检索结果-内蒙古大学图书馆

Assessing young people who deliberately harm themselves

BRITISH JOURNAL OF PSYCHIATRY 2000年第2期176卷 126-131页

作者： Hurry, J Storey, P Univ London Inst Educ Thomas Coram Res Unit London WC1H 0AL England

Background Many young people who harm themselves have chronic mental hearth or social problems or are at risk of future self-harm or even suicide. The accident and emergency (A&E) clinic is an important gateway to treatment. Aims To describe the psychosocial assessment of 12- to 24-year-old patients attending A&E clinics following deliberate self-harm (DSH) and to identify features of service management and provision which maximise specialist assessment. Method A postal questionnaire wa;sent to a sample of one in three A&E departments in England. In a representative sample of 18 of these hospitals, staff were interviewed and 50 case notes per hospital were examined. Results Psychosocial assessment by non-specialist doctors in A&E departments tended to be of variable quality, focused on short-term risk. Around 43% of patients aged 12-24 were assessed by a specialist;specialist assessment was associated with high admission rates and the presence of on-site psychiatric departments and DSH teams, Conclusions Young DSH patients at risk often go unidentified;as a result their psychological problems may not be treated. Hospitals are frequently unaware of the proportion of patients discharged without adequate assessment. Declaration of interest This work was funded by the Department of Health.

关键词：急诊室医院/组织和管理病史记录/标准病人遴选精神病学/统计学和数值数据转诊和会诊/统计学和数值数据危险性评估自我伤害行为/诊断自我伤害行为/心理学青少年成年人儿童女(雌)性人类男(雄)性

来源：评论

学校读者我要写书评

暂无评论

"INTERMED": A method to assess health service needs - II. Results on its validity and clinical use

引用

GENERAL HOSPITAL PSYCHIATRY 1999年第1期21卷 49-56页

作者： Stiefel, FC de Jonge, P Huyse, FJ Guex, P Slaets, JPJ Lyons, JS Spagnoli, J Vannotti, M CHU Vaudois Div Autonome Med Psychosociale Vaudois Switzerland Vrije Univ Amsterdam Ziekenhuis Psychiat Consultatieve Dienst NL-1007 MB Amsterdam Netherlands Ziekenhuis Leyenburg Dept Geriatr Med NL-2545 CH Den Haag Netherlands NW Mem Hosp Dept Psychiat Chicago IL 60611 USA

The validity and clinical use of a recently developed instrument to assess health care needs of patients with it physical illness, called INTERMED, is investigated. The INTERMED combines data reflecting patients' biological, psychological, and social characteristics with information on health care utilization characteristics. An example of a patient population in which such an integral assessment can contribute to the appropriateness of care, are patients with low back pain of degenerative or unknown origin. It supports the validity and the clinical usefulness of the INTERMED when clinically relevant subgroups in this heterogeneous population can be identified and described based on their INTERMED scores. The INTERMED was utilized in a group of patients (N = 108) having low back pain who vary on the chronicity of complaints, functional status, and associated disability. All patients underwent a medical examination and responded to a battery of validated questionnaires assessing biological, psychological, and social aspects of their life. In addition, the patients mere assessed by the INTERMED. It tons studied whether it proved to be possible to form clinically meaningful groups of patients based on their INTERMED scores;for this, a hierarchical cluster analysis tons performed. In order to clinically describe them, the groups of patients weve compared with the data from the questionnaires. The cluster analysis on the INTERMED scores revealed three distinguishable groups of patients. Comparison with the questionnaires assessing biological, psychological, and social aspects of disease showed that one group can be characterized as complex patients with chronic complaints and reduced capacity to work who apply for a disability compensation. The other groups differed explicitly with regard to chronicity, but also on other variables. By means of the INTERMED, clinically relevant groups of patients can be identified, which supports ifs use in clinical practice and its use a

关键词：方差分析卡方分布聚类分析横断面研究腰痛/诊断腰痛/心理学腰痛/治疗病史记录/标准需求估价/标准病人医疗护理计划心理测定学/标准可重复性结果瑞士女(雌)性人类男(雄)性

来源：评论

学校读者我要写书评

暂无评论

Ways to minimize adverse drug reactions - Individualized doses and common sense are key

