Effect of medical care linkage-continuous management mode in patients with posterior circulation cerebral infarction undergoing endovascular interventional therapy

BACKGROUND Acute cerebral infarction is a severe type of ischemic stroke that can be divided into anterior circulation cerebral infarction and posterior circulation cerebral infarction(PCCI).PCCI affects the structure of the posterior circulation brain,because posterior part of the brain,which has more complex anatomical structures and more prone to posterior circulation vascular variation.Therefore,improving the prognosis of PCCI patients is necessary.AIM To explore the effect of medical care linkage-continuous management mode(MCLMM)on endovascular interventional therapy(EIT)for PCCI.METHODS Sixty-nine patients with PCCI who received EIT and conventional nursing intervention were selected as the control group,and 78 patients with PCCI who received EIT and MCLMM intervention were selected as the observation group.The incidence of postoperative complications,compliance and disease selfmanagement behavior after six months of intervention,modified Rankin scale(mRS)and Barthel index(BI)scores in the acute phase and after one year of intervention,and recurrence within one year were compared between the two groups.RESULTS The total incidence rate of postoperative complications in the observation group(7.69%)was lower than that in the control group(18.84%)(P<0.05).The scores for medical compliance behavior(regular medication,appropriate diet,and rehabilitation cooperation rates)and disease self-management behavior(self-will,disease knowledge,and self-care ability)in the observation group were higher than those in the control group(P<0.05).After one year of intervention,in the observation group,the mRS score was significantly lower,and the BI score was significantly higher than those in the control group(P<0.05).The recurrence rate within one year in the observation group(3.85%)was significantly lower than that in the control group(13.04%)(P<0.05).CONCLUSION MCLMM can reduce the incidence of complications after EIT for PCCI,improve patient compliance behavior and disease self-management ability,and promote the recovery of neurological function.

Effect of internet multiple linkage mode-based extended care combined with in-hospital comfort care on colorectal cancer patients undergoing colostomy

BACKGROUND Patients with colorectal cancer may need postoperative nursing to improve prognosis,and conventional nursing is not effective.Clinical research is needed to explore nursing methods that can more effectively improve postoperative conditions on colorectal cancer patients undergoing colostomy.AIM To explore the effect of internet multiple linkage mode-based extended care combined with in-hospital comfort care on colorectal cancer patients undergoing colostomy.METHODS Data from 187 patients with colostomy treated in our hospital from May 2019 to March 2022 were collected and divided into three groups,A(n=62),B(n=62)and C(n=63),according to different intervention methods.Group A received internet multiple linkage mode-based extended care combined with in-hospital comfort care.Group B received internet multiple linkage mode-based extended care.Group C received usual care intervention.Complications were compared among the three groups.The stoma self-efficacy scale,Hamilton Anxiety Scale,RESULTS The complication rate of group A,B and C(16.13%,20.97%and 60.32%,respectively)was significantly different(all P<0.05).The incidence of complications in groups A and B was lower than that in group C,and there was no significant difference between groups A and B(P>0.05).After intervention,the scores of ostomy care,social contact,diet choice,confidence in maintaining vitality,confidence in self-care of ostomy,confidence in sexual life,confidence in sexual satisfaction and confidence in physical labor in the three groups were all higher than before intervention,and the scores of groups A and B were higher than those of group C,with statistical significance(P<0.05).The Hamilton Anxiety Scale and Hamilton Depression Scale scores of the three groups after intervention were lower than those before intervention.The scores of groups A and B were lower than those of group C,and the score of group A was lower than that of group B,all with statistical significance(all P<0.05).There was a statist-ically significant difference in cancer-induced fatigue among the three groups(P<0.05).After intervention,the scores of physical health,psychological health,social health and mental health of the three groups were lower than before the intervention.The scores of group A and B were lower than that of group C;and the score of group A was lower than that of group B,all with statistical significance(all P<0.05).CONCLUSION Internet multiple linkage mode-based extended care combined with in-hospital comfort care can effectively improve self-efficacy,bad mood,cancer-related fatigue and life quality of colorectal cancer patients undergoing colostomy.

