Person-centered endoscopy safety checklist: development,implementation,and evaluation

AIM To describe the development and implementation of a person-centered endoscopy safety checklist and to evaluate the effects of a "checklist intervention".METHODS The checklist,based on previously published safety checklists,was developed and locally adapted,taking patient safety aspects into consideration and using a person-centered approach. This novel checklist was introduced to the staff of an endoscopy unit at a Stockholm University Hospital during half-day seminars and team training sessions. Structured observations of the endoscopy team's performance were conducted before and after the introduction of the checklist. In addition,questionnaires focusing on patient participation,collaboration climate,and patient safety issues were collected from patients and staff. RESULTS A person-centered safety checklist was developed and introduced by a multi-professional group in the endoscopy unit. A statistically significant increase in accurate patient identity verification by the physicians was noted(from 0% at baseline to 87% after 10 mo,P < 0.001),and remained high among nurses(93% at baseline vs 96% after 10 mo,P = nonsignificant). Observations indicated that the professional staff made frequent attempts to use the checklist,but compliance was suboptimal: All items in the observed nurse-led "summaries" were included in 56% of these interactions,and physicians participated by directly facing the patient in 50% of the interactions. On the questionnaires administered to the staff,items regarding collaboration and the importance of patient participation were rated more highly after the introduction of the checklist,but this did not result in statistical significance(P = 0.07/P = 0.08). The patients rated almost all items as very high both before and after the introduction of the checklist;hence,no statistical difference was noted.CONCLUSION The intervention led to increased patient identity verification by physicians-a patient safety improvement. Clear evidence of enhanced person-centeredness or team work was not found.

Research Progress in "Person-centered" Nursing

This paper reviews the research progress of “person-centered” nursing,and provides reference for the development of “person-centered” nursing in China.Currently,foreign scales have been developed to measure “person-centered” nursing,such as Individualized Care Scale,P-CA,Assess Health Care Providers’ Implementation of Patient-Cen,Person-centered Critical Care Nursing and Human-based Perioperative Care Scale.The “Person-centered” nursing model has been widely used in clinical nursing and nursing management.Studies have shown that “person-centered” nursing can improve patient satisfaction and promote the physical and mental health of patients.At the same time,the combination of “person-centered” nursing and teaching promotes the innovation of medical education medicine,and its combination with architecture promotes the progress of hospital construction.Future research should focus on the overall layout of hospitals and wards,use more holistic means of psychosomatic medicine to set up more comprehensive humanistic concepts such as accompanying family members area,improve the breadth and depth of humanistic nursing field,and promote the development of humanistic nursing in China.

‘Diversity Culture’in Social Services:Person-Centered Care

This article addresses the issue of‘diversity culture’in social services with the purpose of re-conceptualizing person-centered social services theory and practice.The increased participation of women,minorities,and people of different nationalities and cultures in the business world is outlining a transformation of the workforce.In parallel,there is also a diversification and heterogeneity of customers,social service users’needs,and markets and consumers’styles.The paper analyzes main groups of theories that inform social services techniques-psychological theories,cognitive behavioral theories,systemic theories,humanistic theories,and constructionist theories-with the aim of re-thinking models and practices to address the challenges that the social services are facing in responding to needs of cultural,gender,action potential,and age diversity.Specifically,social workers and the social services system are required to adapt to the changing circumstances of the social,economic,cultural and communicative environment.

Person-centered Care for Institutionalized Older Adults in the Context of the COVID-19 Pandemic in Brazil

Objective:This study aims to discuss the caregiving practices developed by Long-term Care Facilities(LTCFs)during the COVID-19 pandemic and analyze the daily care practices in long-term institutions for older adults in Brazil,all in light of the PCC framework.Methods:This is a mixed methods study in which data were collected through interviews with managers from 10 LTCFs.The qualitative discussion was carried out through the PCC framework divided into 5 categories:leisure,accommodation,food,hygiene and comfort,and clinical care.The quantitative data collected were analyzed in a descriptive way,being discussed in the light of the literature.Results:Analyzed LTCFs are unaware of our present difficulties in the implementation of PCC,with a greater presence of the traditional biomedical model being recognized.Given the vulnerabilities that the LTCFs present,PCC is an important alternative for LTCFs to promote the quality of life and autonomy of residents.Deconstructing the vision of LTCFs as a last resort of care and investing in the quality of care is an urgent and essential imperative for dignified and comprehensive care.Conclusions:This study highlights the need for a change in culture and understanding of the LTCFs not only as a place to provide healthcare,but also as a residents’home that fosters their autonomy,and feeling of belonging.Thus,it is essential to ensure that healthcare teams in LTCFs know about PCC and that further studies investigate the impact on the costs of PCC for institutionalized older adults.

