality markers will be used by EM education innovators to support the dissemination of novel educational practices.
    背景与目标: 目的:对医学创新实践的学术传播有助于拓宽此类工作的范围,使奖学金的影响力超越单一机构。对于那些寻求发布程序评估研究和创新论文的人,文献中几乎没有指导。这项研究旨在得出一组有关急诊医学教育创新的高质量报告的基于证据的特征。
    方法:我们进行了范围审查和主题分析,以确定医学教育创新报告的质量标志,重点是EM。通过手动搜索相关的出版指南,作者指南以及医学教育和EM期刊的网站提交门户,扩大了对MEDLINE,EMBASE,ERIC和Google Scholar的搜索。研究调查人员审查了选定的文章,并进行了主题分析。
    结果:我们的搜索策略确定了14篇相关文章,从中提取了34篇质量标记。这些标记分为七个重要主题:创新的目标和需求,准备,创新发展,创新实施,创新评估,反思性实践的证据以及报告和传播。此外,还确定并汇编了多个出版新兴市场教育创新的渠道。
    结论:创新的出版和传播对新兴市场教育界和卫生专业人员的培训至关重要。我们期望EM教育创新者将使用我们的创新报告质量标记列表来支持新颖教育实践的传播。
  • 【调整i.v.继续手术前接受血液透析的患者服用铁和EPO剂量:我们能否保护我们的患者接受铁缺乏性贫血的教育?】 复制标题 收藏 收藏
    DOI: 复制DOI
    作者列表:Deaver K,Bennington L
    BACKGROUND & AIMS: :Ongoing blood loss and iron-deficiency anemia are common problems in patients on hemodialysis; therefore, nephrology clinicians are particularly concerned with their patients who are scheduled for surgery Surgery can cause significant blood and iron losses, thereby worsening their preexisting anemia. However, patients on hemodialysis can be effectively treated preoperatively by adjusting their continued doses of intravenous (i.v.) iron and recombinant human erythropoietin (EPO) therapy, based on expected blood and iron losses. This valuable strategy can help improve surgical and anemia outcomes as well as decrease EPO requirements and the need for transfusions. This article examines the use of IV iron and EPO therapy as preventive therapy for anemia in patients on hemodialysis prior to invasive surgical procedures, illustrated with an experience from a dialysis unit and patient case studies.
    背景与目标: :持续的失血和缺铁性贫血是血液透析患者的常见问题;因此,肾脏病临床医生特别关心计划进行手术的患者。手术可能会导致大量的血液和铁丢失,从而加剧他们先前的贫血。但是,可以根据预期的血液和铁损失,通过调整静脉注射铁和重组人促红细胞生成素(EPO)治疗的持续剂量,对接受血液透析的患者进行术前有效治疗。这种有价值的策略可以帮助改善手术和贫血结果,并降低EPO需求和输血需求。本文探讨了在进行侵入性外科手术之前,静脉铁剂和EPO疗法作为血液透析患者贫血的预防性疗法的用途,并结合透析部门和患者案例研究的经验进行了说明。
  • 【放射肿瘤科医生(RO)临床实践的综合持续医学教育(CME)和质量改进(QI)计划的功效。】 复制标题 收藏 收藏
    DOI:10.1016/j.ijrobp.2006.07.018 复制DOI
    作者列表:Leong CN,Shakespeare TP,Mukherjee RK,Back MF,Lee KM,Lu JJ,Wynne CJ,Lim K,Tang J,Zhang X
    BACKGROUND & AIMS: PURPOSE:There has been little radiation oncologist (RO)-specific research in continuing medical education (CME) or quality improvement (QI) program efficacy. Our aim was to evaluate a CME/QI program for changes in RO behavior, performance, and adherence to department protocols/studies over the first 12 months of the program. METHODS AND MATERIALS:The CME/QI program combined chart audit with feedback (C-AWF), simulation review AWF (SR-AWF), reminder checklists, and targeted CME tutorials. Between April 2003 and March 2004, management of 75 patients was evaluated by chart audit with feedback (C-AWF) and 178 patients via simulation review audit (SR-AWF) using a validated instrument. Scores were presented, and case management was discussed with individualized educational feedback. RO behavior and performance was compared over the first year of the program. RESULTS:Comparing the first and second 6 months, there was a significant improvement in mean behavior (12.7-13.6 of 14, p = 0.0005) and RO performance (7.6-7.9 of 8, p = 0.018) scores. Protocol/study adherence significantly improved from 90.3% to 96.6% (p = 0.005). A total of 50 actions were generated, including the identification of learning needs to direct CME tutorials, the systematic change of suboptimal RO practice, and the alteration of deficient management of 3% of patients audited during the program. CONCLUSION:An integrated CME/QI program combining C-AWF, SR-AWF, QI reminders, and targeted CME tutorials effectively improved targeted RO behavior and performance over a 12-month period. There was a corresponding increase in departmental protocol and study adherence.
