Concept Of Care Research Articles

银发一族智慧社区养老服务参与意愿影响因素研究

With the accelerating global aging population, solving eldercare issues has become a significant challenge, and smart community elderly care services based on big data and internet technology have emerged as a response. To further analyze the factors influencing the elderly’s willingness to participate in smart community elderly care services, this study first reviews relevant literature from the perspectives of smart community elderly care and willingness to participate, providing a theoretical basis for this paper. Next, to ensure the typicality of the research, Weifang City is selected as the study’s experimental site. Questionnaires were distributed to collect data on the elderly’s willingness to participate in smart community elderly care services, and univariate analysis was conducted for factor screening. The screened results were then analyzed using binary logistic regression. The results are mainly analyzed from three aspects: individual factors such as age, type of household registration, and occupation; family internal factors such as living situation, family support for participating in community elderly care, and external factors such as neighborhood relationships and exposure to privacy. These factors influence the elderly’s willingness to participate in smart community elderly care. Finally, through discussion, the study identifies existing problems and proposes measures to improve the elderly’s willingness to participate in smart community elderly care, such as providing demand-oriented services, updating elderly care concepts, and creating a favorable external environment.

Building a Practice Ready and Resilient Nursing Workforce.

Nurse leaders depend upon resiliency skills to support their practice. It is important to provide opportunities for nursing students to learn, practice, and observe these skills, which are needed to navigate challenging work environments. This article describes the impact of a resiliency curricular component in a grant-funded BSN elective course, Concepts of Primary Care. Program evaluation was performed using a pre/posttest format and 2 surveys, the Brief Resilience Scale (BRS) and the Brief Resilience Coping Scale (BRCS). Three open-ended questions were administered upon completion of the elective course. A concurrent nested design was utilized with a thematic analysis undertaken to analyze qualitative data. Analysis of quantitative data was performed using descriptive statistics. Undergraduate BSN students showed an overall increase in resiliency (BRS: P = .112; BCRS: P = .064), and responses to open-ended questions supported the ability to apply and analyze most of the resiliency skills presented during the didactic portion of the elective course. This course promoted the development and refinement of undergraduate BSN student resilience skills. Integration of resilience content in the primary care course also supported student professional development. The addition of resiliency concepts and skills into undergraduate nursing curricula is recommended to enhance the ability of novice nurses to address work-related challenges and promote career satisfaction for the future.

Validation and Clinical Application of the Japanese Version of the Patient-Reported Experience Measures for Intermediate Care Services: A Cross-Sectional Study.

Older adult patients account for 70% of all hospitalized patients in Japan, and intermediate care based on patient-centered care (PCC) that ensures continuity and quality of care at the interface between home services and acute care services and restores patient's independence and confidence is necessary for them to continue living independently. At present, no concept of intermediate care is established in Japan, and the implementation of PCC has been delayed. Thus, in this study, a Japanese version of the intermediate care evaluation index (patient-reported experience measure (PREM)) was created on the basis of the original PREM developed in the UK, and data in wards with intermediate care functions in Japan were collected to confirm internal consistency and validity from 2020 to 2022. The Japanese version of PREM was found to have a factor structure with two potential factors. Given the clear correlation with the shared decision-making evaluation index, which is the pinnacle of PCC, the theoretical validity of the Japanese version of PREM, which is based on PCC as a theoretical basis, was confirmed.

The Reasons for Unfinished Nursing Care during the COVID-19 Pandemic: An Integrative Review.

Background: The concept of unfinished nursing care (UNC) describes nursing interventions required by patients and families that nurses postpone or omit. UNC reasons have been documented; however, no studies have summarised the underlying factors triggering the UNC during the pandemic. Therefore, the aim was to synthesise the available studies exploring factors affecting UNC during a pandemic. Methods: We conducted an integrative review following Whittemore and Knafl's framework according to the Reporting Items for Systematic reviews and Meta-Analyses (PRISMA) guidelines. PubMed, the Cumulative Index to Nursing and Allied Health Literature (CINAHL) and the Scopus databases were searched for primary studies that collected data from 1 January 2020 to 1 May 2023. Both qualitative and quantitative studies assessing the reasons for UNC were eligible and evaluated in their quality using the Critical Appraisal Skills Programme and the Mixed Methods Appraisal Tool. Results: Four studies were included-three qualitative and one cross-sectional. The reasons for UNC have been documented at the following levels: (a) system (e.g., new healthcare system priorities); (b) unit (e.g., ineffective work processes); (c) nurse management (e.g., inadequate nurse manager's leadership); (d) nurse (e.g., nurses' attitudes, competences, performances); and (e) patient (increased demand for care). Conclusion: The reasons for UNC during the COVID-19 pandemic are different to those documented in the pre-pandemic times and reflect a pre-existing frailty of the National Health Service towards nursing care.

