Assessing Community Health Interventions in Reducing Infant and Child Mortality in the Southeastern Benin

Background: To reduce infant and child mortality in Benin, a package of high-impact interventions per healthcare level was implemented in 2009. This study aimed to assess the quality of community-based health interventions in reducing infant and child mortality within the municipality of Pobè in southeastern Benin. Methods: This was a cross-sectional evaluative study carried out in November 2021 focused on children aged 0 - 59 months, their mothers, health workers, community facilitators, community health workers and the Town Hall health focal point. Mothers and their children were targeted by cluster sampling, and exhaustive selection was used to recruit all other participants. Predetermined scores based on rating criteria were used to assess the quality of community health interventions using the “input, process and outcome” of Donabedian approach. Results: Over 300 mother-child couples, 46 community health workers, 7 health agents, 1 community facilitator and 1 health focal point from Pobè town hall were surveyed. Intervention quality was judged as “average”, with a score of 73.80%. The “inputs” and “outcomes” components were the weakest links. Conclusion: Improving access to the inputs needed by community health workers can enhance the quality of PIHI interventions.

Impact of an emergency department nursing intervention on continuity of care, self-care, and psychological symptoms

BACKGROUND The emergency department plays a crucial role in providing acute care to patients.Nursing interventions in this setting are essential for improving the continuity of care,enhancing patients’self-care abilities,and reducing psychological symp-toms.AIM To evaluate the effect of nursing interventions in the emergency department on these indicators in an emergency department.METHODS A retrospective analysis was conducted on 120 patients admitted to the emergency department between January 2022 and May 2023.The patients were divided into two groups:The control group(conventional nursing intervention)and the observation group(conventional nursing intervention+emergency department nursing intervention).The two groups were compared regarding continuity of care,self-care ability,psychological symptoms,and satisfaction with care.RESULTS The emergency department nursing interventions significantly improved the continuity of care,enhanced patients’self-care abilities,and reduced psycho-logical symptoms such as anxiety and depression.CONCLUSION Nursing interventions in the emergency department positively impact continuity of care,self-care,and psychological symptoms.However,it is important to acknowledge the limitations of this study,including the small number of studies,variable methodological quality,and the heterogeneity of the study population.Future research should address these limitations and further explore the effects of different types of nursing interventions in the emergency department.Additionally,efforts should be made to enhance the application and evaluation of these interventions in clinical practice.

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.

Impact of continuous care on cardiac function in patients with lung cancer complicated by coronary heart disease

BACKGROUND Despite sharing similar pathogenic factors,cancer and coronary heart disease(CHD)occur in comparable populations at similar ages and possess similar susceptibility factors.Consequently,it is increasingly commonplace for patients to experience the simultaneous occurrence of cancer and CHD,a trend that is steadily rising.AIM To determine the impacts of continuing care on lung cancer patients with CHD following percutaneous coronary intervention(PCI).METHODS There were 94 lung cancer patients with CHD following PCI who were randomly assigned to the intervention group(n=38)and the control group(n=41).In the intervention group,continuing care was provided,while in the control group,routine care was provided.An evaluation of cardiac and pulmonary function,medication compliance,a 6-min walk test,and patient quality of life was performed.RESULTS Differences between the two groups were significant in left ventricular ejection fraction,6-min walk test,oxygen uptake,quality of life and medication compliance(P<0.05).In comparison with the control group,the enhancement in the intervention group was more significant.The intervention group had more patients with high medication compliance than the control group,with a statistically significant difference(P<0.05).CONCLUSION After undergoing PCI,lung patients with CHD could benefit from continued care in terms of cardiac and pulmonary function,medications compliance,and quality of life.