    背景与目标: 目的:在继续医学教育(CME)或质量改善(QI)计划功效方面,几乎没有针对放射肿瘤学家(RO)的研究。我们的目的是评估一个CME / QI计划,以了解该计划的前12个月RO行为,绩效以及对部门规约/研究的遵守情况的变化。
    方法和材料:CME / QI程序将图表审核与反馈(C-AWF),模拟审阅AWF(SR-AWF),提醒清单和目标CME教程相结合。在2003年4月至2004年3月之间,使用经过验证的工具,通过带有反馈的图表审计(C-AWF)评估了75名患者的管理,通过模拟审查审计(SR-AWF)评估了178名患者的管理。提出分数,并通过个性化的教育反馈讨论案例管理。在该计划的第一年,对RO的行为和性能进行了比较。
    结果:与前六个月和第二个六个月相比,平均行为(14.12.7-13.6,p = 0.0005)和反渗透表现(7.6-7.9,8,p = 0.018)有显着改善。方案/研究依从性从90.3%显着提高到96.6%(p = 0.005)。总共产生了50项行动,包括确定直接进行CME指导的学习需求,对次优RO实践的系统性改变以及在该计划中审核的3%的患者管理不善的变更。
    结论:结合了C-AWF,SR-AWF,QI提示和目标CME教程的集成的CME / QI程序可以在12个月内有效改善目标RO的行为和性能。部门规程和研究依从性相应增加。
  • 【注意缺陷/多动症患者的药物使用与高等教育入学考试成绩之间的关联。】 复制标题 收藏 收藏
    DOI:10.1001/jamapsychiatry.2017.1472 复制DOI
    作者列表:Lu Y,Sjölander A,Cederlöf M,D'Onofrio BM,Almqvist C,Larsson H,Lichtenstein P
    BACKGROUND & AIMS: Importance:Individuals with attention-deficit/hyperactivity disorder (ADHD) are at greater risk for academic problems. Pharmacologic treatment is effective in reducing the core symptoms of ADHD, but it is unclear whether it helps to improve academic outcomes. Objective:To investigate the association between the use of ADHD medication and performance on higher education entrance tests in individuals with ADHD. Design, Setting, and Participants:This cohort study observed 61 640 individuals with a diagnosis of ADHD from January 1, 2006, to December 31, 2013. Records of their pharmacologic treatment were extracted from Swedish national registers along with data from the Swedish Scholastic Aptitude Test. Using a within-patient design, test scores when patients were taking medication for ADHD were compared with scores when they were not taking such medication. Data analysis was performed from November 24, 2015, to November 4, 2016. Exposures:Periods with and without ADHD medication use. Main Outcomes and Measures:Scores from the higher education entrance examination (score range, 1-200 points). Results:Among 930 individuals (493 males and 437 females; mean [SD] age, 22.2 [3.2] years) who had taken multiple entrance tests (n = 2524) and used ADHD medications intermittently, the test scores were a mean of 4.80 points higher (95% CI, 2.26-7.34; P < .001) during periods they were taking medication vs nonmedicated periods, after adjusting for age and practice effects. Similar associations between ADHD medication use and test scores were detected in sensitivity analyses. Conclusions and Relevance:Individuals with ADHD had higher scores on the higher education entrance tests during periods they were taking ADHD medication vs nonmedicated periods. These findings suggest that ADHD medications may help ameliorate educationally relevant outcomes in individuals with ADHD.