An active-learning laboratory focused on critical care topics

Background and purposeTo describe an active-learning laboratory on critical care topics including advanced cardiac life support (ACLS), rapid sequence intubation (RSI), and toxicology and its effect on students' knowledge, skills, and confidence. Educational activity and settingThird year pharmacy students (n = 88) participated in a critical care focused laboratory with four stations focused on ACLS review, ABBOJECTⓇ syringe assembly, ACLS simulations, RSI cases, and toxicology. Prior to the critical care focused skills laboratory, students completed an optional assessment composed of six confidence and eight knowledge questions. After the laboratory, students completed the same confidence and knowledge assessment. Descriptive statistics assessed pre/post-assessment responses. Paired pre/post-assessment Likert data were analyzed using the Wilcoxon signed-rank test and paired pre/post-test multiple choice responses were analyzed using the McNemar test. FindingsOf the 88 students in the cohort, 76 students completed both the pre/post-assessments (response rate: 86.4%). Students demonstrated a significant increase in their overall knowledge and confidence scores on the post-assessment. All students successfully assembled an ABBOJECTⓇ syringe. The majority of respondents rated the critical care laboratory as excellent or good with regards to how enjoyable and effective the activity was to help understand critical care topics. SummaryA hands-on, active-learning laboratory devoted to teaching and reinforcing common critical care concepts allowed students to gain knowledge and confidence regarding ACLS, RSI, and toxicology.

Urogenital tumors following kidney transplantation-monocentric analysis of incidences and overview of urological preventive measures

Urogenital tumors are among the most common solid malignancies after kidney transplantation (TX). We analyzed the incidence and mortality of urogenital tumors after kidney TX in our own patient population as well as answered the question of recommended follow-up necessity and frequency in this cohort. Retrospective monocentric data collection of tumor diseases and the most common urogenital tumors after kidney TX at the Transplant Center Dresden between 2010 and 2020 was done. From this, we derived recommendations for auseful follow-up concept. Atotal of 13% (93/710) of kidney TX patients developed aneoplasm. Older patients (60.1 ± 10.6 vs. 53.8 ± 12.5; p < 0.001), with higher Charlson scores (≥ 4: 68% vs. 46%; p < 0.001) and aprevious tumor history (18% vs. 8%; p < 0.001) were more likely to develop aneoplasm after transplantation. In the multivariate analysis, previous tumor history was found to be an independent predictor of tumor development after renal transplantation (OR 2.2; 95%-KI [1.2-4.1]; p = 0.01). Urogenital tumors accounted for 30% (28/93) of all malignancies. Renal cell carcinoma of the native kidney was the most common (n = 12) neoplasm, followed by prostate cancer (n = 9). Most solid malignancies after kidney TX arise from the urinary tract. Due to their frequency, there is an urgent need for specialized urological therapy and long-term follow-up care. Even before listing for TX, risk factors can be recognized and individual concepts for follow-up care can be developed.

PERLINDUNGAN KANAK-KANAK DI MALAYSIA: MENILAI KEBERKESANAN JAGAAN PELIHARA DARI PERSPEKTIF UNDANG-UNDANG

Foster care serves as a crucial support system for children in need of care and protection in Malaysia who cannot live with their biological families due to issues such as neglect, abuse, or abandonment. This article examines the concept of foster care, its legal implementation, and challenges. By scrutinizing existing legislation, the paper aims to identify areas for improvement to enhance the effectiveness of foster care as part of the child protection system in Malaysia. The foster care system in Malaysia is primarily governed by the Child Act 2001 and managed by the Social Welfare Department in providing family-based care, especially for abandoned children. This article employs a qualitative study, revealing challenges and limitations within the existing legal framework. The findings indicate that there is no specific law governing foster care in Malaysia. Therefore, the article emphasizes the need to enhance the effectiveness of foster care legislation by increasing resources and support for foster parents, implementing standardized training programs for them, strengthening monitoring and evaluation mechanisms, and encouraging cooperation and information sharing among relevant agencies. This is to ensure positive outcomes and long-term welfare for children in foster care in Malaysia.

