Analysis of the Current Status and Influencing Factors of Family Members’Collateral Stigma in Schizophrenia Patients

Objective: To investigate the associated collateral stigma of the family members of schizophrenia patients and analyze its current status and influencing factors. Methods: The Link Depreciation-Discrimination Perception Scale was used to investigate the status quo of the associated stigma of the family members of 169 schizophrenia patients diagnosed in 4 hospitals in a certain province. The results of the investigation were analyzed and summarized. Results: The detection rate of stigma associated with the family members of schizophrenia patients was 72.78%, with a score of 28.41 ± 3.92 points. The main influencing factors were the family member’s education level, the patient’s illness duration, the family member’s occupation, and the family-patient relationship. Conclusion: The detection rate of stigma associated with schizophrenia was relatively high. This requires increased attention and appropriate nursing intervention.

Analysis of the effectiveness of cognitive rehabilitation for patients with chronic mental illness:A meta-analysis

BACKGROUND People suffering from chronic mental illness are sensitive to stressful stimuli,lack coping skills,and have low self-esteem due to problems such as social situations.They also experience depression,isolation,fear,and frustration.Due to cognitive dysfunction,people suffering from chronic mental illness have inadequate cognitive processes that lead to distorted thinking.AIM To confirm the effectiveness of cognitive rehabilitation therapy in improving cognitive function and alleviating behavioral and psychological symptoms in patients with chronic mental illness,and to identify the cognitive function that had the main effect.METHODS The quality of the studies was evaluated using the Assessment of Multiple Systematic Reviews criteria,and data published from 2011 to December 2022 were searched using PubMed,Cochrane,RISS,KISS,and DBpia.The keywords used in the search were“mental illness,”“cognitive rehabilitation,”“cognition,”and“mental.”A meta-analysis was conducted on the 12 selected papers.RESULTS The level of evidence for the 12 documents was that of a randomized experimental study.Intervention types in cognitive rehabilitation can be divided into cognitive behavior,cognitive training,cognitive rehabilitation,and computerized cognitive programs.Most of the studies were on schizophrenia,and the measurement areas were cognitive functions(e.g.,concentration,memory,and executive function)as well as depression,sociability,and quality of life.As a result of the meta-analysis of each variable,the effect size for cognitive rehabilitation treatment was in the following order:Sociability,memory,concentration,executive function,quality of life,and depression.Particularly,sociability and memory exhibited significant effects.CONCLUSION Cognitive rehabilitation aids cognitive function and sociability in patients with chronic mental illness and can be used as evidence for cognitive rehabilitation in mental health and occupational therapy.

Effect of multidimensional rehabilitation on the neurotrophy state and inflammatory response - apoptosis mechanism in patients with schizophrenia

Objective: To study the effect of multidimensional rehabilitation on the neurotrophy state and inflammatory response-apoptosis mechanism in patients with schizophrenia. Methods: Patients with schizophrenia who were treated in West China Hospital, Sichuan University between February 2015 and April 2016 were selected and randomly divided into two groups, the multidimensional group received multidimensional rehabilitation therapy, and the conventional group received conventional rehabilitation therapy. The levels of neurotrophy indexes, inflammatory response indexes and apoptosis molecules in serum as well as the expression of apoptosis molecules in peripheral blood were measured before treatment and 6 months after treatment. Results: 6 months after rehabilitation, serum NGF, BDNF, IGF-1 and IGF-2 levels of both groups of patients were higher than those before rehabilitation while serum sTNFR1, sTNFR2, TNF-α, IL-1β, FasL, Fas and Caspase-3 levels as well as peripheral blood FasL, Fas and Caspase-3 expression were lower than those before rehabilitation, and serum NGF, BDNF, IGF-1 and IGF-2 levels of multidimensional group were higher than those of conventional group while serum sTNFR1, sTNFR2, TNF-α, IL-1β, FasL, Fas and Caspase-3 levels as well as peripheral blood FasL, Fas and Caspase-3 expression were lower than those of conventional group. Conclusion: Multidimensional rehabilitation for schizophrenia can improve the neurotrophy state, and inhibit the inflammatory response and apoptosis of nerve cells.

