Health Workers’ Documentation Process as a Prerequisite to the Integration of Patient Care at a Regional Referral Hospital in Uganda

Background: Integrated patient care is necessary for better care outcomes. Documentation enhances the integration of care;however, in the Ugandan setting, documentation of care is poor (e.g., omissions and incomplete records) and integration of patient care is not visible. This study presents a review of patient health records that was undertaken to understand documentation of care at a regional referral hospital in Eastern Uganda. This information will help in developing a documentation model to facilitate the integration of patient care in Uganda. Methodology: This retrospective review involved 513 patient health records from the medical-surgical, pediatric, and obstetric/gynecological departments of Jinja Regional Referral Hospital. Data were collected using checklists. Stratified sampling was used to capture variations in ward unit records and identify a fair representation of each department. Data were analyzed with descriptive and inferential statistics. All analyses were performed with SPSS version 22. Results: On average, the study hospital attended to 1000 patients per day and discharged 100 patients per ward unit per month. Our record review showed that documentation by both nurses and doctors was incomplete, and care was fragmented. However, doctors documented care more often than nurses, although the integration of patient care was not evident in doctors’ documentation. Conclusion: To establish integrated patient care, documentation must meet standards set by relevant professional bodies. The findings of this study will inform the development of a feasible documentation model to facilitate the integration of patient care in Uganda.

Evidence of Linkages between Patient Safety and Person-Centred Care in the Maternity and Obstetric Context—An Integrative Review

The aim was to evaluate the current state of knowledge pertaining to patient safety and its link to person-centred care. The international relevance of patient safety has expanded, as have the models of person-centred care. Inspired by this new trend, we collated and summarized the literature for evidence of the two topics. The study was guided by Russell, Whittemore and Knafl’s integrative review framework. An electronic database search was conducted for relevant articles from 2005 to 2016. This review was conducted in accordance with the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. The structure and process of the evaluation of the evidence are described and the findings interpreted by means of a thematic synthesis. One theme emerged: trustful, safe communication in the relationship between the patient, family members and healthcare professionals and two domains;safety culture and multidisciplinary capacity building. The dominant dimension in the safety culture domain is respectful communication, which implies sharing experiences that lead to a sense of control during labour and birth and is related to the women’s feeling of personal capacity. The dominant dimensions in the multidisciplinary capacity building domain are collaborative teamwork, coordination and risk management, knowledge sharing and patient-centred communication. In conclusion, to enhance patient safety, it is necessary to develop patient-focused, evidence-based skills and guidelines as well as a supportive organization. Due to their interaction with patients, midwives’ communication competence on the part of midwives is essential for supporting the birth and fulfilling the women’s needs and expectations.

A Literature Review: Potential Effects That Health Apps on Mobile Devices May Have on Patient Privacy and Confidentiality

Purpose: This research aims to evaluate the potential threats to patient privacy and confidentiality posed by mHealth applications on mobile devices. Methodology: A comprehensive literature review was conducted, selecting eighty-eight articles published over the past fifteen years. The study assessed data gathering and storage practices, regulatory adherence, legal structures, consent procedures, user education, and strategies to mitigate risks. Results: The findings reveal significant advancements in technologies designed to safeguard privacy and facilitate the widespread use of mHealth apps. However, persistent ethical issues related to privacy remain largely unchanged despite these technological strides.

Ethical framework for artificial intelligence in healthcare research:A path to integrity

The integration of Artificial Intelligence(AI)into healthcare research promises unprecedented advancements in medical diagnostics,treatment personalization,and patient care management.However,these innovations also bring forth significant ethical challenges that must be addressed to maintain public trust,ensure patient safety,and uphold data integrity.This article sets out to introduce a detailed framework designed to steer governance and offer a systematic method for assuring that AI applications in healthcare research are developed and executed with integrity and adherence to medical research ethics.

Wearable Healthcare and Continuous Vital Sign Monitoring with IoT Integration

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.

Study on the quality of life and the factors influencing it in elderly patients

A society of advanced age is arriving with the increasing number of elderly patients. Little attention has been paid to the quality of life of elderly patients, which is decreasing gradually. This article aims to study the quality of life among elderly patients and explore the factors influencing it, in addition to exploring effective ways to improve the quality of life of elderly patients.

