Artificial Intelligence and Autonomous Machines: Influences, Consequences, and Dilemmas in Human Care

In the field of robotics and in the health sciences, transitions have been occurring in the control of robots operating with predetermined logic and rules. Robotics in health care are influencing human caring dynamics in many ways such as enhancing dependency and surrender to machine technologies. Situations such as these are charged with possibilities of legal liabilities triggered by influences and consequences of advancing robotic technology dependency. The purpose of this paper is to identify, describe, and explain legal issues and/or dilemmas centered on robotics in healthcare while providing engaging opportunities to limit consequent legalities thus forming beneficial human health care outcomes. Laying bare these liabilities will provide critically informative data that can foster proactive encounters which can or may deter health care liabilities while ensuring quality healthcare outcomes. An attempt is made to re-conceptualize how to view agency, causality, liability responsibility, culpability, and autonomy for the new age of autonomous robots. While it is still not clear how this would turn out, a clear framing of the problem is the first step in the project.

Human Care Theory and Influences on the Life Quality Index of Cancer Patients in Household Life

To investigatetheinfluences of the application of human care theory on the life quality and happiness of cancer patients after they receiveda community nursing care which was implemented by the human care theory. The quality life and the happiness index of 93 patients with cancer living in the six communities in Jillin were assessed, the assessment of the life quality was based on a life quality scale (SF-36) and that of the happiness index was based on Memorial University of Newfoundland Scale of Happiness (MUNSH). The community nurses cared for these patients by applying the theory of human care and the life quality and the happiness index of the patients were observed after the care. The results showed that there were significant differences in the score of 5 dimensions in the eight dimensions of the life quality between before the care and after the care (<0.05), and there were significant differences in the average sores of the positive emotion, positive experience, negative emotion, negative experience and level of happiness included in the happiness index between before the care and after the care (<0.05), suggesting that the theory of human care can be used for the care of patients with cancer and the application of the theory can effectively improve the life quality and the happiness index of the patients, strengthen their problem-solving abilities and let them have a positive attitude towards their lives.

Healthcare interprofessional team members' perspectives on human caring: A directed content analysis study

Objectives:As Watson's Human Caring Theory continues to evolve and guide the discipline of nursing,the challenge is to find ways to integrate it into practice.The purpose of this study is to describe interprofessional team members'perspectives on human caring based on the Ten Caritas Processes(R)/Caritas-Veritas Literacy of Watson's Human Caring Theory within the Unitary Caring Science.Methods:This is a qualitative directed content analysis study,taking place in a Children's Hospital in the United States between November 2017 and April 2018.Information redundancy was utilized to guide the recruitment.Data were collected via a one-time face-to-face individual interview.A qualitative directed content analysis was conducted using Watson's Ten Caritas Processes(R)/Caritas-Veritas Literacy as a coding framework.Results:Twenty-seven healthcare professionals participated in the study.Interprofessional human caring,based on the Ten Caritas Processes(R)/Caritas-Veritas Literacy,was referred to as performing lovingkindness to patients,each other,and self;maintaining faith-hope in teamwork;valuing intersubjective interactions and building trust among team members;cultivating heart-centered-caring relations;acknowledging and processing positive and negative feelings non-judgmentally;applying all ways of knowing in caring;encouraging reciprocal teaching-learning;developing caring-healing environments collaboratively;respecting human dignity of patients and each other;and being open-minded to the unknowns and believing in miracles.Conclusions:Watson's Human Caring Theory can be an underlying guide to enrich human-to-human relations and create a caring-healing environment.When human caring is applied in interprofessional teams,healthcare professionals find a caring consciousness to care for oneself and each other and promote patient care.

Effects of humanized nursing care on negative emotions and complications in patients undergoing hysteromyoma surgery

BACKGROUND Uterine fibroids,are prevalent benign tumors affecting women of reproductive age.However,surgical treatment is often necessary for symptomatic hysteromyoma cases.This study examines the impact of humanized nursing care on reducing negative emotions and postoperative complications in patients receiving hysteromyoma surgery.AIM To investigate the impact of humanized nursing care on patients undergoing hysteromyoma surgery.METHODS Among patients who underwent hysteromyoma surgery at the Fudan University Affiliated Obstetrics and Gynecology Hospital,200 were randomly assigned to either the control group(n=100)or the humanized nursing care group(n=100).The control group received traditional nursing care,while the humanized nursing care group received a comprehensive care plan encompassing psychological support,pain management,and tailored rehabilitation programs.In addition,anxiety and depression levels were assessed using the hospital anxiety and depression scale preoperatively and postoperatively.Postoperative complications were evaluated during follow-up assessments and compared between both groups.RESULTS The humanized nursing care group demonstrated a significant decrease in anxiety and depression levels compared to the control group(P<0.05).The rate of postoperative complications,including infection,bleeding,and deep venous thrombosis,was also markedly lower in the humanized nursing care group(P<0.05).CONCLUSION Humanized nursing care can effectively alleviate negative emotions and reduce the incidence of postoperative complications in patients undergoing hysteromyoma surgery.This approach should be considered a crucial component of perioperative care for these patients.Further research may be needed to explore additional benefits and long-term outcomes of implementing humanized nursing care in this population.