A Qualitative Study on What It Means for Patients with Schizophrenia Living in the Community to Remain on Medication

Background: Little is known about what the experience of “taking antipsychotics” means in a patient’s life. Therefore, this study aims to identify what it means for patients with schizophrenia living in the community to remain on medication. Methods: The participants were five residents of communities, who had been discharged from a psychiatric hospital, but were currently visiting a private psychiatric hospital. In this study, we used participants’ narratives as data and analyzed them according to the procedures described in “An Application of Phenomenological Method in Psychology” (Giorgi, 1975), and “Practice of analyzing materials describing experiences” (Giorgi, 2004). Results: The study results are as follows. 1) The drug may be effective, but Subject (below, S) still wants to take it as little as possible. Meanwhile, S has people who care about S and a person who S can rely on nearby, to manage S’s life. The people above tell S to take medicine, and S takes it. 2) S does not know what kind of medication S is consuming, but recently S has been having a hard time walking;S has people who care for S’s foot and look after S. S thinks taking medicine is for living. 3) S feel some drugs is ineffective. However, S met some people S could trust who passionately recommended the medication to S. S started being careful in remembering to take it. 4) S does not think drugs are necessary for S, but S can interact with people and spend S’s days. S has people who accept S as S is. S continues living in the community while taking medicine that a doctor offers. 5) S was skeptical about the drugs. However, S has a person S can trust, who recommended a way to take the medication in a way that S does not feel overwhelmed. S thinks that it may be a good idea to take it. Conclusions: Based on the analysis of the narratives of each of the five participants, the essential structure was read from the perspective of a third party regarding participants’ medication adherence. A generalized reading of the structure common to the above five essential structures reveals a structure that includes the following three opportunities: 1) Patients realize the importance of people;2) They sometimes entrust themselves to people or follow people’s opinions when taking actions;3) They have come to terms with their initial negative feelings about antipsychotic drugs, subsequently continuing to take antipsychotic drugs. This suggests that the following are important attitudes of supporters of patients with schizophrenia who continue to live in the community: To accept what is happening to the patients, to talk to them with encouragement and compassion, and to be there for them. It is also important for supporters to make patients feel comfortable in opening up while the patients reside in the community and to support patients in making decisions.

The study of the opening-up rehabilitation to the inpatients with chronic schizophrenia

Objective To investigate the opening-up rehabilitation to the inpatients with chronic schizophrenia .Methods We carried out the rehabilitation opening-up in the hospital to 40 inpatients with chronic schizophrenia from 1990 to 1995. We regulated carefully , respected the personality and lawful rights of the patients , set up the equality between the medical staff and patients , evaluated according to their achievements, took the keeping-watch nursery to the patients with severe condition .No accident happened in the study. Results The social function and negative symptoms of most patients improved greatly. Medicine treatment with maintenance dosage is the basic grantee of the safe rehabilitation . The treatment of working can let the patients regain the skill of working and study .The treatment of entertainment can relaxed ,dredged their emotion and stimulated them .The treatment of reading can increase the knowledge of patients .The patients can recognize and solve their own problems by reading. So, it has educational function. The individual or group psychological therapy can eradicate the disturbance of psychology and emotion of the patients .Conclusions It is effective by carrying out rehabilitation opening-up in the hospital to the inpatients with chronic schizophrenia .

The effects of day rehabilitation training on stable schizophrenia

Objective:To investigate the effects of day rehabilitation exercises on patients with stable schizophrenia.Methods:A total of 80 patients with stable schizophrenia who had been admitted to Yunnan Psychiatric Hospital between July,2022 and December,2022 were randomly selected as the subjects of this study.The selected patients were distributed equally at random between a reference group and an experimental group.The experimental group received day interventions based on a traditional rehabilitation model,and the reference group received traditional rehabilitation measures.Results:Prior to the procedure,the values of the Nucleolus Organizer Regions Scale(NORS)and the Positive and Negative Syndrome Scale(PANSS)were slightly different between the reference and experimental groups,but the difference was not statistically significant(P>0.05).After the intervention,the values of the NORS and PANSS scale were statistically different(P<0.05).Conclusion:The day rehabilitation training improved the NORS and PANSS scores of stable schizophrenia patients compared to traditional rehabilitation methods.

