S. Zyoud, Rawan M. Shtaya, Dana Q. Hamadneh, Shyma N. Sawalmeh, H. Khadrah, Rasha R. Zedat, A. Othman, W. Sweileh, R. Awang, Samah W. Al-Jabi
Abstract Background Self-therapy with various medications is a commonly practised form of children self-care among parents throughout the world, with the prevalence and pattern differing from country to country. Parental knowledge, attitudes, and practices (KAP) regarding self-medication of their children need to be taken into consideration because children are more sensitive to adverse consequences of medication. This study was designed to assess Palestinian parents’ KAP towards self-medication for their children. Methods A descriptive, cross-sectional study was conducted in Palestine from October 2016 to February 2017, using a face-to-face interview questionnaire format, which was adapted from previous studies in this field. Data was collected by convenient sampling. The parents answered a questionnaire covering socio-demographic and economic variables; medication information; knowledge, attitudes, and practices regarding self-medication; and the toxicity of medications used for self-therapy. Results Among the 500 respondents interviewed, the total parents of 357 (73.4%) accepted using medications as self-therapy for their children. The most common reason for using self-medication was previous experience (54.6%). The medications most often used in such self-therapy are antipyretics (95%), followed by skin creams (46%) and anti-cough and anti-influenza medication (44.2%). Parental knowledge about toxicity was found to be inadequate knowledge. For example, around 70% of parents believe that paracetamol and multivitamin are not fatal in cases of overdose. Conclusions Self-medication of children is common among parents in Palestine. There has been a high tendency for parents to self-medicate their children, in particular with antipyretics. Moreover, antibiotics have been used without prescriptions by a large proportion of parents. As such, specific guidelines for appropriate self-therapy should be established. We must encourage pharmacists to educate parents on how to self-medicate medicine in proper doses and at the correct time, as well when the dose reaches a toxic level.
{"title":"Parental knowledge, attitudes, and practices towards self-medication for their children: a cross-sectional study from Palestine","authors":"S. Zyoud, Rawan M. Shtaya, Dana Q. Hamadneh, Shyma N. Sawalmeh, H. Khadrah, Rasha R. Zedat, A. Othman, W. Sweileh, R. Awang, Samah W. Al-Jabi","doi":"10.22146/apfm.v18i1.37","DOIUrl":"https://doi.org/10.22146/apfm.v18i1.37","url":null,"abstract":"Abstract Background Self-therapy with various medications is a commonly practised form of children self-care among parents throughout the world, with the prevalence and pattern differing from country to country. Parental knowledge, attitudes, and practices (KAP) regarding self-medication of their children need to be taken into consideration because children are more sensitive to adverse consequences of medication. This study was designed to assess Palestinian parents’ KAP towards self-medication for their children. Methods A descriptive, cross-sectional study was conducted in Palestine from October 2016 to February 2017, using a face-to-face interview questionnaire format, which was adapted from previous studies in this field. Data was collected by convenient sampling. The parents answered a questionnaire covering socio-demographic and economic variables; medication information; knowledge, attitudes, and practices regarding self-medication; and the toxicity of medications used for self-therapy. Results Among the 500 respondents interviewed, the total parents of 357 (73.4%) accepted using medications as self-therapy for their children. The most common reason for using self-medication was previous experience (54.6%). The medications most often used in such self-therapy are antipyretics (95%), followed by skin creams (46%) and anti-cough and anti-influenza medication (44.2%). Parental knowledge about toxicity was found to be inadequate knowledge. For example, around 70% of parents believe that paracetamol and multivitamin are not fatal in cases of overdose. Conclusions Self-medication of children is common among parents in Palestine. There has been a high tendency for parents to self-medicate their children, in particular with antipyretics. Moreover, antibiotics have been used without prescriptions by a large proportion of parents. As such, specific guidelines for appropriate self-therapy should be established. We must encourage pharmacists to educate parents on how to self-medicate medicine in proper doses and at the correct time, as well when the dose reaches a toxic level.","PeriodicalId":39050,"journal":{"name":"Asia Pacific Family Medicine","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-04-30","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"45145311","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Background. Plantar cutaneous conditions are the most common causes of foot discomfort limiting ambulation. Identification of indwelling foreign bodies is greatly facilitated by dermoscopy, allowing early detection of the character