Background: The lack of cause of death information is the main challenge in monitoring the effectiveness of interventions aimed at reducing HIV and AIDS-related deaths in countries where the majority of deaths occur a...Background: The lack of cause of death information is the main challenge in monitoring the effectiveness of interventions aimed at reducing HIV and AIDS-related deaths in countries where the majority of deaths occur at home. Objective: To evaluate the accuracy of physician reviewers of verbal autopsies in diagnosing HIV and AIDS-related deaths in the adult population of Addis Ababa, the capital of Ethiopia. Methods: This study was done within the context of a burial surveillance system in Addis Ababa. Trained interviewers completed a standard verbal autopsy questionnaire and an independent panel of physicians reviewed the completed form to assign cause of death. Physicians' review was compared to a reference standard constructed based on prospectively collected HIV-serostatus and patients' hospital record. Sensitivity and specificity were calculated to validate the physicians' verbal autopsy diagnoses against reference standards. Results: Physicians accurately identified AIDS-related deaths with sensitivity and specificity of 0.88 (95% CI: 0.80 - 0.93) and 0.77 (95% CI: 0.64 - 0.87), respectively. Generally, there was high level of agreement (Cohen's Kappa Statistic (K > 0.6) between the first two physicians with some yearly variations. In 2008 and 2009 there was an almost perfect agreement (K > 0.80). Conclusion: This study demonstrated the agreement level between two independent physicians in diagnosing AIDS-related death is very high and thus using a single verbal autopsy coder is practical for programmatic purposes in countries where there is critical shortage of doctors.展开更多
Background: Care is a team effort that its continuity is not possible by a person alone. Nurses and physicians should have collaboration with other professions to solve care complex problems. Aim: We conducted a revie...Background: Care is a team effort that its continuity is not possible by a person alone. Nurses and physicians should have collaboration with other professions to solve care complex problems. Aim: We conducted a review of the literature to evaluate clinical nurses collaboration with other disciplines examined by qualitative approach. Method: We searched all articles that published from 1995 to 2014 in both English and Persian which had been performed interdisciplinary collaboration processes in the clinical nursing. These articles were done with qualitative approach for nurse’s collaboration with other disciplines. We searched using databases of Proquest, Scopus, pub Med, Science Direct, and Iranian databases of Sid, Magiran, Iran Medex. This review was performed using keywords matching with MESH terms such as interdisciplinary relations, nurse-physician relations, care team, collaboration, and their Persian equivalents at the first separately and then with AND/OR as combination. In most studies, the main structure was three components of collaboration process, context of collaboration and consequences that they were emphasized. Results & Conclusions: However context and processes were different but most studies reported outcomes similarity of interdisciplinary collaboration. Thus to achieve common goals between different disciplines working together is essential for effective care in clinical settings.展开更多
目的：了解三级甲等综合医务人员直接面对病人对其主观幸福感的影响。方法：采用中国城市居民幸福感量表简本（subjective well-being scale for Chinese citizen,SWBS-cc20）,于2012,2013及2014年5月对湖南省某三级甲等综合性医院医务...目的：了解三级甲等综合医务人员直接面对病人对其主观幸福感的影响。方法：采用中国城市居民幸福感量表简本（subjective well-being scale for Chinese citizen,SWBS-cc20）,于2012,2013及2014年5月对湖南省某三级甲等综合性医院医务人员进行调查。结果：医务人员的主观幸福感评分较高（81.67±12.33）;在10个分维度中,家庭氛围、成长进步及人际适应得分最高;知足充裕、心理健康及身体健康得分最低。职称、工作性质、受教育程度及职业影响医务人员的主观幸福感。直接面对病人的医务人员主观幸福感低于非直接面对病人者（t=–4.80,P〈0.001）;直接面对病人的医务人员在知足充裕维度（OR=0.079,95%CI：1.278~2.214,P〈0.001）高于非直接面对病人者,在心理健康（OR=1.315,95%CI：1.023~1.690,P〈0.05）及身体健康（OR=1.313,95%CI：1.029~1.677,P〈0.05）维度低于非直接面对病人者。结论：医务人员的主观幸福感较高。直接面对病人的医务人员主观幸福感总体低于非直接面对病人者;且在知足充裕维度高于非直接面对病人者,在心理健康及身体健康维度低于非直接面对病人者。展开更多
