Validation of Patient Satisfaction Scale and Measurement of Patient Satisfaction Level Among Inpatient of a Tertiary Care Hospital, Chengalpattu District Tamil Nadu

Background: Patient satisfaction is crucial for research, administration, and planning. Since it reveals the ef-fectiveness of the provider, customer happiness is of utmost importance as a gauge of the quality of service.Inpatient satisfaction is an essential tool to identify the level of patient satisfaction and it is one of the im-portant goals of any healthcare system. The objective of the study is to validate the questionnaire developed and to assess the inpatient satisfaction level among patients admitted to OBG ward in a tertiary care hospital. Methods: A cross-sectional study was done among 160 women inpatients admitted in the OBG ward in a ter-tiary care hospital, Chengalpattu. Patient satisfaction was measured by a validated questionnaire with seven domains, the data were collected by face-to-face interview method. Results: Themean age of the respondent were 28 years. 60% of respondents were highly satisfied with the effectiveness of the treatment. Only 33.8% of respondents were highly satisfied with the diet food served and 56.3% were highly satisfied with the cleanliness of wards, and restrooms. Conclusions: The results obtained from the present study can serve as a baseline to compare the future sur-vey and helps to provide healthcare services that fulfil patient desires and expectations.

Causes & risk factors for unscheduled readmissions in the paediatric ward of a major public hospital

Background & objectives: Readmissions are often considered as an indicator of poor quality of care during previous hospitalization, although many of these are unavoidable or unrelated to the past admission. The identification of high-risk cases for readmissions and appropriate interventions will help not only reduce the hospital burden but also to establish the credibility of the hospital. So this study aimed to determine the readmission percentage in the paediatric wards of a tertiary care hospital and to identify the reasons and risk factors that can help minimize preventable re-hospitalizations. Methods: This prospective study from a public hospital included 563 hospitalized children, classified as first admission or readmissions. Readmissions were defined as one or more hospitalizations within preceding six months, excluding scheduled admissions for investigations or treatment. Reason-wise, the readmissions were classified into various categories, based on the opinion of three paediatricians. Results: The percentage of children getting readmitted within six, three and one month time from the index admission was 18.8, 11.1 and 6.4 per cent, respectively. Among readmissions, 61.2 per cent were disease-related, 16.5 per cent unrelated, 15.5 per cent patient-related, 3.8 per cent medication/procedure-related and 2.9 per cent physician-related causes. Patient- and physician-related causes were deemed preventable, contributing to 18.4 per cent. The proximity of residence, undernutrition, poor education of the caretaker and non-infectious diseases were associated with increased risk of readmission. Interpretation & conclusions: The findings of this study suggest that readmissions pose a substantial burden on the hospital services. The primary disease process and certain sociodemographic factors are the major determinants for the increased risk of readmissions among paediatric patients.

Current status and influencing factors of discharge planning of ward nurses in cardiovascular / 中国实用护理杂志

Objective:To explore the current status of discharge planning of ward nurses in cardiovascular department and analyzed influencing factors, and to provide reference for intervention strategies to build the discharge planning ability of the responsible nurses in cardiovascular department.Methods:This study was a cross-sectional survey. Convenience sampling method was adopted to select 267 ward nurses of cardiovascular department from 5 first-class hospitals in Dalian City from July to August 2022 as the research objects. The questionnaire survey was conducted by general data questionnaire, Job-Esteem Scale for Nurses in Hospital and Discharge Planning of Ward Nurses. Multiple linear regression analysis and Pearson correlation analysis were used for data analysis.Results:The total score of discharge planning of ward nurses in cardiovascular department was (103.86 ± 16.20) points; the total score of nurses' professional respect was (98.92 ± 13.67) points, and the total score of discharge planning of ward nurses in cardiovascular department was positively correlated with the total score of job-esteem and scores of all dimensions ( r values were 0.382-0.551, all P<0.01). Multiple linear regression analysis showed that age, professional title, certificate of cardiovascular nurses and job-esteem of nurses were influencing factors of discharge planning of ward nurses in cardiovascular department ( t values were 2.57-8.27, all P<0.05), accounting for 47.3% of the total variation. Conclusions:The discharge planning of ward nurses in cardiovascular department was above the medium level, and age, professional title, whether they were cardiovascular nurses and job-esteem were the influencing factors. From the perspective of improving nurses' job-esteem, nursing managers can focus on young nurses and nurses with low professional titles, attach importance to the training of specialized ward nurses in cardiovascular department, and take certain countermeasures to improve the discharge planning of ward nurses in cardiovascular department.