A Health Service Transition to Adult Patient Care for Sickle Cell Disease

This paper explores the challenges related to long-term conditions,focusing on sickle cell disease(SCD)as a case study.Long-term conditions,characterized by the need for ongoing management,present a substantial burden on healthcare systems globally.A careful transition from pediatric to adult healthcare is needed for SCD.The discussion extends to the broader health service transition to adult patient care in SCD,emphasizing the World Health Organization’s definition of care transitions and the necessity for an integrated healthcare service.The emphasis is on a multidisciplinary approach to medical,mental health,and educational problems.A person-centered model of care should be used more consistently to resolve these long-term condition-related challenges.To evaluate the effectiveness of new interventions in improving the transition of care from pediatrics to adult patients with SCD,continuous quality improvement strategies should be implemented and prospectively measured in younger patients.In conclusion,this study highlights the critical importance of an effective transition from pediatric to adult healthcare.The continued research of effective transition practices is essential for the future and there is still a requirement to develop pragmatic approaches to enhance research on the transition to improve the quality of healthcare for patients with long-term conditions.

Significant Differences in Elderly Health between Urban and Rural Communities: A Literature Review

This study aimed to examine measures pertaining to elderly health in urban versus rural settings, and to identify differences in the health of elderly people living in urban and rural communities through a literature review. An electronic literature search was performed using PubMed for English articles published in peer-reviewed journals up to August 2018, with the following search terms: “urban”, “rural”, “comparison of community”, “elderly health”, and “comparison of community health”. A total of 35 articles were extracted for a critical full-text review, and six articles that met the inclusion criteria were subjected to analysis. Measures related to elderly health in urban and rural communities were classified into the following three categories: functional abilities, health, and health perception. Five of the six articles described functional abilities (e.g., social function) and health (e.g., mental health, depression) as categories with significant differences in elderly health between urban and rural communities. The results suggest that elderly health measures related to social function and mental health or depression are more important outcome measures of effective person-centered integrated community care systems from the perspective of community characteristics. As there were only a few articles reporting on elderly health according to differences in environment between urban and rural communities, further investigation is globally warranted.

以人为本:高等学校师资队伍建设的根本原则

以人为本的思想被广泛应用到管理、教育诸多领域。本文阐述了在高等学校师资队伍建设中的以人文本的内涵以及为何要以人为本及其如何以人为本这三个问题。

从认知发展局限到健康人格缺失——大学生自我中心的理论嬗变

在处于形式运算思维阶段的部分大学生身上,仍然可以看到明显自我中心表现.认知发展阶段理论、咨询心理学、教育学、社会文化学、发展心理学和社会心理学对此作出了各自的解释,都有其合理性,但也都存在研究视角、理论和方法的局限.因此,必须对这些理论进行整合,才能全面考察影响大学生自我中心解除困难的原因,提出行之有效的解决策略.

Healthy axis: Towards an integrated view of the gut-brain health

Despite the lack of precise mechanisms of action, a growing number of studies suggests that gut microbiota is involved in a great number of physiological functions of the human organism. In fact, the composition and the relations of intestinal microbial populations play a role, either directly or indirectly, to both the onset and development of various pathologies. In particular, the gastrointestinal tract and nervous system are closely connected by the so-called gut–brain axis, a complex bidirectional system in which the central and enteric nervous system interact with each other, also engaging endocrine, immune and neuronal circuits. This allows us to put forward new working hypotheses on the origin of some multifactorial diseases: from eating to neuropsychiatric disorders (such as autism spectrum disorders and depression) up to diabetes and tumors (such as colorectal cancer). This scenario reinforces the idea that the microbiota and its composition represent a factor, which is no longer negligible, not only in preserving what we call “health” but also in defining and thus determining it. Therefore, we propose to consider the gut-brain axis as the focus of new scientific and clinical investigation as long as the locus of possible systemic therapeutic interventions.

Longitudinal trajectories of athlete burnout among young table tennis players: A 3-wave study

Purpose:The purposes of this study were to examine the trajectories of athlete burnout across a 2-month period characterized by high physical,psychological,and social demands to explore(1)whether several subgroups of athletes representing distinct burnout trajectories emerged from the analyses and(2)whether athlete burnout symptoms(reduced accomplishment,sport devaluation,and exhaustion)developed in tandem or whether some burnout dimensions predicted downstream changes in other dimensions(causal ordering model).Methods:One hundred and fifty-nine table tennis players in intensive training centers completed a self-reported athlete burnout measure across 3 time points within a 2-month period characterized by high demands.Data were analyzed through latent class growth analysis.Results:Results of latent class growth analysis showed 3 distinct trajectories for each athlete burnout dimension,indicating not only linear or quadratic change but also stability in longitudinal athlete burnout perceptions.Results also suggested that the 3 dimensions of athlete burnout did not develop in tandem.Rather,the likelihood of belonging to particular emerging trajectories of sport devaluation and physical/emotional exhaustion was significantly influenced by the athletes’perception of reduced accomplishment assessed at Time 1.Thus,reduced accomplishment predicted downstream changes in the 2 other athlete burnout dimensions.Conclusion:As a whole,these results highlighted that the multinomial heterogeneity in longitudinal athlete burnout symptoms needs to be accounted for in future research.

