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Forging an easier path through graduation:Improving the patient transition from paediatric to adult critical care
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作者 Stephen Warrillow Ben Gelbart +2 位作者 Jess Stevens Gordon Baikie Mark E Howard 《World Journal of Critical Care Medicine》 2025年第1期82-90,共9页
Adolescence and the journey to adulthood involves exciting opportunities as well as psychosocial stress for young people growing up.These normal experiences are potentially magnified for teenagers living with chronic ... Adolescence and the journey to adulthood involves exciting opportunities as well as psychosocial stress for young people growing up.These normal experiences are potentially magnified for teenagers living with chronic illness or disability and their families.Advances in care have improved survival for children with a variety of serious chronic medical conditions such that many who may once have died in childhood now survive well into adulthood with ongoing morbidity.For those with highly complex needs,care is often provided at major paediatric hospitals with expertise,specially trained personnel,and resources to support young people and their families for the first decades of life.At the end of adolescence,however,it is generally appropriate and necessary for young adults and their caregivers to transition to the care of clinicians trained in the care of adults at general hospitals.While there are some well-managed models to support this journey of transition,these are often specific to certain conditions and usually do not involve intensive care.Many patients may encounter considerable challenges during this period.Difficulties may include the loss of established therapeutic relationships,a perception of austerity and reduced amenity in facilities oriented to caring for adult patients,and care by clinicians with less experience with more common paediatric conditions.In addition,there is a risk of potential conflict between clinicians and families regarding goals of care in the event of a critical illness when it occurs in a young adult with major disability and long-term health issues.These challenges present genuine opportunities to better understand the transition from paediatric to adult-based care and to improve processes that assist clinicians who support patients and families as they shift between healthcare settings. 展开更多
关键词 Paediatric intensive care DISABILITY Adult intensive care TRANSITION Critical care
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Impact of community public health care on treatment effect,health cognition,and self-management in patients with type 2 diabetes
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作者 Hong Shi Chun Liu Hong-Yan Luo 《World Journal of Clinical Cases》 SCIE 2025年第5期22-29,共8页
BACKGROUND At present,China has become the country with the largest number of individuals with diabetes mellitus(DM)in the world,with a total of approximately 140 million patients,the majority of whom have type 2 DM(T... BACKGROUND At present,China has become the country with the largest number of individuals with diabetes mellitus(DM)in the world,with a total of approximately 140 million patients,the majority of whom have type 2 DM(T2DM).Based on conven-tional nursing methods,community home care has important clinical significance in controlling blood sugar and disease progression.AIM To explore the impact of community public health nursing on treatment effect,health cognition,and self-management in patients with T2DM.METHODS One hundred patients with T2DM were selected as the research subjects.The patients were divided into either a conventional nursing group or community nursing(CN)group using the random number table method.The conventional nursing group(50 cases)received routine care,while the CN group(50 cases)received community public health care in addition to routine care as that for the conventional nursing group.The rate of excellent and good blood glucose control,fasting blood glucose before and after care,2-h postprandial blood glucose,health cognition,and self-management ability,and patient satisfaction were compared between the two groups.RESULTS The CN group had a higher rate of excellent blood sugar control than the conventional nursing group(88%vs 70%,P<0.05).Before care,there was no significant difference in fasting blood glucose or 2-h postprandial blood glucose between the two groups of patients(P>0.05).After nursing,fasting blood glucose and 2-h postprandial blood glucose were reduced to varying degrees in both groups,and both blood glucose levels in the CN group were lower than those of the conventional nursing group(P<0.05).Compared with the scores before care,the cognitive level score for diabetes and self-management ability score improved after care in both groups.The cognitive level and self-management ability of patients in the CN group were higher than those of the conventional nursing group(P<0.05).The overall satisfaction of the CN group was better than that of the conventional nursing group(98%vs 86%,P<0.05).CONCLUSION Community public health care based on conventional care of T2DM can achieve better blood sugar control,and improve patients’health cognitive level and self-management ability. 展开更多
关键词 Community public health care Type 2 diabetes Blood sugar control Self-management ability Cognition level
