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1.
Int J Nurs Educ Scholarsh ; 22(1)2025 Jan 01.
Artigo em Inglês | MEDLINE | ID: mdl-38459787

RESUMO

OBJECTIVES: This systematic review of qualitative studies explored interventions to improve student nurses' knowledge, attitudes or willingness to work with older people. Student nurses are likely to encounter older people in all health and aged care settings, however, research demonstrates that few have career aspirations in gerontological nursing. METHODS: Qualitative systematic review method based on the Cochrane Handbook for Systematic Reviews of Interventions. RESULTS: Search of Medline, Embase, PsycINFO, EBSCOhost and Scopus yielded 1841 articles which were screened to include primary research about educational interventions to improve student nurses' knowledge, attitudes and/or willingness to work with older people. Data extraction was performed on the 14 included studies, and data were analysed using directed content analysis. The Mixed Methods Appraisal Tool (MMAT) was used the assess the quality of the studies. CONCLUSIONS: Educational interventions included theory or practice courses, or a combination of theory and practice. While most interventions changed nursing students' negative attitudes towards older people, few increased their willingness to work with them. Practice courses had the most significant impact on willingness to work with older people. Quality assessment revealed methodical limitations. More research is needed to better understand the elements of practice interventions that enhance student nurses' knowledge, attitudes, and willingness to work with older people, so that they can be replicated.


Assuntos
Enfermeiras e Enfermeiros , Estudantes de Enfermagem , Idoso , Humanos , Competência Clínica , Revisões Sistemáticas como Assunto , Atitude do Pessoal de Saúde
2.
An. psicol ; 40(1): 110-118, Ene-Abri, 2024. ilus, tab
Artigo em Inglês | IBECS | ID: ibc-229033

RESUMO

Objetivo: La soledad se asocia a la discapacidad funcional en la población mayor, aunque se sabe poco sobre el papel de la afectividad en esta relación. Nos proponemos explorar el efecto mediador de la afectividad en la relación entre funcionalidad y soledad, controlando el efecto de las variables relevantes. Métodos: Se administró la Escala de Soledad de la Universidad de California-16, la Escala de Funcionalidad Geriátrica, las Escalas de Afecto Positivo y Negativo-14 y la Escala de Depresión Geriátrica-8 a 489 adultos mayores (65–100 años), 428 de residencias geriátricas y 61 de la comunidad. Resultados: Los residentes en una institución, mujeres, viudos, con baja educación, más discapacidad funcional, más afecto negativo, menos afecto positivo y más síntomas depresivos reportaron más soledad. Controlando el efecto de los síntomas depresivos, género, situación residencial, estado civil y educación, solo el afecto positivo medió, parcialmente, la relación entre funcionalidad y soledad. Conclusión: Se sugieren intervenciones para aumentar la concienciación por parte de los adultos mayores en los perfiles personalizados de afecto positivo, aliviando así los sentimientos de soledad en los que sufren limitaciones funcionales (especialmente mujeres, con síntomas depresivos, viudos, residiendo en una institución y con bajo nivel educativo).(AU)


Objective: Research has shown that loneliness is associated with functional disability in the older population. However, little is known about the role of affectivity in this relationship. The present study explored a mediation model in which affectivity was hypothesized to mediate the re-lationship between functionality and loneliness, controlling for the effect of relevant variables.Methods:The University of California Loneliness Scale-16 items, Geriatric Functionality Scale, Positive and Negative AffectSchedule-14, and Geriatric Depression Scale-8 were administered to 489 old adults (65–100 years old), 428 from social care homes (SCH), and 61 from the community.Results:Those from SCH, women, widowed, withlow education, more functional disability, more negative affect, less posi-tive affect, and more depressive symptoms reported more loneliness. Con-trolling for the effect of depressive symptoms, gender, residential status, marital status, and education, only positive affect mediated, partially, the relationship between functionality and loneliness.Conclusion:We suggest implementing interventions that increase older adults' insights in personal-ized patterns of positive affect and, consequently, ease feelings of loneli-ness in older people suffering from functional limitations (especially wom-en, with depressive symptoms, widowed, residing in an institution, and with low educational level).(AU)


