The constantly expanding world wide mobility and globalization within the pediatric community puts new demands on pediatric surgical health care systems worldwide. Forcing carers to pay attention not only on their bes...The constantly expanding world wide mobility and globalization within the pediatric community puts new demands on pediatric surgical health care systems worldwide. Forcing carers to pay attention not only on their best surgical and medical performance like in the past. In contrary, they are forced to pay much more attention on psycho-medical aspects like finance, rehabilitation, socialization and integration, culture, management and logistics, health edu-cation and language skills. Then, according to our opinion these aspects should be considered as Post Traumatic Stress Disorder (PTSD)-like syndrome and treated accordingly. Then handling this problem succesfully, would be essential for the future survival of any health care system.展开更多
Evaluating care pathways, strengthening patient education, developing staff’s patient education skills, and improving collaboration between primary and special healthcare workers are all topical challenges. Successfu...Evaluating care pathways, strengthening patient education, developing staff’s patient education skills, and improving collaboration between primary and special healthcare workers are all topical challenges. Successful patient education requires seamless cooperation across organizational boundaries throughout the whole nursing process. The aim of this study is to describe participants’ experiences of development work between primary and special health care units on patient education. In this qualitative descriptive study twenty four health care workers who took part in development work in a collaborative project of special and primary health care service in northern Finland were interviewed when they had nine months’ experience of the development work. The material was analysed using content analysis. Experiences of the nature of development work were described using the following categories: attachment to development work, delight in participation, factors supporting success and challenges of development work. Improvement of co-operation between special and primary health service is a topical challenge. Participation in development work offers occupational learning opportunities. Evaluation and development of own work strengthens staff members’ occupational know-how. The results of this research may be utilized in the planning and execution of development work in the field of health care.展开更多
Whereas global medicine and health care practices have improved the quality of people's lives, especially in the developing countries data abounds that local communities have been crippled by the same medical practis...Whereas global medicine and health care practices have improved the quality of people's lives, especially in the developing countries data abounds that local communities have been crippled by the same medical practises. Some societies in developing countries have become sources of specimen for clinical trials of biomedicine which is unaffordable to their citizens. This paper explores the neglect of traditional African medicinal innovations and research in favour of imported Western medicine perpetuated by the developed countries. The paper argues that global medicine and health care have neither utilized nor recognized the African Traditional Medicine (ATM) fully, despite the fact that cultures in developed world used and continue to utilize the indigenous medical knowledge. The paper further argues that instead of neglecting African Traditional Medicine, ATM and biomedicine can be more beneficial by blending them into a single system, through what we would call in this paper High-Performance Medical Research (HPMR). This would allow participation of communities to achieve both socio-eeonomic and medical knowledge growth rather than being a monopoly and preserve of developed organizations in the North. This paper proposes that HPMR should be a systematic and scientific approach for enhancing local people's participation in the development of medical ventures. This paper draws on secondary data on traditional African therapeutic practices by some local communities in East Africa combined with literature review on medical practice in Western societies.展开更多