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Prognostic impact of hypernatremia for septic shock patients in the intensive care unit
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作者 Mai-Qing Shi Jun Chen +6 位作者 Fu-Hai Ji Hao Zhou Ke Peng Jun Wang Chun-Lei Fan Xu Wang Yang Wang 《World Journal of Clinical Cases》 SCIE 2025年第7期28-38,共11页
BACKGROUND Hypernatremia represents a significant electrolyte imbalance associated with numerous adverse outcomes,particularly in cases of intensive care unit(ICU)-acquired hypernatremia(IAH).Nevertheless,its relevanc... BACKGROUND Hypernatremia represents a significant electrolyte imbalance associated with numerous adverse outcomes,particularly in cases of intensive care unit(ICU)-acquired hypernatremia(IAH).Nevertheless,its relevance in patients with septic shock remains uncertain.AIM To identify independent risk factors and their predictive efficacy for IAH to improve outcomes in patients with septic shock.METHODS In the present retrospective single-center study,a cohort of 157 septic shock patients with concurrent hypernatremia in the ICU at The First Affiliated Hospital of Soochow University,between August 1,2018,and May 31,2023,were analyzed.Patients were categorized based on the timing of hypernatremia occurrence into the IAH group(n=62),the non-IAH group(n=41),and the normonatremia group(n=54).RESULTS In the present study,there was a significant association between the high serum sodium concentrations,excessive persistent inflammation,immunosuppression and catabolism syndrome and chronic critical illness,while rapid recovery had an apparent association with normonatremia.Moreover,multivariable analyses revealed the following independent risk factors for IAH:Total urinary output over the preceding three days[odds ratio(OR)=1.09;95%CI:1.02–1.17;P=0.014],enteral nutrition(EN)sodium content of 500 mg(OR=2.93;95%CI:1.13–7.60;P=0.027),and EN sodium content of 670 mg(OR=6.19;95%CI:1.75–21.98;P=0.005)were positively correlated with the development of IAH.Notably,the area under the curve for total urinary output over the preceding three days was 0.800(95%CI:0.678–0.922,P=0.001).Furthermore,maximum serum sodium levels,the duration of hypernatremia,and varying sodium correction rates were significantly associated with 28-day in-hospital mortality in septic shock patients(P<0.05).CONCLUSION The present findings illustrate that elevated serum sodium level was significantly associated with a poor prognosis in septic shock patients in the ICU.It is highly recommended that hypernatremia be considered a potentially important prognostic indicator for the outcome of septic shock. 展开更多
关键词 HYPERNATREMIA Hypernatremia acquired in the intensive care unit Septic shock Persistent inflammation IMMUNOSUPPRESSION Catabolism syndrome Chronic critical illness Prognosis
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Patients admitted in the intensive care unit after solid organ or bone marrow transplantation:Retrospective cohort study
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作者 Ana Vujaklija Brajkovic Iva Kosuta +5 位作者 Lucija Batur Sara Sundalic Marijana Medic Andro Vujevic Luka Bielen Jaksa Babel 《World Journal of Transplantation》 2025年第1期95-104,共10页
BACKGROUND Solid organ transplantation(SOT)and hematopoietic stem cell transplantation(HSCT)revolutionized the survival and quality of life of patients with malignant diseases,various immunologic,and metabolic disorde... BACKGROUND Solid organ transplantation(SOT)and hematopoietic stem cell transplantation(HSCT)revolutionized the survival and quality of life of patients with malignant diseases,various immunologic,and metabolic disorders or those associated with a significant impairment in a patient's quality of life.AIM To investigate admission causes and treatment outcomes of patients after SOT or HSCT treated in a medical intensive care unit(ICU).METHODS We conducted a single-center,retrospective epidemiological study in the medical ICU at the University Hospital Centre Zagreb,Croatia covering the period from January 1,2018 to December 31,2023.RESULTS The study included 91 patients with either SOT[28 patients(30.8%)]or HSCT[63 patients(69.2%)].The median age was 56(43.2-64.7)years,and 60.4%of the patients were male.Patients with SOT had more comorbidities than patients after HSCT[χ^(2)(5,n=141)=18.513,P<0.001].Sepsis and septic shock were the most frequent reasons for admission,followed by acute respiratory insufficiency in patients following HSCT.Survival rate significantly differed between SOT and HSCT[χ^(2)(1,n=91)=21.767,P<0.001].ICU survival was 57%in the SOT and 12.7%in the HSCT group.The need for mechanical ventilation[χ^(2)(1,n=91)=17.081,P<0.001]and vasopressor therapy[χ^(2)(1,n=91)=36.803,P<0.001]was associated with survival.The necessity for acute renal replacement therapy did not influence patients'survival[χ^(2)(1,n=91)=0.376,P=0.54].In the subgroup of patients with infection,90%had septic shock,and the majority had positive microbiological samples,mostly Gram-negative bacteria.The ICU survival of patients with sepsis/septic shock cumulatively was 15%.The survival of SOT patients with sepsis/shock was 45%.CONCLUSION Patients with SOT or HSCT are frequently admitted to the ICU due to sepsis and septic shock.Despite advancements in critical care,the mortality rate of patients with refractory septic shock and multiorgan failure in this patient population is extremely high.Early recognition and timely ICU admittance might improve the outcome of patients,especially after HSCT. 展开更多