of the underlying pathological etiology. Furthermore, polarized dermoscopy provides ideal conditions of illumination and three- dimensional visualization of the involved site, without direct contact with the cutaneous surface. This unprecedented report describes its implementation for a solitary hair implanted into plantar skin. Case Presentation. A patient presented with localized plantar discomfort diagnosed as a soft tissue reaction to an embedded single human hair, folded and rooted inside the epidermis. Under magnified vision the phenomenon was characterized, the hair was extracted, the source was manipulated with a hypodermic needle and the lesion was removed with ensuing complete resolution. Conclusions. Previous reports of hair slivers embedded inside the skin were attributed to barbers or animal grooming and the treatment was dictated by the severity of the complications. In this relatively mild case the intervention was greatly facilitated by therapeutic dermoscopy. Therapeutic dermoscopy is advocated for use to evaluate and treat many diverse body surfaces, especially the plantar skin as it raises the likelihood of successful treatment of embedded foreign bodies. Precisely how a single hair may become lodged into normal plantar skin remains to be explained
{"title":"Polarized Dermoscopy Facilitates Diagnosis and Treatment of Plantar Pseudohirsutism","authors":"S. Naimer","doi":"10.22146/apfm.v18i1.77","DOIUrl":"https://doi.org/10.22146/apfm.v18i1.77","url":null,"abstract":"Background. Plantar cutaneous conditions are the most common causes of foot discomfort limiting ambulation. Identification of indwelling foreign bodies is greatly facilitated by dermoscopy, allowing early detection of the character of the underlying pathological etiology. Furthermore, polarized dermoscopy provides ideal conditions of illumination and three- dimensional visualization of the involved site, without direct contact with the cutaneous surface. This unprecedented report describes its implementation for a solitary hair implanted into plantar skin. Case Presentation. A patient presented with localized plantar discomfort diagnosed as a soft tissue reaction to an embedded single human hair, folded and rooted inside the epidermis. Under magnified vision the phenomenon was characterized, the hair was extracted, the source was manipulated with a hypodermic needle and the lesion was removed with ensuing complete resolution. Conclusions. Previous reports of hair slivers embedded inside the skin were attributed to barbers or animal grooming and the treatment was dictated by the severity of the complications. In this relatively mild case the intervention was greatly facilitated by therapeutic dermoscopy. Therapeutic dermoscopy is advocated for use to evaluate and treat many diverse body surfaces, especially the plantar skin as it raises the likelihood of successful treatment of embedded foreign bodies. Precisely how a single hair may become lodged into normal plantar skin remains to be explained","PeriodicalId":39050,"journal":{"name":"Asia Pacific Family Medicine","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-04-03","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48947427","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Shuji Tsuda, M. Janevic, K. Shikano, T. Matsui, Tsukasa Tsuda
Background: Older adults who have health conditions with good prognoses typically fall outside the scope of efforts encouraging advance care planning. We developed group and individual versions of an advance care planning program for use in primary care. Methods: We conducted a quasi-experimental trial in a rural family clinic in Japan. Medically stable patients aged ≥65 years were invited to watch an educational video on advance care planning, followed by an individual (n=46) or group-based (n=63) discussion. Advance directive completion was tracked over four months. Participants completed baseline and follow-up questionnaires and reported occurrence of family discussions about advance care planning and attitudes toward advance care planning. Group discussions were recorded and thematically analyzed to identify barriers and facilitators to engaging in advance care planning. Results: Advance directive completion rates were high for both intervention versions but did not significantly differ between arms (85.7% vs. 80.4%, p=0.45). Only one-fifth of patients in both arms discussed advance care planning with their family after the intervention (20.7% and 21.7%, p=0.89). Patients in the group arm rated their experience slightly higher than those in the individual arm (4.2 and 3.9 out of 5, p=0.023). Qualitative analysis of group discussions revealed that patients were affected by their perceptions of societal norms that prioritize family consensus over patient autonomy; however, these perceptions influenced advance care planning behaviors in inconsistent ways. Conclusions: Group-based advance care planning intervention among medically stable older patients is as effective as an individually-focused discussion in promoting advance directive completion. Future research is needed on ways to enhance patients’ ability to discuss advance care planning with their family members.
