Best evidence summary of cancer-related fatigue in children with leukemia / 中国实用护理杂志

Objective:To evaluate and summarize the best evidence related to the management of cancer-related fatigue in children with leukemia and provide an evidence-based basis for clinical practice.Methods:The search for the relevant guidelines and evidence synthesis from UpToDate, JBI, Cochrane Library, Registered Nurses′ Association of Ontario, Guidelines International Network, National Institute for Health and Clinical Excellence, National Guideline Clearinghouse, YiMaiTong Guideline Network, National Comprehensive Cancer Network, PubMed, CINAHL, EMbase, China National Knowledge Infrastructure, Wanfang, China Biology Medicine from January 1st, 2012 to May 1st, 2022. Two researchers evaluated the quality of the literature independently according to the unified standard and extracted the best evidence.Results:A total of 13 literatures were extracted, including three clinical practice guidelines, two evidence summaries and eight systematic reviews. Finally, 22 pieces of evidence were summarized, involving six aspects which were environmental management, cancer-related fatigue assessment, exercise management, adventure therapy, sleep management and psychosocial interventions.Conclusions:Best evidence for the management of cancer-related fatigue in children with leukemia, which should be used in conjunction with the environment, the child's age, physical ability, medical condition and psychological acceptability to develop an individualized symptom management plan to improve the quality of care and the child′s quality of life.

Summary of the best evidence for physical activity in patients with chronic obstructive pulmonary disease / 中华健康管理学杂志

Objective:To summarize the best evidence of physical activity (PA) in patients with chronic obstructive pulmonary disease (COPD).Methods:According to the 6S evidence model, BMJ Best Practice, UpToDate, Joanna Briggs Institute (JBI) database, National Guideline Clearinghouse (NGC), National Institute for Health and Clinical Excellence (NICE) network, Scottish Intercollegiate Guidelines Network (SIGN), Guidelines International Network (GIN), New Zealand Guideline Group (NZGG) network, Registered Nurses′ Association of Ontario (RNAO) network, Medlive, PubMed, Web of Science, Cochrane Library, CNKI, Wanfang Knowledge Data Service Platform, VIP database and Chinese Biomedical Database and European Respiratory Society/American Thoracic Society were searched systematically to obtain guidelines, expert consensus, best practice information book, clinical decision-making, recommended practice, and systematic review on PA management in patients with COPD. The data retrieval time was from the establishment of the databases to April 30, 2022. Two researchers with evidence-based medicine background evaluated the quality and extracted evidence of the included literature.Results:A total of 19 articles were selected including 4 guidelines, 2 clinical decision, 9 systematic reviews, 3 expert consensus and 1 randomized controlled trial. Finally, 33 pieces of best evidence were formed from 10 themes, namely pre-exercise assessment, exercise prescription, exercise style, time, intensity, PA location, safety and effectiveness of PA, intervention strategies, effect evaluation and quality control.Conclusions:This study summarizes the best evidence of PA in patients with COPD. Health professionals should choose and apply the best evidence with consideration of the clinical situation and patient preference.

Evidence summary of exercise rehabilitation for heart transplantion patients / 中国实用护理杂志

Objective:To search and analyze the relevant evidence of exercise rehabilitation in heart transplant patients and summarize the best evidence.Methods:The best practice information book, evidence summary, guidelines, expert consensus and systematic review of exercise rehabilitation for heart transplant patients in CNKI, Wanfang, CBM, PubMed, Embase, Cochrane Library, UpToDate, BMJ Best Practjce, National Institute for Health and Clinical Excellence (NICE), International Guidelines Network (GIN), Scottish Intercollegiate Guidelines Network (SIGN), New England Medicine (NEJM), Joanna Briggs Institute (JBI) Evidence-based Health Care Center in Australia, American Health Care Policy Research Institute (AHRQ), American Heart Association (AHA), American College of Cardiology (ACC), American Association for Cardiopulmonary Rehabilitation (AACVPR), European Society of Cardiology (ESC), International Society for Heart and Lung Transplantation (ISHLT) were searched by computer.Results:A total of 10 articles were included, including 1 clinical decision, 2 guidelines, 1 expert consensus and 6 systematic reviews; after evaluation, a total of 21 best evidences in 7 aspects: exercise effectiveness, exercise timing, exercise assessment, exercise modality, exercise duration, pre-habilitation, exercise compliance were summarized.Conclusions:This study summarizes the best evidence of exercise rehabilitation in patients undergoing heart transplantation and provides a reference for medical staff to develop exercise rehabilitation programs for patients after heart transplantation.

