The objective of this study is to clarify the relevance of qualitative research in the context of critical care and renal dialysis requires using narrative sources. Also specific objectives are to identify the phases ...The objective of this study is to clarify the relevance of qualitative research in the context of critical care and renal dialysis requires using narrative sources. Also specific objectives are to identify the phases or cultural moments that are distinguished in these processes. Research Question: How can the narrative materials contribute to the study of the processes of critical care and/or qualitative research in nephrology? Method and Sources: There have been studies focusing on the narrative of patients who have written their experiences building a literature experience ill (Siles et al., 1997, 1999, 2000). Sources have been used to extract testimony retrospective autobiographies written by people who have experienced the experiences of different diseases (Allué, 1996, 1997, Zorn, 1991, Gilbert, 1993;Comas, 2009;Gracia Armendáriz, 2010;Sampedro, 1996, Sacks, 2010). The analysis was developed by categorizing units of meaning, meaning families and networks. To identify the cultural moments we have followed the criteria established by Siles and Solano (2009): Multiculturalism, interculturalism and transculturalism. To identify rites of passage and liminality states have followed the principles outlined by Van Gennep (2013) and Turner (1990, 2008). Results: We identified cultural moments and characteristic states of liminality in critical care and kidney. Conclusions: narrative sources are effective for analyzing the meanings and experiences of patients in critical care and nephrology tool.展开更多
Bettering orphan rescue and assistance policies and improving the upbringing of orphans have been top on the agenda of China＇s civil affairs departments in 2006. A survey conducted by the Ministry of Civil Affairs in...Bettering orphan rescue and assistance policies and improving the upbringing of orphans have been top on the agenda of China＇s civil affairs departments in 2006. A survey conducted by the Ministry of Civil Affairs in 2005 shows that one-third of the country＇s 573,＇30 orphans do not receive regular, system-guaranteed help. Some orphans have been forced to drop out of school and lead a vagrant life, Some have even become petty thieves.展开更多
BACKGROUND Addressing the growing challenge of hospitalizing chronic multimorbid patients,this study examines the strain these conditions impose on healthcare systems at a local level,focusing on a pilot program.Chron...BACKGROUND Addressing the growing challenge of hospitalizing chronic multimorbid patients,this study examines the strain these conditions impose on healthcare systems at a local level,focusing on a pilot program.Chronic diseases and complex patients require comprehensive management strategies to reduce healthcare burdens and improve patient outcomes.If proven effective,this pilot model has the potential to be replicated in other healthcare settings to enhance the management of chronic multimorbid patients.AIM To evaluate the effectiveness of the high complexity unit(HCU)in managing chronic multimorbid patients through a multidisciplinary care model and to compare it with standard hospital care.METHODS The study employed a descriptive longitudinal approach,analyzing data from the Basic Minimum Data Set(BMDS)to compare hospitalization variables among the HCU,the Internal Medicine Service,and other services at Antequera Hospital throughout 2022.The HCU,designed for patients with complex chronic conditions,integrates a patient-centered model emphasizing multidisciplinary care and continuity post-discharge.RESULTS The study employed a descriptive longitudinal approach,analyzing data from the BMDS to compare hospitalization variables among the HCU,the Internal Medicine Service,and other services at Antequera Hospital throughout 2022.The HCU,designed for patients with complex chronic conditions,integrates a patient-centered model emphasizing multidisciplinary care and continuity post-discharge.CONCLUSION This study demonstrates the effectiveness of the HCU in managing patients with complex chronic diseases through a multidisciplinary approach.The coordinated care provided by the HCU results in improved patient outcomes,reduced unnecessary hospitalizations,and better management of patient complexity.The superiority of the HCU compared to standard care is evident in key outcomes such as fewer readmissions and higher patient satisfaction,reinforcing its value as a model of care to be replicated.展开更多