背景:具有良好预后的健康状况的老年人通常不在鼓励提前护理计划的范围之内。我们开发了小组和个人版本的预先护理计划程序，用于初级保健。方法:在日本农村家庭诊所进行准实验试验。年龄≥65岁的病情稳定的患者被邀请观看关于预先护理计划的教育视频，随后进行个人(n=46)或小组(n=63)讨论。预先指示完成情况跟踪了四个月。参与者完成了基线和随访问卷，并报告了家庭讨论提前护理计划的情况和对提前护理计划的态度。小组讨论记录和专题分析，以确定障碍和促进参与提前护理计划。结果:两种干预版本的预先指示完成率都很高，但两组间无显著差异(85.7% vs. 80.4%， p=0.45)。两组均仅有五分之一的患者在干预后与家人讨论了预先护理计划(20.7%和21.7%，p=0.89)。组组患者对自身体验的评价略高于单独组(5分中的4.2分和3.9分，p=0.023)。小组讨论的定性分析显示，患者受到他们对社会规范的看法的影响，这些规范优先考虑家庭共识而不是患者的自主权;然而，这些观念以不一致的方式影响提前护理计划行为。结论:在医学稳定的老年患者中，以小组为基础的提前护理计划干预与以个人为中心的讨论在促进提前指示完成方面同样有效。未来需要研究如何提高患者与家人讨论预先护理计划的能力。
{"title":"Group-based educational intervention for advance care planning in primary care: a quasi-experimental study in Japan","authors":"Shuji Tsuda, M. Janevic, K. Shikano, T. Matsui, Tsukasa Tsuda","doi":"10.22146/APFM.V18I1.54","DOIUrl":"https://doi.org/10.22146/APFM.V18I1.54","url":null,"abstract":"Background: Older adults who have health conditions with good prognoses typically fall outside the scope of efforts encouraging advance care planning. We developed group and individual versions of an advance care planning program for use in primary care. \u0000Methods: We conducted a quasi-experimental trial in a rural family clinic in Japan. Medically stable patients aged ≥65 years were invited to watch an educational video on advance care planning, followed by an individual (n=46) or group-based (n=63) discussion. Advance directive completion was tracked over four months. Participants completed baseline and follow-up questionnaires and reported occurrence of family discussions about advance care planning and attitudes toward advance care planning. Group discussions were recorded and thematically analyzed to identify barriers and facilitators to engaging in advance care planning. \u0000Results: Advance directive completion rates were high for both intervention versions but did not significantly differ between arms (85.7% vs. 80.4%, p=0.45). Only one-fifth of patients in both arms discussed advance care planning with their family after the intervention (20.7% and 21.7%, p=0.89). Patients in the group arm rated their experience slightly higher than those in the individual arm (4.2 and 3.9 out of 5, p=0.023). Qualitative analysis of group discussions revealed that patients were affected by their perceptions of societal norms that prioritize family consensus over patient autonomy; however, these perceptions influenced advance care planning behaviors in inconsistent ways. \u0000Conclusions: Group-based advance care planning intervention among medically stable older patients is as effective as an individually-focused discussion in promoting advance directive completion. Future research is needed on ways to enhance patients’ ability to discuss advance care planning with their family members.","PeriodicalId":39050,"journal":{"name":"Asia Pacific Family Medicine","volume":"18 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-03-31","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44090102","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
K. L. Son, Andri Setyo Dwi Nugroho, Baning Rahayujati, La K. Gozali
Background: On May, 13 2019, a food poisoning outbreak of diarrhoeal B. cereus associated with contaminated chicken satay occurred in Tegalkenongo village involving villagers after attending mass iftar in a mosque. Health office of Bantul District revealed two attendances were hospitalized in the hospital of PKU Muhammadiyah after consuming food served during mass iftar. Based on the information, we immediately conducted an epidemiological investigation to make sure of the existence of the outbreak. Objectives: This study aimed to investigate the causative agents, source of food poisoning and mode of food poisoning transmission in Tegalkenongo Village. Methods: A retrospective cohort study was used in the epidemiological investigation during one week from 13 May 2019 – 20 May 2019. Results: Based on the investigation, Of the 303 villagers involved in the event, 188 villagers were ill with the median age of cases was 38 years old, the average incubation period was 8 hours, and the predominate symptoms were diarrhea (93.62%), nausea (84.57%), and abdominal cramps (64.89%). Contaminated chicken satay was determined as the source of contamination with adjusted Risk Ratio (aRR) was 4.36; 95% CI 1.1538, 16.5285. Initial epidemiological features and cultures from food items served in the event and stool sample of one patient suggested that the causative agent was Bacillus Cereus which was supported by Klebsiella Pneumoniae. Conclusion: Based on the field investigation result related to symptoms and incubation period and laboratory identification, we conclude that the causative agent was diarrhoeal B. cereus. Keywords: Food poisoning, Bacillus cereus, Klebsiella pneumoniae
