Health Care Science最新文献_第8页

Formulation of a CITE metric for evaluating the clinical implications of medical studies and their originating hospitals in China 制定用于评估中国医学研究及其原产医院临床意义的 CITE 指标

Health Care Science

Pub Date : 2024-08-06 DOI: 10.1002/hcs2.108

Gao Jianchao, Chen Xiaoyuan, Gao Chenyan

Background

The number of medical research publications by Chinese clinical investigators has risen substantially, contributing to 14.63% of the global total in 2019; however, their tangible impact on clinical decision-making remains limited. Various evaluation methods have been developed to measure hospital research competence in China, such as Fudan University's China hospital ranking and Science and Technology Evaluation Metrics (STEM) ranking, which predominantly focuses on factors such as academic reputation, volume of publications and patents, and research resources. However, composite indices may not fully capture the actual clinical value generated by medical research. To address this gap, we introduced the “Clinical Influence and Timeliness Evaluation (CITE)” metric to assess both the clinical importance of a given medical research study and the clinical influence of the hospital where it originated. The methodology used relies on the premise that influential medical research would be referenced in clinical guidelines, which serve as critical resources for clinicians.

Methods

The CITE metric was applied for 78,636 medical studies concerning chronic obstructive pulmonary disease (COPD) published between 2000 and 2020 and referenced in both Chinese and international clinical guidelines for COPD. Specific indexes and formulas were derived to quantify the clinical weight of a medical research study (W) and its timeliness (T), enabling a dynamic assessment of the clinical value of each study and the overall contribution of a particular hospital.

Results

In this analysis, we incorporated 499 hospitals in China and quantitatively identified their dynamic clinical influence in COPD from 2000 to 2020. Our findings offer objective and targeted evaluation metrics by focusing on clinical relevance and recognizing the collaborative nature of medical research.

Conclusion

The CITE metric provides an innovative method to gauge the true impact of medical research in China, with potential applications across different medical specialties. CITE can serve as a useful tool for understanding the relationship between research input and practical clinical outcomes, ultimately promoting more clinically relevant research endeavors.

背景中国临床研究人员发表的医学研究论文数量大幅增加，2019年占全球总数的14.63%；然而，这些论文对临床决策的实际影响仍然有限。目前已开发出多种评价方法来衡量中国医院的科研能力，如复旦大学的中国医院排名和科技评价指标（STEM）排名，主要关注学术声誉、论文和专利数量以及科研资源等因素。然而，综合指数可能无法完全反映医学研究产生的实际临床价值。为了弥补这一不足，我们引入了 "临床影响力和及时性评估（CITE）"指标，以评估特定医学研究的临床重要性和该研究所在医院的临床影响力。使用该方法的前提是，有影响力的医学研究会在临床指南中被引用，而临床指南是临床医生的重要资源。方法对 2000 年至 2020 年间发表的 78,636 项有关慢性阻塞性肺病（COPD）的医学研究应用 CITE 指标，这些研究被中国和国际慢性阻塞性肺病临床指南引用。得出了具体的指标和公式来量化医学研究的临床权重（W）和时效性（T），从而能够动态评估每项研究的临床价值和特定医院的整体贡献。结果在这项分析中，我们纳入了中国的 499 家医院，并定量确定了它们从 2000 年到 2020 年在慢性阻塞性肺病领域的动态临床影响力。我们的研究结果通过关注临床相关性和承认医学研究的合作性质，提供了客观和有针对性的评价指标。结论 CITE 指标为衡量中国医学研究的真实影响力提供了一种创新方法，并有可能应用于不同的医学专业。CITE 可作为了解研究投入与实际临床成果之间关系的有用工具，最终促进更多与临床相关的研究工作。

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引用次数: 0

Confirmatory analysis of the 13-MD and ranking of its meta-dimensions and items 13-MD 的确认分析及其元维度和项目排序

Health Care Science

Pub Date : 2024-08-04 DOI: 10.1002/hcs2.106

Moustapha Touré, Thomas G. Poder

Background

The 13-MD is a new generic instrument developed to measure general health-related quality of life (GHRQoL). This instrument considers all aspects of health (i.e., physical, mental, and social) in a balanced way. A previous study led to minor changes in the original version of the 13-MD. The objective of this study was to confirm the validity of the modified 13-MD.