Effects of Continuous Nursing Intervention on Postoperative Rehabilitation of Patients with Craniocerebral Trauma

Objective:To study and analyze the clinical effect of continuous nursing in the process of postoperative rehabilitation for patients with craniocerebral trauma.Methods:From August 2018 to July 2021,40 patients who came to our hospital for craniocerebral trauma treatment were randomly selected as clinical experimental research objects,and they were divided into continuous nursing group and routine nursing group.The rehabilitation of patients in the two groups before and after postoperative nursing was observed and counted.Results:Before nursing intervention,there was no significant difference in MMSE score and Fugl-Meyer score between the two groups,p>0.05.After nursing,the scores were scored again at 3 and 6 months after nursing.It was found that the two groups were improved,but the improvement range in the continuous nursing group was significantly higher than that in the routine nursing group,the difference was statistically significant(p<0.05).From the score of quality of life,the scores of physical pain,psychological function,mental health and social function in the continuous nursing group were better than those in the routine nursing group,the difference was statistically significant(p<0.05).Conclusion:Using continuous nursing measures for rehabilitation nursing of patients with craniocerebral trauma after discharge can significantly improve the quality of life of patients,restore the mental state and limb function of patients,and has significant clinical effect.

Analysis of the Effect of Continuous Nursing Care in Patients with COPD

Objective:to study the effect of continuous nursing intervention in patients with chronic obstructive pulmonary disease(COPD).Methods:In this paper,56 COPD patients were selected and grouped by drawing lots,with 28 cases in each group.The study group underwent continuous nursing intervention,while the control group underwent conventional care,and the parameters of both groups of patients were compared.Results:Compared with the control group,the patients in the study group had a significantly higher forced expiratory volume in one second to forced vital capacity ratio(FEV1/FVC),a significantly lower COPD Assessment Test(CAT)score,and Hamilton Depression(HAM-D)score,and a significantly higher 6-Minute Walk Test(6WMT)score after nursing care.Besides,their self-care ability score and SaO_(2)were significantly higher,while their PaCO_(2)and coagulation indexes were significantly lower(P<0.05).Conclusion:Continuous nursing intervention is beneficial for COPD patients.

Effectiveness of cognitive behavior therapy for sleep disturbance and glycemic control in persons with type 2 diabetes mellitus:A community-based randomized controlled trial in China

BACKGROUND Poor sleep quality is a common clinical feature in patients with type 2 diabetes mellitus(T2DM),and often negatively related with glycemic control.Cognitive behavioral therapy(CBT)may improve sleep quality and reduce blood sugar levels in patients with T2DM.However,it is not entirely clear whether CBT delivered by general practitioners is effective for poor sleep quality in T2DM patients in community settings.AIM To test the effect of CBT delivered by general practitioners in improving sleep quality and reducing glycemic levels in patients with T2DM in community.METHODS A cluster randomized controlled trial was conducted from September 2018 to October 2019 in communities of China.Overall 1033 persons with T2DM and poor sleep quality received CBT plus usual care or usual care.Glycosylated hemoglobin A1c(HbAlc)and sleep quality[Pittsburgh Sleep Quality Index(PSQI)]were assessed.Repeated measures analysis of variance and generalized linear mixed effects models were used to estimate the intervention effects on hemoglobin A1c and sleep quality.RESULTS The CBT group had 0.64,0.50,and 0.9 lower PSQI scores than the control group at 2 mo,6 mo,and 12 mo,respectively.The CBT group showed 0.17 and 0.43 lower HbAlc values than the control group at 6 mo and 12 mo.The intervention on meanΔHbAlc values was significant at 12 mo(t=3.68,P<0.01)and that meanΔPSQI scores were closely related toΔHbAlc values(t=7.02,P<0.01).Intentionto-treat analysis for primary and secondary outcomes showed identical results with completed samples.No adverse events were reported.CONCLUSION CBT delivered by general practitioners,as an effective and practical method,could reduce glycemic levels and improve sleep quality for patients with T2DM in community.