Methodology of Care Humanitude Implementation at an Integrated Continuing Care Unit: Benefits for the Individuals Receiving Care

The increasing number of elderly people with behavioral changes, agitation, aggressiveness, and refusal to receive care imposes new challenges to caregivers, who need to take ownership of innovative care methodologies to better take care of this group of people. Objective: To evaluate the benefits of the Humanitude Care Methodology (HCM) in order to improve the health condition of people admitted in a Portuguese Integrated Continuing Care Unit (UCCI). Methods: An action research study was conducted between September and December 2016. The sample consisted of 33 people who were admitted in this UCCI for at least 90 days. Monthly data collection, during four periods, using the Braden Scale, Morse Scale, Barthel Index and Mini Mental State Examination. The data was processed using the Statistical Package for Social Science, version 17.0. Results: The following decreases were observed: in individuals with cognitive deficit (93.94 percent to 81.82 percent);in individuals considered totally dependent (60.61 percent to 30.30 percent);at risk developing pressure ulcers (PU) (84.85 percent to 51.52 percent);in individuals who had PU (24.24 percent to 15.15 percent);in people with high risk of fall (45.45 percent to 39.39 percent);in the number of individuals with two antipsychotic prescriptions (27.27 percent to 9.09 percent). Conclusions: These results allowed to understand the positive benefits, of implementing the HCM, on the people receiving care, specifically at cognitive level, dependency level in activities of daily living, and the avoidance of physical and mental deterioration.

Research of the Exploitation of Human Resources in Blind Prevention and Primary Eye Care

Purpose:This research studied how to establish a relatively advanced blindness prevention and eye care cause in economically underdeveloped countryside.Methods:Ophthalmic vocational schools and professional lectures were held to train“practical type”primary eye care workers for the coumtryside.Further study in high-level(above provincial)hospitals was taken to train blindness preention &eye care backbones and leaders.Results:In 1986,the ratio of the number of the eye care workers of all levels to the number of the whole population in the prefecture was1:26000.In1992,it roseto1:17000.Aneye care network of 222stations had been established in tb countryside.Ten in the 13county hospitals had a seperated ophthalmology ed- partment,in which 3were awarded“National advanced blindness prevention County”.Twenty one hospitals were appointed as the Unit of Surgical Vision-Rehabilitation of Cataract.Blindness prevention and eye care convered1000000population(eye care avaliable within 5kilometers),23.5%of the whol popula-tion.Conclusions:In a demographically large but economically underdexeloped country-side area,the key to wide-range blindness prevention and eye oare is to exploti human resources effectively.We should train“Practical type”primary eye care workers,and have a number of edpartment leaders who are authoritive,influential in this field and ready to sacrifice to this cause.

Cytotoxicity of Contact Lens Care Solution to Human Corneal Epithelium in Vitro

Purpose: To investigate the cytotoxicity of soft contact lens multi-purpose care solutions which are now in common use in China.Methods: The cell culture method was used. Cytotoxicity was indicated by significant increases in the number of dead cells relative to controls.Results: Cells were exposed to soft contact lens care solutions for 15 min. They were irregular in shape and variable in size. The intercellular space increased and variable in size.The in-tercelluar space increased and the cells became scrunken. With the time of exposure elongated , damage of cells became more severe.Conclusions: Four kinds of soft contact lens multi-purpose care solutions may have harmful effects on the culture of human corneal epithelial cells. Soaked lenses should be rinsed with saline before being placed in the eyes in order to reduce the potential toxicity of contact lens care solutions. Eye science 1998; 14 :45 - 47.

Twenty years of human immunodeficiency virus care at the Mayo Clinic:Past,present and future

The Mayo human immunodeficiency virus(HIV) Clinic has been providing patient centered care for persons living with HIV in Minnesota and beyond for the past 20 years. Through multidisciplinary engagement, vital clinical outcomes such as retention in care, initiation of antiretroviral therapy and virologic suppression are maximized. In this commentary, we describe the history of the Mayo HIV Clinic and its best practices, providing a "Mayo Model" of HIV care that exceeds national outcomes and may be applicable in other settings.