Assuntos
Humanos , Masculino , Feminino , Idoso , Casas de Saúde , Solidão/psicologia , Saúde do Idoso , Afeto , Envelhecimento/psicologia
3.
Rev. esp. geriatr. gerontol. (Ed. impr.) ; 59(2): [101453], Mar-Abr. 2024. ilus, tab
Artigo em Inglês | IBECS | ID: ibc-231166

RESUMO

Background: Nursing homes are becoming increasingly important as end-of-life care facilities. However, many older adults want to stay in their homes as they age. Objective: To assess the feasibility of a deinstitutionalization process on selected institutionalized older adults who are willing to initiate the process. Methods: This study, divided into two phases, will be carried out over 15 months on 241 residents living in two nursing homes in Navarra (Spain). The first phase has a cross-sectional design. We will identify the factors and covariates associated with feasibility and willingness to participate in a deinstitutionalization process by bivariate analysis, essential resources for the process and residents to participate in the process. The second phase has a complex interventional design to implement a deinstitutionalization process. An exploratory descriptive and comparative analysis will be carried out to characterize the participants, prescribed services and the impact deinstitutionalization intervention will have over time (quality of life will be the main outcome; secondary variables will be health, psychosocial, and resource use variables). This study will be accompanied by a pseudo-qualitative and emergent sub-study to identify barriers and facilitators concerning the implementation of this process and understand how intervention components and context influence the outcomes of the main study. Intervention components and the way the intervention is implemented will be of great relevance in the analysis. Discussion: Alternatives to institutionalization with adapted accommodation and community support can allow people who wish to return to the community.(AU)


Introducción: Las residencias de personas mayores cobran cada vez más importancia como centros de atención al final de la vida. Sin embargo, muchos adultos mayores desean permanecer en sus casas mientras envejecen. Objetivo: Se pretende evaluar la viabilidad de un proceso de desinstitucionalización en adultos mayores seleccionados que viven en las residencias y que expresen la voluntad para iniciar el proceso. Métodos: Este estudio, dividido en dos fases, se llevará a cabo durante 15 meses en 241 sujetos que viven en dos residencias de personas mayores en Navarra (España). La primera fase tiene un diseño transversal en donde se identificarán los factores y covariables asociadas a la viabilidad y voluntad para participar en un proceso de desinstitucionalización a través de un análisis bivariante, los recursos imprescindibles para el proceso y los residentes que quieran participar en él. La segunda fase tiene un diseño de intervención compleja en la que se implementa un proceso de desinstitucionalización. Se realizará un análisis exploratorio descriptivo y comparativo para caracterizar a los participantes, los servicios prescritos y el efecto de la intervención de desinstitucionalización a lo largo del tiempo (la calidad de vida será la variable principal; las secundarias serán las referentes a la salud, las psicosociales y de uso de recursos). Este estudio irá acompañado de un subestudio pseudocualitativo y emergente para identificar las barreras y los elementos facilitadores relativos a la implementación de este proceso y comprender cómo los componentes de la intervención y el contexto influyen en los resultados del estudio principal. Los componentes de la intervención y su ejecución serán de gran relevancia en el análisis. Discusión: Las alternativas a la institucionalización con viviendas adaptadas y apoyos comunitarios pueden permitir a las personas que así lo desean el retorno a la comunidad.(AU)


Assuntos
Humanos , Masculino , Feminino , Desinstitucionalização , Instituição de Longa Permanência para Idosos , Qualidade de Vida , Saúde do Idoso , Estudos Transversais , Geriatria , Guias como Assunto , Espanha
4.
Radiología (Madr., Ed. impr.) ; 66(2): 196-204, Mar.- Abr. 2024. tab, graf
Artigo em Espanhol | IBECS | ID: ibc-231521