Community-based obesity prevention initiatives in aboriginal communities: The experience of the eat well be active community programs in South Australia

Childhood obesity is a growing concern world-wide, and obesity rates are higher in certain groups in the developed world, including Australian Aboriginal people. Community-based obesity prevention interventions (CBOPI) can help to address obesity, however the approach of such programs to reach diverse groups, including Aboriginal people, must be considered. This paper considers one mainstream1 CBOPI, the eat well be active (ewba) Community Programs in South Australia, which was delivered in two communities and sought to reach Aboriginal people as part of the overall program. This paper considers how well this approach was received by the Aboriginal people living and working in those communities. Semi-structured interviews were conducted with nine Aboriginal workers who had some connection to the ewba program, and seven ewba project staff. Qualitative data analysis was performed and factors found to affect how well the program was received by Aboriginal people include relationships, approach and project target group, including geographical area. A different response was observed in the two communities, with a more positive response being observed in the community where more relationships were developed between ewba and Aboriginal staff. For any CBOPI seeking to work with Aboriginal (or other Indigenous) communities, it is vital to consider and plan how the program will meet the needs and preferences of Aboriginal people in all stages of the project, in order to reach this group.

Cultural Sensitivity of a Community-Based Falls Prevention Program Targeting Older Arab American

Falls are a frequent and costly cause of injuries and functional decline in the elderly. Tai Chi is a cost-effective strategy for preventing falls in older adults. Many senior centers have introduced Tai Chi programs to increase mobility and decrease the risk of falls. However, the practice has yet to be widely disseminated to ethnic minorities who are not culturally connected to Tai Chi. This paper describes implementation barriers and recruitment and retention challenges of Arab American participants in a Tai Chi intervention-based health promotion program, including issues related to community organization and staffing, recruitment and retention, need for building relationships, need for translation and interpreters, and cultural barriers & misconceptions. Understanding and paying adequate attention to these challenges may help facilitate in planning other health promotion interventions targeting Arab American population.

多元化延续性干预在乳腺癌术后上肢淋巴水肿康复中的应用效果

目的分析多元化延续性干预在乳腺癌患者术后上肢淋巴水肿康复中的应用效果。方法根据干预方法的不同将96例乳腺癌手术患者分为对照组(n=47)和研究组(n=49),对照组患者采用常规干预,研究组患者在对照组的基础上采用多元化延续性干预。比较两组患者的满意度、上肢功能活动情况[臂肩手功能障碍评估表(DASH)]、上肢淋巴水肿情况。结果研究组患者的总满意度为97.96%,明显高于对照组患者的80.85%,差异有统计学意义(P﹤0.01)。干预后,两组患者DASH评分均明显低于本组干预前,研究组患者DASH评分明显低于对照组,差异均有统计学意义(P﹤0.01)。干预后,研究组患者上肢淋巴水肿情况优于对照组(P﹤0.05)。结论多元化延续性干预可减轻乳腺癌患者术后上肢淋巴水肿,促进患者上肢功能恢复,提高满意度,值得临床推广应用。

个性化饮食干预结合延续性护理追踪对2型糖尿病留守老人血糖控制及生活质量影响

目的分析个性化饮食干预结合延续性护理追踪对2型糖尿病留守老人血糖控制及生活质量的影响。方法选择2021年1月—2023年10月寿光市人民医院收治的146例2型糖尿病留守老人为研究对象,通过随机数表法将其分为参考组(n=73,常规护理)和观察组(n=73,个性化饮食干预结合延续性护理)。比较两组血糖指标、护理满意度、心理状态评分以及生活质量评分。结果护理后,观察组血糖指标和心理状态评分的改善程度显著优于参考组,护理满意度和生活质量评分显著高于参考组,差异具有统计学意义(P均<0.05)。结论个性化饮食干预结合延续性护理追踪用于2型糖尿病留守老人的效果确切,对于留守老人的血糖控制和生活质量均有积极影响。

