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Increasing African American Advance Directives: Implementing the Five Wishes Education Protocol 增加非裔美国人的预先指示:实施五个愿望教育协议
Pub Date : 2014-08-01 DOI: 10.5176/2345-718X_1.2.49
Patricia L. Marshall, Glenda Avery, L. D. Weed
The completion rate of advance directives by older African Americans remains low. This pilot study evaluated attitudes related to African Americans and advance directives and the effectiveness of the Five Wishes Education Protocol to increase completion rates. The researchers used a descriptive, cross-sectional pilot study and convenience sampling. Three group sessions were conducted over a 2-month period at three senior centers. Twenty-two older African Americans participated. The mean total score on the attitude survey indicated that participants were moderately positive towards advance directives. Following the intervention, the completion rate of the advance directive Five Wishes was 77.35% (n=17), and 54.5% (n=12) of the participants provided copies of the Five Wishes advance directives to their healthcare providers.
老年非裔美国人的预先指示完成率仍然很低。这项试点研究评估了与非裔美国人有关的态度和预先指示以及五个愿望教育协议提高完成率的有效性。研究人员采用了描述性、横断面的初步研究和方便抽样。在三个老年中心进行了为期两个月的三个小组会议。22名年长的非裔美国人参加了这项研究。态度调查的平均总分表明,参与者对事前指示有适度的积极态度。干预后,预先指示5个愿望的完成率为77.35% (n=17), 54.5% (n=12)的参与者向其医疗保健提供者提供了预先指示5个愿望的副本。
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引用次数: 4
Health within Illness among Persons living with Chronic Obstructive Pulmonary Disease 慢性阻塞性肺病患者疾病中的健康状况
Pub Date : 2014-08-01 DOI: 10.5176/2345-718X_1.2.37
B. Leonard, M. Clark
The purpose of this descriptive qualitative study is to explore perceptions of health within illness, a health strategy used by persons with chronic obstructive pulmonary disease (COPD) to maintain their quality of life. A convenience sample of 11 community-dwelling, English-speaking adults with COPD was recruited from the Southwestern United States. The study was conducted in the homes of the participants. Naturalistic inquiry using content analysis and constant comparative techniques was used to analyze the transcribed data. Five conceptual categories emerged in the final stage of analysis that provided answers to the research questions from the perspectives of the participants. The categories were: (a) Cut Off from Life, (b) Health is Everything, (c) Making the Best of It, (d) Living with It, and (e) Breaking the Cycle. Each of the categories was inducted from emergent themes and clusters of data that represented the participants’ descriptions of living with COPD. The findings of this study highlight strategies and practices portrayed by the participants to promote their health despite suffering from a serious illness. Data from the study participants suggest the management of COPD is a complex process that requires considerable flexibility, creativity, and resilience to achieve a sense of health within illness. The study highlights important ways to improve self-care among COPD sufferers on how to manage this chronic illness beyond a trial and error process.