Service Delivery Factors That Influence Utilization of HIV Integrated Primary Health Care Programme in Embu Referral Hospital, Kenya

Globally, there are approximately 36.7 million people living with HIV. Integration of HIV treatment with primary care services improves effectiveness, efficiency and equity in service delivery. The study sought to establish service delivery factors that influenced utilization of integrated HIV and primary health care services in Embu Teaching and Referral hospital. A descriptive cross-sectional survey design was used to collect data at a specific period and point of time from a sample of 302 seropositive clients who were selected using simple random method. Data collection tool was structured and semi-structured questionnaire. The tool was reliable at Cronbach’s alpha of 0.817. SPSS version 23 was used to analyze the data. A binary logistic regression model was used to predict the relationship between service delivery and utilization of integrated services. Results: Majority of the respondents (59.6%) were aged over 35 years with majority being female (58.9%) and the married were 57.6% of the total sample. On service delivery factors, majority (94.7%) felt that their health status had improved. Action taken when clients developed side effects, 78.8% reported that the drugs were changed. Action taken following drug side effects significantly affected utilization, χ2 = 1.305, p = 0.001, df = 1. The findings showed that waiting time significantly influenced utilization, χ2 = 9.284, df = 1, p = 0.002. Source of information on self care also significantly influenced utilization, χ2 = 10.689, df = 1, p = 0.001. Kind of treatment at the facility also significantly influenced utilization, χ2 = 5.713, p = 0.048. Conclusion: significant factors that influenced utilization of integrated services were source of health care information, secondly waiting time was another factor which influenced utilization. Majority of the respondents were satisfied with duration of time they take before they were served;they reported to take utmost 1 hour to be attended to and action taken by health care provider following side effects was another factor that influenced the utilization.

Integrated Behavioral Healthcare in Thailand:A Case Study from Chiang Mai

Purpose:This study aims to examine the level of behavioral health integration in primary care clinics among patients with hypertension and type 2 diabetes in Chiang Mai,Thailand.It also aims to explore the provider perceived prevalence of behavioral problems and need for an expert behavioral health consultant on the primary care team and the risk and protective factors of the patients’psychological and cardio-metabolic health outcomes.Methodology:Using survey data between 2017 and 2018 regarding the level of integration as measured by a Practice Integration Profile,provider ratings of prevalence and need based on a Provider Survey,and patient lifestyle and behavioral problems with a Health Risk Assessment in six primary health care settings in Chiang Mai,Thailand(n=335).We conducted ordinary least squares regressions to explore the relationship between each of the patient psychological and cardio-metabolic health outcomes and physical,mental health and substance abuse variables while controlling for the demographics.Results:The results showed overall high levels of integration,but significant variability across clinics.Providers rated prevalence of health risk and need for a Behavioral Health Consultant as moderate.Results of the patient health risk assessment were variable,with some problems high severity,others low.Conclusion:The results reflect a need for integrated behavioral health into the health care system in Thailand especially for those who are in the chronic illness condition.Recommendations for future study include an evaluation of the translation quality and validity and reliability of the study measures under the Thai context.This study fills the research gap of lacking research on the level of integrated care in clinics in Thailand.

Integrating Psychiatric Services into Comprehensive Dementia Care in the Community

Purpose: This study was conducted to clarify the utility of patient-held records as an integrated care approach for patients with dementia in the community. Method: We analyzed the family-held/patient-held records of patients with dementia in the community. The inclusion criteria in the study were as follows: 1) patient-held/family member-held records of patients with dementia in the community;2) patient-held records designed to share information across different professionals, direct-care staff members, and local government staff;and 3) the continuous participation of psychiatrists in the development and use of the patient-held records. Results: We identified eight sets of family-held/patient-held records in Japanese communities of various sizes, all of which were aimed at integrating information from various services, including information provided by medical and psychiatric professionals to the family and patient. Innovative tools have been available in the areas of the hopes and preferences of the patient, medication and monitoring, sharing information, and the use of information technology. Conclusion and Discussion: Family-held/patient-held records have potential as a tool to enhance the integrated care of people with dementia in the community.