Effects of the combination of second-generation antipsychotics on serum concentrations of aripiprazole and dehydroaripiprazole in Chinese patients with schizophrenia

Background Aripiprazole(ARI)is often prescribed alone or in combination with other second-generation antipsychotics(SGAs)to treat patients with schizophrenia.However,this may increase the potential clinical significance of drug-drug interactions.Therapeutic drug monitoring(TDM)is an important and fundamental tool both when administering ARI alone and in combination with other SGAs to monitor ARI pharmacokinetics,adjust the dosage and thereby achieve more effective and safer treatment.Aims This study retrospectively investigated the effects of four SGA comedications(clozapine,risperidone,quetiapine(QTP)and olanzapine)and other potential factors(sex,age and ARI dose)on the serum concentrations of ARI and dehydroaripiprazole(DARI)in Chinese patients with schizophrenia using TDM data.Methods High-performance liquid chromatography was used to test the serum concentrations of ARI,DARI and ARI+DARI.In addition,steady-state dose-adjusted serum concentrations(ie,concentration-to dose ratios,C:D ratios)of ARI,DARI and ARI+DARI;sex;age;ARI dose and SGA comedication dose between 299 inpatients with schizophrenia who received ARI or SGA comedication were all collected and analysed.Spearman’s correlation and multiple linear regression analysis were used to evaluate bivariate associations between ARI dose and serum ARI and DARI concentrations and describe the effect of independent variables on serum ARI and DARI concentrations,respectively.Results There were significant differences in the C:D ratios of ARI(χ^(2)=−3.21,p=0.001)and ARI+DARI(χ^(2)=−2.50,p=0.01)between the ARI and SGA groups,as well as in the C:D ratios of ARI(χ^(2)=−3.59,p<0.001)and ARI+DARI(χ^(2)=−3.10,p=0.002)between the female patients in the two groups.Of the four SGAs,only QTP had significant effects on the C:D ratios of ARI(Z=−4.12,p<0.001)and ARI+DARI(Z=−3.62,p<0.001)when compared with the ARI group in the whole sample and on the C:D ratios of ARI,DARI and ARI+DARI(Z=−3.96,p<0.001;Z=−2.22,p=0.03;Z=−3.75,p<0.001,respectively)in women when compared with their counterparts in the ARI group.Conclusion Comedication with SGAs resulted in lower C:D ratios of ARI and ARI+DARI compared with ARI monotherapy,and comedication with QTP resulted in lower C:D ratios of ARI and ARI+DARI than ARI monotherapy.Despite this statistical significance of our findings,whether the presently observed effect has clinical significance requires exploration by further research.TDM and dosage regulation of ARI should be performed in Chinese inpatients with schizophrenia who are receiving SGA comedication(especially QTP)to maintain a safe and effective dose-adjusted serum concentration of ARI and DARI.

Improvement in social skills in patients with schizophrenia following 6 months of day-care treatment

Using role-playing tests simulating real-life situations, we investigated improvement in the social skills, especially information processing, of patients with schizophrenia in response to day-care in psychiatry and social skills training. From 20 pair-matched schizophrenia patients, 10 were assigned to a day-care/SST group and 10 to a control group undergoing usual treatment. After 6 months, sending and receiving skills were assessed by means of role-playing tests, psychiatric symptoms, social function, and cognitive function. The day-care/SST group showed a significant improvement and a large effect size in sending skills. Receiving skills also improved, showing a medium effect size, but the difference from the control group was not statistically significant. No statistically significant changes were observed in the other measures. That no changes occurred in social function, psychiatric symptoms, or cognitive function leads to two conclusions: 1) cognition targeted, specialized training and comprehension of cognitive remediation, psychiatric rehabilitation, and social skill development are necessary for improvement in other domains, especially symptoms and social functions;and 2) improvement resulting from day-care in psychiatry and SST alone is limited. In addition, further investigations over a longer observation period and a greater sample size are needed.