关键词 Liver transplantation Kidney transplantation Hematopoietic stem cell transplantation Critical care SEPSIS Septic shock MORTALITY
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Beyond statistical significance:Embracing minimal clinically important difference for better patient care
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作者 Naveen Jeyaraman Madhan Jeyaraman +2 位作者 Swaminathan Ramasubramanian Sangeetha Balaji Sathish Muthu 《World Journal of Methodology》 2025年第1期33-41,共9页
The minimal clinically important difference(MCID)represents a pivotal metric in bridging the gap between statistical significance and clinical relevance,addressing the direct impact of medical interventions from the p... The minimal clinically important difference(MCID)represents a pivotal metric in bridging the gap between statistical significance and clinical relevance,addressing the direct impact of medical interventions from the patient's perspective.This comprehensive review analyzes the evolution,applications,and challenges of MCID across medical specialties,emphasizing its necessity in ensuring that clinical outcomes not only demonstrate statistical significance but also offer genuine clinical utility that aligns with patient expectations and needs.We discuss the evolution of MCID since its inception in the 1980s,its current applications across various medical specialties,and the methodologies used in its calculation,highlighting both anchor-based and distribution-based approaches.Furthermore,the paper delves into the challenges associated with the application of MCID,such as methodological variability and the interpretation difficulties that arise in clinical settings.Recommendations for the future include standardizing MCID calculation methods,enhancing patient involvement in setting MCID thresholds,and extending research to incorporate diverse global perspectives.These steps are critical to refining the role of MCID in patient-centered healthcare,addressing existing gaps in methodology and interpretation,and ensuring that medical interventions lead to significant,patient-perceived improvements. 展开更多
关键词 Minimal clinically important difference Patient-centered care Clinical relevance Global health
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Perspectives on non-emergent neonatal intensive care unit to pediatric intensive care unit care transfers in the United States
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作者 Phillip D Cohen Renee D Boss +3 位作者 David C Stockwell Meghan Bernier Joseph M Collaco Sapna R Kudchadkar 《World Journal of Critical Care Medicine》 2024年第4期73-80,共8页
BACKGROUND There is a substantial population of long-stay patients who non-emergently transfer directly from the neonatal intensive care unit(NICU)to the pediatric intensive care unit(PICU)without an interim discharge... BACKGROUND There is a substantial population of long-stay patients who non-emergently transfer directly from the neonatal intensive care unit(NICU)to the pediatric intensive care unit(PICU)without an interim discharge home.These infants are often medically complex and have higher mortality relative to NICU or PICUonly admissions.Given an absence of data surrounding practice patterns for nonemergent NICU to PICU transfers,we hypothesized that we would encounter a broad spectrum of current practices and a high proportion of dissatisfaction with current processes.AIM To characterize non-emergent NICU to PICU transfer practices across the United States and query PICU providers’evaluations of their effectiveness.METHODS A cross-sectional survey was drafted,piloted,and sent to one physician representative from each of 115 PICUs across the United States based on membership in the PARK-PICU research consortium and membership in the Children’s Hospital Association.The survey was administered via internet(REDCap).Analysis was performed using STATA,primarily consisting of descriptive statistics,though logistic regressions were run examining the relationship between specific transfer steps,hospital characteristics,and effectiveness of transfer.RESULTS One PICU attending from each of 81 institutions in the United States completed the survey(overall 70%response rate).Over half(52%)indicated their hospital transfers patients without using set clinical criteria,and only 33%indicated that their hospital has a standardized protocol to facilitate non-emergent transfer.Fewer than half of respondents reported that their institution’s nonemergent NICU to PICU transfer practices were effective for clinicians(47%)or patient families(38%).Respondents evaluated their centers’transfers as less effective when they lacked any transfer criteria(P=0.027)or set transfer protocols(P=0.007).Respondents overwhelmingly agreed that having set clinical criteria and standardized protocols for non-emergent transfer were important to the patient-family experience and patient safety.CONCLUSION Most hospitals lacked any clinical criteria or protocols for non-emergent NICU to PICU transfers.More positive perceptions of transfer effectiveness were found among those with set criteria and/or transfer protocols. 展开更多
关键词 TRANSFER Chronic critical illness Intensive care units Pediatric intensive care Neonatal intensive care care transition
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21st century critical care medicine:An overview 被引量:1