<strong>Introduction:</strong> Continual education is recognized worldwide as a tool for the professional development of health care practitioners. It is however effective when the training targets the app...<strong>Introduction:</strong> Continual education is recognized worldwide as a tool for the professional development of health care practitioners. It is however effective when the training targets the appropriate needs of the target beneficiaries. This study was therefore aimed at identifying priority training needs of Primary Care Level health professionals in rural Western Uganda. <strong>Methods:</strong> This was a descriptive cross-sectional survey among 35 rural community health facilities represented by their managers in rural Western Uganda. Participants were invited to Mbarara University of Science and Technology and responded to a self-administered questionnaire and also participated in qualitative group discussions guided by Facilitators from the Community Based Education and Research Services unit within the Community Health Department of Mbarara University of Science and Technology. Priority health training needs were determined based on the computed weighted scores. <strong>Results:</strong> The majority of managers of rural primary care level health facilities were medical officers by the level of training (51.43%) and male by gender (68.57%). Priority health training needs identified were child health and maternal health with total weighted scores of 12.0 and 10.9 respectively. Qualitatively, emerging themes included;leadership and management, and supervisory roles during student field attachments.<strong> Conclusion:</strong> Priority health training needs at rural Primary Care level health facilities were child health, maternal health, leadership and management, and supervisory skills. There is dire need to train rural primary care level, health professionals. In-service training based on identified needs should be offered by MUST in partnership with regional stakeholders. This is likely to enhance the quality of services provided by rural primary care level health facilities.展开更多
In this paper we reflect on the evolution of medical education, with the medical curriculum at the University of Leuven as a concrete example. Formally, the Leuven curriculum follows a bachelor's and master's ...In this paper we reflect on the evolution of medical education, with the medical curriculum at the University of Leuven as a concrete example. Formally, the Leuven curriculum follows a bachelor's and master's structure that leads to the degree of Medical Doctor after which further advanced training is required to become a practising physician. The Leuven curriculum takes the CanMEDS model as its educational framework. Embedding the CanMEDs roles within the curriculum is achieved using four learning pathways(Knowledge and Fundamentals of Medicine; Scientific Training; The Physician in Society; Skills and Communication) that run across the bachelor's and master's programmes. A stepwise approach is adopted whereby students progressively acquire the required competences to translate medical knowledge into evidence-based clinical practice. The learning process initially takes place in a simple and controlled environment, e.g. lectures or demonstrations with(simulated) patients. As the programme progresses, learning and assessment occur in ever more authentic medical situations,e.g. during the clerkships. In the future it will be important to capture new developments in e.g. education technology, health care organisation and patient involvement, and incorporate them into the medical curriculum. In this way we may fulfil our ambition to train medical doctors that are ready to participate in the 21^(st) century health care system and take their responsibility towards both the individual patient and public health care.展开更多
Sand therapy of Mongolian medicine is one of traditional Mongolian medical treatments.It conducts heat energy to the human body through natural hot sand applied on the body,achieving the effect of preventing and curin...Sand therapy of Mongolian medicine is one of traditional Mongolian medical treatments.It conducts heat energy to the human body through natural hot sand applied on the body,achieving the effect of preventing and curing disease.It is an external treatment method,characterized with easy operation,obvious curative effect and small side effects.Referring to the relevant literature of sand therapy in Mongolian medicine and combined with actual situation,the functions and use of sand therapy are summarized in this article,thereby providing theoretical basis and reference for research on sand therapy.展开更多
