Objective:To analyze the impact of continuous quality care on HAMA,HAMD score,and quality of life in patients with acute myocardial infarction.Methods:The 100 patients with acute myocardial infarction admitted to our ...Objective:To analyze the impact of continuous quality care on HAMA,HAMD score,and quality of life in patients with acute myocardial infarction.Methods:The 100 patients with acute myocardial infarction admitted to our hospital from January 2020 to January 2021 were selected and divided into control and observation groups according to the random number table method,with 50 patients in each group.Patients in the control group were given routine care after discharge,and patients in the observation group received continuous quality care intervention to compare the changes in HAMA,HAMD and quality of life scores before and after care between the two groups.Results:Lower HAMA,HAMD scores and higher quality of life scores compared to care in the observation group,and the difference between groups before and after care was significant(P<0.05).Conclusion:Continuous quality care can effectively reduce anxiety and depression in AMI patients and improve quality of life,which deserves clinical application.展开更多
Objective To evaluate and overview the experience of quality care of family planning of China. Methods The framework of quality care of China was summarized and analyzed, that was clients, technology and management tr...Objective To evaluate and overview the experience of quality care of family planning of China. Methods The framework of quality care of China was summarized and analyzed, that was clients, technology and management triangle program system. Results The 8 fundamental elements of quality care in China were presented: 1) policy environment of QoC, 2) comprehensive services, 3) choice of method, 4) IEC to policy-makers and providers, 5) technical competence, 6) interpersonal communications, 7) institutional guideline and regulation, 8) appropriate constella- tion of service. Conclusion FP sectors should prepare different constellations of service to meet their individual reproductive health need for different clients and develop institutional guide-line and regulation for FP service to follow up in practice. QoC should be a kind of standardized service process.展开更多
Objective: This study aimed to evaluate the quality care received by senior citizens in Primary Health Care (PHC) in the Unified Health System, with the objectives of contributing with the comprehensive implementation...Objective: This study aimed to evaluate the quality care received by senior citizens in Primary Health Care (PHC) in the Unified Health System, with the objectives of contributing with the comprehensive implementation of humanized conduct and actions for this part of the population. Methods: This is a descriptive-exploratory study with a quantitative approach that was conducted in the city of Santa Cruz, which is located in the Brazilian state of Rio Grande do Norte, with a population of 130 senior citizens. The research was approved by the Committee for Ethics in Research at the Federal University at Rio Grande do Norte under protocol 152/2012. Results: In the results, the classification of the PHC services varied from good to reasonable. Regarding the assistance offered to the aging and comprehensive care, there were failures in accordance with how it’s recommended in the National Healthcare System. This concludes, through the perspective of the elderly user, the need for the reformulation of the activities which are offered to this population and therefore the implementation of conduct for better service in the area of Primary Health Care.展开更多
Background: Nigeria, a nation grappling with rapid population growth, economic intricacies, and complex healthcare challenges, particularly in Lagos State, the economic hub and most populous state, faces the challenge...Background: Nigeria, a nation grappling with rapid population growth, economic intricacies, and complex healthcare challenges, particularly in Lagos State, the economic hub and most populous state, faces the challenge of ensuring quality healthcare access. The overview of the effect of quality improvement initiatives in this paper focuses on private healthcare providers in Lagos State, Nigeria. The study assesses the impact of donor-funded quality improvement projects on these private healthcare facilities. It explores the level of participation, perceived support, and tangible effects of the initiatives on healthcare delivery within private healthcare facilities. It also examines how these initiatives influence patient inflow and facility ratings, and bring about additional benefits and improvements, provides insights into the challenges faced by private healthcare providers in implementing quality improvement projects and elicits recommendations for improving the effectiveness of such initiatives. Methods: Qualitative research design was employed for in-depth exploration, utilizing semi-structured interviews. Private healthcare providers in Lagos involved in the SP4FP Quality Improvement Project were purposively sampled for diversity. Face-to-face interviews elicited insights into participation, perceived support, and project effects. Questions covered participation levels, support perception, changes observed, challenges faced, and recommendations. Thematic analysis identified recurring themes from interview transcripts. Adherence to ethical guidelines ensured participant confidentiality and informed consent. Results: Respondents affirmed active involvement in the SP4FP Quality Improvement Project, echoing literature emphasizing private-sector collaboration with the public sector. While acknowledging positive influences on facility ratings, respondents highlighted challenges within the broader Nigerian healthcare landscape affecting patient numbers. Respondents cited tangible improvements, particularly in staff management and patient care processes, validating the positive influence of quality improvement projects. Financial constraints emerged as a significant challenge, aligning with existing literature emphasizing the pragmatic difficulties faced by private healthcare providers. Conclusions: This study illuminates the complex landscape of private healthcare provision in Lagos State, emphasizing the positive impact of donor-funded quality improvement projects. The findings provide nuanced insights, guiding policymakers, healthcare managers, and practitioners toward collaborative, sustainable improvements. As Nigeria progresses, these lessons will be crucial in shaping healthcare policies prioritizing population well-being.展开更多
Objective:To analyze the effect of using continuity of care for elderly patients with coronary heart disease(CHD)with unstable angina pectoris(UAP)and its impact on their quality of life.Methods:100 cases of elderly p...Objective:To analyze the effect of using continuity of care for elderly patients with coronary heart disease(CHD)with unstable angina pectoris(UAP)and its impact on their quality of life.Methods:100 cases of elderly patients with CHD with UAP admitted to our hospital from March 2022 to March 2023 were selected and grouped into an observation group and a control group of 50 cases each according to the randomized number table method.The nursing effect and quality of life of the observation group(continuity nursing)and the control group(routine nursing)were compared.Results:The total effective rate of nursing care was 96.00%observation group and 80.00%for the control group,and the differences were significant(χ2=6.061,P<0.05).Patients in the observation group had fewer episodes(1.42±0.21)times/week and a shorter duration(5.46±0.39)min,which were better than the control group(t=3.465,2.973;P<0.05).The depression self-rating depression scale(SDS)score(42.16±6.64)and anxiety self-rating scale(SAS)score(32.26±7.35)in the observation group were lower and the quality of life was higher as compared to that of the control group(P<0.05).Conclusion:Continuous nursing care improved the nursing effect of elderly CHD with UAP patients,promoted the alleviation of UAP symptoms,improved patient mentality,and improved their quality of life.Hence,continuous nursing care possesses significant clinical application value.展开更多