RESUMO

Tras la implantación del Espacio Europeo de Formación Superior, los contenidos del Área de Radiología y Medicina Física que se impartían tradicionalmente en la Licenciatura de Medicina se han incorporado también a los nuevos grados de Odontología, Enfermería, Fisioterapia, Podología y, en menor medida, Farmacia, Terapia Ocupacional, Logopedia, e Ingeniería Biomédica. En su conjunto, los conceptos básicos de radiología y protección radiológica se imparten en Murcia en 5 grados diferentes con un total de 52,5 créditos ECTS, participando en la formación de 1219 alumnos cada curso académico. Esta incorporación en los nuevos grados ha triplicado el número de asignaturas en las que se imparte docencia pregrado, y duplicado tanto el número de créditos ECTS como el número de alumnos de pregrado a los que dirige su labor de formación. Así, ante la posible creación de nuevos grados universitarios en un futuro próximo (Imagen para el Diagnóstico y Técnico en Radioterapia) sería necesaria la implicación de un mayor número de profesionales acreditados, de diferentes especialidades, y que optimicen los recursos docentes (bibliografía, material docente, casos clínicos, etc.) para su utilidad en las diferentes asignaturas que comparten contenidos similares.(AU)


After the implementation of the European Space for Higher Education, the contents of the Radiology and Physical Medicine Area that were taught in the Medicine Degree have also been incorporated into the new degrees of Dentistry, Nursing, Physiotherapy, Podiatry, and, to a lesser extent, Pharmacy, Occupational Therapy, Logopedia, and Biomedical Engineering As a whole, the basic concepts of radiology and radiological protection are taught in Murcia in 5 different degrees with a total of 52.5 ECTS credits, participating in the training of 1,219 students each academic year. This incorporation in the new degrees has tripled the number of subjects in which undergraduate teaching is taught, and doubled both the number of ECTS credits and the number of undergraduate students to whom it directs its training work. Thus, given the possible creation of new university degrees in the near future (Diagnostic Imaging and Radiotherapy Technicians), it would be necessary to involve a greater number of accredited professionals, from different specialties, and to optimize teaching resources (bibliography, material teacher, clinical cases, etc.) for its usefulness in the different subjects that share similar contents.(AU)


Assuntos
Humanos , Masculino , Feminino , Estudantes de Medicina , Educação Médica , Radiologia/educação , Educação de Pós-Graduação
5.
Recurso na Internet em Português | LIS - Localizador de Informação em Saúde, LIS-controlecancer | ID: lis-49579

RESUMO

No dia 28 de fevereiro foi publicado no Diário Oficial da União e entrou em vigor a Resolução do Conselho Federal de Enfermagem (Cofen) de N° 741, de fevereiro de 2024 que Regulamenta e normatiza a assistência de Enfermagem nos Bancos de Leite Humano e Posto de Coleta de Leite Humano.


Assuntos
Cuidados de Enfermagem , Conselhos de Saúde , Bancos de Leite Humano , Leite Humano
6.
Multimedia | Recursos Multimídia | ID: multimedia-12936

RESUMO

Encontro com os Especialistas Egberto Moura, médico, professor de fisiologia e fisiopatologia endócrina na Universidade do Estado do Rio de Janeiro (UERJ) e Patrícia Lisboa, bióloga, professora da UERJ.


Assuntos
Aleitamento Materno , Desenvolvimento Humano , Cuidado do Lactente , Doenças Metabólicas , Obesidade
7.
J Am Geriatr Soc ; 2024 Feb 29.
Artigo em Inglês | MEDLINE | ID: mdl-38424687

