Analysis of the Effect of Integrated Extended Care Model in Improving the Quality of Life of Elderly Patients with Type 2 Diabetes Mellitus

Objective: To analyze the impact of an integrated extended care model on improving the quality of life of elderly patients with Type 2 Diabetes Mellitus (T2DM). Methods: A total of 176 patients admitted to the hospital from March 2015 to February 2018 were selected and randomly assigned to an observation group and a control group, with 88 patients each. The control group implemented conventional nursing interventions, and the observation group carried out an integrated extended-care model. The level of glycemic control, quality of life, and daily medication adherence between both groups were compared. Results: The observation group showed significant improvement in the level of glycemic control, and their fasting blood glucose, 2-hour postprandial blood glucose, and glycated hemoglobin levels were significantly lower as compared with those in the study group (P < 0.05). The quality of life of the patients in the observation group was higher than that of the control group (P < 0.05). The observation group had a higher compliance score (95.48 ± 7.45) than the control group (81.31 ± 8.72) (t = 8.909, P < 0.05). Conclusion: The integrated extended care model allows patients to receive comprehensive and individualized nursing services after discharge, which improves the effect of drug therapy and the quality of life of patients.

Analysis of the Application Effect of Family Collaborative Care Model on Elderly Patients with Type 2 Diabetes Mellitus and the Situation of Self-Care Ability

Objective: To study the application effect of the family collaborative care model on elderly patients with type 2 diabetes mellitus and its influence on self-care ability. Methods: The elderly type 2 diabetes mellitus patients (400 cases) treated in our hospital between March 2020 and July 2023 were divided into two groups by randomized grouping method;the control group received the conventional nursing program, while the observation group received the family collaborative nursing model. Blood glucose level, self-care ability, and quality of life were compared between the groups. Results: The blood glucose level of the observation group was lower than that of the control group (P < 0.05). The self- care ability and quality of life scores of the observation group were higher than those of the control group (P < 0.05). Conclusion: The family collaborative care model for elderly patients with type 2 diabetes mellitus can promote their self- care ability, improve the effect of glycemic control, and improve their quality of life, and is suitable for further promotion and application.

Effects of health concept model-based detailed behavioral care on mood and quality of life in elderly patients with chronic heart failure

BACKGROUND With the intensification of social aging,the susceptibility of the elderly population to diseases has attracted increasing attention,especially chronic heart failure(CHF)that accounts for a large proportion of the elderly.AIM To evaluate the application value of health concept model-based detailed behavioral care in elderly patients with CHF.METHODS This study recruited 116 elderly CHF patients admitted from October 2018 to October 2020 and grouped them according to the nursing care that they received.The elderly patients who underwent health concept model-based detailed behavioral care were included in a study group(SG;n=62),and those who underwent routine detailed behavioral nursing intervention were included as a control group(CG;n=54).Patients’negative emotions(NEs),quality of life(QoL),and nutritional status were assessed using the self-rating anxiety/depression scale(SAS/SDS),the Minnesota Living with Heart Failure Questionnaire(MLHFQ),and the Modified Quantitative Subjective Global Assessment(MQSGA)of nutrition,respectively.Differences in rehabilitation efficiency,NEs,cardiac function(CF)indexes,nutritional status,QoL,and nursing satisfaction were comparatively analyzed.RESULTS A higher response rate was recorded in the SG vs the CG after intervention(P<0.05).After care,the left ventricular ejection fraction was higher while the left ventricular end-diastolic dimension and left ventricular end systolic diameter were lower in the SG compared with the CG(P<0.05).The post-intervention SAS and SDS scores,as well as MQSGA and MLHFQ scores,were also lower in the SG(P<0.05).The SG was also superior to the CG in the overall nursing satisfaction rate(P<0.05).CONCLUSION Health concept model-based detailed behavioral care has high application value in the nursing care of elderly CHF patients,and it can not only effectively enhance rehabilitation efficiency,but also mitigate patients’NEs and improve their CF and QoL.

