BACKGROUND Data from the World Health Organization’s International Agency for Research on Cancer reported that China had the highest prevalence of cancer and cancer deaths in 2022.Liver and pancreatic cancers account...BACKGROUND Data from the World Health Organization’s International Agency for Research on Cancer reported that China had the highest prevalence of cancer and cancer deaths in 2022.Liver and pancreatic cancers accounted for the highest number of new cases.Real-world data(RWD)is now widely preferred to traditional clinical trials in various fields of medicine and healthcare,as the traditional research approach often involves highly selected populations and interventions and controls that are strictly regulated.Additionally,research results from the RWD match global reality better than those from traditional clinical trials.AIM To analyze the cost disparity between surgical treatments for liver and pancreatic cancer under various factors.METHODS This study analyzed RWD 1137 cases within the HB1 group(patients who underwent pancreatectomy,hepatectomy,and/or shunt surgery)in 2023.It distinguished different expenditure categories,including medical,nursing,technical,management,drug,and consumable costs.Additionally,it assessed the contribution of each expenditure category to total hospital costs and performed cross-group comparisons using the non-parametric Kruskal–Wallis test.This study used the Steel–Dwass test for post-hoc multiple comparisons and the Spearman correlation coefficient to examine the relationships between variables.RESULTS The study found that in HB11 and HB13,the total hospitalization costs were significantly higher for pancreaticoduodenectomy than for pancreatectomy and hepatectomy.Although no significant difference was observed in the length of hospital stay between patients who underwent pancreaticoduodenectomy and pancreatectomy,both were significantly longer than those who underwent liver resection.In HB15,no significant difference was observed in the total cost of hospitalization between pancreaticoduodenectomy and pancreatectomy;however,both were significantly higher than those in hepatectomy.Additionally,the length of hospital stay was significantly longer for patients who underwent pancreaticoduodenectomy than for those who underwent pancreatectomy or liver resection.CONCLUSION China Healthcare Security Diagnosis Related Groups payment system positively impacts liver and pancreatic cancer surgeries by improving medical quality and controlling costs.Further research could refine this grouping system and ensure continuous effectiveness and sustainability.展开更多
Stunting has remained the nutrition condition of public health concern affecting one in three children under the five years Zimbabwe.Causes of stunting are multiple and poor infant and young child feeding(IYCF)practic...Stunting has remained the nutrition condition of public health concern affecting one in three children under the five years Zimbabwe.Causes of stunting are multiple and poor infant and young child feeding(IYCF)practices are among the top factors associated with stunting.IYCF indicators in Zimbabwe are not performing very well with 61%of children 0 to 5 months being exclusively breastfed,and only 7%of children 6 to 23 months receiving minimum acceptable diet(MAD).The care group approach been piloted in 5 districts to promote and influence behaviour change towards uptake of optimal IYCF practices.The paper assesses progress made in the implementation of the approach after six months of implementation.Results show that implementation of the care group approach,with appropriate coordination structures at community level,yields considerable improvement in health,IYCF,and water and sanitation hygiene(WASH)behaviours and practices.Community level initiatives like income generating activities,food production,and cooking demonstrations are proving to be the sustainability pillars for the care group approach.Conclusively,with proper leadership and coordination,care groups help to affect behaviour change in improving the health,nutrition and caring practices for children.展开更多
Background: Despite efforts to increase participation in prenatal care, outcomes for women and infants in the United States remain below global and national health targets. CenteringPregnancy, a model of group prenata...Background: Despite efforts to increase participation in prenatal care, outcomes for women and infants in the United States remain below global and national health targets. CenteringPregnancy, a model of group prenatal care, incorporates practices consistent with national and international guidelines while allowing for greater freedom in providing content tailored to the specific needs of women receiving care. Objective: To determine whether the CenteringPregnancy model improves maternal and neonatal health indicators such as prenatal care attendance, smoking cessation, weight gain during pregnancy, gestational age at delivery, mode of delivery, and initiation and continuation of breastfeeding. Methods: A retrospective study was conducted including all pregnant women participating in CenteringPregnancy at two prenatal clinic sites in southwest Michigan from January 2010 to April 2012 (n = 173). A comparison group of women receiving traditional care from certified nurse-midwives was created using propensity scores to match for age, race, and insurance status (n = 170). A chart review was performed to analyze maternal and neonatal health indicators including attendance at prenatal visits, gestational age at delivery, baseline maternal weight and weight gain during pregnancy, smoking cessation, infant birth weight, mode of delivery (vaginal birth vs. cesarean section), and rates of breastfeeding. Results: There were no significant differences in pre-pregnancy weight, amount of weight gained during pregnancy, prenatal care attendance, gestational age at delivery, mode of delivery or infant birth weight. The CenteringPregnancy group had significantly higher rates of smoking cessation during pregnancy, as well as higher rates of breastfeeding initiation and continuation. Conclusions: This study provides support for the benefits of CenteringPregnancy in improving rates of smoking cessation during pregnancy which is important to both maternal and infant health. Additionally, in this population CenteringPregnancy resulted in improved rates of breastfeeding initiation and continuation, providing benefits to both infants and mothers.展开更多
