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.

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.

Effects of comprehensive nursing with cognitive behavioral therapy in orthodontic osteodilated arch treatment

BACKGROUND This work explored the effects of cognitive behavior therapy(CBT)-based comprehensive nursing intervention(CNI)mode in arch expansion to treat patients with orthodontic osteodilated arch(OOA).AIM To explore the application effect of CBT-based CNI model in orthodontic expansion arch treatment.METHODS Using convenient sampling method,81 patients with OOA were selected and rolled into a control group(Ctrl group,40 cases)and an observation group(Obs group,41 cases).During the treatment,patients in the Ctrl group received routine nursing intervention mode,and the those in the Obs group received CBT mode on the basis of this.Before and after intervention,the incidence of oral mucositis,the mastery rate of correct arch expansion method,self-rating anxiety scale score,soft scale index,and plaque index were compared for patients in different groups.In addition,satisfaction and complications were comparatively analyzed.RESULTS Incidence of oral mucositis in the Obs group was lower(14.6%vs 38.5%),and the mastery rate of correct arch expansion method was obviously higher(90.2%vs 55.0%)was obviously higher(all P<0.05).Meanwhile,the soft scale index and plaque index in the Obs group were much lower(P<0.05).The compliance(90.24%)and satisfaction(95.12%)in the Obs group were greatly higher(P<0.05).CONCLUSION The CBT-based CNI mode greatly improved the mastery rate of correct arch expansion method during arch expansion in treating patients with OOA and enhanced the therapeutic effect of arch expansion and the oral health of patients,improving the patient compliance.

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.

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.

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.

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.

The Elements of a Design Entity

Any type of organism can be identified by examination of DNA sequences unique to that species. DNA is a substance carrying an organism’s genetic information. My definition of DNA is Designing New Architecture. The purpose is to examine the DesignInc entity to look for the specific features that make up the organisation where the whole is greater than the sum of its parts. As human beings we are 99 per cent similar but the one per cent difference is so complex that it allows for us all to be unique. This is the same for design-based practices, where superficially many firms of architects and urban and interior designers look very similar. In fact, the process and opportunities of design initiatives are so complex that vast differences can be detected if a careful investigative analysis is undertaken.

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。

Barthel指数分级指导下的Orem自理模式在脑卒中偏瘫患者中的应用

目的探讨Barthel指数分级指导下Orem自理模式在脑卒中偏瘫患者中的应用。方法选取2016年9月至2017年9月我院脑卒中偏瘫患者86例为研究对象,将其随机等分为对照组和观察组。对照组患者采取常规护理模式干预,观察组患者采取Barthel指数分级指导下Orem自理护理。比较两组患者护理干预前后Barthel指数、脑卒中专用生活质量量表(SS-QOL)评分。结果护理干预后,观察组Barthel指数、SS-QOL量表评分和患者满意度均高于对照组(P <0. 05)。结论 Barthel指数分级指导下Orem自理模式在脑卒中偏瘫患者中的护理价值较高,有助于改善患者的自理能力及生存质量。

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。

Old-age Care Modes and Facility Planning Based on the Concept of “Continuum of Care”

Through the comparative analysis on the theories and practical experience of the development of old-age care (OAC) in both China and other countries,and based on the interview and questionnaire survey in Zhejiang Province and Hangzhou City,this paper proposes the research and analysis framework for the old-age service system,i.e.,"OAC mode-OAC service system-OAC facility system." The paper argues that,oriented by OAC mode of "taking community-and home-based care as the main body and institution-based care as supplement," China should build an OAC facility system and planning thoughts that take "continuum of care" as concept and long-term care system as core.Taking Zhejiang Province and Hangzhou City as examples,the paper conducts the optimization research on current OAC facilities planning in terms of hierarchical system,scale,and differentiation,so as to formulate more systematic and operable planning standards for OAC facilities.

采用Barthel指数评定表对医养结合老年患者护理级别再分度研究

目的探讨Barthel指数评定表在医养结合老年科分级护理等级划分的应用效果。方法对医养结合老年科193例患者(干预组)结合医嘱已确定的护理级别(Ⅰ、Ⅱ、Ⅲ级),由责任护士对患者使用Barthel指数评定表(ADL量表)进行评估,根据患者自理能力分为A、B、C三度,划分为ⅠA、ⅠB、ⅠC、ⅡA、ⅡB、ⅡC、ⅢA、ⅢB、ⅢC 9个等级,分别实施相应的护理服务。与实施前的189例(对照组)的专科护理质量以及满意度得分进行比较。结果干预组安全事件发生率低于对照组,其中坠床发生率两组差异有统计学意义(均P<0.05),干预组其他安全问题如压疮、烫伤等发生率为0;干预组专科护理质量及患者满意度得分显著高于对照组(均P<0.01)。结论在医养结合老年科应用Barthel指数评定表辅助划分老年患者护理级别和度数,能将各项措施落到实处,提高护理质量和患者满意度。

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。

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。

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。

VIGOROUSLY CARRYING OUT FOREIGN TRADE AGENCY SYSTEM

Voices are growing louder and louder,calling for vigorously carryingout the foreign trade agency system in China’s foreign economic andtrade field.Vice Premier Li Lanqing in charge of foreign trade andeconomic cooperation has pointed out many times recently that theoperational mode of foreign trade should be transferred from thetraditional purchase system to service-type agency system.This isimportant to deepening the reform of the foreign trade system.