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Patient-centered care in diabetes care-concepts,relationships and practice
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作者 Tsung-Tai Chen Wei-Chih Su Mei-I Liu 《World Journal of Diabetes》 SCIE 2024年第7期1417-1429,共13页
We still do not have comprehensive knowledge of which framework of patientcentered care(PCC)is appropriate for diabetes care,which elements of PCC are evidence-based,and the mechanism by which PCC elements are associa... We still do not have comprehensive knowledge of which framework of patientcentered care(PCC)is appropriate for diabetes care,which elements of PCC are evidence-based,and the mechanism by which PCC elements are associated with outcomes through mediators.In this review,we elaborate on these issues.We found that for diabetes care,PCC elements such as autonomy support(patient individuality),cooperation and collaboration(system-level approach),communication and education(behavior change techniques),emotional support(biopsychosocial approach),and family/other involvement and support are critically important.All of these factors are directly associated with different patient outcomes and indirectly associated with outcomes through patient activation.We present the practical implications of these PCC elements. 展开更多
关键词 Diabetes mellitus patient-centered care Autonomy support Patient activation Patient adherence
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Supportive care in transplantation: A patient-centered care model to better support kidney transplant candidates and recipients
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作者 Anita Slominska Katya Loban +2 位作者 Elizabeth Anne Kinsella Julie Ho Shaifali Sandal 《World Journal of Transplantation》 2024年第4期15-28,共14页
Kidney transplantation(KT),although the best treatment option for eligible patients,entails maintaining and adhering to a life-long treatment regimen of medications,lifestyle changes,self-care,and appointments.Many pa... Kidney transplantation(KT),although the best treatment option for eligible patients,entails maintaining and adhering to a life-long treatment regimen of medications,lifestyle changes,self-care,and appointments.Many patients experience uncertain outcome trajectories increasing their vulnerability and symptom burden and generating complex care needs.Even when transplants are successful,for some patients the adjustment to life post-transplant can be challenging and psychological difficulties,economic challenges and social isola-tion have been reported.About 50%of patients lose their transplant within 10 years and must return to dialysis or pursue another transplant or conservative care.This paper documents the complicated journey patients undertake before and after KT and outlines some initiatives aimed at improving patient-centered care in transplantation.A more cohesive approach to care that borrows its philosophical approach from the established field of supportive oncology may improve patient experiences and outcomes.We propose the"supportive care in transplantation"care model to operationalize a patient-centered approach in transplantation.This model can build on other ongoing initiatives of other scholars and researchers and can help advance patient-centered care through the entire care continuum of kidney transplant recipients and candidates.Multi-dimensionality,multi-disciplinarity and evidence-based approaches are proposed as other key tenets of this care model.We conclude by proposing the potential advantages of this approach to patients and healthcare systems.Core Tip:Kidney transplant recipients and candidates face several uncertainties in their care journey and have several expressed unmet healthcare needs.We recommend a structured and comprehensive approach to transplant care across the entire continuum of a transplant patient’s journey similar to what has been developed in the field of oncology.The supportive care in transplantation model can operationalize patient-centered care and build on the efforts of other researchers in the field.We postulate that such a model would significantly improve care delivery and patients’experiences and outcomes and potentially decrease healthcare utilization and cost.INTRODUCTION Patients with kidney failure benefit from(KT)[1,2],and experience improved survival rates when compared with dialysis[3-6].KT studies,using validated instruments,have also consistently demonstrated that kidney transplant recipients(KTRs)experience better health-related quality of life and several improvements in other disease-specific domains when compared with dialysis[7].In countries where dialysis is out of reach for many,the diagnosis of kidney failure would be futile without KT[8].Thus,increasing KT has been a priority for the nephrology and transplant communities.This priority has been reflected in recent global trends:Of the 79 countries where data were available,the International Society of Nephrology’s Global Kidney Atlas reported that the prevalence of KTRs in 2023 was 279 per million population which represented an increase of 9.4%from the data published four years prior[8].Despite this growth,KT can be a challenging journey for many