With the continuous intensification of global aging,the issue of elderly care has become an increasingly prominent social problem.The Internet of Things(IoT)technology,as an emerging field,holds broad application pros...With the continuous intensification of global aging,the issue of elderly care has become an increasingly prominent social problem.The Internet of Things(IoT)technology,as an emerging field,holds broad application prospects.This article focuses on the application of IoT technology in group elderly care services and constructs a quality evaluation system for these services based on IoT technology.Through the analysis of practical application cases,the advantages and challenges of IoT technology in group elderly care services have been examined,confirming the feasibility and effectiveness of the evaluation system.展开更多
Background:Risk perception and COVID‑19 anxiety in pregnant women restrict access to health services,cause pregnant women to resort to alternative channels such as the Internet,and affect prenatal care quality(PCQ)neg...Background:Risk perception and COVID‑19 anxiety in pregnant women restrict access to health services,cause pregnant women to resort to alternative channels such as the Internet,and affect prenatal care quality(PCQ)negatively.Purpose:The purpose of this study was to examine the effect of risk perception and COVID‑19 anxiety in pregnancy on decision‑making via the Internet(DMI)and PCQ with multivariate analysis.Materials and Methods:This cross‑sectional study was conducted with 406 pregnant women selected using the convenience sampling method in a training and research hospital,in Turkey.The data were collected using the information form,the perception of pregnancy risk questionnaire,the Coronavirus Anxiety Scale,the DMI Scale,and the PCQ Scale.The data obtained were subject to descriptive analysis and the multivariate analysis of variance.Results:Approximately 24.9%of the pregnant women were found to have a high perception of risk and 18%had symptoms of COVID‑19 anxiety.Pregnant women with high COVID‑19 anxiety and a higher perception of risk perceived the Internet as less influential for decision‑making(P<0.05).Pregnant women with a high‑risk perception had lower PCQ(P<0.05).Conclusion:The findings can be used to enhance mental health and resilience in pregnant women and to formulate appropriate intervention strategies.展开更多
Objective:Sub-Saharan Africa accounts for 66%of global maternal deaths.In Kenya,362 maternal deaths occur in every 100000 live births.Most of these deaths occur as a result of suboptimal quality care of mothers during...Objective:Sub-Saharan Africa accounts for 66%of global maternal deaths.In Kenya,362 maternal deaths occur in every 100000 live births.Most of these deaths occur as a result of suboptimal quality care of mothers during labor,delivery,or within 24h of delivery.This study explored barriers that nurse-midwives encounter in trying to provide high-quality obstetric care during these periods.Methods:A qualitative research design utilizing focus group discussion as part of a mixed method study was used to find out the participants'experiences.Data were collected between February and March 2022 in the maternity units of two regional teaching and referral hospitals in Kenya.Eligible participants were nurse-midwives in charge of the maternity unit.The discussion was conducted in English,tape-recorded,and transcribed verbatim,Data were analyzed thematically,following Braun and Clarke 6-step framework.Nvivo version 7.0 computer software was used to facilitate this process.Results:Two focused group discussions each involving seven participants were conducted.The participants agreed that maternal mortality due to postpartum hemorrhage and pregnancy-induced hypertension is a major health concern.Further,maternal care in the two hospitals was substandard.Themes that emerged as barriers were:inadequate supplies;inadequate obstetric knowledge and skills;shortage of nurse-midwives,and inadequate support supervision.The underlying factors include inadequate funding by the county government and high staff turnover.Conclusion:This study showed that nurse-midwives are working under very difficult circumstances which are hindering the provision of quality maternal care.This is mainly due to system failures and inadequate nursemidwife numbers.Targeted strategies need to be urgently implemented to mitigate these challenges to improve the quality of maternal health care.展开更多
Introduction: Little is known about the quality of healthcare in intensive care units (ICUs) in Poland. Data on patients hospitalized in ICUs in Warsaw and the results of their treatment are scarce. This information, ...Introduction: Little is known about the quality of healthcare in intensive care units (ICUs) in Poland. Data on patients hospitalized in ICUs in Warsaw and the results of their treatment are scarce. This information, crucial for improving the quality of ICU healthcare services, is not collected routinely. Quality indicators are essential in the concept of holistic quality management. Implementation of these indicators in ICUs is a complex and time-consuming process. Systematic increase in demand for quality assessment tools that can reflect real conditions of the practices of ICUs, prompts the search for effective solutions. Methods: The study included 12,155 patients hospitalized in 16 ICUs of Warsaw hospitals (8 ICUs, n = 3293 of the first level of care, and 8 ICUs, n = 8862 of the second level) between 1<sup>st</sup> January 2017 and 31<sup>st</sup> December 2018. ICUs in pediatric and oncological hospitals were excluded from the study. Characteristics and demography of patients as well as the structure, treatment and human resources of the ICUs in Warsaw were analyzed. Length of stay, unexpected extubations, nosocomial infections, ICU readmissions and standardized mortality ratios (SMR) were retrieved from National Health Fund, Ministry of Health, and other public databases. Results: In primary level ICUs patients’ age (66.42 vs. 64.43 years;p = 0.005) and comorbidity rate (30.56% vs. 22.78%, p = 0.037) were higher when compared to ICUs of the second level of care. The crude mortality rate in ICUs in Warsaw was significantly higher than in other EU countries and differed between ICUs of the first and the second level (34.77% vs. 24.53%, respectively;p = 0.004). SMRs were however very low: 0.71 and 0.64 (ns), respectively. ICU readmission rate, unexpected extubations, central catheter related infections, and length of stay were identical in both groups. More patients were admitted to ICU form emergency department and/or discharged home in Level 1 ICUs (18.9% vs 12.9%, p Conclusions: There are no major differences in quality of care provided by Level 1 and Level 2 ICUs in Poland, although more rigorous adhesion to admission and discharge policies is needed. Implementation of the instruments for assessing quality of ICUs including benchmarking, self-assessment of departments and evaluation of changes resulting from audits according to the Deming cycle is of utmost importance. Standardization of quality measures and markers, communication, and cooperation in reporting and creation of ICU medical registers is necessary to improve the quality of healthcare.展开更多