    背景与目标: 重要性:患有注意力缺陷/多动症(ADHD)的人更容易出现学术问题。药物治疗可有效减轻多动症的核心症状,但尚不清楚它是否有助于改善学业成果。
    目的:探讨多动症患者使用多动症药物与高等教育入学考试成绩之间的关系。
    设计,背景和参与者:该队列研究从2006年1月1日到2013年12月31日观察了61640名患有ADHD的患者。他们的药物治疗记录与瑞典的学历能力数据一起被提取。测试。使用患者内设计,将患者服用ADHD药物时的测试得分与未服用ADHD药物时的得分进行比较。数据分析时间为2015年11月24日至2016年11月4日。
    暴露:有或没有使用ADHD药物的时期。
    主要成果和措施:高等教育入学考试分数(分数范围:1-200分)。
    结果:在930名个体(平均年龄[SD],22.2 [3.2]岁)中,参加多次入院测试(n = 2524)并间歇性使用ADHD药物,测试得分平均为4.80分在调整年龄和实践影响后,他们在服药期间与非服药期间相比更高(95%CI,2.26-7.34; P <.001)。在敏感性分析中,ADHD药物使用与测试评分之间存在相似的关联。
    结论与相关性:ADHD患者在接受ADHD药物治疗期间与非药物治疗期间在高等教育入学考试中得分较高。这些发现表明,多动症药物可能有助于改善多动症患者的教育相关成果。
  • 【电子教育档案袋的开发:医学教育专业人员的大纲。】 复制标题 收藏 收藏
    DOI:10.1080/10401330701332219 复制DOI
    作者列表:Lewis KO,Baker RC
    BACKGROUND & AIMS: BACKGROUND:A growing body of literature shows that many universities and colleges are making educational portfolios part of their faculty assessment and student's learning plan for both undergraduate and graduate programs. We provide an outline for the development of a medical educator's portfolio, including an electronic version. DESCRIPTION:Guidelines for the development of an educational portfolio focusing on medical education are provided, including design, format, and content. An electronic version of the portfolio, which combines flexibility and ease of revision, is also described, including formats for publication and distribution. Student reflections on the e-portfolio are presented, and potential applications of the e-portfolio in medical education are described. CONCLUSION:We believe that portfolio development is a valuable application that provides rich documentation of participants' educational history, accomplishments, and intellectual property as related to their professional learning and growth.
    背景与目标: 背景:越来越多的文献表明,许多大学和学院正在将教育档案袋作为其本科和研究生课程教师评估和学生学习计划的一部分。我们为医学教育者的档案袋的发展提供了一个大纲,包括电子版本。
    描述:提供了针对医学教育的教育档案袋的开发指南,包括设计,格式和内容。还介绍了组合的灵活性和易于修改的电子版本,包括发布和分发的格式。介绍了学生对电子档案夹的思考,并描述了电子档案夹在医学教育中的潜在应用。
    结论:我们认为,档案袋开发是一个有价值的应用程序,它为参与者的教育历史,成就和与他们的专业学习和成长有关的知识产权提供了丰富的文档。
  • 【澳大利亚护理实践,护士教育和护理人员国际化面临的挑战。】 复制标题 收藏 收藏
    DOI:10.5172/conu.2007.24.2.128 复制DOI
    作者列表:Parker V,McMillan M
    BACKGROUND & AIMS: :This paper examines factors that have lead to increasing internationalisation in nursing workforce and nursing education and contends that education and support for nurse managers and nurse academics is required in order to better prepare them for the challenges they will face. There are many benefits to be gained from internationalisation of nursing, the most significant being greater cross-cultural understanding and improved practices in workplaces across countries. However, the way in which nursing and nurses contribute to the international agenda is crucial to maintaining standards of education and nursing care in Australia and in countries with whom Australians collaborate. Internationalisation poses numerous challenges that need to be carefully thought through. This paper seeks to unravel and scrutinize some of the issues central to internationalisation in nursing, particularly in the Australian context.