Summary of best evidence for exercise rehabilitation for atrial fibrillation / 中国实用护理杂志

Objective:To evaluate and summarize the best evidence of exercise instructions for patients with atrial fibrillation.Methods:A comprehensive search about evidence on exercise rehabilitation in patients with atrial fibrillation was conducted in following databases: Joanna Briggs Institute (JBI) Library, The Agency for Healthcare Research and Quality (AHRQ), National Institute for Health and Clinic Excellence (NICE), Scottish Intercollegiate Guidelines Network (SIGN), Registered Nurses′ Association of Ontario (RNAO), Physiotherapy Evidence Database (PEDro), American College of Physicians (ACP), Cochrane Library, PubMed, Embase, CINAHL, Medlive, China National Knowledge Infrastructure (CNKI), WanFang Database, VIP Database, and China Biology Medicine (CBM). The retrieval period was from the inception of databases to January 2021. Two researchers with evidence-based nursing background assessed the quality of the literature independently and identified the level of evidence.Results:A total of 16 articles were included, including 4 guidelines, 4 systematic reviews, 4 expert consensuses, 4 randomized controlled trials. Combined with professional judgment, 35 pieces of best evidence in 7 aspects were summarized, including exercise benefits, the appropriate crowd, exercise evaluation, exercise mode, exercise intensity, exercise time, exercise supervision and safety.Conclusions:Regular exercise is safe and beneficial for patients with atrial fibrillation. Clinical staff should guide patients to exercise moderately by applying the best evidence with scientific exercise intervention, promoting patients′ physical and mental health.

The best evidence summary for prevention of hypothermia at birth in newborn / 中国实用护理杂志

Objective:To retrieve and summarize evidence for prevention of hypothermia at birth in newborn.Methods:Databases such as Up To Date, BMJ Best Practice, National Institute for Health and Care Excellence(NICE), Joanna Briggs Institute (JBI), Cochrane Library, Registered Nurses′Association of Ontario (RNAO), American Heart Association(AHA), Web of Science, PubMed, Chinese Biology Medical Literature database, Wanfang Med Online were searched to collect relevant evidence for prevention of hypothermia at birth in newborn, including guidelines, systematic reviews, evidence summaries and expert consensus. Two researchers independently evaluated the quality of the literature and extracted the data of the literature which met the criteria.Results:Six articles were selected, including 1 clinical decision support system, 2 guidelines, 1 systematic review and 2 expert consensuses. Nineteen pieces of best evidence were summarized.Conclusions:This study summarized the best evidence for the prevention of hypothermia at birth in newborn, and provided evidence-based support for clinical practice.

A survey of the best evidence communication and application of blood specimen collection / 中国实用护理杂志

Objective@#To investigate the present situation about the best evidence communication and application of blood specimen collection.@*Methods@#A total of 312 nurses from Zhongshan Hospital Affiliated to Fudan University were investigated with self-designed questionnaire.@*Results@#The scores of the best evidence knowledge of blood specimen collection was 15.23±2.45, 1.9% (6/312) nurses obtained full score. The scores of the best evidence behavior of blood specimen collection was 38.11±2.93, 1.6% (5/312) nurses got full score.@*Conclusions@#The nursing staff had a poor knowledge in the best evidence of blood specimen collection. There was a gap between the best evidence of blood specimen collection and clinical practice. The state of communication and application of the best evidence of blood specimen collection is not good.

Evaluación de un programa de educación médica para el mejoramiento de la calidad de atención de los médicos generales de la red prestadora de servicio de primer y segundo nivel de atención del suroccidente del Distrito Capital / Evaluation of a medical education program to improve the quality of care of general practitioners of the first and second level of care service provider network in the southwest of the Capital District