Outpatient Experience of Human Caring Scale （OEHC-Scale）： Improvement by Delphi Method

Based on the outpatient interview and literature review, the initial framework of the outpatient experience of human caring scale was formed with 9 dimensions of outpatient process. The research aim was to improve the scale by Delphi method. Sixteen experts in medical management, human caring or medical education were invited to evaluate the importance of the dimensions and items of the scale and provided some expertise via filling out the DeLphi consultation questionnaires twice in the consulting round. In the first round, the recovery rate showing the experts＇ positivity was 80%; the coefficient of reliability （Cr） ascertaining the authority of the evaluation was 0.92; the mean and full mark ratios responding the concentration of the evaluation were 2.88-4.94 and 6.25%-93.75% respectively; the coefficients of variation （CV） and the Kendall＇s W determining the concordance of the evaluation were 5.06%-52.15% and 0.21-0.24 respectively. In the second round, the recovery rate was 93.75%; the Cr was 0.93; the mean was 3.93-4.93; the full mark ratios were 26.67%-93.33%; the Kendall＇s W was 0.14- 0.31, the CV was 5.25%-23.61%. Via the two-round Delphi study, the scale that included 10 dimensions and 61 items has been improved. Ten dimensions are pre-hospital medical service, guidance, registration, waiting, diagnosis ＆ treatment, paying, inspection ＆ assay, medicine receiving, therapy/injection/transfusion and global evaluation. It was concluded that Chinese scholars have paid high attention to human caring and outpatient experience. The experts have given high agreements about the dimensions which were established with Chinese outpatient process. The dimensions are different from the similar researches about outpatient experience study. In the future, it is necessary to survey the outpatients to test the construct validity, internal consistency reliability and others of the scale to improve the scale.

Expert Consensus on Nurses'Human Caring for COVID-19 Patients in Different Sites

Summary:This study aims to develop the expert consensus on nurse's human caring for Corona Virus Disease 2019(COVID-19)patients in different sites,and thus provide a guideline on providing whole process and systematic caring for COVID-19 patients.Based on the frontline experiences of human caring for COVID-19 patients and the review of literature,the initial draft of consensus was made and finalized after online meeting and revisions.The experts reached consensus on the following parts:terms and definitions,principles of human caring for COVID-19 patients,and human caring measures for COVID-19 patients in different sites.The expert consensus is practical,concise,and reasonable for guiding the nurses providing human caring for COVID-19 patients,as well as other similar infectious diseases.

Human caring for patients suffering from major infectious disease-nurses’ entire use of self

Human caring is regarded as the essence and core of nursing.Based on Dr.Watson′s human caring science theory,nursing staff in Wuhan Union Hospital and other healthcare institutions have delivered warm human caring service in patients′ daily care.During the outbreak of major infectious disease-pandemic of COVID-19,patients are suffering from great psychological distress and pressure.Like nursing professionals around the world,nurses in Wuhan,Hubei,China,along with the colleagues from the National Aid Medical Team,used entire of themselves to conduct diversity human caring measures to patients suffering from the major infectious disease with love and responsibilities,which greatly demonstrated the essence and value of nursing care,and has wide implications for further development of nursing.

CICARE沟通模式的人性化护理在腹腔镜胆囊切除术中的效果

目的 应用基于六步标准沟通法(CICARE)的人性化护理干预后,对行腹腔镜胆囊切除术(LC)患者的干预效果进行评估。方法 在2019年5月至2022年5月将南阳医学高等专科学校第三附属医院行LC手术的70例患者纳入本次研究对象,入选患者分成两组,即观察组、对照组,分组工具为随机数表法。对照组(n=35)行应用常规护理,观察组(n=35)行基于CICARE沟通模式的人性化护理干预。对两组手术指标、护理满意度、并发症发生情况进行评价,干预前后,评估两组焦虑评分(SAS)、抑郁评分(SDS)、生活质量(SF-36)评分。结果 与对照组相比,观察组肛门排气时间、住院时间、胃肠道功能恢复时间更短,差异有统计学意义(P<0.05)。干预前,两组SAS、SDS、SF-36评分相较差异无统计学意义(P>0.05);干预后,两组患者SAS、SDS评分呈现降低趋势,SF-36评分呈现增高趋势,观察组优于对照组,差异有统计学意义(P<0.05)。与对照组相比,观察组的并发症总发生率更低,且护理满意度更高(P<0.05)。结论 基于CICARE沟通模式的人性化护理在LC围手术期中具有较高的应用价值,可改善患者的心理状态,促进患者术后恢复,提高患者生活质量,并发症少,护理满意度高,临床应用安全有效。