RESUMO

BACKGROUND: Older adults with severe dementia are at increased risk of being physically restrained in nursing homes and acute care settings, but little is known about restraint use among those cared for at home. This study explores caregiver-reported use of restraints among community-dwelling older adults with severe dementia. METHODS: Using cross-sectional data from 215 family caregivers, we describe restraint use among older adults with severe dementia living at home. We then use multivariable logistic regression to identify factors associated with restraint use. RESULTS: Nearly half (47%) of caregivers reported on older adults who had been subject to restraints. Most caregivers reporting restraint use suggested safety reasons, such as prevention of falls (68%), wandering (30%), and removal of catheters or feeding tubes (29%); and 44% indicated doctors or other health care providers were involved in the decision to restrain. Feeding tubes (OR = 4.16, 95% CI: 1.27-13.59) and physically aggressive agitation behaviors (OR = 1.93, 95% CI: 1.09-3.40) were associated with higher odds of restraint use among older adults with severe dementia. Caregivers who received strong emotional support from friends (OR = 0.45, 95% CI: 0.21-0.95) were less likely to report restraint use while serving as a caregiver to others (OR = 2.77, 95% CI: 1.36-5.63) increased the odds of restraint use. CONCLUSIONS: The pervasiveness of restraint use is concerning and suggests a lack of evidence-based guidance and support for both caregivers and healthcare providers to prevent restraint use among older adults with severe dementia cared for at home.

8.
Jpn J Nurs Sci ; : e12594, 2024 Feb 29.
Artigo em Inglês | MEDLINE | ID: mdl-38425133

RESUMO

AIM: Generation Z students do not get much benefit from traditional distance education methods. Instead, they need new platforms and methods that will motivate them and increase their success. METHODS: A randomized controlled study was performed on 42 students. The experimental group students were presented with metaverse, and the control group students were taught the distance education course. RESULTS: In this study, in the students' Instructional Materials Motivation Survey, the mean scores of both the experimental and control groups exhibited no significant difference before the intervention. Regarding the effect of metaverse-based learning on students' Instructional Materials Motivation Survey, the mean score of the control group was 82.55 ± 13.18, and the mean score of the experimental group was 96.52 ± 9.54 and there was a significant difference between groups after the intervention. When the academic achievement levels of the groups were examined, it was determined that the experimental group scored 76.57 ± 13.33 and the control group received 64.40 ± 16.42 points. It was determined there was a significant difference between the groups in terms of learning motivation and academic achievement. CONCLUSION: The study results show that the participants accepted the important role of metaverse as an effective learning method compared to traditional distance education methods. It is recommended to expand the use of metaverse in various fields of nursing education.

9.
J Adv Nurs ; 2024 Mar 01.
Artigo em Inglês | MEDLINE | ID: mdl-38426358

RESUMO

AIM: To examine and compare the level of cancer-related concerns and affecting factors between cancer survivors who completed their treatment and those still receiving treatment. DESIGN: The study has a cross-sectional comparative design. METHODS: Convenience sampling was used and the study included 350 Turkish cancer survivors. Data were collected between March and June 2022 online with a descriptive characteristics form and the Assessment of Survivor Concerns. Obtained data were analysed with numbers, percentages, mean values, t-test and multiple linear regression analysis. RESULTS: The cancer survivors who completed their treatment had a significantly higher level of concerns than those who were still on treatment. Female cancer survivors, cancer survivors with less than 5-year time elapsing after diagnosis and gynaecological cancer survivors with completed cancer treatment can also have a higher level of cancer-related concerns. CONCLUSION: Cancer survivors who have completed their treatment have a higher level of concerns than those who still receive treatment. Gender, time elapsing after diagnosis and type of cancer affect the level of concerns. IMPLICATIONS FOR THE PROFESSION AND/OR PATIENT CARE: Nurses should evaluate psychosocial care and needs of cancer survivors in addition to their physical care. Raising awareness about the concerns of the cancer survivors with completed treatment in addition to those still receiving treatment and providing holistic care to them can reduce their concerns. IMPACT: It is of great importance to be aware of the factors likely to increase cancer-related concerns during and after cancer treatment. This study identifies cancer-related concerns in cancer survivors who completed or were still receiving treatment and provides a comparison with other studies in the literature. REPORTING METHOD: We have adhered to STROBE statement using STROBE checklist for cross-sectional studies. PATIENT OR PUBLIC CONTRIBUTION: There was no patient or public involvement.

