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African Journal of Nursing and Midwifery最新文献

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Note from the Editor-in-chief 总编辑注
Q4 NURSING Pub Date : 2023-10-19 DOI: 10.25159/2520-5293/14997
Lindiwe Zungu
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引用次数: 0
Utilisation of Maternal Health Services and its Impact on Maternal Mortality Rate: A Case for KwaZulu-Natal, South Africa 产妇保健服务的利用及其对产妇死亡率的影响:以南非夸祖鲁-纳塔尔省为例
Q4 NURSING Pub Date : 2023-10-19 DOI: 10.25159/2520-5293/14062
Nellie Naranjee, Vasanthrie Naidoo, Suresh B. N. Krishna, Champaklal C. Jinabhai, Maureen N. Sibiya
Despite several strategies in place in South Africa and globally to prevent maternal mortality and morbidity, maternal deaths remain high, especially in sub-Saharan Africa and lower to middle-income countries. The aim of the study was to identify the challenges that lead to pregnant women’s delays in seeking antenatal care (ANC) early and to find strategies to prevent such delays, contributing to a reduction of maternal deaths in South Africa. The study was conducted in two phases. Phase one analysed data on maternal deaths collected by the District Health Information System (DHIS) of the KwaZulu-Natal Department of Health from all 11 districts over a 10-year period (2009–2019). The data on maternal deaths revealed that there was a very high maternal mortality rate; between 800 and 1 780 per 100 000 live births. This correlated with very low antenatal visits; between 695–895 per 100 000 live births. In phase two, a literature review was conducted using several computer-assisted databases, bibliographies and websites to identify and source current policies. The literature review presents causes of delay in seeking ANC and strategies to prevent maternal deaths. Recommendations were made to consider strengthening education and awareness related to family planning; women empowerment through community health programmes and change in healthcare providers’ behaviours and attitudes; ensuring availability of maternal health resources; and developing strategies to ensure that the ANC services delivered are in line with the South African Department of Health Guidelines.
尽管南非和全球制定了若干预防孕产妇死亡和发病的战略,但孕产妇死亡率仍然很高,特别是在撒哈拉以南非洲和中低收入国家。这项研究的目的是确定导致孕妇推迟及早寻求产前护理的挑战,并找出防止这种延误的战略,从而有助于减少南非的孕产妇死亡。这项研究分两个阶段进行。第一阶段分析了夸祖鲁-纳塔尔省卫生部地区卫生信息系统(DHIS)在10年期间(2009-2019年)从所有11个地区收集的孕产妇死亡数据。关于产妇死亡的数据显示,产妇死亡率非常高;每10万活产800至1780人。这与非常低的产前检查相关;每10万活产695-895人。在第二阶段,利用若干计算机辅助数据库、书目和网站进行了文献审查,以确定现行政策的来源和来源。文献综述介绍了延迟寻求非分娩性分娩的原因和预防产妇死亡的战略。建议考虑加强与计划生育有关的教育和认识;通过社区保健方案和改变保健提供者的行为和态度赋予妇女权力;确保提供孕产妇保健资源;制定战略,确保所提供的非裔国民保健服务符合南非卫生部的指导方针。
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引用次数: 0
Analysis of Pathways Influencing the Quality of Nursing Documentation Practice in Central Java Province of Indonesia 影响印尼中爪哇省护理文献实践质量的途径分析
Q4 NURSING Pub Date : 2023-10-16 DOI: 10.25159/2520-5293/14376
Jebul Suroso, Agus Santosa
Incomplete and poor-quality nursing documentation can negatively impact patients and nurses; therefore, finding the root causes of poor-quality nursing documentation is essential. This study aims to analyse the pathways affecting the quality of nursing documentation to identify the root of the existing problems. This study was an analytic observational study with a cross-sectional study design. The research was conducted at two regional general hospitals in Banyumas and Purbalingga districts, Central Java Province, Indonesia; 128 nurses in the inpatient rooms participated. Their age, gender, education, work experience, workload, nurse fatigue, and the quality of nursing documentation were observed and assessed directly and analysed using a path analysis method. The results found that 46.9% of nursing documentation was of poor quality. It was found that the nurses' workload and nurse fatigue directly affected the quality of nursing documentation (t>1.96; P<0.05). The quality of nursing documentation was also indirectly influenced by gender and work experience through the intervening variables of workload and job fatigue (t>1.96; P<0.05). This study concludes that workload is felt heavier in female nurses with extended work experience; this causes job fatigue, which impacts the poor quality of nursing documentation.