Methods

Validity was assessed with recent data from the general population of Quebec, Canada. The meta-dimensions and items composing the 13-MD were also subjected to a ranking procedure, which allowed to determine the most important aspects for respondents.

Results

A total of 1337 French-speaking participants were recruited with 1099 completing the 13-MD for validation purposes and 1084 completing the ranking procedure. The 13-MD showed very satisfactory results and confirmed to be a valid instrument. The ranking of the meta-dimensions revealed that “Well-being” received the most points, followed by “Sleep and energy” and “Body functioning.”

Conclusion

These results will be very useful in the continuous improvement of the 13-MD, ultimately leading to the valuation stage (i.e., development of a value set).

背景 13-MD 是一种新的通用工具，用于测量与健康相关的总体生活质量（GHRQoL）。该工具均衡地考虑了健康的各个方面（即身体、精神和社交）。此前的一项研究对 13-MD 的原始版本进行了细微修改。本研究的目的是确认修改后的 13-MD 的有效性。方法使用加拿大魁北克省普通人群的最新数据对有效性进行评估。此外，还对构成 13-MD 的元维度和项目进行了排序，以确定受访者认为最重要的方面。结果共招募了 1337 名法语参与者，其中 1099 人完成了 13-MD 验证，1084 人完成了排序程序。13-MD 的结果非常令人满意，被证实是一个有效的工具。元维度排名显示，"幸福 "得分最高，其次是 "睡眠和精力 "和 "身体机能"。结论这些结果将对 13-MD 的不断改进非常有用，并最终进入评估阶段（即制定价值集）。

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引用次数: 0

Health performance assessment modeling and its application to compact medical communities in China 健康绩效评估模型及其在中国紧密型医疗社区中的应用

Health Care Science

Pub Date : 2024-07-23 DOI: 10.1002/hcs2.105

Miao Yu, Zhongmou Huang, Dan Zhang, Yansui Yang, Ching-Wen Chien, Hongwu Tuo

Some regions in China have already implemented capitation payment or capitation budget management for medical insurance funds. However, there remains a shortage of adequate tools and methodologies to accurately quantify differences in population health risks. Therefore, this paper constructs a health performance assessment model that comprises four steps. The first step is to categorize all participants into health risk groups based on whether they have contracted with a family doctor, their age, sex, and the type of consultation. The second step is to categorize health risk groups based on differences in healthcare resource utilization. The third step is to analyze health performance by examining healthcare resource utilization year over year. The fourth step is to apply the assessment results to assist local finance bureaus and medical insurance bureaus in developing incentive schemes. According to cost weights, the health risk groups are split into six classes: insured residents without health care visits, healthy insured person, slightly ill insured patients, ill insured patients, more seriously disease patients, and severely ill insured patients. We evaluate one compact medical community's health performance by examining changes in the proportion of resource usage group size and expense. From 2019 to 2021, both the proportion of patients with severe and ultra-severe diseases and the proportion of costs in the sample increased, according to changes in resource utilization levels. This result indicates that the population's overall health has not improved and that the compact medical community is still primarily focused on treating diseases, with poor implementation of health maintenance measures and minimal improvement in health performance.

我国部分地区已对医保基金实行按人头付费或按人头预算管理。然而，目前仍缺乏足够的工具和方法来准确量化人群健康风险的差异。因此，本文构建了一个包括四个步骤的健康绩效评估模型。第一步是根据参保人是否与家庭医生签约、年龄、性别和就诊类型，将所有参保人划分为不同的健康风险群体。第二步是根据医疗资源利用率的差异对健康风险组进行分类。第三步是通过逐年检查医疗资源使用情况来分析健康绩效。第四步是应用评估结果，协助地方财政局和医疗保险局制定激励计划。根据费用权重，将健康风险群体划分为六个等级：未就医的参保居民、健康参保人员、轻度疾病参保患者、疾病参保患者、重度疾病参保患者和重症疾病参保患者。我们通过考察资源使用群体规模和支出比例的变化来评估一个紧密型医疗社区的健康绩效。从 2019 年到 2021 年，根据资源使用水平的变化，样本中重症和超重症患者的比例和费用比例均有所上升。这一结果表明，居民的整体健康水平并未得到改善，紧密型医疗共同体仍以治疗疾病为主，健康维护措施落实不力，健康绩效改善甚微。

