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Objective:To explore the intervention effects of an Internet-based blood pressure monitoring and management platform in a prehypertensive population.Methods:One hundred and fifty-eight prehypertensive patients who were examined at the Third Xiangya Hospital in Changsha, China, from August to December 2019 were randomly divided into either the experimental or control groups using the random number table method. The experimental group utilized an Internet-based blood pressure monitoring and management platform, whereas the control group utilized regular telephone and SMS health management routines. The intervention duration was 12 months for both groups. Data were analyzed using descriptive analysis, t-tests, chi-square tests, χ 2 tests, and rank-sum tests. Results:Post intervention systolic blood pressure (124.79±9.71 mmHg) (1 mmHg=0.133 kPa) and diastolic blood pressure measurements (77.41±8.21 mmHg) of the participants in the experimental group were significantly lower than those before the intervention (128.29±5.10 mmHg and 79.99±6.01 mmHg, respectively), and significantly lower than those of the control group′s measurements after the intervention (130.00±7.78 mmHg and 80.33±7.90 mmHg, respectively) (all P<0.05). The blood pressure goal attainment rate was significantly higher in the experimental group (23.08%) than that of the control group (8.75%), with statistically significant differences within the experimental group before and after intervention, as well as between the groups post intervention ( P<0.05). Positive lifestyle changes, such as prehypertension knowledge score, active restriction and control of salt and oil intake, reduction of smoking, and exercising weekly, were significantly higher than those in the control group before the intervention (all P<0.05). Conclusion:The use of an Internet-based blood pressure monitoring and management platform can effectively help patients with prehypertension control their blood pressure levels, improve their knowledge about the condition, and improve their lifestyle choices.
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Objective:To determine the relationship between health self-empowerment level and health self-management skill in older adults.Methods:A household survey was conducted from June 2020 to April 2021, among older adults in two communities each in Zhuzhou and Changsha selected by stratified cluster sampling. Data were collected through a general questionnaire, simplified. Elders Health Empowerment Scale, and Rating Scale of Health Self-Management Skill for Adults. A total of 444 questionnaires were distributed, of which 425 were valid. Pearson correlation and hierarchical regression analyses were used to analyze the relationship between health self-empowerment level and health self-management skill.Results:Final sample included 425 elderly people. Health self-empowerment was at medium to high level (30.9±5.6), whereas health self-management was at medium level (146.2±21.7); and the two factors were significantly correlated (Pearson coefficient was 0.724). After controlling for confounding factors (demographic characteristics), health self-empowerment independently accounted for 34.3% of the variation in health self-management ability.Conclusion:Health self-empowerment positively affects health self-management ability among older adults, which suggests the importance of stimulating health self-empowerment awareness in the process of health self-management.
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Objective:To examine the influencing factors of endothelial injury using the structural equation model (SEM).Methods:A total of 6 861 asymptomatic individuals free of cardiovascular disease underwent health examinations at the health management center of the third Xiangya hospital, Central South University from May 2015 to August 2020. And collected their questionnaire and checkup data. Spearman′s rank correlation coefficient was used to analyze metabolic factors and brachial artery flow-mediated dilatation (FMD). Exploratory factor analysis (3 430/6 861) and confirmatory factor analysis (3 431/6 861) were conducted on the diet items. An SEM was constructed using the diet pattern data, cardiovascular risk factors and FMD, and using multi-path regression analysis to determine the correlation between the indicators.Results:Based on the factor analysis, diet items were divided into three patterns: healthy food, meat, and supplementary food. The SEM indicated that age ( β=0.27) and blood pressure ( β=0.12) had obvious effects on low FMD. Triglyceride ( β=0.03), fasting blood glucose ( β=0.04), and body mass index ( β=0.08) were positively correlated with low FMD. On the upstream, healthy food was negatively correlated with blood pressure ( β=-0.04) and body mass index ( β=-0.04), meat was positively correlated with triglyceride ( β=0.33), blood pressure ( β=0.06), fasting blood glucose ( β=0.20), and body mass index ( β=0.16), and supplementary food was negatively correlated with fasting blood glucose ( β=-0.30). This was the only pattern that was directly correlated with FMD ( β=0.05). Conclusions:SEM is an effective method to analyze the influence of various risk factors on the population and the relationship between individual indicators. This study revealed direct and indirect correlations between age, diet pattern, cardiovascular-metabolic risk, and FMD impairment. Comprehensive control of dietary patterns and metabolic indicators could prevent and improve early cardiovascular injury.
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To study the salivary cortisol level, and to analyze the correlation between salivary cortisol and peri-abortion depression in the women suffering termination of pregnancy for fetal anomaly. Methods: Comparing the difference in salivary cortisol level between the women with and without depression when they underwent termination of pregnancy for fetal anomaly in a prospective cohort study. Analyzing the correlation between salivary cortisol and peri-abortion depression through logistics regression analysis. Results: The salivary cortisol awakening response was lower in women with depression than women without depression. Based on the logistics regression analysis, the salivary cortisol awakening response showed a negative correlation with pre-abortion (OR=0.063, 95% CI 0.005 to 0.754) and post-abortion (OR=0.002, 95% CI 0.000 to 0.061) depression. Conclusion: Cortisol awakening response possesses a negative correlation with peri-abortion depression, and it is a predictive factor for post-abortion depression.