Wisdom and Old --age Pension： Reflections on China＇s Elderly Care Model

The care of the elderly is both a human basic human rights and a manifestation of social civilization. ＂Family pension＂ has always been the main pension model in China for thousands of years. However, with the transformation of social structure and population structure, the traditional ＂family pension＂ model is facing increasing challenges. While other emerging ＂institutions pension＂, ＂community pension＂ and failed to become a ＂family pension＂ alternative options, the role is limited. With the development of a variety of integrated technology, a new integrated technology based on the wisdom of the pension model began to emerge, wisdom pension as a new pension model has been in China with a preliminary attempt, it can maximize the elimination of the Chinese labor force The risk of population loss, the greatest extent to meet the needs of the elderly, the risk of dealing with old age, improve pension efficiency, and give the elderly equalization of power and ability, so as to fundamentally enhance the subjectivity of the elderly. But as a new exploration, but also faced with manyproblems, it is worth our in-depth thinking.

Thoughts on the Innovative Design of the Integrated Service Mode of Pharmacies and Elderly Care Centers

Objective To evaluate the service model that integrates medical treatment and elderly care to provide a reference for the development of pharmacies and elderly care centers.Methods Through the literature investigation and case analysis,the domestic integrated medical treatment and elderly care service model was analyzed,and new ideas for the integration of pharmacies and elderly care centers were provided.Results and Conclusion The integrated service model of pharmacies and elderly care centers is designed and the integration mode of pharmacies,hospitals and elderly care centers is proposed by analyzing their advantages.The“pharmacy+elderly care”mode and the“pharmacy+medical treatment+elderly care”mode that integrates pharmacies,hospitals,and elderly care centers are put forward to predict its new development opportunities in the future.

CICARE沟通模式在2型糖尿病患者延伸性护理中的应用效果

目的评估实施六步标准沟通模式(CICARE)在2型糖尿病患者住院及出院延伸性护理工作中的效果。方法选取新疆医科大学第六附属医院2018年1月—2020年6月收治的2型糖尿病患者489例,采用随机数字表法分为对照组(244例)和观察组(245例)。对照组实施常规护理,观察组在此基础上运用CICARE沟通模式进行护理。比较两组患者入院时、出院时及出院第3、6个月的血糖值、总胆固醇、甘油三酯、护理满意度及生存质量情况。结果与对照组比较,观察组出院第3、6个月的空腹血糖值,餐后2 h血糖值,总胆固醇值和甘油三酯值降低,差异均有统计学意义(P<0.05);观察组出院第3、6个月总有效率(93.1%、86.5%)均高于对照组(81.2%、60.2%),且有效人数均显著增多(P<0.01);与对照组比较,观察组住院期间护理满意度显著提高(P<0.05);与对照组比较,观察组第3、6个月生理功能、心理和精神、治疗3个维度得分增加,差异均有统计学意义(P<0.05)。结论CICARE沟通模式护理既能提高住院期间2型糖尿病患者满意度及治疗效果,又能有效维持2型糖尿病患者出院后的治疗效果,提高患者自我健康管理能力及生存质量,值得临床推广应用。

CICARE 沟通模式结合人文关怀在危重症患者家属探视沟通中的应用

目的研究危重症患者家属探视沟通中实施CICARE沟通模式结合人文关怀的效果。方法选择郑州大学第一附属医院2019年4月至2022年4月430例危重症患者家属作为研究对象,随机分为观察组和对照组,各215例。对照组接受人文关怀,观察组接受人文关怀和CICARE沟通模式。观察两组患者家属干预前后心理状态变化情况[焦虑自评量表(SAS)、抑郁自评量表(SDS)],护理干预后家属需求满足情况(病情动态信息、救治方案及预后、自身舒适、安抚患者、明确治疗费用)、护理满意度及投诉率。结果观察组护理干预后SAS、SDS评分均低于对照组(P<0.05);观察组护理干预后,病情动态信息、救治方案及预后、自身舒适、安抚患者、明确治疗费用评分均高于对照组(P<0.05);观察组护理干预后护理满意率为93.96%,高与对照组(86.98%),投诉率为0.93%低于对照组(6.98%)(P<0.05)。结论危重症患者家属探视沟通中实施CICARE沟通模式结合人文关怀能有效改善患者家属不良情绪,同时改善家属需求满足情况,进而提升护理满意度,降低投诉率,临床应用价值较高。