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作者 Smitesh Padte Vikramaditya Samala Venkata +3 位作者 Priyal Mehta Sawsan Tawfeeq Rahul Kashyap Salim Surani 《World Journal of Critical Care Medicine》 2024年第1期1-14,共14页
Critical care medicine in the 21st century has witnessed remarkable advancements that have significantly improved patient outcomes in intensive care units(ICUs).This abstract provides a concise summary of the latest d... Critical care medicine in the 21st century has witnessed remarkable advancements that have significantly improved patient outcomes in intensive care units(ICUs).This abstract provides a concise summary of the latest developments in critical care,highlighting key areas of innovation.Recent advancements in critical care include Precision Medicine:Tailoring treatments based on individual patient characteristics,genomics,and biomarkers to enhance the effectiveness of therapies.The objective is to describe the recent advancements in Critical Care Medicine.Telemedicine:The integration of telehealth technologies for remote patient monitoring and consultation,facilitating timely interventions.Artificial intelligence(AI):AI-driven tools for early disease detection,predictive analytics,and treatment optimization,enhancing clinical decision-making.Organ Support:Advanced life support systems,such as Extracorporeal Membrane Oxygenation and Continuous Renal Replacement Therapy provide better organ support.Infection Control:Innovative infection control measures to combat emerging pathogens and reduce healthcare-associated infections.Ventilation Strategies:Precision ventilation modes and lung-protective strategies to minimize ventilatorinduced lung injury.Sepsis Management:Early recognition and aggressive management of sepsis with tailored interventions.Patient-Centered Care:A shift towards patient-centered care focusing on psychological and emotional wellbeing in addition to medical needs.We conducted a thorough literature search on PubMed,EMBASE,and Scopus using our tailored strategy,incorporating keywords such as critical care,telemedicine,and sepsis management.A total of 125 articles meeting our criteria were included for qualitative synthesis.To ensure reliability,we focused only on articles published in the English language within the last two decades,excluding animal studies,in vitro/molecular studies,and non-original data like editorials,letters,protocols,and conference abstracts.These advancements reflect a dynamic landscape in critical care medicine,where technology,research,and patient-centered approaches converge to improve the quality of care and save lives in ICUs.The future of critical care promises even more innovative solutions to meet the evolving challenges of modern medicine. 展开更多
关键词 Critical care medicine Intensive care unit Precision medicine TELEMEDICINE Artificial intelligence Organ support SEPSIS Infection control Patient-centered care
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Discharging patients home from the intensive care unit:A new trend
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作者 Esraa M Hassan Abbas B Jama +4 位作者 Ahmed Sharaf Asim Shaikh Mohamad El Labban Salim Surani Syed A Khan 《World Journal of Clinical Cases》 SCIE 2024年第23期5313-5319,共7页
Discharging patients directly to home from the intensive care unit(ICU)is becoming a new trend.This review examines the feasibility,benefits,challenges,and considerations of directly discharging ICU patients.By analyz... Discharging patients directly to home from the intensive care unit(ICU)is becoming a new trend.This review examines the feasibility,benefits,challenges,and considerations of directly discharging ICU patients.By analyzing available evidence and healthcare professionals'experiences,the review explores the potential impacts on patient outcomes and healthcare systems.The practice of direct discharge from the ICU presents both opportunities and complexities.While it can potentially reduce costs,enhance patient comfort,and mitigate complications linked to extended hospitalization,it necessitates meticulous patient selection and robust post-discharge support mechanisms.Implementing this strategy successfully mandates the availability of home-based care services and a careful assessment of the patient's readiness for the transition.Through critical evaluation of existing literature,this review underscores the significance of tailored patient selection criteria and comprehensive post-discharge support systems to ensure patient safety and optimal recovery.The insights provided contribute evidence-based recommendations for refining the direct discharge approach,fostering improved patient outcomes,heightened satisfaction,and streamlined healthcare processes.Ultimately,the review seeks to balance patientcentered care and effective resource utilization within ICU discharge strategies. 展开更多
关键词 Intensive care unit Critical care Early discharge Cost effective critical care Patient comfort Early recovery
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Factors influencing individualized nursing care in acute medical and perioperative settings: A scoping review
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作者 Ana RAMOS Eunice SÁ +8 位作者 Delmira POMBO Florinda SÁ Filipe RAMOS Fernanda BERNARDO Helena MIRA Hélder LOPES Paula SANTOS Regina MARCÃO Idalina GOMES 《Journal of Integrative Nursing》 2024年第4期231-240,共10页
