Objective:To explore the therapeutic effects of community health management and nursing strategies for elderly hypertensive patients.Methods:A total of 64 elderly hypertensive patients who were treated in our hospital...Objective:To explore the therapeutic effects of community health management and nursing strategies for elderly hypertensive patients.Methods:A total of 64 elderly hypertensive patients who were treated in our hospital from March 2020 to March 2021 were selected.The control group took conventional care and guidance.The research group carried out community health management and nursing strategy guidance on the basis of the control group.Then compare the blood pressure levels of the two groups of patients before and after nursing and the patients’satisfaction with nursing.Results:Through comparison,it can be seen that the diastolic and systolic blood pressure levels of the study group and the control group are not significantly different before nursing.After nursing,the diastolic blood pressure of the patients in the study group was 81.22.1 mmHg and the systolic blood pressure was 126.58.7 mmHg.The diastolic blood pressure of the control group was 90.55.4 mmHg and the systolic blood pressure was 136.412.9 mmHg.There are obvious differences in the comparison of the two sets of data.By comparing the two groups of patients’satisfactions with nursing care,it can be seen that among the 32 patients in the study group:31 were very satisfied and basically satisfied,with a satisfaction rate of 96.87%.Among the 32 patients in the control group,28 were very satisfied and basically satisfied,with a satisfaction rate of 87.5%.The data of the two groups of patients are clearly comparable.Conclusion:Through community health management and nursing strategies,the satisfaction and treatment effect of elderly hypertensive patients can be improved,thereby contributing to the recovery of patients.展开更多
Objective:This study aimed to determine the availability of community health management services and the relevant social determinants for elderly patients with chronic diseases.Methods:All data were obtained from the ...Objective:This study aimed to determine the availability of community health management services and the relevant social determinants for elderly patients with chronic diseases.Methods:All data were obtained from the 2013 random sampling household survey on an elderly population conducted by the School of Public Health of Peking University in an eastern metropolis in China.Information from the database of the above survey involving 1495 hypertensive or diabetic patients>60 years of age,as representatives of the city,were included.The study described the availability of follow-up services by community doctors among elderly hypertensive and diabetic patients during the 12 months before the survey.An ordinal multinomial logistic regression model was used to conduct the analysis on the influence of socio-economic background upon such availability.Results:Eighty-one percent of hypertensive patients and 84.7%of diabetic patients had not received any follow-up service from community doctors within 12 months prior to the survey.Among elderly hypertensive patients,those registered as non-agricultural household members,those with high and above-average income,as well as management personnel of government agencies,enterprises,and social programs have a greater chance of accepting follow-up service by community doctors because of their relatively higher socio-economic rankings.Among elderly diabetic patients,such socio-economic factors had no significant influence on the availability of the follow-up service for chronic diseases.Conclusion:The coverage of community health management services for elderly hypertensive and diabetic patients needs improvement.More effort should focus on promoting the availability of community health management services for elderly hypertensive patients,especially those with lower socio-economic status.展开更多
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。...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。展开更多
Background:To avoid or mitigate potential project-related adverse health effects,the Trident copper project in Kalumbila,northwestern Zambia,commissioned a health impact assessment.HIV was identified a priority health...Background:To avoid or mitigate potential project-related adverse health effects,the Trident copper project in Kalumbila,northwestern Zambia,commissioned a health impact assessment.HIV was identified a priority health issue based on the local vulnerability to HIV transmission and experience from other mining projects in Africa.Hence,an HIV/AIDS management plan was developed,including community and workplace interventions,with HIV testing and counselling(HTC)being one of the key components.We present trends in HTC data over a 4-year period.Methods:In 13 communities affected by the Trident project,HTC was implemented from 2012 onwards,using rapid diagnostic tests,accompanied by pre-and post-test counselling through trained personnel.In addition,HTC was initiated in the project workforce in 2013,coinciding with the launch of the mine development.HTC uptake and HIV positivity rates were assessed in the study population and linked to demographic factors using regression analysis.Results:In total,11,638 community members and 5564 workers have taken up HTC with an increase over time.The HIV positivity rate in the community was 3.0%in 2012 and 3.4%in 2015,while positivity rate in the workforce was 5.2%in 2013 and 4.3%in 2015.Females showed a significantly higher odds of having a positive test result than males(odds ratio(OR)=1.96,95%confidence interval(CI):1.55-2.50 among women in the community and OR=2.90,95%CI:1.74-4.84 among women in the workforce).HTC users in the 35-49 years age group were most affected by HIV,with an average positivity rate of 6.6%in the community sample and 7.9%in the workforce sample.These study groups had 4.50 and 4.95 higher odds of being positive,respectively,compared to their younger counterparts(15-24 years).Conclusions:While HTC uptake increased five-fold in the community and almost three-fold in the workplace,the HIV positivity rates were insignificantly higher in 2015 compared to 2012.Our data can be used alongside other surveillance data to track HIV transmission in this specific context.Guided by the health impact assessment,the HIV prevention and control programme was readily adapted to the current setting through the identification of socioeconomic and environmental determinants of health.展开更多