背景近十年来,随着医疗保健生态学模型(ecology of medical care model)应用价值的突显,该模型得到了学者们的高度关注。医疗保健生态学理论模型构建的差异与变化在一定程度上可以反映医疗模式的转变,为了解我国人群健康需求和卫生服务...背景近十年来,随着医疗保健生态学模型(ecology of medical care model)应用价值的突显,该模型得到了学者们的高度关注。医疗保健生态学理论模型构建的差异与变化在一定程度上可以反映医疗模式的转变,为了解我国人群健康需求和卫生服务利用情况提供证据基础。目的对运用医疗保健生态学模型的研究进行整合和对比,以描述使用医疗保健生态学模型建立的研究现状、对比研究方法和主要发现。方法于2022年6月,在PubMed、Ovid Medline、Web of Science、EmBase、中国生物医学文献服务系统、中国知网、万方数据知识服务平台中根据关键词、不限制语种开展检索,检索时限为1961-2022年。在Joanna Briggs Institute(JBI)概况性评价方法学手册的指导下,对文献进行筛选、信息提取,并开展描述性分析。结果共纳入符合要求的文献28篇,其中22篇(78.6%)发表于2010年以后。多数研究运用医疗保健生态学模型重点关注人群的健康需求、医疗资源利用模式,聚焦就医行为模式、疾病转诊等问题。在研究人群方面,多数研究覆盖全年龄段人群(11篇,39.3%),针对特定人群开展的研究有7篇(25.0%)。有4项研究在中国开展,均针对城市地区。相较于发达国家(地区),发展中国家(地区)研究中较少关注患者自我寻求帮助(非处方药、按摩等)情况,已有的医疗保健生态学模型反映出发展中国家(地区)具有较低的患者自报有健康问题(症状)比例,但具有更高的医院门诊就诊和急诊就诊比例。结论医疗保健生态学模型及其研究方法在过去20年间不断演进,仍然是帮助研究者和政策制定者了解医疗保健需求和医疗资源供需关系的重要工具。目前,中国对医疗保健生态学框架的应用程度不高,未来可更多地运用该模型反映卫生服务不平等和健康需求未被满足情况,并可开展群医学等领域的研究,为提高我国人群健康资源合理分配提供证据基础。展开更多
背景应对当前健康挑战需要为患者提供整合和连续性服务,初级卫生保健人员与全科医生外其他专科医务人员协作是最常见的实现途径,不同学科人员之间协作的模式及效果直接影响整合服务的提供质量,并对患者的健康结局改善至关重要。目的采...背景应对当前健康挑战需要为患者提供整合和连续性服务,初级卫生保健人员与全科医生外其他专科医务人员协作是最常见的实现途径,不同学科人员之间协作的模式及效果直接影响整合服务的提供质量,并对患者的健康结局改善至关重要。目的采用概况性评价的方法,对初级卫生保健人员与专科医务人员协作模式相关研究特征、协作模式内容、作者报告的协作模式效果进行系统梳理。方法于2022-09-03,系统检索PubMed、EmBase、Web of Science、中国知网、万方数据知识服务平台中与初级卫生保健人员和专科医务人员协作相关的文献,检索时限设定为建库至检索当日。提取纳入文献的基本特征、协作模式特征及效果。基于Mulave齿轮模型对团队协作模式进行元素分解,结合内容分析法对文献中的协作模式内容进行整合和展示。结果最终纳入与主题相关的文献420篇,其中214篇(51.0%)的研究目的为评价协作模式效果,但仅82篇(19.5%)能够提取出具体的协作方式内容。提取有限的协作模式细节信息发现,初级卫生保健人员和专科医务人员协作模式的突出特点是共同工作方式明确且正规、协作服务内容有循证指南/规范支持、在两类人员协作中有信息系统和专职协调人员的支持。82篇文献中,54篇(65.9%)文献报告了明确的效果指标,其中90.7%(49/54)的结论为协作对服务提供过程、服务利用和健康结果相关指标的改善有影响,但较高比例(90.7%,49/54)的研究报告正面效果不能排除发表偏倚的存在。结论整合型服务使用初级卫生保健人员和专科医务人员协作模式时,需要确保两类人员合作方式、工作内容的明确化,同时注重信息和协调人员的支持作用;卫生体系与政策相关干预研究应重视对干预设计细节和执行过程的描述,未来有必要对该主题研究开展方法学质量评价和Meta分析。展开更多
在我国医疗改革的大背景下,基于疾病诊断相关分组(diagnosis related groups,DRGs)付费制度的推广与实施为医疗行业带来了新的挑战与机遇。这种付费方式不仅改变了医院传统的收入模式,还对医院的绩效管理产生了深远的影响。文章旨在深...在我国医疗改革的大背景下,基于疾病诊断相关分组(diagnosis related groups,DRGs)付费制度的推广与实施为医疗行业带来了新的挑战与机遇。这种付费方式不仅改变了医院传统的收入模式,还对医院的绩效管理产生了深远的影响。文章旨在深入探讨DRGs付费制度对医院绩效管理各个方面的影响,包括医院收入结构、医疗质量提升、医疗资源的有效利用以及医疗成本控制等。经过全面而系统的分析,阐明了DRGs付费制度对医院绩效管理所带来的多重挑战。这些挑战不仅涵盖了医院收入结构的调整、医疗服务质量的提升,还涉及医疗资源的有效利用以及医疗成本的控制等方面,对医院的运营和管理提出了更高的要求。针对这些问题,文章提出了一系列对策建议,旨在帮助医院在DRGs付费制度下优化绩效管理体系,实现科学、合理的绩效管理,从而提高医院的可持续发展能力。展开更多
文摘The constantly expanding world wide mobility and globalization within the pediatric community puts new demands on pediatric surgical health care systems worldwide. Forcing carers to pay attention not only on their best surgical and medical performance like in the past. In contrary, they are forced to pay much more attention on psycho-medical aspects like finance, rehabilitation, socialization and integration, culture, management and logistics, health edu-cation and language skills. Then, according to our opinion these aspects should be considered as Post Traumatic Stress Disorder (PTSD)-like syndrome and treated accordingly. Then handling this problem succesfully, would be essential for the future survival of any health care system.
文摘Evaluating care pathways, strengthening patient education, developing staff’s patient education skills, and improving collaboration between primary and special healthcare workers are all topical challenges. Successful patient education requires seamless cooperation across organizational boundaries throughout the whole nursing process. The aim of this study is to describe participants’ experiences of development work between primary and special health care units on patient education. In this qualitative descriptive study twenty four health care workers who took part in development work in a collaborative project of special and primary health care service in northern Finland were interviewed when they had nine months’ experience of the development work. The material was analysed using content analysis. Experiences of the nature of development work were described using the following categories: attachment to development work, delight in participation, factors supporting success and challenges of development work. Improvement of co-operation between special and primary health service is a topical challenge. Participation in development work offers occupational learning opportunities. Evaluation and development of own work strengthens staff members’ occupational know-how. The results of this research may be utilized in the planning and execution of development work in the field of health care.