Individualized nursing care addresses the needs,experiences,behaviors,feelings,and perceptions of patients and families,but its implementation in clinical practice contexts remains challenging.This review aims to map ... Individualized nursing care addresses the needs,experiences,behaviors,feelings,and perceptions of patients and families,but its implementation in clinical practice contexts remains challenging.This review aims to map the factors that interfere with the individualization of nursing care,in acute medical and perioperative settings.Scoping review was conducted according to the Joanna Briggs Institute guidelines.The MEDLINE,CINAHL,Cochrane,SciELO,Scientific Repository of Open Access,and LILACS databases were searched for publications from January 2017 up to March 2023.Of the 124 articles selected,17 met the inclusion criteria.The individualization of nursing care is complex and shaped by multiple variables in the care environment,nursing,and patient characteristics.The institutional organization,the nurses’expertise,and the patient’s attributes were identified as variables that interfere with the individualization of nursing care.Individualized nursing care is responsible for better quality of care and health outcomes.The identification of the variables that affect individualized care contributes to planning programs to improve individualization,during hospitalization and the discharge. 展开更多
关键词 Acute care nursing care patient individualization perioperative care
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Palliative care with adequate pain relief challenges the need for euthanasia legislation
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作者 Renald Blundell Martina Cini Kimberley Blundell 《History & Philosophy of Medicine》 2024年第2期6-13,共8页
Background:In today’s society the ongoing discussion about euthanasia triggers emotionally charged debates surrounding the delicate balance between valuing life and respecting an individual’s autonomy.With the persi... Background:In today’s society the ongoing discussion about euthanasia triggers emotionally charged debates surrounding the delicate balance between valuing life and respecting an individual’s autonomy.With the persistence of this debate,there has been the emergence of the concept of the so-called alternative:palliative care.Positioned as a substitute for euthanasia,palliative care aims to alleviate suffering in terminally ill patients without engaging in the ethical dilemmas associated with euthanasia.Methods:This paper explores the facets of palliative care highlighting its core objectives such as providing adequate pain relief as a compassionate alternative to euthanasia.Results:By examining palliative care as a comprehensive approach to end of life support,this study challenges the perceived necessity of euthanasia and advocates,for compassionate and dignified end of life experiences.Conclusion:In conclusion,palliative care emerges as a viable and ethically sound alternative to euthanasia,emphasizing the importance of compassionate end-of-life care and pain management. 展开更多
关键词 palliative care adequate pain relief euthanasia legislation end-of-life care patient-centered care policy development
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Electrochemical biosensors for point-of-care testing 被引量:1
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作者 Jinsol Kim Juho Jeong Seung Hwan Ko 《Bio-Design and Manufacturing》 SCIE EI CAS CSCD 2024年第4期548-565,共18页
Point-of-care testing(POCT)is the practice of diagnosing and monitoring diseases where the patient is located,as opposed to traditional treatment conducted solely in a medical laboratory or other clinical setting.POCT... Point-of-care testing(POCT)is the practice of diagnosing and monitoring diseases where the patient is located,as opposed to traditional treatment conducted solely in a medical laboratory or other clinical setting.POCT has been less common in the recent past due to a lack of portable medical devices capable of facilitating effective medical testing.However,recent growth has occurred in this field due to advances in diagnostic technologies,device miniaturization,and progress in wearable electronics.Among these developments,electrochemical sensors have attracted interest in the POCT field due to their high sensitivity,compact size,and affordability.They are used in various applications,from disease diagnosis to health status monitoring.In this paper we explore recent advancements in electrochemical sensors,the methods of fabricating them,and the various types of sensing mechanisms that can be used.Furthermore,we delve into methods for immobilizing specific biorecognition elements,including enzymes,antibodies,and aptamers,onto electrode surfaces and how these sensors are used in real-world POCT settings. 展开更多
关键词 Point-of-care testing(POCT) Electrochemical sensor ENZYME ANTIBODY Health care
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个性化护理联合CICARE沟通模式在耳鼻喉门诊患者中的应用
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作者 吕国苹 田志森 张帆 《齐鲁护理杂志》 2024年第17期29-32,共4页
目的:探讨个性化护理联合CICARE沟通模式在耳鼻喉门诊患者中的应用效果。方法:采用便利取样法将2022年6月1日~2023年12月31日就诊于耳鼻喉门诊的256例患者作为研究对象,将2022年6月1日~2023年1月31日就诊的128例作为对照组,将2023年2月1... 目的:探讨个性化护理联合CICARE沟通模式在耳鼻喉门诊患者中的应用效果。方法:采用便利取样法将2022年6月1日~2023年12月31日就诊于耳鼻喉门诊的256例患者作为研究对象,将2022年6月1日~2023年1月31日就诊的128例作为对照组,将2023年2月1日~12月31日就诊的128例作为实验组;对照组给予常规耳鼻喉门诊护理,实验组给予个性化护理联合CICARE沟通模式;比较两组护理前后护理质量、护理满意度。结果:护理后,实验组有形性感知、可靠性感知、响应性感知、保证性感知评分均高于对照组(P<0.05,P<0.01),两组移情性感知比较差异无统计学意义(P>0.05);护理后,实验组服务态度、沟通能力、就诊秩序、专业素质、护理安全、护理满意度总分均高于对照组(P<0.05,P<0.01)。结论:将个性化护理联合CICARE沟通模式应用于耳鼻喉门诊患者中,能够提高护理质量和护理满意度。 展开更多
