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New Zealand hospice staff perspectives on 'Xcellent Gowns' for big bodied palliative care patients: a qualitative study. 新西兰临终关怀工作人员对大型姑息治疗患者的“Xcellent Gowns”的看法:一项定性研究。
IF 1.2 Q4 PRIMARY HEALTH CARE Pub Date : 2023-09-01 DOI: 10.1071/HC23009
Jazmin Phillips, Emily Wood, Tanya Loveard, Eileen McKinlay, Carol MacDonald, George Parker, Lesley Gray

Introduction A handful of reports detail efforts to redesign traditional hospital gowns to address common concerns related to patient comfort and privacy for big bodied patients. Results suggest that improving gown design has the potential to improve both the patient and carer experience and satisfaction of care. Aim This study aimed to ascertain the utility of gowns purposely designed for big bodied patients (named Xcellent Gowns) from a staff perspective. Methods Qualitative semi-structured interviews were conducted in 2022 with 14 hospice staff members. Interview transcripts were uploaded to DedooseTM . Data were analysed utilising reflexive thematic analysis according to a six-phase process including data familiarisation, iterative data coding, and theme development and refinement. Results The qualitative analysis of the interview data identified four main themes: (1) the gown experience, (2) fit-for-purpose, (3) love and dignity, (4) design principles. Each theme is presented and discussed with illustrative quotes from participants' interview transcripts. Discussion The perspectives of the staff participants in this study confirm research findings from other healthcare settings, that the patient and carer experience may be improved through focused redesign of this vital item of patient clothing.

引言一些报告详细介绍了重新设计传统医院长袍的努力,以解决与患者舒适度和大体型患者隐私相关的常见问题。结果表明,改进长袍设计有可能提高患者和护理人员的体验和护理满意度。目的本研究旨在从工作人员的角度确定专为体型较大的患者设计的长袍(名为Xcellent gowns)的实用性。方法于2022年对14名临终关怀工作人员进行定性半结构化访谈。面试记录已上传至DedooseTM。根据六个阶段的过程,包括数据熟悉、迭代数据编码以及主题开发和提炼,利用反射性主题分析对数据进行分析。结果访谈数据的定性分析确定了四个主要主题:(1)礼服体验,(2)符合目的,(3)爱与尊严,(4)设计原则。每一个主题都被介绍和讨论,并引用了参与者访谈记录中的例证。讨论本研究工作人员参与者的观点证实了其他医疗机构的研究结果,即通过重点重新设计这一重要的患者服装,可以改善患者和护理人员的体验。
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引用次数: 1
Defining comprehensiveness in primary care: a scoping review. 界定初级保健的全面性:范围界定审查。
IF 1.2 Q4 PRIMARY HEALTH CARE Pub Date : 2023-09-01 DOI: 10.1071/HC23067
Derek Baughman, Rafay Nasir, Lynda Ngo, Andrew Bazemore

Introduction The term comprehensiveness was introduced into the literature as early as the 1960s and is regarded as a core attribute of primary care. Although comprehensive care is a primary care research priority encompassing patient and provider experience, cost, and health outcomes, there has been a lack of focus on consolidating existing definitions. Aim To unify definitions of comprehensiveness in primary care. Methods The PRISMA extension for scoping reviews was followed, hierarchically filtering 'comprehensiveness' MeSH terms and literature-defined affiliated terms. Snowballing methods were used to include additional literature from known experts. Articles were systematically reviewed with a three-clinician team. Results The initial search populated 679 607 articles, of which 25 were included. Identified key terms include: whole-person care (WPC), range of services, and referral to specialty care. WPC is the extent which primary care physicians (PCPs) consider the physical, emotional, and social aspects of a patient's health. It has been shown to positively impact clinical costs and outcomes, satisfaction, and trust. Range of services encompasses most health problems to reduce unnecessary spending on specialty care and promote continuity. Referral to specialty care is utilized when PCPs cannot provide the necessary services - balancing depth and breadth of care with the limitations of primary care scope. Discussion This scoping review unified the interrelatedness of comprehensiveness's main aspects - whole-person care, range of services, and referral to specialty care - framing a working, evidence-based definition: managing most medical care needs and temporarily complementing care with special integrated services in the context of patient's values, preferences, and beliefs.