应用CICARE沟通模式对内科住院患者护理质量的影响

目的探讨CICARE沟通模式对内科住院患者护理质量的影响。方法对2017年1月—2017年6月的患者采用CICARE沟通模式实施护理服务,观察比较实施前后分级护理工作质量和患者满意度评价。结果实施CICARE沟通模式后,对分级护理质量进行比较,实验组健康教育维度得分、总分明显增高,比较差异有统计学意义(P<0.05)。实施CICARE沟通模式后,实验组综合满意度、单项满意度得分高于对照组,比较差异有统计学意义(P<0.05)。结论运用CICARE沟通模式,围绕护患沟通重点环节制作标准作业指导书,能够促进各层级护士同质化的执行护理工作,从而提高分级护理质量和患者满意度。

CICARE沟通模式联合小丑照护在居家隔离手足口病患儿门诊健康教育中的应用

目的探讨CICARE沟通模式联合小丑照护在居家隔离手足口病(HFMD)患儿门诊健康教育中的应用效果。方法选取2018年1月至2019年9月经南阳医学高等专科学校第一附属医院门诊确诊并实施居家隔离的90例HFMD患儿及其家长为研究对象。按照收治时间的先后顺序,分为对照组和研究组,每组45例。对照组患儿男27例,女18例,年龄(4.18±0.39)岁;研究组患儿男24例,女21例,年龄(4.10±0.43)岁。对照组实施传统模式门诊宣教,研究组在对照组基础上实施CICARE沟通联合小丑照护。记录两组患儿相关临床症状的改善情况,采用儿童孤独量评估患儿孤独感水平,自制HFMD治疗依从性调查问卷评估患儿治疗依从性,采用《HFMD儿童家长疾病认知表》评估家长对疾病知识的掌握水平,根据第4周随访情况评价家长居家遵医行为的执行状况,采用焦虑自评量表(SAS)、抑郁自评量表(SDS)评估家长焦虑、抑郁水平。结果研究组患儿溃疡痊愈时间、皮疹消退时间、食欲不振消失时间、腹泻停止时间、退热时间及口腔黏膜愈合时间均低于对照组,差异均有统计学意义(均P<0.001);研究组的治疗依从性总分[(9.83±1.24)分比(18.79±1.56)分]、孤独感评分[(28.70±3.18)分比(39.20±6.15)分]均低于对照组,差异均有统计学意义(均P<0.001);干预1个月后,研究组家长居家隔离认知情况得分、居家隔离遵医率均高于对照组,SAS、SDS评分均低于对照组,两组比较差异均有统计学意义(均P<0.05)。结论CICARE沟通模式联合小丑照护干预,利于缩短居家隔离HFMD患儿各症状的改善时间,缓解其孤独感,避免自我隔绝,促进遵医行为,夯实治疗效果,提高患儿及其家长的隔离依从性,防止交叉感染,保障患儿健康。

CICARE沟通模式联合艾灸对肠系膜淋巴结炎患儿依从性及临床疗效的影响

目的探究CICARE沟通模式联合艾灸对肠系膜淋巴结炎患儿依从性、临床疗效的影响。方法选取2019年8月至2021年8月安徽省中医药大学附属太和中医院儿一科收治的90例肠系膜淋巴结炎患儿为研究对象。依据随机数字表法将其分为试验组与对照组,每组45例。对照组给予常规沟通联合艾灸干预,试验组行CICARE沟通模式联合艾灸干预。比较两组患儿干预前及干预后14 d的依从性评分;比较两组临床疗效、护理满意度、症状缓解时间。结果干预后,试验组患儿饮食配合程度、用药配合程度、护患沟通、返院复查配合度及治疗依从性评分均高于干预前,且试验组高于对照组(P<0.05)。试验组临床疗效优于对照组(P<0.05)。试验组护患沟通、病房环境、健康教育、护理技术满意度评分高于对照组(P<0.05)。试验组患儿腹痛、呕吐、高热、大便异常消失时间短于对照组(P<0.05)。结论CICARE沟通模式联合艾灸能够改善肠系膜淋巴结炎患儿的依从性及临床疗效,提高患儿家属的护理满意度,具有重要的临床应用价值。

Reform and Reconstruction of the Rural Elderly Care Service System in the New Era