Application of intelligent ward combined with DMAIC method in optimizing the process of patients receiving surgery / 中国实用护理杂志

Objective:To explore the application effect of the intelligent ward combined with DMAIC in improving the procedure and shortening the time of operation, so as to provide a reasonable basis for optimizing and improving the operation process.Methods:This was a prospective study. A total of 240 patients with gynecological surgery hospitalized in Shengjing Hospital of China Medical University from August to November 2021 were selected as the research object. From August to September 2021, the routine management mode of staff in the operating room and ward was adopted as the control group, with a total of 120 cases. From October to November 2021, the intelligent ward combined with DMAIC mode of staff in the operating room and ward was adopted as the observation group, with a total of 120 cases. The time of receiving operation notice, preoperative preparation time, preparation time of transfer personnel, waiting time after the arrival of transfer personnel and the total time of receiving operation were compared between the two groups.Results:The time of receiving operation notice was (1.42 ± 0.61) min in the observation group, which was less than that in the control group (3.53 ± 1.12) min, the difference was statistically significant ( t=18.14, P<0.05). The preoperative preparation time was (8.43 ± 1.80) min in the observation group,which was less than that in the control group (11.36 ± 2.01) min, the difference was statistically significant ( t=11.89, P<0.05). There was no significant difference in the preparation time of transfer personnel between the two groups ( P>0.05). The waiting time after the arrival of transfer personnel was 2.33(1.75, 2.93) min in the observation group, which was less than that in the control group 5.19(3.46, 8.42) min, the difference was statistically significant ( t=-10.06, P<0.05). The total time of receiving operation was (23.90 ± 4.94) min in the observation group, which was less than that in the control group (28.84 ± 4.75) min, the difference was statistically significant ( t=7.90, P<0.05). Conclusions:The intelligent ward combined with DMAIC improves the operation receiving process of the ward, shortens the total time for receiving the operation, and effectively improves the work quality and efficiency of the medical staff.

Evaluation of the effect of the traditional ward wisdom upgrade based on the Internet of Things platform / 中国实用护理杂志

Objective:To upgrade the wisdom of traditional wards through the internet of things platform to achieve intelligent and refined management of wards, and to evaluate the effect of the upgrade.Methods:In June 2020, the convenience sampling method was used to selecte two wards of the cardiology department of Shandong First Medical University as the pilot units of the affiliated provincial Hospital to implement the intelligent ward management mode. Based on the principle of easy transformation, easy construction and easy maintenance, on the basis of realizing the full coverage of the internet of things, the hardware and software system were connected to complete the intelligent upgrade of the traditional ward, and the structured observation and semi-structured interview methods were adopted to evaluate the upgraded work efficiency and the use experience of patients.Results:The time spent on vital sign collection and recording, nursing risk assessment and time spent, and signage production and hanging were (4.24 ± 0.87), (4.07 ± 0.86) and 0 min respectively, which were effectively reduced than those before the upgrade (6.50 ± 2.95), (4.73 ± 1.62) and (1.13 ± 0.43) min, with statistically significant differences ( t=8.04, 3.99, 28.96, all P<0.01). The results of semi-structured interviews showed that patients perceived the smart ward as intelligent, saving manpower and waiting time; simple to operate, improving the experience of healthcare workers and patients in using it; and untimely system updates. Conclusions:The wisdom upgrade of traditional wards can help refine patient management, improve work efficiency, and improve the experience of health care workers and patients in using them, which will be continuously improved in future development and can provide practical paths for reference for the wisdom upgrade of similar wards.