U. S. Academic Medical Centers Under the Managed Health Care Environment

This research investigates the impact of managed health care on academic medical centers in the United States. Academic medical centers hold a unique position in the U. S. health care system through their missions of conducting cutting-edge biomedical researeh, pursuing clinical and technological innovations, Providing state-of-the-art medical care and producing highly qUalified health professionals. However, policies to control costs through the use of managed care and limiting resources are detrimental to academic medical centers and impede the advancement of medical sciTo survive the threats of managed care in the health care environment, acadendc medical centers must rely on their upper level managers to derive successful strategies. The methods used in this study include qualitative approaches in the form of key informants and case studies. In addition, a survey questionnaire was sent to 1h8 CEOs in all the academic medical centers in the U. S. The findings revealed that managers who perform the liaison, monitor, entrepreneur and resource allocator roles are crucial to ensure the survival of academic medical centers, so that academic medical centers can continue their missions to serve the general public and promote their well-being.

Bibliometrics analysis of Jean Waston’s Human caring theory in China in the past 10 years

Aims:To analyze the research status and development trend of human caring theory in the field of nursing in China,and to provide better reference for theory and research.Methods:All articles related to human caring theory were searched in the China national knowledge infrastructure(CNKI),Wanfang Data and VIP database which were published in the past year was searched.NoteExpress document management software and Excel software were used to conduct bibliometrics analysis on the annual distribution,regional distribution,journal distribution,fund support and research content of the documents.The search time was from 1 January 2009 to 31 December 2009.Results:A total of 113 articles were included in the literature.The total number of published articles showed a slow and tortuous trend.After 2013,the volume of publications was relatively stable.The core journals accounted for 17.7%of the total number of articles,and most of them came from hospitals.The research covers clinical applications,nursing education,nursing management and other fields.Conclusion:Human caring theory is an important part of nursing theory,Nursing researchers in China can conduct clinical research,nursing management and nursing education research based on their theoretical connotation,combined with clinical and teaching environment.

Human Factor Based Leadership: Critical Leadership Tools to Reduce Burnout and Latent Error in a Time of Accelerating Change

The majority of errors in healthcare are from systems factors that create the latent conditions for error to occur. The majority of occupational stressors causing burnout are also the result of systemic factors. Advances in technology create new levels of stress and expectations on healthcare workers (HCW) with an endless infusion of requirements from multiple authoritative sources that are tracked and monitored. The quality of care and safety of patients is affected by the wellbeing of HCWs who now practice in an environment that has become more complex to navigate, often expending limited neural resource (brainpower) on classifying, organizing, constantly making decisions on how and when they can accomplish what is required(extraneous cognitive load) in addition to direct patient care. New information demonstrates profound biological impact on the brains of those who have burnout in areas that affect the quality and safety of the decisions they make-which affects risk to patients in healthcare. Healthcare administration curriculum currently does not include ways to address these stress-induced problems in healthcare delivery. The science of human factors and ergonomics (HFE) promotes system performance and worker wellbeing. Patient safety is one component of system performance. Since many requirements come without resource to accomplish them, it becomes incumbent upon health system leadership to organize the means for completion of these to minimize the needless loss of brain power diverted away from the delivery of patient care. Human Factor-Based Leadership (HFBL) is an interactive, problem solving seminar series designed for healthcare leaders. The purpose is to provide relevant human factor science to integrate into their leadership and management decisions to make HCWs occupational environment more manageable and sustainable-which makes safer conditions for clinician wellbeing and patient care. After learning the content, a cohort of healthcare leaders believed that adequately addressing HFE in healthcare delivery would significantly reduce clinician burnout and risk of latent errors from upstream leadership decisions. An overview of the content of the seminars is described. Leadership feedback on usability of these seminars is reported. Three HFBL seminars described are Human Factor Relevance in Leadership, Biopsychosocial Approach to Wellness and Burnout, Human Factor Based Leadership: Examples and Applications.