Effect of information-motivation-behavioral skills model based perioperative nursing on pain in patients with gallstones

BACKGROUND The incidence of cholecystolithiasis is on the rise.Use of information,motivation,and behavioral skills can play a positive role in promoting changes in individual health behaviors.However,reports on the effects of information-motivationbehavioral(IMB)skills model based high-quality nursing as a perioperative nursing intervention for patients with gallstones are nonexistent.AIM To explore the application of IMB skills model based high-quality nursing in patients with gallstones.METHODS Two hundred and sixteen patients with cholecystolithiasis treated at our hospital from January 2022 to January 2023 were enrolled and divided into a control,highquality,and combined nursing groups,with 72 patients in each group.The control,high-quality,and combination groups received conventional,high-quality,and IMB skills model based perioperative nursing services,respectively.Differences in clinical indicators,stress levels,degree of pain,emotional state,and quality of life were observed,and complications and nursing satisfaction among the three groups were evaluated.RESULTS After nursing,the time to recovery of gastrointestinal function in the high-quality and combined nursing groups was significantly shorter than that of the control group,with the recovery of gastrointestinal function being the fastest in the combined nursing group(P<0.05).After nursing intervention,cortisol and norepinephrine levels in the high-quality and combined nursing groups were closer to normal than those of the control group 24 h after surgery,with the combined nursing group having the closest to normal levels(P<0.05).After 3 and 7 d of intervention,the patients’pain significantly improved,which was more prominent in the highquality and combination groups.Meanwhile,the pain score in the combination group was significantly lower than those of the control and high-quality nursing groups(P<0.05).After nursing intervention,the emotional states of all patients improved,and the scores of patients in the combination group were significantly lower than those of the control and high-quality nursing groups.The quality of life of patients in the high-quality and combined nursing groups significantly improved after nursing intervention compared to that of the control group,with the combined nursing group having the highest quality of life score.After intervention,the incidence of complications in the high-quality and combination groups was significantly lower than that of the control group(P<0.05),but the difference between the combination and high-quality nursing groups was not significant.Nursing satisfaction of patients in the high-quality and combination groups was significantly higher than that of the control group,with the nursing satisfaction being the highest in the combination group(P<0.05).CONCLUSION IMB skills model based nursing can improve surgical stress levels,degrees of pain,emotional state,quality of life,and nursing satisfaction of patients with gallstones and reduce the incidence of complications.

Developing an evidence-based and theory informed intervention to involve families in patients care after surgery: A quality improvement project

Objectives: In the post-surgical setting,active involvement of family caregivers has the potential to improve patient outcomes by prevention of surgical complications that are sensitive to fundamental care.This paper describes the development of a theoretically grounded program to enhance the active involvement of family caregivers in fundamental care for post-surgical patients.Methods: We used a quality improvement project following a multi-phase design.In Phase 1,an iterative method was used to combine evidence from a narrative review and professionals' preferences.In Phase 2,the logic model underlying the program was developed guided by four steps: (1) confirm situation,intervention aim,and target population;(2) documented expected outcomes,and outputs of the intervention;(3) identify and describe assumptions,external factors and inputs;and (4) confirm intervention components.Results: Phase 1 identified a minimum set of family involvement activities that were both supported by staff and the narrative review.In Phase 2,the logic model was developed and includes (1) the inputs (e.g.educational-and environmental support),(2) the ultimate outcomes (e.g.reduction of postoperative complications),(3) the intermediate outcomes (e.g.behavioural changes),and (4) immediate outcomes (e.g.improved knowledge,skills and attitude).Conclusions: We demonstrated how we aimed to change our practice to an environment in which family caregivers were stimulated to be actively involved in postoperative care on surgical wards,and how we took different factors into account.The description of this program may provide a solid basis for professionals to implement the family involvement program in their own setting.

Practice Environment, Work Characteristics and Levels of Burnout as Predictors of Nurse Reported Job Outcomes, Quality of Care and Patient Adverse Events: A Study across Residential Aged Care Services

To understand how to create a stabile workforce achieving excellent quality of care and patient safety, associations between practice environments and nurse and patient outcomes have been widely studied in acute and psychiatric care hospitals. Knowing residential aged care services are challenged to tackle complex patients’ needs within certain working conditions, to what extent do nurses perceive their practice environment in geriatric care? In a cross-sectional survey, a sample of 709 registered nurses, licensed practical nurses and nurse aides employed in 25 residential aged care services completed a structured questionnaire composed of various validated instruments measuring nurse practice environment factors, nurse work characteristics, burnout, nurse reported job outcomes, quality and patient adverse events. Associations between variables across residential aged care services were examined using multilevel modelling techniques. Associations were identified between practice environment factors, work characteristics, burnout dimensions, and reported outcome variables across residential aged care services. Multiple multilevel models showed independent variables (nursing management at the unit level, workload, decision latitude, social capital, emotional exhaustion and depersonalization) as important predictors of nurse reported outcome (job satisfaction, turnover intensions), quality of care (at the unit, the last shift, and in the service within the last year) and patient adverse events (patient and family complaints, patient falls, pulmonary and urinary tract infections, and medications errors). Results suggested the importance of nurse practice environment factors, nurse work characteristics and perception of burnout on nurse and patient outcomes across their nurse practice environment. Challenging the complex care of a vulnerable and frail population executives, physicians, nursing leaders as well as nurses in their nurse practice environment shared responsibility to create working conditions achieving excellent quality and patient safety.

