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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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Open Journal of Nursing 2022年第3期12卷 220-233页

作者： Adepeju Lateef Euphemia Mbali Mhlongo Department of Nursing Osun State University Osogbo Nigeria School of Nursing & Public Health University of KwaZulu-Natal Durban South Africa

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 enviro

关键词： Healthcare Service Nursing Quality care Improvement Work Environment patient-centered care And Primary Health care

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21st century critical care medicine:An overview

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World Journal of Critical care Medicine 2024年第1期13卷 1-14页

作者： Smitesh Padte Vikramaditya Samala Venkata Priyal Mehta Sawsan Tawfeeq Rahul Kashyap Salim Surani Department of Research Global Remote Research Scholars ProgramSt.PaulMN 55104United States Department of Hospital Medicine Cheshire Medical Center/Dartmouth HealthKeeneNH 03431United States Department of Research WellSpan HealthYorkPA 17403United States Department of Pulmonary&Critical care Medicine Mayo ClinicRochesterMN 55905United States Department of Medicine&Pharmacology Texas A&M UniversityCollege StationTX 77843United States

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 land

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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World Journal of Clinical Cases 2024年第18期12卷 3281-3284页

作者： Amit Arvind Agrawal Department of Peridontology and Implantology Mahatma Gandhi Vidyamandir’s Karmaveer Bhausaheb Hiray Dental College and HospitalNasik 422003India

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.

关键词： patient-centered care Clinical research Surrogate endpoints Quality of life Oral health patient reported treatment outcomes

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Challenges for Nurses in Providing patient-centered care in Rural Primary Health care Clinics in Nigeria

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Open Journal of Nursing 2021年第9期11卷 772-793页

作者： Adepeju Lateef Euphemia M. Mhlongo School of Nursing and Public Health College of Health Sciences University of KwaZulu-Natal Durban South Africa

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.

关键词： patient-centered care Challenges Nurses Primary Health care Healthcare Service

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Palliative care with adequate pain relief challenges the need for euthanasia legislation

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History & Philosophy of Medicine 2024年第2期6卷 6-13页

作者： Renald Blundell Martina Cini Kimberley Blundell Department of Physiology and Biochemistry Faculty of Medicine and SurgeryUniversity of MaltaMsida MSD2080Malta Centre for Molecular Medicine and Biobanking University of MaltaMsida MSD2080Malta Faculty of Law University of MaltaMsida MSD2080Malta

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.

关键词： palliative care adequate pain relief euthanasia legislation end-of-life care patient-centered care policy development

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Psychological, social, and sexual challenges affecting men receiving male infertility treatment: a systematic review and implications for clinical care

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Asian Journal of Andrology 2023年第4期25卷 448-453页

作者： Winston Wu Justin La Kathryn M Schubach Daniel Lantsberg Darren J Katz Department of Urology Western HealthSt AlbansVIC 3021Australia Department of Urology Kaiser Permanente San Rafael Medical CenterSan RafaelCA 94903USA Men’s Health Melbourne MelbourneVIC 3000Australia Reproductive Services Unit The Royal Women’s HospitalParkvilleVIC 3052Australia Melbourne IVF East MelbourneVIC 3002Australia Department of Surgery Western PrecinctUniversity of MelbourneParkvilleVIC 3010Australia

In recent years, social research surrounding the consequences of infertility has increasingly focused on the male perspective;however, a gap exists in the understanding of men’s experiences of male infertility treatment. This review aims to synthesize theexisting evidence concerning the psychological, social, and sexual burden of male infertility treatment on men, as well as patientneeds during clinical care. A systematic search identified 12 studies that are diverse in design, setting, and methods. Psychologicalevaluations have found that urological surgery may have a lasting impact on infertility-specific stress, and treatment failure canlead to feelings of depression, grief, and inadequacy. Men tended to have an avoidant coping mechanism throughout fertilitytreatment, and their self-esteem, relationship quality, and sexual functions can be tied to outcomes of treatment. Partner bonds canbe strengthened by mutual support and enhanced communication;couple separation, however, has been noted as a predominantreason for discontinuing male infertility treatment and may be associated with difficult circumstances surrounding severe maleinfertility. Surgical treatments can affect the sexual functioning of infertile men;however, the impact of testicular sperm extractionoutcomes appears to be psychologically driven whereas the improvements after microsurgical varicocelectomy are only evident inhypogonadal men. Clinically, there is a need for better inclusion, communication, education, and resource provision, to addressreported issues of marginalization and uncertainty in men. Routine psychosocial screening in cases of severe male infertility andfollow-up in cases of surgical treatment failure are likely beneficial.

关键词： male infertility male infertility treatment patient experience patient-centered care psychosocial sexual

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Characterizing the patient experience during neoadjuvant therapy for pancreatic ductal adenocarcinoma:A qualitative study

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World Journal of Gastrointestinal Oncology 2022年第6期14卷 1175-1186页

作者： Lena Stevens Zachary J Brown Ryan Zeh Christina Monsour Sharla Wells-Di Gregorio Heena Santry Aslam M Ejaz Timothy Michael Pawlik Jordan M Cloyd Department of Surgery The Ohio State University Wexner Medical CenterColumbusOH 43210United States Department of General Surgery University of Pittsburgh Medical CenterPittsburghPA 15213United States Department of Psychiatry Center for Palliative CareThe Ohio State University Wexner Medical CenterColumbusOH 43210United States