BACKGROUND With the intensification of social aging,the susceptibility of the elderly population to diseases has attracted increasing attention,especially chronic heart failure(CHF)that accounts for a large proportion...BACKGROUND With the intensification of social aging,the susceptibility of the elderly population to diseases has attracted increasing attention,especially chronic heart failure(CHF)that accounts for a large proportion of the elderly.AIM To evaluate the application value of health concept model-based detailed behavioral care in elderly patients with CHF.METHODS This study recruited 116 elderly CHF patients admitted from October 2018 to October 2020 and grouped them according to the nursing care that they received.The elderly patients who underwent health concept model-based detailed behavioral care were included in a study group(SG;n=62),and those who underwent routine detailed behavioral nursing intervention were included as a control group(CG;n=54).Patients’negative emotions(NEs),quality of life(QoL),and nutritional status were assessed using the self-rating anxiety/depression scale(SAS/SDS),the Minnesota Living with Heart Failure Questionnaire(MLHFQ),and the Modified Quantitative Subjective Global Assessment(MQSGA)of nutrition,respectively.Differences in rehabilitation efficiency,NEs,cardiac function(CF)indexes,nutritional status,QoL,and nursing satisfaction were comparatively analyzed.RESULTS A higher response rate was recorded in the SG vs the CG after intervention(P<0.05).After care,the left ventricular ejection fraction was higher while the left ventricular end-diastolic dimension and left ventricular end systolic diameter were lower in the SG compared with the CG(P<0.05).The post-intervention SAS and SDS scores,as well as MQSGA and MLHFQ scores,were also lower in the SG(P<0.05).The SG was also superior to the CG in the overall nursing satisfaction rate(P<0.05).CONCLUSION Health concept model-based detailed behavioral care has high application value in the nursing care of elderly CHF patients,and it can not only effectively enhance rehabilitation efficiency,but also mitigate patients’NEs and improve their CF and QoL.展开更多
Background: Value-Based Care is a program that was created by Professor Michael E. PORTER and Elizabeth O. TEISBERG which has been modified for implementation over the last seventeen years. This new program is paid by...Background: Value-Based Care is a program that was created by Professor Michael E. PORTER and Elizabeth O. TEISBERG which has been modified for implementation over the last seventeen years. This new program is paid by Commercial Health Insurers (Insurance Companies) and Centers for Medicare and Medicaid Services (Medicare). This program incorporates the patients, doctors, Life Sciences Companies, Insurance Companies, Holistic practice, traditional Chinese medicine, etc. with alternative traditional treatments and therapies for Real-World Evidence based and value-based treatment customized to patients’ needs and the patients benefit. Methods: The program was proposed to achieve value for patients and an improved healthcare system which is especially needed to provide treatment for patients in Serious or Life-threatening conditions or diseases. The program will accurately measure the outcomes of patients and provide a wider choice of treatments that matter to patients, also to measure the cost that successful alternative treatments provide which may lower the cost to Medicare and Insurance Companies. Conclusion: The proposed and now implemented program is to achieve value for patients. Golden Sunrise Nutraceutical (Golden Sunrise) provides a New Medical Innovation and treatment alternative to patients suffering from Serious or Life-threatening illnesses. By using Golden Sunrise Innovation and with the incorporation of Value-based Care patients will become the drivers or it could be said the patient Ambassadors of their own health. By incorporating Golden Sunrise Innovation, the doctors will have more diversity of treatments available for their patients. Payment should reflect value not volume, and the New Medical Innovation Golden Sunrise offers will help in reducing the costs to Insurance Companies accelerating the adoption of Value-Based Care.展开更多
Over the past few decades,the Internet has rapidly diffused across China.The spread of the Internet has had a profound economic and social impact on Chinese rural areas.Existing research shows that Internet access sig...Over the past few decades,the Internet has rapidly diffused across China.The spread of the Internet has had a profound economic and social impact on Chinese rural areas.Existing research shows that Internet access significantly impacts agricultural production and improves smallholder farmers’income.Beyond these,the Internet can affect other dimensions of social welfare.However,research about the impact of Internet access on dietary quality in rural China remains scarce.This study utilizes multi-period panel data from Fixed Observation Point in rural China from 2009 to 2015 to estimate the impact of Internet access on dietary quality and food consumption of rural households and conducts a causal analysis.Regression models with time and household fixed effects allow robust estimation while reducing potential issues of unobserved heterogeneity.The estimates show that Internet access has significantly increased rural household dietary quality(measured by the Chinese Diet Balance Index).Further research finds that Internet access has increased the consumption of animal products,such as aquatic and dairy products.We also examine the underlying mechanisms.Internet access improves dietary quality and food consumption mainly through increasing household income and food expenditure.These results encourage the promotion of Internet access as a valuable tool for nutritional improvements,especially in rural areas.展开更多
Purpose: To contribute to the improvement of the quality of prenatal consultation at the reference health center of the commune IV of the district of Bamako. Patients Methods: This was a qualitative cross-sectional st...Purpose: To contribute to the improvement of the quality of prenatal consultation at the reference health center of the commune IV of the district of Bamako. Patients Methods: This was a qualitative cross-sectional study to assess the quality of prenatal consultation that took place from December 1, 2017 to January 31, 2018. It included 139 pregnant women whose consultations were monitored by the investigator and then the women were interviewed upon discharge from the facility to collect their opinions on the services they received. Results: The age group of 20 to 29 years was the most represented with 60.44%. In our study, 50% of our patients were managed by midwives. Among the antecedents constituting the risk factors sought in pregnant women, scar uterus was more frequent with 33.93% followed by arterial hypertension with 14.28% and multiparity with 7.14%. Conclusion: This study shows that the evaluation of the quality of services is an absolute necessity for the improvement of services in integrated reproductive health care centers.展开更多