Holistic care model of time-sharing management for severe and critical COVID-19 patients

The rapid global outbreak of coronavirus disease 2019(COVID-19)and the surge of infected patients have led to the verge of exhaustion of critical care medicine resources worldwide,especially with regard to critical care staff.A holistic care model on time-sharing management for severe and critical COVID-19 patients is proposed,which includes formulation of individualized care objectives and plans,identification of care tasks in each shift and making detailed checklist,and management of quality of care.This study was conducted in the COVID-19 treatment center of Harbin,Heilongjiang Province.The data collected from the treatment center were recorded and analyzed.From the results we can deduce that it is especially suitable for non-intensive care unit(non-ICU)nurses to adapt care management mode of ICU as soon as possible and ensure the quality and efficiency of care during the epidemic.The holistic care model on time-sharing management for severe and critical cases with COVID-19 proposed based on our daily work experiences can assist in improving the quality and efficiency of care,thus reducing the mortality rate of patients in ICU.

基于三维质量结构模型构建老年失能患者延续护理的质量评价指标体系

目的 探讨并构建老年失能患者延续护理质量评价指标体系。方法 于2022年7-9月,以三维质量结构模型为理论基础,结合文献回顾、德尔菲专家函询方法,根据老年失能患者延续护理服务内容和评估需求,构建了以“结构-过程-结果”模式为框架的老年失能患者延续护理服务质量评价体系。结果 经过2轮护理专家函询的权威系数、判断系数、熟悉系数分别为0.931、0.929、0.933;确定老年失能患者延续护理服务三维质量评价体系中包含一级指标3项,二级指标9项,三级指标36项;2轮专家函询的协调系数为0.455、0.410。结论 老年失能患者延续护理服务三维质量评价体系内容严谨、科学、全面及可靠,有利于延续护理服务质量的改进。

基于学术团体的肿瘤安宁疗护共同照护模式在晚期肿瘤病人中的应用

目的:探讨基于学术团体的安宁疗护共同照护模式在晚期肿瘤病人中的应用效果。方法:采用便利抽样方法,选取2021年1月—6月江西省某肿瘤医院收治的136例晚期肿瘤病人为研究对象。采用随机数字表法将其分为对照组和干预组,每组68例。对照组采用常规护理,干预组在常规护理基础上给予基于学术团体的安宁疗护共同照护模式。干预前后采用医院焦虑抑郁量表(HADS)、欧洲癌症研究与治疗组织生活质量核心量表(EORTC QLQ-C30)对两组病人焦虑、抑郁情绪及生活质量进行评价。结果:干预组病人干预后焦虑子量表、抑郁子量表以及总分低于对照组,2个功能领域(躯体功能、角色功能)、总体健康状况、总体生命质量得分均高于对照组,3个症状领域以及5个单测项目(失眠、食欲减退、便秘、腹泻、经济困难)得分均低于对照组,经比较差异均有统计学意义(均P<0.05)。结论:基于学术团体的肿瘤安宁疗护共同照护模式能有效降低病人焦虑、抑郁水平,提升其生活质量。

问题导向模式联合预知护理在慢性阻塞性肺疾病患者中的应用

目的:探讨问题导向模式联合预知护理在慢性阻塞性肺疾病(COPD)患者中的应用效果。方法:选取2022年1月1日~2023年1月1日收治的120例COPD患者作为研究对象,遵循抽签双盲法分为对照组和研究组各60例,对照组实施预知护理干预,研究组在对照组基础上实施问题导向模式;比较两组干预前后肺功能指标、生活质量[采用圣乔治呼吸问卷(SGRQ)]、自我管理能力(采用自我管理量表)、自我护理能力[采用自我护理能力测定量表(ESCA)],并发症发生情况。结果:干预后,研究组肺功能各项指标、SGRQ评分、自我管理能力均优于对照组(P<0.01);干预后,两组ESCA评分均高于干预前(P<0.01),且研究组高于对照组(P<0.01);研究组并发症发生率低于对照组(P<0.05)。结论:问题导向模式联合预知护理在COPD患者中效果显著,可以有效改善患者肺功能,提高患者生活质量、自我护理及自我管理能力,从而降低并发症发生率。