关键词 个性化护理 CIcare沟通模式 耳鼻喉门诊
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Factors influencing the employed caregiver burden for patients with dementia residing in nursing homes:A cross-sectional study from China
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作者 Caixia Liu Huiling Zheng +6 位作者 Baiyu Li Shijia He Rongrong Hu Feifei Li Yao Zheng Weimin Lou Biyan Jiang 《International Journal of Nursing Sciences》 CSCD 2024年第4期457-464,共8页
Objective:The institutionalization of care for patients with dementia is becoming a trend.Understanding the burden on employed caregivers and exploring associated factors are of great importance in practice.Therefore,... Objective:The institutionalization of care for patients with dementia is becoming a trend.Understanding the burden on employed caregivers and exploring associated factors are of great importance in practice.Therefore,this study aimed to examine the relationship between basic attributes,caring ability,and caregiver burden in employed caregivers practicing in nursing homes.Methods:This cross-sectional study included 541 employed caregivers in 11 four-star nursing homes in Zhejiang Province from April to December 2022.Caregiver burden was assessed using the Zarit Burden Interview(ZBI).Demographic characteristics of participants,characteristics of the older patients with dementia,caring characteristics,training in dementia care,and caring abilities were collected for analysis of influencing factors.A hierarchical multiple regression analysis was conducted to explore the factors influencing the burden on employed caregivers in nursing homes.Results:The ZBI score of employed caregivers in nursing homes was 40.42±10.18,representing a moderate caregiver burden.Factors such as age(U=27.82,P<0.001),residence(U=7.89,P<0.001),educational level(H=55.81,P<0.001),self-care of older patients with dementia(H=85.21,P<0.001),daily care hours(H=73.25,P<0.001),number of older people with dementia cared for(H=14.56,P<0.012)and training in dementia care(U=-9.43,P<0.001)were significantly associated with caregiver burden.Caring ability was negatively associated with caregiver burden(r=-0.22,P<0.01).Furthermore,after controlling for demographic characteristics,the characteristics of older people with dementia,caring characteristics,training in dementia care,and caring ability explained 8.5%,5.8%,and 4.8%of the caregiver burden,respectively.Conclusion:The burden of employed caregivers on patients with dementia in nursing homes can be attributed to various factors.We recommend tailored interventions,such as dementia care training and reviewing the number and duration of hours worked to reduce the burden experienced by caregivers. 展开更多
关键词 caregiver burden Caring ability DEMENTIA Employed caregivers Nursing homes
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Intensity of nursing work in a primary healthcare center:An observational study
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作者 Melita Peršolja 《International Journal of Nursing Sciences》 CSCD 2024年第5期536-543,共8页
Objectives:In the sphere of occupational intensity,nursing stands recognized for its inherently demanding nature,marked by a rapid succession of tasks.Our primary aim was to assess the level of job intensity within nu... Objectives:In the sphere of occupational intensity,nursing stands recognized for its inherently demanding nature,marked by a rapid succession of tasks.Our primary aim was to assess the level of job intensity within nursing by analyzing the frequency and duration of activities performed by nurses,instances of task overlap,and the distribution of break times within a primary healthcare center.Methods:This study was conducted using a descriptive working method.Nursing activities were recorded with the observation of six nurses,each monitored for 37.5 h.We used the Maribor System for measuring Quantity in Nursing Care in Primary Health Care Settings to measure the nursing care activities about direct patient care,indirect patient care,and other unproductive aspects through direct non-participant observations.Results:About 41.5%(n=1,640)of all nursing activities involving direct contact with patients,about 38.2%(n=1,508)was indirect patient care,where a large amount worked with paper files(n=666,16.9%).In addition,about 15.0%were other nursing activities(mostly computer work),and just 5.3%(n=210)of tasks were unproductive.The observational findings indicate a pronounced level of work intensity experienced by nurses in primary health clinics.Significantly,nurses were predominantly engaged in direct patient care tasks,often managing multiple activities simultaneously.Their transitions between tasks occurred approximately every 3 min,frequently without adequate intervals for breaks.Conclusions:This study highlights the need to shift nurses’focus from a task-centric approach to one centered on patient care.The prevailing emphasis on tasks may contribute to enduring fatigue and professional dissatisfaction.Consequently,there is an urgent need to redefine the scope of a nurse’s role and implement a comprehensive computer information system as an integral part of this redefined approach. 展开更多
关键词 Intensity nursing care Nurses Primary healthcare Quality services
