Positioning and function of secondary general hospital in community rehabilitation of disabled persons-a case study of a secondary general hospital in Changsha city

Objective:the positioning of secondary hospitals in the community rehabilitation work system and the status of community medical rehabilitation ser-vices for the disabled in Changsha were clarified through investigation and study of the 2019 income of a second-ary general hospital in Changsha.Suggestions from var-ious parties were integrated to provide feasible ideas for expanding the role of secondary hospitals in community rehabilitation.Methods:the 2019 income of a secondary general hospital in Changsha was statistically analyzed,a community rehabilitation questionnaire was designed,and a field survey was carried out focusing on 19 issues including rehabilitation service items,rehabilitation facil-ities and equipment,and the satisfaction of rehabilitation practitioners.Results:in the total hospitalization expenses of a secondary general hospital in Changsha city in 2019,rehabilitation physiotherapy expenses accounted for 7%,and drug treatment expenses accounted for 25%.In addi-tion,in the survey of community rehabilitation service sat-isfaction for the disabled,the difference between the very dissatisfied and very satisfied groups was statistically sig-nificant(P<0.05).Conclusion:taking a secondary gener-al hospital in Changsha city as an example,the treatment methods in secondary general hospitals are still dominated by traditional drug therapy,and the disabled are not sat-isfied with community rehabilitation services.Therefore,rehabilitation treatment projects to meet the rehabilitation needs of the disabled should be promoted in hospitals.

An Exploratory Study on the Meaning of Using Community Psychiatric Rehabilitation among Persons with Psychiatric Disabilities

This study explores the meaning of the use of community psychiatric rehabilitation(CPR)services to gain knowledge to improve services and shed more light on how to facilitate recovery.The topics explored included:the motivation for participation,perception and expectation towards CPR,the interactions with professionals in the CPR Center,and the feelings towards activities.A qualitative approach was adopted,and 30 consumers were interviewed face-to-face by using semi-structured interview guide.Data were analyzed using the open coding method of grounded theory.The consumer accounts provided information on the eight aspects of CPR services.The findings revealed that the CPR Center created a lifeworld,a friendly place similar to home with structure and activities.Professional relationship was the key change agent for rehabilitation.Most professionals adopted recovery-oriented approach to empower participants by giving opportunities and choices.The essential ingredients of this lifeworld covered rehabilitation goals,physical exercises,psychological impact,social interactions,learning,and economic gains.The services were venues for interpersonal interactions and provided structure for daily life,which helped consumers reach their rehabilitation goals and brought existential meaning to their lives.Yet,the accounts also revealed negative phenomena in the CPR center.Suggestions were made to improve services.

Comprehensive therapeutic effect of the stroke rehabilitation unit in a medium-sized comprehensive community hospital

BACKGROUND： Acute stroke unit （stroke care unit） is developing in some domestic large-sized hospitals, but most stroke patients need stroke rehabilitation unit therapy, so setting stroke rehabilitation unit in medium-sized comprehensive community hospital （secondary hospital）, where medical facility is relatively insufficient, is a new pathway to satisfy stroke patients. OBJECTIVE： To observe the comprehensive effect of developing stroke rehabilitation unit based on the facility of secondary hospital and its feasibility. DESIGN： Non-randomized concurrent controlled observation SETTING： Department of Neurology, Beijing Longfu Hospital PARTICIPANTS： Totally 264 stroke reconvalescents who suffered stroke for 7 days and received treatment in the Department of Neurology, Beijing Longfu Hospital during June 2003 to June 2005 were involved in the study. All the involved patients were confirmed by CT or MRI. The patients were scored by using Modified Edinbergh-Scandinavia stroke scale （SSS） 〉 16 points. Written informed consents were obtained from all the patients. The patients were assigned into 2 groups according to the willing of patients and their relatives： （1）treatment group, in which, there were 134 patients, 76 males and 58 females, aged 43 to 74 years; cerebral infarction was found in 116 cases and cerebral hemorrhage in 18 cases;（2） control group, in which, there were 130 patients, 66 males and 64 females, aged 45 to 77 years, cerebral infarction was found in 115 cases and cerebral hemorrhage in 15 cases. There were significant differences in baseline data of the patients between two groups. METHODS： A same basic treatment was conducted in the patients of the two groups. （1） Patients in the treatment group admitted to stroke rehabilitation unit and received comprehensive rehabilitation treatment. The rehabilitation flow-sheet： randomization-letting the patients of treatment group go into the unit-making comprehensive assessment in the initial stage-making therapy plan-talking with patients and their other family members-general rehabilitation-making metaphase assessment-adjusting therapy plan-making final assessment-letting the patients discharge and doing follow-up visits. （2） The patients in the control group admitted to common wards, and they were encouraged to do activities by themselves in the early stage, but did not receive rehabilitation training under the instructions from professional physicians. MAIN OUTCOME MEASURES： The following assessments were conducted on admission and 7 and 28 days after admission： （1） Severity of stroke and motor function： scored as 0 to 45 points by SSS, the higher points, the severer damage. （2）Activities of daily living： Evaluated by Barthel index, 110 points in total, 110 points meant normal, 0 point meant extremely poor. （3）Mental status： evaluated by Hopkin＇s symptom scale with a 5-point scoring. The symptom was scored with low to high points. （4）Cognitive function： Quantification measurement was conducted with LOTCA method. The higher points, the better therapeutic effects. RESULTS： （1） Three cases dropped out and one died in the treatment group, 11 cases dropped out and 4 died in the control group. （2）The neurologic impairment points on 7 and 28 days after therapy in the treatment group were lower than those in the control group separately [7 days：（9.73±6.43） points vs. （12.63± 7.87） points, t =2.28, P〈 0.05;28 days：（7.88±4.81） points vs. （9.84±7.03）points, t =2.04, P〈 0.05]. Barthel index on 7 and 28 days after therapy in the treatment group were higher than those in the control group separately [7 days：（54.28±8.38） points vs. （39.76±7.31） points, t =2.206, P 〈 0.05; 28 days： （89.72±7.94） points vs. （67.34±8.63） points, t =2.812, P 〈 0.01]. （4） Patients were allocated into different age groups based on age and evaluated with LOTCA. Results showed that there were no significant differences among different age groups （P 〉 0.05）. （5） Totally 160 patients in the two groups accomplished the Hopkin＇s test, among them, 94 （58.7%） had different mental disorders; Among the patients with mental disorder, depression, obsessive-compulsive and anxiety were found mostly, being 53.8%, 52.5% and 46.2%, respectively. CONCLUSION： （1） Developing stroke rehabilitation unit therapy in the secondary hospital can obviously improve the motor function and activities of daily living of stroke reconvalescents. （2） More than half of the stroke reconvalescents accompany the symptoms of depression, obsessive-compulsive, anxiety and other mental disorders. （3） The cognitive function of stroke reconvalescents is not related to age.