基于跨理论模型护理对非小细胞肺癌化疗患者的应用效果

目的:分析基于跨理论模型护理对非小细胞肺癌(NSCLC)化疗患者自护行为、生活质量及护理满意度的影响.方法:选择2018年5月至2020年6月期间本院收治的NSCLC化疗患者75例作为研究对象,按照护理干预方式的不同分成观察组(n=40,跨理论模型护理模式干预)和对照组(n=35,常规护理干预).比较两组生活质量、自我护理行为评价及护理满意度.结果:干预后,观察组自护行为量表(SCHFI)自护维持、自护信心、自护管理评分高于对照组,差异有统计学意义(P<0.05);干预后,观察组以卡诺夫斯基健康状况量表评分(KPS)及生活质量核心问卷量表(QLQ-C30)评分低于对照组,差异有统计学意义(P<0.05);观察组满意度较对照组更高,差异有统计学意义(P<0.05).结论:NSCLC化疗患者采用跨理论模型护理模式干预可明显提升患者满意度、提高患者生活质量并坚持自我护理行为.

综合运动护理模式对宫颈癌化疗患者睡眠质量和依从性的影响

目的分析综合运动护理模式应用于宫颈癌化疗患者中的作用。方法选取78例宫颈癌患者,按照随机数字表法分为对照组与观察组,每组39例。对照组给予常规护理,观察组给予综合运动护理模式,比较两组护理效果。结果干预后观察组治疗依从性评分较对照组高,焦虑、抑郁评分较对照组低,差异有统计学意义(P<0.05)。干预后观察组患者睡眠质量总分较对照组低,差异有统计学意义(P<0.05)。结论宫颈癌患者化疗期间,实施综合运动护理模式可有效提高其治疗依从性,同时改善睡眠质量。

基于公办与民办差异视角的养老机构医养结合服务质量评价研究

背景近几年,关于我国医养结合服务模式、影响因素等的研究报道较多,但关于养老机构医养结合服务质量的研究报道较少,且缺乏对不同类型养老机构医养结合服务质量差异的比较研究。目的评价公办与民办养老机构医养结合服务质量。方法2020年10月—2021年9月,采用分层随机抽样方法在内蒙古自治区包头市、陕西省西安市、湖北省宜昌市、浙江省绍兴市共4个地区进行问卷调查,共选取25家养老机构老年人1106名。通过SERVQUAL模型构建包含可靠性、及时性、保障性、规范性、移情性5个维度和15项二级指标的医养结合服务质量评价指标体系,结合熵权法与模糊综合评价法分别计算公办、民办养老机构医养结合服务质量评分并进行比较。结果公办、民办养老机构老年人对医养结合服务质量满意度综合评价值分别为41.66、38.82分,其中公办养老机构15项二级指标评分均在40.00分以上,民办养老机构13项二级指标评分在40.00分以下。结论公办与民办养老机构老年人对医养结合服务质量满意度综合评价结果存在一定差异,其中规范性、移情性维度评分差异较大,可靠性、及时性、保障性维度评分差异较小,这为发现不同维度下医养结合服务存在的问题、促进养老机构医养结合服务高质量提供了参考。

多学科团队协作干预在高脂血症性胰腺炎患者中的应用

目的 探讨多学科团队协作(MDT)护理在高脂血症性胰腺炎患者中的应用效果。方法 选择2022年1月至12月安徽省亳州市人民医院收治的90例高脂血症性胰腺炎患者,采用随机数字表法将其分为对照组和研究组,各45例。对照组行常规护理,研究组在常规护理基础上行MDT护理干预。观察两组负面情绪、睡眠质量、遵医行为变化情况。结果 干预后,两组汉密尔顿焦虑量表、汉密尔顿抑郁量表评分及匹兹堡睡眠质量指数评分均低于干预前,且研究组低于对照组(P<0.05);干预后,研究组规律服药、饮食、锻炼、复诊占比均高于对照组(P<0.05)。结论 MDT干预用于高脂血症性胰腺炎患者,在负面情绪、睡眠质量及遵医行为改善方面均效果显著。

质量—关怀模型在人文关怀护理中的应用研究进展

该文对Duffy质量—关怀模型的发展背景、基本框架及其在临床人文关怀护理实践和人文关怀护理能力培养中的应用研究进行综述,并结合我国人文关怀护理现存问题提出后续研究建议,以期为关怀理念在我国护理实践环境中的落实和实施提供参考。

创优护理模式用于内分泌科护理中的效果

目的 探讨内分泌科护理中运用创优护理模式的效果。方法 选取2022年7月至2023年7月本院内分泌科的104例患者和36名护理人员,通过掷硬币法分为两组,其中试验组运用创优护理模式,对照组则实施常规护理模式,比较护理质量和护理效果。结果 试验组护理人员的护理质量相关指标评分高于对照组(P <0.05)。试验组患者的自我管理能力相关指标评分高于对照组(P <0.05)。试验组患者护理投诉率为0、护理纠纷率为1.92%,分别低于对照组的7.69%和13.46%(P <0.05)。结论 创优护理模式的应用,有助于提高内分泌科护理人员的护理质量,同时还能增强患者的自护能力、减少护理不良事件。