融媒体传播下某肿瘤专科医院网站建设的实践与思考

在当今的数字化时代,医院门户网站已成为医院与患者之间的重要桥梁。门户网站的设计、开发、维护和升级对于医院的形象塑造和患者的就诊体验具有重大影响。文章结合浙江某肿瘤专科医院官网近年来实际运营经验,阐述其在患者视角下的开发理念、设计思路与实践方案,对网站访问数据进行分析讨论。数据证实,改版后的网站流量稳步上升,以手机为代表的移动类设备已逐步呈现快速上升的趋势,这与近年来移动互联网的迅猛发展是同步的。其经验表明医院网站建设应以患者视角,结合融媒体传播理论,走集群化、移动化和大数据之路。

中西医结合治疗1例高龄顽固性便秘患者的护理体会

本文总结1例高龄顽固性便秘患者的中西结合治疗和护理经验。在常规治疗的同时,依据知识转化模型(KTA),将循证指南推荐的便秘管理最佳证据进行临床实践,并依据相关中西医结合诊疗专家共识,形成基于循证的个体化中西医协同护理方案,采用中药保留灌肠软化粪石、中药离子导入促进肠蠕动、子午流注经皮穴位电刺激治疗促进气血运行,并配合营养、运动、排便等多维度护理,有效改善患者便秘症状。

医护患一体化模式在口腔癌患者术后口腔功能康复中的应用效果评价

目的:探讨医护患一体化模式在口腔癌患者术后口腔功能康复中的临床应用效果。方法:选择上海交通大学医学院附属第九人民医院2023年1—3月收治的40例口腔癌患者作为对照组,2023年4—6月收治的40例口腔癌患者作为试验组,对照组予以常规护理,试验组给予医护患一体化护理。随访3个月,比较2组患者口腔功能和心理健康情况。采用SPSS 23.0软件包对数据进行统计学分析。结果:试验组吞咽功能、言语功能得分分别为(2.20±0.90)和(76.50±9.7)分,开口度为(39±2.2)mm,对照组分别为(2.70±0.7)分、(64.57±8.2)分和(38±4.3)mm,2组比较差异均有统计学意义(P<0.05);试验组口腔卫生检查合格率、洁牙合格率、冲牙合格率分别为87.5%(35/40)、97.5%(39/40)和92.5%(37/40),对照组分别为67.5%(27/40)、57.5%(23/40)和75.0%(30/40),2组比较有统计学差异(P<0.05)。试验组焦虑、抑郁得分分别为(42.10±3.37)、(40.33±3.56)分,对照组分别为(45.26±3.27)、(46.39±3.10)分,2组比较有统计学差异(P<0.05)。结论:医护患一体化模式可促进口腔癌患者口腔功能康复,提高口腔健康状态,缓解焦虑抑郁状态,改善术后营养状况。

专病一体化护理联合协同护理模式对老年慢性心力衰竭患者的影响

目的:探讨专病一体化护理联合协同护理模式对老年慢性心力衰竭(CHF)患者的影响。方法:选取2022年2月1日~2023年2月28日收治的98例老年CHF患者作为研究对象,依据入院时间采用抽签法分为对照组和观察组各49例,对照组给予常规护理,观察组在此基础上实施专病一体化护理联合协同护理模式;比较两组入院时、出院时、出院3个月的积极度评分,护理前后生命质量[简明健康状况调查问卷(SF-36)]评分、睡眠质量(明尼苏达心力衰竭睡眠质量量表)评分、自我护理(欧洲心力衰竭自我护理行为量表)评分、汉密顿焦虑量表(HAMA)评分、汉密顿抑郁量表(HAMD)评分,护理满意度。结果:干预后,两组积极度评分逐渐提高(P<0.01),观察组出院时、出院3个月积极度评分高于对照组(P<0.01);护理后,两组生命质量评分高于护理前(P<0.05),且观察组高于对照组(P<0.01);护理后,两组睡眠质量、自我护理评分及HAMA、HAMD评分低于护理前(P<0.05),且观察组低于对照组(P<0.01);观察组护理满意度高于对照组(P<0.01)。结论:专病一体化护理联合协同护理模式能够有效改善CHF患者的不良情绪和积极度,提高睡眠质量和生命质量,提升护理满意度。