The partogram is an accurate labor monitoring tool for reducing maternal and perinatal mortality due to prolonged labor and dystocia. The aim of this study is to assess how the quality of the partogram has evolved in ...The partogram is an accurate labor monitoring tool for reducing maternal and perinatal mortality due to prolonged labor and dystocia. The aim of this study is to assess how the quality of the partogram has evolved in health care institutions (HCI in short) that have benefited from the primary health care support project (ASSP in short) after formative supervision. This is a descriptive study by periodic clinical audit between 2020 and 2022, carried out in 96 HCI in 3 provincial health divisions (DPS in short) of DR Congo. Each photographed partogram page was sent to the project’s central level for review by a team of experts (3 obstetric gynecologists and 3 midwives). The compliance rate for completing partograms in the 96 health facilities of the 3 DPS was 86.8%. The rate of traceability of labor continuity was 88.2%, and that of traceability of acts, incidents and treatments during labor was 87.1%. Finally, the compliance rate for filling out partograms in the immediate post-partum period was 81%. A clear improvement was noted between the January 2020 and March 2022 assessments.展开更多
Objective: To comprehensively understand the impact of the quality of life of elderly nurses in two selected elderly care institutions in Zibo city, Shandong province, and to provide a scientific basis for improving t...Objective: To comprehensively understand the impact of the quality of life of elderly nurses in two selected elderly care institutions in Zibo city, Shandong province, and to provide a scientific basis for improving the professional quality of life of elderly nurses. Methods: The convenient sampling method was used to investigate the professional quality of life (proQOL) questionnaire Version 5 and the self-designed demographic data of 82 elderly nurses working in two elderly care institutions. Result: From this score, it can be seen that the occupational burnout problem of elderly nursing staff in the two nursing homes is the most significant, with empathy and secondary trauma emergency at a moderate level. After controlling the demographic variables, the working hours and monthly income level had a significant impact on nurses’ job burnout. Conclusion: Due to the particularity and high intensity of elderly nurses’ work, their physical and mental health faces many challenges, which affect their quality of life. At present, efforts will be made to reduce work pressure, increase wages and benefits, and thereby improve the quality of life.展开更多
The collaboration of medical care,parenting,and education aims to integrate nursing,midwifery,infant and child care services,and management with speech and hearing rehabilitation technology,among other elements relate...The collaboration of medical care,parenting,and education aims to integrate nursing,midwifery,infant and child care services,and management with speech and hearing rehabilitation technology,among other elements related to the infant care industry chain.This integration targets pediatrics talent training in nine infant care positions,including nursing,infant health care and management,and child rehabilitation,to ensure that the capabilities and quality of professional talents can meet the health care needs of infants and young children.This article briefly explains the background of the“collaboration of medical care,parenting,and education,and integration of industry and education.”It analyzes the necessity of cultivating infant and child care service talents based on the perspective of“collaboration of medical care,parenting,and education,and integration of industry and education.”Based on this perspective,we conducted an in-depth study of the cultivation of professional qualities of infant and child care service talents.展开更多
Objective:The study was conducted with the aim of determining the spiritual well-being(SWB)of nursing students and its association with quality of life(QOL).Materials and Methods:A cross-sectional analytical study was...Objective:The study was conducted with the aim of determining the spiritual well-being(SWB)of nursing students and its association with quality of life(QOL).Materials and Methods:A cross-sectional analytical study was conducted with a sample size of 504 nursing students collected from January 2023 to March 2023 in the nursing institutes of Khyber Pakhtunkhwa,Pakistan,using convenient sampling techniques.A Spiritual Health and Life-Orientation Measure(SHALOM)questionnaire for SWB and K-27 QOL(K-27 QOL)instrument were used for data collection that contains three parts.Results:The number of female participants was in the majority(50.4%)compared to male nurses(49.6%).The overall mean score of SWB of the students was 3.79±0.48,while the mean K-27 QOL score was 3.73±0.57.There were significant differences between the groups of gender(P=0.001),while no significant difference within the groups of semester(P=0.061)and college status(0.285).In QOL,there were significant differences within the groups of semester(P=0.000)and college status(P=0.036)while no significant difference in gender category(P=0.480).SHALOM score is positively and moderately correlated with QOL score(r=0.597,P<0.05).Conclusion:Spiritual practices are one of the important factors that are associated positively with QOL,therefore to enhance the QOL,it will require spiritual practices.展开更多
Objective:To explore the role of specialized group management in the quality control of perioperative nursing.Methods:45 surgical nurses from our hospital were selected as the research subjects.Traditional operating r...Objective:To explore the role of specialized group management in the quality control of perioperative nursing.Methods:45 surgical nurses from our hospital were selected as the research subjects.Traditional operating room management was adopted from July 2019 to June 2020,and specialized group management was adopted from July 2020 to June 2021.The surgeon’s satisfaction,surgical nurses’core professional competence,and surgical patients’satisfaction were obtained through surveys and the results were analyzed.Results:Surgeon satisfaction before the implementation of specialized group management was significantly lower than after its implementation(P<0.05).Besides,surgical nurses’core professional competency scores before the implementation of specialized group management were significantly lower than after its implementation(P<0.05).Lastly,surgical patients’satisfaction before the implementation of specialized group management was significantly lower than after its implementation(P<0.05).Conclusion:Specialized group management helps to improve the quality of perioperative care and should be applied in clinical practice.展开更多
New clinical approaches are imperative beyond the widely adopted National Comprehensive Cancer Network (NCCN) guidelines, utilized by prominent cancer institutions. Cancer is the leading cause of death among individua...New clinical approaches are imperative beyond the widely adopted National Comprehensive Cancer Network (NCCN) guidelines, utilized by prominent cancer institutions. Cancer is the leading cause of death among individuals younger than 85 years within the United States. Despite significant technological advances, including the expenditure of hundreds of billions, treatment outcomes and overall survival have not notably improved for most types of advanced cancer over the last several decades. Over the past 24 years, Envita Medical Centers has pioneered a unique form of personalized treatment approach for late-stage and refractory cancer patients, introducing groundbreaking innovations in the field. Our integrated algorithm utilizes advanced genomics, transcriptomics, and highly tailored immunotherapy, resulting in remarkable outcome improvements. This study presents Envita’s innovative personalized treatment algorithms and examines the response outcomes of 199 late-stage cancer patients treated at Envita Medical Centers over a two-year period. Compared to standard of care and palliative chemotherapy, Envita’s treatment demonstrated a remarkable 35-fold improvement in overall response rates (Figure 1). Moreover, 88% of the patients, the majority presenting with Stage 3 or 4 cancer, experienced a 43-fold improvement in quality of life with minimal side effects, as compared to standard of care chemotherapy and palliative care. This revolutionary success is attributed to Envita’s personalized therapeutic algorithms, which incorporate customized immunotherapy. Envita’s precision care approach has also achieved a 100% better response rate compared to over 65 global chemotherapy clinical trials with more than 2700 patients. The results from this study suggest that a wider utilization of Envita’s personalized approach can significantly benefit patients with late-stage and refractory cancer.展开更多