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引用次数: 0

Rethinking counterfeit medical supply chains: A critical review of the current literature 反思假冒医疗供应链：对当前文献的批判性回顾。

Health Care Science

Pub Date : 2024-06-17 DOI: 10.1002/hcs2.97

Iffath U. Syed, Travis W. Milburn

The medical device and pharmaceutical industries include a range of drugs, machines, instruments, and apparatuses used to prevent, diagnose, treat disease and illness, or aid in rehabilitation for patients, and are expected to grow substantially in the coming years. However, they are often targets of criminal organizations who manufacture and profit from fraudulent products, infiltrating the market with counterfeit medical supply chains. In this paper, we discuss and analyze the extent and nature of this problem and make suggestions for mitigation and prevention of this worldwide challenge. Ultimately, we argue that a holistic approach is essential to addressing this problem, including the creation and dissemination of reliable and good quality data, developing healthcare systems to be more robust, establishing/enhancing intra- and international cooperation around this issue, and employing effective technological solutions, such as digital tracing.

医疗器械和制药行业包括一系列用于预防、诊断、治疗疾病或帮助患者康复的药物、机器、仪器和设备，预计在未来几年将大幅增长。然而，这些产品往往成为犯罪组织的目标，他们制造假冒产品并从中获利，利用假冒医疗供应链渗透市场。在本文中，我们将讨论和分析这一问题的程度和性质，并就如何减轻和预防这一世界性挑战提出建议。最终，我们认为，要解决这一问题，必须采取综合方法，包括创建和传播可靠、优质的数据，发展更强大的医疗保健系统，围绕这一问题建立/加强内部和国际合作，以及采用有效的技术解决方案，如数字追踪。

引用次数: 0

Evaluation of the predictors and frequency of silent hypoxemia in COVID-19 patients and the gap between pulse oximeter and arterial blood gas levels: A cross-sectional study 评估 COVID-19 患者无声低氧血症的预测因素和频率，以及脉搏血氧仪与动脉血气水平之间的差距：一项横断面研究。

Health Care Science

Pub Date : 2024-06-17 DOI: 10.1002/hcs2.98

Mohammad Javad Fallahi, Fatemehsadat Pezeshkian, Keivan Ranjbar, Rojan Javaheri, Reza Shahriarirad

Background

Silent hypoxemia is when patients do not experience breathing difficulty in the presence of alarmingly low O₂ saturation. It could cause rapid deterioration and higher mortality rates among patients, so prompt detection and identifying predictive factors could result in significantly better outcomes. This study aims to document the evidence of silent hypoxemia in patients with COVID-19 and its clinical features.

Methods

A total of 78 hospitalized, nonintubated patients with confirmed COVID-19 infection were included in this study. Their O₂ saturation was measured with a pulse oximeter (PO), and arterial blood gas (ABG) was taken. Demographic and clinical features were recorded. The Borg scale was used to evaluate dyspnea status, and patients with a score of less than two accompanied by O₂ saturation of less than 94% were labeled as silent hypoxic. Univariate analysis was utilized to evaluate the correlation between variables and their odds ratio (OR) and 95% confidence interval (CI).

Results

Silent hypoxemia was observed in 20 (25.6%) of the participants. The average difference between the PO and ABG methods was 4.36 ± 3.43. Based on regression analysis, dyspnea and respiratory rate demonstrated a statistically significant correlation with the O₂ saturation difference between PO and ABG (OR: 2.05; p = 0.026; 95% CI: 0.248–3.847 and OR: 0.144; p = 0.048, 95% CI: 0.001–0.286). Furthermore, the Borg scale (OR: 0.29; p = 0.009; 95% CI: 0.116–0.740) had a significant reverse correlation with silent hypoxia.