体医融合对中老年2型糖尿病患者干预效果研究

目的:研究体医融合对中老年2型糖尿病患者血糖及健康体适能干预效果,为推进体医融合提供实验依据。方法:招募43名45~65岁2型糖尿病患者,进行14周体医融合干预。分别测试干预前、干预8周、干预14周受试者的血糖、糖化血红蛋白及身体成分、最大摄氧量、握力、坐位体前屈、闭眼单足站立、选择反应时等健康体适能,并使用SPSS26.0进行数据统计分析。结果:(1)干预后男性糖尿病患者体重、BMI、脂肪重量、脂肪百分比较干预前下降(P<0.05),且干预8周与14周比较,具有统计学差异(P<0.05);女性患者上述指标干预14周较干预前下降(P<0.05)。(2)干预后糖尿病患者VO_(2)max较干预前增加(P<0.05),但干预8周与14周比较,无统计学差异(P>0.05)。(3)干预后女性握力和男性坐位体前屈,干预14周女性坐位体前屈均较干预前升高(P<0.05),干预8周男性坐位体前屈与14周比较,具有统计学差异(P<0.05)。(4)干预后糖尿病患者闭眼单足站立时间较干预前延长,男性选择反应时较干预前缩短(P<0.05),女性干预14周选择反应时与干预前比较,具有统计学差异(P<0.05)。(5)干预后糖尿病患者糖化血红蛋白及女性血糖较干预前下降(P<0.05)。结论:体医融合干预可改善中老年2型糖尿病患者血糖和健康体适能水平。

基于医护患一体化护理模式在急性淋巴细胞白血病患儿化疗期间的应用效果

目的:探讨医护患一体化护理模式在急性淋巴细胞白血病(ALL)患儿中的应用效果。方法:选择2022年1月—2023年7月在南京医科大学附属淮安第一医院收治的80例ALL患儿作为研究对象。随机将其分为对照组(常规健康教育)及观察组(在对照组基础上给予医护患一体化护理模式),各40例。比较两组护理效果、治疗依从性及家属满意度。结果:观察组护理总有效率为95.00%,高于对照组的77.50%,差异有统计学意义(P<0.05)。观察组总依从率为92.50%,高于对照组的75.00%,差异有统计学意义(P<0.05)。观察组家属满意度为95.00%,高于对照组的77.50%,差异有统计学意义(P<0.05)。结论:医护一体化护理模式在ALL患儿化疗期间,可进一步提升临床疗效及依从性,提高家属满意度。

“精诚合一”理念下《伤寒琢》辅助伤寒学课程的实践研究

目的:明晰《伤寒琢》在中医学生伤寒学课程中的教学效果。方法:在2020~2021学年第一学期,选择南京中医药大学两个同年级相同专业中医本科大三班级,分别设为对照组(n=53)及试验组(n=51),每组总课时皆为72学时,其中对照组采用传统伤寒论教学,而试验组则在传统教学基础上,适当压缩教材教学时间,在平时教学过程中融入《伤寒琢》相关教学内容。学期末课程结束后,两组分别进行考核,考核内容分为两大部分,临床标准化病人(standardized patients,SP)考核及统一试卷考试,具体为中医临床诊疗操作、医德考核及SP打分,各占总成绩20%,而试卷考试占总成绩40%;最后将2大考核部分、4个项目成绩按比例计算总成绩。结果:对照组缓考3人,试验组缓考2人。SP考核中,中医临床诊疗操作、医德考核及SP打分成绩两组差异皆有统计学意义(P<0.05),而卷面成绩无统计学差异(P>0.05)。最后两组总成绩有统计学差异(P<0.05)。结论:将《伤寒琢》内容融入中医学生伤寒学教学实践中,并不影响学生卷面成绩,且对学生的医德修养、临床诊疗水平及总体学习成绩皆有促进作用。