引用

POSTGRADUATE MEDICINE 1999年第3期106卷 163-+页

作者： Cohen, JS Univ Calif San Diego Sch Med Dept Psychiat La Jolla CA 92093 USA

According to some estimates, patient response can vary 4-fold to 40-fold with any drug at any given dose. Obviously, when it comes to drugs, one size does not fit all. Dr Cohen maintains that by relying on manufacturer-recommended doses, physicians are attempting to tailor the patient to fit the drug, rather than tailoring the drug to fit the patient, and the result is dose-related side effects. He describes how to individualize drug doses on the basis of patients' drug-reaction history and age, the specific situation, and pharmacokinetic clues.

关键词：剂量效应关系药物制药工业药物信息机构病史记录/标准药用制剂/投药和剂量参考书美国人类

来源：评论

学校读者我要写书评

暂无评论

"INTERMED": A method to assess health service needs - I. Development and reliability

引用

GENERAL HOSPITAL PSYCHIATRY 1999年第1期21卷 39-48页

作者： Huyse, FJ Lyons, JS Stiefel, FC Slaets, JPJ de Jonge, P Fink, P Gans, ROB Guex, P Herzog, T Lobo, A Smith, GC van Schijndel, RS Vrije Univ Amsterdam Ziekenhuis Psychait Consultatieve Dienst NL-1007 MB Amsterdam Netherlands Northwestern Univ Mem Hosp Dept Psychiat Chicago IL 60611 USA CHU Vaudois Dept Psychosocial Med CH-1011 Lausanne Switzerland Ziekenhuis Leyenburg Dept Geriatr Med NL-2545 CH Den Haag Netherlands Aarhus Univ Hosp Hosp Psychiat DK-8240 Risskov Denmark Vrije Univ Amsterdam Ziekenhuis Dept Internal Med NL-1007 MB Amsterdam Netherlands Univ Freiburg Klinikum Abt Psychotherapie & Psychosomat Med D-7800 Freiburg Germany Univ Hosp Psychosomat Serv E-50009 Zaragoza Spain Monash Med Ctr Dept Psychol Med Clayton Vic 3168 Australia

The purpose of this paper is to describe the development and to test the reliability of a new method called INTERMED, for health service needs assessment. The INTERMED integrates the biopsychosocial aspects of disease and the relationship between patient and health care system in a comprehensive scheme and reflects an operationalized conceptual approach to case mix or case complexity. The method is developed to enhance interdisciplinary communication between (para-) medical specialists and to provide a method to describe case complexity for clinical, scientific, and educational pur poses. First, a feasibility study (N = 21 patients) tons conducted which included double scoring and discussion of the results. This led to a version of the instrument on which two interrater reliability studies were performed. In study 1, the INTERMED was double scored for 14 patients admitted to an internal ward by a psychiatrist and an internist on the basis of a joint interview conducted by both. In study 2, on the basis of medical charts, two clinicians separately double scored the INTERMED in 16 patients referred to the outpatient psychiatric consultation service. Aver aged over both studies, in 94.2% of all ratings there was no important difference between the raters (more than 1 point difference). As a research interview, it takes about 20 minutes;as part of the whole process of history taking it takes about 15 minutes. In both studies, improvements were suggested by the results. Analyses of study I revealed that on most items there was considerable agreement;some items were improved. Also, the reference point for the prognoses was changed so that it reflected both short- and long-term prognoses. Analyses of study 2 showed that in this setting, less agreement between the raters was obtained due to the fact that the raters were less experienced and the scoring procedure was move susceptible to differences. Some improvements-mainly of the anchor points-were specified which may furth

关键词：病史记录/方法病史记录/标准模型心理学需求估价/标准荷兰观察者偏差预后心理测定学/方法心理测定学/标准社会适应人类

来源：评论

学校读者我要写书评

暂无评论

临床输血病历质量调查分析

引用

医学临床研究 2015年第2期 362-363页

作者：张毅中国医科大学附属第四医院输血科辽宁沈阳110032

【目的】通过调查分析，了解本院临床输血病历中存在的问题，加强临床输血病历规范化管理，提高临床输血的安全性及合理性。【方法】2012年1月至2013年12月每月随机抽查本院输血病历20份共480份，按照相关管理办法及规范对病历首页、输... 详细信息