文摘Objective:To explore the therapeutic effects of community health management and nursing strategies for elderly hypertensive patients.Methods:A total of 64 elderly hypertensive patients who were treated in our hospital from March 2020 to March 2021 were selected.The control group took conventional care and guidance.The research group carried out community health management and nursing strategy guidance on the basis of the control group.Then compare the blood pressure levels of the two groups of patients before and after nursing and the patients’satisfaction with nursing.Results:Through comparison,it can be seen that the diastolic and systolic blood pressure levels of the study group and the control group are not significantly different before nursing.After nursing,the diastolic blood pressure of the patients in the study group was 81.22.1 mmHg and the systolic blood pressure was 126.58.7 mmHg.The diastolic blood pressure of the control group was 90.55.4 mmHg and the systolic blood pressure was 136.412.9 mmHg.There are obvious differences in the comparison of the two sets of data.By comparing the two groups of patients’satisfactions with nursing care,it can be seen that among the 32 patients in the study group:31 were very satisfied and basically satisfied,with a satisfaction rate of 96.87%.Among the 32 patients in the control group,28 were very satisfied and basically satisfied,with a satisfaction rate of 87.5%.The data of the two groups of patients are clearly comparable.Conclusion:Through community health management and nursing strategies,the satisfaction and treatment effect of elderly hypertensive patients can be improved,thereby contributing to the recovery of patients.
文摘Objective:This study aimed to determine the availability of community health management services and the relevant social determinants for elderly patients with chronic diseases.Methods:All data were obtained from the 2013 random sampling household survey on an elderly population conducted by the School of Public Health of Peking University in an eastern metropolis in China.Information from the database of the above survey involving 1495 hypertensive or diabetic patients>60 years of age,as representatives of the city,were included.The study described the availability of follow-up services by community doctors among elderly hypertensive and diabetic patients during the 12 months before the survey.An ordinal multinomial logistic regression model was used to conduct the analysis on the influence of socio-economic background upon such availability.Results:Eighty-one percent of hypertensive patients and 84.7%of diabetic patients had not received any follow-up service from community doctors within 12 months prior to the survey.Among elderly hypertensive patients,those registered as non-agricultural household members,those with high and above-average income,as well as management personnel of government agencies,enterprises,and social programs have a greater chance of accepting follow-up service by community doctors because of their relatively higher socio-economic rankings.Among elderly diabetic patients,such socio-economic factors had no significant influence on the availability of the follow-up service for chronic diseases.Conclusion:The coverage of community health management services for elderly hypertensive and diabetic patients needs improvement.More effort should focus on promoting the availability of community health management services for elderly hypertensive patients,especially those with lower socio-economic status.
基金This work was supported from First Quantum Minerals Limited.The funder had a supporting role in the study design,data collection,and analysis,and preparation of the manuscript.
文摘Background:To avoid or mitigate potential project-related adverse health effects,the Trident copper project in Kalumbila,northwestern Zambia,commissioned a health impact assessment.HIV was identified a priority health issue based on the local vulnerability to HIV transmission and experience from other mining projects in Africa.Hence,an HIV/AIDS management plan was developed,including community and workplace interventions,with HIV testing and counselling(HTC)being one of the key components.We present trends in HTC data over a 4-year period.Methods:In 13 communities affected by the Trident project,HTC was implemented from 2012 onwards,using rapid diagnostic tests,accompanied by pre-and post-test counselling through trained personnel.In addition,HTC was initiated in the project workforce in 2013,coinciding with the launch of the mine development.HTC uptake and HIV positivity rates were assessed in the study population and linked to demographic factors using regression analysis.Results:In total,11,638 community members and 5564 workers have taken up HTC with an increase over time.The HIV positivity rate in the community was 3.0%in 2012 and 3.4%in 2015,while positivity rate in the workforce was 5.2%in 2013 and 4.3%in 2015.Females showed a significantly higher odds of having a positive test result than males(odds ratio(OR)=1.96,95%confidence interval(CI):1.55-2.50 among women in the community and OR=2.90,95%CI:1.74-4.84 among women in the workforce).HTC users in the 35-49 years age group were most affected by HIV,with an average positivity rate of 6.6%in the community sample and 7.9%in the workforce sample.These study groups had 4.50 and 4.95 higher odds of being positive,respectively,compared to their younger counterparts(15-24 years).Conclusions:While HTC uptake increased five-fold in the community and almost three-fold in the workplace,the HIV positivity rates were insignificantly higher in 2015 compared to 2012.Our data can be used alongside other surveillance data to track HIV transmission in this specific context.Guided by the health impact assessment,the HIV prevention and control programme was readily adapted to the current setting through the identification of socioeconomic and environmental determinants of health.