引言“全面性”一词早在20世纪60年代就被引入文献,被视为初级保健的核心属性。尽管综合护理是初级保健研究的优先事项,包括患者和提供者的经验、成本和健康结果,但缺乏对整合现有定义的关注。目的统一初级保健全面性的定义。方法遵循PRISMA范围界定审查扩展,分层筛选“全面性”MeSH术语和文献定义的附属术语。滚雪球法被用于纳入已知专家的额外文献。由三名临床医生组成的团队对文章进行了系统的审查。结果初始搜索填充679 607篇文章,其中包括25篇。已确定的关键术语包括:全人护理(WPC)、服务范围和专科护理转诊。WPC是初级保健医生(PCP)考虑患者健康的身体、情感和社会方面的程度。它已被证明对临床成本和结果、满意度和信任有积极影响。服务范围涵盖了大多数健康问题,以减少专业护理的不必要支出并促进连续性。当PCP无法提供必要的服务时,会使用转诊到专科护理——在护理的深度和广度与初级护理范围的限制之间取得平衡。讨论这一范围审查统一了全面性的主要方面——全人护理、服务范围和转诊到专科护理——的相互关系,制定了一个有效的、基于证据的定义:在患者的价值观、偏好和信仰的背景下,管理大多数医疗护理需求,并暂时用特殊的综合服务补充护理。
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引用次数: 1
Ganoderma lucidum. 灵芝。
IF 1.2 Q4 PRIMARY HEALTH CARE Pub Date : 2023-09-01 DOI: 10.1071/HC23105
Aleksandra Milosavljevic, Jo Barnes
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引用次数: 49
Nurse prescriber's understanding of their antimicrobial stewardship role: a qualitative study. 开处方护士对其抗菌药物管理作用的理解:一项定性研究。
IF 1.2 Q4 PRIMARY HEALTH CARE Pub Date : 2023-09-01 DOI: 10.1071/HC23006
Anecita Gigi Lim, Dianne C Marshall, Kenzie Roberts, Michelle L L Honey

Introduction Antimicrobial resistance is an infectious disease threat to public health globally, and antimicrobial stewardship among healthcare professionals is one key way to address this potential problem. Registered nurse designated prescribers are the newest group of health professionals to gain prescribing authority in Aotearoa New Zealand, yet little is known about their understanding of their antimicrobial stewardship role. Aim The aim of this study was to explore registered nurse designated prescribers' understanding of their antimicrobial stewardship role through their prescribing practices and approaches to clinical reasoning. Methods This exploratory descriptive qualitative study used individual semi-structured interviews with six registered nurse designated prescribers. Thematic analysis was used to analyse the interviews. Results Four themes were identified: antibiotic prescribing practices and antimicrobial resistance; clinical indicators for prescribing antibiotics, with the sub-themes of history taking, presence of infection and bacterial versus viral infection; patient education; and safety and monitoring. These themes provide insight into registered nurse designated prescribers' understanding of their antimicrobial stewardship role and prescribing of antibiotics. Discussion This research found that the registered nurse designated prescribers had an awareness of the importance of their antimicrobial stewardship role in relation to antibiotic prescribing and reducing antimicrobial resistance. Education about antimicrobial resistance and antimicrobial stewardship for this professional group can be effective, but further research is needed to understand their ongoing educational needs.

引言抗微生物耐药性是全球公共卫生面临的传染病威胁,医疗保健专业人员的抗微生物管理是解决这一潜在问题的关键途径之一。注册护士指定处方医生是新西兰奥特亚最新一批获得处方授权的卫生专业人员,但人们对他们的抗菌管理作用知之甚少。目的本研究的目的是通过处方实践和临床推理方法,探讨注册护士指定处方医生对其抗菌药物管理作用的理解。方法这项探索性的描述性定性研究采用了对六名注册护士指定处方医生的个体半结构化访谈。采用专题分析法对访谈进行分析。结果确定了四个主题:抗生素处方实践和耐药性;开具抗生素处方的临床指标,包括病史、是否存在感染以及细菌与病毒感染;耐心教育;以及安全和监测。这些主题深入了解了注册护士指定的处方医生对其抗菌药物管理作用和抗生素处方的理解。讨论这项研究发现,注册护士指定的处方医生意识到他们在抗生素处方和减少抗生素耐药性方面的抗菌管理作用的重要性。对这一专业群体进行抗微生物耐药性和抗菌管理的教育可能是有效的,但需要进一步的研究来了解他们持续的教育需求。
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引用次数: 1
Changing patterns of otitis media in the Waikato region during the COVID-19 pandemic. 新冠肺炎大流行期间怀卡托地区中耳炎的变化模式。
IF 1.2 Q4 PRIMARY HEALTH CARE Pub Date : 2023-09-01 DOI: 10.1071/HC23026
Andre Becker, Ha Nguyen, Michael Becker, Andrew Wood, Ross Lawrenson