Kawasaki disease(KD)is a significant pediatric vasculitis known for its potential to cause severe coronary artery complications.Despite the effectiveness of initial treatments,such as intravenous immunoglobulin,KD pat...Kawasaki disease(KD)is a significant pediatric vasculitis known for its potential to cause severe coronary artery complications.Despite the effectiveness of initial treatments,such as intravenous immunoglobulin,KD patients can experience long-term cardiovascular issues,as evidenced by a recent case report of an adult who suffered a ST-segment elevation myocardial infarction due to previous KD in the World Journal of Clinical Cases.This editorial emphasizes the critical need for long-term management and regular surveillance to prevent such complications.By drawing on recent research and case studies,we advocate for a structured approach to follow-up care that includes routine cardiac evaluations and preventive measures.展开更多
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
Shen et al’s retrospective study aims to compare the utility of two separate scoring systems for predicting mortality attributable to gastrointestinal(GI)injury in critically ill patients[the GI Dysfunction Score(GID...Shen et al’s retrospective study aims to compare the utility of two separate scoring systems for predicting mortality attributable to gastrointestinal(GI)injury in critically ill patients[the GI Dysfunction Score(GIDS)and the Acute Gastroin-testinal Injury(AGI)grade].The authors note that this study is the first proposal that suggests an equivalence between the ability of both scores to predict mor-tality at 28 days from intensive care unit(ICU)admission.Shen et al retrospec-tively analysed an ICU cohort of patients utilising two physicians administering both the AGI grade and GIDS score,using electronic healthcare records and ICU flowsheets.Where these physicians disagreed about the scores,the final decision as to the scores was made by an associate chief physician,or chief physician.We note that the primary reason for the development of GIDS was to create a clear score for GI dysfunction,with minimal subjectivity or inter-operator variability.The subjectivity inherent to the older AGI grading system is what ultimately led to the development of GIDS in 2021.By ensuring consensus between physicians administering the AGI,Shen et al have controlled for one of this grading systems biggest issues.We have concerns,however,that this does not represent the real-world challenges associated with applying the AGI compared to the newer GIDS,and wonder if this arbitration process had not been instituted,would the two scoring systems remain equivalent in terms of predicted mortality?展开更多
BACKGROUND Endoscopic submucosal dissection(ESD)has become a widely accepted,minimally invasive treatment for gastrointestinal submucosal tumors.It has been reported that humanistic nursing care with graded psychologi...BACKGROUND Endoscopic submucosal dissection(ESD)has become a widely accepted,minimally invasive treatment for gastrointestinal submucosal tumors.It has been reported that humanistic nursing care with graded psychological interventions can effectively enhance patients’physical activity in patients,reduce postoperative complications,and improve their postoperative quality of life.AIM To investigate the effects of combining humanistic care with graded psychological support on nursing satisfaction and quality of life in patients undergoing ESD for gastrointestinal submucosal tumors.METHODS A retrospective analysis was conducted on the clinical data of 180 patients who underwent ESD surgery for gastrointestinal submucosal tumors at our hospital between March 2021 and February 2023.Patients were allocated into groups based on the nursing care they received:The control group,which received routine care(n=90),and the observation group,which was subjected to humanistic nursing care in combination with graded psychological support(n=90).Patient anxiety and depression were assessed using the self-rating anxiety scale(SAS)and self-rating depression scale(SDS).Quality of life was evaluated using the shortform 36 health survey,and additional indications such as time to first food intake,surgery duration,length of hospital stay,nursing satisfaction,and adverse reactions were also recorded.Data was analyzed using SPSS22.0,with t-tests employed for continuous variables andχ2 tests for categorical data.RESULTS Patients in the observation group experienced significantly shorter times to first postoperative meal,surgery,and hospital stay compared to the control group.After the intervention,the SAS score of the observation group was 43.17±5.68,and the SDS score was 41.57±6.52,both significantly lower than those of the control group,with SAS score of 52.38±5.21 and SDS score of 