In this editorial,we comment on the article by Wang and Long,published in a recent issue of the World Journal of Clinical Cases.The article addresses the challenge of predicting intensive care unit-acquired weakness(I...In this editorial,we comment on the article by Wang and Long,published in a recent issue of the World Journal of Clinical Cases.The article addresses the challenge of predicting intensive care unit-acquired weakness(ICUAW),a neuromuscular disorder affecting critically ill patients,by employing a novel processing strategy based on repeated machine learning.The editorial presents a dataset comprising clinical,demographic,and laboratory variables from intensive care unit(ICU)patients and employs a multilayer perceptron neural network model to predict ICUAW.The authors also performed a feature importance analysis to identify the most relevant risk factors for ICUAW.This editorial contributes to the growing body of literature on predictive modeling in critical care,offering insights into the potential of machine learning approaches to improve patient outcomes and guide clinical decision-making in the ICU setting.展开更多
文摘Objective:To analyze the impact of continuous quality care on HAMA,HAMD score,and quality of life in patients with acute myocardial infarction.Methods:The 100 patients with acute myocardial infarction admitted to our hospital from January 2020 to January 2021 were selected and divided into control and observation groups according to the random number table method,with 50 patients in each group.Patients in the control group were given routine care after discharge,and patients in the observation group received continuous quality care intervention to compare the changes in HAMA,HAMD and quality of life scores before and after care between the two groups.Results:Lower HAMA,HAMD scores and higher quality of life scores compared to care in the observation group,and the difference between groups before and after care was significant(P<0.05).Conclusion:Continuous quality care can effectively reduce anxiety and depression in AMI patients and improve quality of life,which deserves clinical application.
文摘Objective To evaluate and overview the experience of quality care of family planning of China. Methods The framework of quality care of China was summarized and analyzed, that was clients, technology and management triangle program system. Results The 8 fundamental elements of quality care in China were presented: 1) policy environment of QoC, 2) comprehensive services, 3) choice of method, 4) IEC to policy-makers and providers, 5) technical competence, 6) interpersonal communications, 7) institutional guideline and regulation, 8) appropriate constella- tion of service. Conclusion FP sectors should prepare different constellations of service to meet their individual reproductive health need for different clients and develop institutional guide-line and regulation for FP service to follow up in practice. QoC should be a kind of standardized service process.
文摘Objective: This study aimed to evaluate the quality care received by senior citizens in Primary Health Care (PHC) in the Unified Health System, with the objectives of contributing with the comprehensive implementation of humanized conduct and actions for this part of the population. Methods: This is a descriptive-exploratory study with a quantitative approach that was conducted in the city of Santa Cruz, which is located in the Brazilian state of Rio Grande do Norte, with a population of 130 senior citizens. The research was approved by the Committee for Ethics in Research at the Federal University at Rio Grande do Norte under protocol 152/2012. Results: In the results, the classification of the PHC services varied from good to reasonable. Regarding the assistance offered to the aging and comprehensive care, there were failures in accordance with how it’s recommended in the National Healthcare System. This concludes, through the perspective of the elderly user, the need for the reformulation of the activities which are offered to this population and therefore the implementation of conduct for better service in the area of Primary Health Care.
文摘Background: Nigeria, a nation grappling with rapid population growth, economic intricacies, and complex healthcare challenges, particularly in Lagos State, the economic hub and most populous state, faces the challenge of ensuring quality healthcare access. The overview of the effect of quality improvement initiatives in this paper focuses on private healthcare providers in Lagos State, Nigeria. The study assesses the impact of donor-funded quality improvement projects on these private healthcare facilities. It explores the level of participation, perceived support, and tangible effects of the initiatives on healthcare delivery within private healthcare facilities. It also examines how these initiatives influence patient inflow and facility ratings, and bring about additional benefits and improvements, provides insights into the challenges faced by private healthcare providers in implementing quality improvement projects and elicits recommendations for improving the effectiveness of such initiatives. Methods: Qualitative research design was employed for in-depth exploration, utilizing semi-structured interviews. Private healthcare providers in Lagos involved in the SP4FP Quality Improvement Project were purposively sampled for diversity. Face-to-face interviews elicited insights into participation, perceived support, and project effects. Questions covered participation levels, support perception, changes observed, challenges faced, and recommendations. Thematic analysis identified recurring themes from interview transcripts. Adherence to ethical guidelines ensured participant confidentiality and informed consent. Results: Respondents affirmed active involvement in the SP4FP Quality Improvement Project, echoing literature emphasizing private-sector collaboration with the public sector. While acknowledging positive influences on facility ratings, respondents highlighted challenges within the broader Nigerian healthcare landscape affecting patient numbers. Respondents cited tangible improvements, particularly in staff management and patient care processes, validating the positive influence of quality improvement projects. Financial constraints emerged as a significant challenge, aligning with existing literature emphasizing the pragmatic difficulties faced by private healthcare providers. Conclusions: This study illuminates the complex landscape of private healthcare provision in Lagos State, emphasizing the positive impact of donor-funded quality improvement projects. The findings provide nuanced insights, guiding policymakers, healthcare managers, and practitioners toward collaborative, sustainable improvements. As Nigeria progresses, these lessons will be crucial in shaping healthcare policies prioritizing population well-being.