基于赋能理论的延续性干预对脑梗死患者应对情况及心理状态的影响

目的探讨基于赋能理论的延续性干预对脑梗死患者应对情况及心理状态的影响。方法采用随机数字表法,将2021年7月至2022年3月在河北医科大学第二医院接受治疗的脑梗死患者112例分为对照组和观察组,每组56例。对照组给予常规护理,观察组在对照组的基础上,采用基于赋能理论的延续性干预,2组均干预6个月。比较2组干预后的治疗依从性及满意度,干预前后的医学应对方式问卷(MCMQ)、神经功能缺损量表(NIHSS)、日常生活活动能力(ADL)、脑卒中残损评定法量表(SIAS)、生活质量评分、心理状况[汉密尔顿焦虑量表(HAMA)、汉密尔顿抑郁量表(HAMD)、心理弹性量表(CD-RISC)]。结果2组回避、屈服、NIHSS、HAMA、HAMD评分干预后较干预前降低,且观察组低于对照组(P<0.05);面对、ADL、SIAS、CD-RISC、生活质量各项评分升高,且观察组高于对照组(P<0.05);观察组的治疗总依从性高于对照组(P<0.05),观察组总满意度高于对照组(P<0.05)。结论基于赋能理论的延续性干预应用于脑梗死患者中,能够帮助调节患者的负性情绪,改善其神经功能,促进其身体功能恢复,提升生活质量、心理弹性恢复能力以及生活的自理能力,患者对其有较高的满意度,且能够提高患者面对疾病的信心,使其更加配合治疗。

全程护理干预在脑卒中患者康复过程中的应用观察

目的探讨全程护理干预在脑卒中患者康复过程中的应用价值,以期为临床治疗提供参考。方法选取2023年1—11月郴州市第一人民医院收治的120例脑卒中患者为研究对象,采用随机数字表法将患者分为观察组和对照组,每组60例。对照组患者给予常规康复护理干预;观察组患者在常规康复护理基础上进行全程护理干预。比较2组患者干预前后(干预4周时)健康知识掌握程度、满意度、自我行为管理能力及日常生活自理能力。结果干预前,2组患者健康知识掌握程度比较,差异无统计学意义(P>0.05)。干预4周时,2组患者健康知识掌握程度优良率均高于干预前,且观察组高于对照组,差异均具有统计学意义(P<0.05)。观察组患者护理总满意度高于对照组,差异具有统计学意义(P<0.05)。干预前,2组患者脑卒中自我行为管理调查问卷评分比较,差异无统计学意义(P>0.05)。干预4周时,2组患者脑卒中自我行为管理调查问卷评分均高于干预前,且观察组高于对照组,差异均具有统计学意义(P<0.05)。干预前,2组患者改良Barthel指数评定量表评分比较,差异无统计学意义(P>0.05)。干预后,2组患者改良Barthel指数评定量表评分均高于干预前,且观察组高于对照组,差异均具有统计学意义(P<0.05)。结论全程护理干预能让医护技工作得到无缝隙对接,保障患者康复质量,帮助患者掌握健康知识,提高患者自我行为管理能力及日常生活自理能力,改善患者就医体验,提高患者满意度,值得临床推广应用。

三位一体式延续性干预在糖尿病肾病患者中的效果及对依从性的影响研究

目的 探讨三位一体式延续性干预在糖尿病肾病患者中的效果及对依从性的影响。方法 选取2020年3月—2022年1月潍坊市益都中心医院收治的糖尿病肾病患者164例为研究对象,采用信封法分为两组,各82例。对照组给予常规护理与随访,观察组联合三位一体式延续性干预,比较两组自我效能量表(Exercise of Self-care Agency, ESCA)评分、自我管理水平及依从性。结果 干预后,观察组ESCA评分、自我管理水平评分高于对照组,差异有统计学意义(P均<0.05)。干预后,观察组治疗方案、按时复查、体位指导、液体摄入及对症治疗依从性高于对照组,差异有统计学意义(P均<0.05)。结论 三位一体式延续性干预用于糖尿病肾病患者中,能提高患者自我效能水平及自我管理能力,有助于提高患者出院后依从性。