Health-care needs of remitted patients with bipolar disorder: A comparison with schizophrenia

AIM To investigate health-care needs and their correlates among patients with remitted bipolar disorder(BD) compared to patients with remitted schizophrenia. METHODS Outpatients with BD(n = 150) and schizophrenia(n = 75) meeting clearly defined remission criteria were included in the study along with their relatives. Diagnostic ascertainment was carried out using the Mini International Neuropsychiatric Interview. Demographic and clinical details were recorded using structured formats. Residual symptoms were assessed using standardized scales. Health-care needs were assessed on two separate scales. The principal instrument employed to assess health-care needs was the Camberwell Assessment of Need-Research version(CAN-R). To further evaluate health-care needs we felt that an additional instrument, which was more relevant for Indian patients and treatment-settings and designed to cover those areas of needs not specifically covered by the CAN-R was required. This instrument with a structure and scoring pattern similar to the CAN-R was used for additional evaluation of needs. Patients' level offunctioning was assessed using the Global Assessment of Functioning Scale and their quality of life(QOL) using the World Health Organization Quality Of Life-BREF version in Hindi.RESULTS An average of 6-7 needs was reported by patients with BD as well as their relatives. Commonly reported needs were in the areas of economic and welfare needs, informational needs, social needs and the need for treatment. According to the CAN-R, both patients and relatives reported that more than 60% of the total needs were being met. However, over 90% of the needs covered by the additional evaluation were unmet according to patients and relatives. Needs in the areas of economic and welfare-benefits, information, company, daytime activities and physical health-care were largely unmet according to patients and relatives. Total, met and unmet needs were significantly higher for schizophrenia, but the most common types of needs were quite similar to BD. Relatives reported more needs than patients with certain differences in the types of needs reported. Level of patients' functioning was the principal correlate of greater total and unmet needs in both groups. Significant associations were also obtained with residual symptoms and QOL.CONCLUSION The presence of unmet needs in remitted patients with BD was an additional marker of the enduring psychosocial impairment characteristic of the remitted phase of BD.

Evaluating the effectiveness of hospitalized occupational rehabilitation on social functioning in chronic schizophrenic patients

AIM:To evaluate the effectiveness of hospitalized occupational rehabilitation for chronic schizophrenic patients in social functioning.METHODS:79 qualified cases were selected from chronic psychiatric inpatient departments,divided into two groups randomly,of which 45 cases of treatment group accepted hospitalized occupational rehabilitation,another 34 cases of control group accepted ordinary treatment.Social functioning was evaluated by the Scale of Social Skills of Chronic Schizophrenic In patients(SSSI). RESULTS:6 month course of research figured out that the rank of improvement of the total disability degree of the treatment was significantly larger than that of the control group(P< 0.05).Items of which rank of improvement of the treatment was significantly larger than those of the control group are participating in the occupational rehabilitation,social withdraw and concern and care about others (P< 0.01-0.05).The level of disability of 55.6%of the treatment decreased more than that of the control (26.5%) (P< 0.05) evaluated by SSSI.CONCLUSION:Hospitalized occupational rehabilitation is effective in improving social functioning of chronic schizophrenic patients,especially in improving items like participating in the occupational rehabilitation, social withdraw and concern and care about others.

Botulinum toxin type A plus rehabilitative training for improving the motor function of the upper limbs and activities of daily life in patients with stroke and brain injury