Nurses’ Attitudes Towards Ambiguity in Communication with Patients and Families, Emotional Coping Strategies and Attitudes Towards End-Of-Life Care in General Wards

Purpose: We clarified the relationship between attitudes towards ambiguity in nurses’ communication with patients and families, emotional coping strategies and attitudes towards end-of-life care among nurses in general wards. Methods: Requests for participation in a survey were sent to nurses working in general wards with 3 or more years of work experience. The survey was in the form of an online self-administered questionnaire. Results: The responses of the 239 nurses who answered the survey were subject to analysis. Among nurses’ attitudes towards ambiguity, the highest scores were for “control of ambiguity” followed by “enjoyment of ambiguity.” Among emotional coping strategies, the highest scores were for “regulating both patients’ and one’s own emotions.” “Positive attitudes toward caring for dying persons” was most significantly associated with “enjoyment of ambiguity.” “Recognition of caring for the pivot dying persons and his families” was most significantly associated with “regulating both patients’ and one’s own emotions.” Conclusion: The results suggest that nurses working in general wards may need to foster attitudes towards “enjoyment of ambiguity” in communication with patients and families, and also coping abilities “regulating both patients’ and one’s own emotions”, so that they can enhance the attitude toward end-of-life care.

Practice and Thinking of Medical Ethics Ward Rounds in Constructing a Harmonious Doctor-patient Relationship / 中国医学伦理学

Medical ethics ward rounds truly embody the behavior of respecting human nature and providing humanistic care for patients, which is conducive to the unity of medical scientific judgment and decision-making with medical ethical judgment and decision-making, and the integration of medical ethics and medical skills. Medical ethics ward rounds focus on both doctors and patients. Through reviewing medical records and medical-related documents, interviewing medical staff as well as patients, observing doctor-patient communication, the ward environment and facilities, etc., the medical ethics ward round team conducted comprehensive ethical ward rounds on the clinical departments of the hospital, and evaluated the actual situation of them in terms of patients’ informed consent, privacy protection, application of new clinical technologies, medical quality, ward environment and facilities, professional dedication of medical staff, and so on. The respect of medical staff for the rights and interests of patients is not only the respect for the basic personality of patients, but also the external embodiment of bioethics. Medical ethics ward rounds combined with the PDCA cycle can understand the pain points and difficulties in diagnosis and treatment, as well as the experience of patients in the process of medical treatment, and construct a harmonious doctor-patient relationship through the joint efforts of both doctors and patients.

Role of pharmacists in the construction and operation of research ward / 中华医学科研管理杂志

Objective:This study aims to summarize the achievements of the research wards in a large grade A tertiary hospital in Beijing, discuss the important role of pharmacists, and provide a reference for improving the functions and responsibilities of pharmacists in the research ward construction.Methods:Combining the practice of research ward construction in a grade A tertiary hospital in Beijing, the important role of pharmacists in the construction and operation of research wards were analyzed in system construction, information construction, analysis laboratory construction, and project management.Results:The participation of pharmacists with professional pharmaceutical knowledge and familiarity with the relevant policies and regulations of clinical research can greatly improve the quality and efficiency of research ward construction and operation.Conclusions:Pharmacists' participation in the construction of research wards is beneficial to improving clinical research ability and quality, and is of great significance to the development of China′s pharmaceutical health industry.