Introduction Acute otitis media (AOM) is a common condition of children encountered in general practice. A proportion of children develop otitis media with effusion (OME), which may require tympanostomy and ventilation tube insertion. Aim The aim of the study was to compare the incidence of AOM in Māori and New Zealand (NZ) European children in general practice and the referral practices to secondary care for tympanostomy and ventilation tube insertion. Methods The study was conducted in two parts: (1) an analysis of the incidence of AOM and OME in a rural Waikato general practice (Ōtorohanga) with a high Māori population over a 2-year period; and (2) an analysis of all referrals to the otorhinolaryngology (ORL) department at Waikato District Health Board and tympanostomy and ventilation tube insertion by this service over the same period. Results The incidence of AOM was similar in Māori compared with NZ European children. The incidence declined significantly between 2019 and 2020 and 50% of children with AOM were treated with antibiotics. Referral rates to the ORL department were greater for Māori compared with NZ European children as were tympanostomy and ventilation tube insertion rates. Discussion Although AOM is common, OME was rarely diagnosed. The clinical guidelines regarding antibiotic use for common conditions are not being readily adopted and further research is needed into this matter. The COVID-19 pandemic had a substantial effect on demand both in general practice and in the hospital sector. This may have been due to a reduction in the incidence of AOM or due to system changes caused by the pandemic.

引言急性中耳炎(AOM)是儿童在全科医学中常见的疾病。一部分儿童发展为渗出性中耳炎(OME),可能需要鼓室造瘘和插入通气管。目的本研究的目的是比较毛利和新西兰(NZ)欧洲儿童在全科医学和转诊到鼓室造瘘和通气管插入二级护理的实践中AOM的发生率。方法本研究分为两个部分:(1)分析怀卡托乡村全科诊所(Ōtorohanga)2年来毛利人较多的AOM和OME的发病率;以及(2)对怀卡托区卫生委员会耳鼻喉科的所有转诊以及同期该服务的鼓室造口术和通气管插入的分析。结果毛利人AOM的发生率与NZ-欧洲儿童相似。2019年至2020年间,发病率显著下降,50%的AOM儿童接受了抗生素治疗。与新西兰-欧洲儿童相比,毛利人到ORL部门的转诊率更高,鼓室造口术和通气管插入率也更高。讨论尽管AOM很常见,但OME很少被诊断出来。关于常见疾病使用抗生素的临床指南尚未被采纳,需要对此进行进一步研究。新冠肺炎大流行对全科医学和医院部门的需求产生了重大影响。这可能是由于AOM发病率的降低,或者是由于大流行导致的系统变化。
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引用次数: 1
Is the extra expense for blue-light filtering glass in spectacles worth it? 眼镜中的蓝光过滤玻璃的额外费用值得吗?
IF 1.2 Q4 PRIMARY HEALTH CARE Pub Date : 2023-09-01 DOI: 10.1071/HC23101
Vanessa Jordan
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引用次数: 1
Promoting the use of long-acting reversible contraceptives to reduce unplanned pregnancies 推广使用长效可逆避孕药具,减少意外怀孕
IF 1.2 Q4 PRIMARY HEALTH CARE Pub Date : 2023-08-16 DOI: 10.7748/phc.2023.e1800
E. Jones
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引用次数: 1
Health visitor workload: an integrative review of the literature 健康访客工作量:文献的综合回顾
IF 1.2 Q4 PRIMARY HEALTH CARE Pub Date : 2023-08-02 DOI: 10.7748/phc.2023.e1804
Bernie Reid, Julie M Tracey
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引用次数: 0
The risks and benefits of vapes and e-cigarettes 电子烟和电子烟的风险和好处
IF 1.2 Q4 PRIMARY HEALTH CARE Pub Date : 2023-08-01 DOI: 10.7748/phc.33.4.10.s4
Pavan Amara
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引用次数: 0
Clinical supervision aids well-being and protects nurses 临床监督有助于健康和保护护士
IF 1.2 Q4 PRIMARY HEALTH CARE Pub Date : 2023-08-01 DOI: 10.7748/phc.33.4.5.s1
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Journal of primary health care
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