Objective To assess the effectiveness of the course of “Being a Friend with Patients”. Methods There were three parts in this course: (1) To experience what the empathy was, by counseling activities; (2) To accompany patients in hospital; (3) To share the experience after accompanying. There were 118 participants who were freshmen at the end of 2005. Results and Conclusions According to feedback from the students, they understand empathy and how the patients feel after the counseling. The course is accepted by all students. It may help students to be more attentive to and concerned about their patients, and to provied help for them.
“Patient profile” is a specific application of user profile technology in the field of healthcare. As an emerging means of integrating health information, it provides personalized and precise health management for patients by analyzing multidimensional health data, improving health management effectiveness, reducing medical costs, and increasing their satisfaction and participation. It has broad application prospects in the field of nursing, but the current research status of its application in the field of nursing is not clear. This article reviews the application progress of patient profile based on big data in the field of nursing at home and abroad, systematically analyzes its construction methods, application scenarios, implementation effects and challenges, and puts forward relevant suggestions, aiming to provide references for the precise and intelligent development of nursing services.
Objective To understand the effect and influencing factors of humanistic care on improving the experience of inpatients. Methods Patients were collected from a third grade class A women’s and children’s hospital in June 2015 and June 2016, and their satisfaction was investigated by a third party. The service items of Inpatients Satisfaction Item Score Table in 2015 were analyzed. Appropriate intervention measures were taken to low-score items, such as humanistic knowledge training to all medical staff, improvement health guidelines, implementation of recycling process, carrying out high quality nursing interventions, and so on. The patients satisfaction survey results in 2016 were compared with those of 2015. Results In 2016, the total satisfaction rate (89.94%), and the average score of items ranked the top three (94.64±0.14), including the level of medical technology, medical ethics and the overall evaluation of doctor’s professional ehtics, medical communication and service attitude, were higher than those of 2015 (85.25, 90.86±1.53). The average score of items ranked the last three (89.25±9.21), including hospital ward, hospital environment (clean, quiet and safe), hospital meals and room service, and hospital food quality, was higher than that of 2015 (78.64±2.40). However, compared with the same period in the last year, the rank of hospital environment fell by two places. Conclusions Hardware conditions like physical environment have an important impact on the experience of hospital patients. However, humanistic care is the key factor to improve the patients’ inpatient experience and satisfaction.
Objective To systematically review the abroad studies on patients for patient safety, and compare them with the current status of domestic studies, so as to provide suggestions for evidence-based strategic decision about how to conduct the education of patients for patient safety and improve the medical quality. Methods The databases of MEDLINE, EMbase and Chinese Biomedical Literature Database (CBM) were searched to identify the relevant studies and their references. Literatures were screened with data extraction in accordance with the predefined inclusive and exclusive criteria. The quality of literatures was assessed with the standard of Cochrane Handbook 5.0 and Critical Appraisal Skills Programme, and the data were comprehensively analyzed with qualitative research methods.Results Among 28 included studies, 5 were Chinese literatures, 1 was RCT, and the others were cross-sectional studies. The results showed that: a) Generally, the patients at home and abroad were poor in the awareness of patient safety, but they were eager to participate in the patient safety; b) Factors affecting patients’ participation were their characteristics, disease-related, and emotional feelings; c) Three studies reported the methods of involving patients in patient safety from the aspects of infection, malpractice, and medication; d) Some studies showed that patients’ participation could effectively promote the standardized operation of medical staffs, prevent unsafe events, and reduce damages; and e) The research contents of the included Chinese literatures were just related to the patients’ awareness of patient safety, attitude to participation, and influencing factors. Conclusion The limited studies relevant to patients for patient safety are short of high-quality RCTs for proving the effectiveness of patient participation methods, so it indicates that the stress should be laid on evaluating the effectiveness of patients for patient safety in future research.
Objective To provide evidence for establishing a medical risk precaution and monitoring system in China by evidence-based evaluation of the medical risk monitoring and precaution system in Canada, including the current situation and corresponding prevention measures. Method According to the unified search strategy made by our research group, we searched relevant databases and official or government websites. We included articles about medical risk management, medical error and patient safety in Canada. The included articles were classified and the quality was ranked. Results A total of 15 articles were included, among which 10 were official documents (about 2/3) and 5 described research methods (about 1/3), mainly involving medical risk management or evaluation, medical error and patient safety. In 2002, Canada established its National Steering Committee on Patient Safety (NSCPS) and proposed the suggestions to integrate health care resources accross the country, build a patient safety system, and established the Canada Patient Safety Institution (CPSI) to improve patient safety. Canada revised the patient safety management system, collected and issued related information, strengthened doctor-patient communication, developed continuous education for medical staff, practiced the best medical behavior and model and improved lawsuit procedures. These activities have achieved great progress in practice. Conclusions What have been done in Canada will provide a guide for us to establish scientific patient safety system and promote public awareness of patient safety.