    背景与目标: :本文探讨了导致护理人员队伍和护理教育国际化的因素,并认为需要对护士管理者和护士学者进行教育和支持,以使他们更好地为即将面临的挑战做好准备。护理国际化将带来许多好处,其中最重要的是在各国之间提高对跨文化的了解和改进工作场所的实践。但是,护理和护士为国际议程做出贡献的方式对于维持澳大利亚以及与澳大利亚人合作的国家的教育和护理标准至关重要。国际化提出了许多挑战,需要仔细考虑。本文旨在探讨和审查护理国际化中的一些重要问题,特别是在澳大利亚的情况下。
  • 【收集经验丰富的专业知识来支持糖尿病患者的安全驾驶:一项由同伴在一项调查中评估的定性研究。】 复制标题 收藏 收藏
    DOI:10.1007/BF03262497 复制DOI
    作者列表:Burda MH,van der Horst F,van den Akker M,Stork AD,Mesters I,Bours S,Ploeg M,Winkens B,Knottnerus JA
    BACKGROUND & AIMS: BACKGROUND:Hypoglycemia is a frequent phenomenon in people being treated for diabetes mellitus, which can acutely disrupt driving performance. For the benefit of personal and public traffic safety, we decided to identify successful diabetes-related (SDR) behaviors to support safe driving for people with diabetes, from the perspective of experiential experts with diabetes mellitus. Experiential experts are people who can manage their own illness and conditions by developing expertise relevant to maintaining health and countering illness, and who are able to use this expertise to the benefit of peers. OBJECTIVE:The aim of our study was to objectify and systematize experiential expertise in terms of SDR behaviors, based on reports by experiential experts, to support safe driving for people with type 1 and type 2 diabetes mellitus. The emphasis was on preventing hypoglycemia as a short-term complication during driving. METHODS:We performed a mixed-methods study involving (i) semi-structured in-depth interviews with 33 experiential experts with diabetes mellitus from the Dutch Diabetes Association (DVN; Diabetesvereniging Nederland), in order to identify SDR behaviors regarding safe driving, and (ii) a validation study by means of a survey among a panel of 98 experiential experts (peers) from the DVN, to determine the extent to which they agreed with the communicability, importance, and feasibility of these behaviors for drivers with diabetes mellitus. RESULTS:We identified a comprehensive set of 11 SDR behaviors, differentiated into seven general and four specific behaviors, to support safe driving. The general behaviors concern the following topics: (i) acquiring knowledge and information; (ii) acquiring and using self-measuring of blood glucose (SMBG) equipment; (iii) knowing one's physical response pattern; (iv) obtaining knowledge about the medication used; (v) preventing long-term eye complications; (vi) influencing factors that can affect blood glucose; and (vii) renewal procedure for driving license. The four specific behaviors refer to the following topics: (i) measures to be taken before driving; (ii) responding effectively to hypoglycemia while driving; (iii) informing and instructing passengers; and (iv) preventing hypoglycemia in drivers with type 2 diabetes mellitus not using SMBG equipment. Key factors for safe driving proved to be the ability of drivers to anticipate and respond effectively to hypoglycemia while driving and to inform and instruct fellow passengers. Participants of the validation survey agreed to a considerable degree with the communicability, importance, and feasibility of these behaviors to support safe driving for people with diabetes mellitus. CONCLUSIONS:This study resulted in the identification and description of SDR behaviors to support safe driving. It proved possible to operationalize experiential expertise in terms of such behaviors. The next step is to have these behaviors validated by professional care providers in the field of diabetes, followed by translation into recommendations in self-management programs.
    背景与目标: 背景:低血糖症在接受糖尿病治疗的人们中很常见,会严重破坏驾驶性能。为了个人和公共交通安全,我们决定从经验丰富的糖尿病专家的角度确定成功的糖尿病相关(SDR)行为,以支持糖尿病人安全驾驶。经验丰富的专家可以通过发展与维护健康和对抗疾病有关的专业知识来管理自己的疾病和状况,并能够利用这些专业知识来为同行带来好处。
    目的:我们的研究目的是根据经验专家的报告,对SDR行为进行客观化和系统化的专门知识,以支持1型和2型糖尿病患者的安全驾驶。重点是预防驾驶过程中的短期并发症即低血糖症。
    方法:我们进行了一项混合方法研究,涉及(i)对来自荷兰糖尿病协会(DVN; Diabetesvereniging Nederland)的33位糖尿病专家进行的半结构化深度访谈,以确定与安全驾驶有关的SDR行为,以及(ii)通过对来自DVN的98位经验丰富的专家(同行)进行的调查来进行验证研究,以确定他们在多大程度上同意这些行为对于糖尿病驾驶员的可传播性,重要性和可行性。
    结果:我们确定了11种SDR行为的综合集合,分为7种一般行为和4种特定行为,以支持安全驾驶。一般行为涉及以下主题:(i)获取知识和信息; (ii)获取和使用自我测量的血糖仪(SMBG); (iii)了解一个人的身体反应方式; (iv)获得有关所用药物的知识; (v)预防眼部长期并发症; (vi)可能影响血糖的影响因素; (vii)驾驶执照的续签程序。四种具体行为涉及以下主题:(i)驾驶前应采取的措施; (ii)驾驶时有效应对低血糖; (iii)通知和指示乘客; (iv)预防不使用SMBG设备的2型糖尿病驾驶员的低血糖症。事实证明,安全驾驶的关键因素是驾驶员在驾驶时能够预见和有效应对低血糖以及告知和指导同伴的能力。验证调查的参与者在相当程度上同意这些行为的可传播性,重要性和可行性,以支持糖尿病人的安全驾驶。
    结论:本研究确定并描述了支持安全驾驶的SDR行为。事实证明,可以根据这种行为来操作经验专业知识。下一步是使这些行为得到糖尿病领域专业护理人员的验证,然后转化为自我管理计划中的建议。
  • 【急诊科的预防保健,第一部分:临床预防服务-它们与急诊医学有关吗?学术急诊医学学会公共卫生和教育工作队预防服务工作组。】 复制标题 收藏 收藏
    DOI:10.1111/j.1553-2712.2000.tb02097.x 复制DOI
    作者列表:Rhodes KV,Gordon JA,Lowe RA
    BACKGROUND & AIMS: :In 1998 the Society for Academic Emergency Medicine's (SAEM's) Board of Directors asked the SAEM Public Health and Education Task Force to develop recommendations for prevention, screening, and counseling activities to be conducted in emergency departments (EDs). The Task Force's work was divided into two phases: 1) a discussion of the rationale for preventive services in the ED, along with generation of a preliminary list of prevention activities that could be studied for ED implementation; and 2) a formal evidence-based review of topics chosen from the preliminary list, along with recommendations for ED implementation and further study. This paper represents Phase I of the project. Phase II, the formal evidence-based review and recommendations, is published separately in this issue.