BACKGROUND:Botulinum toxin type A(BTX-A)is mostly to be used to treat various diseases of motor disorders,whereas its effect on muscle spasm after stroke and brain injury needs further observation.OBJECTIVE:To observe the effect of BTX-A plus rehabilitative training on treating muscle spasm after stroke and brain injury.DESIGN:A randomized controlled observation.SETTINGS:Department of Rehabilitation,Department of Neurology and Department of Neurosurgery,the Second Hospital of Hebei Medical University.PARTICIPANTS:Sixty inpatients with brain injury and stroke were selected from the Department of Rehabilitation,Department of Neurology and Department of Neurosurgery,the Second Hospital of Hebei Medical University from January 2001 to August 2006.They were all confirmed by CT and MRI,and had obvious increase of spastic muscle strength in upper limbs,their Ashworth grades were grade 2 or above.The patients were randomly divided into treatment group(n=30)and control group(n=30).METHODS:①Patients in the treatment group undertook comprehensive rehabilitative trainings,and they were administrated with domestic BTX-A,which was provided by Lanzhou Institute of Biological Products,Ministry of Health(S10970037),and the muscles of flexion spasm were selected for upper limbs,20-25 IU for each site.②Patients in the treatment group were assessed before injection and at 1 and 2 weeks,1 and 3 months after injection respectively,and those in the control group were assessed at corresponding time points.The recovery of muscle spasm was assessed by modified Ashworth scale(MAS,grade 0-Ⅳ;Grade 0 for without increase of muscle strength;GradeⅣfor rigidity at passive flexion and extension);The recovery of motor function of the upper limbs was evaluated with Fugl-Meyer Assessment(FMA,total score was 226 points,including 100 for exercise,14 for balance,24 for sense,44 for joint motion,44 for pain and 66 for upper limb);The ADL were evaluated with Barthel index,the total score was 100 points,60 for mild dysfunction,60-41 for moderate dysfunction,<40 for severe dysfunction).MAIN OUTCOME MEASURES:Changes of MAS grade,FMA scores and Barthel index before and after BTX-A injection.RESULTS:All the 60 patients with brain injury and stroke were involved in the analysis of results.①FMA scores of upper limbs:The FMA score in the treatment group at 2 weeks after treatment was higher than that before treatment[(14.98±10.14),(13.10±9.28)points,P<0.05],whereas there was no significant difference at corresponding time point in the control group.The FMA scores at 1 and 3 months in the treatment group[(23.36±10.69),(35.36±11.36)points]were higher than those in the control group[(20.55±10.22),(30.33±10.96)points,P<0.01].②MAS grades of upper limbs:There were obviously fewer cases of gradeⅢin MAS at 2 weeks after treatment than before treatment in the treatment group(0,9 cases,P<0.05),whereas there was no obvious difference in the control group.There were obviously fewer cases of gradeⅢin MAS at 2 weeks and 1 month after treatment in the treatment group(0,0 case)than the control group(5,2 cases,P<0.01).③Barthel index of upper limbs:The Barthel index at 2 weeks after treatment was higher than that before treatment in the treatment group[(30.36±22.25),(28.22±26.21)points,P<0.05],whereas there was no significant difference in the control group.The Barthel indexes at 1 and 3 months after treatment in the treatment group were obviously higher than those in the control group[(20.55±10.22),(30.33±10.96)points,P<0.01].CONCLUSION:BTX-A has obvious efficacy on decreasing muscle tension after stroke and brain injury,and relieving muscle spasm;Meanwhile,the combination with rehabilitative training can effectively ameliorate the motor function of upper limbs and ADL of the patients.

The Relationship of Meta-Emotion Dimensions and Positive and Negative Symptoms in the Patients of Chronic Schizophrenia

The aim of the present research was to determine the relationship of meta-emotion dimensions and positive and negative symptoms in the patients with chronic schizophrenia. This research is a correlation study. The statistical sample of the current research includes 100 patients with chronic schizophrenia. To collect the data, Meta-Emotion Questionnaire, Positive, and Negative Symptoms Schizophrenia Scale were used. The results of Pearson correlation coefficient showed meta-emotion with positive and negative symptoms. These results suggest that the meta-emotion of chronic schizophrenia patients may well be of important prognostic value in the intensity of symptom logy, prevention and planning of cognitive enhancement therapy.

Correlation of hair risperidone concentration and serum level among patients with schizophrenia

Background Risperidone (RSP) has a rapid onset in vivo, low dosage and high plasma protein binding rate, therefore therapeutic drug monitoring (TDM) is needed to ensure safety in clinical treatment. However, compared with blood, hair is non-invasive, safe, non-infectious and easy to transport and store. Aims This study aims to investigate the correlations among the drug concentrations of RSP in hair and serum, which provides an experimental basis to explore hair as a novel biomaterial to meet the needs of clinical detection. Methods 34 patients with schizophrenia treated with RSP for more than 3 months were enrolled in this study. About 1 cm section of hair near the scalp was taken from the subjects, pretreated and detected by liquid chromatography-mass spectrometry. A correlation analysis was conducted among the drug concentrations in hair, the serum concentrations and the daily dosage. The data were analysed usi叩 SPSS 20.0 software. Results There was significant correlation between the hair concentration of RSP (two-tailed test, r=0.440, p=0.009) with the serum concentration of RSP, and the hair concentration of 9-hydroxyrisperidone (9-HR) with the serum concentration of 9-HR had no significant correlation (two-tailed test, r=-0.217, p=0.217);the total concentration of the RSP and 9-HR had no significant correlation between hair and serum (r=0.227, p=0.196). The dosage had no statistically significant correlation with the concentration of RSP in hair (r=0.207, p=0.241), 9-HR in hair (r=-0.194, p=0.271) and the total concentration of RSP and 9-HR in hair (r=0.188, p=0.288). There was no statistical correlation between the dosage and the concentration of RSP in serum (r=-0.059, p=0.741), but significant correlation between the dosage and 9-HR in serum (r=0.581 p<0.001) was found, and the correlation between the dosage and the total concentration of the two drugs RSP and 9-HR in serum was also significant (r=0.437, p=0.01). Conclusion The correlation analysis showed that the concentration of RSP in hair was statistically significant with the serum RSP concentration. In this study, we provided some experimental basis for hair as a new biomaterial to monitor the therapeutic drug concentration.