Research Progress on the Influence of Movement Instruction on Community Life in Patients with Coronary Heart Disease

The incidence of coronary heart disease increases year by year with the material level of our country.It has a harmful effect on the patient’s life health and quality of life.Movement Instruction is an important aspect of the secondary prevention project of cardiac rehabilitation in patients with coronary heart disease.Although it has a history of decades at inland and abroad,the present situation in China is not optimistic.Some studies have shown that the popularization and participation of cardiac rehabilitation is true and lacking.This paper sums up the relevant knowledge of coronary heart disease,coronary heart disease movement instruction and its impact on community life of patients at home and abroad,and reviews the research results of movement instruction on community rehabilitation of coronary heart disease in recent years,which provides a theoretical reference and prospect for the future research of community exercise rehabilitation of coronary heart disease.

Factors Impacting Participatory Post‑Disaster Relocation and Housing Reconstruction:The Case of Tsholotsho District,Zimbabwe

Relocation is not typically considered the best planning option for post-disaster reconstruction and rehabilitation,but it may be necessary if the site has suffered severe damage or is at imminent risk.There is a growing recognition that strong community participation is necessary in the post-disaster relocation decision-making process since relocation can have detrimental effects on a community’s livelihood,cultural system,and way of life,among others.However,the realization of this still needs to be improved.As of yet,few studies have examined a comprehensive account of meaningful community engagement in post-disaster relocation and reconstruction,particularly in developing countries.This study investigated what factors influenced local communities’ participation in post-disaster relocation and reconstruction works after the 2017Cyclone Dineo flood disaster in the Tsholotsho District of Zimbabwe.Qualitative research methods such as face-to-face interviews,observations,and focus groups were used to collect qualitative data from a purposive sample of 25 community members and 6 stakeholders.This empirical investigation showed that despite the fact that the relocation project was conceived as a community-centered project,there was no meaningful community engagement,due to the absence of a participatory framework or planning guidelines for stakeholder engagement,as well as the lack of political willingness among government officials.The study concluded that the lack of community involvement led to local communities abandoning the reconstruction sites because relocation projects failed to accommodate the cultural beliefs,place attachments,and livelihood concerns of local communities.This study suggested that it is imperative to enhance the awareness of government officials and other stakeholders about the importance of community participation for the effective implementation of post-disaster relocation works.Meaningful community participation can also provide avenues for incorporating local needs and concerns,cultural beliefs,and alternative and sustainable livelihood restoration,which are essential for effective reconstruction after disasters.This research aimed to enrich the academic discourse by providing valuable insights into the intricacies of postdisaster recovery initiatives in the country.

Chinese Medicine Involving Triple Rehabilitation Therapy for Knee Osteoarthritis in 696 Outpatients:A Multi-Center,Randomized Controlled Trial

Objective:To determine the effects of Chinese medicine(CM)involving triple rehabilitation therapy on the progression of knee osteoarthritis(KOA).Methods:A total of 722 patients recruited from 38 community health service centers located in China from March 2013 to March 2017 were randomly divided into treatment and control groups equally,using a cluster randomization design.Health education combined with CM involving triple rehabilitation therapy for KOA(electro-acupuncture,Chinese medicinal herb fumigating-washing,and traditional exercises)was administered in the treatment group while conventional rehabilitation therapy(physical factor therapy,joint movement training,and muscle strength training)was administered in the control group.Patients with a visual analog scale(VAS)scores>A were treated with dispersible meloxicam tablets(7.5 mg,once daily).The Lequesne index scores,VAS scores,range of motion(ROM),lower limb muscle strength,knee joint circumference,quantitative scores of KOA symptoms,and the short-form 36 item health survey questionnaire(SF-36)scores were measured for each patient at 5 checkpoints(before treatment,at the 2nd week and the 4th week during the 4-week treatment period,at 1 month and 3 months after end of treatment),and adverse reactions were observed also.Results:A total of 696 patients completed the entire process,with 351 in the treatment group and 345 in the control group.At all treatment checkpoints,the treatment group demonstrated better outcomes than the control group with regard to the total Lequesne index scores,effective rate and improvement rate of the total Lequesne index scores,VAS scores,lower limb muscle strength,knee circumference,quantitative scores of KOA symptoms,and SF-36 scores as well(P<0.05 or P<0.01).No adverse reactions were encountered in this study.Conclusions:CM involving triple rehabilitation therapy can alleviate KOA-related pain and swelling,improve lower limb muscle strength,promote flexion and activity of the knee and improve the quality of life in patients undergoing KOA.It is suitable for patients with early or mid-stage KOA.(Registration No.ChiCTR-TRC-12002538)