【目的】通过调查分析，了解本院临床输血病历中存在的问题，加强临床输血病历规范化管理，提高临床输血的安全性及合理性。【方法】2012年1月至2013年12月每月随机抽查本院输血病历20份共480份，按照相关管理办法及规范对病历首页、输血指征、输血医嘱、输血前相关检查、《输血治疗同意书》、输血病程记录、输血过程护理记录、输血后疗效观察、临床输血记录单、输血不良反应报告10项内容进行调查分析。【结果】480份输血病历中，输血病历不合格率为37．30％（179／480）；不合格率较高的检查项目为输血病程记录10．42％、输血前相关检查9．58％、输血指征7．92％。【结论】医院临床输血病历存在的问题还很多，应加强对医务人员相关法规、病历书写规范化培训与病历质量管理，提高临床输血的合理性和安全性。

关键词：输血病史记录/标准书写质量控制

来源：评论

学校读者我要写书评

暂无评论

Medical evaluation of patients before ocular surgery

引用

AMERICAN JOURNAL OF OPHTHALMOLOGY 2003年第2期136卷 338-339页

作者： Marcus, EN Gayer, S Anderson, DR Univ Miami Sch Med Bascom Palmer Eye Inst Dept Ophthalmol Miami FL 33136 USA Univ Miami Sch Med Bascom Palmer Eye Inst Dept Clin Med Miami FL USA Univ Miami Sch Med Bascom Palmer Eye Inst Dept Clin Anesthesiol Miami FL USA

来源：评论

学校读者我要写书评

暂无评论

Accuracy of questions related to allergic contact dermatitis

引用

American Journal of Contact Dermatitis 2000年第4期11卷 218-221页

作者： Fleming, Colin John Burden, Arthur David Forsyth, Angela Department of Dermatology Ninewells Hospital Dundee United Kingdom Department of Dermatology Glasgow Western Infirmary Glasgow United Kingdom Contact Dermatitis Investigation Unit Glasgow Royal Infirmary Glasgow United Kingdom

Background: The ability of a physician to select individuals likely to benefit from patch testing depends on his or her ability to interpret responses to enquiries related to contact allergy. The significance of such responses to questions of nickel, fragrance and colophony allergy is unclear. Objective: The specificity, sensitivity and predictive value of questions relating to nickel, fragrance and colophony allergy were determined. Method: A total of 258 patients attending for routine patch testing were questioned about skin reactions to nickel, fragrances and Elastoplast (Smith and Nephew Healthcare, Hull, England). All subjects were then patch tested to nickel, fragrance mix, and colophony, Responses to questions were compared with patch test results. Results: The sensitivity of questions relating to nickel, fragrance, and colophony was 82%, 49%, and 71%, respectively. The specificity of the same questions was 77%, 79%, and 90%;the positive predictive value was 54%, 46% and 29%, respectively. After adjustment to include clinical relevance, the sensitivity of nickel questions rose to 100%. Conclusion: These data permit greater understanding of the role of patient history in selection of patients for patch testing. (C) 2000 by W.B. Saunders Company.

关键词：皮炎变应性接触性/诊断皮炎变应性接触性/病因学病史记录/标准斑片试验试验预期值问卷调查/标准敏感性与特异性人类

来源：评论

学校读者我要写书评

暂无评论

Preventing perioperative adverse drug reactions.

引用

AORN journal 2003年第1期77卷 104-106,109页

作者： Pribisko, Alaine L University of North Carolina at Chapel Hill USA.

The purpose of this article is to help nurses prevent adverse drug reactions (ADRs) in the perioperative, endoscopic, and special procedure areas. Up to 30% of hospitalized patients experience an ADR. Taking comprehensive medication histories, maintaining constant vigilance, and recognizing inherently dangerous patient/medication combinations are essential in preventing ADRs. The mechanisms of medication toxicity and identifying potentially preventable adverse reactions are discussed. Practical nursing guidelines and tips that patients can use to prevent ADRs from occurring are delineated. Not every ADR can be prevented, but informed nurses can implement measures to reduce their occurrence.