10.
J Adv Nurs ; 2024 Mar 01.
Artigo em Inglês | MEDLINE | ID: mdl-38426656

RESUMO

AIM: This study aimed to test the propositions using the job demands-resources (JD-R) model for main/moderation/mediation effects of a sense of coherence and practice environment support on mental well-being (anxiety, depression and burnout) outcomes in nurses and midwives in Australia during the COVID-19 pandemic. DESIGN: Cross-sectional quantitative survey. DATA SOURCES: The study was a cross-sectional design using self-report questionnaires reported as per the Reporting of Observational Studies in Epidemiology Guidelines. Following human research ethics approval (2020.ETH.00121) participants were recruited to take part in an online anonymous survey using self-report instruments to test the JD-R model in Australia. RESULTS: 156 participant nurses and midwives experienced anxiety, depression and emotional burnout during COVID-19. While a considerable proportion of participants indicated high levels of emotional exhaustion, their responses showed low levels of depersonalization (detached response to other people) and high levels of personal accomplishment (high levels of work performance and competence). A sense of coherence was a significant protective factor for mental health well-being for the participants, which is to say, high levels of sense of coherence were predictive of lower levels of anxiety, depression and burnout in this study sample. CONCLUSION: It is evident that both nursing and midwifery professions require psychosocial support to preserve their health both in the short and long term. Ensuring individualized tailored support will require a layered response within organizations aimed at individual self-care and collegial peer support. PATIENT OR PUBLIC CONTRIBUTION: There was no patient or public contribution in this study, as the focus was on nurses and midwives.

11.
Artigo em Inglês | MEDLINE | ID: mdl-38432711
12.
Int J Nurs Educ Scholarsh ; 21(1)2024 Jan 01.
Artigo em Inglês | MEDLINE | ID: mdl-38433122

RESUMO

BACKGROUND: The flipped classroom (FC) pedagogy improves undergraduate student proficiency and satisfaction. However, its effectiveness has not been demonstrated in nursing anesthesia education. OBJECTIVES: Pre- and post-FC tests and course evaluations were retrospectively compared to determine if FC was an effective pedagogy for a nursing anesthesia program (NAP). METHODS: The design of the study was a retrospective program evaluation. Two groups were compared with 59 students in the pre-FC group taught via traditional lecture and 61 students in the post-FC group taught with FC. Answers to the same 167 test questions were compared using an independent t-test and five course evaluation questions were statistically compared using NPAR1WAY procedure with the Wilcoxon option to determine if significant differences existed between the two nursing anesthesia student cohorts. RESULTS: The post-FC students exhibited a significant 4 % increase in test scores and expressed increased satisfaction compared to their pre-FC counterparts. CONCLUSIONS: This retrospective program evaluation showed that student proficiency and satisfaction improved between the groups after changing to the FC pedagogy. However, research is needed to determine the true value of using FC in nursing anesthesia education. IMPLICATIONS FOR AN INTERNATIONAL AUDIENCE: The flipped classroom model can be beneficial in graduate nursing education with our ever-changing student population.


Assuntos
Anestesia , Educação de Pós-Graduação em Enfermagem , Educação em Enfermagem , Humanos , Estudos Retrospectivos , Avaliação de Programas e Projetos de Saúde
13.
Zhongguo Yi Xue Ke Xue Yuan Xue Bao ; 46(1): 49-54, 2024 Feb.
Artigo em Chinês | MEDLINE | ID: mdl-38433631