文摘Whereas global medicine and health care practices have improved the quality of people's lives, especially in the developing countries data abounds that local communities have been crippled by the same medical practises. Some societies in developing countries have become sources of specimen for clinical trials of biomedicine which is unaffordable to their citizens. This paper explores the neglect of traditional African medicinal innovations and research in favour of imported Western medicine perpetuated by the developed countries. The paper argues that global medicine and health care have neither utilized nor recognized the African Traditional Medicine (ATM) fully, despite the fact that cultures in developed world used and continue to utilize the indigenous medical knowledge. The paper further argues that instead of neglecting African Traditional Medicine, ATM and biomedicine can be more beneficial by blending them into a single system, through what we would call in this paper High-Performance Medical Research (HPMR). This would allow participation of communities to achieve both socio-eeonomic and medical knowledge growth rather than being a monopoly and preserve of developed organizations in the North. This paper proposes that HPMR should be a systematic and scientific approach for enhancing local people's participation in the development of medical ventures. This paper draws on secondary data on traditional African therapeutic practices by some local communities in East Africa combined with literature review on medical practice in Western societies.
文摘<strong>Introduction:</strong> Continual education is recognized worldwide as a tool for the professional development of health care practitioners. It is however effective when the training targets the appropriate needs of the target beneficiaries. This study was therefore aimed at identifying priority training needs of Primary Care Level health professionals in rural Western Uganda. <strong>Methods:</strong> This was a descriptive cross-sectional survey among 35 rural community health facilities represented by their managers in rural Western Uganda. Participants were invited to Mbarara University of Science and Technology and responded to a self-administered questionnaire and also participated in qualitative group discussions guided by Facilitators from the Community Based Education and Research Services unit within the Community Health Department of Mbarara University of Science and Technology. Priority health training needs were determined based on the computed weighted scores. <strong>Results:</strong> The majority of managers of rural primary care level health facilities were medical officers by the level of training (51.43%) and male by gender (68.57%). Priority health training needs identified were child health and maternal health with total weighted scores of 12.0 and 10.9 respectively. Qualitatively, emerging themes included;leadership and management, and supervisory roles during student field attachments.<strong> Conclusion:</strong> Priority health training needs at rural Primary Care level health facilities were child health, maternal health, leadership and management, and supervisory skills. There is dire need to train rural primary care level, health professionals. In-service training based on identified needs should be offered by MUST in partnership with regional stakeholders. This is likely to enhance the quality of services provided by rural primary care level health facilities.
文摘In this paper we reflect on the evolution of medical education, with the medical curriculum at the University of Leuven as a concrete example. Formally, the Leuven curriculum follows a bachelor's and master's structure that leads to the degree of Medical Doctor after which further advanced training is required to become a practising physician. The Leuven curriculum takes the CanMEDS model as its educational framework. Embedding the CanMEDs roles within the curriculum is achieved using four learning pathways(Knowledge and Fundamentals of Medicine; Scientific Training; The Physician in Society; Skills and Communication) that run across the bachelor's and master's programmes. A stepwise approach is adopted whereby students progressively acquire the required competences to translate medical knowledge into evidence-based clinical practice. The learning process initially takes place in a simple and controlled environment, e.g. lectures or demonstrations with(simulated) patients. As the programme progresses, learning and assessment occur in ever more authentic medical situations,e.g. during the clerkships. In the future it will be important to capture new developments in e.g. education technology, health care organisation and patient involvement, and incorporate them into the medical curriculum. In this way we may fulfil our ambition to train medical doctors that are ready to participate in the 21^(st) century health care system and take their responsibility towards both the individual patient and public health care.
基金General Scientific Research Project of Xilingol Vocational College(YB-2019-30).
文摘Sand therapy of Mongolian medicine is one of traditional Mongolian medical treatments.It conducts heat energy to the human body through natural hot sand applied on the body,achieving the effect of preventing and curing disease.It is an external treatment method,characterized with easy operation,obvious curative effect and small side effects.Referring to the relevant literature of sand therapy in Mongolian medicine and combined with actual situation,the functions and use of sand therapy are summarized in this article,thereby providing theoretical basis and reference for research on sand therapy.