{"title":"The Food poisoning outbreak caused by diarrhoeal Bacillus Cereus in Tegalkenongo Village, Bantul, Yogyakarta, Indonesia: a retrospective study","authors":"K. L. Son, Andri Setyo Dwi Nugroho, Baning Rahayujati, La K. Gozali","doi":"10.22146/APFM.V18I1.62","DOIUrl":"https://doi.org/10.22146/APFM.V18I1.62","url":null,"abstract":"Background: On May, 13 2019, a food poisoning outbreak of diarrhoeal B. cereus associated with contaminated chicken satay occurred in Tegalkenongo village involving villagers after attending mass iftar in a mosque. Health office of Bantul District revealed two attendances were hospitalized in the hospital of PKU Muhammadiyah after consuming food served during mass iftar. Based on the information, we immediately conducted an epidemiological investigation to make sure of the existence of the outbreak. \u0000Objectives: This study aimed to investigate the causative agents, source of food poisoning and mode of food poisoning transmission in Tegalkenongo Village. \u0000Methods: A retrospective cohort study was used in the epidemiological investigation during one week from 13 May 2019 – 20 May 2019. \u0000Results: Based on the investigation, Of the 303 villagers involved in the event, 188 villagers were ill with the median age of cases was 38 years old, the average incubation period was 8 hours, and the predominate symptoms were diarrhea (93.62%), nausea (84.57%), and abdominal cramps (64.89%). Contaminated chicken satay was determined as the source of contamination with adjusted Risk Ratio (aRR) was 4.36; 95% CI 1.1538, 16.5285. Initial epidemiological features and cultures from food items served in the event and stool sample of one patient suggested that the causative agent was Bacillus Cereus which was supported by Klebsiella Pneumoniae. \u0000Conclusion: Based on the field investigation result related to symptoms and incubation period and laboratory identification, we conclude that the causative agent was diarrhoeal B. cereus. \u0000Keywords: Food poisoning, Bacillus cereus, Klebsiella pneumoniae","PeriodicalId":39050,"journal":{"name":"Asia Pacific Family Medicine","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-03-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"49352426","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
China was the first country where the novel coronavirus appeared. General Practitioners (GPs) in China are at the forefront of tackling the spread of the virus. While the health sector in China has been under scrutiny globally, many articles have been disseminated within the country about the response. GPs in China are keen to share their experiences with GP colleagues, as other countries go through similar experiences. The hope is that by sharing our experiences, our international colleagues can benefit from what worked well and what went less well. Coronavirus started spreading from Wuhan in Hubei Province in late 2019. As in many parts of China, Wuhan is a hospital-oriented health service, as the family medicine system is not yet fully implemented. The surge of patients to hospitals quickly overwhelmed the health system in Wuhan and surrounding towns and cities, as patients sought testing and treatment, and in the process helped to spread the virus more quickly. The experience has put the spotlight on the ineffectiveness of hospitals as the first port of call for this and other types of virus.
{"title":"Sharing experience from Chinese General Practitioners to International colleagues on how to tackle COVID-19","authors":"Shanzhu Zhu, D. Li","doi":"10.22146/apfm.v18i1.217","DOIUrl":"https://doi.org/10.22146/apfm.v18i1.217","url":null,"abstract":"China was the first country where the novel coronavirus appeared. General Practitioners (GPs) in China are at the forefront of tackling the spread of the virus. While the health sector in China has been under scrutiny globally, many articles have been disseminated within the country about the response. GPs in China are keen to share their experiences with GP colleagues, as other countries go through similar experiences. The hope is that by sharing our experiences, our international colleagues can benefit from what worked well and what went less well. \u0000Coronavirus started spreading from Wuhan in Hubei Province in late 2019. As in many parts of China, Wuhan is a hospital-oriented health service, as the family medicine system is not yet fully implemented. The surge of patients to hospitals quickly overwhelmed the health system in Wuhan and surrounding towns and cities, as patients sought testing and treatment, and in the process helped to spread the virus more quickly. The experience has put the spotlight on the ineffectiveness of hospitals as the first port of call for this and other types of virus.","PeriodicalId":39050,"journal":{"name":"Asia Pacific Family Medicine","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-03-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"46237541","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
What is Covid-19? Definition: COVID-19 is the infectious disease caused by the most recently discovered coronavirus. It was first recognized in Wuhan, China, in December 2019. Symptoms: The most common symptoms are fever, tiredness, and dry cough. Some people may have aches and pains, nasal congestion, runny nose, sore throat or diarrhea. Course: Symptoms usually begin gradually. Some people become infected but don’t develop any symptoms. Most people (about 80%) recover from the disease without needing special treatment. Around 1 out of every 6 people becomes seriously ill and develops difficulty breathing. At risk: Older people, and those with underlying medical problems. People with fever, cough and difficulty breathing should seek medical attention.