With decades of hard work,socialism with Chinese characteristics has crossed the threshold into a new era.The transformation of the principal contradiction in the new era has imposed new and higher requirements on the rural elderly care service system.However,the current service system based on welfare-multiplex and urban community environment is often difficult to operate in the rural areas of central and western China.And the urban home care service for the aged is inappropriate to the rural reality;community service for the aged faces difficulties in practice;institution care for the aged develops slowly;the synergy among different elderly care service models is poor.Through observing the rural areas of central and western China in the field for a long time,this paper proposes to build the rural elderly care service system based on family supporting,supported by community mutual assistance care,supplemented by institution care for the aged,combined with medical care,and localized with diversified forms for targeted groups according to different realities.And the system should follow the fundamental guidance of development-oriented family policy,adhere to the governance mode of multiple subjects with one core and respect rural reality,which could provide a feasible way for the reform and reconstruction of the rural elderly care service system.

Guided Care护理模式干预对老年原发性高血压患者服药依从性及生活质量的影响

目的探讨Guided Care护理模式干预对老年原发性高血压患者服药依从性及生活质量的影响。方法将146例老年原发性高血压患者按建档时间分为两组,各73例。两组均给予常规护理干预,研究组在此基础上给予Guided Care护理模式干预,观察2个月。干预前及干预1个月、2个月末采用Morisky服药依从性问卷评定服药依从性,采用自我护理能力量表评定自我护理能力;干预前后采用生活质量综合评定问卷-74评定生活质量,采用纽卡斯尔护理服务满意度量表评定患者满意度。结果干预1个月、2个月末研究组Morisky服药依从性问卷评分显著低于对照组(P<0.01),自我护理能力量表评分显著高于对照组(P<0.01)。干预后研究组生活质量综合评定问卷-74的躯体功能、心理功能、社会功能、物质生活状态维度分及纽卡斯尔护理服务满意度量表评分均显著高于对照组(P<0.05或0.01)。结论Guided Care护理模式干预能增强老年原发性高血压患者的服药依从性,增强自我护理能力,提高患者满意度及生活质量。

Incongruence between the Preferred Mode of Delivery and Risk of Childbirth Complications among Antepartum Women in Mulago Hospital, Uganda

Objective: Women’s preferences for the mode of delivery provide clues on their knowledge and perceptions of anticipated risk of childbirth complications.?The objective was toinvestigate?incongruence between preferred mode of delivery and risk of adverse pregnancy outcomes. Methods: Through a cross-sectional study, data were?collected from 327?women admitted to Mulago hospital. Data included socio-demographic?characteristics, past medical, gynaecological and obstetric history, pregnancy complications, knowledge of pregnancy complications and preferred mode of delivery. The preferred mode of delivery and knowledge of related risks for adverse pregnancy outcomes were compared. Results: The mean age of participants was 24.7 years (±5.9), ranging?14?-?43 years, of whom 41.4% were nulliparous. The preferred mode of delivery was vaginal (84.1%). Incongruence?(preference for a mode of delivery that did not correspond to expected or anticipated risks) occurred in 88 (26.9%) of the women, and was associated with having secondary school or higher level of education (OR 2.49, CI 1.52?-?4.08) and history of previous vaginal delivery (OR 3.82,?CI 1.94?-?7.49). Conclusion: One in four women had incongruence between preferred mode of delivery and risks of adverse pregnancy outcomes, which called?for urgent interventions to improve decision-making about intrapartum care.

CICARE沟通模式对肝癌行经导管动脉化疗栓塞术患者的影响

目的:探讨CICARE沟通模式对肝癌行经导管动脉化疗栓塞术(TACE)患者的影响。方法:将100例肝癌行TACE患者随机分为研究组和对照组各50例,对照组采用常规沟通模式,研究组采用CICARE沟通模式,比较两组护理效果。结果:研究组护理满意度高于对照组(P<0.05);研究组护理后心理状态评估量表(MSSNS)中焦虑、抑郁、孤独维度评分低于对照组(P<0.05);研究组术后1个月自主护理能力评分高于对照组(P<0.05,P<0.01);研究组术后1个月匹兹堡睡眠质量指数(PSQI)评分低于对照组(P<0.01),生活质量量表(QOL)评分高于对照组(P<0.01)。结论:CICARE沟通模式可改善肝癌行TACE患者的心理状态,改善自护能力和生活质量,提高护理满意度。