不完整和质量差的护理文件会对患者和护士产生负面影响;因此,找出护理文件质量差的根本原因是至关重要的。本研究旨在分析影响护理文献质量的途径,找出存在问题的根源。本研究为分析性观察性研究,采用横断面研究设计。该研究在印度尼西亚中爪哇省Banyumas和Purbalingga地区的两家地区综合医院进行;住院病房的128名护士参与了调查。直接观察、评估患者的年龄、性别、学历、工作经历、工作量、护士疲劳程度、护理文件质量,并采用通径分析法进行分析。结果发现,46.9%的护理文件质量较差。结果发现,护士工作量和护士疲劳直接影响护理文件质量(t>1.96;术中,0.05)。性别和工作经验也通过工作量和工作疲劳的干预变量间接影响护理文件的质量(t>1.96;术中,0.05)。研究结果表明:工作经验越丰富的女护士工作负荷越重;这会导致工作疲劳,从而影响护理文件的低质量。
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引用次数: 0
Correlation Between Fear of Postoperative Pain and the Use of Analgesics Among Elderly Patients in Turkey 土耳其老年患者术后疼痛恐惧与镇痛药使用的相关性
Q4 NURSING Pub Date : 2023-10-16 DOI: 10.25159/2520-5293/13948
Ayşe Topal Hançer
In elderly patients, preoperative assessment of pain fear could provide essential information for improving perioperative care and could be the first step toward targeted pain management. This study aimed to determine the effect of fear of postoperative pain and the use of analgesics among elderly patients in Turkey. The method used was a descriptive cross-sectional study with 231 elderly patients. In this study, the levels of fear of pain were significantly higher in those who had a history of surgery, experienced severe pain, and had a feeling of fear before surgery (p<. 05). The mean pain Visual Analog Scale (VAS) first day postoperatively was 8.20±1.69, and the mean VAS second day postoperatively was 5.20±1.51. It was determined who received tramadol (opioid) 100 mg intravenously (IV) on the first and second postoperative day with a significantly higher mean score on the fear of pain (p<. 05). It was determined that pain intensity and the rate of analgesic use on the first and second postoperative days were positively correlated with fear of pain (p<. 001). This research demonstrated that as the elderly patients’ pain fear increased, postoperative pain severity and amount of analgesia increased. Therefore, reducing the fear of pain, which is one of the main factors in pain, is essential in pain management. Evaluation of postoperative pain not only in terms of drug intervention but also in terms of other factors that modulate pain, such as fear of pain—it is thought that the elderly, who constitute a risky group in terms of analgesic use, can provide convenience in pain management.