    背景与目标: :1998年,美国学术急诊医学协会(SAEM)董事会要求SAEM公共卫生和教育工作组制定有关在急诊科(ED)开展的预防,筛查和咨询活动的建议。专责小组的工作分为两个阶段:1)讨论急诊中预防服务的理由,并生成可以进行急诊研究的预防活动初步清单; 2)对从初步清单中选择的主题进行基于证据的正式审查,以及有关ED实施和进一步研究的建议。本文代表了该项目的第一阶段。第二阶段,即正式的基于证据的审查和建议,在本期中单独出版。
  • 【取得许可前学士学位的护士教育中的师生信任和学生成功。】 复制标题 收藏 收藏
    DOI:10.1016/j.nedt.2012.08.006 复制DOI
    作者列表:Scarbrough JE
    BACKGROUND & AIMS: OBJECTIVE:Nurse educators need an enhanced understanding of factors contributing to nursing student success to decrease attrition and increase retention. Improved understanding of factors related to successful nurse preparation could improve educational processes and facilitate student success, thereby addressing the worldwide nursing shortage as well as increasing the competence and expertise of new graduates. Student-faculty trust and related characteristics have been identified as factors associated with student success (Applebaum, 1995). Research investigating trust in communications and education has been conducted with students in other disciplines but not with nursing students. This research investigated the complex relationships between students' trust in faculty, the students' mood states, and students' educational performance and outcomes. METHOD:The study utilized a quantitative, cross-sectional, descriptive, and correlational design. Student volunteers were recruited from a baccalaureate nursing education program located in the southwest United States. Participants completed three instruments: the Health Sciences Reasoning Test (HSRT), Profile of Mood States (POMS), and Interpersonal Trust Scale (ITS). The resulting scores were compared and contrasted along with selected demographic variables. RESULTS:The study identified a significant relationship between total mood disturbance and interpersonal trust. The trends in the POMS subscales of Anger and Confusion are of particular interest, as the two factors strongly influenced shifts in Total Mood Disturbance. As students progressed through the nursing program, experiences of Anger and Confusion increased with each progressive semester and were accompanied by corresponding decreases in trust. CONCLUSIONS:The results complement established findings relating mood and cognitive function. Alterations in the student's level of trust potentially could share relationships with cognition and critical thinking, although perhaps not in a direct and linear fashion.