Objective To investigate the attitudes of Chinese doctors towards the difficulties they have concerning the involvement of patients in decision-making about treatment. Method We surveyed 1 088 doctors at different levels (70% internal medicine, 22% general surgery, 8% gynecology) from 20 general hospitals and 5 university hospitals covering 25 provinces and cities in China, using a simple questionnaire, which we had developed. Results A total of 780 doctors returned the questionnaire and of these only 488 (62%) had completed it. The difficulties that doctors were most concerned about focused on lack of time (27%), expressing uncertainties to patients (15%), dealing with patients who have little medical knowledge (13%), eliciting patients’ preferences (12%), and establishing a stable relationship (9%). Conclusion Increasing their knowledge of patient involvement in making treatment decisions may reinforce appropriate attitudes towards this concept among doctors.
The postoperative symptom burden in patients with lung cancer is severe and adversely impairs their quality of life. Symptom management is the cornerstone of medical care. Patient-reported outcome (PRO)-based symptom management is being increasingly recognized as the best "patient-centered care" model in clinical practice. However, the precise implementation of this model in patients undergoing lung cancer surgery is hindered by the lack of a lung cancer surgery-specific scale, implementation standards, clinical application parameters and high-quality researches. The use of a precise and simple PRO scale and an electronic PRO platform may greatly improve the feasibility of implementing this model. Currently, the application of PRO-based symptom management in lung cancer surgery is still being explored and needs to be improved in clinical research and practice.
Objective To investigate the scientificity of patient-reported outcomes instrument for asthma ( Asthma-PRO) , which maybe used to evaluate the efficacy of anti-asthma drugs in clinical trials and clinical practice.Methods 366 asthma patients and 100 healthy subjects were face-to-face interviewed by well-trained investigators, and the data of Asthma-PRO instrument were collected. The psychometric performance such as reliability, validity, responsiveness and clinical feasibility in the Asthma-PRO instrument was evaluated. Results The split-half reliabilities of the Asthma-PRO instrument and each dimension were greater than 0.8. In the analysis of internal consistency of each dimension, the cronbach’s alpha coefficient was greater than 0.7. Factor analysis showed that the instrument has good construct validity. The scores of each of the facets and total scores between the asthma patients and the healthy subjects were different. The recovery rate and the efficient rate of the questionnaire were more than 95%, and the time required to complete a questionnaire was within 20 minutes, indicating that the scale had a high clinical feasibility. Conclusion The Asthma-PRO instrument has good reliability, validity, responsiveness and clinical feasibility.
Objective To evaluate evidence from American medical risk monitoring and precaution system (AMRMPS) which may affect the construction of Chinese medical risk monitoring and precaution system (CMRMPS). Methods We searched relevant databases and Internet resources to identify literature on AMRMPS, medical errors, and patient safety. We used the quality evaluation system for medical risk management literature to extract and evaluate data. Results In 1999, a report from the Institute of Medicine (IOM) not only showed the severity and cause of medical errors in America but also gave the solution of it. In 2000, the Quality Interagency Coordination Task Force (QuIC) was appointed to assess the IOM report and take specific steps to improve AMRMPS. After 5 years, a well-developed medical risk management system was established with the improvement in the public awareness of medical errors, patient safety, performance criteria of medical safety, information technology and error reporting system. There was still some weakness of this system in risk precaution and prevention. Conclusion The experience from AMRMPS can be used to establish the CMRMPS. Firstly, we should disseminate and strengthen the awareness of medical risk and patient safety in public. Secondly, we should establish hospital audit system which includes auditing of medical staff and course of medical risk in continuing and academic education. Thirdly, we should develop regulations and guidelines on health care, medical purchase and drug supply which will benefit in management of regular work. Fourthly, we should develop computer information system for hospital which will regulate the management without the disturbance from human. Lastly, we should emphasize outcome evaluations and strive for perfection during the process.
Objectives To construct patient trust evaluation index system based on the background of hierarchical medical system, and to provide reference for the evaluation of the degree of patient trust on medical institutions and offer guidence to the implementation and further improvement of the hierarchical medical policy in China. Methods Based on literature review, the modified Delphi method was used to carry out 2 rounds of expert consultations from 11 experts in different fields to determine the indicators of patient trust evaluation index system. Results Questionnaire recovery rates of 2 rounds were 100.00% and 90.91%, the expert authority coefficient was greater than 0.75, the coefficient of variation of each index was less than 0.25, and the coordination coefficient of experts in the total index were 0.236 and 0.424 (P<0.001). Patient trust evaluation index system was preliminary constructed including medical environment, service trust, technical skills, pharmaceutical and equipment, the overall trust 5 first-level indexes and 20 level two indexes. Conclusions The patient trust evaluation index system can be used to evaluate patients' trust in different levels of medical institutions under the hierarchical medical system.