Research on the development mode of long-term nursing insurance ——taking Qingdao as an example

With the gradual development of society, scientific and technological progress, aging gradually aggravated, has become a hot topic of society. People to old age, self-care ability than in the past, not only suffer from disease, life has become difficult, coupled with the large number of empty nest family, the cost of care is also very high, whether it is to receive home care or professional institutions of care have great difficulties. Therefore, the community should be a large number of people with long-term care needs of the appropriate economic compensation, in this context, long-term care insurance is born. As a leading city in Shandong Province, Qingdao has introduced long-term care insurance and achieved good results. This paper analyzes the practical problems faced by Qingdao, that is, the development background of Qingdao long-term nursing insurance model, obtains the deficiency of Qingdao long-term nursing insurance, and then puts forward the corresponding countermeasures, and then ponders how to choose the long-term nursing insurance model of our country＇s future development.

整体护理联合CICARE沟通模式在冠心病患者中的应用效果评价

目的探讨整体护理联合CICARE沟通模式在冠心病患者护理中的应用效果。方法采用半随机法,将2020年5—10月笔者所在科室符合纳入和排除标准的120例冠心病患者分为试验组和对照组,各60例。对照组患者按照冠心病护理常规进行护理,试验组患者在进行整体护理的基础上采用CICARE沟通模式进行沟通。比较两组患者住院满意度评价和健康教育知识知晓率。结果试验组患者在住院满意度评价的六个维度中,沟通、安全、指导、护理、护理技术五个维度评价得分结果优于对照组(P<0.05),两组患者对物理环境评价得分,差异无统计学意义(P>0.05)。试验组患者健康教育知晓率高于对照组,差异有统计学意义(P<0.01)。结论整体护理联合CICARE沟通模式,能够提高冠心病住院患者满意度和健康教育知晓率。

基于微信小程序的“校企社”联动社区药学服务模式构建与应用

目的构建基于微信小程序的“校企社”联动社区药学服务模式,提档升级社区药学服务内容和服务方式,提升居民健康生活质量。方法围绕社区居民药学服务需求,整合学校、企业及社区药学资源,打造“药享健康”微信小程序,构建“线上+线下”社区药学服务模式。采用分类随机抽样,随机选取小程序用户为观察组,以线下药学服务结对帮扶社区居民为对照组,围绕用药健康知识掌握合格率、用药依从率、用药行为正确率3个方面进行干预效果比较。结果“药享健康”小程序由“药健康”“药温暖”“药安全”“个人信息”4个模块构成。基于“药享健康”小程序的“校企社”联动社区药学服务模式于2022年7月开始实践应用,小程序现有用户6185人,完成回收过期药品2732次,完成药学服务941次,完成咨询订单3354次。干预后,观察组居民的用药健康知识掌握合格率、用药完全依从率、用药行为正确率分别由干预前的33.53%、20.23%、49.71%提升至76.87%、46.26%、89.80%,且干预后的提升效果均显著优于对照组(P<0.05)。结论该服务模式有效提升了社区药学服务质量,提高了社区居民用药健康意识,促进了居民用药规范化、合理化、安全化。

时效性激励模式下的延伸护理在老年慢性萎缩性胃炎癌前病变患者中的应用效果

目的探讨时效性激励模式下的延伸护理在老年慢性萎缩性胃炎癌前病变患者中的应用效果。方法选取该院2020年7月至2022年7月收治的老年慢性萎缩性胃炎癌前病变患者100例作为研究对象,按照随机数字表法将其分成观察组与常规组,每组50例。常规组采用常规延伸护理,观察组在常规组的基础上采用时效性激励模式下的延伸护理,两组均持续干预3个月。对比两组遵医行为、护理满意度[采用纽卡斯尔护理服务满意度量表(NSNS)评分进行评估],比较两组干预前后自我效能感[采用一般自我效能感量表(GSES)评分进行评估]、应对方式[采用简易应对方式量表(SCSQ)评分进行评估]、健康行为[采用健康促进生活方式量表(HPLP-Ⅱ)评分进行评估]、自我管理能力[采用成年人健康自我管理能力测评表(AHSMSRS)评分进行评估]及生活质量[采用慢性病患者生命质量测定量表体系-慢性胃炎(QLICD-CG)评分进行评估]情况。结果观察组遵医率(98.00%)和护理满意度(100.00%)均高于常规组(84.00%、88.00%),差异均有统计学意义(P<0.05)。干预后,观察组GSES、HPLP-Ⅱ、AHSMSRS、QLICD-CG评分均高于常规组(P<0.05)。与常规组相比,干预后观察组积极应对评分升高,而消极应对评分降低,差异均有统计学意义(P<0.05)。结论时效性激励模式下的延伸护理可提高老年慢性萎缩性胃炎癌前病变患者自我效能感,增强其自我管理能力及遵医行为,提高患者生活质量水平及护理满意度。