Conclusions

Silent hypoxemia can be a possible complication that affects some COVID-19 patients. Further care should be bestowed upon the younger population and those with underlying neurological or mental illnesses. Furthermore, the respiratory rate, pulse oximeter, and arterial blood gas O₂ levels should be considered alongside each other.

背景：无声低氧血症是指患者在氧气饱和度低得惊人的情况下没有呼吸困难。它可能导致患者病情迅速恶化，死亡率升高，因此及时发现并确定预测因素可显著改善预后。本研究旨在记录 COVID-19 患者无声低氧血症的证据及其临床特征：方法：本研究共纳入 78 名确诊感染 COVID-19 的住院非插管患者。用脉搏血氧仪（PO）测量他们的血氧饱和度，并采集动脉血气（ABG）。记录了人口统计学和临床特征。采用博格量表评估呼吸困难状况，得分低于 2 分且血氧饱和度低于 94% 的患者被标记为沉默性缺氧。利用单变量分析评估变量之间的相关性及其几率比（OR）和 95% 置信区间（CI）：20名参与者（25.6%）出现了静默性低氧血症。PO 和 ABG 方法之间的平均差异为 4.36 ± 3.43。根据回归分析，呼吸困难和呼吸频率与 PO 和 ABG 之间的氧气饱和度差异有显著的统计学相关性（OR：2.05；p = 0.026；95% CI：0.248-3.847 和 OR：0.144；p = 0.048，95% CI：0.001-0.286）。此外，博格量表（OR：0.29；P = 0.009；95% CI：0.116-0.740）与静默性低氧血症有显著的反向相关性：无声低氧血症可能是影响部分 COVID-19 患者的并发症之一。结论：无声低氧血症可能是影响部分 COVID-19 患者的并发症，对年轻人和患有潜在神经或精神疾病的患者应给予更多关注。此外，呼吸频率、脉搏血氧计和动脉血气中的氧气水平也应一并考虑。

{"title":"Evaluation of the predictors and frequency of silent hypoxemia in COVID-19 patients and the gap between pulse oximeter and arterial blood gas levels: A cross-sectional study","authors":"Mohammad Javad Fallahi, Fatemehsadat Pezeshkian, Keivan Ranjbar, Rojan Javaheri, Reza Shahriarirad","doi":"10.1002/hcs2.98","DOIUrl":"10.1002/hcs2.98","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>Silent hypoxemia is when patients do not experience breathing difficulty in the presence of alarmingly low O<sub>2</sub> saturation. It could cause rapid deterioration and higher mortality rates among patients, so prompt detection and identifying predictive factors could result in significantly better outcomes. This study aims to document the evidence of silent hypoxemia in patients with COVID-19 and its clinical features.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A total of 78 hospitalized, nonintubated patients with confirmed COVID-19 infection were included in this study. Their O<sub>2</sub> saturation was measured with a pulse oximeter (PO), and arterial blood gas (ABG) was taken. Demographic and clinical features were recorded. The Borg scale was used to evaluate dyspnea status, and patients with a score of less than two accompanied by O<sub>2</sub> saturation of less than 94% were labeled as silent hypoxic. Univariate analysis was utilized to evaluate the correlation between variables and their odds ratio (OR) and 95% confidence interval (CI).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>Silent hypoxemia was observed in 20 (25.6%) of the participants. The average difference between the PO and ABG methods was 4.36 ± 3.43. Based on regression analysis, dyspnea and respiratory rate demonstrated a statistically significant correlation with the O<sub>2</sub> saturation difference between PO and ABG (OR: 2.05; <i>p</i> = 0.026; 95% CI: 0.248–3.847 and OR: 0.144; <i>p</i> = 0.048, 95% CI: 0.001–0.286). Furthermore, the Borg scale (OR: 0.29; <i>p</i> = 0.009; 95% CI: 0.116–0.740) had a significant reverse correlation with silent hypoxia.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusions</h3>\u0000 \u0000 <p>Silent hypoxemia can be a possible complication that affects some COVID-19 patients. Further care should be bestowed upon the younger population and those with underlying neurological or mental illnesses. Furthermore, the respiratory rate, pulse oximeter, and arterial blood gas O<sub>2</sub> levels should be considered alongside each other.</p>\u0000 </section>\u0000 </div>","PeriodicalId":100601,"journal":{"name":"Health Care Science","volume":"3 3","pages":"172-180"},"PeriodicalIF":0.0,"publicationDate":"2024-06-17","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11212329/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"141474388","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