在老年患者中,术前疼痛恐惧评估可以为改善围手术期护理提供必要的信息,并可能是有针对性的疼痛管理的第一步。本研究旨在确定土耳其老年患者对术后疼痛的恐惧和镇痛药的使用的影响。使用的方法是对231例老年患者进行描述性横断面研究。在这项研究中,有手术史、经历过剧烈疼痛、在手术前有恐惧感的患者的疼痛恐惧水平明显更高(p<05). 术后第1天疼痛视觉模拟评分(VAS)平均值为8.20±1.69,术后第2天VAS平均值为5.20±1.51。确定在术后第一天和第二天静脉注射曲马多(阿片类药物)100 mg的患者疼痛恐惧平均评分明显较高(p<05). 术后第1天和第2天疼痛强度和镇痛药使用率与疼痛恐惧呈正相关(p<001)。本研究表明,随着老年患者疼痛恐惧程度的增加,术后疼痛严重程度和镇痛量增加。因此,减少对疼痛的恐惧,这是疼痛的主要因素之一,在疼痛管理中至关重要。对术后疼痛的评估不仅要从药物干预的角度出发,还要从调节疼痛的其他因素(如对疼痛的恐惧)的角度出发。人们认为,老年人在使用镇痛药方面构成了一个危险群体,他们可以为疼痛管理提供便利。
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引用次数: 0
Nursing Educators’ Experiences and Expectations of Research Production at a Faculty of Health Sciences: A Qualitative Study 健康科学学院护理教育工作者的经验与研究成果的期望:一项质性研究
Q4 NURSING Pub Date : 2023-10-12 DOI: 10.25159/2520-5293/14153
Gelasius Panduleni Shatimwene, Daniel Opotamutale Ashipala
Research production remains one of the most important tools to predict the likely number of future outputs for a set of researchers. Nursing educators have expectations when they enter an academic institution; however, if these expectations are not matched with their experiences, then their research production will be hampered. The purpose of this study was to explore nursing educators’ expectations and experiences regarding research production at the Faculty of Health Sciences at a national university in Namibia. The study used the qualitative approach with an explorative, descriptive and contextual design. Eighteen nursing educators from the School of Nursing and Public Health participated in the study. Participants were chosen by using a convenience sampling method. Data were collected through semi-structured interviews between June and September 2022 and were analysed using thematic analysis for recurring themes. The following themes emerged from the data analysis: individual research output and role expectations; institutional factors affecting research production; and corrective measures to improve research production. These findings demonstrate that there is a significant need to support the production of quality research of nursing educators by addressing the requirements of the academic and research staff so as to maximise the impact of their research and establish the University of Namibia as a renowned international research institution. This can be achieved through creating an opportunity for hosting research seminars, and by providing adequate financial support to academics and research staff to maximise the impact of their research. The findings of this study can be used to develop baseline data, which can enable a “point-in-time” snapshot of individual activity. This will enable consolidation of metrics on research activity up to faculty, school and institutional performance that is geared towards improving research production among academics, as well as the development of policies that support such production.
研究产出仍然是预测一组研究人员未来可能产出数量的最重要工具之一。护理教育工作者在进入学术机构时是有期望的;然而,如果这些期望与他们的经验不匹配,那么他们的研究成果就会受到阻碍。本研究的目的是探讨纳米比亚一所国立大学健康科学学院护理教育工作者对研究成果的期望和经验。本研究采用了探索性、描述性和情境性设计的定性方法。来自护理与公共卫生学院的18名护理教育工作者参与了这项研究。研究对象的选择采用方便抽样法。通过2022年6月至9月的半结构化访谈收集数据,并对反复出现的主题进行主题分析。从数据分析中得出以下主题:个人研究产出和角色期望;影响科研成果的制度因素;以及提高科研成果的纠正措施。这些研究结果表明,通过满足学术和研究人员的要求,支持护理教育工作者进行高质量的研究,从而最大限度地发挥其研究的影响,并将纳米比亚大学建设成为一所著名的国际研究机构,这是非常必要的。这可以通过创造举办研究研讨会的机会,以及为学者和研究人员提供足够的财政支持,以最大限度地发挥其研究的影响来实现。这项研究的发现可以用来开发基线数据,这可以使个人活动的“时间点”快照成为可能。这将使研究活动的指标得以整合,直至教员、学校和机构的绩效,以改善学术界的研究成果,并制定支持这种成果的政策。
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引用次数: 0
Evolving Roles of Public Health Nurses in the Age of Pandemics: A Rapid Review 流行病时代公共卫生护士角色的演变:快速回顾
Q4 NURSING Pub Date : 2023-10-12 DOI: 10.25159/2520-5293/14054
Samer Sharkiya
Background: Public health nurses are essential in reacting to and controlling pandemics. Their responsibilities have changed as the globe faces more intricate health issues relating to newly developing infectious illnesses. This literature review aims to identify suggestions to enhance public health nurses' practice and offer a thorough knowledge of the changing responsibilities of public health nurses in the era of pandemics. Methods: The important themes, difficulties, and possibilities connected to public health nursing during pandemics were highlighted after relevant papers were found through a thorough search of databases. Conclusion: Public health nurses play a vital role in combating new infectious illnesses, utilising technology, bolstering health systems, fostering interprofessional teamwork, advocating for health equality, engaging communities, and supporting mental health and wellbeing. However, they deal with serious issues such as a lack of skilled labour, poor funding, and quickly advancing knowledge. Enhancing workforce planning and development, bolstering public health infrastructure, creating and disseminating evidence-based guidelines and protocols, encouraging interprofessional collaboration and education, addressing health disparities and promoting health equity, and supporting continuous learning and professional development are all recommendations for improving pandemic preparedness and response.