文摘背景近十年来,随着医疗保健生态学模型(ecology of medical care model)应用价值的突显,该模型得到了学者们的高度关注。医疗保健生态学理论模型构建的差异与变化在一定程度上可以反映医疗模式的转变,为了解我国人群健康需求和卫生服务利用情况提供证据基础。目的对运用医疗保健生态学模型的研究进行整合和对比,以描述使用医疗保健生态学模型建立的研究现状、对比研究方法和主要发现。方法于2022年6月,在PubMed、Ovid Medline、Web of Science、EmBase、中国生物医学文献服务系统、中国知网、万方数据知识服务平台中根据关键词、不限制语种开展检索,检索时限为1961-2022年。在Joanna Briggs Institute(JBI)概况性评价方法学手册的指导下,对文献进行筛选、信息提取,并开展描述性分析。结果共纳入符合要求的文献28篇,其中22篇(78.6%)发表于2010年以后。多数研究运用医疗保健生态学模型重点关注人群的健康需求、医疗资源利用模式,聚焦就医行为模式、疾病转诊等问题。在研究人群方面,多数研究覆盖全年龄段人群(11篇,39.3%),针对特定人群开展的研究有7篇(25.0%)。有4项研究在中国开展,均针对城市地区。相较于发达国家(地区),发展中国家(地区)研究中较少关注患者自我寻求帮助(非处方药、按摩等)情况,已有的医疗保健生态学模型反映出发展中国家(地区)具有较低的患者自报有健康问题(症状)比例,但具有更高的医院门诊就诊和急诊就诊比例。结论医疗保健生态学模型及其研究方法在过去20年间不断演进,仍然是帮助研究者和政策制定者了解医疗保健需求和医疗资源供需关系的重要工具。目前,中国对医疗保健生态学框架的应用程度不高,未来可更多地运用该模型反映卫生服务不平等和健康需求未被满足情况,并可开展群医学等领域的研究,为提高我国人群健康资源合理分配提供证据基础。
文摘背景应对当前健康挑战需要为患者提供整合和连续性服务,初级卫生保健人员与全科医生外其他专科医务人员协作是最常见的实现途径,不同学科人员之间协作的模式及效果直接影响整合服务的提供质量,并对患者的健康结局改善至关重要。目的采用概况性评价的方法,对初级卫生保健人员与专科医务人员协作模式相关研究特征、协作模式内容、作者报告的协作模式效果进行系统梳理。方法于2022-09-03,系统检索PubMed、EmBase、Web of Science、中国知网、万方数据知识服务平台中与初级卫生保健人员和专科医务人员协作相关的文献,检索时限设定为建库至检索当日。提取纳入文献的基本特征、协作模式特征及效果。基于Mulave齿轮模型对团队协作模式进行元素分解,结合内容分析法对文献中的协作模式内容进行整合和展示。结果最终纳入与主题相关的文献420篇,其中214篇(51.0%)的研究目的为评价协作模式效果,但仅82篇(19.5%)能够提取出具体的协作方式内容。提取有限的协作模式细节信息发现,初级卫生保健人员和专科医务人员协作模式的突出特点是共同工作方式明确且正规、协作服务内容有循证指南/规范支持、在两类人员协作中有信息系统和专职协调人员的支持。82篇文献中,54篇(65.9%)文献报告了明确的效果指标,其中90.7%(49/54)的结论为协作对服务提供过程、服务利用和健康结果相关指标的改善有影响,但较高比例(90.7%,49/54)的研究报告正面效果不能排除发表偏倚的存在。结论整合型服务使用初级卫生保健人员和专科医务人员协作模式时,需要确保两类人员合作方式、工作内容的明确化,同时注重信息和协调人员的支持作用;卫生体系与政策相关干预研究应重视对干预设计细节和执行过程的描述,未来有必要对该主题研究开展方法学质量评价和Meta分析。
文摘在我国医疗改革的大背景下,基于疾病诊断相关分组(diagnosis related groups,DRGs)付费制度的推广与实施为医疗行业带来了新的挑战与机遇。这种付费方式不仅改变了医院传统的收入模式,还对医院的绩效管理产生了深远的影响。文章旨在深入探讨DRGs付费制度对医院绩效管理各个方面的影响,包括医院收入结构、医疗质量提升、医疗资源的有效利用以及医疗成本控制等。经过全面而系统的分析,阐明了DRGs付费制度对医院绩效管理所带来的多重挑战。这些挑战不仅涵盖了医院收入结构的调整、医疗服务质量的提升,还涉及医疗资源的有效利用以及医疗成本的控制等方面,对医院的运营和管理提出了更高的要求。针对这些问题,文章提出了一系列对策建议,旨在帮助医院在DRGs付费制度下优化绩效管理体系,实现科学、合理的绩效管理,从而提高医院的可持续发展能力。