引用次数: 0

Theranostic aspects of palladium-based bimetallic nanoparticles in biomedical field: A state-of-the-art 钯基双金属纳米粒子在生物医学领域的抗肿瘤方面：最新进展

Health Care Science

Pub Date : 2024-06-11 DOI: 10.1002/hcs2.96

Shwetha B. Nagarajan, Sanjeevi Ramakrishnan, Anuradha Jayaraman

The exploration of newer antibacterial strategies is driven by antibiotic-resistant microbes that cause serious public health issues. In recent years, nanoscale materials have developed as an alternative method to fight infections. Despite the fact that many nanomaterials have been discovered to be harmful, numerous researchers have shown a keen interest in nanoparticles (NPs) made of noble metals like silver, gold and platinum. To make environmentally safe NPs from plants, green chemistry and nanotechnology have been combined to address the issue of toxicity. The study of bimetallic nanoparticles (BNPs) has increased tremendously in the past 10 years. The production of BNPs mediated by natural extracts is straightforward, low cost and environmentally friendly. Due to their low toxicity, safety and biological stability, noble BNPs with silver, gold, platinum and palladium have the potential to be used in biomedical applications. They have a significant impact on human health and are used in medicine and pharmacy due to their biological characteristics, which include catalytic, antioxidant, antibacterial, antidiabetic, anticancer, hepatoprotective and regenerative activity.

抗生素耐药微生物导致了严重的公共卫生问题，这推动了对新型抗菌策略的探索。近年来，纳米级材料已发展成为抗感染的另一种方法。尽管许多纳米材料被发现是有害的，但许多研究人员对银、金和铂等贵金属制成的纳米粒子（NPs）表现出浓厚的兴趣。为了从植物中提取对环境安全的纳米粒子，绿色化学和纳米技术被结合起来，以解决毒性问题。在过去 10 年中，对双金属纳米粒子（BNPs）的研究急剧增加。以天然提取物为介质生产 BNPs 简单、成本低且环保。银、金、铂和钯等贵金属 BNPs 具有低毒性、安全性和生物稳定性，因此有可能应用于生物医学领域。由于它们具有催化、抗氧化、抗菌、抗糖尿病、抗癌、保肝和再生活性等生物特性，因此对人类健康有重大影响，并被用于医学和药学领域。

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引用次数: 0

Occupational therapy's role in promoting the “Learn the Signs. Act Early.” developmental monitoring program to public health employees 职业疗法在促进 "了解迹象。及早行动。"发展监测计划。

Health Care Science

Pub Date : 2024-05-27 DOI: 10.1002/hcs2.95

Kate Barlow, Kelsey Sullivan, Scott Lauren

Background

Occupational therapists can play a key role in early identification of delay at the population health level by providing education to public health employees on how to implement developmental monitoring with caregivers of children birth to age 5.

Methods

A pretest posttest design was utilized to assess the online education and training that was provided to Department of Public Health employees (N = 339), including Head Start, Special Supplemental Nutrition Program for Women, Infants and Children, Home Visiting, and Early Intervention.

Results

Analysis of pretest-posttest survey data showed significant results for all 12 key learning outcomes. Six out of 12 outcomes were found to have a large effect size (d > 0.8), 4 outcomes indicated a medium effect size (d > 0.5), and 2 outcomes had a small effect size (d > 0.2). Participants gained knowledge of the “Learn the Signs. Act Early.” (LTSAE) developmental monitoring program, the difference between developmental monitoring and screening, the state's referral system and age-appropriate parental engagement activities through knowledge of child development.