文摘Objective:To analyze the effect of using continuity of care for elderly patients with coronary heart disease(CHD)with unstable angina pectoris(UAP)and its impact on their quality of life.Methods:100 cases of elderly patients with CHD with UAP admitted to our hospital from March 2022 to March 2023 were selected and grouped into an observation group and a control group of 50 cases each according to the randomized number table method.The nursing effect and quality of life of the observation group(continuity nursing)and the control group(routine nursing)were compared.Results:The total effective rate of nursing care was 96.00%observation group and 80.00%for the control group,and the differences were significant(χ2=6.061,P<0.05).Patients in the observation group had fewer episodes(1.42±0.21)times/week and a shorter duration(5.46±0.39)min,which were better than the control group(t=3.465,2.973;P<0.05).The depression self-rating depression scale(SDS)score(42.16±6.64)and anxiety self-rating scale(SAS)score(32.26±7.35)in the observation group were lower and the quality of life was higher as compared to that of the control group(P<0.05).Conclusion:Continuous nursing care improved the nursing effect of elderly CHD with UAP patients,promoted the alleviation of UAP symptoms,improved patient mentality,and improved their quality of life.Hence,continuous nursing care possesses significant clinical application value.
基金Phased Achievement of the National College Student Innovation and Entrepreneurship Training Project“Time Bay-A Group Elderly Care Service Platform Based on Internet of Things Technology”(S202013836008X)2021 Chongqing Education Commission Science and Technology Research Program Youth Project(KJQN202105501).
文摘With the continuous intensification of global aging,the issue of elderly care has become an increasingly prominent social problem.The Internet of Things(IoT)technology,as an emerging field,holds broad application prospects.This article focuses on the application of IoT technology in group elderly care services and constructs a quality evaluation system for these services based on IoT technology.Through the analysis of practical application cases,the advantages and challenges of IoT technology in group elderly care services have been examined,confirming the feasibility and effectiveness of the evaluation system.
文摘Background:Risk perception and COVID‑19 anxiety in pregnant women restrict access to health services,cause pregnant women to resort to alternative channels such as the Internet,and affect prenatal care quality(PCQ)negatively.Purpose:The purpose of this study was to examine the effect of risk perception and COVID‑19 anxiety in pregnancy on decision‑making via the Internet(DMI)and PCQ with multivariate analysis.Materials and Methods:This cross‑sectional study was conducted with 406 pregnant women selected using the convenience sampling method in a training and research hospital,in Turkey.The data were collected using the information form,the perception of pregnancy risk questionnaire,the Coronavirus Anxiety Scale,the DMI Scale,and the PCQ Scale.The data obtained were subject to descriptive analysis and the multivariate analysis of variance.Results:Approximately 24.9%of the pregnant women were found to have a high perception of risk and 18%had symptoms of COVID‑19 anxiety.Pregnant women with high COVID‑19 anxiety and a higher perception of risk perceived the Internet as less influential for decision‑making(P<0.05).Pregnant women with a high‑risk perception had lower PCQ(P<0.05).Conclusion:The findings can be used to enhance mental health and resilience in pregnant women and to formulate appropriate intervention strategies.
文摘Objective:Sub-Saharan Africa accounts for 66%of global maternal deaths.In Kenya,362 maternal deaths occur in every 100000 live births.Most of these deaths occur as a result of suboptimal quality care of mothers during labor,delivery,or within 24h of delivery.This study explored barriers that nurse-midwives encounter in trying to provide high-quality obstetric care during these periods.Methods:A qualitative research design utilizing focus group discussion as part of a mixed method study was used to find out the participants'experiences.Data were collected between February and March 2022 in the maternity units of two regional teaching and referral hospitals in Kenya.Eligible participants were nurse-midwives in charge of the maternity unit.The discussion was conducted in English,tape-recorded,and transcribed verbatim,Data were analyzed thematically,following Braun and Clarke 6-step framework.Nvivo version 7.0 computer software was used to facilitate this process.Results:Two focused group discussions each involving seven participants were conducted.The participants agreed that maternal mortality due to postpartum hemorrhage and pregnancy-induced hypertension is a major health concern.Further,maternal care in the two hospitals was substandard.Themes that emerged as barriers were:inadequate supplies;inadequate obstetric knowledge and skills;shortage of nurse-midwives,and inadequate support supervision.The underlying factors include inadequate funding by the county government and high staff turnover.Conclusion:This study showed that nurse-midwives are working under very difficult circumstances which are hindering the provision of quality maternal care.This is mainly due to system failures and inadequate nursemidwife numbers.Targeted strategies need to be urgently implemented to mitigate these challenges to improve the quality of maternal health care.
文摘Introduction: Little is known about the quality of healthcare in intensive care units (ICUs) in Poland. Data on patients hospitalized in ICUs in Warsaw and the results of their treatment are scarce. This information, crucial for improving the quality of ICU healthcare services, is not collected routinely. Quality indicators are essential in the concept of holistic quality management. Implementation of these indicators in ICUs is a complex and time-consuming process. Systematic increase in demand for quality assessment tools that can reflect real conditions of the practices of ICUs, prompts the search for effective solutions. Methods: The study included 12,155 patients hospitalized in 16 ICUs of Warsaw hospitals (8 ICUs, n = 3293 of the first level of care, and 8 ICUs, n = 8862 of the second level) between 1<sup>st</sup> January 2017 and 31<sup>st</sup> December 2018. ICUs in pediatric and oncological hospitals were excluded from the study. Characteristics and demography of patients as well as the structure, treatment and human resources of the ICUs in Warsaw were analyzed. Length of stay, unexpected extubations, nosocomial infections, ICU readmissions and standardized mortality ratios (SMR) were retrieved from National Health Fund, Ministry of Health, and other public databases. Results: In primary level ICUs patients’ age (66.42 vs. 64.43 years;p = 0.005) and comorbidity rate (30.56% vs. 22.78%, p = 0.037) were higher when compared to ICUs of the second level of care. The crude mortality rate in ICUs in Warsaw was significantly higher than in other EU countries and differed between ICUs of the first and the second level (34.77% vs. 24.53%, respectively;p = 0.004). SMRs were however very low: 0.71 and 0.64 (ns), respectively. ICU readmission rate, unexpected extubations, central catheter related infections, and length of stay were identical in both groups. More patients were admitted to ICU form emergency department and/or discharged home in Level 1 ICUs (18.9% vs 12.9%, p Conclusions: There are no major differences in quality of care provided by Level 1 and Level 2 ICUs in Poland, although more rigorous adhesion to admission and discharge policies is needed. Implementation of the instruments for assessing quality of ICUs including benchmarking, self-assessment of departments and evaluation of changes resulting from audits according to the Deming cycle is of utmost importance. Standardization of quality measures and markers, communication, and cooperation in reporting and creation of ICU medical registers is necessary to improve the quality of healthcare.