patients and it is sometimes regarded as a‘cure’,which does not conform with the reality that many patients experience[9-13].KTRs must maintain a life-long treatment regimen of medications,lifestyle changes,self-care and medical appointments[14-17].As poignantly stated by a young female transplant recipient,“I thought everything would change once I got my kidney.I thought I would be healthy again”but after experiencing multiple side effects of immunosuppressive medications and graft loss,she stated,“I am just a different kind of patient now”[18].Indeed,a significant proportion of patients experience graft failure and return to dialysis;it is estimated that over 50%return to dialysis within 10 years of KT[19-23].Patients are often not prepared for this outcome and report several psychosocial and physical ramifications of graft failure[24,25].Overall,high symptom burden,adverse effects of immunosuppressants,risk of graft rejection or failure and mortality,contribute to complex needs,vulnerability and uncertainties for patients,increasing their care needs and treatment burden[26-30].In this paper,we highlight the complex journey that KTRs and candidates undertake that can generate varied outcome trajectories and complex healthcare needs.We highlight the need for a comprehensive patient-centered approach to care and conclude with a proposal for a“supportive care in transplantation”care model. 展开更多
关键词 Supportive care Kidney transplantation DEATH Graft failure Adverse outcomes Kidney transplant recipients
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Factors Influencing Patient-Centered Care in the Primary Health Care Settings: The Impact of the Pandemic Crisis and Nurses’ Experience
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作者 Adepeju Lateef Euphemia Mbali Mhlongo 《Open Journal of Nursing》 2022年第3期220-233,共14页
Patient-centered care has over the past decades, been recognized worldwide as an important component of the health system giving a wider dimension to high-quality healthcare and service delivery. The impact on healthc... Patient-centered care has over the past decades, been recognized worldwide as an important component of the health system giving a wider dimension to high-quality healthcare and service delivery. The impact on healthcare and services to the patient is the nurses’ ability to create a friendly rapport with the patients. Yet, the majority in the rural Primary Health Care facilities are still facing many challenges in demonstrating patient-centeredness services to the community. Thus, the objective of this study is to explore and describe the factors influencing patient-centered care provision and nurses’ experience in Primary Health Care facilities. An exploratory qualitative approach with purposive sampling was used to gather data. Individual interviews with 35 nurses were conducted using a semi-structure interview guide question in the Primary Health Care settings in Nigeria. Each of the interviews with the nurses lasted for 25 minutes to one hour. All interviews were audio-taped, and transcribed verbatim using Microsoft Word. The transcripts were read and re-read, coded using NVivo version 12 software to organize the relevant information and categorized them into themes and sub-themes. Thematic analysis guided this study. The findings revealed three themes and sub-themes. The impact of environmental factors with two subthemes—suitable working environment and coordinated care;resources—shortage of staff and inadequate resources as sub-themes, and lastly, cultural sensitivity and religious influence—communication. Poor implementation of PCC strategies in most of the PHC facilities could lead to poor patient care and a lack of job satisfaction among nurses. This study identified that nurses have both negative and positive experience in providing patient-centered care health services. Providing patient-centered care in the Primary Health Care setting promotes the goal of achieving universal health coverage in Nigeria if the government would prioritize nurses’ pay, employ more staff, provide a conducive working environment, and opportunities for further training programs for nurses to enable and empower them with the necessary knowledge and skills. This, in turn, will translate into a range of outcomes that are socially valued, such as health responsiveness, health coverage and fairness. 展开更多
关键词 Healthcare Service NURSING Quality care Improvement Work Environment patient-centered care And Primary Health care
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Challenges for Nurses in Providing Patient-Centered Care in Rural Primary Health Care Clinics in Nigeria
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作者 Adepeju Lateef Euphemia M. Mhlongo 《Open Journal of Nursing》 2021年第9期772-793,共22页