本描述性定性研究的目的是探讨疾病中的健康观念,这是慢性阻塞性肺疾病(COPD)患者用于维持其生活质量的一种健康策略。从美国西南部招募了11名居住在社区、说英语的慢性阻塞性肺病成年人作为方便样本。这项研究是在参与者家中进行的。使用内容分析和持续比较技术的自然查询来分析转录数据。在分析的最后阶段出现了五个概念类别,从参与者的角度提供了研究问题的答案。这些类别是:(a)与生活断绝关系;(b)健康就是一切;(c)充分利用健康;(d)与健康共存;(e)打破循环。每个类别都是从代表参与者对COPD生活的描述的紧急主题和数据簇中归纳出来的。这项研究的结果强调了参与者所描绘的策略和做法,以促进他们的健康,尽管患有严重的疾病。来自研究参与者的数据表明,慢性阻塞性肺病的管理是一个复杂的过程,需要相当大的灵活性、创造力和适应力,才能在疾病中实现健康感。该研究强调了改善慢性阻塞性肺病患者自我保健的重要方法,即如何在试验和错误过程之外管理这种慢性疾病。
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引用次数: 0
A Proposed Blended Course Design for Inter- Professional Education: Using Inquiry to Develop Critical Thinking for Inter-Professional Practice in Undergraduate Students 跨专业混合式课程设计建议:利用探究培养大学生跨专业实践的批判性思维
Pub Date : 2014-07-24 DOI: 10.5176/2315-4330_WNC14.06
Ruth Swart
The purpose of this proposed blended course design is to develop inter-professional communication and collaboration in critical thinking, inquiry, and learning. Implementation of inter-professional education between undergraduate students from different faculties enables a building of connections and relationships which could lead to improved collaboration in future inter-professional practice. Critical thinking has been acclaimed as essential in the provision of competent healthcare. The proposal of a blended-learning format provides a means to accommodate the inherent scheduling challenges between different faculties, and captures the potential of cultivating critical thinking in learning experiences during face-to-face, simulation, online learning, and social media interactions. This proposal of a blended inquiry-based approach employing various educational strategies endeavours to present an innovative means to teaching and learning within inter-professional healthcare education.
这门混合课程设计的目的是培养学生在批判性思维、探究和学习方面的跨专业沟通与合作。在不同学院的本科生之间实施跨专业教育,可以建立联系和关系,从而在未来的跨专业实践中改善合作。批判性思维被认为是提供合格医疗保健的必要条件。混合学习模式的提议提供了一种适应不同院系之间固有的时间表挑战的方法,并抓住了在面对面、模拟、在线学习和社交媒体互动的学习经验中培养批判性思维的潜力。这一混合探究式方法的建议采用各种教育策略,努力在跨专业的医疗保健教育中提出一种创新的教学方法。
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引用次数: 0
Aberrant Work Environments – Rationed Care as System Failure or Missed Care as Skills Failure? 异常的工作环境——定量护理是系统故障还是错过护理是技能故障?
Pub Date : 2014-07-23 DOI: 10.5176/2315-4330_WNC14.78
C. Harvey, R. Forrest, A. Meyers, C. Buckley, Jennifer Roberts, S. Thompson, J. Searle
Missed’ care has emotional, professional and legal connotations because, as one participant from our study noted, the environment can change so quickly and staffing is not allocated to accommodate this. This study used the MISSCARE survey distributed to nurses in New Zealand to find out what care was routinely missed, and why they missed it. The analysis of data returned from 199 nurses revealed that nurses routinely miss care and become frustrated because they are unable to use the knowledge and skill to provide the care; rather they are forced to prioritise care, some of which is either delayed or consciously missed. Whilst this study supported findings of previous research, the emergence of presenteeism as a factor that affects nurses missing care, was highlighted. This has wider implications to the nursing workforce related to their ability to provide safe and effective care, as well as to the organisations in terms of both budget and safety in care provision.
正如我们研究中的一位参与者所指出的那样,缺失的护理具有情感、专业和法律内涵,因为环境变化如此之快,而人员配置却无法适应这种变化。这项研究使用了MISSCARE调查,分发给新西兰的护士,以找出他们经常错过的护理,以及他们错过的原因。从199名护士返回的数据分析显示,护士经常错过护理,因为他们无法使用知识和技能来提供护理而感到沮丧;相反,他们被迫优先考虑医疗保健,其中一些要么被推迟,要么被有意忽视。虽然这项研究支持了之前的研究结果,但强调了出勤作为影响护士缺勤的一个因素的出现。这对护理人员提供安全和有效护理的能力以及组织在预算和护理提供安全方面具有更广泛的影响。
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引用次数: 15
Legal Aspects of the Care of Older People in Hong Kong and Nurse's Role in it 香港照顾长者的法律问题及护士在其中的角色
Pub Date : 2014-07-23 DOI: 10.5176/2345-718X_1.2.50
B. Kaur
Legal system provide different means of protection to older people in Hong Kong in terms of life ending decision making, elder abuse, financial and housing affairs. Nurses often plays an important role in it such as begin an advocator and providing professional views and knowledge for helping the older people to plan their life.