基金Supported by Zhejiang Medical and Health Science and Technology Program(Project Name:Construction and Application of Exercise Fear Intervention Program for Elderly Patients with Chronic Heart Failure Based on HBM and TPB Theory),No.2023KY180.
文摘BACKGROUND With the intensification of social aging,the susceptibility of the elderly population to diseases has attracted increasing attention,especially chronic heart failure(CHF)that accounts for a large proportion of the elderly.AIM To evaluate the application value of health concept model-based detailed behavioral care in elderly patients with CHF.METHODS This study recruited 116 elderly CHF patients admitted from October 2018 to October 2020 and grouped them according to the nursing care that they received.The elderly patients who underwent health concept model-based detailed behavioral care were included in a study group(SG;n=62),and those who underwent routine detailed behavioral nursing intervention were included as a control group(CG;n=54).Patients’negative emotions(NEs),quality of life(QoL),and nutritional status were assessed using the self-rating anxiety/depression scale(SAS/SDS),the Minnesota Living with Heart Failure Questionnaire(MLHFQ),and the Modified Quantitative Subjective Global Assessment(MQSGA)of nutrition,respectively.Differences in rehabilitation efficiency,NEs,cardiac function(CF)indexes,nutritional status,QoL,and nursing satisfaction were comparatively analyzed.RESULTS A higher response rate was recorded in the SG vs the CG after intervention(P<0.05).After care,the left ventricular ejection fraction was higher while the left ventricular end-diastolic dimension and left ventricular end systolic diameter were lower in the SG compared with the CG(P<0.05).The post-intervention SAS and SDS scores,as well as MQSGA and MLHFQ scores,were also lower in the SG(P<0.05).The SG was also superior to the CG in the overall nursing satisfaction rate(P<0.05).CONCLUSION Health concept model-based detailed behavioral care has high application value in the nursing care of elderly CHF patients,and it can not only effectively enhance rehabilitation efficiency,but also mitigate patients’NEs and improve their CF and QoL.
文摘Background: Value-Based Care is a program that was created by Professor Michael E. PORTER and Elizabeth O. TEISBERG which has been modified for implementation over the last seventeen years. This new program is paid by Commercial Health Insurers (Insurance Companies) and Centers for Medicare and Medicaid Services (Medicare). This program incorporates the patients, doctors, Life Sciences Companies, Insurance Companies, Holistic practice, traditional Chinese medicine, etc. with alternative traditional treatments and therapies for Real-World Evidence based and value-based treatment customized to patients’ needs and the patients benefit. Methods: The program was proposed to achieve value for patients and an improved healthcare system which is especially needed to provide treatment for patients in Serious or Life-threatening conditions or diseases. The program will accurately measure the outcomes of patients and provide a wider choice of treatments that matter to patients, also to measure the cost that successful alternative treatments provide which may lower the cost to Medicare and Insurance Companies. Conclusion: The proposed and now implemented program is to achieve value for patients. Golden Sunrise Nutraceutical (Golden Sunrise) provides a New Medical Innovation and treatment alternative to patients suffering from Serious or Life-threatening illnesses. By using Golden Sunrise Innovation and with the incorporation of Value-based Care patients will become the drivers or it could be said the patient Ambassadors of their own health. By incorporating Golden Sunrise Innovation, the doctors will have more diversity of treatments available for their patients. Payment should reflect value not volume, and the New Medical Innovation Golden Sunrise offers will help in reducing the costs to Insurance Companies accelerating the adoption of Value-Based Care.
基金This study was supported in part by the National Natural Science Foundation of China(71973136 and 72061147002)the 2115 Talent Development Program of China Agricultural University.
文摘Over the past few decades,the Internet has rapidly diffused across China.The spread of the Internet has had a profound economic and social impact on Chinese rural areas.Existing research shows that Internet access significantly impacts agricultural production and improves smallholder farmers’income.Beyond these,the Internet can affect other dimensions of social welfare.However,research about the impact of Internet access on dietary quality in rural China remains scarce.This study utilizes multi-period panel data from Fixed Observation Point in rural China from 2009 to 2015 to estimate the impact of Internet access on dietary quality and food consumption of rural households and conducts a causal analysis.Regression models with time and household fixed effects allow robust estimation while reducing potential issues of unobserved heterogeneity.The estimates show that Internet access has significantly increased rural household dietary quality(measured by the Chinese Diet Balance Index).Further research finds that Internet access has increased the consumption of animal products,such as aquatic and dairy products.We also examine the underlying mechanisms.Internet access improves dietary quality and food consumption mainly through increasing household income and food expenditure.These results encourage the promotion of Internet access as a valuable tool for nutritional improvements,especially in rural areas.
文摘Purpose: To contribute to the improvement of the quality of prenatal consultation at the reference health center of the commune IV of the district of Bamako. Patients Methods: This was a qualitative cross-sectional study to assess the quality of prenatal consultation that took place from December 1, 2017 to January 31, 2018. It included 139 pregnant women whose consultations were monitored by the investigator and then the women were interviewed upon discharge from the facility to collect their opinions on the services they received. Results: The age group of 20 to 29 years was the most represented with 60.44%. In our study, 50% of our patients were managed by midwives. Among the antecedents constituting the risk factors sought in pregnant women, scar uterus was more frequent with 33.93% followed by arterial hypertension with 14.28% and multiparity with 7.14%. Conclusion: This study shows that the evaluation of the quality of services is an absolute necessity for the improvement of services in integrated reproductive health care centers.
文摘The partogram is an accurate labor monitoring tool for reducing maternal and perinatal mortality due to prolonged labor and dystocia. The aim of this study is to assess how the quality of the partogram has evolved in health care institutions (HCI in short) that have benefited from the primary health care support project (ASSP in short) after formative supervision. This is a descriptive study by periodic clinical audit between 2020 and 2022, carried out in 96 HCI in 3 provincial health divisions (DPS in short) of DR Congo. Each photographed partogram page was sent to the project’s central level for review by a team of experts (3 obstetric gynecologists and 3 midwives). The compliance rate for completing partograms in the 96 health facilities of the 3 DPS was 86.8%. The rate of traceability of labor continuity was 88.2%, and that of traceability of acts, incidents and treatments during labor was 87.1%. Finally, the compliance rate for filling out partograms in the immediate post-partum period was 81%. A clear improvement was noted between the January 2020 and March 2022 assessments.