Thinking and exploration on the construction of research ward in a psychiatric hospital / 中华医学科研管理杂志

Objective:This study aims to explore the key points of the operation mode and construction of psychiatric research ward, provide possible reference for the construction of research ward.Methods:In this study, the construction of research ward in a psychiatric hospital was considered and explored through literature review, drawing on the operation mode of other research wards, combined with the characteristics of psychiatric clinical research.Results:This Study put forward the construction orientation and operation management mode of the psychiatric research ward, and analyzed the advantages of existing platform and key points for future development.Conclusions:The construction of psychiatric research ward should be based on clinical needs and hospital practice. Strategies including tailored fine management, optimize platform supporting, efficient organizing and management system, talent team and appropriate incentive mechanism should be implemented to strengthen the construction.

Exploration of accelerating the high-quality development of research wards / 中华医学科研管理杂志

Objective:As a newly emerging thing, the construction and operation management of research wards are still being explored. According to the previous practice, this study summarized and shared the key points of a demonstration research ward in Beijing, and provided a reference for the development of domestic research wards.Methods:Focusing on improving the efficiency and quality of clinical research, this article summarizes and shares the experience of research ward construction. In addition, this study explores how to maintain the high-quality sustainable development of research wards from the aspects of improving core competence, system construction, and talent training.Results:Professional teams, innovative operation modes, as well as intelligence and informatization could improve the quality of clinical research. Besides, the improvement of core competence, talent training, and policy support ensure sustainable development of research wards.Conclusions:As clinical research platforms, the development paths of research wards need to be clarified further. The standardized construction and sustainable development of research wards can effectively improve clinical research capability and promote the transformation of scientific achievements.

Profile of dermatology inpatients and admissions over a four year period in a tertiary level government teaching hospital in North India

Background: Although dermatology is mostly an outpatient specialty, some patients with severe skin disease need hospital admission for management. There is a paucity of data regarding the profile of these dermatology in-patient admissions. Aims: We studied the profile of patients admitted to the dermatology ward of our tertiary care government hospital in North India. Methods: This was a retrospective analysis of discharge sheets of patients admitted in the dermatology ward from January 1, 2014 to December 31, 2017. Results: Discharge sheets of 2032 admissions for 1664 patients were analyzed. The most common diagnoses in the admitted patients were immunobullous disorders (576, 28%), connective tissue diseases (409, 20%), infections, including leprosy and sexually transmitted infections (179, 8.8%), psoriasis (153, 7.5%) and reactive arthritis (92, 4.5%). The mean duration of admission was 13.95±11.67 days (range 1-118 days). Two hundred and fifty-six patients (15.38%) were re-admitted, accounting for 368 (18.11%) re-admissions. Patients with immunobullous disorders (OR 1.72, 95% CI 1.29-2.28) and psoriasis (OR 1.62, 95% CI 1.02-2.55) were more likely to be re-admitted. Adult patients, those who were admitted for more than four weeks, those who had comorbidities, and those who developed a complication during the hospital stay also had a greater likelihood of being re-admitted. Limitations: The retrospective design of the study, and the non-availability of data regarding transfers to other specialties or intensive care units and deaths were the main limitations of this study. Conclusion: This study describes the profile of patients admitted in a dermatology ward of a tertiary care centre center in North India. The patient profile and admission characteristics associated with a higher probability of re-admission were identified.

On the application of teaching ward-round workshop in the teaching ability training for clinical teachers / 中华医学教育探索杂志

Objective:To explore the application effect of the teaching ward-round workshop on the teaching ability training for clinical teachers.Methods:From July to October 2019, 83 clinical teachers from The Affiliated Huai'an No.1 People's Hospital of Nanjing Medical University included in the study were divided into 8 groups for the training of teaching ward-round workshop. After the training, the evaluation results of clinical teaching ward-round, the satisfaction of clinical teaching ward-round, and the satisfaction of the workshop teaching model were compared. Chi-square test and t test were performed by SPSS 22.0. Results:The trainees were highly satisfied with the training mode of the teaching ward-round workshop. After the training, the clinical teaching ward-round assessment scores [(96.83±1.77) points] were higher than the average scores of the same period from April to June in 2019 [(91.25±2.86) points], with statistical significance ( P<0.05). In terms of satisfaction with clinical teaching ward rounds, the scores of 7 dimensions including preparation before ward rounds, highlighting the key and difficulties, and standard physical examination after the training were all higher than those before the training, with significant differences ( P<0.05). Conclusion:The training model of the teaching ward-round workshop helps to enhance the training effect, promote the teaching ability of clinical teachers, and improve the clinical teaching ward-round assessment results and satisfaction, which provides new ideas and references for the training of clinical medical professionals.

