Exploring the Effects of Health Education and Chronic Disease Management Nursing in the Management of Hypertension in Elderly Patients in the Community

Objective:To explore the effects of health education and chronic disease management nursing in elderly community patients with hypertension,in order to provide scientific evidence for improving the health management level of these patients.Methods:Sixty-four elderly hypertension patients treated at this hospital between March 2022 and March 2024 were selected and randomly divided into two groups,with 32 patients in each group.One group received conventional management,designated as the control group,while the other group received a combined management strategy involving health education and chronic disease management,designated as the experimental group.The study compared the management outcomes of the two groups to evaluate the value of the combined management approach in elderly hypertensive patients in the community.Results:The study found that the experimental group showed significantly lower systolic blood pressure(SBP),diastolic blood pressure(DBP),and scores on the Self-Rating Anxiety Scale(SAS)and Self-Rating Depression Scale(SDS)compared to the control group,with statistically significant differences(P<0.05).Additionally,the experimental group demonstrated significantly higher scores in disease cognition levels regarding awareness of normal blood pressure ranges,prevention of complications,identification of high-risk factors,and healthy lifestyle practices,with statistically significant differences(P<0.05).Moreover,the experimental group showed significantly better rates of self-management behaviors,such as quitting smoking and alcohol,self-monitoring of blood pressure,dietary control,regular medication adherence,and consistent exercise,compared to the control group,with statistically significant differences(P<0.05).Conclusion:This study indicates that a combined management model integrating health education and chronic disease management effectively improves the emotional state of elderly hypertensive patients in the community,significantly enhances their disease cognition levels,and boosts their self-management abilities.Furthermore,this model can effectively lower patients’blood pressure,thereby achieving better health management outcomes for elderly hypertensive patients in the community.

Study on the Management of Chronic Diseases in American and British Community Pharmacy

Objective To provide a reference for promoting the construction of chronic disease management in community pharmacies in China.Methods Literature research and comparative research methods were used to analyze the management of chronic disease carried out by community pharmacies in the United States and the United Kingdom.Results and Conclusion The management of chronic diseases in American and British community pharmacies has formed retail health clinic and online chronic disease mode.It is recommended that Chinese government should issue measures and supporting guidelines for the management of chronic diseases in community pharmacies as soon as possible.Community pharmacies should be encouraged to carry out chronic disease management with the concept of prudent inclusion and gradual progression.Meanwhile,the concentration of drug retail industry should be improved to carry out the systematic construction of chronic disease management and build a standardized chronic disease service process.Besides,community pharmacies should make full use of new technologies such as the Internet,cloud computing and big data,smart wearable devices,and chronic disease management Apps to explore and carry out online professional chronic disease management mode.

Discussion on the model of community management of chronic diseases in cold areas

Because of the overbearing low temperature,cold areas increase the morbidity and mortality of chronic non-communicable diseases(chronic diseases)in exposed populations.With the growth of the aging population and the superposition of lifestyle risk factors,the number of people with chronic diseases in cold areas is climbing,and the family and social burdens are rising.These health-threatening circumstances in the cold areas render the general practitioners to face serious challenges and difficulties in the community management of chronic diseases.This paper summarizes the current situation of chronic disease management in cold areas and explores the relevant management models so as to provide a useful reference for regional health construction,graded diagnosis and treatment,and prevention and control of chronic diseases in China.

Community-based intervention of chronic disease management program in rural areas of Indonesia

Objective:This study evaluates the community-based intervention of chronic disease management(CDM)through the Integrated Non-Communicable Diseases Health Post(Posbindu-NCD)conducted by a community of health workers(CHWs)in Indonesia’s rural areas.Methods:A cohor t retrospective study evaluated 577 par ticipants from Posbindu-NCD in 7 public health centers(PHCs)in 2019.Activities of intervention of CDM for Posbindu-NCD was included,identified risk factors to NCDs,and provided counselling education and other follow-ups based on interviews and measurement results from the five Desk systems that recorded in a medical record as a form of the monthly activity report each the first month,the 6 months,and the 12th month.Results:There were statistically significant differences for alcohol consumed and diabetes mellites(χ^(2)=10.455;P=0.001).There were significant differences on gender(χ^(2)=3.963;P=0.047),on ethnicity(χ^(2)=19.873;P<0.001),and hypertension.In addition,there were also significant differences on ethnicity(χ^(2)=15.307;P<0.001),vegetable consumption(χ^(2)=4.435;P=0.035),physical exercise(χ^(2)=6.328;P=0.012),and the current diseases of hypercholesterolemia of par ticipants.Fur thermore,the survival rate among patients who have overweight,abdominal overweight,hyper tension,diabetes mellitus,and hypercholesterolemia increased among par ticipants who regularly visited Posbindu-NCD compared with the non-regularly one.Conclusions:The CDM program’s community-based intervention through Posbindu-NCD conducted by CHWs improved survival rates in Indonesia’s rural areas.Therefore,this program can be fur ther developed in conducting CDM in the community with the active involvement of CHWs so that the community becomes active regularly in par ticipating in Posbindu-NCD activities in rural areas of Indonesia.

上海市实施整合式慢性病社区健康管理模式的促进和障碍因素

目的分析整合式慢性病社区健康管理模式实施的促进和障碍因素,区分模式服务量高覆盖率组和低覆盖率组在实施性研究的整合性理论框架(consolidated framework for implementation research,CFIR)上的结构差异,为政府部门提供政策建议。方法结合CFIR对22名专家进行半结构化访谈,采用定性结构评级法对13家社区卫生服务中心受访者评分,利用NVivo 12软件编码。结果高覆盖率组和低覆盖率组的相对优势、外部政策与激励、实施准备度、反思和评价、领导个人特质5个CFIR结构有差异。促进因素包括:测量数据更加精准,提高了高血压和糖尿病患者的异常检出率和控制率;模式实现了服务、技术、数据“三整合”,优化管理流程,提供管理抓手;基础性和个性化服务结合吸引患者到基层就诊;模式与我国政策背景,初级卫生保健工作和以患者为中心理念兼容;数字化工具的应用减轻医护人员工作负担;领导重视是基础,利益方间的通力合作是重要保障。障碍因素包括:宏观层面缺少卫生行政机构的支持性政策,组织架构和运行机制尚未建立,建设、投入主体以及具体工作规范和流程有待明确;缺乏监督管理机制和质量评估小组;模式推广目标模糊;缺乏规范化系统性的培训计划;为不同群体提供服务存在挑战,缺乏有效的社会面宣传;模式仍须提高需方获得感;社区布局限制了模式的服务提供。结论卫生行政部门应明确模式的建设、运行、投入主体,完善组织架构并明确各利益方的功能定位和职责分工,进一步制定工作规范和工作流程;建立信息反馈机制和质量控制小组并进行定期评估;制定清晰的目标;加大宣传教育,扩大宣传面;利用数字化工具形成良性医患互动机制。

社区四病管理模式的探讨——以医院为中心开展四病防治的可行性

本文根据四平市几年来社区四病防治管理的实践,提出了以医院为中心扩大预防,开展社区四病防治管理的基本模式及其可行性.文章认为:以医院为中心开展社区四病防治管理具有明显的优越性.促进了医院由单纯医疗型向医疗、预防型转化以及同防保部门的联合,增强了医院的社会效益,顺应了医学模式的转变,符合我国现有国情;尤其适合于没有街道医院的城市开展四病防治工作.对探索具有中国特色的卫生事业也是一种新尝试.