Background: Patient-reported outcome measures (PROMS) are essential tools in clinical practice and research to assess patients’ needs from their unique perspectives. They allow the healthcare team to monitor patient ...Background: Patient-reported outcome measures (PROMS) are essential tools in clinical practice and research to assess patients’ needs from their unique perspectives. They allow the healthcare team to monitor patient status and concerns outside the clinical setting. However, the real innovation in this field is its digitization: electronic patient-reported outcome measures (ePROMs). Aims: This review aimed to get an overview of whether these new technologies are being used to aid palliative care teams in their daily struggle to provide comfort to their patients. Methods: We conducted a systematic review of articles retrieved from PubMed and Web of Science, up to November 2021. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines were followed. The search strategy yielded 242 records, of which 13 met the predefined inclusion and exclusion criteria. In addition, relevant information related to ePROMs was extracted from each study. Results: Outcomes were grouped into the quality of life assessment, symptom burden and simple assessments, and the decision to introduce Palliative Cures (PC). In 61.5% of cases, ePROMs positively impacted patients’ quality of life. Furthermore, in 46.15% of cases, ePROMs led Primary Care (PC) teams to make an ethical decision;the same relative value as in the circumstances did not define the direction in ethical terms. Conclusion: Remind professionals and patients that these tools exist and can be applied in many situations. If used correctly, they can provide patients with a better quality of life and more complete information for professionals.展开更多
Background: involving patient in end of life decision is important to understand their wishes and preferences to help health care providers in improving the quality of dying and minimizing suffering. Aim: the aim of t...Background: involving patient in end of life decision is important to understand their wishes and preferences to help health care providers in improving the quality of dying and minimizing suffering. Aim: the aim of this review was to provide a detailed examination of the available literature related to patients’ involvement in decision making at end of life. Design: a systematic review following the PRISMA protocol was used, the review protocol was registered on PROSPERO: CRD42019128556. Data sources: we conducted a literature search in two electronic databases “CINAHL and Medline” during March-April 2019. The retrieved articles were included if they were: research reports or literature review;examined patient involvement in end-of-life discussions;full text publications, written in English and published from 2000-2019. Results: a total of (22) articles were included in the review;there was diversity in the purposes and design approach of the retrieved studies. The available literature explored patient’s involvement at end-of-life decision making through;describing current practices;understanding perspectives of end of life discussions;investigating the impact and identifying the barriers and facilitators of patients’ involvement in end of life discussions. Conclusion: involvement in end-of-life discussions improved the recognition of patients’ wishes, improved death experience, and decreased posttraumatic stress, depression, and anxiety among family members. Despite the documented benefits, some barriers against patient’s involvement in end-of-life decisions were recognized;lack of awareness;lack of education, training and experience;concerns about ethical and legal issues;and personal preferences of doctors or nurses were among the most commonly identified barriers.展开更多
This paper is based on an ethical analysis of 1,200 reports submitted to one of the five Regional Review Committees on Euthanasia in the Netherlands in the years 2005-09. Despite legal and professional safeguards with...This paper is based on an ethical analysis of 1,200 reports submitted to one of the five Regional Review Committees on Euthanasia in the Netherlands in the years 2005-09. Despite legal and professional safeguards with regard to euthanasia, and despite the overall high quality of care, the Dutch euthanasia practice is still not unproblematic. This paper identifies some important ethical issues： the sometimes obscure meaning of ＂patient autonomy＂; inferior quality of care or refusal to accept care, which aggravates a patient＇s suffering; insufficient spiritual, social, and psychological care; fears for a terrible death on the basis of outdated experiences in the past; and undue pressure from the side of relatives. Despite these concerns, and despite the fact that euthanasia remains a morally problematic death, however, the Dutch euthanasia practice can be described as morally solid.展开更多
伴随市场环境的复杂多变,高端装备制造业必须通过协同创新来增强技术实力及提高创新成效,其中伙伴选择是其实现创新的关键一步。首先,分析总结伙伴选择评价指标相关文献,并结合高端装备制造业协同创新发展需求,从互补性、兼容性、创新...伴随市场环境的复杂多变,高端装备制造业必须通过协同创新来增强技术实力及提高创新成效,其中伙伴选择是其实现创新的关键一步。首先,分析总结伙伴选择评价指标相关文献,并结合高端装备制造业协同创新发展需求,从互补性、兼容性、创新资源、创新能力、创新环境、声誉与信任及技术水平这7个维度,建立了高端装备制造业协同创新伙伴选择指标体系;然后,考虑到高端装备制造业的复杂性及专家评价的模糊性,在概率犹豫模糊环境下,构建基于可能度的平均解距离法(evaluation based on distance from average solution,EDAS)群决策评价模型,并将其应用到该指标体系下的协同创新伙伴选择中;最后,通过一个算例,对该研究方法加以验证,为高端装备制造业进行协同创新伙伴选择提供一定的参考。展开更多