{"title":"Preparing for COVID-19: The lessons from SARS 2003 in Canada","authors":"D. White","doi":"10.22146/apfm.v18i1.216","DOIUrl":"https://doi.org/10.22146/apfm.v18i1.216","url":null,"abstract":"What is Covid-19? \u0000Definition: COVID-19 is the infectious disease caused by the most recently discovered coronavirus. It was first recognized in Wuhan, China, in December 2019. \u0000Symptoms: The most common symptoms are fever, tiredness, and dry cough. Some people may have aches and pains, nasal congestion, runny nose, sore throat or diarrhea. \u0000Course: Symptoms usually begin gradually. Some people become infected but don’t develop any symptoms. Most people (about 80%) recover from the disease without needing special treatment. Around 1 out of every 6 people becomes seriously ill and develops difficulty breathing. \u0000At risk: Older people, and those with underlying medical problems. People with fever, cough and difficulty breathing should seek medical attention.","PeriodicalId":39050,"journal":{"name":"Asia Pacific Family Medicine","volume":"1 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-03-23","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42146412","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Winky Law, D. Xue, Sibei Lin, Y. H. Wong, R. W. Sit
Background: Chronic musculoskeletal pain (CMSP) is common in older people with multimorbidity (MM). Given the complex etiology of CMSP, it is worthwhile to explore the meanings attached to an individual and its interaction with MM. The study aimed to explore the meanings underneath the experience of CMSP and MM, to generate new insight on the support of pain management in the elderly population. Methods: 20 eligible subjects aged between 65 and 80 were recruited through purposive sampling. Semi-structured in-depth interviews were conducted, with data transcript, coded and analyzed using grounded theory approach. Results: Quotes evolved on the interaction between CMSP and MM, with participants expressed worries of pain may affect disease control. Three themes emerged which included the impact of CMSP on the physical and psychosocial well-being among the elderly with MM, the barriers to pain care in the community, and the perception and strategies on pain management. Conclusions: Older people with CMSP and MM were suffering from a significant physical and psychological impact on their well-being. Self-care remains a preferred adjunct in pain management; support should be strengthened at individual (education) and community (urban development) level.
{"title":"Exploring the Pain Experience of Chinese Elderly Patients with Chronic Musculoskeletal Pain and Multimorbidity in Primary Care: A Qualitative Study using a Grounded Theory Approach","authors":"Winky Law, D. Xue, Sibei Lin, Y. H. Wong, R. W. Sit","doi":"10.22146/APFMJ.47316","DOIUrl":"https://doi.org/10.22146/APFMJ.47316","url":null,"abstract":"Background: Chronic musculoskeletal pain (CMSP) is common in older people with multimorbidity (MM). Given the complex etiology of CMSP, it is worthwhile to explore the meanings attached to an individual and its interaction with MM. The study aimed to explore the meanings underneath the experience of CMSP and MM, to generate new insight on the support of pain management in the elderly population. \u0000Methods: 20 eligible subjects aged between 65 and 80 were recruited through purposive sampling. Semi-structured in-depth interviews were conducted, with data transcript, coded and analyzed using grounded theory approach. \u0000Results: Quotes evolved on the interaction between CMSP and MM, with participants expressed worries of pain may affect disease control. Three themes emerged which included the impact of CMSP on the physical and psychosocial well-being among the elderly with MM, the barriers to pain care in the community, and the perception and strategies on pain management. \u0000Conclusions: Older people with CMSP and MM were suffering from a significant physical and psychological impact on their well-being. Self-care remains a preferred adjunct in pain management; support should be strengthened at individual (education) and community (urban development) level.","PeriodicalId":39050,"journal":{"name":"Asia Pacific Family Medicine","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-01-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47779210","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
N. Arisanti, P. Hadisoemarto, E. P. S. Sasongko, Veranita Pandia, D. Hilmanto
Backgorund: Many models of palliative care have already been implemented, however, a model of health care cannot be directly applied in a country because of the differences in socio-cultural, disease patterns and health systems within the country. This study aimed to conduct a systematic review to analyze models of palliative care and elements of model for palliative care. Methods: A systematic review was conducted. Articles were searched by four electronic databases; PubMed, Web of Science, Ovid and NICE Database. Three reviewers screened the search results and data were classified according to their main objective. Further synthesize was conducted to show element and model of care. Results: The initial search strategy identified 218. Based on Hawker quality assessment scale, only 14 articles met criteria for review and synthesis. Out of 14, 4 articles describe palliative care for chronic disease (heart failure, end stage renal disease) and 10 for cancer. The integrated palliative care model has been the most frequently described. The other models are respite care, care-aide and personal alarm model, family centered advanced care, and end of life care for young adults. This systematic review also identified elements of model for palliative care and categorized as element from patient and family, personnel and health care system. Conclusion: A few studies are describing a model of palliative care and elements of model for palliative care in detail. More detailed methodological and population specifications are needed to accurately find the results.