51.23±8.25.In addition,the observation group scored significantly higher in daily living,physical function,psychological well-being,and social functioning(80.01±6.39,83.59±6.89,81.69±5.34,and 85.23±6.05,respectively).Moreover,the observation group also exhibited higher satisfaction and selfefficacy scores and a lower incidence of adverse reactions compared to the control group(P<0.05).CONCLUSION For patients undergoing ESD for gastrointestinal submucosal tumors,humanistic nursing care in combination with graded psychological nursing care significantly shorten the times to first postoperative meal,surgery,and hospital stay,effectively alleviates anxiety and depression,improves quality of life and nursing satisfaction,and mitigate the incidence of adverse reactions.展开更多
Gertrude Nyathi walks calmly into Zimbabwe’s Mahusekwa Hospital for antenatal care in Mashonaland,where she is expected to give birth in the next five months.In a country where medical facilities are obsolete,patient...Gertrude Nyathi walks calmly into Zimbabwe’s Mahusekwa Hospital for antenatal care in Mashonaland,where she is expected to give birth in the next five months.In a country where medical facilities are obsolete,patients flock to seek medical care at the Chinese-aided hospital,seen by many as a game changer in Marondera district.展开更多
Objective:To explore the perspectives of high-risk pregnant women regarding the home care program for high-risk pregnancies.Methods:This qualitative study was conducted in a university hospital and 5 comprehensive hea...Objective:To explore the perspectives of high-risk pregnant women regarding the home care program for high-risk pregnancies.Methods:This qualitative study was conducted in a university hospital and 5 comprehensive health centers in Ahvaz,Iran,from February 2023 to July 2023.The sampling method used was purposive sampling considering the maximum possible diversity,which continued until data saturation.11 in-depth and semistructured interviews were conducted with high-risk pregnant women.Data were simultaneously analysed using Graneheim and Lundman content analysis by MAXQDA version 20 software.Results:Data analysis extracted 3 themes,12 categories,and 26 subcategories.The themes and categories were“high-risk pregnancy and related issues(pursuing treatment and paying attention to the high-risk situation by pregnant women,psychological aspect of high-risk pregnancy on pregnant women and caregivers,emotional and physical aspects of high-risk pregnancy,the consequences of high-risk pregnancy on the people around them and empowerment of high-risk pregnant women)”,“support dimension(family and community support for high-risk pregnant women)”,and“framework of program(acculturalization,means and equipment,security,manpower and the necessary arrangements for the home care)”.Conclusions:High-risk pregnancy affects various aspects of the lives of high-risk pregnant women and their families.Creating the necessary conditions for providing care at home plays a vital role in supporting high-risk pregnant women and removing related obstacles to receiving prenatal care in person.It will be especially beneficial for high-risk pregnant women in low-income areas.展开更多
文摘The objective of this study is to clarify the relevance of qualitative research in the context of critical care and renal dialysis requires using narrative sources. Also specific objectives are to identify the phases or cultural moments that are distinguished in these processes. Research Question: How can the narrative materials contribute to the study of the processes of critical care and/or qualitative research in nephrology? Method and Sources: There have been studies focusing on the narrative of patients who have written their experiences building a literature experience ill (Siles et al., 1997, 1999, 2000). Sources have been used to extract testimony retrospective autobiographies written by people who have experienced the experiences of different diseases (Allué, 1996, 1997, Zorn, 1991, Gilbert, 1993;Comas, 2009;Gracia Armendáriz, 2010;Sampedro, 1996, Sacks, 2010). The analysis was developed by categorizing units of meaning, meaning families and networks. To identify the cultural moments we have followed the criteria established by Siles and Solano (2009): Multiculturalism, interculturalism and transculturalism. To identify rites of passage and liminality states have followed the principles outlined by Van Gennep (2013) and Turner (1990, 2008). Results: We identified cultural moments and characteristic states of liminality in critical care and kidney. Conclusions: narrative sources are effective for analyzing the meanings and experiences of patients in critical care and nephrology tool.