关键词：药物过敏/病因学药物过敏/病理生理学药物过敏/预防和控制病史记录/标准病案病人教育(主题) 围手术期护理/方法人类

来源：评论

学校读者我要写书评

暂无评论

THE IMPACT OF EXPERTISE AND SUFFICIENT INFORMATION ON PSYCHOLOGISTS ABILITY TO DETECT MALINGERING

引用

BEHAVIORAL SCIENCES & THE LAW 1995年第4期13卷 505-515页

作者： BOURG, S CONNOR, EJ LANDIS, EE FED CORRECT INST BUTNERNC

Twenty-two forensic diplomates and 22 general clinical psychologists were asked to review a variety of psychological data from one of four cases (two cases of malingering and two cases of legal insanity) to determine whether data suggested malingering or insanity. Of the 44 psychologists who reviewed cases, determined whether their protocol malingerer or an insane person. Forensic diplomates and clinical psychologists were equally accurate in their determinations;only three subjects hom each group misidentified their case. In spite of their success, confidence levels for both groups were reported as moderate. These results contradict previous studies that have found psychologists to not only be poor detectors of malingering, but also overconfident in their ability to detect it. It is believed that the success of psychologists in this study compared to previous studies was due to improved methodology.

关键词：临床工作能力/标准诊断鉴别误诊司法精神病学/标准诈病/诊断病史记录/标准精神障碍/诊断心理学临床/标准研究设计成年人女(雌)性人类男(雄)性中年人

来源：评论

学校读者我要写书评

暂无评论

Can we trust the quality of routine hospital outpatient information in the UK? Validating outpatient data from the patient administration system (PAS)

引用

Journal of Health Services Research and Policy 1998年第4期3卷 203-206页

作者： Shaw, A. Somerset, M. Dunn, L. Peters, T. Faulkner, A. Sharp, D. Department of Clinical Medicine University of Bristol Bristol United Kingdom

Background: A validation study of routine hospital outpatient data was carried out as part of a broader project focusing on outpatient re-attendance. The aim was to compare two patient administration system (PAS) data items with the same information collected directly from hospital clinicians. Methods: A total of 140 cases from four specialties at four National Health Service hospitals was randomly selected for comparison. The specific data items compared were the grade of doctor seen and the management decision taken following an outpatient appointment. The proportion of cases in which there was agreement was calculated, together with kappa values and relevant statistics indicating the accuracy of the PAS data when compared with information compiled immediately after the consultation by the relevant clinician. Results: There was agreement between the clinician's data and the PAS data in 118/140 (84.3%) cases for grade of doctor seen and in 105/139 (76.7%) cases for the management decision. There was complete agreement for both items in 88/139 (62.6%) cases. Kappa values indicated good agreement between the two data sources. However, 'sensitivity' statistics suggested that the likely accuracy of each data item varied. Conclusion: Although there was good agreement within individual categories between the two sources, 37% of patient computerised records held at least one inconsistency in this small study focusing on only two data items. Further systematic evaluation is needed to test the extent to which other items are similarly discrepant.

关键词：数据收集/标准大不列颠医院信息系统/标准医院公立病史记录/标准病案系统计算机化/标准门诊部医院/利用病人医护管理可重复性结果专业医学公费医疗

来源：评论

学校读者我要写书评

暂无评论

建议与咨询留下您的常用邮箱和电话号码，以便我们向您反馈解决方案和替代方法

时间限定

文献类型

馆藏选择

核心期刊

语言

文献类型

帮助

文字说明：

检索规则说明：

检索范例：

分类表

所选分类

限定检索结果

文献类型

馆藏范围

日期分布

学科分类号

主题

机构

作者

语言

请选择保存的检索档案：

请选择收藏分类：

通借通还

建议与咨询 留下您的常用邮箱和电话号码，以便我们向您反馈解决方案和替代方法

时间限定

文献类型

馆藏选择

核心期刊

语言

文献类型

帮助

文字说明：

检索规则说明：

检索范例：

分类表

所选分类

限定检索结果

文献类型

馆藏范围

日期分布

学科分类号

主题

机构

作者

语言

请选择保存的检索档案： 新增检索档案 确定 取消

请选择收藏分类： 新增自定义分类 确定 取消

通借通还

建议与咨询留下您的常用邮箱和电话号码，以便我们向您反馈解决方案和替代方法

请选择保存的检索档案：

请选择收藏分类：