背景:许多姑息治疗模式已经实施，然而，由于一个国家内部的社会文化、疾病模式和卫生系统的差异，一种卫生保健模式不能直接应用于一个国家。本研究旨在对姑息治疗模式和姑息治疗模式要素进行系统回顾分析。方法:进行系统评价。文章通过四个电子数据库检索;PubMed, Web of Science, Ovid和NICE数据库。三位审稿人对搜索结果进行筛选，并根据其主要目的对数据进行分类。进一步综合得出了关怀的要素和模式。结果:初步搜索策略确定218个。根据霍克质量评估量表，只有14篇文章符合评审和综合标准。在14篇文章中，4篇描述了慢性疾病(心力衰竭、终末期肾病)的姑息治疗，10篇描述了癌症的姑息治疗。综合姑息治疗模式是最常被描述的。其他模式有临时护理、护理辅助和个人报警模式、以家庭为中心的高级护理和年轻人的生命终结护理。本系统综述还确定了姑息治疗模式的要素，并将其分类为来自患者和家属、人员和卫生保健系统的要素。结论:一些研究详细描述了姑息治疗模式和姑息治疗模式的要素。需要更详细的方法和人口规格才能准确地找到结果。
{"title":"The model and elements of palliative care for patients with terminal illness: A systematic review","authors":"N. Arisanti, P. Hadisoemarto, E. P. S. Sasongko, Veranita Pandia, D. Hilmanto","doi":"10.22146/APFMJ.47034","DOIUrl":"https://doi.org/10.22146/APFMJ.47034","url":null,"abstract":"Backgorund: Many models of palliative care have already been implemented, however, a model of health care cannot be directly applied in a country because of the differences in socio-cultural, disease patterns and health systems within the country. This study aimed to conduct a systematic review to analyze models of palliative care and elements of model for palliative care. \u0000Methods: A systematic review was conducted. Articles were searched by four electronic databases; PubMed, Web of Science, Ovid and NICE Database. Three reviewers screened the search results and data were classified according to their main objective. Further synthesize was conducted to show element and model of care. \u0000Results: The initial search strategy identified 218. Based on Hawker quality assessment scale, only 14 articles met criteria for review and synthesis. Out of 14, 4 articles describe palliative care for chronic disease (heart failure, end stage renal disease) and 10 for cancer. The integrated palliative care model has been the most frequently described. The other models are respite care, care-aide and personal alarm model, family centered advanced care, and end of life care for young adults. This systematic review also identified elements of model for palliative care and categorized as element from patient and family, personnel and health care system. \u0000Conclusion: A few studies are describing a model of palliative care and elements of model for palliative care in detail. More detailed methodological and population specifications are needed to accurately find the results. ","PeriodicalId":39050,"journal":{"name":"Asia Pacific Family Medicine","volume":" ","pages":""},"PeriodicalIF":0.0,"publicationDate":"2020-01-27","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"47527080","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Koki Nakamura, Satoshi Kanke, Goro Hoshi, Yoshihiro Toyoda, Kazutaka Yoshida, T. Kitamura, R. Kassai
Background: Despite recognition of the importance of primary health care, the opportunities for medical students to participate in family medicine clerkships (FMCs) are still inadequate around the world. In order for FMCs to be accepted in the undergraduate curriculum, it is necessary to clarify whether FMCs complement clerkships at teaching hospitals.Methods: Throughout the academic year 2018–2019, a total of 125 fifth-year students in Fukushima Medical University participated in an FMC. The students evaluated themselves at the beginning and end of their FMC whilst the family doctors evaluated students at the end of the FMC. The evaluations were a 5-point scale on 31 items in the following seven areas; objectives in general practice, practical skills and patient care, communication skills, patient-physician relationship, practice of team-based health care, medical practice in society and medical knowledge and problem-solving ability. A multiple regression analysis was conducted to assess whether self-evaluation was increased by clerkships at teaching hospitals where students rotated before the start of FMC. A Wilcoxon signed-rank sum test was used to assess self-evaluation changes before and after the FMC.Results: All 125 students completed the study. Pre-FMC self-evaluation scores for 19 items tended to be higher depending on when the FMC was conducted; the later the semester, the higher the score (e.g. diagnostic reasoning: first semester, 2.23; second semester, 2.48 [p = 0.11]; third semester, 2.61 [p = 0.02]). However, this tendency was not observed in the remaining 12 items: psychological and social background, home medical care, interprofessional work, healthcare system, team-based health care, participate as a member of the team, role of the physician in team collaboration, current medical situation in the community, community-based integrated care system, necessity of primary care, discover necessary tasks, and rank the tasks. In post-FMC evaluation, six of the 12 items were higher than four point in both the self-evaluations and family doctor evaluations. A significant increase was observed between the pre-and post-FMC self-evaluation scores in all 31 items (e.g. diagnostic reasoning: pre 2.2 and post 3.9 [p <0.0001]).Conclusion: The results of the present study suggest that FMCs complement clerkships at teaching hospitals.