Globally, patient-centered care has become the focus of the healthcare system. It is imperative to note that during a global pandemic crisis, patient-centered care principles seek to empower partnering approaches in P... Globally, patient-centered care has become the focus of the healthcare system. It is imperative to note that during a global pandemic crisis, patient-centered care principles seek to empower partnering approaches in Primary Health Care (PHC), and have recently gained prominence in nursing practice and applied nursing research. However, nurses are faced with challenges in achieving the desired results in the PHC system. Thus, the study aimed to explore the factors that influence PCC utilization in the PHC facilities in Nigeria. A qualitative exploratory-descriptive design was used for this study. Data collection was conducted with the nurses from PHC facilities through individual interviews. Data saturation was achieved with 35 participants from 30 PHC facilities in Osun State, Nigeria, using a purposive sampling technique. All interviews were audio-recorded, later transcribed verbatim, and analyzed using the thematic analysis approach. NVivo 12 software was used for data management. The results from this study were categorized into two factors: Organizational factors and individual factors. Six themes that emerged from the study include inadequate management support, insufficient opportunities for further training, work overload and time constraints, health personnel readiness to use PCC, dearth enthusiasm for change, and poor nurses’ Accountability. The study shows that nurses encountered diverse challenges in providing patient-centered care. To improve the quality of healthcare delivery in the PHC facilities, there is a need to reinforce adequate management support, education, continued training, and the internal motivation of nurses to achieve transformative health outcomes in the community. 展开更多
关键词 patient-centered care CHALLENGES Nurses Primary Health care Healthcare Service
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Quality in Healthcare: The New Frontier of“Patient-Centered Care Approach” in Day Clinics
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作者 Michele Di Sivo1 Claudia Balducci2 《Journal of Civil Engineering and Architecture》 2020年第3期160-167,共8页
This article aims to study methodologically hospital buildings and, in particular, the design of day clinics in the recovery area. The definition of design guidelines to improve and qualify the day clinic, enhancing t... This article aims to study methodologically hospital buildings and, in particular, the design of day clinics in the recovery area. The definition of design guidelines to improve and qualify the day clinic, enhancing their performance, takes into account the fact that the established requirements of medical protocols must be accompanied by those new requirements related to the massive evolution in health organizations. Changes in medicine, culture and society have necessarily led to a new formulation of the hospital model and the introduction of the theme of the humanization of the curing process has conditioned the morphological-space configuration and the presence of new relationships and spatial functions in the hospitals. The research of this article attempts, therefore, to explore the use of technology to improve the quality of day clinics’ design, formulating strategies that contribute on one side to facilitating the efficiency of service, and on the other side to making the user feel at ease in a welcoming and comfortable environment. 展开更多
关键词 QUALITY in healthcare DAY CLINICS patient-centered care APPROACH technology healthcare structures healthcare outcomes
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21st century critical care medicine:An overview 被引量:1
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作者 Smitesh Padte Vikramaditya Samala Venkata +3 位作者 Priyal Mehta Sawsan Tawfeeq Rahul Kashyap Salim Surani 《World Journal of Critical Care Medicine》 2024年第1期1-14,共14页
Critical care medicine in the 21st century has witnessed remarkable advancements that have significantly improved patient outcomes in intensive care units(ICUs).This abstract provides a concise summary of the latest d... Critical care medicine in the 21st century has witnessed remarkable advancements that have significantly improved patient outcomes in intensive care units(ICUs).This abstract provides a concise summary of the latest developments in critical care,highlighting key areas of innovation.Recent advancements in critical care include Precision Medicine:Tailoring treatments based on individual patient characteristics,genomics,and biomarkers to enhance the effectiveness of therapies.The objective is to describe the recent advancements in Critical Care Medicine.Telemedicine:The integration of telehealth technologies for remote patient monitoring and consultation,facilitating timely interventions.Artificial intelligence(AI):AI-driven tools for early disease detection,predictive analytics,and treatment optimization,enhancing clinical decision-making.Organ Support:Advanced life support systems,such as Extracorporeal Membrane Oxygenation and Continuous Renal Replacement Therapy provide better organ support.Infection Control:Innovative infection control measures to combat emerging pathogens and reduce healthcare-associated infections.Ventilation Strategies:Precision ventilation modes and lung-protective strategies to minimize ventilatorinduced lung injury.Sepsis Management:Early recognition and aggressive management of sepsis with tailored interventions.Patient-Centered