    背景与目标: 目的:护士教育者需要加深对有助于护理学生成功的因素的了解,以减少损耗和增加保留率。更好地理解与成功的护士准备相关的因素,可以改善教育过程并促进学生的成功,从而解决全球范围内的护理短缺问题,并提高新毕业生的能力和专业知识。学生与教师之间的信任和相关特征已被确定为与学生成功相关的因素(Applebaum,1995)。已经与其他学科的学生进行了调查研究,以研究对交流和教育的信任,但没有与护理专业的学生进行。这项研究调查了学生对教师的信任,学生的情绪状态以及学生的教育表现和成果之间的复杂关系。
    方法:本研究采用定量,横断面,描述性和相关性设计。学生志愿者是从位于美国西南部的学士学位护理教育计划招募的。参与者完成了三项工具:健康科学推理测验(HSRT),情绪状态简介(POMS)和人际信任量表(ITS)。将所得分数与选定的人口统计学变量进行比较和对比。
    结果:该研究确定了总情绪障碍与人际信任之间的显着关系。愤怒和混乱的POMS子量表的趋势特别受关注,因为这两个因素强烈影响了总情绪干扰的变化。随着学生逐步完成护理计划,每学期的学期中,愤怒和困惑的经历就会增加,随之而来的是信任的减少。
    结论:该结果补充了有关情绪和认知功能的既定发现。学生信任度的改变可能会与认知和批判性思维共享关系,尽管可能不是直接和线性的方式。
  • 【基于学校的口腔健康教育计划对伊朗儿童的影响:一项小组随机试验的结果。】 复制标题 收藏 收藏
    DOI:10.1111/j.1600-0722.2012.00993.x 复制DOI
    作者列表:Yekaninejad MS,Eshraghian MR,Nourijelyani K,Mohammad K,Foroushani AR,Zayeri F,Pakpour AH,Moscowchi A,Tarashi M
    BACKGROUND & AIMS: :Parents and school staff play important roles in promoting children's oral health. Our study goals were to investigate whether an intervention targeting parents and school staff can improve the oral-health behavior and oral-health status of schoolchildren. Three-hundred and ninety-two schoolchildren in six schools in Tehran participated in a group randomized trial from September 2010 to March 2011. Schools were randomly allocated into three groups: comprehensive, student, and control. Intervention in the comprehensive group consisted of strategies to encourage children, their parents, and school staff to increase the frequency of toothbrushing and flossing. In the student group, the intervention targeted only children. The control group received no intervention. The primary outcome was change in oral-health behaviors (brushing and flossing), while the secondary outcomes were changes in oral hygiene and Community Periodontal indices and in Health Belief Model components. Multilevel modeling was employed for data analyses. Students who were in the comprehensive intervention group brushed and flossed significantly more frequently compared with those in the student intervention group. Although students' gingival health improved significantly in the comprehensive intervention group, such significant improvement was not seen in the student group. In conclusion, promising results are seen when the oral-health education targets both school and home settings.
    背景与目标: :父母和学校职员在促进儿童口腔健康中发挥重要作用。我们的研究目标是调查针对父母和学校员工的干预措施是否可以改善小学生的口腔健康行为和口腔健康状况。从2010年9月至2011年3月,德黑兰六所学校的392名学童参加了一项小组随机试验。学校被随机分为三组:综合,学生和对照。对综合人群的干预包括鼓励儿童,他们的父母和学校工作人员增加刷牙和使用牙线的策略。在学生群体中,干预仅针对儿童。对照组未接受干预。主要结果是口腔健康行为的变化(刷牙和使用牙线),而次要结果是口腔卫生和社区牙周指数以及健康信念模型组成部分的变化。采用多级建模进行数据分析。与学生干预组相比,综合干预组的学生刷牙和使用牙线的频率明显更高。尽管在综合干预组中学生的牙龈健康显着改善,但在学生组中却没有看到这种显着改善。总之,当口腔健康教育针对学校和家庭环境时,可以看到令人鼓舞的结果。
  • 【通过糖尿病自我管理教育和培训,提高与糖尿病相关的公平性:现有的医疗保障要求和增加参与的考虑。】 复制标题 收藏 收藏
    DOI:10.1097/PHH.0000000000001109 复制DOI
    作者列表:Carr D,Kappagoda M,Boseman L,Cloud LK,Croom B
    BACKGROUND & AIMS: :America is in the grips of a diabetes epidemic. Underserved communities disproportionately bear the burden of diabetes and associated harms. Diabetes self-management education and training (DSME/T) may help address the epidemic. By empowering patients to manage their diabetes, DSME/T improves health outcomes and reduces medical expenditures. However, participation in DSME/T remains low. Insurance coverage offers 1 approach for increasing participation in DSME/T. The impact of DSME/T insurance coverage on advancing diabetes-related health equity depends on which types of insurers must cover DSME/T and the characteristics of such coverage. We conducted a legal survey of DSME/T coverage requirements for private insurers, Medicaid programs, and Medicare, finding that substantial differences exist. Although 43 states require that private insurers cover DSME/T, only 30 states require such coverage for most or all Medicaid beneficiaries. Public health professionals and decision makers may find this analysis helpful in understanding and evaluating patterns and gaps in DSME/T coverage.