Conclusions

Occupational therapists are child development specialists who can provide education on developmental monitoring and activities for parental engagement. The online course proved to be an effective platform to promote LTSAE within state agencies.

背景：职业治疗师可以通过向公共卫生员工提供教育，让他们了解如何对出生至 5 岁儿童的看护者实施发育监测，从而在人口健康层面的早期识别发育迟缓方面发挥关键作用：方法：采用前测后测设计，评估为公共卫生部员工（N = 339）提供的在线教育和培训，包括启蒙教育、妇女、婴儿和儿童特别补充营养计划、家访和早期干预：结果：对前测-后测调查数据的分析表明，所有 12 项主要学习成果都取得了显著成效。在 12 项成果中，有 6 项具有较大的效果（d > 0.8），4 项具有中等效果（d > 0.5），2 项具有较小的效果（d > 0.2）。参与者获得了 "了解迹象。及早行动 "的知识。(LTSAE) 发展监测计划、发展监测与筛查之间的区别、州转诊系统以及通过儿童发展知识开展的适龄家长参与活动等方面的知识：职业治疗师是儿童发展专家，他们可以提供有关发展监测和家长参与活动的教育。在线课程被证明是在州立机构内推广 LTSAE 的有效平台。

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引用次数: 0

Evaluating rural health outcomes: A methodological approach using population-level data 评估农村健康成果：使用人口数据的方法论

Health Care Science

Pub Date : 2024-05-07 DOI: 10.1002/hcs2.94

Gal Av-Gay, Anshu Parajulee, Kathrin Stoll, Jude Kornelsen

Background

The sustainability of rural surgical and obstetrical facilities depends on their efficacy and quality of care, which are difficult to measure in a rural context. In an evaluation of rural practice, it is often the case that the only comparators are larger referral facilities, for which facility-level comparisons are difficult due to differences in population demographics, acuity of patients, and services offered. This publication outlines these limitations and highlights a best-practice approach to making facility-level comparisons using population-level data, risk stratification, tests of noninferiority, and Firth logistic regression analysis. This includes an investigation of minimum sample-size requirements through Monte Carlo power analysis in the context of low-acuity rural surgical care.

Methods

Monte Carlo power analysis was used to estimate the minimum sample size required to achieve a power of 0.8 for both logistic regression and Firth logistic regression models that compare the proportion of surgical adverse events against facility type, among other confounders. We provide guidelines for the implementation of a recommended methodology that uses risk stratification, Firth penalized logistic regression, and tests of noninferiority.

Results

We illustrate limitations in facility-level comparison of surgical quality among patients undergoing one of four index procedures including hernia repair, colonoscopy, appendectomy, and cesarean delivery. We identified minimum sample sizes for comparison of each index procedure that fluctuate depending on the level of risk stratification used.

Conclusion

The availability of administrative data can provide an adequate sample size to allow for facility-level comparisons in surgical quality, at the rural level and elsewhere. When they are made appropriately, these comparisons can be used to evaluate the efficacy of general practitioners and nurse practitioners in performing low-acuity procedures.

农村外科和产科医疗机构的可持续性取决于其疗效和医疗质量，而这在农村地区很难衡量。在对农村医疗机构进行评估时，往往只能将较大的转诊机构作为比较对象，而由于人口统计、患者病情严重程度和所提供服务等方面的差异，很难对这些机构进行机构层面的比较。本刊物概述了这些局限性，并重点介绍了使用人群数据、风险分层、非劣效性检验和 Firth logistic 回归分析进行机构级别比较的最佳实践方法。蒙特卡洛功率分析用于估算逻辑回归和 Firth 逻辑回归模型达到 0.8 功率所需的最小样本量，该模型将手术不良事件的比例与设施类型及其他混杂因素进行比较。我们说明了对接受疝修补术、结肠镜检查、阑尾切除术和剖宫产术等四种指标手术之一的患者进行设施水平手术质量比较的局限性。我们确定了每种指标手术的最低比较样本量，这些样本量会根据所使用的风险分层水平而波动。行政数据的可用性可以提供足够的样本量，以便在农村和其他地区进行医疗机构层面的手术质量比较。在适当的情况下，这些比较可用于评估全科医生和执业护士在进行低急性手术时的效率。