Care:A shift towards patient-centered care focusing on psychological and emotional wellbeing in addition to medical needs.We conducted a thorough literature search on PubMed,EMBASE,and Scopus using our tailored strategy,incorporating keywords such as critical care,telemedicine,and sepsis management.A total of 125 articles meeting our criteria were included for qualitative synthesis.To ensure reliability,we focused only on articles published in the English language within the last two decades,excluding animal studies,in vitro/molecular studies,and non-original data like editorials,letters,protocols,and conference abstracts.These advancements reflect a dynamic landscape in critical care medicine,where technology,research,and patient-centered approaches converge to improve the quality of care and save lives in ICUs.The future of critical care promises even more innovative solutions to meet the evolving challenges of modern medicine. 展开更多
关键词 Critical care medicine Intensive care unit Precision medicine TELEMEDICINE Artificial intelligence Organ support SEPSIS Infection control patient-centered care
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Patient-centric periodontal research:A pioneering application of patient-reported outcome measures
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作者 Amit Arvind Agrawal 《World Journal of Clinical Cases》 SCIE 2024年第18期3281-3284,共4页
Conventional dentistry or periodontal research often ignores the human component in favor of clinical outcomes and biological causes.Clinical research is driven by the statistical significance of outcome parameters ra... Conventional dentistry or periodontal research often ignores the human component in favor of clinical outcomes and biological causes.Clinical research is driven by the statistical significance of outcome parameters rather than the satisfaction level of the patient.In this context,patient-centric periodontal research(PCPR)is an approach that considers the patient´s feedback concerning their functional status,experience,clinical outcomes,and accessibility to their treatments.It is argued that data self-reported by the patient might have low reliability owing to the confounding effect of their personal belief,cultural background,and social and economic factors.However,literature has shown that the incorporation of“patient-centric outcome”components considerably enhances the validity and applicability of research findings.Variations in the results of different studies might be due to the use of different and non-standardized assessment tools.To overcome this problem,this editorial enlists various reliable tools available in the literature.In conclusion,we advocate that the focus of researchers should shift from mere periodontal research to PCPR so that the results can be effectively applied in clinical settings and the therapeutic strategy can also change from mere periodontal therapy to patient-centric periodontal therapy. 展开更多
关键词 patient-centered care Clinical research Surrogate endpoints Quality of life Oral health Patient reported treatment outcomes
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Palliative care with adequate pain relief challenges the need for euthanasia legislation
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作者 Renald Blundell Martina Cini Kimberley Blundell 《History & Philosophy of Medicine》 2024年第2期6-13,共8页
Background:In today’s society the ongoing discussion about euthanasia triggers emotionally charged debates surrounding the delicate balance between valuing life and respecting an individual’s autonomy.With the persi... Background:In today’s society the ongoing discussion about euthanasia triggers emotionally charged debates surrounding the delicate balance between valuing life and respecting an individual’s autonomy.With the persistence of this debate,there has been the emergence of the concept of the so-called alternative:palliative care.Positioned as a substitute for euthanasia,palliative care aims to alleviate suffering in terminally ill patients without engaging in the ethical dilemmas associated with euthanasia.Methods:This paper explores the facets of palliative care highlighting its core objectives such as providing adequate pain relief as a compassionate alternative to euthanasia.Results:By examining palliative care as a comprehensive approach to end of life support,this study challenges the perceived necessity of euthanasia and advocates,for compassionate and dignified end of life experiences.Conclusion:In conclusion,palliative care emerges as a viable and ethically sound alternative to euthanasia,emphasizing the importance of compassionate end-of-life care and pain management. 展开更多
关键词 palliative care adequate pain relief euthanasia legislation end-of-life care patient-centered care policy development
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个性化护理联合CICARE沟通模式在耳鼻喉门诊患者中的应用
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作者 吕国苹 田志森 张帆 《齐鲁护理杂志》 2024年第17期29-32,共4页