背景:公共卫生护士在应对和控制流行病方面至关重要。随着全球面临与新发传染病有关的更复杂的健康问题,他们的责任也发生了变化。本文献综述旨在确定建议,以加强公共卫生护士的做法,并提供一个全面的知识,公共卫生护士的责任变化在大流行的时代。方法:通过对数据库的全面检索,找到相关文献,突出大流行期间公共卫生护理的重要主题、难点和可能性。结论:公共卫生护士在抗击新的传染病、利用技术、加强卫生系统、促进跨专业团队合作、倡导卫生平等、参与社区以及支持心理健康和福祉方面发挥着至关重要的作用。然而,它们面临着一些严重的问题,如缺乏熟练劳动力、资金不足和知识快速发展。加强人力资源规划和发展,加强公共卫生基础设施,制定和传播循证指南和协议,鼓励专业间合作和教育,解决卫生差距和促进卫生公平,以及支持持续学习和专业发展,这些都是改进大流行防范和应对的建议。
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引用次数: 0
A Cultural Nursing Care Model to Prevent Preeclampsia in the Provision of Basic Services in Eastern Indonesia 文化护理模式预防子痫前期在印尼东部提供基本服务
Q4 NURSING Pub Date : 2023-09-27 DOI: 10.25159/2520-5293/13903
Awatiful Azza, Esti Yunitasari, Mira Triharini, Cipto Susilo, Satriya Pranata, Machmudah Machmudah
Preeclampsia is a specific multisystemic disorder that appears as a complication of pregnancy, and it is a cause of death for pregnant women. Societies in different countries strongly believe that pregnancy is part of a woman’s nature; therefore, pregnancy is considered a normal event that does not require special treatment. This study aims to develop a cultural care model to prevent preeclampsia through basic services. Research following an explanatory design was conducted on a cross-sectional sample of 150 pregnant women who were selected based on a formula using the range rule of thumb with multistage random sampling at the primary level of service in eastern Indonesia. The researchers used a modified questionnaire on individual factors, social factors, policy factors, religious factors, technological factors, and culture of prevention to predict preeclampsia prevention behaviour. The results of this study reveal that individual factors affect preeclampsia prevention behaviour factors (p = 0.038); social factors affect preeclampsia prevention behaviour factors (p = 0.005), and technological factors have an effect on preeclampsia prevention behaviour factors (p = 0.001). Meanwhile, policy factors and religious factors did not influence preeclampsia prevention behaviour, with p values of 0.735 and 0.596, respectively. Cultural values are values inherent in society that are useful for regulating harmony and balance. The development of a cultural model of preeclampsia prevention through a cultural care model as a basic intervention to care for mothers throughout their pregnancy can increase positive behaviour in society.