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引用次数: 0

Animation-guided family empowerment program on perioperative care after neurosurgery: A randomized controlled trial for preventing respiratory complications 神经外科手术后围术期护理的动画指导家庭赋权计划：预防呼吸系统并发症的随机对照试验。

Health Care Science

Pub Date : 2024-04-28 DOI: 10.1002/hcs2.93

Yunfen Lv, Ziwei Zhao, Xinyi Wu, Yao Wang, Shanshan Qiu

Background

This study aimed to evaluate the effectiveness of using animation as education material for family empowerment program on perioperative care for caregivers whose children were to undergo neurosurgery.

Methods

A total of 204 caregivers were randomly assigned to either the face-to-face oral nursing educated group (Oral Group) or the animation-assisted nursing educated group (Animated Group). The nursing education primarily focused on instructing caregivers about the manual vibration method. The primary outcome of interest in this study was participants' knowledge level, collected by a 10-item questionnaire. Secondary outcomes included child patients' clinical data, including hospitalization days, treatments, and signs of pneumonia.

Results

Participants in the Animated Group exhibited significantly higher accuracy in perioperative care knowledge assessment, and patients in this group had a lower chance of requiring atomization therapy compared to the Oral Group.

Conclusions

The animation-assisted nursing education program effectively enhances pediatric caregivers' knowledge, reduces respiratory complications after surgery, and offers valuable insights for future studies on the use of such programs to instruct caregivers.

研究背景本研究旨在评估使用动画作为家庭赋权项目的教育材料，对子女接受神经外科手术的护理人员进行围手术期护理的效果：共有 204 名护理人员被随机分配到面对面口头护理教育组（口头组）或动画辅助护理教育组（动画组）。护理教育主要侧重于指导护理人员了解手动振动法。本研究的主要结果是参与者的知识水平，通过 10 项调查问卷收集。次要结果包括儿童患者的临床数据，包括住院天数、治疗方法和肺炎体征：结果：动画组的参与者在围手术期护理知识评估中表现出明显更高的准确性，与口述组相比，该组患者需要雾化治疗的几率更低：动画辅助护理教育项目有效地提高了儿科护理人员的知识水平，减少了术后呼吸系统并发症的发生，为今后利用此类项目指导护理人员的研究提供了宝贵的启示。

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引用次数: 0

The role of community pharmacists and their perception towards antimicrobial stewardship in Baghdad, Iraq 伊拉克巴格达社区药剂师的作用及其对抗菌药物管理的看法

Health Care Science

Pub Date : 2024-04-11 DOI: 10.1002/hcs2.92

Akram Alkadhimi, Omar T. Dawood, Amer H. Khan

Background

This study aimed to assess the role of community pharmacists and their perception toward antimicrobial stewardship, in addition to identifying factors influencing their perception and practices in community pharmacy.

Methods

A cross-sectional study was carried out among community pharmacists regarding antimicrobial stewardship. Convenience sampling was used to obtain the required sample from a community pharmacy in Baghdad. In total, 381 participants have completed the survey.

Results

The majority of the participants (85.6%) strongly agreed/agreed that “antimicrobial stewardship programs reduce the problems of antibiotic resistance”; and 85.5% of them strongly agreed/agreed that community pharmacists required adequate training on antibiotics use. In addition, high percent of community pharmacists (88.4%) strongly agreed/agreed that pharmacists have a responsibility to take a prominent role in antimicrobial stewardship programs and infection-control programs in the health system. The total score of perception was significantly influenced by older age groups, postgraduate degrees, and experience of 6–10 years (p < 0.001). This study also showed that 65.4% of pharmacists always/often advise patients to continue the full course of antimicrobials, and 64.9% of them reported always/often considering clinical and safety parameters before dispensing antibiotics. The role of pharmacists was significantly influenced by the younger age group, females, higher degree in pharmacy, experience of 3–5 years, and medical complex pharmacy (p < 0.001).