多学科协作护理新模式对慢性阻塞性肺疾病患者肺功能及护理效果的影响

目的 对慢性阻塞性肺疾病(慢阻肺)实施多学科协作护理新模式的效果观察及有关指标分析。方法 选择2022年1月至2023年1月我院收治的68例慢阻肺患者,按随机数字表法分为两组,对照组(34例)予常规护理,观察组(34例)予多学科协作护理新模式,比较两组护理效果。结果 干预后,观察组肺功能(FVC、FEV1、MVV)均高于对照组,护理总有效率高于对照组(P <0.05),SAS、SDS分值均低于对照组(P <0.05),各项生存质量分值均低于对照组(P <0.05),睡眠质量改善效果均优于对照组(P <0.05)。结论 慢阻肺实施多学科协作护理新模式后可取得较好的护理效果,利于强化肺功能,纠正心理及睡眠状况,提升生存质量。

医护一体化管理模式在全瓷高嵌体修复患者护理中的应用

目的研究医护一体化管理模式在全瓷高嵌体修复患者临床护理中的应用效果。方法将本院2021年6月-2022年3月收治的90例行全瓷高嵌体修复治疗的牙体缺损患者按随机数字表法分为各含45例的试验组(施行医护一体化管理模式)与对照组(施行常规护理),比较两组患者的治疗效果、情绪状态及护理满意度。结果对照组总治疗优良率为77.78%低于试验组的95.56%,(P<0.05);护理前,两组焦虑自测量表(SAS)与抑郁自测量表(SDS)评分无差异(P>0.05);护理后,对照组SAS、SDS评分均高于试验组(P<0.05);对照组、一体化组护理总满意率分别为:82.22%、97.78%,对照组护理总满意率低于试验组(P<0.05)。结论将医护一体化管理模式应用于全瓷高嵌体修复患者,可有效提升临床疗效,改善患者的心理状态,提高其护理满意度,有较高的临床应用价值。

医养结合护理模式对多病共存老年患者自护能力及生存质量的影响

目的 探讨分析医养结合护理模式对多病共存老年患者自护能力及生存质量的影响。方法 纳入2022年1月至2023年6月在我院住院治疗的80例多病共存老年患者,按照随机数字表法分为常规干预组、医养结合组,每组40例,分别接受常规干预及医养结合干预。比较两组患者干预前、后的生存质量(WHOQOL-BREF评分)、自我护理能力(ESCA评分)及对护理工作的满意率。结果 两组患者干预前的WHOQOL-BREF、ESCA评分对比无统计学差异(P> 0.05)。干预后,相较于常规干预组,医养结合组患者的WHOQOL-BREF、ESCA评分均明显提高,且该组患者的护理满意率更高(均P <0.05)。结论 多病共存的老年患者采用医养结合护理干预,相比常规护理模式,可进一步提高患者的生存质量,提高自我护理能力。

基于双心医学模式的干预对CCU急性心肌梗死合并心力衰竭患者心理状态、睡眠质量和生存质量的影响

目的探讨基于双心医学模式的干预对冠心病监护病房(CCU)急性心肌梗死合并心力衰竭患者心理状态、睡眠质量和生存质量的影响。方法纳入2020年12月至2022年12月CCU收治的急性心肌梗死合并心力衰竭患者120例为研究对象,随机分2组,每组60例。参照组采用常规干预,试验组在参照组基础上实施基于双心医学模式的干预,比较2组的心理状态、睡眠质量、生存质量和疾病管理能力。结果2组干预后的汉密尔顿焦虑量表(HAMA)评分和汉密尔顿抑郁量表(HAMD)评分均低于干预前,且试验组低于参照组(P<0.05)。2组干预后的匹兹堡睡眠质量指数(PSQI)评分均低于干预前,且试验组低于参照组(P<0.05)。2组干预后的世界卫生组织生存质量测定量表(WHO-QOL-BRE)评分均高于干预前,且试验组高于参照组(P<0.05)。2组干预后的疾病管理能力评分均高于干预前,且试验组高于参照组(P<0.05)。结论CCU急性心肌梗死合并心力衰竭患者采用基于双心医学模式的干预,能有效改善患者的心理状态和睡眠质量,提高患者的生存质量和疾病管理能力。