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Enregistrement W2526909081 · doi:10.1111/jpc.13331

The hospital world according to Aaron

2016· article· en· W2526909081 sur OpenAlexaffabout
Sue Robins

Notice bibliographique

RevueJournal of Paediatrics and Child Health · 2016
Typearticle
Langueen
DomaineMedicine
ThématiqueEthics and Legal Issues in Pediatric Healthcare
Établissements canadiensSimon Fraser University
Organismes subventionnairesnon disponible
Mots-clésWonderMedicineSedationSurgeryPsychologySocial psychology

Résumé

récupéré en direct d'OpenAlex

My youngest son Aaron (who is 12 and happens to have Down syndrome) had day surgery recently at our children's hospital. In an effort not to be a ‘secret shopper’, I try to take my family centred care hat off when I'm in the hospital with my boy. I focus on him as opposed to critiquing every single interaction. Yes, the experience wasn't perfect – the clerk calling me to confirm Aaron's surgery time didn't mention that the entrance to the day ward had been moved in the midst of renovations (so I got lost); kids waiting for surgery were jammed into a makeshift waiting room; I was called ‘mom’ an awful lot; and one of the nurses said to me, ‘It is so good he's so high functioning’. Overall, the clinical care was exceptional, everybody was respectful towards Aaron, and we were able to go home 5 h after we arrived. That seems like success to me. My youngest son has had four surgeries in his life, and this was the first time I did not push the pre-sedation request. Aaron was relaxed and joking with the nurses, so I thought – let's just see what happens if he doesn't get sedation before he goes into the operating room (OR). I warned him there would be lots of people and bright lights in the OR, and he was perfectly fine (I now wonder if the pre-sedation request was more for me: mom needs sedation). It is fortunate that our hospital has parental presence at induction, which means I was able to go into the OR with him until he was asleep. I teared up a bit when he was put under, as I always do – and the kind anaesthetist said to me: ‘We will take good care of him’. And that they did. Afterwards, I reflected on Aaron's own experience as a patient. He was annoyed that he had to wear a dress (Fig. 1). Apparently, the hospital switched to gowns for kids and don't use pyjamas any more. He had to wear a mask because he had a cough. Sensory-wise, that was not great – it was scratchy and bothered him and he kept taking it off. Despite the fact we explained the going to sleep thing, the first thing he shouted when he woke up after surgery was: ‘I AM NOT DEAD!’ I'm horrified he thought he might have died – I am constantly in awe of how this kid's mind works. I harkened back to earlier in the year when we had to put our beloved chocolate lab ‘to sleep’ and realised I needed to adjust my own explanations and avoid euphemisms. In Aaron's mind, the dog died after he was put to sleep, so why shouldn't he? Oy. Point well taken. The day surgery unit was busy and unfortunately, some of the kids didn't wake up well after surgery, and there was a fair bit of crying and screaming. There was also a considerable amount of construction noise – hammering and drilling. ‘I don't like hospitals’, Aaron told me. I asked why. ‘I don't like these screaming kids. It is too noisy here’, he said. I realised that a less open physical space would have worked better for him, a boy with auditory sensory issues. He wouldn't even consider the popsicle the nurses offered him after surgery. He said, ‘The food here is disgusting’, drawing upon his (accurate) memory as a hospital inpatient. ‘I want to go home’, he concluded. Ask him about his own patient experience, and this is what you get – he is a fountain of truth. I'm grateful for his uneventful experience. I'm also thankful for the folks at the hospital who cared for him: the clerk at reception, the practical nurses, the recovery room nurses, the porters, the surgeon, the OR nurses and the anaesthetist. They all had smiles on their faces, spoke to Aaron directly and did their jobs quickly and competently. This story is a gentle reminder that all surgery is a big deal to families and kids, even if it is considered ‘minor’ to the professionals. I feel fortunate that Aaron's experience included such caring health professionals, and that he is now home safe and sound. What is most interesting about this brief time in the hospital is Aaron's perception of it. For a child with Down syndrome and an identified intellectual disability, he communicated well about his own patient experience. It reminded me that none of us should speak up on his behalf, for he is quite capable of speaking up for himself. Sue Robins is a mother of three and a writer and speaker in the world of patient and family centred care. In her paid work life, she is the Family Advisor at the Sunny Hill Health Centre for Children in Vancouver, Canada. She also co-owns a health communication company called Bird Communications.

Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.

Comment cette classification a été obtenuedéplier

Prédiction machine sur la base complète

Imitation des enseignants

Ni prévalence calibrée, ni vérité terrain. Validation humaine à venir. Le volet Gemma est une étiquette directe du modèle pour chaque travail de la base, lue sur la notice réduite au titre. Le volet Codex est un classifieur appris des 10 348 étiquettes directes de Codex et calibré sur les taux pondérés de l'échantillon; les champs sans appui suffisant ne portent aucun appel Codex. Le mode candidate est l'union des deux volets; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont pas des étiquettes humaines.

score de la tête « metaresearch » (Codex)0,003
score de la tête « metaresearch » (Gemma)0,012
Version: metacan-v3-hybrid-931329e0061cStatut de validation: machine_predicted_unvalidated
Catégories candidatesaucune
Catégories consensuellesaucune
DomaineSignal candidat: aucune · Signal consensuel: aucune
Devis d'étudeSignal candidat: Sans objet · Signal consensuel: Sans objet
GenreSignal candidat: Autre · Signal consensuel: aucune
Score de désaccord entre enseignants0,071
Score d'incertitude au seuil0,237

Scores du classifieur distillé par catégorie (deux têtes)

CatégorieCodexGemma
Métarecherche0,0030,012
Méta-épidémiologie (sens strict)0,0010,001
Méta-épidémiologie (sens large)0,0010,001
Bibliométrie0,0010,001
Études des sciences et des technologies0,0090,005
Communication savante0,0120,007
Science ouverte0,0010,009
Intégrité de la recherche0,0080,017
Charge utile insuffisante (le modèle a refusé de juger)0,0710,046

Scores machine (provisoires)

Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.

Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.

Tête enseignante Opus0,016
Tête enseignante GPT0,335
Écart entre enseignants0,319 · la distance entre les deux têtes enseignantes sur ce seul travail
Statut de validationscore_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découle

Classification

machine, non validée

Prédiction automatique; un appel candidat d’une seule source (Gemma direct ou Codex distillé), pas un consensus.

Les modèles n’ont appliqué aucune catégorie : rien dans la taxonomie ne correspondait à ce travail.
Devis d'étudeSans objet
Domainenon disponible
GenreAutre

Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».

En bref

Citations0
Publié2016
Routes d'admission2
Résumé présentoui

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