Background: Many studies have focused on exploring the concept of care from patient and nurse perspectives, but knowledge is limited regarding student perceptions. Objective: To explore the meanings given to the conce...Background: Many studies have focused on exploring the concept of care from patient and nurse perspectives, but knowledge is limited regarding student perceptions. Objective: To explore the meanings given to the concept of professional care from the perspective of graduate students in nursing and pastoral care. Research design: A qualitative study was employed with the formation of six focus groups. Data were analyzed via a thematic content analysis of the discussions. Participants and research context: Thirty-one students attending a University College in Oslo participated. Findings: Seven main themes and forty-four subthemes were identified. Major themes included reverence and respect for the dignity and value of human life, bonding, sensitive to self and other, communication, competence, willfulness and deep caring. Discussion: Different levels of intentionality, professional comportment and caring consciousness were revealed in the discussions. Findings also lend support to major beliefs and values in Watson’s Human Caring Theory. Conclusion: The focus groups generated valuable detail of complex experiences behind student’s perceptions, attitudes, beliefs and actions. Focus group methodology can enhance holistic nursing practice by providing opportunities to explore and clarify holistic care values, create opportunities for self-awareness and transformative learning in education, clinical practice, administration and research.展开更多
The purpose of this Integrated Care Practice Change and Quality Improvement (ICPCQI) initiative was to evaluate the impact of wellness and relaxation and group psycho-education on health out-comes in an integrated car...The purpose of this Integrated Care Practice Change and Quality Improvement (ICPCQI) initiative was to evaluate the impact of wellness and relaxation and group psycho-education on health out-comes in an integrated care setting. Individuals diagnosed with mental illness and a co-occurring chronic medical condition participated in the ICPCQI initiatives which were run by peer support and wellness experts in an integrated care setting over the one-year project implementation period. Evaluation of outcome measures revealed an overall decline of 8.3% (p < 0.0001) and 7.3% (p < 0.0001) in the average systolic and diastolic blood pressure respectively. There was a 12.3% (p = 0.02) reduction on the average PHQ-9 scores. GAD-7 (p = 0.9) scores had a mean reduction of 1.5%. These preliminary results suggest that the evidence-based ICPCQI initiatives positively impact health outcomes among individuals with mental illness and chronic medical conditions.展开更多
Background: With the inflation of economic constraints on health care and demand to increase care quality, there is an increasing need to develop a clear understanding of what actions by health professionals are perce...Background: With the inflation of economic constraints on health care and demand to increase care quality, there is an increasing need to develop a clear understanding of what actions by health professionals are perceived as threatening quality care. Objective: To explore graduate nursing and pastoral care student’s perceptions of missed care in Norway. Research design: A qualitative study was employed with the formation of six focus groups. Data was analyzed via a thematic content of the discussions. Participants and research context: Thirty-one students attending a University College in Oslo participated. Findings: Five major themes and thirty subthemes were identified. Major themes included labor constraints, organizational contraints, professional constraints, communication constaints and emotional strain. Discussion: Findings of this study resonate with other research as well as with studies on missed nursing care. Findings also lend support to the definition of missed nursing care actions as required care that is omitted, either in part or whole, or delayed. Conclusion: The findings from this study extend understanding of what barriers health professionals perceive as inhibiting them from offering quality care. The focus groups provided a valuable flora for discussion regarding what participants perceived as missed.展开更多
目的探讨“互联网+”群组化孕期保健模式在孕晚期孕妇中的应用效果。方法选取2023年7-8月在上海市同济大学附属妇产科医院产检的孕晚期孕妇120例为研究对象,采用随机数字表法将研究对象分为观察组和对照组,各60例。对照组采用传统孕期...目的探讨“互联网+”群组化孕期保健模式在孕晚期孕妇中的应用效果。方法选取2023年7-8月在上海市同济大学附属妇产科医院产检的孕晚期孕妇120例为研究对象,采用随机数字表法将研究对象分为观察组和对照组,各60例。对照组采用传统孕期保健模式,观察组应用“互联网+”群组化保健模式,比较2组分娩方式、产程时间、产后2 h出血量、分娩自我效能、母乳喂养效能、焦虑抑郁得分、新生儿出生1 min Apgar评分、新生儿出生体重的差异。结果观察组剖宫产率、分娩第一、二、总产程时间、产后焦虑、抑郁得分、新生儿出生体重均低于对照组(P<0.05),分娩自我效能、母乳喂养自我效能得分均显著高于对照组(P<0.05)。结论“互联网+”群组化孕期保健模式可以明显改善初产妇的分娩结局,降低产后焦虑抑郁的发生,提高分娩自我效能和母乳喂养自我效能。展开更多
基金Research Center for Capital Health Management and Policy,No.2024JD09.