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Unveiling significant risk factors for intensive care unit-acquired weakness:Advancing preventive care
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作者 Chun-Yao Cheng Wen-Rui Hao Tzu-Hurng Cheng 《World Journal of Clinical Cases》 SCIE 2024年第18期3288-3290,共3页
In this editorial,we discuss an article titled,“Significant risk factors for intensive care unit-acquired weakness:A processing strategy based on repeated machine learning,”published in a recent issue of the World J... In this editorial,we discuss an article titled,“Significant risk factors for intensive care unit-acquired weakness:A processing strategy based on repeated machine learning,”published in a recent issue of the World Journal of Clinical Cases.Intensive care unit-acquired weakness(ICU-AW)is a debilitating condition that affects critically ill patients,with significant implications for patient outcomes and their quality of life.This study explored the use of artificial intelligence and machine learning techniques to predict ICU-AW occurrence and identify key risk factors.Data from a cohort of 1063 adult intensive care unit(ICU)patients were analyzed,with a particular emphasis on variables such as duration of ICU stay,duration of mechanical ventilation,doses of sedatives and vasopressors,and underlying comorbidities.A multilayer perceptron neural network model was developed,which exhibited a remarkable impressive prediction accuracy of 86.2%on the training set and 85.5%on the test set.The study highlights the importance of early prediction and intervention in mitigating ICU-AW risk and improving patient outcomes. 展开更多
关键词 Intensive care unit-acquired weakness Artificial intelligence Machine learning Neural network Risk factors Prediction Critical care
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Evaluation of the effectiveness of preventive nursing measures for pressure injuries in patients in the neurology intensive care unit
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作者 Rong Zhang Peng-Xin Ma Juan-Juan Zhang 《World Journal of Clinical Cases》 SCIE 2024年第19期3807-3814,共8页
BACKGROUND Patients in neurology intensive care units(ICU)are prone to pressure injuries(PU)due to factors such as severe illness,long-term bed rest,and physiological dysfunction.PU not only causes pain and complicati... BACKGROUND Patients in neurology intensive care units(ICU)are prone to pressure injuries(PU)due to factors such as severe illness,long-term bed rest,and physiological dysfunction.PU not only causes pain and complications to patients,but also increases medical burden,prolongs hospitalization time,and affects the recovery process.AIM To evaluate and optimize the effectiveness of pressure injury prevention nursing measures in neurology ICU patients.METHODS A retrospective study was conducted,and 60 patients who were admitted to the ICU of the Department of Neurology were selected and divided into an observation group and a control group according to the order of admission,with 30 people in each group.The observation group implemented pressure injury prevention and nursing measures,while the control group adopted routine care.RESULTS Comparison between observation and control groups following pressure injury prevention nursing intervention revealed significantly lower incidence rates in the observation group compared to the control group at 48 h(8.3%vs 26.7%),7 d(16.7%vs 43.3%),and 14 d(20.0%vs 50.0%).This suggests a substantial reduction in pressure injury incidence in the observation group,with the gap widening over time.Additionally,patients in the observation group exhibited quicker recovery,with a shorter average time to get out of bed(48 h vs 72 h)and a shorter average length of stay(12 d vs 15 d)compared to the control group.Furthermore,post-intervention,patients in the observation group reported significantly improved quality of life scores,including higher scores in body satisfaction,feeling and function,and comfort(both psychological and physiological),indicating enhanced overall well-being and comfort following the implementation of pressure injury prevention nursing measures.CONCLUSION Implementing pressure injury preventive care measures for neurology ICU patients will have better results. 展开更多
关键词 Neurology intensive care units Pressure injury Preventive care Effect evaluation Optimization research Prognostic effect
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Wearable Healthcare and Continuous Vital Sign Monitoring with IoT Integration
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作者 Hamed Taherdoost 《Computers, Materials & Continua》 SCIE EI 2024年第10期79-104,共26页