    背景与目标: :美国正处于糖尿病流行的风口浪尖。服务不足的社区过多地承受着糖尿病和相关危害的负担。糖尿病自我管理教育和培训(DSME / T)可能有助于解决这一流行病。通过授权患者管理糖尿病,DSME / T改善了健康状况并减少了医疗费用。但是,对DSME / T的参与仍然很低。保险范围提供了一种增加DSME / T参与度的方法。 DSME / T保险承保范围对推进与糖尿病相关的健康公平性的影响取决于哪些类型的保险公司必须承保DSME / T和这种承保范围的特征。我们对私人保险公司,Medicaid计划和Medicare的DSME / T承保要求进行了法律调查,发现存在实质性差异。尽管有43个州要求私人保险公司承保DSME / T,但只有30个州要求大多数或所有医疗补助受益人都享有这种保险。公共卫生专业人员和决策者可能会发现此分析有助于理解和评估DSME / T覆盖率的模式和差距。
  • 【批判性思维教育对护理学生解决问题能力的影响。】 复制标题 收藏 收藏
    DOI:10.1080/10376178.2017.1339567 复制DOI
    作者列表:Kanbay Y,Okanlı A
    BACKGROUND & AIMS: THE AIM OF THE STUDY:The aim of this study is to examine the effect of critical thinking education on nursing students' problem-solving skills. MATERIALS AND METHOD:This study was conducted with 93 nursing students, 49 in the control group and 44 in the education group. The California Critical Thinking Disposition Inventory and the Problem-solving Inventory were administered to them before and after 12 weeks of critical thinking education. RESULTS:The education group's mean critical thinking score was 253.61 on the pretest and 268.72 on the posttest. This increase was statistically significant (p < .001). The posttest mean score of the control group fell to 258.18 on the posttest after a pretest mean score of 260.79, and this difference was statistically significant (p < .001). According to the posttest results, the problem-solving skills of education group increased significantly (p < .001), while the control group's score fell significantly (p < .001). CONCLUSION:This study determined that critical thinking education improves problem-solving skills.
    背景与目标: 研究目的:本研究的目的是检验批判性思维教育对护理学生解决问题能力的影响。
    材料与方法:本研究针对93名护理专业学生,对照组49名,教育组44名进行。在进行批判性思维教育12周之前和之后,对他们进行了加利福尼亚批判性思维倾向量表和问题解决量表。
    结果:教育组的平均批判性思维得分在测验前为253.61,在测验后为268.72。这种增加具有统计学显着性(p <0.001)。对照组的测试后平均得分在测试前平均得分为260.79后下降至测试后的258.18,这一差异具有统计学意义(p <0.001)。根据测试后的结果,教育组解决问题的技能显着提高(p <0.001),而对照组的得分显着下降(p <0.001)。
    结论:这项研究确定批判性思维教育可以提高解决问题的能力。
  • 【重新分类患者以进行积极的胆固醇治疗:多层冠状动脉造影对国家胆固醇教育计划指南的附加价值。】 复制标题 收藏 收藏
    DOI:10.1002/clc.20256 复制DOI
    作者列表:Scridon T,Novaro GM,Bush HS,Asher CR,Dandes E,Kabirdas D,Scridon C,Kuo BT,Whiteman M,Shen MY
    BACKGROUND & AIMS: BACKGROUND:National Cholesterol Education Program (NCEP) guidelines have been used to define treatment goals in patients with hypercholesterolemia. However, epidemiology-based guidelines are unable to identify all subjects with coronary artery disease for aggressive lipid intervention. OBJECTIVE:We sought to evaluate the additive value of multislice computed tomography (MSCT) angiography to the NCEP guideline classification for lipid treatment. METHODS:Multislice computed tomography was performed in 114 consecutive patients (mean age 57+/-14 y; 59% male) without known coronary artery disease. Subjects were classified into 3 categories (low-, intermediate-, and high-risk) according to their Framingham risk scores (FRS). RESULTS:Traditional cardiac risk factors were common: hypertension 59%, diabetes 13%, and smoking 22%. On the basis of the FRS, 11% (n=12/114) of the patients met high-risk criteria requiring aggressive cholesterol reduction. Of those in the low- and intermediate-risk groups, MSCT found coronary plaque in 76% (n=77/102), with moderate or severe plaque in 38% (n=39/102), thus reclassifying them in the high-risk category. Use of statin drugs increased from 32% at baseline to 53% (p=0.002) based on MSCT results; statin dose was increased in 31% of the patients who were already on a statin. The mean low-density lipoprotein cholesterol (LDL-c) decreased from 114 mg/dL to 91 mg/dL after MSCT (p<0.001). CONCLUSION:Multislice computed tomography reclassifies a high percentage of patients considered to be low- to intermediate-risk into the high-risk category based on their coronary artery lesions. Thus, the rise in MSCT use at present may have a large impact on clinician practice patterns in lipid-lowering therapy.
