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Objective To construct the key-point guidelines of bowel preparation for elderly patients with colonoscopy. Methods The guidelines were made based on literature review,theoretical analysis,qualitative interview.Then they were determined by 14 clinical nurse specialists, nursing education experts and medical experts from 6 provinces or cities through two rounds of expert consultations. Results The response rate of two rounds'questionnaire was 100.00%. The authority of experts coefficient in the two rounds were 0.89. The coefficients of variation of the first and second rounds were respectively 0.07~0.27 and 0.05~0.13. The coordination coefficients for the 2 rounds were 0.377 and 0.404 respectively (Χ2=105.473 and 124.307,P<0.001).In the first round,the average of the importance rating was 3.50~4.95, with a standard deviation of 0.35~0.95.In the second round,the average of the importance rating was 4.71~4.93,with a standard deviation of 0.27~0.61.The key-point guidelines of bowel preparation included 3 key points for bowel preparation, 4 key moments,7 key guidance contents, 4 criteria for the process of bowel preparation and the corresponding remedial measures. Conclusion This study established the key-point guidelines of bowel preparation for elderly patientsand the degree of enthusiasm,authority,coordination and concentration of the experts was high so as to provide a reference for the clinical implementation of standardized bowel preparation guidance.
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Objective To explore the reliability of handgrip strength test for evaluating mobility in patients with stable chronic obstructive pulmonary disease.Methods Sixty-one COPD patients in stable stage were measured for handgrip strength and 6-minute walking test(6MWT).The receiver operating characteristic curve(ROC) was calculated to determine the best cutoff points of handgrip strength.Results Handgrip strength was (33.72-±7.47) kgf,6MWD was (437.06±97.96) m,handgrip strength was moderately correlated with 6MWD (r=0.404,P=0.001).6MWD≥350 m was used to classify two groups,and there was significant difference between two groups(P＜0.05).Area under the curv e was 0.722,and the best cutoff points was 32.8 kgf.Conclusion Handgrip strength test can be a useful tool to quickly identify mobility in patients with stable COPD.
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Objective To investigate the effect of bowel preparation before colonoscopy and its influencing factors. Methods A total of 283 patients with colonoscopy were recruited by convenience sampling method. They were investigated with basic information questionnaire of bowel preparation and their intestinal cleanliness were assessed by the Ottawa Assessment Scale. The status of bowel preparation and it′s influenced factors were analyzed. Results The total score of Ottawa Assessment Scale was (5.37 ± 2.22) points, and the efficiency of intestinal cleaning was only 59%(167/283). Logistic regression analysis showed that age (OR=1.033, P=0.013); history of chronic constipation (OR=10.341, P=0.000);history of appendectomy (OR=5.349, P=0.007); walking time during medication (OR=0.350, P=0.000);incomplete intake of the preparation (OR=0.078, P=0.000), the time interval between the initiation of ingestion and the onset of bowel activity (OR=1.034, P=0.000), defecation frequency (OR =0.794, P=0.004);characteristics of last stool (OR=0.159, P=0.000) were influencing factors of intestinal cleanliness. Conclusions The intestinal cleanliness of patients with colonoscopy is still at a low level. In the future, medical personnel should identify patients with risk factors early, and give them specific bowel preparation, so as to improve the quality of bowel preparation effectively.