子痫前期是一种特殊的多系统疾病,作为妊娠并发症出现,是孕妇死亡的原因之一。不同国家的社会都坚信怀孕是女性天性的一部分;因此,怀孕被认为是正常事件,不需要特殊治疗。本研究旨在建立文化照护模式,透过基础服务预防子痫前期。研究遵循解释性设计,对150名孕妇进行了横断面抽样,这些孕妇是根据印度尼西亚东部初级服务中使用范围经验法则进行多阶段随机抽样的公式选择的。研究人员使用了一份关于个人因素、社会因素、政策因素、宗教因素、技术因素和预防文化的修正问卷来预测子痫前期预防行为。本研究结果显示个体因素影响子痫前期预防行为因素(p = 0.038);社会因素影响子痫前期预防行为因素(p = 0.005),技术因素影响子痫前期预防行为因素(p = 0.001)。政策因素和宗教因素不影响子痫前期预防行为,p值分别为0.735和0.596。文化价值观是社会固有的价值观,有助于调节和谐与平衡。通过文化护理模式发展预防先兆子痫的文化模式,作为在整个怀孕期间照顾母亲的基本干预措施,可以增加社会中的积极行为。
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引用次数: 0
Comparing the Efficiency of Hospitals in Northern Iran Before and After the Covid-19 Pandemic Using the Pabon Lasso Model 使用Pabon Lasso模型比较伊朗北部医院在Covid-19大流行前后的效率
Q4 NURSING Pub Date : 2023-09-14 DOI: 10.25159/2520-5293/13774
Roya Malekzadeh, Mozhgan Tavana, Ghasem Abedi, Arash Ziapour, Ehsan Abedini
The Pabon Lasso Model is often used to assess the efficiency of hospitals as the most important component of the health care system. The present study sought to evaluate and compare the efficiency of hospitals in northern Iran before and after the COVID-19 pandemic using the Pabon Lasso Model. This descriptive study was conducted in 36 public, private, and social security hospitals in northern Iran from 2019 to 2020. The hospitals were selected using the census method. The data were collected using the forms approved by the Ministry of Health and Education. The three indices of bed occupancy rate, bed turnover frequency, and the average length of stay were calculated and plotted using the Pabon Lasso graphs. The collected data were analysed using the paired samples t-test. The average bed occupancy rates in 2019 and 2020 were equal to 67.72% and 52.28%, lower than the national standard rate. Moreover, the average lengths of stay were 2.58 and 2.83 days and the bed turnover rates were 96.7 and 77.94, higher than the national standard rate. Of the total 36 hospitals in 2019, 33.3% of hospitals were in the first quarter (low efficiency), and 16.6% in the third quarter (high efficiency). Furthermore, the data for 2020 indicated that 38.8% of hospitals were in the first quarter (low efficiency), showing an increase compared to 2019 and 19.4% of hospitals were in the third quarter, indicating a decrease compared to 2019. The paired samples t-test indicated that the bed occupancy rate and bed turnover showed significant differences in 2019 and 2020 (P-value<0.05). The data confirmed that the average length of stay and bed turnover in the studied hospitals were favourable. In addition, unlike private hospitals, the number of efficient units in public hospitals decreased during the COVID-19 pandemic. Thus, hospital managers need to pay more attention to improving performance indicators and increasing productivity in these hospitals.
Pabon Lasso模型通常用于评估医院作为医疗保健系统中最重要的组成部分的效率。本研究试图使用Pabon Lasso模型评估和比较伊朗北部医院在COVID-19大流行前后的效率。这项描述性研究于2019年至2020年在伊朗北部的36家公立、私立和社会保障医院进行。采用普查方法选择医院。数据是使用卫生和教育部批准的表格收集的。利用Pabon Lasso图计算床位入住率、换床频率和平均住宿时间3个指标。收集的数据采用配对样本t检验进行分析。2019年和2020年平均床位入住率分别为67.72%和52.28%,均低于国家标准。平均住院天数分别为2.58天和2.83天,床位数周转率分别为96.7天和77.94,均高于国家标准。2019年36家医院中,第一季度(低效率)占33.3%,第三季度(高效率)占16.6%。此外,2020年的数据显示,38.8%的医院在第一季度(低效率),比2019年有所增加,19.4%的医院在第三季度,比2019年有所下降。配对样本t检验显示,2019年和2020年的床位入住率和床位周转率存在显著差异(p值0.05)。数据证实,所研究医院的平均住院时间和床位周转率是有利的。此外,与私立医院不同,公立医院的有效单位数量在新冠肺炎大流行期间有所减少。因此,医院管理者需要更多地关注改善这些医院的绩效指标和提高生产力。
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引用次数: 0
Harnessing Capacity in Southern Africa to Support and Develop Human Resources for Nursing and Midwifery in Africa – Part 2: Case Studies from the DRC and Mozambique 利用南部非洲的能力支持和开发非洲护理和助产人力资源——第二部分:刚果民主共和国和莫桑比克的案例研究
Q4 NURSING Pub Date : 2023-05-30 DOI: 10.25159/2520-5293/13333
Judith Bruce, Mzobanzi Mboya, Lizeth Roets
Human resources for health has been the centre of attention for many decades as more African countries fail to meet health targets even though there is no shortage of country-specific policies and strategies to improve these resources. The WHO Africa region has a critical shortage of nurses and midwives, which will remain unresolved as long as funding and policy implementation challenges persist. In the interim, the profession itself must find innovative and collaborative ways to make inroads into the nursing shortages – specifically in areas where advanced clinical skills are needed. Harnessing capacity from within universities in southern Africa is posited as one of the ways to bolster the education of nurses and midwives. Presented in part 1, the New Partnership for Africa’s Development project aimed to increase the number and enhance the quality of postgraduate education and clinical training of nurses and midwives to improve the quality of healthcare services with particular reference to the reduction of maternal and neonatal mortality rates. In fulfilling this aim, clinical master’s programmes were developed and implemented in seven African countries. In this article, we chose illustrative case studies to describe the master’s programme design and roll-out, in line with the health profile of the Democratic Republic of the Congo and the Republic of Mozambique. We explain the programme electives, enrolments and throughput, including outputs and outcomes. From experiences gained and lessons learnt, we extrapolate implications for future cases that employ pan-African and south-to-south university partnerships.