Low Cost Equipment and Short Duration Program Are Not Barriers to Good Outcomes of Cardiac Rehabilitation in Senegalese Patients with Coronary Artery Disease

Cardiac rehabilitation is still underused in Africa, despite its cost effectiveness widely demonstrated around the world. Aim: To evaluate the results of a cardiac rehabilitation program in the first Senegalese outpatient center in low resource context. Patients and Method: We carried out a prospective and interventional study. It compared on one hand a group of coronary patients at baseline and after 6 months of our rehabilitation program and on the other hand a control group of patients not enrolled in rehabilitation. Results: We included 70 patients (30 in the rehabilitation group and 40 in the control group). After rehabilitation, the functional capacity improved: 6.99 ± 2.9 Mets at M0 vs 8.8 ± 2.23 Mets at M6, p = 0.0001. Patients of intervention group significantly increased motivation to lifestyle changes and knowledge about their disease. We found better control at 6 months of hypertension (84.50% vs 33.70%, p = 0.003), diabetes (70.00% vs 26.70%, p = 0.0042), LDL cholesterol (33.00% vs 5.00%, p = 0.002) in the group “Rehabilitation”. Prevalence of psychosocial issues like anxiety and depression decreased in intervention group: 50.00% at M0 to 23.33% at M3 (p = 0.021), then 30.00% at M6 (p = 0.18). Return to work and resuming sexual activity were not significantly different. Conclusion: Comprehensive cardiac rehabilitation program, with low cost equipment in a short duration, could have real benefits in the management of coronary artery disease by reducing anxiety and depression, improving treatment compliance, control of cardiovascular risk factors, lifestyle changes and disease knowledge.

Study on the Application Effect of Family Follow-Up Rehabilitation Nursing in Elderly Autistic Patients in Community Institutions

Objective:To study the effect of family follow-up nursing in rehabilitation of elderly autistic patients in community institutions.Methods:120 elderly autistic patients from February 2021 to July 2022 were randomly divided into a control group and a test group with 60 cases each.The patients in the control group were cared for at home by their family members,while the patients in the test group were given family follow-up rehabilitation care on the basis of the control group.The compliance of patients in the rehabilitation process,the UCLA loneliness score,the autism treatment assessment scale(ATEC)score of patients after this nursing care,and the quality-of-life scores of patients of the two groups before and after nursing care were compared.Results:The compliance of patients in the process of rehabilitation treatment was better in the experimental group than in the experimental group.The physical function score of patients after nursing was better in the experimental group than in the experimental group.The UCLA loneliness score and ATEC score of patients in the experimental group after nursing were lower than those of the control group(P<0.05);the quality-of-life score was higher in the experimental group(P<0.05).Conclusion:The application of family follow-up nursing in the rehabilitation of elderly autistic patients in community institutions can significantly improve patients’compliance and improve their prognosis,thus having high clinical value.