香港的法律制度在临终决定、虐待长者、经济及房屋事务等方面为长者提供不同的保障。护士往往扮演着重要的角色,如开始一个倡导者,提供专业的意见和知识,帮助老年人计划他们的生活。
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引用次数: 0
Health Insights: The Efficacy of Current Prenatal Education on Listeria Monocytogenes 健康洞察:当前产前教育对单核细胞增生李斯特菌的影响
Pub Date : 2014-06-23 DOI: 10.5176/2251-3833_GHC14.20
Lindsay Fahnestock, M. Randhawa, Gagandeep Gill, Evangelista V. Shirley, Robin D. Smith, Jesse C. Bliss, Corwin Porter, S. Soret
Every year, at least one major Listeria monocytogenes (Listeria) outbreak occurs within the United States. If pregnant women are uninformed of possible ramifications of contracting Listeria, the mother and child are at risk for health complications. One possibly effective communication approach to this population regarding prevention and risk is through Listeria Educational Materials (LEM). In order to ascertain the status and effectiveness of currently available LEM for pregnant women, a systematic literature review was conducted. Literature searches were conducted using widely accepted public/private databases. The mesh terms used included “Listeria pregnancy”, “listeria education”, “Listeriosis”, “Listeria pregnancy prevalence” “Listeria monocytogenes”. Articles published within the past 10 years pertaining to educational materials for pregnant women were evaluated. Articles relating to general information of Listeria, were also narrowed to specific characteristics, traits, and origin for exposure. References to Listeria in elderly and immunocompromised individuals were excluded. Four studies involving Listeria interventions including LEM for pregnant women were identified. These studies all concluded a majority of pregnant women were still not provided with sufficient information on infection prevention of Listeria. Most educational materials provided to the women were in the form of pamphlets, and the majority of pregnant women who had heard of Listeria gathered the information through their own research efforts. The current evaluation of the available studies concludes there is inadequate emphasis placed on educational interventions for pregnant women regarding Listeria risk. These interventions concluded more must be done to inform these pregnant women of the dangers of Listeria as well as on the high-risk foods they consume on a daily basis.
每年,在美国至少发生一次主要的单核细胞增生李斯特菌(李斯特菌)爆发。如果孕妇不知道感染李斯特菌的可能后果,母亲和孩子就有出现健康并发症的风险。通过李斯特菌教育材料(LEM)向这一人群宣传预防和风险的一种可能有效的方法。为了明确目前可用于孕妇的LEM的现状和有效性,我们进行了系统的文献综述。文献检索使用广泛接受的公共/私人数据库进行。使用的网格术语包括“李斯特菌妊娠”、“李斯特菌教育”、“李斯特菌病”、“李斯特菌妊娠患病率”、“单核增生李斯特菌”。对过去10年内发表的有关孕妇教育材料的文章进行了评价。与李斯特菌的一般信息有关的文章也被缩小到特定的特征、特征和暴露的来源。排除了老年人和免疫功能低下个体中李斯特菌的文献。确定了四项涉及李斯特菌干预的研究,包括孕妇的LEM。这些研究都得出结论,大多数孕妇仍然没有获得关于李斯特菌感染预防的足够信息。提供给妇女的大多数教育材料是以小册子的形式,大多数听说过李斯特菌的孕妇通过自己的研究努力收集了这些信息。目前对现有研究的评价得出的结论是,对孕妇关于李斯特菌风险的教育干预重视不够。这些干预措施得出的结论是,必须做更多的工作来告知这些孕妇李斯特菌的危险以及她们每天食用的高风险食物。
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引用次数: 0
Public Private Partnership in Italian Health Care Management An Organizational Maturity Assessment Model 意大利卫生保健管理中的公私伙伴关系:组织成熟度评估模型
Pub Date : 2014-06-23 DOI: 10.5176/2251-3833_GHC14.34
Marcello Martinez, C. Galdiero
This work aims to analyze a specific phenomenon of innovation in health management: public private partnerships within the Italian healthcare sector. The object of the study is to measure the degree of organizational maturity (OM) of the forms of public-private partnerships (PPP) analyzing and measuring key managerial processes, in terms of innovation in meeting the partnership‘s goals/targets. The analysis is based on the identification of key processes relevant to the management of partnerships, to check which systems of governance are able to meet different stakeholder interests. We therefore built a conceptual standard for analysis of the OM through a field survey based on visits, participant observation, analysis of documents and semi-structured interviews with the management.