Recovery-quality-directed peri-operative teaching reform for clinical internship training of anesthesiology / 中华医学教育探索杂志

Objective:To explore the application and effect of peri-operative recovery-quality-directed teaching reform for clinical internship training of anesthesiology.Methods:A total of 60 interns of five-year program anesthesiology from the Department of Anesthesiology of Chongqing Medical University were recruited for this teaching reform and randomly allocated to teaching reform group ( n=30) and control group ( n=30). Students in control group received conventional training for internship of clinical anesthesiology and follow-up, while students in teaching reform group received additional recovery-quality-directed clinical rounds per teaching week and patients discussed in those rounds were followed up until 30 days after operation. At the end of internship, teaching satisfaction, graduation test scores and patients' satisfaction were compared. SPSS 21.0 was used for t test. Results:Compared with those students in control group, interns in teaching reform group had significantly higher scores on teaching satisfaction [(9.1±1.3) vs. (6.7±1.9), P<0.05], graduation test scores [(80.0±5.0) vs. (67.0±6.0), P<0.05] and patients' satisfaction [(92.0±6.0) vs. (83.0±11.0), P<0.05]. Conclusion:Recovery-quality-directed peri-operative teaching reform can enhance the professional identity and sense of responsibility of anesthesiology students, improve their teaching satisfaction and theoretical knowledge level, and improve the satisfaction of related patients with anesthesia services.

Practice and exploration of an all-scenario smart hospital based on hospital intelligent twins / 中华医院管理杂志

Application of new technical means and methods and in-depth exploration in medical service scenarios, for improving the efficiency and quality of diagnosis and treatment, improving the operation and management level and patient′s medical experience are the goals aimed by smart hospitals. Guangdong Second Provincial General Hospital, based on the technical framework of hospital intelligent twins, was exploring to build an all-scenario smart hospital. The hospital built an intelligent operations center, all-scenario smart wards and a smart security and fire protection integrated management center. These practices promoted the service synergy, provided efficient internet of everything experience, and promoted the integrated linkage management of security and fire protection. The hospital effective resolved such deficiencies as insufficient data connectivity, fragmented application scenarios, limited coverage and poor mobility, hence providing reference for the construction and application of whole-scenario smart hospitals.

Current situation and strategy analysis of research ward construction in Beijing municipal hospitals / 中华医院管理杂志

Objective:To understand the current situation and problems in the construction of research wards in Beijing municipal hospitals, and put forward corresponding strategies and suggestions to explore the path for the construction of research hospitals.Methods:From March 2020 to May 2021, through the method of questionnaire and expert interview, the bed and personnel allocation, projects undertaken, review efficiency and problems faced by the research wards of 22 Beijing municipal hospitals were analyzed in depth.Results:82%(18/22)of the municipal hospitals explored the construction of research wards, and 27%(6/22) were Beijing Demonstration research wards construction units. In 2020, the overall performance of the construction of research ward was as follows: the investment of clinical research resources was increased, the ability of clinical research was enhanced, the ability to serve enterprises in Beijing was improved, the efficiency of examination was improved, but the enrollment rate of clinical research(including clinical trials) was reduced. At present, the main problems were focused on investment, personnel and informatization.Conclusions:The construction of research wards in Beijing municipal hospitals is developing steadily, but there are still some problems, such as lack of clinical research talents, performance incentive and guarantee to be strengthened. In the future, we should strengthen the training of clinical research talents, improve the incentive and guarantee mechanism, promote the integration of industry, university and research, accelerate the construction of clinical research information system, further improve the hospital′s clinical research ability and level, and accumulate experience for the construction of research hospitals.

