We studied the relationship between patient-pharmacist communication and asthma treatment, including patient understanding of drug therapy, ability to self-treat with inhaled drugs, and control over asthma. The study was among adult patients who had received inhaled steroidal or other drugs from community pharmacies in Hokkaido, Ibaragi, Tochigi, Kanagawa, and Osaka prefectures for at least one year. During the month of November 2007, pharmacists explained the study to patients and obtain consent before distributing questionnaires to beˆlled out and mailed back. Survey items covered the nature/extent of the pharmacist's explanation, the patient's degree of understanding, frequency of inhaled steroid use, frequency of asthma attacks, degree of improvement with inhaler use, skill in using inhaled drugs, and self-evaluation of communication with the pharmacist. Analysis was carried out using the 114 valid data sets obtained. The ratio of men to women was 4: 6, and the average age was 61.8 years. Compared with patients citing communication problems with pharmacists, those who had good communication received signiˆcantly higher scores in terms of understanding the purpose of inhalers, drug interactions, and side eŠects, and coping with attacks, as well as in indices of skill in using inhaled drugs. The degree of improvement in asthma attacks was also signiˆcantly higher among patients with self-evaluation of good communication with pharmacists. We suggest that communication between patient and pharmacist is associated with understanding of pharmacotherapy, as well as their ability to use inhaled medications and gaining good control over their asthma.
To meet the desired demand for qualified nurses in healthcare facilities, we should (i) develop more supportive working environment for nurses with preschool children, such as more flexible working time and shifts; (ii) encourage the employment of higher educated nurses by reforming compensation scheme, as well as reconsidering of the standard of skill-mix; and (iii) redevelop training programme for returners with more practical contents.
Managing medical simulation is not easy for facilities facing high operation costs and human resource shortages, while it would be expected as a method of realizing higher medical quality and safety. From the results of our small questionnaire survey, over sixty percent of facilities claimed that the university budget is the only financial source of operating simulation center, as well as making students and early year residents the main recipients of training. The outcome of medical simulation training, however, should be meaningful to society. Therefore medical simulation could be a type of social and public capital in its function. This essay will list the essential requirements for establishing public capital substances in simulation training through considering the feasibility of building a new business paradigm of co-payment and co-provision of simulation outcome, and the necessity of policy change for the disbursement of simulation as well.
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