这项工作旨在分析健康管理创新的具体现象:意大利医疗保健部门的公私伙伴关系。本研究的目的是衡量公私伙伴关系(PPP)形式的组织成熟度(OM),分析和衡量关键管理过程,在满足伙伴关系目标/指标的创新方面。分析的基础是确定与伙伴关系管理相关的关键过程,以检查哪些治理系统能够满足不同利益相关者的利益。因此,我们通过实地调查、参与者观察、文件分析和与管理层的半结构化访谈,建立了一个概念性的OM分析标准。
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引用次数: 0
Development of Measurement Tool Mini-CEX (Mini Clinical Evaluation Exercise) as an Evaluation Tool of Nursing Students in Teaching Hospital of Universitas Muhammadiyah Yogyakarta 测量工具Mini- cex(迷你临床评估练习)作为日惹穆罕默德大学教学医院护生评估工具的开发
Pub Date : 2013-10-01 DOI: 10.5176/2345-718X_1.1.17
Syafrina Arbaani Djuria, .. Moh.Afandi
Mini-CEX (Mini Clinical Evaluation Exercise) was a method of evaluation to assess the clinical skills of students through direct observation and provide constructive feedback. To develop a measure tool mini-CEX as an effective measure of evaluation, it is necessary to the validity and reliability of the accuracy of the mini-CEX to improving students’ learning and develop clinical education program. In the developing country, very few studies have been designed and conducted on Mini-CEX of Nursing. Moreover, in Indonesia, there is no instrument Mini-CEX of Nursing yet. Generally, this research aims to develop the use of the mini-CEX measure as professional nurses performance evaluation tool. In particular aims (a) to analyze the mini-CEX measure existing in the profession nurses, (b) to analyze the mini-CEX focused on nursing education, (c) for the validity and reliability of the tool with the mini-CEX as educational evaluation tools Nurses. This research was a descriptive quantitative method with cross sectional design. It developed an assessment tool in measuring competencies nursing students from the competencies published by PSIK UMY, 2011 adopted of ABIM (American Board of Internal Medicine), 1995; Taiwan, 2011; and British Dermatological Nursing Group. Content validity was done by the expert review to consist of 4 people are 2 nursing education and 2 medical education. The result validity are trial with used questionnaire. The respondents were 35 preceptors in the teaching hospitals of Universitas Muhammadiyah Yogyakarta. The reliability test was done by Cronbach alpha test. From the initial assessment tool which had 51 items, it became 47 items after the expert review and the reliability test. The computed Cronbach’s alpha for the 47-item scale for mini-CEX was 0.988, indicating high internal consistency. So the instrument is reliable for measuring the competencies of nursing students. This research concluded that the assessment tool in measuring competencies of the nursing student had demonstrated evidence of internal consistency reliability and content validity. It provided an objective tool for assessing the nursing students competencies during do clinical education program.