BACKGROUND Neoadjuvant therapy(NT)has increasingly been utilized for patients with localized pancreatic ductal adenocarcinoma(PDAC).It is the recommended approach for borderline resectable(BR)and locally advanced(LA)cancers and an increasingly utilized option for potentially resectable(PR)disease.Despite its increased use,little research has focused on patient-centered metrics among patients undergoing NT,including patient experiences,preferences,and recommendations.A better understanding of all aspects of the patient experience during NT may identify opportunities to design interventions aimed at improving quality of life;it may also facilitate the completion of NT and receipt of surgery,ultimately optimizing long-term outcomes.AIM To understand the experience of patients initiating and receiving NT to identify opportunities to improve neoadjuvant cancer care delivery.METHODS Semi-structured interviews of patients with localized PDAC during NT were conducted to explore their experience initiating and receiving NT.Interviews took place between August 2020 and October 2021.Due to the descriptive nature of the research,questions were open ended.Interviews were conducted over the phone,audio recorded and then transcribed.All interviews were coded by two independent researchers using NVivo 12,iteratively identifying themes until thematic saturation was achieved.An integrative approach to qualitative analysis was used,utilizing both inductive and deductive methods.RESULTS A total of 12 patients with localized PDAC were interviewed.patients with BR(n=7),PR(n=2),and LA(n=3)cancers participated in the study.All patients indicated that choosing NT was the doctor’s recommendation,while most reported not being familiar with the concept of NT(n=11)and that NT was presented as the only option(n=8).Five themes describing the patient experience emerged:physical symptoms,emotional symptoms,coping mechanisms,access to care,and life factors.The most commonly cited recommendation for improving the experience of NT was improved educ

关键词： Pancreatic ductal adenocarcinoma Neoadjuvant therapy patient experience patient-centered care Quality of life Qualitative research

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Emperor’s syndrome in the COVID-19 era:Time for patient-centered nephrology?

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World Journal of Nephrology 2021年第1期10卷 1-7页

作者： Dimitra Bacharaki Athanasios Diamandopoulos Department of Nephrology Attikon University HospitalChaidari 12462Greece EKPA Louros Foundation for the History of MedicineChaidari 12462Greece

The coronavirus disease-19(COVID-19)pandemic has been a wake-up call in which has forced us to react worldwide.Health policies and practices have attracted particular attention in terms of human and financial cost.Before COVID-19,chronic kidney disease was already considered a risk multiplier in patients with diabetes and hypertension,the two now being the major risk factors for COVID-19 infection and adverse outcome.In contrast to the urgent need for action,the nephrology field is considered to be in a state of stagnation regarding the management of chronic kidney disease patients who still experience unacceptably high morbidity and mortality.Ironically and paradoxically in a field lacking robust clinical trials,clinical practice is driven by guidelines-based medicine on weak evidence.The Emperor’s syndrome,referring to Hans Christian Andersen’s fairy tale,has been described in medicine as voluntary blindness to an obvious truth,being a weak evidence-based therapeutic intervention or weak health care.A promising positive example of improving heart and kidney outcomes is the emerging treatment with sodium-glucose cotransporter 2 inhibitors.COVID-19 could boost actions for patient-centered care as a positive shift in nephrology care.

关键词： Emperor’s syndrome Chronic kidney disease Guidelines-based medicine patient-centered care COVID-19 Evidence-based medicine

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Prenatal radiographic evaluation of congenital transverse limb deficiencies:A scoping review

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World Journal of Orthopedics 2023年第3期14卷 155-165页

作者： Neeraj Vij Luis F Goncalves Aaron Llanes Sean Youn Mohan V Belthur Department of Orthopedic Surgery Phoenix Children’s HospitalPhoenixAZ 85016United States Department of Radiology Phoenix Children's HospitalPhoenixAZ 85016United States Department of Orthopedics University of Arizona College of Medicine-PhoenixPhoenixAZ 85004United States

BACKGROUND Congenital transverse deficiencies are horizontal deficiencies of the long bones that occur with a reported incidence as high 0.38%.They can occur alone or represent a manifestation of a various clinical syndromes.Diagnosis has tradi-tionally comprised of conventional radiography and prenatal imaging studies.There has been much advancement regarding prenatal imaging modalities to allow for early diagnosis and appropriate treatment.AIM To summarize the current state of knowledge on congenital transverse limb deficiencies and to provide an update regarding the radiographic evaluation of congenital transverse limb deficiencies.METHODS This IRB-exempt scoping review followed the PRISMA-ScR checklist for scoping reviews strictly.Five search engines were searched for a total of 265 publications.Four authors reviewed these during the screening process.Of these,51 studies were included in our article.Prenatal magnetic resonance imaging(MRI),3D Ultrasound,and multidetector Computed tomography(CT)exist are emerging modalities that have the potential to improve diagnosis.RESULTS Use of the appropriate classification system,three-dimensional ultrasonography with a maximum intensity projection,and appropriate use of prenatal MRI and prenatal CT can improve diagnosis and inter-provider communication.CONCLUSION Further scholarly efforts are required to develop improve standardized guidelines regarding the pre-natal radiographic evaluation of congenital limb deficiencies.

关键词： Terminal deficiencies Roentgenographic evaluation Pediatric skeletal deficiencies Early diagnosis patient-centered care Prenatal imaging©The Author(s)2023.Published by Baishideng Publishing Group Inc.All rights reserved.

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

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World Journal of Gastroenterology 2017年第48期23卷 8605-8614页

作者： Hanna Dubois Peter T Schmidt Johan Creutzfeldt Mia Bergenmar Center for Digestive Diseases Karolinska University Hospital Center for Advanced Medical Simulation and Training Karolinska University Hospital Department of Medicine Karolinska Institutet Department of Perioperative Medicine and Intensive care Karolinska University Hospital Department of Clinical Science Intervention and Technology(CLINTEC)Karolinska Institutet Department of Oncology-Pathology Karolinska Institutet

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 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 fo

关键词： Checklist Communication Endoscopy Observation patient-centered care Person-centered care patient safety Teamwork

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