Listen and talk to the older patients:a critical emancipatory reflection on the practice of communication issues

Objective: Reflection is a process of deliberating thinking and examining one's practice in the past and thereby encouraging nurses to make improvements in future care delivery. This work outlines a piece of reflection involving the practice of communication between nurses and the elderly, to emancipate the authors from their constraints, help to find values as practitioners, and gain a greater understanding of the nurse-patient relationship.Methods: Using Smyth's four-stage model as a guide, as well as empirical and theoretical knowledge on nurse-patient relationships, this paper presents a deep reflection on the relationship that the authors developed with elderly patients and their families, encountered during the practice as a nurse. By applying the four main stages consisting of describe, inform, confront, and reconstruct, this model enabled the authors to frame, describe the practice issue, and explore the meaning behind it, which helps to facilitate a structured reflection.Results: Critical emancipatory reflection, in association with the Espoused theory and Theory-in-use, as well as reflexivity, critical social theory, and hegemony, was applied to uncover the various power relationships and constraining forces in the authors' practice involved in communicating with the elderly, such as the underlying false consciousness, hegemony, hidden assumptions, influential values, and dominant power structure, which are subtle and persuasive. By applying this process of critical reflection, transformative practice could be achieved.Conclusions: The process of critical reflection facilitated the development of the abilities required to develop and maintain the nursepatient relationship. It helps to enhance the care of old patients and their families, which illuminates the future nursing practice.

Critical reflection on the role of theater nurses in a multidisciplinary team for perioperative care in China

Objective: The aim of this article is to reflect on the role of theater nurses in a multidisciplinary team, understand the factors that have influenced theater nurses' practice, and improve the authors' clinical practice ultimately.Methods: The author used Smyth's model to guide the process of reflection on the practice issue. Critical reflection, critical emancipatory theory, reflexivity, and critical social theory were used to help the author analyze the factors that have affected theater nurses' practice in the organization.Results: There are gaps between the espoused and enacted theories. A theater nurse's practice is determined by multiple factors, such as political, structural, social, historical, cultural issues, and so on. The hierarchy of the health context could hinder possible changes in theater nurses' practice. To better understand our practice and implement transformation, we should shape a supportive environment,bear in mind the practice motto of "patient-centered" care, and improve our knowledge and reflection skills.Conclusions: Reflection plays a significant role in the advancing of practice among theater nurses and needs to be combined with clinical practice. To provide the best service of care to perioperative patients, a theater nurse should have an insightful understanding of the factors that have influenced her/his behaviors historically, socially, and culturally. By improving their critical reflection skills,practitioners could gain knowledge from experience.

Functional Contentment Model: Optimizing Quality of Life for Nursing Home Residents with Dementia

The Functional Contentment Model (FCM) attains two objectives: 1) building a relationship focused plan of care for nursing home residents diagnosed with dementia;and 2) maximizing and maintaining older adults’ contentment, peace, and happiness while living in dementia care environments. There are three essential components within the FCM: 1) Person/Family Centered Care;2) Slow Medicine;and 3) Team Care Management. The principles of “Person/Family-Centered Care” are coupled with the philosophy of “Slow Medicine,” and neither can exist without the engagement of “Team Care Management.” In short, the FCM maximizes the older adult’s potential functioning in activities of daily living, cognition, gross and fine motor skills, communication, and physical well-being, while maintaining the highest possible level of contentment, peace, and happiness. This is accomplished through dynamically utilized professional modalities adapted to the changing needs of the older adult resident—pharmacologic, physical and occupational therapies, family education and involvement, dietary, spiritual, stimulating activities, as well as any individualized modality. The lead for operationalizing the Functional Contentment Model is the nursing home medical director, whose key role is assuring a team approach to care including the older adult resident, the family, and all staff (dietary, housekeeping maintenance as well as care and administrative staff). The FCM is a culture change model that has implications in practice and policy for each nursing home.