文摘Background: The lack of cause of death information is the main challenge in monitoring the effectiveness of interventions aimed at reducing HIV and AIDS-related deaths in countries where the majority of deaths occur at home. Objective: To evaluate the accuracy of physician reviewers of verbal autopsies in diagnosing HIV and AIDS-related deaths in the adult population of Addis Ababa, the capital of Ethiopia. Methods: This study was done within the context of a burial surveillance system in Addis Ababa. Trained interviewers completed a standard verbal autopsy questionnaire and an independent panel of physicians reviewed the completed form to assign cause of death. Physicians' review was compared to a reference standard constructed based on prospectively collected HIV-serostatus and patients' hospital record. Sensitivity and specificity were calculated to validate the physicians' verbal autopsy diagnoses against reference standards. Results: Physicians accurately identified AIDS-related deaths with sensitivity and specificity of 0.88 (95% CI: 0.80 - 0.93) and 0.77 (95% CI: 0.64 - 0.87), respectively. Generally, there was high level of agreement (Cohen's Kappa Statistic (K > 0.6) between the first two physicians with some yearly variations. In 2008 and 2009 there was an almost perfect agreement (K > 0.80). Conclusion: This study demonstrated the agreement level between two independent physicians in diagnosing AIDS-related death is very high and thus using a single verbal autopsy coder is practical for programmatic purposes in countries where there is critical shortage of doctors.
文摘Background: Care is a team effort that its continuity is not possible by a person alone. Nurses and physicians should have collaboration with other professions to solve care complex problems. Aim: We conducted a review of the literature to evaluate clinical nurses collaboration with other disciplines examined by qualitative approach. Method: We searched all articles that published from 1995 to 2014 in both English and Persian which had been performed interdisciplinary collaboration processes in the clinical nursing. These articles were done with qualitative approach for nurse’s collaboration with other disciplines. We searched using databases of Proquest, Scopus, pub Med, Science Direct, and Iranian databases of Sid, Magiran, Iran Medex. This review was performed using keywords matching with MESH terms such as interdisciplinary relations, nurse-physician relations, care team, collaboration, and their Persian equivalents at the first separately and then with AND/OR as combination. In most studies, the main structure was three components of collaboration process, context of collaboration and consequences that they were emphasized. Results & Conclusions: However context and processes were different but most studies reported outcomes similarity of interdisciplinary collaboration. Thus to achieve common goals between different disciplines working together is essential for effective care in clinical settings.
文摘目的：了解三级甲等综合医务人员直接面对病人对其主观幸福感的影响。方法：采用中国城市居民幸福感量表简本（subjective well-being scale for Chinese citizen,SWBS-cc20）,于2012,2013及2014年5月对湖南省某三级甲等综合性医院医务人员进行调查。结果：医务人员的主观幸福感评分较高（81.67±12.33）;在10个分维度中,家庭氛围、成长进步及人际适应得分最高;知足充裕、心理健康及身体健康得分最低。职称、工作性质、受教育程度及职业影响医务人员的主观幸福感。直接面对病人的医务人员主观幸福感低于非直接面对病人者（t=–4.80,P〈0.001）;直接面对病人的医务人员在知足充裕维度（OR=0.079,95%CI：1.278~2.214,P〈0.001）高于非直接面对病人者,在心理健康（OR=1.315,95%CI：1.023~1.690,P〈0.05）及身体健康（OR=1.313,95%CI：1.029~1.677,P〈0.05）维度低于非直接面对病人者。结论：医务人员的主观幸福感较高。直接面对病人的医务人员主观幸福感总体低于非直接面对病人者;且在知足充裕维度高于非直接面对病人者,在心理健康及身体健康维度低于非直接面对病人者。