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Female , Humans , Pregnancy , Depression , Depressive Disorder , Metabolism , Hydrocortisone , Metabolism , Prospective Studies , Saliva , MetabolismABSTRACT
Objective To retrieve literature on physician-patients relations for analysis of current studies and hotspots. Methods Papers on physician-patient relations published from January 2013 to September 2017 were retrieved in PubMed using such key words as "physician-patient relations" and"nurse-patient relations" respectively for analysis and comparison. Bibliographies of literature on such relations were downloaded, and their publication years, journals, and countries of the journal, as well as their first authors were also analyzed. High frequency words were chosen using a new method based on Zipf's law to identify the cut-off points of high-low frequency words in the corpus. Then the co-word matrix was formed using BICOMB2 to calculate the frequency of main key words,and a dendrogram was developed using SPSS 24.0 for clustering analysis. Results A total of 4 924 papers on physician-doctor relations were reviewed using 74 key words with occurrence higher than 31 times, and 2 145 papers on nurse-patient relations were retrieved using 41 key words with occurrence higher than 25 times. Co-word clustering analysis found six research focuses in recent five years: "informed consent and ethical issues","communication barriers", "trust", "implementation and construction of training courses for improving the relationship between doctors and patients","hospice care", and "patient participation in shared decision-making". It also found four research focuses on nurse-patient relations: "health knowledge, attitude and behavior", "communication and psychological nursing", "psychiatry and hospice care", and "patient centered and patient education". Conclusions Co-word clustering analysis found six research focuses in the recent five years helps understand the current situation and development trend.
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Objective To translate and revise the Individualized Care Scale-Patient Version(ICS-P) into Chinese,then to assess the reliability and validity of the Chinese version of the Individualized Care Scale-Patient Version (C-ICS-P).Methods Standard forward-back translation techniques were used in the translation of the ICS-P according to the Brislin translation model.Cross-cultural revision of the translated ICS-P was carried out through group discussion and pretesting.Totally 223 patients were recruited through convenience sampling method from a tertiary hospital in Changsha and investigated using general information questionnaire and the C-ICS-P,and its reliability and validity were assessed.Results The C-ICS-P contained two subscales,and both C-ICS-P-A and C-ICS-P-B contained 3 factors explaining 61.330％ and 65.263％ of the total variance.The dimensions of C-ICS-P-A were clinical characteristics (6 items),personal life characteristics (4 items) and participation willingness (5 items);the dimensions of C-ICS-P-B were clinical care (6 items),personal life care (4 items) and decisional control over care (5 items).The Cronbach's α coefficients of C-ICS-P-A and its dimensions were 0.897,and 0.730～0.774;the Cronbach's α coefficients of C-ICS-P-B and its dimensions were 0.909,and 0.688～0.754.Split-half reliability was 0.856 for C-ICS-P-A and 0.688～0.754 for its dimensions;split-half reliability was 0.889 for C-ICS-P-B and 0.750～0.758 for its dimensions.Analysis of content validity of the C-ICS-P indicated that I-CVI was at least 0.83,S-CVI was 0.943.Conclusion The reliability and validity of C-ICS-P are satisfactory and well meet the requirements of psychological measurement,indicating C-ICS-P is a reliable and valid instrument in the context of Chinese culture.
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Objective:To investigate the preoperational nutritional condition for the children with congenital heart disease,and to analyze the relevant factors.Methods:According to the standards of WHO,the Z-scores was used to assess the nutritional condition for the children,and the generational information questionnaire,State-Trait Anxiety Inventory,Self-Rating Depression Scale and Parent Understanding Questionnaire were used to analyze the maternal factors.Results:Stunting,underweighting and wasting represented the poor nutritional conditions,which accounted for 28.6％,25.3％ and 25.3％,respectively.Maternal accurate perception and the psychological problems such as anxiety and depression were the main relevant factors.Conclusion:The poor nutritional condition for the congenital heart disease was serious.It is very important to improve the maternal accurate perception and to relieve the maternal psychological problems for changing the nutritional condition through appropriate health education and effective intervention.
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OBJECTIVE@#To explore the application and the effect of early recognition of deteriorating patient program in department of cardiac surgery.@*METHODS@#We used the early recognition of deteriorating patient program in the cardiac surgery groups, including cardiac surgeons, nurses in ward, ICU and operation rooms of the cardiac surgery department, and compared the satisfaction of nurses and doctors, handover time, handover score of critical patients, and rate of unplanned ICU admission before and after the intervention.@*RESULTS@#After using the early recognition of deteriorating patient program, the satisfaction of doctors and nurses was increased, the handover time was lowered 0.56 min/time (t=2.22, P<0.05), the handover score of critical patients enhanced by 19.59 points (t=30.57, P<0.001), the rate of unplanned ICU readmission after the operation reduced by 4.8% (χ2=4.14, P<0.05).@*CONCLUSION@#Early recognition of deteriorating patient program can improve the safety of cardiac patients, enhance the self-confidence of nurses and work efficiency.