Background:Much has been written about the loss to follow-up in the transition between pediatric and adult Congenital Heart Disease(CHD)care centers.Much less is understood about the loss to follow-up(LTF)after a succ...Background:Much has been written about the loss to follow-up in the transition between pediatric and adult Congenital Heart Disease(CHD)care centers.Much less is understood about the loss to follow-up(LTF)after a successful transition.This is critical too,as patients lost to specialised care are more likely to experience mor-bidity and premature mortality.Aims:To understand the prevalence and reasons for loss to follow-up(LTF)at a large Australian Adult Congenital Heart Disease(ACHD)centre.Methods:Patients with moderate or highly complex CHD and gaps in care of>3 years(defined as LTF)were identified from a comprehensive ACHD data-base.Structured telephone interviews examined current care and barriers to clinic attendance.Results:Overall,407(22%)of ACHD patients(n=1842)were LTF.The mean age at LTF was 31(SD 11.5)years and 54%were male;311(76%)were uncontactable.Compared to adults seen regularly,lost patients were younger,with a greater socio-economic disadvantage,and had less complex CHD(p<0.05 for all).We interviewed 59 patients(14%).The top 3 responses for care absences were“feeling well”(61%),losing track of time(36%),and not needing fol-low-up care(25%).Conclusions:A large proportion of the ACHD population becomes lost to specialised cardiac care,even after a successful transition.This Australian study reports younger age,moderate complexity defects,and socio-economic disadvantage as predictive of loss to follow-up.This study highlights the need for novel approaches to patient-centered service delivery even beyond the age of transition and resources to maintain patient engagement within the ACHD service.展开更多
Objective: To explore the effects of “hospital–community integrated transitional care” model on quality of life in patients with chronic obstructive pulmonary disease (COPD). Methods: A total of 117 inpatients with...Objective: To explore the effects of “hospital–community integrated transitional care” model on quality of life in patients with chronic obstructive pulmonary disease (COPD). Methods: A total of 117 inpatients with COPD from the Department of Respiratory Medicine in a tertiary general hospital in Nanjing were enrolled by convenience sampling from January to December in 2016 and then were divided into intervention group (n = 60) and control group (n = 57) by random number table. Patients in the intervention group accepted both routine care and hospital– community integrated transitional care for 3 months after discharge. Assessment of quality of life by telephone follow-up or interview within a week before discharge and 1, 3, and 6 months after discharge was evaluated using the Short Form-36 (SF-36) health survey questionnaire. Results: For a total score of quality of life, there was a significant difference between the two groups (P < 0.05): 1, 3, and 6 months after discharge. In addition, for each dimension score of quality of life, there were no significant differences (P > 0.05) except vitality dimension, 1 month after discharge, and there were significant differences in all dimensions, 3 and 6 months after discharge (P < 0.05) Conclusions: Hospital–community integrated transitional care model can improve the quality of life of patients with COPD.展开更多
目的:探讨跟进式电话随访在出院心肌梗死(myocardial infarction,MI)患者中的应用价值。方法:选取2015年1月至2016年5月滨州医学院烟台附属医院收治的MI患者128例。采用随机数字表法将患者分为观察组和对照组,每组64例。对照组只进行出...目的:探讨跟进式电话随访在出院心肌梗死(myocardial infarction,MI)患者中的应用价值。方法:选取2015年1月至2016年5月滨州医学院烟台附属医院收治的MI患者128例。采用随机数字表法将患者分为观察组和对照组,每组64例。对照组只进行出院健康教育,观察组接受为期6个月的跟进式电话随访。结果:干预前,两组健康调查简表(short from health survey,SF-36)量表各维度得分比较差异均无统计学意义(P>0.05)。干预6个月后,观察组生活质量显著上升,差异有统计学意义(P<0.05),对照组无明显变化,差异无统计学意义(P>0.05)。干预前,两组自护能力测定量表(exercise of selfcare agency scale,ESCA)各维度得分比较差异均无统计学意义(P>0.05)。干预6个月后,观察组自护能力显著上升,差异有统计学意义(P<0.05),对照组无明显变化(P>0.05)。干预前,两组焦虑自评量表(self-rating anxiety scale,SAS)和抑郁自评量表(self-depression anxiety scale,SDS)得分比较差异均无统计学意义(P>0.05)。干预6个月后,观察组焦虑、抑郁状况显著改善(P<0.05),对照组无明显变化(P>0.05)。结论:跟进式电话随访有助于提高MI出院患者的生活质量和自护能力,改善心理健康状况,值得临床推荐。展开更多