RESUMO

Objective To investigate the effect of Lemiancao on insomnia in the patients with depressive disorder. Methods Totally 79 patients diagnosed with both insomnia and depressive disorder from February to August in 2022 in Peking University Sixth Hospital were selected and classified into a control group(n=40) and a Lemiancao group(n=39).The Lemiancao group received routine nursing and medical treatment combined with Lemiancao training in the morning and evening every day,while the control group received routine nursing and medical treatment.The sleep status was evaluated based on the Pittsburgh sleep quality index(PSQI),insomnia severity index(ISI),and 36-item short-form health survey(SF-36) before and after treatment. Results The general information of patients showed no significant difference between the two groups(all P>0.05).After a 2-week intervention with Lemiancao training,the Lemiancao group showed lower PSQI and ISI scores and higher SF-36 score than the control group(all P<0.001). Conclusion Lemiancao training has therapeutic effects on insomnia in the patients with depressive disorder.


Assuntos
Transtorno Depressivo , Distúrbios do Início e da Manutenção do Sono , Humanos , Distúrbios do Início e da Manutenção do Sono/complicações , Sono , Inquéritos Epidemiológicos , Transtorno Depressivo/complicações
14.
Zhongguo Yi Xue Ke Xue Yuan Xue Bao ; 46(1): 55-61, 2024 Feb.
Artigo em Chinês | MEDLINE | ID: mdl-38433632

RESUMO

Objective To build a whole-course nursing quality evaluation system for liver transplantation in children,so as to provide a basis for nursing quality evaluation and management. Methods With Donabedian's "structure-process-outcome" model as the theoretical framework,we employed literature analysis,Delphi method,and hierarchical analysis to determine the contents and weights of indexes in the whole-course nursing quality evaluation system for liver transplantation in children. Results The three rounds of survey based on questionnaires showed the questionnaire recovery rate of 100%,the expert authority coefficients of 0.95,0.96,and 0.98,and the Kendall's coefficients of concordance of 0.165,0.209,and 0.220,respectively(all P<0.001).The established nursing quality evaluation system included 3 first-level indexes,15 second-level indexes,and 67 third-level indexes. Conclusion The whole-course nursing quality evaluation system for liver transplantation in children that was built in this study can provide a basis for the evaluation of the nursing quality.


Assuntos
Transplante de Fígado , Criança , Humanos
15.
Front Cardiovasc Med ; 11: 1352515, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38433756

RESUMO

Objective: This study aims to explore the effects of the Information-Motivation-Behavioral (IMB) Skills Model on the prevention of Venous Thromboembolism (VTE) in elderly lung cancer patients. Methods: A convenience sampling method was used to select study participants who were hospitalized for treatment between November 2022 and August 2023 at a tertiary hospital in Neijiang and met the inclusion and exclusion criteria. The control group (n = 41) received conventional health education, while the intervention group (n = 40) received health education based on the IMB Skills Model over three months. The scores of the Venous Thrombosis Knowledge, Participation in Thrombosis Prevention Willingness and Behavior Questionnaire, and Quality of Life Measurement Scale (QLQ-C30) were compared before the intervention and after three months. After three months of intervention, the hospital satisfaction and VTE incidence rates in both groups were investigated and compared. Results: After three months of intervention, the scores for the Venous Thrombosis Knowledge, (Participation in Thrombosis Prevention Willingness and Behavior Questionnaire in the intervention group were higher than those in the control group (P < 0.05). The QLQ-C30 scores in the intervention group for physical function, role function, emotional function, insomnia, appetite loss, and overall health status were higher than those in the control group (P < 0.05). The intervention group rated higher in doctor's professional skills, information provision, accessibility; nurse's professional skills, humanistic care, information provision, accessibility; team communication, services of other personnel, overall satisfaction compared to the control group (P < 0.05). The rate of VTE in the intervention group was 2.5%(1/40), and that in the control group was 19.5%(8/41). There was a significant difference (χ2 = 4.336, P = 0.037). Conclusion: Nursing interventions based on the IMB Skills Model for elderly lung cancer patients can enhance patients' understanding of venous thrombosis, increase willingness and active participation in thrombosis prevention, improve quality of life, increase hospital satisfaction, and reduce the incidence of VTE.

