在急性尿失禁患者中使用计算机化决策分析工具
Hoa Nguyen1, Oluwateniola Brown, Carol E Bretschneider
1From the Division of Female Pelvic Medicine and Reconstructive Surgery, Department of Obstetrics and Gynecology, Northwestern University, Chicago, IL.
Urogynecology (Philadelphia, Pa.)
|August 22, 2023
概括
针对尿失禁 (UI) 的新计算机化决策分析工具 (DAT) 显示,65%的患者在医生咨询后选择了与DAT建议一致的治疗方法,改善了共享决策.
科学领域:
- 泌尿器科 泌尿器科 泌尿器科 泌尿器科
- 医疗信息学 医疗信息学
- 以患者为中心的护理
背景情况:
- 决策分析工具 (DAT) 通过纳入患者的价值观和目标来增强共享决策.
- 以前的研究表明,DATs减少了妇女医疗保健中的决策遗憾.
- 尿失禁 (UI) 影响了许多女性,需要有效的共享决策工具.
研究的目的:
- 评估DAT预测的治疗适合性和医生选择的紧急UI和紧急占主导地位的混合UI治疗之间的一致性.
- 为了评估一个新的,计算机化的DAT,为UI患者设计.
主要方法:
- 回顾性队列研究涉及489名UI患者.
- 开发了一个计算机化的DAT,集成UI证据和患者偏好.
- 将DAT预测的治疗与选择的治疗进行比较. 医生咨询后.
主要成果:
- 65%的患者选择了与他们最高的DAT-确定治疗适合性相一致的治疗方法.
- 该研究包括急性UI和急性占主导地位的混合UI患者.
- 数据是从电子医疗记录中抽取的.
结论:
- 一种新的计算机化DAT可以有效地准备患者在UI治疗中共享决策.
- 大多数患者在医生咨询后遵循DAT建议.
- 这种工具显示了改善UI管理中的治疗选择的希望.
相关概念视频
Urinary Tract Calculi III: Medical Management
9
The diagnosis of renal calculi involves several imaging techniques, including non-contrast CT scans and ultrasound. These methods help visualize kidney stones, assess their size and location, and detect possible obstructions. Additionally, Measuring urine pH is useful for diagnosing specific stone types, such as struvite (alkaline pH) and uric acid stones (acidic pH). Cystine stones are primarily linked to cystinuria, a genetic condition. A urinalysis helps detect blood in the urine (hematuria)...
9
Urinary Tract Calculi VI: Surgical Management
10
Procedures for Kidney StonesMedical intervention is necessary when kidney stones or renal calculi are too large to pass spontaneously (typically greater than 5 millimeters) when stones are accompanied by symptomatic infection (such as fever or pyelonephritis), when they impair kidney function, or when they cause persistent symptoms like severe pain, nausea, or urinary retention. Additionally, patients with only one kidney or those who cannot be treated with medical management also require...
10
Urinary Tract Calculi V: Nursing Management
14
AssessmentSubjective Data: Obtain a detailed health history, including any recent or chronic urinary tract infections, periods of immobilization, previous episodes of renal calculi, and medical conditions such as gout, benign prostatic hyperplasia, or hyperparathyroidism. Review the medication history for drugs that may influence stone formation, including allopurinol, analgesics, loop diuretics, or thiazide diuretics. Document the use of long-term indwelling catheters and any past surgical...
14
Urodynamic Studies: Uroflowmetry
83
Uroflowmetry is a non-invasive urodynamic test designed to measure various aspects of urination, including volume, flow rate, and the time to void. This test is crucial for diagnosing and assessing conditions such as bladder outlet obstruction, bladder dysfunction, incomplete bladder emptying, incontinence, and urinary tract blockages caused by benign prostatic hyperplasia (BPH) and urethral strictures.Pre-Test Instructions:Before a uroflowmetry test, patients are typically advised to drink...
83
Urinary Tract Calculi I: Introduction
16
Renal calculi, or kidney stones, are solid deposits of minerals and salts formed inside the kidneys. In medical terminology, "calculus" refers to the stone itself, while "lithiasis" describes the process of stone formation. Depending on their location within the urinary system, these stones may be classified as either urolithiasis, when situated within the urinary tract, or nephrolithiasis, when located within the kidneys. Each term signifies the specific impact of the stone.Predisposition...
16
Urinary Tract Infection IV: Nursing Management
24
In managing urinary tract infections (UTIs) in nursing, a comprehensive assessment is essential. Begin by gathering subjective data, such as the patient’s complaints of dysuria (painful urination), urinary frequency, urgency, suprapubic pain, and any lower abdominal discomfort. This information can be complemented by questions regarding previous UTIs, sexual activity, and personal hygiene practices, which can provide insight into risk factors. Objective assessment should focus on signs...
24