下肢静脉曲张术后延续性干预的效果及复发影响因素分析

目的探讨下肢静脉曲张术后延续性干预的效果及复发影响因素。方法选择2020年3月至2022年9月收治的下肢静脉曲张并行手术治疗的患者100例,随机分为观察组和对照组各50例,对照组行常规干预,观察组使用延续性干预,对比2组复发情况、凝血功能及生活质量。根据患者术后12个月是否复发分为复发组42例和未复发组58例,收集2组一般资料,应用多因素Logistic回归分析术后复发的影响因素。结果观察组术后6、9、12个月复发率低于对照组(P<0.05,P<0.01);观察组凝血酶时间、凝血酶原时间及活化部分凝血酶原时间均长于对照组(P<0.05);观察组躯体、心理、角色、社会四个维度评分均高于对照组(P<0.05)。年龄≥60岁、体质量指数、文化程度、静脉曲张年限、凝血功能以及延续性干预均是下肢静脉曲张术后复发的影响因素(P<0.05,P<0.01)。结论年龄、体质量指数、文化程度、静脉曲张年限及凝血功能是下肢静脉曲张术后复发影响因素,术后应用延续性干预能降低复发率,提高患者生活质量。

多学科协作式延续性干预对老年神经胶质瘤患者术后并发症及生活质量的影响

目的探讨多学科协作(MDT)式延续性干预对老年神经胶质瘤患者术后并发症及生活质量的影响。方法将106例老年神经胶质瘤患者根据干预方式的不同分为干预组(56例)和对照组(50例)。对照组患者接受常规术后干预,干预组患者接受MDT式延续性干预。比较两组患者的生活质量[日常生活活动量表(ADL)]、神经功能[美国国立卫生研究院卒中量表(NIHSS)和简易精神状态量表(MMSE)]、神经肽[β-内啡肽(β-EP)、神经降压素(NT)和精氨酸升压素(AVP)]水平及术后并发症发生情况。结果干预后1个月,两组患者身体机能、心理状况、社会能力和整体生活质量评分均较干预前升高,且干预组患者身体机能、心理状况、社会能力和整体生活质量评分均高于对照组,差异均有统计学意义(P﹤0.05)。干预后1个月,两组患者NIHSS评分均较干预前降低,MMSE评分均较干预前升高,且干预组患者NIHSS评分低于对照组,MMSE评分高于对照组,差异均有统计学意义(P﹤0.05)。干预后,两组患者β-EP、NT、AVP水平均较干预前升高,且干预组患者β-EP、NT、AVP水平均高于对照组,差异均有统计学意义(P﹤0.05)。干预组患者术后并发症总发生率低于对照组患者,差异有统计学意义(P﹤0.05)。结论MDT式延续性干预能够显著减少老年神经胶质瘤患者的术后并发症,提高生活质量,减轻炎症反应,促进神经功能恢复。

基于IKAP理论的延续性护理在脑血管介入术后患者中的应用效果

目的:观察基于信息-知识-信念-行为(IKAP)理论的延续性护理在脑血管介入术后患者中的应用效果。方法:选取2019年1月至2021年4月于该院行脑血管介入术的80例患者进行前瞻性研究,按照随机数字表法将其分为对照组和观察组各50例。对照组实施常规护理,观察组实施基于IKAP理论的延续性护理,比较两组疾病知晓率、护理前后日常活动能力[Barthel指数(BI)]评分、自我管理能力评分及睡眠质量[匹兹堡睡眠质量指数(PSQI)]评分。结果:观察组疾病知识知晓率为92.00%(46/50),高于对照组的76.00%(38/50),差异有统计学意义(P<0.05);护理1、2、3个月后,两组BI评分均高于护理前,且观察组高于对照组,差异有统计学意义(P<0.05);护理后,两组自我管理能力评分均高于护理前,且观察组高于对照组,差异有统计学意义(P<0.05);胡护理后,两组PSQI评分均低于护理前,且观察组低于对照组,差异有统计学意义(P<0.05)。结论:基于IKAP理论的延续性护理应用于脑血管介入术后患者可提高疾病知识知晓率、日常生活能力评分和自我管理能力评分,以及降低睡眠质量评分的效果优于常规护理效果。