2023 Walter C. Alvarez Award Address

The Walter C. Alvarez Award is named in honor of Walter C. Alvarez, MD, a pioneer in the field of medical communication. The award is presented to either a member or nonmember of the American Medical Writers Association (AMWA) to honor excellence in communicating health care developments and concepts to the public. The Alvarez Award is presented during AMWA’s Medical Writing &amp; Communication Conference.

The Aesthetic Fashioning of the Self: Failure of Dissensual Subjectivity in The Hairy Ape

ABSTRACT In The Hairy Ape Eugene O’Neill reveals the instrumental control of society and accentuates the decline of an authentic self-relation against the backdrop of capitalist modernity. He creates an alienated and robotized character who breaks free of his designated role as a docile subject. This article draws upon the later work of Michel Foucault, especially his notions of care of the self and aesthetic self-fashioning, in order to consider the consequences of an ethical viewpoint toward subjectivity in O’Neill’s play. Associating Foucault’s concept of care of the self with social action, this article argues that Yank’s desire to act emanates from his ethical commitment to subjectivity and agency, but he fails because biopower contains and eliminates any resistance that calls its authority into question. It is the author’s contention that he carries the weight of revolt alone and thus cannot experience a self-fashioned form of subjectivity without bringing ruin upon himself.

Optimizing presurgical education for patients with head and neck cancer receiving laryngectomy and free flap surgery: A qualitative study.

There has been limited study of oncology professionals' perspectives on optimizing delivery of presurgical education for individuals with head and neck cancer (HNC). Therefore, we assessed oncology professionals' perspectives about presurgical education for laryngectomy and free flap surgeries, which have a significant impact on patients' quality of life. Interviews were conducted with 27 oncology professionals from an NCI-designated Comprehensive Cancer Center and a community oncology setting. Participants identified six recommendations to improve presurgical education: (1) establishing preoperative consultations with allied health professionals; (2) educating patients and providers on the concept of team-based care; (3) optimizing education through multimodal strategies; (4) connecting patients with other HNC surgical patients; (5) preparing caregivers for their role; and (6) educating patients on insurance navigation. Study findings demonstrate gaps in the timing, content, and mode of delivery for presurgical education and suggest strategies for further evaluation in future studies.

Interprofessional collaboration in the home care setting: perspectives of people receiving home care, relatives, nurses, general practitioners, and therapists—results of a qualitative analysis

BackgroundAbout one million people in need of home care in Germany are assisted by 15,400 home care services. Home healthcare is mostly a complex endeavour because interprofessional collaboration is often challenging. This might negatively impact patient safety. The project interprof HOME aims to develop an interprofessional person-centred care concept for people receiving home care in a multistep approach. In one of the work packages we explored how people receiving home care, relatives, nurses, general practitioners, and therapists (physiotherapists, occupational therapists, and speech therapists) perceive collaboration in this setting.MethodsSemi-structured interviews were conducted with 20 people receiving home care and with 21 relatives. Additionally, we worked with nine monoprofessional focus groups involving nurses of home care services (n = 17), general practitioners (n = 14), and therapists (n = 21). The data were analysed by content analysis.ResultsThree main categories evolved: “perception of interprofessional collaboration”, “means of communication”, and “barriers and facilitators”. People receiving home care and relatives often perceive little to no interprofessional collaboration and take over a significant part of the organisational coordination and information exchange. Interprofessional collaboration in steady care situations does exist at times and mostly occurs in coordination tasks. Contact and information exchange are rare, however, interprofessional personal encounters are sporadic, and fixed agreements and permanent contact persons are not standard. These trends increase with the complexity of the healthcare situation. Joint collaborations are often perceived as highly beneficial. Means of communications such as telephone, fax, or e-mail are used differently and are often considered tedious and time-consuming. No interprofessional formal written or electronic documentation system exists. Personal acquaintance and mutual trust are perceived as being beneficial, while a lack of mutual availability, limited time, and inadequate compensation hinder interprofessional collaboration.ConclusionsInterprofessional collaboration in home care occurs irregularly, and coordination often remains with people receiving home care or relatives. While this individual care set-up may work sufficiently well in low complex care situations, it becomes vulnerable to disruptions with increasing complexity. Close interactions, joint collaboration, and fixed means of communication might improve healthcare at home. The findings were integrated into the development of the person-centred interprofessional care concept interprof HOME.Trial registrationThis study is registered on the International Clinical Trails registry platform ClinicalTrials.gov as NCT05149937 on 03/11/2021.