文摘Bettering orphan rescue and assistance policies and improving the upbringing of orphans have been top on the agenda of China＇s civil affairs departments in 2006. A survey conducted by the Ministry of Civil Affairs in 2005 shows that one-third of the country＇s 573,＇30 orphans do not receive regular, system-guaranteed help. Some orphans have been forced to drop out of school and lead a vagrant life, Some have even become petty thieves.
基金Supported by Fundación Progreso y Salud,No.AP-0306-2022-C3-F2.
文摘BACKGROUND Addressing the growing challenge of hospitalizing chronic multimorbid patients,this study examines the strain these conditions impose on healthcare systems at a local level,focusing on a pilot program.Chronic diseases and complex patients require comprehensive management strategies to reduce healthcare burdens and improve patient outcomes.If proven effective,this pilot model has the potential to be replicated in other healthcare settings to enhance the management of chronic multimorbid patients.AIM To evaluate the effectiveness of the high complexity unit(HCU)in managing chronic multimorbid patients through a multidisciplinary care model and to compare it with standard hospital care.METHODS The study employed a descriptive longitudinal approach,analyzing data from the Basic Minimum Data Set(BMDS)to compare hospitalization variables among the HCU,the Internal Medicine Service,and other services at Antequera Hospital throughout 2022.The HCU,designed for patients with complex chronic conditions,integrates a patient-centered model emphasizing multidisciplinary care and continuity post-discharge.RESULTS The study employed a descriptive longitudinal approach,analyzing data from the BMDS to compare hospitalization variables among the HCU,the Internal Medicine Service,and other services at Antequera Hospital throughout 2022.The HCU,designed for patients with complex chronic conditions,integrates a patient-centered model emphasizing multidisciplinary care and continuity post-discharge.CONCLUSION This study demonstrates the effectiveness of the HCU in managing patients with complex chronic diseases through a multidisciplinary approach.The coordinated care provided by the HCU results in improved patient outcomes,reduced unnecessary hospitalizations,and better management of patient complexity.The superiority of the HCU compared to standard care is evident in key outcomes such as fewer readmissions and higher patient satisfaction,reinforcing its value as a model of care to be replicated.
文摘Kawasaki disease(KD)is a significant pediatric vasculitis known for its potential to cause severe coronary artery complications.Despite the effectiveness of initial treatments,such as intravenous immunoglobulin,KD patients can experience long-term cardiovascular issues,as evidenced by a recent case report of an adult who suffered a ST-segment elevation myocardial infarction due to previous KD in the World Journal of Clinical Cases.This editorial emphasizes the critical need for long-term management and regular surveillance to prevent such complications.By drawing on recent research and case studies,we advocate for a structured approach to follow-up care that includes routine cardiac evaluations and preventive measures.
文摘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.
文摘Shen et al’s retrospective study aims to compare the utility of two separate scoring systems for predicting mortality attributable to gastrointestinal(GI)injury in critically ill patients[the GI Dysfunction Score(GIDS)and the Acute Gastroin-testinal Injury(AGI)grade].The authors note that this study is the first proposal that suggests an equivalence between the ability of both scores to predict mor-tality at 28 days from intensive care unit(ICU)admission.Shen et al retrospec-tively analysed an ICU cohort of patients utilising two physicians administering both the AGI grade and GIDS score,using electronic healthcare records and ICU flowsheets.Where these physicians disagreed about the scores,the final decision as to the scores was made by an associate chief physician,or chief physician.We note that the primary reason for the development of GIDS was to create a clear score for GI dysfunction,with minimal subjectivity or inter-operator variability.The subjectivity inherent to the older AGI grading system is what ultimately led to the development of GIDS in 2021.By ensuring consensus between physicians administering the AGI,Shen et al have controlled for one of this grading systems biggest issues.We have concerns,however,that this does not represent the real-world challenges associated with applying the AGI compared to the newer GIDS,and wonder if this arbitration process had not been instituted,would the two scoring systems remain equivalent in terms of predicted mortality?