卫生人力资源几十年来一直是关注的中心,因为更多的非洲国家未能实现卫生目标,尽管并不缺乏改善这些资源的具体国家政策和战略。世卫组织非洲区域严重缺乏护士和助产士,只要资金和政策实施方面的挑战持续存在,这一问题就不会得到解决。在此期间,护理专业本身必须找到创新和合作的方式来解决护理短缺问题,特别是在需要高级临床技能的领域。利用南部非洲大学内部的能力被认为是加强护士和助产士教育的方法之一。在第1部分中介绍了非洲发展新伙伴关系项目,其目的是增加研究生教育的数量并提高其质量以及护士和助产士的临床培训,以提高保健服务的质量,特别是降低孕产妇和新生儿死亡率。为了实现这一目标,在七个非洲国家制定和实施了临床硕士课程。在本文中,我们根据刚果民主共和国和莫桑比克共和国的卫生概况,选择了说明性案例研究来描述硕士课程的设计和推出。我们解释课程选修,入学和吞吐量,包括产出和结果。根据获得的经验和吸取的教训,我们推断了对未来采用泛非和南南大学伙伴关系的案例的影响。
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引用次数: 0
Should Placebo Treatment Be Used in the Clinical Setting for Pain Management? A Commentary 在临床疼痛管理中应该使用安慰剂治疗吗?一篇评论
Q4 NURSING Pub Date : 2023-05-30 DOI: 10.25159/2520-5293/13343
Mehreen Aslam
A placebo should not be used in clinical settings for pain management because it is associated with ethical dilemmas and also has detrimental health effects. It is illegal and immoral to fabricate, suppress and misrepresent information to the client, because concealing information has a considerable outcome on the patient-doctor relationship. The use of a placebo has a substantial negative impact on clients’ health when they are actually in pain. However, a placebo has an impact on patients’ expectations by activating a series of endogenous opioids that modify the experience of pain. While it is true that a placebo helps in reducing pain in some circumstances, we cannot just assume that a placebo always works effectively for all patients. The use of a placebo can compromise the patient’s safety or underrate the potential risk associated with disregarding the patient’s actual pain. The use of a placebo is ethically problematic as it falls under the concept of deception, and it is also injurious to misunderstand the actual pain that may lead to serious health consequences.
安慰剂不应该在临床环境中用于疼痛管理,因为它与伦理困境有关,也有有害的健康影响。向当事人捏造、隐瞒和歪曲信息是违法的,也是不道德的,因为隐瞒信息对医患关系有相当大的影响。当病人真正处于痛苦之中时,使用安慰剂对他们的健康有实质性的负面影响。然而,安慰剂通过激活一系列内源性阿片类药物来改变疼痛体验,从而对患者的预期产生影响。虽然在某些情况下,安慰剂确实有助于减轻疼痛,但我们不能想当然地认为安慰剂对所有患者都有效。使用安慰剂可能会危及患者的安全,或者低估与忽视患者实际疼痛相关的潜在风险。使用安慰剂在道德上存在问题,因为它属于欺骗的概念,而且误解可能导致严重健康后果的实际疼痛也是有害的。
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引用次数: 0
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African Journal of Nursing and Midwifery
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