党建引领视角下医疗卫生人才培养的实践研究

加强党建工作建设,充分发挥党组织领导核心的作用,为医疗卫生教育机构深化医疗人才培养提供坚强保障。在党建引领背景下对医疗卫生人才培养进行探索和研究,构建全员、全方位、全过程育人体系,聚焦党建引领,建强育人队伍,凸显全员育人合力,培养兼具扎实专业理论和综合素质能力的复合型人才成为重要的育人目标。推动党建引领实践育人工作,即有利于强化党对医疗卫生教育机构的领导,还有利于创新党建引领、医疗卫生教育机构主导和社会力量参与的实践育人模式。文章从党建引领,在医疗人才培养的实践探索、实践策略等方面,探索党建引领实践育人策略,以为相关工作提供一定的借鉴和参考依据。

多模式促排痰护理联合全人照护管理在支气管肺炎氧疗患儿中的应用

目的探讨支气管肺炎氧疗患儿采用多模式促排痰护理联合全人照护管理的效果。方法选取2017年8月至2019年2月郑州市妇幼保健院接收的86例支气管肺炎氧疗患儿,以随机数字表法分为干预组(n=43,多模式促排痰护理联合全人照护管理干预)与对照组(n=43,常规护理干预),对两组排痰时间、排痰量、肺功能[第1秒用力呼气容积(FEV_1)、最大呼气流速(PEF)]、症状消失情况、生活质量[儿童生活质量测定量表(PedsQL 4.0)]进行比较。结果干预组排痰时间较对照组更短,排痰量更多,差异有统计学意义(P<0.05);干预后两组FEV_1、PEF均有所提高,且干预组高于对照组,差异有统计学意义(P<0.05);干预组症状消失时间较对照组更短,差异有统计学意义(P<0.05);干预后两组PedsQL 4.0评分均提高(P<0.05),且干预组高于对照组,差异有统计学意义(P<0.05)。结论支气管肺炎氧疗患儿给予多模式促排痰护理联合全人照护管理干预能够促进痰液排出,缩短排痰时间,促进肺功能恢复及症状消失,提升生活质量。

远程药学管理模式联合延续护理在2型糖尿病合并冠状动脉病变患者居家用药中的研究

目的探讨远程药学管理模式联合延续护理在2型糖尿病(T2DM)合并冠状动脉病变患者居家用药中的应用效果。方法选取2021年6月—2023年6月在广州医科大学附属第三医院诊治的200例T2DM合并冠状动脉病变患者为研究对象,根据干预方式不同分为常规组100例和研究组100例。常规组患者给予院内院外常规护理,研究组在常规组的基础上给予远程药学管理模式联合延续护理。评估患者用药依从性、饮食依从性、运动依从性、自我管理能力、生活质量[36条目简明健康量表(SF-36)]及心血管事件发生情况。结果研究组用药、饮食、运动依从性均高于常规组(P<0.05)。相较于干预前,两组患者在干预后的自我管理机能、自我责任感、自我概念及健康知识分值均升高,且研究组高于常规组(P<0.05)。相较于干预前,两组患者在干预后的活力(VT)、精神健康(MH)、情感职能(RE)、躯体疼痛(BP)、生理功能(PF)、社会功能(SF)、生理职能(RP)、总体健康(GH)分值均升高,且研究组高于常规组(P<0.05)。研究组与常规组患者心血管不良事件发生率分别为2例(2.00%)、15例(15.09%),研究组高于常规组(χ2=10.865,P<0.05)。结论远程药学管理模式联合延续护理能够提高T2DM合并冠状动脉病变患者的用药管理依从性,提高患者自我管理能力,改善生活质量,降低不良心血管事件的发生率。