目的:探讨个性化护理联合CICARE沟通模式在耳鼻喉门诊患者中的应用效果。方法:采用便利取样法将2022年6月1日~2023年12月31日就诊于耳鼻喉门诊的256例患者作为研究对象,将2022年6月1日~2023年1月31日就诊的128例作为对照组,将2023年2月1... 目的:探讨个性化护理联合CICARE沟通模式在耳鼻喉门诊患者中的应用效果。方法:采用便利取样法将2022年6月1日~2023年12月31日就诊于耳鼻喉门诊的256例患者作为研究对象,将2022年6月1日~2023年1月31日就诊的128例作为对照组,将2023年2月1日~12月31日就诊的128例作为实验组;对照组给予常规耳鼻喉门诊护理,实验组给予个性化护理联合CICARE沟通模式;比较两组护理前后护理质量、护理满意度。结果:护理后,实验组有形性感知、可靠性感知、响应性感知、保证性感知评分均高于对照组(P<0.05,P<0.01),两组移情性感知比较差异无统计学意义(P>0.05);护理后,实验组服务态度、沟通能力、就诊秩序、专业素质、护理安全、护理满意度总分均高于对照组(P<0.05,P<0.01)。结论:将个性化护理联合CICARE沟通模式应用于耳鼻喉门诊患者中,能够提高护理质量和护理满意度。 展开更多
关键词 个性化护理 CIcare沟通模式 耳鼻喉门诊
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Significant risk factors for intensive care unit-acquired weakness:A processing strategy based on repeated machine learning 被引量:9
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作者 Ling Wang Deng-Yan Long 《World Journal of Clinical Cases》 SCIE 2024年第7期1235-1242,共8页
BACKGROUND Intensive care unit-acquired weakness(ICU-AW)is a common complication that significantly impacts the patient's recovery process,even leading to adverse outcomes.Currently,there is a lack of effective pr... BACKGROUND Intensive care unit-acquired weakness(ICU-AW)is a common complication that significantly impacts the patient's recovery process,even leading to adverse outcomes.Currently,there is a lack of effective preventive measures.AIM To identify significant risk factors for ICU-AW through iterative machine learning techniques and offer recommendations for its prevention and treatment.METHODS Patients were categorized into ICU-AW and non-ICU-AW groups on the 14th day post-ICU admission.Relevant data from the initial 14 d of ICU stay,such as age,comorbidities,sedative dosage,vasopressor dosage,duration of mechanical ventilation,length of ICU stay,and rehabilitation therapy,were gathered.The relationships between these variables and ICU-AW were examined.Utilizing iterative machine learning techniques,a multilayer perceptron neural network model was developed,and its predictive performance for ICU-AW was assessed using the receiver operating characteristic curve.RESULTS Within the ICU-AW group,age,duration of mechanical ventilation,lorazepam dosage,adrenaline dosage,and length of ICU stay were significantly higher than in the non-ICU-AW group.Additionally,sepsis,multiple organ dysfunction syndrome,hypoalbuminemia,acute heart failure,respiratory failure,acute kidney injury,anemia,stress-related gastrointestinal bleeding,shock,hypertension,coronary artery disease,malignant tumors,and rehabilitation therapy ratios were significantly higher in the ICU-AW group,demonstrating statistical significance.The most influential factors contributing to ICU-AW were identified as the length of ICU stay(100.0%)and the duration of mechanical ventilation(54.9%).The neural network model predicted ICU-AW with an area under the curve of 0.941,sensitivity of 92.2%,and specificity of 82.7%.CONCLUSION The main factors influencing ICU-AW are the length of ICU stay and the duration of mechanical ventilation.A primary preventive strategy,when feasible,involves minimizing both ICU stay and mechanical ventilation duration. 展开更多
关键词 Intensive care unit-acquired weakness Risk factors Machine learning PREVENTION Strategies
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Electrochemical biosensors for point-of-care testing 被引量:1
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作者 Jinsol Kim Juho Jeong Seung Hwan Ko 《Bio-Design and Manufacturing》 SCIE EI CAS CSCD 2024年第4期548-565,共18页
Point-of-care testing(POCT)is the practice of diagnosing and monitoring diseases where the patient is located,as opposed to traditional treatment conducted solely in a medical laboratory or other clinical setting.POCT... Point-of-care testing(POCT)is the practice of diagnosing and monitoring diseases where the patient is located,as opposed to traditional treatment conducted solely in a medical laboratory or other clinical setting.POCT has been less common in the recent past due to a lack of portable medical devices capable of facilitating effective medical testing.However,recent growth has occurred in this field due to advances in diagnostic technologies,device miniaturization,and progress in wearable electronics.Among these developments,electrochemical sensors have attracted interest in the POCT field due to their high sensitivity,compact size,and affordability.They are used in various applications,from disease diagnosis to health status monitoring.In this paper we explore recent advancements in electrochemical sensors,the methods of fabricating them,and the various types of sensing mechanisms that can be used.Furthermore,we delve into methods for immobilizing specific biorecognition elements,including enzymes,antibodies,and aptamers,onto electrode surfaces and how these sensors are used in real-world POCT settings. 展开更多
关键词 Point-of-care testing(POCT) Electrochemical sensor ENZYME ANTIBODY Health care
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Guided Care护理模式对老年骨质疏松症患者自我管理能力和生活质量的影响
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作者 周晓英 袭玉荣 《中外医疗》 2024年第16期169-173,共5页
目的探讨分析Guided Care护理模式对老年骨质疏松症患者自我管理能力和生活质量的影响。方法简单随机选取2022年1月—2023年9月山东省泰安荣军医院收治的60例老年骨质疏松症患者为研究对象,按随机数表法将其分为常规组(实施常规护理干... 目的探讨分析Guided Care护理模式对老年骨质疏松症患者自我管理能力和生活质量的影响。方法简单随机选取2022年1月—2023年9月山东省泰安荣军医院收治的60例老年骨质疏松症患者为研究对象,按随机数表法将其分为常规组(实施常规护理干预),模式组(在常规组的基础上给予Guided Care护理模式干预),每组30例,两组均持续干预2个月,比较两组患者干预前后的健康认知水平、跌倒风险、自我管理能力、生活质量、护理满意度。结果干预2个月后,模式组的健康认知水平评分高于常规组,差异有统计学意义(P<0.05)。干预2个月后,模式组的跌倒风险评分低于常规组,差异有统计学意义(P<0.05)。干预2个月后,模式组的自我管理能力评分高于常规组,生活质量评分低于常规组,差异有统计学意义(P均<0.05)。干预2个月后,模式组的护理满意度为93.33%,高于常规组的护理满意度73.33%,差异有统计学意义(χ^(2)=4.320,P<0.05)。结论在老年骨质疏松症患者中,应用Guided Care护理模式,可以有效地提升患者的健康认知水平及自我管理能力,提高患者的生活质量,降低患者跌倒的风险。 展开更多