目的系统评价终末期患者营养支持决策过程中患者、家属和医护人员的感受,为改善患者及家属决策体验提供新思路。方法计算机检索Cochrane图书馆、PubMed、Web of Science、Embase、中国知网、万方数据库、维普数据库中有关终末期患者营...目的系统评价终末期患者营养支持决策过程中患者、家属和医护人员的感受,为改善患者及家属决策体验提供新思路。方法计算机检索Cochrane图书馆、PubMed、Web of Science、Embase、中国知网、万方数据库、维普数据库中有关终末期患者营养支持决策过程、体验的质性研究或混合研究。检索时限为建库至2023年8月。基于JBI循证卫生保健中心推荐的PICoS模型确定文献,采用MAXDQA2022软件对纳入文献进行归类整合。结果共纳入10篇文献,提炼38个主题,归纳9个类别,最终形成4个整合结果:决策者的多维度思考得出结果;决策者迫切需要专业支持;决策者认知影响决策结果;决策者同样需要心理干预。结论终末期患者营养支持决策需要经过多方协商、沟通,关注决策者心理体验,必要时给予专业支持,改善患者及家属体验。展开更多
文摘Background: Patient-reported outcome measures (PROMS) are essential tools in clinical practice and research to assess patients’ needs from their unique perspectives. They allow the healthcare team to monitor patient status and concerns outside the clinical setting. However, the real innovation in this field is its digitization: electronic patient-reported outcome measures (ePROMs). Aims: This review aimed to get an overview of whether these new technologies are being used to aid palliative care teams in their daily struggle to provide comfort to their patients. Methods: We conducted a systematic review of articles retrieved from PubMed and Web of Science, up to November 2021. The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines were followed. The search strategy yielded 242 records, of which 13 met the predefined inclusion and exclusion criteria. In addition, relevant information related to ePROMs was extracted from each study. Results: Outcomes were grouped into the quality of life assessment, symptom burden and simple assessments, and the decision to introduce Palliative Cures (PC). In 61.5% of cases, ePROMs positively impacted patients’ quality of life. Furthermore, in 46.15% of cases, ePROMs led Primary Care (PC) teams to make an ethical decision;the same relative value as in the circumstances did not define the direction in ethical terms. Conclusion: Remind professionals and patients that these tools exist and can be applied in many situations. If used correctly, they can provide patients with a better quality of life and more complete information for professionals.
文摘Background: involving patient in end of life decision is important to understand their wishes and preferences to help health care providers in improving the quality of dying and minimizing suffering. Aim: the aim of this review was to provide a detailed examination of the available literature related to patients’ involvement in decision making at end of life. Design: a systematic review following the PRISMA protocol was used, the review protocol was registered on PROSPERO: CRD42019128556. Data sources: we conducted a literature search in two electronic databases “CINAHL and Medline” during March-April 2019. The retrieved articles were included if they were: research reports or literature review;examined patient involvement in end-of-life discussions;full text publications, written in English and published from 2000-2019. Results: a total of (22) articles were included in the review;there was diversity in the purposes and design approach of the retrieved studies. The available literature explored patient’s involvement at end-of-life decision making through;describing current practices;understanding perspectives of end of life discussions;investigating the impact and identifying the barriers and facilitators of patients’ involvement in end of life discussions. Conclusion: involvement in end-of-life discussions improved the recognition of patients’ wishes, improved death experience, and decreased posttraumatic stress, depression, and anxiety among family members. Despite the documented benefits, some barriers against patient’s involvement in end-of-life decisions were recognized;lack of awareness;lack of education, training and experience;concerns about ethical and legal issues;and personal preferences of doctors or nurses were among the most commonly identified barriers.
文摘This paper is based on an ethical analysis of 1,200 reports submitted to one of the five Regional Review Committees on Euthanasia in the Netherlands in the years 2005-09. Despite legal and professional safeguards with regard to euthanasia, and despite the overall high quality of care, the Dutch euthanasia practice is still not unproblematic. This paper identifies some important ethical issues： the sometimes obscure meaning of ＂patient autonomy＂; inferior quality of care or refusal to accept care, which aggravates a patient＇s suffering; insufficient spiritual, social, and psychological care; fears for a terrible death on the basis of outdated experiences in the past; and undue pressure from the side of relatives. Despite these concerns, and despite the fact that euthanasia remains a morally problematic death, however, the Dutch euthanasia practice can be described as morally solid.
文摘伴随市场环境的复杂多变,高端装备制造业必须通过协同创新来增强技术实力及提高创新成效,其中伙伴选择是其实现创新的关键一步。首先,分析总结伙伴选择评价指标相关文献,并结合高端装备制造业协同创新发展需求,从互补性、兼容性、创新资源、创新能力、创新环境、声誉与信任及技术水平这7个维度,建立了高端装备制造业协同创新伙伴选择指标体系;然后,考虑到高端装备制造业的复杂性及专家评价的模糊性,在概率犹豫模糊环境下,构建基于可能度的平均解距离法(evaluation based on distance from average solution,EDAS)群决策评价模型,并将其应用到该指标体系下的协同创新伙伴选择中;最后,通过一个算例,对该研究方法加以验证,为高端装备制造业进行协同创新伙伴选择提供一定的参考。
文摘目的系统评价终末期患者营养支持决策过程中患者、家属和医护人员的感受,为改善患者及家属决策体验提供新思路。方法计算机检索Cochrane图书馆、PubMed、Web of Science、Embase、中国知网、万方数据库、维普数据库中有关终末期患者营养支持决策过程、体验的质性研究或混合研究。检索时限为建库至2023年8月。基于JBI循证卫生保健中心推荐的PICoS模型确定文献,采用MAXDQA2022软件对纳入文献进行归类整合。结果共纳入10篇文献,提炼38个主题,归纳9个类别,最终形成4个整合结果:决策者的多维度思考得出结果;决策者迫切需要专业支持;决策者认知影响决策结果;决策者同样需要心理干预。结论终末期患者营养支持决策需要经过多方协商、沟通,关注决策者心理体验,必要时给予专业支持,改善患者及家属体验。