Conclusion

Community pharmacists have a good perception toward antimicrobial stewardship programs, but their role is still limited. More efforts are needed to design better strategies for antimicrobial stewardship in community pharmacy.

背景本研究旨在评估社区药剂师的角色以及他们对抗菌药物管理的认知，同时确定影响他们在社区药房的认知和实践的因素。方法在社区药剂师中开展了一项有关抗菌药物管理的横断面研究。研究采用便利抽样法从巴格达的一家社区药房获得所需样本。共有 381 名参与者完成了调查。结果大多数参与者（85.6%）非常同意/同意 "抗菌药物管理计划可减少抗生素耐药性问题"；85.5%的参与者非常同意/同意社区药剂师需要接受足够的抗生素使用培训。此外，很高比例的社区药师（88.4%）非常同意/同意药师有责任在抗菌药物管理计划和医疗系统的感染控制计划中发挥重要作用。年龄较大、研究生学历和 6-10 年工作经验对认知总分有明显影响（p < 0.001）。这项研究还显示，65.4%的药剂师总是/经常建议患者继续服用整个疗程的抗菌药物，64.9%的药剂师表示在配发抗生素前总是/经常考虑临床和安全参数。年龄较小、女性、药学学位较高、3-5 年工作经验和医疗综合药房对药剂师的角色有明显影响（p <0.001）。结论社区药剂师对抗菌药物管理项目有良好的认知，但他们的作用仍然有限。需要做出更多努力，为社区药房的抗菌药物管理设计更好的策略。

{"title":"The role of community pharmacists and their perception towards antimicrobial stewardship in Baghdad, Iraq","authors":"Akram Alkadhimi, Omar T. Dawood, Amer H. Khan","doi":"10.1002/hcs2.92","DOIUrl":"https://doi.org/10.1002/hcs2.92","url":null,"abstract":"<div>\u0000 \u0000 \u0000 <section>\u0000 \u0000 <h3> Background</h3>\u0000 \u0000 <p>This study aimed to assess the role of community pharmacists and their perception toward antimicrobial stewardship, in addition to identifying factors influencing their perception and practices in community pharmacy.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Methods</h3>\u0000 \u0000 <p>A cross-sectional study was carried out among community pharmacists regarding antimicrobial stewardship. Convenience sampling was used to obtain the required sample from a community pharmacy in Baghdad. In total, 381 participants have completed the survey.</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Results</h3>\u0000 \u0000 <p>The majority of the participants (85.6%) strongly agreed/agreed that “antimicrobial stewardship programs reduce the problems of antibiotic resistance”; and 85.5% of them strongly agreed/agreed that community pharmacists required adequate training on antibiotics use. In addition, high percent of community pharmacists (88.4%) strongly agreed/agreed that pharmacists have a responsibility to take a prominent role in antimicrobial stewardship programs and infection-control programs in the health system. The total score of perception was significantly influenced by older age groups, postgraduate degrees, and experience of 6–10 years (<i>p</i> < 0.001). This study also showed that 65.4% of pharmacists always/often advise patients to continue the full course of antimicrobials, and 64.9% of them reported always/often considering clinical and safety parameters before dispensing antibiotics. The role of pharmacists was significantly influenced by the younger age group, females, higher degree in pharmacy, experience of 3–5 years, and medical complex pharmacy (<i>p</i> < 0.001).</p>\u0000 </section>\u0000 \u0000 <section>\u0000 \u0000 <h3> Conclusion</h3>\u0000 \u0000 <p>Community pharmacists have a good perception toward antimicrobial stewardship programs, but their role is still limited. More efforts are needed to design better strategies for antimicrobial stewardship in community pharmacy.</p>\u0000 </section>\u0000 </div>","PeriodicalId":100601,"journal":{"name":"Health Care Science","volume":"3 2","pages":"114-123"},"PeriodicalIF":0.0,"publicationDate":"2024-04-11","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://onlinelibrary.wiley.com/doi/epdf/10.1002/hcs2.92","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"140639600","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

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