Patients’ Expectations in a Geriatric Rehabilitation Ward: Matching with Actual Outcomes

Aim: Person-centered care is a core issue in rehabilitation;the study aims at: 1) enquiring the outcome expectations of patients in a geriatric rehabilitation ward;2) matching outcome expectations with actual outcomes. Methods: Expectations of 186 patients [79.4 (8.7) years, 70% females] analyzed through a questionnaire. 80.6% of patients were discharged home;functional recovery = 17.7 (22) points in Barthel Index total score, and 5 (4.2) points in Barthel Index walking subscore;also conditions with nursing needs improved significantly. Results: Patients’ expectations were coded as: functional (31.4%), overall (29.6%), and clinical improvement (21.5%), discharge home (7%);no answers or explicit lack of expectations (7.5%). Walking ability recovery differed according to outcome expectations. Highest improvements were achieved by patients wishing clinical improvement, followed by those expecting functional or overall improvement (5 points) [p = 0.009 (Welch)/p = 0.041 (Brown- Forsythe)];worst improvement in walking ability (2.8 points) were got by patients faulting or declaring explicit failure of expectations. Conditions with nursing needs improved most in those expecting clinical improvements [p = 0.029 (Brown-Forsythe)], and less in case of expectation default. No further matching was found. Conclusions: Improvement in actual outcomes matched expected improvements in two circumstances: recovery in walking ability and in conditions with nursing needs. The high yield of different favorable outcomes may have masked the statistical significance for correspondence between actual and expected results. Special attention is worthy towards patients short of expectations, as their actual outcomes result poorer.

Contemporary Designs for Long-Term Care (LTC) Facilities

In addition to experiencing shortage in LTC workforce, some existing facilities are unable to provide quality service, since they were designed and built decades ago. Thus, the renovation of outdated LTC facilities is currently an unavoidable issue. In this paper, some contemporary practices are presented related to renovating old LTC facilities to improve the quality of service. The most important concept is the person-centered design. Some other elements include the importance of natural lighting for residents, proper practices of flooring and picking doors, some details in home-like design, new guidelines for resident rooms’ design, and other miscellaneous issues. Furthermore, the latest Americans with Disabilities Act (ADA) compliance protocols are reviewed, and some crucial elements are discussed to ensure the renovations will make the facilities compliant with the current standards.

西安市小学生中独生与非独生子女个性品质的比较研究

本文研究了西安城区１０所小学７８７名独生与非独生子女个性品质方面的情况。我们设计了有１８个行为项目的教师问卷（每项按五等评分）及家长问卷；对结果进行了因素分析，据所聚类的项目内容，将所得四个因素命名为人际关系、自我中心、学习动力和独立性，进行多变量的变异数分析结果表明，独生子女的自我中心和学习动力比非独生子女强烈；而独立性却比非独生子女差．这说明独生子女在个性品质方面既有缺点，也有优点，不能说得一无是处；关键在于正确的教育思想和方法。

以人为本——看现代饭店的企业文化

企业文化是以企业为主体的文化,它包含了物质形态和观念形态两个方面,是指企业所创造的物质财富和精神财富的总和。饭店文化是一个极富张力和弹性的概念,"以人为本"就是现代饭店企业文化的核心和灵魂。

中小学班级管理的基本内涵和具体策略

中小学班级管理是一项由学生、教师、学校三个主体多向交互的教育实践活动。在中小学班级管理的基本内涵中,坚持以学生为本是中小学班级管理的核心理念,处理师生关系和同班同学关系是中小学班级管理的主要内容,培养理想人格是中小学班级管理的根本目的。要把这些基本内涵转化为具体实践,既要坚持一切从学生出发,又要构建美丽教室。

Chinese Integrative Medicine:Translation toward PersonCentered and Balanced Medicine

Chinese integrative medicine （CIM） focuses on the integration of conventional medicine （biomedicine） with Chinese medicine （CM）. Although the CIM field has witnessed several advancements, the definition and classification of CIM is not quite clear, given that an independent theory system has not yet been established in this field. Therefore, future research and studies should focus on the following objectives： （1） emphasizing CM features, （2） improving CIM positioning, and （3） establishing CIM standards. These concerted efforts will help CIM be at par with international standards and criteria. With the development of CIM, the world will embrace a new medical system providing person-cantered treatment with a balanced medicine approach.

Reframing Palliative Care:An East-West Integrative Palliative Care Model

Convergence of principles of palliative care and integrative medicine has led to the introduction of the new practice of integrative palliative care in which integrative therapies(including mind-body modalities,traditional Chinese medicine,Ayurveda,and dietary supplements)are used to provide symptom management for patients who are dying or experiencing the sequelae of serious illness and its treatment.We propose an East-West Integrative palliative care model using non-drug therapies,such as acupuncture,diet,exercise,and stress management that shift the paradigm from suppressing the symptoms of illness to addressing both the root cause of the symptoms and the imbalance and declining homeostatic reserve that perpetuate these symptoms.This whole-person model expands the reach of palliative care,prolonging a better quality of life and allowing the patient to maintain as many activities as possible by preventing symptoms and improving function.Through this approach we reframe the dialogue such that patients are"living better"rather than"dying better"when faced with serious illness or death.In this article,we provide an overview of the principles of palliative care,integrative medicine,and the novel area of integrative palliative care,and propose an East-West integrative palliative care model that incorporates and broadens the scope of these existing approaches.