A spiritually orientated (self-)care approach to human rights

In recent years, there have been significant challenges to women’s rights. In addition to external attacks, internal challenges include a dichotomous, oppositional and gendered framework of human rights, as well as the problem of burnout and trauma in the field. Feminists have been addressing these problems by offering a reconceptualisation of rights, developing the concept of spiritual activism, emphasising the power of erotics and pleasure in activism, as well as incorporating self- and collective-care practices. Taking into account feminist contributions and work that still needs to be done, as well as my own personal experiences in the fields of human rights, self-development and spirituality, in this article I engage with the concept of care and spirituality to propose changes in the conceptualisation and practices of human rights, with a view to developing a feminist spiritually orientated (self-)care approach to human rights.

Medical emergencies on board of means of transport

Medical emergencies occur always and everywhere. The care of patients on board means of transport is not possible with the quality and routine that takes place in ground- or air-based emergency services. Nevertheless, there are some concepts for patient care. The article describes typical emergency medical problems for the scenarios of train, ship and air travel and presents the existing possibilities for practical emergency medical assistance.

Evaluation of the accessibility attribute in the conception of women about gynecological assistance

Objective: To evaluate the Accessibility attribute in women's conception of gynecological care in a Basic Health Unit in the Federal District, Brazil. Method: This is an exploratory, cross-sectional descriptive study with a quantitative approach. Results: They showed that the attribute of accessibility in Primary Health Care is still a major conflict, and several problems persist, such as geographic barriers and difficult access by the organization of the service, which highlights the need to break the ordinary care practices that make difficult entry, access, reception and transmission of information. Conclusion: It is necessary to organize more inclusive forms of healthcare offerings, which aim to provide a quality welcome, with a holistic view of the person as a whole, fundamental for better organization of the healthcare service system in healthcare regions.

The circulatory death that saves lives-Intensive care nurses' conceptions of participating during 'donation after circulatory death': A phenomenographic study.

To describe intensive care nurses' conceptions of participating during the donation after circulatory death (DCD) process in intensive care units in Sweden. A qualitative design with a phenomenographic approach. In total, 12 semi-structured interviews were conducted in April 2022 with intensive care nurses from three hospitals. Data were analysed using a phenomenographic approach. Conceptions of participating during the DCD process varied. Four main themes emerged: DCD as a system; Intensive care nurses' role in the situation; Life to death to life; The essence of DCD. Variations emerged regarding what the informants talked about and how they talked about the what. Variations were based on informants' perspective of their role in relation to the structure and the team, and their conceptions of care for patients and their relatives. The findings illustrated success factors and challenges. Knowledge, experience, distinct structure, and relationship with relatives, among other factors, were described as success factors, while a lack of experience, difficulty in prognosing death, and organisational obstacles emerged as challenges. Furthermore, the findings showed that intensive care nurses play an important role in optimising the outcome of the DCD process. Their work related to DCD was conceived as being meaningful to fulfil more peoples' wishes to donate organs. People on the waiting list for organ transplantation are dying due to a shortage of organs. The implementation of DCD, as a complement to Donation after Brain Death (DBD), contributed to an increase in the number of organ donors, and intensive care nurses play an important role during the DCD process. Previous research manifests the complexity concerning their role. There is a lack of nursing research regarding intensive care nurses' conceptions of what it means to participate in the DCD process, which emphasises the significance of this study. This study is reported using consolidated criteria for reporting qualitative research (SRQR). No patient or public contribution.

Nursing student caring behaviours: a systematic review

Caring is central to nursing and requires scientific professional skills and knowledge. Numerous definitions highlight the fact that there is a range of perspectives regarding the caring behaviors. The purpose of this study was to provide a summary of caring behaviors among nursing students in order to depict a more comprehensive view, which could be used as foundational data for the argument that cultivating caring behaviors should be an early focus of the nursing curriculum. Article selection was guided by the preferred reporting items for systematic reviews and meta-analyses (PRISMA) Statements. Literature searches were conducted in June 21, 2022 in PubMed, cumulative index to nursing and allied health (CINAHL), and (OVID). The following search blocks were generated: nursing students, caring behavior, and education. About 318 were found using primary search descriptors and 19 studies were included in the review. All research was published between 2016 and 2020. The majority of studies were conducted using a cross-sectional design, two studies used prospective, and one study used a retrospective design. The caring behavior of nursing students varies depending on the country and instrument used, ranging from a moderate score to a high score, and varies from one study year to the next. The most dominant caring behavior domains reported are the domains of instrumental caring/physical caring and expressive caring/emotional caring. This study adds to the existing literature on nursing care and explains the universality of the concept of care from multiple theoretical perspectives. Caring interventions should be used to help students develop clinically-relevant caring behaviors.

