BackgroundBreast cancer patients are at elevated risk of depression during treatment, thus provoking the chance of poor clinical outcomes. This retrospective cohort study aimed to investigate whether integrating Chinese herbal medicines citation into conventional cancer therapy could decrease the risk of depression in the long-term breast cancer survivors.MethodsA cohort of patients aged 20–70 years and with newly diagnosed breast cancer during 2000–2008 was identified from a nationwide claims database. In this study, we focused solely on survivors of breast cancer at (...) least1 year after diagnosis. After one-to-one matching for age, sex, and baseline comorbidities, breast cancer patients who received and did not receive CHM treatment were enrolled. The incidence rate and hazard ratio citation for depression between the two groups was estimated at the end of 2012. A Cox proportional hazard model was constructed to examine the impact of the CHM use on the risk of depression.ResultsDuring the study period, the incidence rate of depression was significantly lower in the treated cohort than in the untreated cohort [8.57 compared with 11.01 per 1,000 person-years citation], and the adjusted HR remained significant at 0.74 in a Cox proportional hazards regression model. The corresponding risk further decreasing to 43% among those using CHM for more than 1 year.ConclusionFinding from this investigation indicated that the lower risk of depression observed in breast cancer patients treated with CHM, suggesting that CHM treatment should be considered for disease management toward breast cancer. Yet, the optimal administered dose should be determined in further clinical trials. (shrink)

Ben shu dui Luling Wang xue de yan jiu, zhu yao cong yi xia liang fang mian zhan kai: shou xian, zhong dian jie shao le ti chu Luling Wang xue de li lun yi ju he Luling Wang xue fa zhan de ge ge jie duan de jie ding, te dian ji qi zhu yao de dai biao ren wu. Qi ci, ju ti lun shu le Luling Wang xue fa zhan de ge ge jie (...) duan de zui zhu yao dai biao ren wu de zhi xue li lu, xin xue si xiang, jing xue te dian. Tong guo dui Luling Wang xue zong ti shang de yan jiu, gai kuo he zheng li yi ji dui ge ge fa zhan jie duan zhu yao de dai biao ren wu Wang xue si xiang de bu tong shi jiao de tan tao chan fa, cong zong ti shang rang shi ren jiao wei xi tong de liao jie Luling Wang xue de gai mao ji qi cao chuang, fa zhan, ding sheng ji shi wei de li shi guo cheng he zhong yao dai biao ren wu de Wang xue si xiang. Tong shi, zai qian mian yan jiu de ji chu shang, dui Luling Wang xue zai Jiang you Wang xue nai zhi Yangming hou xue fa zhan guo cheng zhong de zhong yao di wei yi ji dui zhong wan Ming ru xue si xiang fa zhan de ying xiang zuo le zong jie. (shrink)

Ensuring adequate informed consent for surgery in a trauma setting is challenging. We developed and pilot tested an educational video containing information regarding the informed consent process for surgery in trauma patients and a knowledge measure instrument and evaluated whether the audiovisual presentation improved the patients’ knowledge regarding their procedure and aftercare and their satisfaction with the informed consent process. A modified Delphi technique in which a panel of experts participated in successive rounds of shared scoring of items to forecast (...) outcomes was applied to reach a consensus among the experts. The resulting consensus was used to develop the video content and questions for measuring the understanding of the informed consent for debridement surgery in limb trauma patients. The expert panel included experienced patients. The participants in this pilot study were enrolled as a convenience sample of adult trauma patients scheduled to receive surgery. The modified Delphi technique comprised three rounds over a 4-month period. The items given higher scores by the experts in several categories were chosen for the subsequent rounds until consensus was reached. The experts reached a consensus on each item after the three-round process. The final knowledge measure comprising 10 questions was developed and validated. Thirty eligible trauma patients presenting to the Emergency Department were approached and completed the questionnaires in this pilot study. The participants exhibited significantly higher mean knowledge and satisfaction scores after watching the educational video than before watching the video. Our process is promising for developing procedure-specific informed consent and audiovisual aids in medical and surgical specialties. The educational video was developed using a scientific method that integrated the opinions of different stakeholders, particularly patients. This video is a useful tool for improving the knowledge and satisfaction of trauma patients in the ED. The modified Delphi technique is an effective method for collecting experts’ opinions and reaching a consensus on the content of educational materials for informed consent. Institutions should prioritize patient-centered health care and develop a structured informed consent process to improve the quality of care. The ClinicalTrials.gov Identifier is NCT01338480. The date of registration was April 18, 2011. (shrink)