Technical and accessibility issues in hospitals often prevent patients from receiving optimal mental and physical health care,which is essential for independent living,especially as societies age and chronic diseases ... Technical and accessibility issues in hospitals often prevent patients from receiving optimal mental and physical health care,which is essential for independent living,especially as societies age and chronic diseases like diabetes and cardiovascular disease become more common.Recent advances in the Internet of Things(IoT)-enabled wearable devices offer potential solutions for remote health monitoring and everyday activity recognition,gaining significant attention in personalized healthcare.This paper comprehensively reviews wearable healthcare technology integrated with the IoT for continuous vital sign monitoring.Relevant papers were extracted and analyzed using a systematic numerical review method,covering various aspects such as sports monitoring,disease detection,patient monitoring,and medical diagnosis.The review highlights the transformative impact of IoTenabled wearable devices in healthcare,facilitating real-time monitoring of vital signs,including blood pressure,temperature,oxygen levels,and heart rate.Results from the reviewed papers demonstrate high accuracy and efficiency in predicting health conditions,improving sports performance,enhancing patient care,and diagnosing diseases.The integration of IoT in wearable healthcare devices enables remote patient monitoring,personalized care,and efficient data transmission,ultimately transcending traditional boundaries of healthcare and leading to better patient outcomes. 展开更多
关键词 Wearable healthcare IoT integration patient care remote patient monitoring real-time data transmission health technology
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Exploration of home care models for disabled older adults in China:Challenges and choices
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作者 Lingling Zhang Ling Yang 《Chinese Journal of Population,Resources and Environment》 2024年第4期526-530,共5页
This study explores the challenges and strategies of home care models for older adults with disabilities in China.The following challenges have been identified:limited policy support and lack of effective connections ... This study explores the challenges and strategies of home care models for older adults with disabilities in China.The following challenges have been identified:limited policy support and lack of effective connections between different systems,pressure on caregivers,underestimation of caregivers’value,and inadequate service capacity of community institutions.Evidence-based suggestions to promote the development of home care models for older adults with disabilities include establishing a family caregiver compensation mechanism and psychological support system,strengthening community health centers from quantity to service capabilities for aging-in-place services,and promoting the integration of pension,disability,and health insurance systems. 展开更多
关键词 DISABILITY Home care Older adults AGING Family caregivers Social welfare
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Predicting intensive care unit-acquired weakness:A multilayer perceptron neural network approach
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作者 Carlos Martin Ardila Daniel González-Arroyave Mateo Zuluaga-Gómez 《World Journal of Clinical Cases》 SCIE 2024年第12期2023-2030,共8页
In this editorial,we comment on the article by Wang and Long,published in a recent issue of the World Journal of Clinical Cases.The article addresses the challenge of predicting intensive care unit-acquired weakness(I... In this editorial,we comment on the article by Wang and Long,published in a recent issue of the World Journal of Clinical Cases.The article addresses the challenge of predicting intensive care unit-acquired weakness(ICUAW),a neuromuscular disorder affecting critically ill patients,by employing a novel processing strategy based on repeated machine learning.The editorial presents a dataset comprising clinical,demographic,and laboratory variables from intensive care unit(ICU)patients and employs a multilayer perceptron neural network model to predict ICUAW.The authors also performed a feature importance analysis to identify the most relevant risk factors for ICUAW.This editorial contributes to the growing body of literature on predictive modeling in critical care,offering insights into the potential of machine learning approaches to improve patient outcomes and guide clinical decision-making in the ICU setting. 展开更多
关键词 Intensive care units Intensive care unit-acquired weakness Risk factors Machine learning Computer neural network
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Machine learning insights on intensive care unit-acquired weakness
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作者 Muad Abdi Hassan Abdulqadir J Nashwan 《World Journal of Clinical Cases》 SCIE 2024年第18期3285-3287,共3页
Intensive care unit-acquired weakness(ICU-AW)significantly hampers patient recovery and increases morbidity.With the absence of established preventive strategies,this study utilizes advanced machine learning methodolo... Intensive care unit-acquired weakness(ICU-AW)significantly hampers patient recovery and increases morbidity.With the absence of established preventive strategies,this study utilizes advanced machine learning methodologies to unearth key predictors of ICU-AW.Employing a sophisticated multilayer perceptron neural network,the research methodically assesses the predictive power for ICU-AW,pinpointing the length of ICU stay and duration of mechanical ventilation as pivotal risk factors.The findings advocate for minimizing these elements as a preventive approach,offering a novel perspective on combating ICU-AW.This research illuminates critical risk factors and lays the groundwork for future explorations into effective prevention and intervention strategies. 展开更多
关键词 Length of intensive care unit stay Intensive care unit-acquired weakness Machine learning Likelihood factors Precautionary measures
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