Antecedentes: los servidos de salud deben buscar siempre el mejoramiento de la calidad de la atención en salud. Una de las formas de lograrlo es colocando a disposición de los médicos mecanismos de educación continuada. El conocimiento actualizado es un factor esencial cuando se quiere lograr la excelencia en el acto médico y la educación continuada es parte de la solución al problema. La práctica médica requiere profesionales permanentemente actualizados. Objetivos: evaluar una estrategia de intervención en educación médica continuada (EMC) para los médicos generales de primer nivel de atención de la red del sur occidente de la Secretaría Distrital de Salud. Población y metodología: se evaluaron 82 de 140 médicos para definir las necesidades en EMC y definir los contenidos de un curso de actualización. Antes y después del curso se evaluaron conocimientos con un examen y desempeño mediante la auditoría de una muestra de historias clínicas (n = 234). Resultados: de los 140 médicos de la red. el 60% son hombres y el 40% mujeres con un promedio de edad de 32.5 años. Realizando el año de servicio social obligatorio hay 20.6%. Se inscribieron 98 médicos (88% del total de 140) y asistieron al curso 54 (49.4%). Al menos al 50% del curso asistieron 54 médicos (55%), 30 hombres (56%) y 24 mujeres (44%). La evaluación del curso por los participantes fue: contenidos, 4.36; cumplimiento, 4.43, y materiales, 3.92. El promedio en los exámenes previos fue de 2.27/5.0 (DS 0.90) y posteriores fue de 2.90 (DS 0.55). Se hicieron auditorías a 122 historias clínicas de control prenatal de primera vez (78 antes y 44 después de la intervención) que mostraron, antes del curso, pobres resultados en los aspectos relacionados con el diagnóstico y las intervenciones, y mejoraría significativa entre los asistentes en los aspectos administrativos, de anamnesis y de diagnóstico, y a 112 historias de control de crecimiento y desarrollo en pediatría (76 antes y 36 después de la intervención) que en la evaluación pre-intervención mostraron pobres resultados en la anamnesis e intervenciones y mejoría significativa entre los asistentes en los aspectos administrativos. Conclusiones y recomendaciones: los médicos generales confirmaron la necesidad de EMC y su satisfacción al realizarla. Sin embargo, el impacto de un curso corto con múltiples temas es limitado y por ello es recomendable considerar la realización de cursos específicos y de mayor profundidad. Se sugiere añadir a la evaluación de conocimientos el uso de nuevas estrategias como la auditoría de las historias clínicas, para así establecer el impacto de la EMC en la atención de los pacientes.

Background: Health services should always seek to improve the quality of health care. One of the ways to achieve this is by making continuing education mechanisms available to physicians. Up-to-date knowledge is an essential factor in achieving excellence in medical practice and continuing education is part of the solution to the problem. Medical practice requires permanently updated professionals. Objectives: to evaluate an intervention strategy in continuing medical education (CME) for general practitioners at the first level of care of the southwestern network of the District Health Secretariat. Population and methodology: 82 out of 140 physicians were evaluated to define the needs in CME and to define the contents of a refresher course. Before and after the course, knowledge was evaluated with a test and performance was assessed by auditing a sample of medical records (n = 234). Results: of the 140 physicians in the network, 60% were men and 40% women with an average age of 32.5 years. There are 20.6% performing the year of compulsory social service. Ninety-eight physicians registered (88% of the total 140) and 54 (49.4%) attended the course. At least 50% of the course was attended by 54 physicians (55%), 30 men (56%) and 24 women (44%). The evaluation of the course by the participants was: contents, 4.36; compliance, 4.43, and materials, 3.92. The average pre-test score was 2.27/5.0 (SD 0.90) and post-test score was 2.90 (SD 0.55). We audited 122 first-time prenatal care records (78 before and 44 after the intervention) that showed, before the course, poor results in aspects related to diagnosis and interventions, and significant improvement among attendees in administrative, anamnesis and diagnostic aspects, and 112 pediatric growth and development records (76 before and 36 after the intervention) that in the pre-intervention evaluation showed poor results in anamnesis and interventions and significant improvement among attendees in administrative aspects. Conclusions and recommendations: the general practitioners confirmed the need for CME and their satisfaction with it. However, the impact of a short course with multiple topics is limited and therefore it is advisable to consider specific and more in-depth courses. It is suggested to add to the evaluation of knowledge the use of new strategies such as the audit of medical records, in order to establish the impact of the CME on patient care.

Methodological Revelation and Ethical Significance of Evidence-based Medicine / 中国医学伦理学

Evidence-based medicine,which can be told from its name,is a new medical model based on evidence.The methodology of the research and thinking pattern of evidence-based medicine is philosophical,thus could be entirely applied to the fields of natural sciences,social sciences,and noetic sciences.The concept of best evidence in evidence-based medicine makes it necessary for us to take a second consideration for the function of medical experts.Its behavioral pattern which shows an overall care for patients from spiritual aspects to material aspects,from hospitalized period to a whole lifetime,from the clinical treatment to post-discharge living quality has truly sublimated ethical care to a new era.