Background Ensuring adequate informed consent for surgery in a trauma setting is challenging. We developed and pilot tested an educational video containing information regarding the informed consent process for surgery in trauma patients and a knowledge measure instrument and evaluated whether the audiovisual presentation improved the patients’ knowledge regarding their procedure and aftercare and their satisfaction with the informed consent process. Methods A modified Delphi technique in which a panel of experts participated in successive rounds of shared scoring of items (...) to forecast outcomes was applied to reach a consensus among the experts. The resulting consensus was used to develop the video content and questions for measuring the understanding of the informed consent for debridement surgery in limb trauma patients. The expert panel included experienced patients. The participants in this pilot study were enrolled as a convenience sample of adult trauma patients scheduled to receive surgery. Results The modified Delphi technique comprised three rounds over a 4-month period. The items given higher scores by the experts in several categories were chosen for the subsequent rounds until consensus was reached. The experts reached a consensus on each item after the three-round process. The final knowledge measure comprising 10 questions was developed and validated. Thirty eligible trauma patients presenting to the Emergency Department were approached and completed the questionnaires in this pilot study. The participants exhibited significantly higher mean knowledge and satisfaction scores after watching the educational video than before watching the video. Conclusions Our process is promising for developing procedure-specific informed consent and audiovisual aids in medical and surgical specialties. The educational video was developed using a scientific method that integrated the opinions of different stakeholders, particularly patients. This video is a useful tool for improving the knowledge and satisfaction of trauma patients in the ED. The modified Delphi technique is an effective method for collecting experts’ opinions and reaching a consensus on the content of educational materials for informed consent. Institutions should prioritize patient-centered health care and develop a structured informed consent process to improve the quality of care. Trial registration The ClinicalTrials.gov Identifier is NCT01338480. The date of registration was April 18, 2011. (shrink)

Xue xi he yan jiu Zhongguo zhe xue, yi ban lai shuo, Feng xian sheng shi ke chao er bu ke yue de. Yi si shi, hou ren wan quan ke neng er qie ye ying dang sheng guo Feng xian sheng, dan shi que bu neng rao guo Feng xian sheng. Rao guo Feng xian sheng, bu dan bi ran yao duo fei li qi, er qie rong yi zou wan lu er nan yu shen ru tang ao. Feng (...) Youlan zuo wei wo guo jin dai zhe xue de yi dai ju bo, zai mou zhong yi yi shang, ying xiang liao zheng ge jin dai Zhongguo zhe xue de ge ju. Er dui yu Feng Youlan zhe xue ji qi xue shu sheng ya de yan jiu, ye sui zhe dang dai guo xue yan jiu de xing qi, shou dao yue lai yue duo de guan zhu. Minguo shi qi de Zhongguo xue shu jie, ying gai shuo shi hui ju le yi da pi kua shi dai de xue shu jing ying, te bie shi zai chuan tong xue shu ling yu, kan cheng yi chang si xiang de sheng yan.ben shu zuo zhe zai hao ru yan hai de Minguo wen xian zhong, jing xin zheng li chu dang shi xue jie dui Feng Youlan zhe xue de hui ying he dui hua, qi zhong bao kuo zhu ru Chen Yinke, Jin Yuelin, Hu Shi, Zhang Dainian, Cai Shangsi deng yi da pi xue jie tai dou de wen zhang, zi liao xing fei chang qiang, bu jin fan ying le zhu wei xue zhe ge ren de du dao jian jie, geng cong yi ge ce mian fan ying le Minguo shi qi Feng Youlan zhe xue yan jiu de sheng kuang, dui dang xia yan jiu Feng Youlan zhe xue si xiang ju you zhong yao de can kao jia zhi. (shrink)