基于患者感知的家庭医生团队医防融合度评价研究

目的:构建患者感知的家庭医生团队服务融合度调查工具,分析医防融合服务现状。方法:通过文献检索和半结构化访谈初步构建调查工具;通过专家咨询修改和完善调查工具;实证研究验证调查工具的适用性并分析医防融合度现状。结果:构建了包括服务综合性、服务闭环、服务深度、关系连续性、以患者为中心和服务协调性共6个维度、18个条目的调查工具;患者感知家庭医生团队医防融合度总得分为(54.30±12.45)分。结论:本研究构建的调查工具为基层家庭医生团队医防融合度评估提供了患者视角。患者感知医防融合度总体水平较高,但服务协调性和深度欠佳。建议优化服务流程、明晰服务路径、细化服务管理、构建医防融合激励机制,迈向医防深度融合。

医护患一体化管理模式在神经外科躁动患者管理中的应用价值

目的探讨神经外科躁动患者管理中应用医护患一体化管理模式的临床效果。方法选取2020年10月至2021年10月收治的86例神经外科重症颅脑损伤躁动患者纳入研究。按随机数字表法分为对照组和观察组,每组43例。对照组采用常规护理,观察组采用医护患一体化管理模式,比较2组的Riker镇静和躁动评分量表(RSAS)评分、医用管道的意外拔管情况、不良事件发生率、一般自我效能感量表(GSES)评分和护理满意度。结果观察组和对照组干预后的RSAS评分分别为(1.15±0.11)分和(1.49±0.23)分,2组的RSAS评分低于干预前,且观察组的RSAS评分低于对照组(P<0.05)。观察组医用管道的意外拔管率低于对照组,差异有统计学意义(P<0.05)。观察组不良事件发生率为2.33%,低于对照组的18.60%,差异有统计学意义(P<0.05)。观察组和对照组干预后的GSES评分分别为(36.86±3.17)分和(30.75±3.13)分,2组的GSES评分高于干预前,且观察组的GSES评分高于对照组,差异有统计学意义(P<0.05)。观察组和对照组护患沟通评分分别为(3.61±0.22)分和(2.89±0.16)分,护理服务态度评分分别为(3.57±0.22)分和(2.76±0.17)分,心理干预评分分别为(3.47±0.12)分和(2.89±0.15)分,健康宣教评分分别为(3.56±0.11)分和(2.51±0.06)分,护理操作技能评分分别为(3.55±0.13)分和(2.76±0.05)分,护理满意度总评分分别为(18.12±0.15)分和(16.47±0.22)分,观察组的护理满意度评分高于对照组,差异有统计学意义(P<0.05)。结论神经外科躁动患者管理中应用医护患一体化管理模式,能有效缓解患者躁动症状,降低医用管道意外拔管和不良事件发生率,提高患者自我效能感和护理满意度。

中西医防治老年肌少症的研究进展

总结中西医防治老年肌少症的相关研究,包括西药、营养支持、运动疗法、中药、针刺、推拿、八段锦等传统特色疗法,提高肌少症患者的肌力、肌量,改善步态、日常生活能力、平衡能力,通过降低炎症反应、提高抗氧化能力、促进细胞凋亡以及蛋白合成以改善骨骼肌萎缩。营养支持及运动疗法作为老年肌少症的主要防治手段,西药治疗处于探索阶段,未被广泛推广应用。中医药治疗老年肌少症疗效确切,不良反应少,但中医药对老年肌少症的临床应用及作用机制研究不够深入,有待于进一步挖掘中医药价值,为肌少症提供更多及良好的治疗方法。

医患视角下初治中青年肺结核患者延迟重返工作成因的质性研究

目的深入了解中青年肺结核患者重返工作的成因,为制定中青年肺结核患者重返工作的支持性干预策略提供参考。方法采取现象学研究方法,于2023年5-7月在广州市某专科医院,选取10名结核科医护人员和16例中青年肺结核患者进行半结构式访谈,采用Colaizzi七步分析法分析访谈资料。结果分析得出3个主题及7个亚主题:污名化伤害(强烈的病耻感、工作被区别对待、来自同事的疏离感)、疾病相关恐惧(持续的身体不适、复发恐惧心理)、专科宣教不足(缺乏专业建议、缺乏专业科普)。结论中青年肺结核患者普遍存在延迟重返工作现象,应通过心理干预和多元化支持,帮助中青年肺结核患者在合适的阶段重返工作。