The effects of a patient-centred rehabilitation model of care targeting older adults with cognitive impairment on healthcare practitioners

Until recently, older adults with a cognitive impairment (CI) who experienced a hip fracture were filtered from being admitted into active rehabilitation units. The increased complexity of care required for older adults with a CI may negatively influence the attitudes and job satisfaction of healthcare practitioners working with this population. The current study is a part of a larger intervention study allowing patients with CI following a hip fracture access to rehabilitation care and implementing a patient-centred model to facilitate caring for this new population. This new model required a substantial change in the skillset and knowledge of healthcare practitioners. The focus of this study was to explore the impact on the healthcare practitioners of adopting this new model for providing care to older adults with a CI following a hip fracture. The attitudes, dementia knowledge, job satisfaction, and work stress of healthcare practitioners were the focus of evaluation. Key study findings showed that stress due to relationships with coworkers, workloads and scheduling, and the physical design and conditions at work were moderated post-intervention. Staff responses also improved for job satisfaction, biomedical knowledge of dementia, and degree of hopefulness about dementia. Although we cannot state conclusively that the our model was solely responsible for all the staff improvements observed post-intervention, our findings provide further support to the argument that patients with CI should be allowed access to rehabilitation care. Rehabilitation units need to provide education that utilizes a person-centred approach accepting of patients with CI, and focuses on areas that can bolster staff’s positive, dementia-sensitive attitudes. Ultimately, the aim is to create a culture that provides the highest standard of care for all patients, reduces work-related stress, increases job satisfaction, and leads to the highest quality of life for patients during and after rehabilitation.

Tripartite intensive intervention for prevention of rebleeding in elderly patients with hypertensive cerebral hemorrhage

BACKGROUND Hypertensive cerebral hemorrhage(HICH)is the rupture and bleeding of vessels of the cerebral parenchyma caused by continuously elevated or violently fluctuating blood pressure.The condition is characterized by high disability and high mortality.Hematoma formation and resulting space-occupying effects following intracerebral hemorrhage are among the key causes of impaired neurological function and disability.Consequently,minimally invasive clearance of the hematoma is undertaken for the treatment of HICH because it can effectively relieve intracranial hypertension.Therefore,special attention should be given to the quality of medical and nursing interventions in the convalescent period after minimally invasive hematoma clearance.AIM The study aim was to determine the value of intensive intervention,including doctors,nurses,and patient families,for the prevention of rebleeding in elderly patients with HICH during the first hospitalization for rehabilitation after the ictal event METHODS A total of 150 elderly HICH patients with minimally invasive hematoma evacuation in our hospital between May 2018 and May 2020 were selected and equally divided into two groups of 75 each by their planned intervention.The control group was given conventional nursing intervention and the observation group was given tripartite intensive intervention.The length of hospital stay,cost,complication rate,satisfaction rate,and rebleeding rate during hospitalization were recorded.Changes in cerebral blood flow indicators were recorded in both groups.Changes in the National Institutes of Health Stroke Scale(NIHSS)score,quality of life index(QLI)score,and health behavior score were evaluated at the National Institutes of Health.RESULTS Duration of hospitalization was shorter in the in the observation group than in the control group,the hospitalization cost was less than in the control group,and the rate of rebleeding during hospitalization was lower than in the control group(all P<0.05).There were no significant differences between the two groups before treatment(all P>0.05).The mean flow rate(Qmean)and mean velocity(Vmean)of the two groups increased(P<0.05),and the dynamic resistance and peripheral resistance decreased(P<0.05).The Qmean and Vmean in the intervention group were higher than those in the control group(P<0.05).Moreover,the dynamic resistance and peripheral resistance of the blood vessels were also lower in the intervention group than in the control group(P<0.05).The difference in health behavior scores between the two groups before treatment was not significant(P>0.05).In both groups,the scores for healthy behaviors such as emotion control,medication adherence,dietary management,exercise management,and selfmonitoring were higher after than before treatment(P<0.05),and the scores of healthy behaviors in the intervention group were higher than those in the control group(P<0.05).There was no significant difference in the NIHSS and QLI scores between the two groups before treatment(P>0.05).The QLI scores of the two groups increased(P<0.05),and the NIHSS scores decreased(P<0.05).The QLI scores of the intervention group were higher than those of the control group(P<0.05),and the NIHSS score was correspondingly lower than that of the control group(P<0.05).The incidence of respiratory infections,pressure sores,central hyperpyrexia,and deep venous thrombosis was lower in the intervention group than in the control group.Accordingly,the satisfaction rate was higher in the treatment group than that in the control group(P<0.05).CONCLUSION Intensive intervention by doctors,nurses,and families of elderly patients with HICH reduced the rate of rebleeding during hospitalization.It also reduced the incidence of complications,promoted rehabilitation,improved the quality of life,and enhanced nerve function.Additionally,it improved satisfaction and promoted healthy behaviors.