16.
Asia Pac J Oncol Nurs ; 11(3): 100361, 2024 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-38433772

RESUMO

Objective: This study aimed to establish a symptom network for patients with primary liver cancer posttranscatheter arterial chemoembolization (TACE), identifying core and bridge symptoms. The goal is to provide a foundation for precise and comprehensive nursing interventions. Methods: A total of 1207 post-TACE patients were included using a consecutive sampling method. Data collection involved a general information questionnaire, the Anderson Symptom Assessment Scale, and a primary liver cancer-specific symptom module. The symptom network was constructed using the R language. Results: In the overall network, distress exhibited the highest strength (rs = 1.31) and betweenness (rb = 62). Fatigue had the greatest closeness (rc = 0.0043), while nausea and vomiting (r = 0.76 ± 0.02) had the highest marginal weights. Nausea had the highest bridge strength (rbs = 5.263). In the first-time TACE-treated symptom network, sadness (rbs = 5.673) showed the highest bridge strength, whereas in the non-first-time symptom network, fever (rbs = 3.061) had the highest bridge strength. Conclusions: Distress serves as a core symptom, and nausea acts as a bridge symptom after TACE treatment in liver cancer patients. Interventions targeting bridge symptoms should be tailored based on the number of treatments, enhancing the quality of symptom management.

17.
Glob Qual Nurs Res ; 11: 23333936241228233, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38433773

RESUMO

Medical Assistance in Dying (MAID) legislation has evolved rapidly in Canada with significant impacts on nursing practice. The purpose of this paper is to describe evolving complexities in legislative context and practice standards that influence the experiences nurse practitioners and registered nurses have with MAID. Qualitative interviews were conducted with 25 registered nurses and 10 nurse practitioners from diverse contexts across Canada. Participants described their practices and considerations when discussing MAID as part of advance care planning; their use of, and challenges with, waivers of consent; their practice considerations in negotiating the complexities of clients for whom death is not reasonably foreseeable; and their moral wrestling with the inclusion of MAID for persons whose sole underlying medical condition is mental illness. Findings illustrate the moral complexities inherent in the evolving legislation and the importance of robust health and social care systems to the legal and ethical implementation of MAID in Canada.

18.
Plast Surg (Oakv) ; 32(1): 40-46, 2024 Feb.
Artigo em Inglês | MEDLINE | ID: mdl-38433790

RESUMO

Introduction: Distal radius fractures are a common injury of the hand and wrist that often require intensive rehabilitation. We sought to identify risk factors associated with discharge to a post-acute care facility following distal radius fracture repair. Methods: The 2011 to 2016 National Surgical Quality Improvement Program® (NSQIP) database was queried for all Current Procedural Terminology (CPT) codes that corresponded with open distal radius fracture repair. Patients with concomitant traumatic injuries were excluded. Patient demographics, comorbidities, perioperative factors, laboratory data, and surgical details were collected. Our primary outcome was to determine postoperative discharge destination: home versus a post-acute care facility, and to identify factors that predict discharge to post-acute care facility. Secondary outcomes included unplanned readmission, reoperation, and complications. Results: Between 2011 and 2016, a total of 12,001 patients underwent open distal radius fracture repair and had complete information for their discharge. Of these analyzed patients, 3.24% (n = 389) were discharged to rehabilitation facilities. The following factors were identified on multivariate analysis to have an association with discharge to a post-acute care facility: 65 years or older, White race, underweight, using steroids preoperatively, American Society of Anesthesiologists (ASA) classification > 2, admitted from a nursing home or already hospitalized, anemic, undergoing bilateral surgery, wound classification other than clean, and complications prior to discharge. Conclusion: Factors identified by our study to have associations with discharge to post-acute care facilities following distal radius fracture repair can help in appropriate patient counseling and triage from the hospital to home versus a post-acute care facility.