Mini- cex (Mini Clinical Evaluation Exercise)是一种通过直接观察来评估学生临床技能并提供建设性反馈的评估方法。开发一种测量工具mini-CEX作为一种有效的评价手段,需要提高mini-CEX准确性的效度和信度,以提高学生的学习水平和制定临床教育计划。在发展中国家,很少有关于护理的Mini-CEX的研究被设计和实施。此外,在印度尼西亚,还没有Mini-CEX护理仪器。总的来说,本研究旨在开发使用mini-CEX测量作为专业护士绩效评估工具。特别的目的是(a)分析存在于专业护士中的mini-CEX测量,(b)分析专注于护理教育的mini-CEX, (c)以mini-CEX作为教育评估工具的工具的效度和信度。本研究采用横断面设计的描述性定量方法。从2011年PSIK UMY出版的《胜任力》和1995年ABIM (American Board of Internal Medicine)出版的《胜任力》中开发了一套衡量护理学生胜任力的评估工具;台湾,2011;和英国皮肤护理小组。内容效度由4人组成,分别为2名护理学历和2名医学学历。用问卷对结果的效度进行了检验。答复者是日惹穆罕默德大学教学医院的35名教师。信度检验采用Cronbach alpha检验。评估工具由最初的51个项目,经过专家评审和信度检验,最终增加到47个项目。47项mini-CEX量表的计算Cronbach 's alpha值为0.988,内部一致性较高。因此,该工具对护生胜任力的测量是可靠的。本研究的结论是,测评工具在衡量护生胜任力方面具有内部一致性、信度和内容效度的证据。为临床护理专业学生的能力评估提供了客观的工具。
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引用次数: 4
Probiotics: Review of Evidence 益生菌:证据回顾
Pub Date : 2013-10-01 DOI: 10.5176/2345-718X_1.1.4
A. Avadhani
Probiotic supplements have gained much popularity in the recent years. Media participation for the promotion of probiotic supplementation for various indications has been quite impressive as well. Traditionally, the word probiotic has been referred to in a positive manner and these supplements have been utilized as helpful resources in some way or another. The fact that makes this topic complicated and challenging, not only for the laymen but also for the healthcare providers is that there are numerous types and strains of probiotics available. Additionally, the standardization for dosing based on the indications is somewhat lacking. Few of the many questions that seem to pose challenges for today’s health care providers are; which probiotic, how much of it, how long to use for and above all is there evidence to support the use of probiotics. The purpose of this article is to summarize the available evidence for Probiotic supplements for various indications and attempt to scratch the surface of probiotics data and seek answers to the pertinent probiotics related questions.
近年来,益生菌补充剂越来越受欢迎。媒体参与促进各种适应症的益生菌补充也相当令人印象深刻。传统上,益生菌这个词一直以积极的方式被提及,这些补充剂已经以某种方式或另一种方式被用作有用的资源。事实上,使这个话题变得复杂和具有挑战性,不仅对门外汉,而且对医疗保健提供者来说,是有许多类型和菌株的益生菌可用。此外,基于适应症的给药标准化也有所欠缺。许多问题似乎对今天的卫生保健提供者构成挑战,但很少有;哪种益生菌,服用多少,服用多长时间,最重要的是,有证据支持益生菌的使用。本文的目的是总结各种适应症的益生菌补充剂的现有证据,并试图触及益生菌数据的表面,并寻求相关益生菌相关问题的答案。
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引用次数: 0
Utilizing Evidence-Based Practice to Achieve “Zero Tolerance” for Catheter-Associated Urinary Tract Infections (CAUTIs) 利用循证实践实现导尿管相关性尿路感染(CAUTIs)的“零容忍”
Pub Date : 2013-10-01 DOI: 10.5176/2345-718x_1.1.22
J. Forehand, M. Stanton
Catheter associated urinary tract infections continue to remain the single most common HAI; with external forces, such as mandated public reporting of HAI and the climate of “zero tolerance” for hospital-acquired infections have led to an increased effort in the reduction and elimination of CAUTIs.
导尿管相关性尿路感染仍然是最常见的HAI;由于外部力量,例如强制性公开报告医疗保健和对医院获得性感染“零容忍”的氛围,导致在减少和消除重症监护感染方面作出了更多努力。
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引用次数: 0
期刊
GSTF journal of nursing and health care
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