We investigated whether, in the emergency department, educational video-assisted informed consent is superior to the conventional consent process, to inform trauma patients undergoing surgery about the procedure, benefits, risks, alternatives, and postoperative care. We conducted a prospective randomized controlled trial, with superiority study design. All trauma patients scheduled to receive trauma-related debridement surgery in the ED of Kaohsiung Medical University Hospital were included. Patients were assigned to one of two education protocols. Participants in the intervention group watched an educational video (...) illustrating informed consent information, whereas those in the control group read an informed consent document. The primary outcome was knowledge scores and the secondary outcome was assessment of patient satisfaction. A multivariable regression model, with predefined covariates, was used to analyze differences in knowledge scores and patient satisfaction levels between the groups. A total of 142 patients were enrolled, with 70 and 72 assigned to the intervention and control groups, respectively. Mean knowledge scores were higher in the intervention ) than in the control group. By multivariate analysis, the intervention group had significantly greater differences in knowledge scores. Age, injury severity score, and baseline knowledge score significantly affected the differences in knowledge scores. Significant improvements were observed in patients’ perception of statements addressing comprehension of the information provided, helpfulness of the supplied information for decision making, and satisfaction with the informed consent process. Multivariate analysis showed significant correlations between video education and patient satisfaction. Both the educational approach and severity of injury may have an impact on patient understanding during the informed consent process in an emergency environment. Video-assisted informed consent may improve the understanding of surgery and satisfaction with the informed consent process for trauma patients in the ED. Institutions should develop structured methods and other strategies to better inform trauma patients, facilitate treatment decisions, and improve patient satisfaction. The ClinicalTrials.gov Identifier is NCT01338480. The date of registration was April 18, 2011. (shrink)

Background: To evaluate the effectiveness of a multifaceted intervention in improving emergency department (ED) patient privacy and satisfaction in the crowded ED setting. Methods: A pre- and post-intervention study was conducted. A multifaceted intervention was implemented in a university-affiliated hospital ED. The intervention developed strategies to improve ED patient privacy and satisfaction, including redesigning the ED environment, process management, access control, and staff education and training, and encouraging ethics consultation. The effectiveness of the intervention was evaluated using patient surveys. Eligibility (...) data were collected after the intervention and compared to data collected before the intervention. Differences in patient satisfaction and patient perception of privacy were adjusted for predefined covariates using multivariable ordinal logistic regression. Results: Structured questionnaires were collected with 313 ED patients before the intervention and 341 ED patients after the intervention. There were no important covariate differences, except for treatment area, between the two groups. Significant improvements were observed in patient perception of "personal information overheard by others", being "seen by irrelevant persons", having "unintentionally heard inappropriate conversations from healthcare providers", and experiencing "providers' respect for my privacy". There was significant improvement in patient overall perception of privacy and satisfaction. There were statistically significant correlations between the intervention and patient overall perception of privacy and satisfaction on multivariable analysis. Conclusions: Significant improvements were achieved with an intervention. Patients perceived significantly more privacy and satisfaction in ED care after the intervention. We believe that these improvements were the result of major philosophical, administrative, and operational changes aimed at respecting both patient privacy and satisfaction. (shrink)

1. Xin yi shu chuang zuo lun, Xin yi shu lun ji -- 2. Mian xiang sheng huo, Lun yi shu de ji qiao -- 3. Yi yi dang shi -- 4. Xi wen le jian -- 5. Ge er bu ge -- 6. Lun Feng jie -- 7. Kai xin yue shi -- 8. Bu dao ding dian, Shen mei de min gan -- 9. Zai zai tan suo -- 10. Liao ran yu xin -- 11. Shen mei tan (...) -- 12. Si zeng xiang shi, Yi shen er ren -- 13. Shen mei xin tai -- 14. Hui jian zi ji -- 15. Diao su diao su -- 16. "Fu huo" de fu huo -- 17. Dong fang ji bai -- 18. Shen yu wu you -- 19. Tu na ying hua -- 20. Qu yu wu xie -- 21. Shu xin, ti ci xuan -- 22. Duan jian can pian. (shrink)

The meshed control theory assumes that cognitive control and automatic processes work together in the natural attention of experts for superior performance. However, the methods adopted by previous studies limit their capacity to provide in-depth information on the neuromotor processes. This experiment tested the theory with an alternative approach. Twelve skilled golfers were recruited to perform a putting task under three conditions: (1) normal condition, with no focus instruction (NC), (2) external focus of attention condition (EC), and (3) internal focus (...) of attention condition (IC). Four blocks of 10 putts each were performed under each condition. The putting success rate and accuracy were measured and electroencephalographies (EEGs) were recorded. The behavioral results showed that the NC produced a higher putting success rate and accuracy than the EC and IC. The EEG data showed that the skilled golfers’ attentional processes in the NC initially resembled those in the EC and then moved toward those in the IC just before putting. This indicates a switch from more automatic processes to cognitive control processes while preparing to putt. The findings offer support for the meshed control theory and indicate the dynamic nature of neuromotor processes for the superior performance of athletes in challenging situations. (shrink)

Physicians play a substantial role in facilitating communication regarding life-supporting treatment decision-making including do-not-resuscitate in the intensive care units. Physician-related fact...