Inpatient rehabilitation outcomes in solid organ transplantation: Results of a unique partnership between the rehabilitation hospital and the multi-organ transplant unit in an acute hospital

Objective: To determine the outcomes in solid organ transplant recipients following inpatient rehabilitation, as a result of a unique partnership between the rehabilitation hospital and the multi-organ transplant program in an acute hospital. Design: Retrospective observational study. Setting: Community rehabilitation hospital affiliated with a university. Participants: A cohort of 173 organ transplant patients admitted consecutively over a four-year period (2004-2008) was compared to a cohort of all rehabilitation patients (n = 9762) admitted to the same inpatient rehab facility during the same period. Interventions: Inpatient rehab program to all participants. Main Outcome Measures: Length of hospital stay, Functional Independence Measure (FIMTM) change (admission-discharge), and rate of discharges to home. Results: Outcomes were measured using components of the FIMTM instrument, admission and discharge data. Chi-square and independent two-sample t-tests were used for statistical analysis. Compared to a general rehabilitation inpatient population, transplant rehabilitation inpatients had: more immediate (TM change (8.9 vs. 20.9, p TM efficiency (1.1 vs. 1.4, p < 0.001);and a higher rate of discharges to home in patients not readmitted to acute care (98.5% vs. 94.5% p < 0.001). Conclusion: Outcomes of rehabilitation in solid organ transplant patients are comparable but not identical to those in other patient groups. Inpatient rehabilitation for transplant patients is therefore fully justifiable and necessary. The ten times higher rate of transplant patient readmission to acute hospital must be communicated, facilitated, accepted and managed within a partnership strategy.

Adjunctive aripiprazole for antipsychotic-related hyperprolactinaemia in patients with first-episode schizophrenia:a metaanalysis

Background Hyperprolactinaemia is a common antipsychotic(AP)-induced adverse effect,particularly in female patients.Aims This meta-analysis examined the efficacy and safety of adjunctive aripiprazole in preventing AP-related hyperprolactinaemia in patients with first-episode schizophrenia.Methods PubMed,PsycINFO,EMBASE,Cochrane Library,WanFang and China Journal Net databases were searched to identify eligible randomised controlled trials(RCTs).Primary outcomes were the reductions of serum prolactin level and prolactin-related symptoms.Data were independently extracted by two reviewers and analysed using RevMan(V.5.3).Weighted/standardised mean differences(WMDs/SMDs)±95%Cis were reported.Results In the five RCTs(n=400),the adjunctive aripiprazole(n=197)and the control groups(n=203)with a mean of 11.2 weeks of treatment duration were compared.The aripiprazole group had a significantly lower endpoint serum prolactin level in all patients(five RCTs,n=385;WMD:-50.43 ng/mL(95%Cl:-75.05 to-25.81),p<0.00001;l2=99%),female patients(two RCTs,n=186;WMD:-22.58 ng/mL(95%Cl:-25.67 to-19.49),p<0.00001;l2=0%)and male patients(two RCTs,n=127;WMD:-68.80 ng/mL(95%Cl:-100.11 to-37.49),p<0.0001).In the sensitivity analysis for the endpoint serum prolactin level in all patients,the findings remained significant(p<0.00001;l2=96%).The aripiprazole group was s叩erior to the control group in improving negative symptoms as assessed by the Positive and Negative Syndrome Scale(three RCTs,n=213;SMD:-0.51(95%Cl:-0.79 to-0.24),p=0.0002;l2=0%).Adverse effects and discontinuation rates were similar between the two groups.Conclusions Adjunctive aripiprazole appears to be associated with reduced AP-induced hyperprolactinaemia and improved prolactin-related symptoms in first-episode schizophrenia.Further studies with large sample sizes are needed to confirm these findings.

Hemiplegia Patients Treatment Should Combine Acupuncture with Rehabilitation Treatment

The acupuncturetherapy for hemiplegiapatients is popular insome Asian countries,and it has been graduallyaccepted in the rehabili-tative medical field ofsome developed countries.Although numer-ous clinical and experimental studies have beendone,many doctors usu-