关键词 Guided care护理模式 老年骨质疏松症 自我管理能力 生活质量
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Current interventional options for palliative care for patients with advanced-stage cholangiocarcinoma 被引量:1
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作者 Maryam Makki Malak Bentaleb +3 位作者 Mohammed Abdulrahman Amal Abdulla Suhool Salem Al Harthi Marcelo AF Ribeiro Jr 《World Journal of Clinical Oncology》 2024年第3期381-390,共10页
Primary biliary tract tumors are malignancies that originate in the liver,bile ducts,or gallbladder.These tumors often present with jaundice of unknown etiology,leading to delayed diagnosis and advanced disease.Curren... Primary biliary tract tumors are malignancies that originate in the liver,bile ducts,or gallbladder.These tumors often present with jaundice of unknown etiology,leading to delayed diagnosis and advanced disease.Currently,several palliative treatment options are available for primary biliary tract tumors.They include percutaneous transhepatic biliary drainage(PTBD),biliary stenting,and surgical interventions such as biliary diversion.Systemic therapy is also commonly used for the palliative treatment of primary biliary tract tumors.It involves the administration of chemotherapy drugs,such as gemcitabine and cisplatin,which have shown promising results in improving overall survival in patients with advanced biliary tract tumors.PTBD is another palliative treatment option for patients with unresectable or inoperable malignant biliary obstruction.Biliary stenting can also be used as a palliative treatment option to alleviate symptoms in patients with unresectable or inoperable malignant biliary obstruction.Surgical interventions,such as biliary diversion,have traditionally been used as palliative options for primary biliary tract tumors.However,biliary diversion only provides temporary relief and does not remove the tumor.Primary biliary tract tumors often present in advanced stages,making palliative treatment the primary option for improving the quality of life of patients. 展开更多
关键词 CHOLANGIOCARCINOMA Palliative care Endoscopic treatment Surgery COMPLICATIONS Interventional radiology
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Continuity of Care in Primary Health Care Affecting Control of Diabetes
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作者 Raneem Alshahrani Ibtihaj Alawadh +1 位作者 Abdulelah Al Namlah Alia Hussain Zawawi 《International Journal of Clinical Medicine》 CAS 2024年第10期457-464,共8页
Background: Continuity of care is a distinguishing feature of primary care. Better continuity of care program showed a significant effect in controlling diabetes and it is complications. This study explores the effect... Background: Continuity of care is a distinguishing feature of primary care. Better continuity of care program showed a significant effect in controlling diabetes and it is complications. This study explores the effect of continuity of care on control of diabetes mellites in primary health care centres. Objectives: 1) To assess the effect of Continuity of care on controlling haemoglobin (Hb A1C) and fasting blood Sugar (FBS);2) To compare the control of Diabetes by using (Hb A1C and FBS) indices on same patient before and after application of chronic illness clinic;3) To identify the relation between age and gender affecting continuity of care in diabetic patient. Methods: It is a Prospective cohort study design. Included both gender and diabetic patient age above 24 years old. The data extracted from health care specialty center (HCSC) clinics in National guard hospital at Riyadh, through HCSC data base on three phases: 1) Phase 1: the data extracted of diabetic patients from October to November 2022 including MRN, diabetic patient, age, Hb A1C, Fasting blood glucose. 2) Phase 2: the same MRN extracted from phase 1 was extracted again retrospectively for six months from April to September 2022, to compare the indices before implanting the chronic illness clinic including Hb A1C, Fasting blood glucose. 3) Phase 3: prospectively from December 2022 to September 2023. Results: Among diabetic patients aged 60 years old and above showed better control of HbA1C and FBS comparing to these patients below age of 60 years old, with significant improvement of HbA1C after implanting chronic illness clinic. Conclusion: The significant improvement in the control of diabetic patients followed in primary health care centers reinforce the evidence of the importance of continuity of care. 展开更多
关键词 Continuity of care Primary Health care Diabetes Mellites
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Discharging patients home from the intensive care unit:A new trend
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作者 Esraa M Hassan Abbas B Jama +4 位作者 Ahmed Sharaf Asim Shaikh Mohamad El Labban Salim Surani Syed A Khan 《World Journal of Clinical Cases》 SCIE 2024年第23期5313-5319,共7页