以家庭为中心模式下的认知行为干预在主动脉夹层术后患者延续护理中的应用

目的探讨以家庭为中心(family-centered care,FCC)模式下的认知行为干预在主动脉夹层术后患者延续性护理中的应用效果。方法采用随机数字表法将2021年1月至2022年12月陕西省人民医院心脏外科收治的106例主动脉夹层术后患者分为对照组与观察组各53例。对照组给予常规延续性护理,观察组在对照组基础上实施FCC模式下认知行为干预的延续性护理,两组均干预8周。比较两组干预前后血压、体质量指数(BMI)、自护能力[采用自我护理能力量表(ESCA)]、生活质量[采用健康调查简表(SF-36)]、抑郁、焦虑状况[医院焦虑抑郁量表(HADS)]的差异。结果两组患者干预后血压、BMI、抑郁、焦虑状况均低于干预前(P<0.05),ESCA评分、SF-36评分均高于干预前(P<0.05);且观察组血压和BMI控制情况分别为[(116.47±28.23)mmHg、(25.33±1.11)kg/m^(2)]均优于对照组[(124.48±29.81)mmHg、(26.18±1.35)kg/m^(2)];观察组自护能力(ESCA)、生活质量(SF-36)评分分别为[(121.15±29.69)分、(67.92±13.69)分]均高于对照组[(106.68±24.71)分、(60.81±10.77)分];观察组抑郁、焦虑状况分别为[(11.07±4.00)分、(12.39±3.59)分]均明显低于对照组[(12.20±4.28)分、(13.45±4.15)分],差异均有统计学意义(t=7.193、2.454、8.243、7.436、3.873、2.852,均P<0.01)。结论将FCC模式下的认知行为干预应用于主动脉夹层术后患者延续性护理中,可明显改善患者血压、BMI和心理状况,提升患者自护能力及生存质量,值得在临床中推广应用。

分析家庭教育-环境改良的延续性干预对哮喘患儿睡眠质量的影响效果

目的:分析家庭教育-环境改良的延续性干预对哮喘患儿睡眠质量的影响效果。方法:选取2021年11月至2023年11月厦门大学附属第一医院儿科急诊收治的哮喘患儿86例作为研究对象,按照随机数字表法分为对照组和观察组,每组43例。对照组给予常规护理干预,观察组给予家庭教育-环境改良的延续性护理干预。采用匹兹堡睡眠质量指数(PSQI)比较2组患儿干预前后睡眠质量的变化,采用智能手环检测2组患儿干预前后入睡潜伏期、觉醒时间及睡眠时间的差异,并使用肺功能仪检测2组的用力肺活量和呼气流量峰值。结果:干预后,观察组睡眠潜伏期、觉醒时间均显著短于对照组,观察组实际睡眠时间显著高于对照组,观察组用力肺活量、呼气流量峰值显著高于对照组,观察组PSQI评分显著低于对照组,差异均有统计学意义(均P<0.05)。结论:家庭教育-环境改良的延续性干预有利于改善哮喘患儿的睡眠质量,提高患儿的肺功能,值得进一步推广应用。

经皮冠状动脉介入治疗术后患者延续性护理的研究进展

延续性护理在术后患者康复护理中展现了良好的应用价值。经皮冠状动脉介入治疗术(PCI)具有创伤小、恢复快等优势,是临床治疗冠心病(CHD)患者的常用方案。PCI术后二级预防对避免CHD复发和不良预后有着重要意义。本研究就PCI术后患者的延续性护理应用现状进行综述,旨在为进一步提高PCI术后患者疾病自我管理能力、改善生活质量提供参考。