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Objective To investigate the effect of transitional care on postpartum negative mood for puerpera. Methods One hundred sixty eligible puerperas were recruited between January 2013 and October 2014. By order of hospitalization, participants were randomly assigned into two groups. The control group (80 cases) received routine care. The study group received transitional care which consisted of predischarge assessment, structured home visits and telephone follow-ups, psychological rehabilitation group activities, phone and internet consulting services within six months after discharge. Screenings of predischarge depression and anxiety symptoms of the study group were done by Hospital Anxiety and Depression Scale (HADS). Evaluations of depression and anxiety symptoms of two groups were done by Edinburgh postnatal depression scale (EPDS) and Self-Rating Anxiety Scale(SAS)on postpartum forty-two days and six months. Results There were no differences in demographics, maternal indicators and completion of follow-up between groups (P > 0.05). On postpartum forty-two days, the study group had significantly better depression and anxiety scores (P 0.05). On postpartum six months, the study group had significantly better depression and anxiety scores, less incidences of depression and anxiety than the control group (P group were 7.13±2.52 and 42.6±6.0, those of control group were 8.87±2.66 and 48.8±5.9. The incidences of depression and anxiety of study group were 6.4%(5/78)and 7.7%(6/78), those of control group were both 26.0%(20/77). Analysis of multiple linear regression suggested that age, education level and family income would affect transitional care intervention on postpartum depression. Conclusions This study established a nurse-led transitional care model which selected the gynecology and obstetrics professional nurse as advanced practice nurse. Results demonstrated that transitional care was effective on improving maternal postpartum depression and anxiety.
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Objective To build a multi-system chain transitional care programme for postpartum pelvic floor training and test its effect.Methods By a prospective randomized controlled trial,the study group (n=60) received a multi-system chain transitional care programme which consisted of ward nurse,home visiting doctor,post-natal care clinic doctor,pelvic floor doctor and pelvic floor nurse.The control group(n=60) received routine care.The pelvic floor muscle strength,sexual function and patient satisfaction of baseline,on the 42th days,3rd months and 6th months were compared between two groups by short-term follow-up.Results There was no difference in baseline consisting of age,gestational weeks,birth weight and so on between groups.Participants in the study group had significantly better improvement and score in pelvic floor muscle strength,sexual thoughts,sexual arousal,sexual psychopathy and problems affecting sexual function.There was no difference in score of sexual pleasure and ejaculation time between two groups.Conclusions This study was an original effort to establish and evaluate a multi-system chain transitional care program for postpartum pelvic floor training.Results demonstrated that this transitional care was effective in improving pelvic floor function.
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Objective: To test applicability of the Center for Epidemiological Studies Depression Scale (CES-D) in different age groups in urban China, and to develop age norms. Methods: In this cross-sectional study, the CES-D was administrated to 16047 community participants with average age of (37.7±21.3) years (age ranged 11～100) in 21 provinces, who were as the norming sample. Criterion validity was tested in 349 psychiatric patients with average age of (32.0±12.1) years (age ranged 16～81) in 4 cities. A subsample (199 workers, 100 col-lege students, and 30 teachers in Beijing, Dongguan, and Baotou) was drawn from the national sample to provide 8 week interval test-retest reliability. Results: The Cronbach α was 0.90 for the scale, and 0.68～0.86 for its fac-tors. The 8 week interval test-retest correlation was 0.49 for the scale (P <0.01) and 0.39～0.51 for factors (P<0.01) . The result of confirmatory factor analysis supported the original 4-factor structure (RMSEA=0.057, CFI =0.976, GFI=0.948) . Patients scored higher than community sample [(21.72±13.39 ) vs.(13.24±10.33),P <0.01], and depression patients scored the highest [(27.82±14.42), P<0.01] . Age difference was signifi-cant. Age groups over 60-year-old scored higher than all the other age groups under 60-year-old (P<0.01). Con-clusion: The Chinese version of CES-D shows good refiability and validity across all ages in urban population-
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In order to provide the "guiding principles of clinical research on mild cognitive impairment (MCI) (protocol)" edited by Beijing United Study Group on MCI of the Capital Foundation of Medical Developments (CFMD) with evidence support, clinical criteria, subtypes, inclusion and exclusion of MCI, and use of rating scales were reviewed. The authors suggested that MCI clinical criteria and new diagnosis procedure from the MCI Working Group of the European Alzheimer's disease Consortium (EADC) may better reflect the heterogeneity of MCI syndrome. Diagnostic rating scales including Clinical Dementia Rating (CDR), Global Deterioration Scale (GDS), Alzheimer's Disease Assessment Scale-cognitive subscale (ADAS-cog) and Instrumental Activities of Daily Living (IADL) are very useful in definition of MCI but can not replace its clinical criteria. Absence of major repercussions on daily life in patients with MCI was emphasized, but the patients may have minimal impairment in complex IADL. According to their previous research, the authors concluded that highly recommendable neuropsychological scales with cut-off scores in the screening of MCI cases should include Mini-Mental State Examination (MMSE), logistic memory test such as Delayed Story Recall (DSR), executive function test such as Clock Draw Test (CDT), language test such as Verbal Category Fluency Test (VCFT), etc. And finally, the detection of biological and neuroimaging changes, including atrophy in hippocampus or medial temporal lobe in patients with MCI, was introduced.