Discharging patients directly to home from the intensive care unit(ICU)is becoming a new trend.This review examines the feasibility,benefits,challenges,and considerations of directly discharging ICU patients.By analyz... Discharging patients directly to home from the intensive care unit(ICU)is becoming a new trend.This review examines the feasibility,benefits,challenges,and considerations of directly discharging ICU patients.By analyzing available evidence and healthcare professionals'experiences,the review explores the potential impacts on patient outcomes and healthcare systems.The practice of direct discharge from the ICU presents both opportunities and complexities.While it can potentially reduce costs,enhance patient comfort,and mitigate complications linked to extended hospitalization,it necessitates meticulous patient selection and robust post-discharge support mechanisms.Implementing this strategy successfully mandates the availability of home-based care services and a careful assessment of the patient's readiness for the transition.Through critical evaluation of existing literature,this review underscores the significance of tailored patient selection criteria and comprehensive post-discharge support systems to ensure patient safety and optimal recovery.The insights provided contribute evidence-based recommendations for refining the direct discharge approach,fostering improved patient outcomes,heightened satisfaction,and streamlined healthcare processes.Ultimately,the review seeks to balance patientcentered care and effective resource utilization within ICU discharge strategies. 展开更多
关键词 Intensive care unit Critical care Early discharge Cost effective critical care Patient comfort Early recovery
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Mitigating the Prevalence of Diabetic Retinopathy in the United States: Utilization of the Chronic Care Model as a Public Health Framework
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作者 Anthony Obiyom Kamalu Austin Ebhodaghe Ekeoba +5 位作者 Emeka Canice Uzor Christian Chukwuka Duru Obinna Princewill Anyatonwu Ogemdi Emmanuel Adiele Chibuike Reginald Amuzie Chima Lawrence Odoemenam 《Open Journal of Ophthalmology》 2024年第2期103-116,共14页
As the prevalence of diabetic retinopathy continues to be on the rise, the Chronic Care Model (CCM) offers a transformative, patient-focused approach for efficient diabetic retinopathy care, emphasizing the need for u... As the prevalence of diabetic retinopathy continues to be on the rise, the Chronic Care Model (CCM) offers a transformative, patient-focused approach for efficient diabetic retinopathy care, emphasizing the need for urgent and innovative strategies in the United States. The model integrates community resources, healthcare organizations, self-management support, delivery system design, decision support, and clinical information systems. Addressing challenges and solutions, the model emphasizes proactive and preventive measures, collaborative multidisciplinary care, technological integration, and overcoming resistance to change. This paper proposes the utilization of the Chronic Care Model (CCM) as a possible public health framework for comprehensive management of diabetic retinopathy in the United States. Implementing the CCM offers a comprehensive approach to diabetic retinopathy care, addressing both individual and systemic factors, essential for improving public health outcomes. 展开更多
关键词 Chronic care Model DIABETES Diabetic Retinopathy Model Implementation Vision care
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Development of Self-Rated Nursing Record Frequency for Delirium Care of Nurses in Acute Care Hospitals (NRDC-Acute)
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作者 Katsuhiko Hattori Kenichi Matsuda 《Open Journal of Nursing》 2024年第8期412-420,共9页
Background: Nursing records play an important role in multidisciplinary collaborations in delirium care. This study aims to develop a self-rated nursing record frequency scale for delirium care among nurses in acute c... Background: Nursing records play an important role in multidisciplinary collaborations in delirium care. This study aims to develop a self-rated nursing record frequency scale for delirium care among nurses in acute care hospitals (NRDC-Acute). Methods: A draft of the scale was developed after a literature review and meeting with researchers with experience in delirium care, and a master’s or doctoral degree in nursing. We identified 25 items on a 5-point Likert scale. Subsequently, an anonymous self-administered questionnaire survey was administered to 520 nurses from 41 acute care hospitals in Japan, and the reliability and validity of the scale were examined. Results: There were 232 (44.6%) respondents and 218 (41.9%) valid responses. The mean duration of clinical experience was 15.2 years (SD = 8.8). Exploratory factor analysis extracted 4 factors and 13 items for this scale. The model fit indices were GFI = 0.991, AGFI = 0.986, and SRMR = 0.046. The Cronbach’s alpha coefficient for the entire scale was .888. The four factors were named “Record of Pharmacological Delirium Care on Pro Re Nata (PRN)”, “Record of Non-Pharmacological Delirium Care”, “Record of Pharmacological Delirium Care on Regular Medication”, and “Record of Collaboration for Delirium Care”. Conclusion: The scale was relatively reliable and valid. Nurses in acute care hospitals can use this scale to identify and address issues related to the documentation of nursing records for delirium care. 展开更多