Introduction: Les fractures du radius distal sont des blessures courantes de la main et du poignet qui exigent souvent une réadaptation intensive. Les chercheurs ont voulu déterminer les facteurs de risque associés au congé dans un établissement de soins post-aigus après la réparation d'une fracture du radius distal. Méthodologie: Les chercheurs ont fouillé la base de données 2011-2016 des NSQIP pour extraire tous les codes CPT (terminologie procédurale actuelle) qui correspondaient aux réparations des fractures ouvertes du radius distal. Les patients atteints d'autres blessures traumatiques ont été exclus. Les chercheurs ont colligé les caractéristiques démographiques des patients, leurs maladies sous-jacentes, les facteurs périopératoires, les données de laboratoire et l'information chirurgicale. Le résultat primaire consistait à déterminer la destination du congé postopératoire, soit le domicile ou l'établissement de soins postaigus, et à établir quels facteurs permettent de prédire un congé dans un établissement de soins postaigus. Les résultats secondaires incluaient des réadmissions non planifiées, la reprise de l'opération et les complications. Résultats: Entre 2011 et 2016, un total de 12 001 patients ont subi la réparation d'une fracture ouverte du radius distal et reçu de l'information complète lors de leur congé. De ce nombre, 3,24% (n = 389) ont obtenu leur congé dans des établissements de réadaptation. L'analyse multivariée a établi que les facteurs suivants étaient associés à un congé dans un établissement de soins postaigus : un âge de 65 ans ou plus, la race blanche, l'insuffisance pondérale, la prise de stéroïdes après l'opération, une classification d'ASA supérieure à 2, l'admission à partir d'un centre de soins de longue durée ou le fait d'être déjà hospitalisé, l'anémie, la chirurgie bilatérale, une classification des plaies autres que propre et des complications avant le congé. Conclusion: La présente étude a déterminé que certains facteurs associés au congé dans un établissement de soins postaigus après une réparation du radius distal peuvent contribuer à des conseils appropriés aux patients et à un triage de l'hôpital vers le domicile plutôt que vers un autre établissement.

19.
Can Geriatr J ; 27(1): 20-28, 2024 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-38433881

RESUMO

Background: Young adults living with disabilities may sometimes end up in long-term care facilities which may not always meet their needs. Our project set out to pilot a supplemental assessment tool, a questionnaire to be used upon admission of younger adults into long-term care. We wanted the opinions of both staff and younger residents on what modifications may be needed in the implementation processes to ensure effectiveness of the tool. Methods: This project followed a qualitative design, implementing a previously designed supplemental assessment tool with five staff members and seven younger residents of two long-term care homes in Halifax, Nova Scotia. Residents completed the questionnaire with members of staff involved in admissions. Each group participated in follow-up interviews regarding their thoughts on implementation of the tool. Responses were analyzed using the constructs of the Consolidated Framework in Implementation Research following direct content analysis methods. Results: Feedback from residents and staff suggested that the tool could not be used as a one-size-fits-all solution but that flexibility in the format, content, and structure of the tool would be beneficial to ensure its utility in a variety of settings. Issues raised by staff and residents included, but were not limited to, accessibility of the intervention, the availability of resources, the format of the intervention and topics covered within it, and ensuring that processes for implementation are clearly defined. Conclusions: Both staff and residents approved of the tool for use in the admissions process and agreed that it would enhance the admissions practices already in place.

20.
J Vasc Bras ; 23: e20230085, 2024.
Artigo em Inglês | MEDLINE | ID: mdl-38433981

RESUMO

The largest branch of the terminal division of the brachial artery is the ulnar artery, which arises after the cubital fossa. This artery usually has a deep path in the muscles of the anterior forearm and is responsible for vascularization of the superficial and deep musculature on the ulnar side of the forearm and hypothenar area of the hand. We report an anatomical variant diagnosed by Doppler ultrasound in which the ulnar artery had a superficial position in the forearm. Occurrence of a superficial ulnar artery is rare, but it is an important fact for clinicians, surgeons, and nursing professionals.

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