Generalizable items and modular structure for computerised physician staffing calculation on intensive care units

Intensive care medicine remains one of the most costdriving areas within hospitals with high personnel costs. Under the scope of limited budgets and reimbursement, realistic needs are essential to justify personnel staffing. Unfortunately, all existing staffing models are top-down calculations with a high variability in results. We present a workload-oriented model, integrating quality of care, efficiency of processes, legal, educational, controlling, local, organisational and economic aspects. In our model, the physician's workload solely related to the intensive care unit depends on three tasks: Patient-oriented tasks, divided in basic tasks(performed in every patient) and additional tasks(necessary in patients with specific diagnostic and therapeutic requirements depending on their specific illness, only), and non patient-oriented tasks. All three tasks have to be taken into account for calculating the required number of physicians. The calculation tool further allows to determine minimal personnel staffing, distribution of calculated personnel demand regarding type of employee due to working hours per year, shift work or standby duty. This model was introduced and described first by the German Board of Anesthesiologists and the German Society ofAnesthesiology and Intensive Care Medicine in 2008 and since has been implemented and updated 2012 in Germany. The modular, flexible nature of the Excel-based calculation tool should allow adaption to the respective legal and organizational demands of different countries. After 8 years of experience with this calculation, we report the generalizable key aspects which may help physicians all around the world to justify realistic workload-oriented personnel staffing needs.

Challenges of the dialog between humanization of health and medicine for the assistance to woman health in the Brazilian scenario

The present article aims to present, by a bibliographic review, the current challenges of the dialog among fundamental issues referring to humanization as for current public policy in Brazilian scenario. The first one concerns with national health humanization policies and ultimately the humanization of the assistance to the woman’s health, especially at delivery and child birth. Using the hermeneutic dialectic as methodology, it’s understood that having these three facets, dialog consists not only of a great challenge but also of a condition on being put into practice, and expected issues become an effective reality.

The Basic Principles of Kin Sociality and Eusociality: Human Evolution

The paper posits that kin sociality and eusociality are derived from the handicap-care principles based on the need-based care to the handicappers from the caregivers for the self-interest of the caregivers. In this paper, handicap is defined as the difficulty to survive and reproduce independently. Kin sociality is derived from the childhood handicap-care principle where the children are the handicapped children who receive the care from the kin caregivers in the inclusive kin group to survive. The caregiver gives care for its self-interest to reproduce its gene. The individual’s gene of kin sociality contains the handicapped childhood and the caregiving adulthood. Eusociality is derived from the adulthood handicap-care principle where responsible adults are the handicapped adults who give care and receive care at the same time in the interdependent eusocial group to survive and reproduce its gene. Queen bees reproduce, but must receive care from worker bees that work but must rely on queen bees to reproduce. A caregiver gives care for its self-interest to survive and reproduce its gene. The individual’s gene of eusociality contains the handicapped childhood-adulthood and the caregiving adulthood. The chronological sequence of the sociality evolution is individual sociality without handicap, kin sociality with handicapped childhood, and eusociality with handicapped adulthood. Eusociality in humans is derived from bipedalism and the mixed habitat. The chronological sequence of the eusocial human evolution is 1) the eusocial early hominins with bipedalism and the mixed habitat, 2) the eusocial early Homo species with bipedalism, the larger brain, and the open habitat, 3) the eusocial late Homo species with bipedalism, the largest brain, and the unstable habitat, and 4) extended eusocial Homo sapiens with bipedalism, the shrinking brain, omnipresent imagination, and the harsh habitat. The omnipresence of imagination in human culture converts eusociality into extended eusociality with both perception and omnipresent imagination.

手术室人性化护理在老年下肢骨折患者中的应用分析

目的探究老年下肢骨折实施手术室人性化护理的作用。方法前瞻性随机选取2023年1—12月南京市第一医院收治的140例老年下肢骨折患者为研究对象。根据不同护理干预分为研究组和参照组,各70例。参照组行常规护理,研究组加用手术室人性化护理。比较两组患者心理状态、并发症发生情况及生活质量。结果护理后,研究组焦虑和抑郁评分分别为(48.51±3.54)分、(50.12±4.02)分,低于参照组的(52.33±4.36)分和(56.92±4.36)分,差异有统计学意义(t=5.691、9.593,P均<0.05)。研究组并发症发生情况优于参照组,差异有统计学意义(P<0.05)。研究组生活质量评分高于参照组,差异有统计学意义(P<0.05)。结论老年下肢骨折患者经手术室人性化护理后心理状态显著改善,并发症发生率较低,生活质量较理想。

缓和医疗之理解与责任

缓和医疗的发展方兴未艾,但临床对其认识仍然浅显,且可能存在较大偏颇。本文从缓和医疗的本源出发,阐释缓和医疗的内涵以及重要性,以期加深医务工作者对缓和医疗的理解,从而推动缓和医疗理念在临床的贯彻实施。