    背景与目标: 背景:国家胆固醇教育计划(NCEP)指南已用于定义高胆固醇血症患者的治疗目标。但是,基于流行病学的指南无法识别出患有冠状动脉疾病的所有受试者进行积极的脂质干预。
    目的:我们试图评估多层计算机断层扫描(MSCT)血管造影对脂质治疗的NCEP指南分类的附加价值。
    方法:对114例无已知冠状动脉疾病的连续患者(平均年龄57 / -14岁;男性59%)进行了多层计算机断层扫描。根据弗雷明汉风险评分(FRS)将受试者分为3类(低,中和高风险)。
    结果:传统的心脏危险因素是常见的:高血压59%,糖尿病13%,吸烟22%。根据FRS,11%(n = 12/114)的患者符合需要积极降低胆固醇的高风险标准。在低危和中危组中,MSCT发现冠状动脉斑块占76%(n = 77/102),中度或重度斑块占38%(n = 39/102),因此将其重新分类为高危风险类别。根据MSCT结果,他汀类药物的使用从基线的32%增加到53%(p = 0.002);在已经接受他汀类药物治疗的患者中,有31%的患者增加了他汀类药物的剂量。 MSCT后,平均低密度脂蛋白胆固醇(LDL-c)从114 mg / dL降至91 mg / dL(p <0.001)。
    结论:多层计算机断层扫描根据其冠状动脉病变将高百分比的被认为是低风险至中风险的患者重新分类为高风险类别。因此,目前MSCT使用量的增加可能对降脂治疗中临床医生的实践模式产生重大影响。
  • 【呼吸疗法国际教育在美国的影响:沙特国际学生的看法。】 复制标题 收藏 收藏
    DOI:10.4187/respcare.06961 复制DOI
    作者列表:AbuNurah HY,Zimmerman RD,Murray RB,Gardenhire DS
    BACKGROUND & AIMS: BACKGROUND:The purpose of this study was to assess graduate and undergraduate international respiratory therapy students' perceptions of the impact of their international educational experience on their life experience and development. METHODS:Data were collected through a validated descriptive survey. Four main dimensions of development were assessed: professional respiratory therapist (RT) role, global understanding, personal development, and intellectual development. RESULTS:The sample size was 62. Just over half of the subjects held a graduate degree in respiratory therapy, and 47% held an undergraduate degree in respiratory therapy. Female participants accounted for 13% of participants. The dimensions of development that were the most affected for RT undergraduate students were professional RT role and global understanding, whereas personal development was the most impacted area of development for graduate RT students. The time spent abroad for education had a positive correlation with the students' perceptions of development of their professional RT role (rs = 0.43, P = .001), personal development (rs = 0.26, P = .047), and overall survey development score (rs = 0.28, P = .036). Former graduates had a significantly higher perception of development of their professional practice (P = .035) and cultural interaction (P = .03) than did current students. CONCLUSIONS:International education has a large overall positive impact on students' life experience and development. The study findings support the value of promoting international education in RT programs due to its role in advancing students' development and the internationalization of RT education.
    背景与目标: 背景:本研究的目的是评估研究生和本科生国际呼吸疗法学生对他们的国际教育经验对其生活经验和发展的影响的看法。
    方法:通过经过验证的描述性调查收集数据。对发展的四个主要方面进行了评估:专业呼吸治疗师(RT)的角色,全球理解,个人发展和智力发展。
    结果:样本大小为62。一半以上的受试者持有呼吸治疗专业的学位,47%的持有呼吸治疗专业的学位。女性参与者占参与者的13%。对RT本科生影响最大的发展维度是专业RT角色和全球理解,而个人发展对RT研究生的发展影响最大。在国外度过的时间与学生对其专业RT角色发展的认识(rs = 0.43,P = .001),个人发展(rs = 0.26,P = .047)和总体调查发展呈正相关。得分(rs = 0.28,P = .036)。与应届毕业生相比,前毕业生对他们的专业实践发展(P = .035)和文化互动(P = .03)的认识要高得多。
    结论:国际教育对学生的生活经历和发展有很大的总体积极影响。这项研究结果支持在RT计划中促进国际教育的价值,因为它在促进学生发展和RT教育的国际化中发挥了作用。

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