Implementation of a SBAR sign-out template in the standardized residency training in a neonatal ward / 中华医学教育探索杂志

Objective:To analyze the effect of SBAR (situation, background, assessment, and recommendation) sign-out template in the standardized residency training in a neonatal ward.Methods:Based on SBAR communication mode, we designed and optimized neonatal ward sign-out checklist, and a total of 67 residents were trained for 2 weeks from April 2019 to June 2019, with control group (before training) and observation group (after training). The assessment indicators of sign-out information included sign-out duration, the incidence of sign-out errors, quality assessment scores and shift satisfaction (including sign-out satisfaction and self-evaluation) as well as competencies. A total of 1 553 children's morning shift data were collected, and SPSS 22. 0 was used for t test and chi-square test. Results:In the control group, the sign-out duration was (23.4±4.7) min, the incidence of sign-out errors was (43.6±6.6)%, quality assessment scores were (6.3±0.7) points, the satisfaction degree was (76.5±4.6)%, and the self-evaluation scores were (5.2±2.1) points. While, in the observation group, the sign-out duration was (15.9±3.2) min, the incidence of sign-out errors was (21.1±2.3)%, quality assessment scores were (8.9±0.9) points, the satisfaction degree was (94.1±2.9)%, and the self-evaluation scores were (8.9±0.8) points, with statistically significant difference ( P<0.05). There were statistically significant differences between the two groups in clinical skills and medical service ability [(2.2±0.1) vs. (3.8±0.3)], interpersonal communication ability [(2.6±0.5) vs. (4.2±0.1) points], teamwork ability [(3.1±0.2) vs. (4.6±0.3)], information and management ability [(2.5±0.5) vs. (4.2±0.2)] ( P<0.05). Conclusion:The SBAR template can improve sign-out process and the clinical skills of standardized training residents.

Objective Criteria for Judging Walking Independence in a Convalescent Rehabilitation Ward for Hemiparetic Stroke：A Study Using Decision Tree Analysis / The Japanese Journal of Rehabilitation Medicine

Objective：This study aimed to clarify the objective criteria for assessing walking independence using cane in patients with stroke in the convalescent rehabilitation ward.Methods：Participants were in-patients with hemiparetic stroke who could walk with a cane, and they were categorized into the independent (ID) and supervised (SV) walking groups. Stroke impairment assessment set-motor for lower extremity (SIAS-LE), trunk control test (TCT), Berg balance scale (BBS), 10-m walking speed (m/s), and functional independence measure-cognitive (FIM-C) were assessed. ID and SV used the scores at the time of independent walking and at the discharge time, respectively. Additionally, falls after independence were investigated. Statistical analysis was performed using univariate analysis and decision tree analysis.Results：In total, 148 patients (ID：n=101, 68±13 years, SV：n=47, 79±12) were included. Significant differences were observed in walking speed, TCT score, BBS score, and FIM-C score between the groups. Moreover, walking speed, FIM-C score, and BBS score were selected in the decision tree analysis in this order and divided into five groups namely：1) walking speed ≥ 0.42 and FIM-C ≥ 22 (percentage of independent patients 97％/percentage of fallers 5％), 2.) walking speed ≥ 0.42, FIM-C＜22, and BBS ≥ 50 (100％/0％), 3.) walking speed ≥ 0.42, FIM-C＜22, and BBS＜50 (52％/8％), 4.) walking speed＜0.42, and BBS ≥ 28 (49％/28％), and 5) walking speed＜0.42 and BBS＜28 (0％/0％). The overall percentage of fallers was 8.9％, with group 4 having the highest number of fallers.Conclusion：Walking speed, FIM-C, and BBS, in decreasing order, were involved in walking independence. Patients with low walking speed were more likely to fall. Therefore, careful assessment of walking independence is particularly required.