文摘BACKGROUND Data from the World Health Organization’s International Agency for Research on Cancer reported that China had the highest prevalence of cancer and cancer deaths in 2022.Liver and pancreatic cancers accounted for the highest number of new cases.Real-world data(RWD)is now widely preferred to traditional clinical trials in various fields of medicine and healthcare,as the traditional research approach often involves highly selected populations and interventions and controls that are strictly regulated.Additionally,research results from the RWD match global reality better than those from traditional clinical trials.AIM To analyze the cost disparity between surgical treatments for liver and pancreatic cancer under various factors.METHODS This study analyzed RWD 1137 cases within the HB1 group(patients who underwent pancreatectomy,hepatectomy,and/or shunt surgery)in 2023.It distinguished different expenditure categories,including medical,nursing,technical,management,drug,and consumable costs.Additionally,it assessed the contribution of each expenditure category to total hospital costs and performed cross-group comparisons using the non-parametric Kruskal–Wallis test.This study used the Steel–Dwass test for post-hoc multiple comparisons and the Spearman correlation coefficient to examine the relationships between variables.RESULTS The study found that in HB11 and HB13,the total hospitalization costs were significantly higher for pancreaticoduodenectomy than for pancreatectomy and hepatectomy.Although no significant difference was observed in the length of hospital stay between patients who underwent pancreaticoduodenectomy and pancreatectomy,both were significantly longer than those who underwent liver resection.In HB15,no significant difference was observed in the total cost of hospitalization between pancreaticoduodenectomy and pancreatectomy;however,both were significantly higher than those in hepatectomy.Additionally,the length of hospital stay was significantly longer for patients who underwent pancreaticoduodenectomy than for those who underwent pancreatectomy or liver resection.CONCLUSION China Healthcare Security Diagnosis Related Groups payment system positively impacts liver and pancreatic cancer surgeries by improving medical quality and controlling costs.Further research could refine this grouping system and ensure continuous effectiveness and sustainability.
文摘Stunting has remained the nutrition condition of public health concern affecting one in three children under the five years Zimbabwe.Causes of stunting are multiple and poor infant and young child feeding(IYCF)practices are among the top factors associated with stunting.IYCF indicators in Zimbabwe are not performing very well with 61%of children 0 to 5 months being exclusively breastfed,and only 7%of children 6 to 23 months receiving minimum acceptable diet(MAD).The care group approach been piloted in 5 districts to promote and influence behaviour change towards uptake of optimal IYCF practices.The paper assesses progress made in the implementation of the approach after six months of implementation.Results show that implementation of the care group approach,with appropriate coordination structures at community level,yields considerable improvement in health,IYCF,and water and sanitation hygiene(WASH)behaviours and practices.Community level initiatives like income generating activities,food production,and cooking demonstrations are proving to be the sustainability pillars for the care group approach.Conclusively,with proper leadership and coordination,care groups help to affect behaviour change in improving the health,nutrition and caring practices for children.
文摘Background: Despite efforts to increase participation in prenatal care, outcomes for women and infants in the United States remain below global and national health targets. CenteringPregnancy, a model of group prenatal care, incorporates practices consistent with national and international guidelines while allowing for greater freedom in providing content tailored to the specific needs of women receiving care. Objective: To determine whether the CenteringPregnancy model improves maternal and neonatal health indicators such as prenatal care attendance, smoking cessation, weight gain during pregnancy, gestational age at delivery, mode of delivery, and initiation and continuation of breastfeeding. Methods: A retrospective study was conducted including all pregnant women participating in CenteringPregnancy at two prenatal clinic sites in southwest Michigan from January 2010 to April 2012 (n = 173). A comparison group of women receiving traditional care from certified nurse-midwives was created using propensity scores to match for age, race, and insurance status (n = 170). A chart review was performed to analyze maternal and neonatal health indicators including attendance at prenatal visits, gestational age at delivery, baseline maternal weight and weight gain during pregnancy, smoking cessation, infant birth weight, mode of delivery (vaginal birth vs. cesarean section), and rates of breastfeeding. Results: There were no significant differences in pre-pregnancy weight, amount of weight gained during pregnancy, prenatal care attendance, gestational age at delivery, mode of delivery or infant birth weight. The CenteringPregnancy group had significantly higher rates of smoking cessation during pregnancy, as well as higher rates of breastfeeding initiation and continuation. Conclusions: This study provides support for the benefits of CenteringPregnancy in improving rates of smoking cessation during pregnancy which is important to both maternal and infant health. Additionally, in this population CenteringPregnancy resulted in improved rates of breastfeeding initiation and continuation, providing benefits to both infants and mothers.
