ABSTRACT
Relying only on the ethics committee to protect subjects is not enough, and the construction of the subject protection system is an inevitable trend for the protection of subjects’ rights. This paper elaborated on the current situation of Chinese subject protection system from four aspects: the lack of laws and regulations and administrative supervision, the insufficient attention of hospitals, poor construction of the subject protection system, and the absence of responsibilities of relevant personnel. Then this paper put forward countermeasures from three aspects: improving laws and regulations and strengthening supervision, mobilizing relevant departments to participate, and strengthening relevant training, in order to standardize the construction of the subject protection system and promote the development of the subject protection work.
ABSTRACT
Objective:To test whether the constructed intervention model of advance care planning (ACP) for patients with advanced cancer can be successfully implemented and the preliminary intervention effect, which provides reference for empirical research.Methods:32 cases of advanced cancer patients and 25 cases of their families at the Fifth Affiliated Hospital of Zunyi Medical University, Zhuhai were selected. The patients were subdivided into the experimental group and the control group by random number table method. The control group received routine nursing, while the experimental group adopted the intervention model of "VIP for future care" on the basis of customary nursing. We measured the main outcome indicators: enrollment rate, consent rate, completion rate and loss of follow-up rate and secondary outcome indicators: decision-making certainty, end-of-life care preference and post-intervention satisfaction of patients and their families, within 1 week and 1 month after intervention.Results:The enrollment rate, consent rate and loss of follow-up rate were 74.6% (206/276), 36.9% (76/151)and 15.6% (5/32), respectively. After intervention, the completion rates of the experimental group and the control group were 16/16 and 15/16 within one week, and 14/16 and 13/16 within one month. All of the family members were conducted during the follow-up period. The intervention mode of "VIP for future care" had a statistically significant difference in decision-making certainty between the two groups of patients ( β=0.63, 95% CI 0.08-1.18, P<0.05), no statistically significant difference in end-of-life care preference between the two groups of patients and their families ( P>0.05), and had a statistically significant difference in "whether to recommend this project to others" between the two groups ( χ2 value was 4.167 , P<0.05). Conclusions:On the premise of sufficient preparation, the "VIP for future care" intervention mode can be successfully implemented in advanced cancer patients in mainland China, can improve the decision-making certainty of patients and the satisfaction of patients and their families, and it is recommended. And should be applied to ACP intervention for patients with advanced cancer.
ABSTRACT
Objective To formulate a practical nursing education project,improving hemodialysis patients'self -maintenance compliance for central venous catheter with dacron cuff and reducing patients'catheter dysfunction rate.Methods 17 patients with hemodialysis who newly had the central venous catheter with dacron cuff from March 2014 to October 2014 in our hospital,were selected and carried out a guidance of daily maintenance according to Lewin's action research theory.Four steps including plan,action,study and reflection were done spirally.The feasibility and validity of the nursing education project were evaluated by assessing the patients'catheter self maintenance com-pliance,and counted up the catheter dysfunction rate within 12 months.Results The action research practice was conducted for 8 weeks,and included 3 rounds circulation.According to the nursing education team's management method,with the improved education method and adjusted education schedule,refined nursing process,family support system and multi -disciplinary coordination,the knowledge of self -maintenance of the hemodialysis patients were improved,and increased the compliance,reduced the dysfunction rate.Conclusion The dialysis catheter nursing education project of this study has been modified and perfected according to the practice of action research,which could improve patients'self maintenance compliance and effectively reduce catheter dysfunction rate.