Evaluation of Taking-Medicine-Support Device for Inpatients / 社会薬学

In Japan, as a Social Security Reform measure against workforce decrease by 2040, robotic devices for nursing care and medication intake support have been utilised. However, evaluation reports about the robots and studies about their evaluation by patients are lacking. Therefore, we studied medication status with robotic assistance as well as patients’ evaluation of usability of robotic assistance. Participants were twelve patients whose median age was 73.0 (min 39.0-max 82.0), the median of number of drugs of a maximum intake day, which means the one of the week in which drugs are taken most, was 10.0 (min 4.0-max 17.0), and the median of maximum number of times to take drugs per day was 3.0 (min 1.0-max 4.0). Four were suspected of having dementia, based on the evaluation of their cognitive function tests. No patient missed any dose during the utilisation of the support device in taking medicine. All patients reported that the conditions of taking medicine and the recognition of the time to take it were improved. Therefore, the incorporation of support devices in taking medicine is expected to avoid missing to doses.

Recidivism Rate among Patients discharged from long care unit in forensic psychiatry program at Mental Health Hospital, Taif, Saudi Arabia

Background: This article reports on an observational study of rate and violent recidivism after discharge from a Long-Term Forensic care unit, in mental Health Hospital, Taif, Saudi Arabia. It is an attempt to examine current state of the service provided and its outcomes. It is supposed to be a base line study on which further efforts are to be directed to understanding the risk factors, effective rehabilitation programs and the necessary community-based follow up strategies that would lead to the best outcome possible towards maximizing the benefits of long-term psychiatric care hospitalization on criminal behaviour. Methodology: We reviewed all psychiatric patients who were admitted to, then discharged from the chronic forensic rehabilitation ward from Mental Health Hospital, Taif, Saudi Arabia, between 2005 and 2020 (N=66). Our study focused exclusively on observational studies. We counted number of times of reconviction after the first Mental Health Hospital admission, and also counted for the number of readmissions. Descriptive statistical analysis was explored and presented as frequencies and percentages. We determined crude rates for all adverse outcomes. Results: We did nearly mean follow up of 15 years, 15.15 percent patients died after discharge with average age of death of 31-40 years, 68.18 percent were hospitalized due to relapse of illness and 16.66 percent violently offended after discharge associated with violent crime. The association between psychiatric diagnosis and outcome varied such as substance use disorder as a primary diagnosis was associated with highest risk of mortality and re-hospitalization, on which personality disorder was linked with the highest risk of violent offending. Furthermore, comorbid substance use disorder typically increased risk of adverse outcomes. Conclusion: Long term unit, although might mitigate the risk of high risk patient group. However, that is not enough and they still in a way or another, and for reasons to be looked at and investigated, pose risk to the public safety

Nurses’ Experience in the Introduction of Palliative Sedation for Patients with Terminal Lung Cancer in Respiratory Medicine Wards

Palliative sedation (PS) is an effective way to alleviate the refractory symptom of terminally ill cancer patients, however it can be ethical. PS is now being implemented in general wards, and there is an urgent need to understand the actual conditions of sedation care for general ward nurses and improve the quality of care. In this study, a semi-structured interview was conducted with nurses working in a respiratory medicine ward of a core cancer treatment hospital. By Krippendorff’s content analysis, 16 categories of nurses’ actions/judgments, 8 categories of positive thoughts, and 5 categories of negative thoughts were extracted. Nurses have always sought the best way to alleviate the pain of patients and their families, and have endeavored to be close to their feelings. However, there was a difference in confidence and positivity regarding multidisciplinary collaboration and sedation discussions. It was suggested that the confident efforts of nurses may support the decision-making of patients and their families and consider methods for pain relief and QOL.