文摘Objective: To comprehensively understand the impact of the quality of life of elderly nurses in two selected elderly care institutions in Zibo city, Shandong province, and to provide a scientific basis for improving the professional quality of life of elderly nurses. Methods: The convenient sampling method was used to investigate the professional quality of life (proQOL) questionnaire Version 5 and the self-designed demographic data of 82 elderly nurses working in two elderly care institutions. Result: From this score, it can be seen that the occupational burnout problem of elderly nursing staff in the two nursing homes is the most significant, with empathy and secondary trauma emergency at a moderate level. After controlling the demographic variables, the working hours and monthly income level had a significant impact on nurses’ job burnout. Conclusion: Due to the particularity and high intensity of elderly nurses’ work, their physical and mental health faces many challenges, which affect their quality of life. At present, efforts will be made to reduce work pressure, increase wages and benefits, and thereby improve the quality of life.
文摘The collaboration of medical care,parenting,and education aims to integrate nursing,midwifery,infant and child care services,and management with speech and hearing rehabilitation technology,among other elements related to the infant care industry chain.This integration targets pediatrics talent training in nine infant care positions,including nursing,infant health care and management,and child rehabilitation,to ensure that the capabilities and quality of professional talents can meet the health care needs of infants and young children.This article briefly explains the background of the“collaboration of medical care,parenting,and education,and integration of industry and education.”It analyzes the necessity of cultivating infant and child care service talents based on the perspective of“collaboration of medical care,parenting,and education,and integration of industry and education.”Based on this perspective,we conducted an in-depth study of the cultivation of professional qualities of infant and child care service talents.
文摘Objective:The study was conducted with the aim of determining the spiritual well-being(SWB)of nursing students and its association with quality of life(QOL).Materials and Methods:A cross-sectional analytical study was conducted with a sample size of 504 nursing students collected from January 2023 to March 2023 in the nursing institutes of Khyber Pakhtunkhwa,Pakistan,using convenient sampling techniques.A Spiritual Health and Life-Orientation Measure(SHALOM)questionnaire for SWB and K-27 QOL(K-27 QOL)instrument were used for data collection that contains three parts.Results:The number of female participants was in the majority(50.4%)compared to male nurses(49.6%).The overall mean score of SWB of the students was 3.79±0.48,while the mean K-27 QOL score was 3.73±0.57.There were significant differences between the groups of gender(P=0.001),while no significant difference within the groups of semester(P=0.061)and college status(0.285).In QOL,there were significant differences within the groups of semester(P=0.000)and college status(P=0.036)while no significant difference in gender category(P=0.480).SHALOM score is positively and moderately correlated with QOL score(r=0.597,P<0.05).Conclusion:Spiritual practices are one of the important factors that are associated positively with QOL,therefore to enhance the QOL,it will require spiritual practices.
基金Hebei University Affiliated Hospital Youth Fund Scientific Research Project Project Number:2019Q017。
文摘Objective:To explore the role of specialized group management in the quality control of perioperative nursing.Methods:45 surgical nurses from our hospital were selected as the research subjects.Traditional operating room management was adopted from July 2019 to June 2020,and specialized group management was adopted from July 2020 to June 2021.The surgeon’s satisfaction,surgical nurses’core professional competence,and surgical patients’satisfaction were obtained through surveys and the results were analyzed.Results:Surgeon satisfaction before the implementation of specialized group management was significantly lower than after its implementation(P<0.05).Besides,surgical nurses’core professional competency scores before the implementation of specialized group management were significantly lower than after its implementation(P<0.05).Lastly,surgical patients’satisfaction before the implementation of specialized group management was significantly lower than after its implementation(P<0.05).Conclusion:Specialized group management helps to improve the quality of perioperative care and should be applied in clinical practice.
文摘New clinical approaches are imperative beyond the widely adopted National Comprehensive Cancer Network (NCCN) guidelines, utilized by prominent cancer institutions. Cancer is the leading cause of death among individuals younger than 85 years within the United States. Despite significant technological advances, including the expenditure of hundreds of billions, treatment outcomes and overall survival have not notably improved for most types of advanced cancer over the last several decades. Over the past 24 years, Envita Medical Centers has pioneered a unique form of personalized treatment approach for late-stage and refractory cancer patients, introducing groundbreaking innovations in the field. Our integrated algorithm utilizes advanced genomics, transcriptomics, and highly tailored immunotherapy, resulting in remarkable outcome improvements. This study presents Envita’s innovative personalized treatment algorithms and examines the response outcomes of 199 late-stage cancer patients treated at Envita Medical Centers over a two-year period. Compared to standard of care and palliative chemotherapy, Envita’s treatment demonstrated a remarkable 35-fold improvement in overall response rates (Figure 1). Moreover, 88% of the patients, the majority presenting with Stage 3 or 4 cancer, experienced a 43-fold improvement in quality of life with minimal side effects, as compared to standard of care chemotherapy and palliative care. This revolutionary success is attributed to Envita’s personalized therapeutic algorithms, which incorporate customized immunotherapy. Envita’s precision care approach has also achieved a 100% better response rate compared to over 65 global chemotherapy clinical trials with more than 2700 patients. The results from this study suggest that a wider utilization of Envita’s personalized approach can significantly benefit patients with late-stage and refractory cancer.
文摘In this editorial,we comment on the article by Wang and Long,published in a recent issue of the World Journal of Clinical Cases.The article addresses the challenge of predicting intensive care unit-acquired weakness(ICUAW),a neuromuscular disorder affecting critically ill patients,by employing a novel processing strategy based on repeated machine learning.The editorial presents a dataset comprising clinical,demographic,and laboratory variables from intensive care unit(ICU)patients and employs a multilayer perceptron neural network model to predict ICUAW.The authors also performed a feature importance analysis to identify the most relevant risk factors for ICUAW.This editorial contributes to the growing body of literature on predictive modeling in critical care,offering insights into the potential of machine learning approaches to improve patient outcomes and guide clinical decision-making in the ICU setting.