Living with dementia in Aotearoa New Zealand: Samoan families’ perspectives

There is very little research about dementia in Aotearoa (New Zealand) New Zealand (NZ) Pacific communities, but information available suggests that Pacific people are presenting with dementia at a younger age and with more severe cognitive symptoms than do non-Pacific. The Samoan ethnic group is NZ’s largest Pacific population. This study explores experiences and understanding of dementia from family sessions with 25 people from 10 Samoan families living with dementia. Thematic analysis of the interviews showed there was no Samoan concept for dementia as a disease of the brain that required special medical attention; instead, Samoan elders spoke of memory loss as part of ageing, signifying the end to one’s purpose in life. A formal medical diagnosis saw family members honouring their obligations to care for their loved one at home, often at great cost. Culturally appropriate services, incorporating Samoan concepts of care and ageing, were rarely available.

Lebanese nursing students' perceptions of barriers to the implementation of person-centered care in clinical settings: A qualitative study.

This study aims to investigate how Lebanese nursing students perceive the challenges of implementing person-centered care in clinical settings. A qualitative descriptive design was adopted for this study. At one of Lebanon's top universities, a qualitative descriptive study design was used with 18 nursing students from various academic levels. Content analysis was used to generate the results after three focus group discussions. The Consolidated Criteria for Reporting Qualitative Research were used to report this study. The content analysis gave rise to four main themes, namely, "overload", "challenges with education", "unawareness", "establishing connection", and "lack of initiatives related to policy". The results showed a number of obstacles that Lebanese nursing students believed were in the path of providing person-centered care. These obstacles included organisational issues like time restraints and an intense workload, as well as interaction difficulties with patients and healthcare teams, and educational issues like insufficient instruction in person-centered care concepts during nursing programs.

Intime Infrastrukturen: Feministisch-geographische Perspektiven auf Energie

Abstract. Facing multiple and embodied inequalities inscribed in the energy system, this intervention argues for a feminist perspective on energy geographies. Extending critical research on urban infrastructure with concepts of care, it seeks to contribute to more just energy relations. In a first step, the article examines two energy fields: The home, where gender identities are produced and challenged, and the urban, where practices of solidarity oppose the conditions of care work in the context of neoliberal service provision. Shedding light on those „labourious spaces“, where urban materialities and its subjects are closely interconnected (Lancione and McFarlane, 2016), I reveal how heterogeneous infrastructural experiences are constantly contested within multiple entanglements of energy flows, gendered labour and care practices. In a second step, I provide three impulses for a relational perspective on energy. I argue for taking the intimate aspects of urban infrastructure as a starting point for feminist scholarship; for tracing a crisis of social reproduction along embodied energetic experiences; and for creating a collective vision of caring infrastructures.

Paradigm Shift: New Approaches to Understanding Autism Spectrum Disorders

A significant increase in the prevalence of autism spectrum disorders (ASD), both worldwide and in our country, dictates the need to search for modern and effective methods of prevention, diagnosis and medical care for such patients. At the same time, the results of numerous biomedical research in the field of autism are not reflected in practical healthcare. Aims of this work — substantiation of new approaches to the organization of medical care for people with ASD. The results of promising areas of autism research in the field of genetics, epigenetics, metabolomics, microbiome and multimorbidity, which marked a paradigm shift in the understanding of autism spectrum disorders, and requiring implementation in practice, are analyzed. Based on the concept of 7-p pediatrics (programming child development and health, preventive, predictive, personalized, participatory, multiprofessional, progressive), the necessity and possibility of implementing the results of scientific research into real clinical practice of managing children with autism are substantiated. The results of fundamental scientific research in the field of ASD, revealing their complex and multifaceted nature, allow us to talk about a paradigm shift in understanding this disorder Based on a new concept of medical care — 7P-pediatrics — the results of scientific research can be translated into real clinical practice, including diagnostic, therapeutic, preventive and rehabilitative effects on autism, as well ase programming of the optimal trajectory of the cognitive-behavioral phenotype of children with neurodevelopmental features, including ASD.