{"title":"Do family medicine clerkships complement clerkships at teaching hospitals in Japanese undergraduate medical education?: An observational study","authors":"Koki Nakamura, Satoshi Kanke, Goro Hoshi, Yoshihiro Toyoda, Kazutaka Yoshida, T. Kitamura, R. Kassai","doi":"10.22146/APFM.V18I2.211","DOIUrl":"https://doi.org/10.22146/APFM.V18I2.211","url":null,"abstract":"Background: Despite recognition of the importance of primary health care, the opportunities for medical students to participate in family medicine clerkships (FMCs) are still inadequate around the world. In order for FMCs to be accepted in the undergraduate curriculum, it is necessary to clarify whether FMCs complement clerkships at teaching hospitals.Methods: Throughout the academic year 2018–2019, a total of 125 fifth-year students in Fukushima Medical University participated in an FMC. The students evaluated themselves at the beginning and end of their FMC whilst the family doctors evaluated students at the end of the FMC. The evaluations were a 5-point scale on 31 items in the following seven areas; objectives in general practice, practical skills and patient care, communication skills, patient-physician relationship, practice of team-based health care, medical practice in society and medical knowledge and problem-solving ability. A multiple regression analysis was conducted to assess whether self-evaluation was increased by clerkships at teaching hospitals where students rotated before the start of FMC. A Wilcoxon signed-rank sum test was used to assess self-evaluation changes before and after the FMC.Results: All 125 students completed the study. Pre-FMC self-evaluation scores for 19 items tended to be higher depending on when the FMC was conducted; the later the semester, the higher the score (e.g. diagnostic reasoning: first semester, 2.23; second semester, 2.48 [p = 0.11]; third semester, 2.61 [p = 0.02]). However, this tendency was not observed in the remaining 12 items: psychological and social background, home medical care, interprofessional work, healthcare system, team-based health care, participate as a member of the team, role of the physician in team collaboration, current medical situation in the community, community-based integrated care system, necessity of primary care, discover necessary tasks, and rank the tasks. In post-FMC evaluation, six of the 12 items were higher than four point in both the self-evaluations and family doctor evaluations. A significant increase was observed between the pre-and post-FMC self-evaluation scores in all 31 items (e.g. diagnostic reasoning: pre 2.2 and post 3.9 [p <0.0001]).Conclusion: The results of the present study suggest that FMCs complement clerkships at teaching hospitals.","PeriodicalId":39050,"journal":{"name":"Asia Pacific Family Medicine","volume":"18 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"68295353","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
Naoto Ishimaru, Satoshi Suzuki, T. Shimokawa, Y. Akashi, Yuto Takeuchi, A. Ueda, Saori Kinami, Hiromichi Suzuki, Y. Tokuda, T. Maeno
Background: Community-acquired pneumonia (CAP) is a common illness that can lead to mortality. Chest radiographs are the gold standard method of confirmation of pneumonia but could unnecessarily expose patients to radiation. Heckerling’s criteria (HC) scoring is a useful substitute for chest radiographs and can be used to rule out CAP. HC score ≥ 4 is strongly indicative of pneumonia, while ≤ 1 indicates the patient is pneumonia-free. HC scoring is well validated in Western populations, but has not been validated in an Asian population. Racial differences in symptoms and differences in the method of measuring body temperature might affect the validity of HC scoring in this population. We evaluate the use of HC scoring in a Japanese primary care setting. Methods: We conducted a prospective observational study of patients aged ≥ 16 years who had fever and respiratory symptoms in one of two community hospitals between December 2016 and October 2018. We evaluated the accuracy of HC in discrimination of patients with and without CAP. Pneumonia was defined as when patients suffered from respiratory symptoms and had new infiltration recognized on chest X-ray or chest computed tomography. Results: Analyzable data from 296 of 341 patients was available (37.2% were female, mean age: 41.1 years). CAP was diagnosed in 58 patients (19.6%). HC discriminated CAP with ROC area of 0.69 (95% CI 0.62-0.76). Sensitivity was 0.66 (95% CI 0.52-0.78) (HC score ≤ 1) and specificity was 0.68 (95% CI 0.61-0.74) (HC score >1). Conclusions: HC failed to detect CAP in approximately 30% of our Japanese cases presenting acute respiratory illness. HC scoring should be used cautiously in non-Western populations.