文摘BACKGROUND Endoscopic submucosal dissection(ESD)has become a widely accepted,minimally invasive treatment for gastrointestinal submucosal tumors.It has been reported that humanistic nursing care with graded psychological interventions can effectively enhance patients’physical activity in patients,reduce postoperative complications,and improve their postoperative quality of life.AIM To investigate the effects of combining humanistic care with graded psychological support on nursing satisfaction and quality of life in patients undergoing ESD for gastrointestinal submucosal tumors.METHODS A retrospective analysis was conducted on the clinical data of 180 patients who underwent ESD surgery for gastrointestinal submucosal tumors at our hospital between March 2021 and February 2023.Patients were allocated into groups based on the nursing care they received:The control group,which received routine care(n=90),and the observation group,which was subjected to humanistic nursing care in combination with graded psychological support(n=90).Patient anxiety and depression were assessed using the self-rating anxiety scale(SAS)and self-rating depression scale(SDS).Quality of life was evaluated using the shortform 36 health survey,and additional indications such as time to first food intake,surgery duration,length of hospital stay,nursing satisfaction,and adverse reactions were also recorded.Data was analyzed using SPSS22.0,with t-tests employed for continuous variables andχ2 tests for categorical data.RESULTS Patients in the observation group experienced significantly shorter times to first postoperative meal,surgery,and hospital stay compared to the control group.After the intervention,the SAS score of the observation group was 43.17±5.68,and the SDS score was 41.57±6.52,both significantly lower than those of the control group,with SAS score of 52.38±5.21 and SDS score of 51.23±8.25.In addition,the observation group scored significantly higher in daily living,physical function,psychological well-being,and social functioning(80.01±6.39,83.59±6.89,81.69±5.34,and 85.23±6.05,respectively).Moreover,the observation group also exhibited higher satisfaction and selfefficacy scores and a lower incidence of adverse reactions compared to the control group(P<0.05).CONCLUSION For patients undergoing ESD for gastrointestinal submucosal tumors,humanistic nursing care in combination with graded psychological nursing care significantly shorten the times to first postoperative meal,surgery,and hospital stay,effectively alleviates anxiety and depression,improves quality of life and nursing satisfaction,and mitigate the incidence of adverse reactions.
文摘Gertrude Nyathi walks calmly into Zimbabwe’s Mahusekwa Hospital for antenatal care in Mashonaland,where she is expected to give birth in the next five months.In a country where medical facilities are obsolete,patients flock to seek medical care at the Chinese-aided hospital,seen by many as a game changer in Marondera district.
文摘Objective:To explore the perspectives of high-risk pregnant women regarding the home care program for high-risk pregnancies.Methods:This qualitative study was conducted in a university hospital and 5 comprehensive health centers in Ahvaz,Iran,from February 2023 to July 2023.The sampling method used was purposive sampling considering the maximum possible diversity,which continued until data saturation.11 in-depth and semistructured interviews were conducted with high-risk pregnant women.Data were simultaneously analysed using Graneheim and Lundman content analysis by MAXQDA version 20 software.Results:Data analysis extracted 3 themes,12 categories,and 26 subcategories.The themes and categories were“high-risk pregnancy and related issues(pursuing treatment and paying attention to the high-risk situation by pregnant women,psychological aspect of high-risk pregnancy on pregnant women and caregivers,emotional and physical aspects of high-risk pregnancy,the consequences of high-risk pregnancy on the people around them and empowerment of high-risk pregnant women)”,“support dimension(family and community support for high-risk pregnant women)”,and“framework of program(acculturalization,means and equipment,security,manpower and the necessary arrangements for the home care)”.Conclusions:High-risk pregnancy affects various aspects of the lives of high-risk pregnant women and their families.Creating the necessary conditions for providing care at home plays a vital role in supporting high-risk pregnant women and removing related obstacles to receiving prenatal care in person.It will be especially beneficial for high-risk pregnant women in low-income areas.