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Mild cognitive impairment (MCI), as a nosological entity referring to elderly people with MCI but without dementia, was proposed as a warning signal of dementia occurrence and a novel therapeutic target. MCI clinical criteria and diagnostic procedure from the MCI Working Group of the European Alzheimer's Disease Consortium (EADC) may better reflect the heterogeneity of MCI syndrome. Beijing United Study Group on MCI funded by the Capital Foundation of Medical Developments (CFMD) proposed the guiding principles of clinical research on MCI. The diagnostic methods include clinical, neuropsychological, functional, neuroimaging and genetic measures. The diagnostic procedure includes three stages. Firstly, MCI syndrome must be defined, which should correspond to: (1) cognitive complaints coming from the patients or their families; (2) reporting of a relative decline in cognitive functioning during the past year by the patient or informant; (3) cognitive disorders evidenced by clinical evaluation; (4) activities of daily living preserved and complex instrumental functions either intact or minimally impaired; and (5) absence of dementia. Secondly, subtypes of MCI have to be recognized as amnestic MCI (aMCI), single non-memory MCI (snmMCI) and multiple-domains MCI (mdMCI). Finally, the subtype causes could be identified commonly as Alzheimer disease (AD), vascular dementia (VaD), and other degenerative diseases such as frontal-temporal dementia (FTD), Lewy body disease (LBD), semantic dementia (SM), as well as trauma, infection, toxicity and nutrition deficiency. The recommended special tests include serum vitamin B12 and folic acid, plasma insulin, insulin-degrading enzyme, Abeta40, Abeta42, inflammatory factors. Computed tomography (or preferentially magnetic resonance imaging, when available) is mandatory. As measurable therapeutic outcomes, the primary outcome should be the probability of progression to dementia, the secondary outcomes should be cognition and function, and the supplement outcome should be the syndrome defined by traditional Chinese medicine. And for APOE epsilon4 carrier, influence of the carrier status on progression rate to dementia and the effect of treatment should be evaluated.
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Objective:To investigate psychological needs, state of mind and psychological feeling, and analyze the related factors.Method:2000 subjects over 60 years of age in Beijing are evaluated with the part of psychological needs of the Life State Inventory for Residents of Beijing.Results:The intergeneration relationship, state of mind and psychological feeling of the elderly were well. They were related each other closely. The state of mind improved with educational level and that of male were better than female. Most of the elderly considered that the effect of the state of mind on the quality of life was obvious. The psychological feeling declined with aged and improved with educational level. The satisfaction degree of economy and care, filial obedience, health were related to life satisfaction degree, state mind and psychological feeling.Conclusion:Psychological needs of the elderly were satisfied in general. The state of mind was one of the important factors on the quality of life.
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Objective: To construct a questionnaire of attitude towar ds aging Method: Open questionnaire was applied to young and age d to collect stereotype phrases The initial questionnaire was applied to 140 el d erly in Beijing and then did item analysis, reliability and validity tests Results: The final questionnaire had two factors: positive and negat ive Consistency reliability and repeated reliability were greater than 0 9, t he split reliability was 0 77 Conclusion: The reliability and v al idity of the self-compiled "questionnaire of attitude towards aging" are satis fying