文摘Background: Many studies have focused on exploring the concept of care from patient and nurse perspectives, but knowledge is limited regarding student perceptions. Objective: To explore the meanings given to the concept of professional care from the perspective of graduate students in nursing and pastoral care. Research design: A qualitative study was employed with the formation of six focus groups. Data were analyzed via a thematic content analysis of the discussions. Participants and research context: Thirty-one students attending a University College in Oslo participated. Findings: Seven main themes and forty-four subthemes were identified. Major themes included reverence and respect for the dignity and value of human life, bonding, sensitive to self and other, communication, competence, willfulness and deep caring. Discussion: Different levels of intentionality, professional comportment and caring consciousness were revealed in the discussions. Findings also lend support to major beliefs and values in Watson’s Human Caring Theory. Conclusion: The focus groups generated valuable detail of complex experiences behind student’s perceptions, attitudes, beliefs and actions. Focus group methodology can enhance holistic nursing practice by providing opportunities to explore and clarify holistic care values, create opportunities for self-awareness and transformative learning in education, clinical practice, administration and research.
文摘The purpose of this Integrated Care Practice Change and Quality Improvement (ICPCQI) initiative was to evaluate the impact of wellness and relaxation and group psycho-education on health out-comes in an integrated care setting. Individuals diagnosed with mental illness and a co-occurring chronic medical condition participated in the ICPCQI initiatives which were run by peer support and wellness experts in an integrated care setting over the one-year project implementation period. Evaluation of outcome measures revealed an overall decline of 8.3% (p < 0.0001) and 7.3% (p < 0.0001) in the average systolic and diastolic blood pressure respectively. There was a 12.3% (p = 0.02) reduction on the average PHQ-9 scores. GAD-7 (p = 0.9) scores had a mean reduction of 1.5%. These preliminary results suggest that the evidence-based ICPCQI initiatives positively impact health outcomes among individuals with mental illness and chronic medical conditions.
文摘Background: With the inflation of economic constraints on health care and demand to increase care quality, there is an increasing need to develop a clear understanding of what actions by health professionals are perceived as threatening quality care. Objective: To explore graduate nursing and pastoral care student’s perceptions of missed care in Norway. Research design: A qualitative study was employed with the formation of six focus groups. Data was analyzed via a thematic content of the discussions. Participants and research context: Thirty-one students attending a University College in Oslo participated. Findings: Five major themes and thirty subthemes were identified. Major themes included labor constraints, organizational contraints, professional constraints, communication constaints and emotional strain. Discussion: Findings of this study resonate with other research as well as with studies on missed nursing care. Findings also lend support to the definition of missed nursing care actions as required care that is omitted, either in part or whole, or delayed. Conclusion: The findings from this study extend understanding of what barriers health professionals perceive as inhibiting them from offering quality care. The focus groups provided a valuable flora for discussion regarding what participants perceived as missed.
文摘目的探讨“互联网+”群组化孕期保健模式在孕晚期孕妇中的应用效果。方法选取2023年7-8月在上海市同济大学附属妇产科医院产检的孕晚期孕妇120例为研究对象,采用随机数字表法将研究对象分为观察组和对照组,各60例。对照组采用传统孕期保健模式,观察组应用“互联网+”群组化保健模式,比较2组分娩方式、产程时间、产后2 h出血量、分娩自我效能、母乳喂养效能、焦虑抑郁得分、新生儿出生1 min Apgar评分、新生儿出生体重的差异。结果观察组剖宫产率、分娩第一、二、总产程时间、产后焦虑、抑郁得分、新生儿出生体重均低于对照组(P<0.05),分娩自我效能、母乳喂养自我效能得分均显著高于对照组(P<0.05)。结论“互联网+”群组化孕期保健模式可以明显改善初产妇的分娩结局,降低产后焦虑抑郁的发生,提高分娩自我效能和母乳喂养自我效能。