关键词 Acute care Hospitals Delirium care Nurses Nursing Records Scale Development
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Personalized Perioperative Care for a Patient with a 10-Year-Old Postpartum Old Thrombus after Neoadjuvant Therapy for Breast Cancer
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作者 Xia Zhang 《Advances in Breast Cancer Research》 CAS 2024年第3期27-35,共9页
Breast cancer is one of the most common malignant tumors in women, and has become the main cause threatening women’s health. A case of breast cancer with neoadjuvant chemotherapy was discharged after active treatment... Breast cancer is one of the most common malignant tumors in women, and has become the main cause threatening women’s health. A case of breast cancer with neoadjuvant chemotherapy was discharged after active treatment and nursing. 展开更多
关键词 Breast Cancer Neoadjuvant Chemotherapy Personalized care
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Facilitators and barriers to parent-child communication in pediatric palliative care:An integrative review
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作者 Miao Zhang Huanhuan Li +1 位作者 Fei Li Yongai Zhang 《International Journal of Nursing Sciences》 CSCD 2024年第4期495-503,共9页
Objectives:This study aimed to identify facilitators and barriers to parent-child communication in pediatric palliative care,providing insights for medical professionals developing targeted interventions to enhance pa... Objectives:This study aimed to identify facilitators and barriers to parent-child communication in pediatric palliative care,providing insights for medical professionals developing targeted interventions to enhance parent-child communication and improve its effectiveness.Methods:Whittemore and Knafl’s integrative review method was employed to guide a systematic search for literature in six databases(Medline,Embase,CINAHL Complete,PsycINFO,Web of Science,and Cochrane Library).Peer-reviewer articles published in the English language from inception to December 2023.All of the identified studies were screened,extracted,and analyzed independently by two researchers.Results:Twenty-four articles were included.Thefindings of the relevant studies were analyzed using thematic analysis.Four themes were identified as facilitators:legacy-making,resilience training programs,guidance from the healthcare team,and positive communication.Seven themes were identified as barriers:denial,being unprepared and evasive,mutual protection,being overwhelmed by painful emotions and overloaded with information,incorrect views of medical professionals and parents,negative communication,and cultural context.Conclusions:Parents and professionals should avoid myths about protecting the child and encourage open communication that respects the child’s wishes.The specialized pediatric palliative care team should carefully monitor parent-child communication,determine if any obstacles exist,and design more interventions to enhance it. 展开更多
关键词 COMMUNICATION Palliative care Parent-child relationship PEDIATRICS REVIEW
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Unveiling significant risk factors for intensive care unit-acquired weakness:Advancing preventive care
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作者 Chun-Yao Cheng Wen-Rui Hao Tzu-Hurng Cheng 《World Journal of Clinical Cases》 SCIE 2024年第18期3288-3290,共3页
In this editorial,we discuss an article titled,“Significant risk factors for intensive care unit-acquired weakness:A processing strategy based on repeated machine learning,”published in a recent issue of the World J... In this editorial,we discuss an article titled,“Significant risk factors for intensive care unit-acquired weakness:A processing strategy based on repeated machine learning,”published in a recent issue of the World Journal of Clinical Cases.Intensive care unit-acquired weakness(ICU-AW)is a debilitating condition that affects critically ill patients,with significant implications for patient outcomes and their quality of life.This study explored the use of artificial intelligence and machine learning techniques to predict ICU-AW occurrence and identify key risk factors.Data from a cohort of 1063 adult intensive care unit(ICU)patients were analyzed,with a particular emphasis on variables such as duration of ICU stay,duration of mechanical ventilation,doses of sedatives and vasopressors,and underlying comorbidities.A multilayer perceptron neural network model was developed,which exhibited a remarkable impressive prediction accuracy of 86.2%on the training set and 85.5%on the test set.The study highlights the importance of early prediction and intervention in mitigating ICU-AW risk and improving patient outcomes. 展开更多
关键词 Intensive care unit-acquired weakness Artificial intelligence Machine learning Neural network Risk factors Prediction Critical care
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