背景:社区获得性肺炎(CAP)是一种可导致死亡的常见疾病。胸部x光片是确诊肺炎的金标准方法，但可能不必要地使患者暴露在辐射下。Heckerling’s criteria (HC)评分是胸片的有效替代，可用于排除CAP。HC评分≥4强烈提示肺炎，而≤1则表明患者无肺炎。HC评分在西方人群中得到了很好的验证，但在亚洲人群中尚未得到验证。症状的种族差异和体温测量方法的差异可能会影响该人群HC评分的有效性。我们评估在日本初级保健设置HC评分的使用。方法:我们对2016年12月至2018年10月在两家社区医院之一就诊的年龄≥16岁的发热和呼吸道症状患者进行了前瞻性观察研究。我们评估了HC在鉴别CAP患者和非CAP患者中的准确性。肺炎的定义是当患者出现呼吸道症状并在胸部x线或胸部计算机断层扫描上发现新的浸润。结果:341例患者中有296例可分析资料，其中女性37.2%，平均年龄41.1岁。58例(19.6%)被诊断为CAP。HC判别CAP的ROC面积为0.69 (95% CI 0.62 ~ 0.76)。敏感性为0.66 (95% CI 0.52 ~ 0.78) (HC评分≤1)，特异性为0.68 (95% CI 0.61 ~ 0.74) (HC评分bbb1)。结论:在我们的日本急性呼吸道疾病病例中，HC未能检测到CAP的病例约占30%。HC评分在非西方人群中应谨慎使用。
{"title":"Heckerling’s criteria to distinguish community-acquired pneumonia in a Japanese primary care setting: observational Study","authors":"Naoto Ishimaru, Satoshi Suzuki, T. Shimokawa, Y. Akashi, Yuto Takeuchi, A. Ueda, Saori Kinami, Hiromichi Suzuki, Y. Tokuda, T. Maeno","doi":"10.22146/APFM.V18I2.25","DOIUrl":"https://doi.org/10.22146/APFM.V18I2.25","url":null,"abstract":"Background: Community-acquired pneumonia (CAP) is a common illness that can lead to mortality. Chest radiographs are the gold standard method of confirmation of pneumonia but could unnecessarily expose patients to radiation. Heckerling’s criteria (HC) scoring is a useful substitute for chest radiographs and can be used to rule out CAP. HC score ≥ 4 is strongly indicative of pneumonia, while ≤ 1 indicates the patient is pneumonia-free. HC scoring is well validated in Western populations, but has not been validated in an Asian population. Racial differences in symptoms and differences in the method of measuring body temperature might affect the validity of HC scoring in this population. We evaluate the use of HC scoring in a Japanese primary care setting. Methods: We conducted a prospective observational study of patients aged ≥ 16 years who had fever and respiratory symptoms in one of two community hospitals between December 2016 and October 2018. We evaluated the accuracy of HC in discrimination of patients with and without CAP. Pneumonia was defined as when patients suffered from respiratory symptoms and had new infiltration recognized on chest X-ray or chest computed tomography. Results: Analyzable data from 296 of 341 patients was available (37.2% were female, mean age: 41.1 years). CAP was diagnosed in 58 patients (19.6%). HC discriminated CAP with ROC area of 0.69 (95% CI 0.62-0.76). Sensitivity was 0.66 (95% CI 0.52-0.78) (HC score ≤ 1) and specificity was 0.68 (95% CI 0.61-0.74) (HC score >1). Conclusions: HC failed to detect CAP in approximately 30% of our Japanese cases presenting acute respiratory illness. HC scoring should be used cautiously in non-Western populations.","PeriodicalId":39050,"journal":{"name":"Asia Pacific Family Medicine","volume":"18 1","pages":""},"PeriodicalIF":0.0,"publicationDate":"2019-01-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"68295368","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
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