Modern drugs have changed epilepsy,which affects people of all ages.However,for young people with epilepsy,the framework of drug development has stalled.In the wake of the thalidomide catastrophe,the misconception eme...Modern drugs have changed epilepsy,which affects people of all ages.However,for young people with epilepsy,the framework of drug development has stalled.In the wake of the thalidomide catastrophe,the misconception emerged that for people<18 years of age drugs,including antiseizure medications(ASMs),need separate proof of efficacy and safety,overall called"pediatric drug development".For ASMs,this has changed to some degree.Authorities now accept that ASMs are effective in<18 years as well,but they still require"extrapolation of efficacy,"as if minors were another species.As a result,some of the pediatric clinical epilepsy research over the past decades was unnecessary.Even more importantly,this has hampered research on meaningful research goals.We do not need to confirm that ASMs work before as they do after the 18th birthday.Instead,we need to learn how to prevent brain damage in young patients by preventing seizures and optimize ASMs’uses.Herein we discuss how to proceed in this endeavor.展开更多
目的系统评价医务人员对于儿科预立医疗照护计划(pediatric advance care planning,pACP)的看法,为护理人员更好地开展pACP提供依据。方法计算机检索Cochrane Library、PubMed、Web of Science、Science Direct、Embase、CINAHL、CNKI...目的系统评价医务人员对于儿科预立医疗照护计划(pediatric advance care planning,pACP)的看法,为护理人员更好地开展pACP提供依据。方法计算机检索Cochrane Library、PubMed、Web of Science、Science Direct、Embase、CINAHL、CNKI、万方、维普、中国生物医学文献数据库。检索时限为建库至2022年11月,搜集有关医务人员对pACP看法的质性研究,对纳入文献进行评价和整合。结果共纳入11篇文献,提炼出32个结果,归纳组合成12个类别,综合形成5个整合结果:pACP的讨论难以发起、儿科与pACP间的文化冲突、pACP管理体系面临巨大挑战、医务人员对pACP持有消极态度、pACP团队合作的重要性。结论pACP面临诸多难以实施的问题,通过有效评估患儿及家属预立医疗照护计划需求,健全管理体系,制订实践指南,加强护士安宁疗护教育,有助于推进pACP在儿科环境下的开展。展开更多
预立医疗照护计划(advance care planning,ACP)是儿童安宁疗护的重要组成部分,是优化儿童临终照护的关键所在。有效的ACP可以了解患儿及其家庭的临终偏好,为患儿提供符合本人意愿的医疗和照护服务。此外,ACP还可以改善家属丧亲后心理疾...预立医疗照护计划(advance care planning,ACP)是儿童安宁疗护的重要组成部分,是优化儿童临终照护的关键所在。有效的ACP可以了解患儿及其家庭的临终偏好,为患儿提供符合本人意愿的医疗和照护服务。此外,ACP还可以改善家属丧亲后心理疾病的发生率和严重程度。目前,国内外在儿科领域的ACP实践均十分有限。成功的ACP需要包括敏感的谈话、循序渐进的过程以及以家庭为中心的方法。未来的研究应在我国文化背景下探索患儿及其家庭的临终阶段各维度需求、偏好和价值观。在中国文化背景下构建适用于我国患儿的ACP模式,并开发相关辅助文件。展开更多
文摘Modern drugs have changed epilepsy,which affects people of all ages.However,for young people with epilepsy,the framework of drug development has stalled.In the wake of the thalidomide catastrophe,the misconception emerged that for people<18 years of age drugs,including antiseizure medications(ASMs),need separate proof of efficacy and safety,overall called"pediatric drug development".For ASMs,this has changed to some degree.Authorities now accept that ASMs are effective in<18 years as well,but they still require"extrapolation of efficacy,"as if minors were another species.As a result,some of the pediatric clinical epilepsy research over the past decades was unnecessary.Even more importantly,this has hampered research on meaningful research goals.We do not need to confirm that ASMs work before as they do after the 18th birthday.Instead,we need to learn how to prevent brain damage in young patients by preventing seizures and optimize ASMs’uses.Herein we discuss how to proceed in this endeavor.
文摘目的系统评价医务人员对于儿科预立医疗照护计划(pediatric advance care planning,pACP)的看法,为护理人员更好地开展pACP提供依据。方法计算机检索Cochrane Library、PubMed、Web of Science、Science Direct、Embase、CINAHL、CNKI、万方、维普、中国生物医学文献数据库。检索时限为建库至2022年11月,搜集有关医务人员对pACP看法的质性研究,对纳入文献进行评价和整合。结果共纳入11篇文献,提炼出32个结果,归纳组合成12个类别,综合形成5个整合结果:pACP的讨论难以发起、儿科与pACP间的文化冲突、pACP管理体系面临巨大挑战、医务人员对pACP持有消极态度、pACP团队合作的重要性。结论pACP面临诸多难以实施的问题,通过有效评估患儿及家属预立医疗照护计划需求,健全管理体系,制订实践指南,加强护士安宁疗护教育,有助于推进pACP在儿科环境下的开展。
文摘预立医疗照护计划(advance care planning,ACP)是儿童安宁疗护的重要组成部分,是优化儿童临终照护的关键所在。有效的ACP可以了解患儿及其家庭的临终偏好,为患儿提供符合本人意愿的医疗和照护服务。此外,ACP还可以改善家属丧亲后心理疾病的发生率和严重程度。目前,国内外在儿科领域的ACP实践均十分有限。成功的ACP需要包括敏感的谈话、循序渐进的过程以及以家庭为中心的方法。未来的研究应在我国文化背景下探索患儿及其家庭的临终阶段各维度需求、偏好和价值观。在中国文化背景下构建适用于我国患儿的ACP模式,并开发相关辅助文件。