文摘Background:Much has been written about the loss to follow-up in the transition between pediatric and adult Congenital Heart Disease(CHD)care centers.Much less is understood about the loss to follow-up(LTF)after a successful transition.This is critical too,as patients lost to specialised care are more likely to experience mor-bidity and premature mortality.Aims:To understand the prevalence and reasons for loss to follow-up(LTF)at a large Australian Adult Congenital Heart Disease(ACHD)centre.Methods:Patients with moderate or highly complex CHD and gaps in care of>3 years(defined as LTF)were identified from a comprehensive ACHD data-base.Structured telephone interviews examined current care and barriers to clinic attendance.Results:Overall,407(22%)of ACHD patients(n=1842)were LTF.The mean age at LTF was 31(SD 11.5)years and 54%were male;311(76%)were uncontactable.Compared to adults seen regularly,lost patients were younger,with a greater socio-economic disadvantage,and had less complex CHD(p<0.05 for all).We interviewed 59 patients(14%).The top 3 responses for care absences were“feeling well”(61%),losing track of time(36%),and not needing fol-low-up care(25%).Conclusions:A large proportion of the ACHD population becomes lost to specialised cardiac care,even after a successful transition.This Australian study reports younger age,moderate complexity defects,and socio-economic disadvantage as predictive of loss to follow-up.This study highlights the need for novel approaches to patient-centered service delivery even beyond the age of transition and resources to maintain patient engagement within the ACHD service.
基金supported by Jiangsu Provincial Commission of Health and Family Planning(No.H2015032)Yancheng Commission of Health and Family Planning(No.YK2017010)
文摘Objective: To explore the effects of “hospital–community integrated transitional care” model on quality of life in patients with chronic obstructive pulmonary disease (COPD). Methods: A total of 117 inpatients with COPD from the Department of Respiratory Medicine in a tertiary general hospital in Nanjing were enrolled by convenience sampling from January to December in 2016 and then were divided into intervention group (n = 60) and control group (n = 57) by random number table. Patients in the intervention group accepted both routine care and hospital– community integrated transitional care for 3 months after discharge. Assessment of quality of life by telephone follow-up or interview within a week before discharge and 1, 3, and 6 months after discharge was evaluated using the Short Form-36 (SF-36) health survey questionnaire. Results: For a total score of quality of life, there was a significant difference between the two groups (P < 0.05): 1, 3, and 6 months after discharge. In addition, for each dimension score of quality of life, there were no significant differences (P > 0.05) except vitality dimension, 1 month after discharge, and there were significant differences in all dimensions, 3 and 6 months after discharge (P < 0.05) Conclusions: Hospital–community integrated transitional care model can improve the quality of life of patients with COPD.
文摘目的:探讨跟进式电话随访在出院心肌梗死(myocardial infarction,MI)患者中的应用价值。方法:选取2015年1月至2016年5月滨州医学院烟台附属医院收治的MI患者128例。采用随机数字表法将患者分为观察组和对照组,每组64例。对照组只进行出院健康教育,观察组接受为期6个月的跟进式电话随访。结果:干预前,两组健康调查简表(short from health survey,SF-36)量表各维度得分比较差异均无统计学意义(P>0.05)。干预6个月后,观察组生活质量显著上升,差异有统计学意义(P<0.05),对照组无明显变化,差异无统计学意义(P>0.05)。干预前,两组自护能力测定量表(exercise of selfcare agency scale,ESCA)各维度得分比较差异均无统计学意义(P>0.05)。干预6个月后,观察组自护能力显著上升,差异有统计学意义(P<0.05),对照组无明显变化(P>0.05)。干预前,两组焦虑自评量表(self-rating anxiety scale,SAS)和抑郁自评量表(self-depression anxiety scale,SDS)得分比较差异均无统计学意义(P>0.05)。干预6个月后,观察组焦虑、抑郁状况显著改善(P<0.05),对照组无明显变化(P>0.05)。结论:跟进式电话随访有助于提高MI出院患者的生活质量和自护能力,改善心理健康状况,值得临床推荐。
