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ObjectiveTo explore the effect of nutrition combined with exercise intervention on stroke patients with sarcopenia. MethodsFrom January to June, 2022, 60 stroke patients with sarcopenia were randomly divided into control group (n = 15), nutrition group (n = 15), exercise group (n = 15) and combined group (n = 15). All the groups received routine rehabilitation training, while the nutrition group received nutrition intervention, the exercise group received exercise intervention, and the combined group received both the nutrition and exercise intervention, for four weeks. Before and after intervention, the muscle index was measured with bioelectrical impedance analysis, gripping strength of the healthy and the affected side was measured with gripping strength meter, and the patients were assessed with modified Barthel Index (MBI) and Berg Balance Scale (BBS). ResultsFour cases in the control group, two in the nutrition group, one in the exercise group, and three in the combined group dropped down. The muscle index, gripping strength, and the scores of MBI and BBS improved in all the groups after intervention (|t| > 3.004, P < 0.05), while all improved more in the combined group than in the other three groups (P < 0.05), and the grip strength of the healthy side was more in the exercise group than in the nutrition group (P < 0.05). ConclusionNutrition or exercise intervention alone can improve the muscle quality, grip strength, activities of daily living and balance of stroke patients with sarcopenia, while the combination is more effective.
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ObjectiveTo explore the effect of intervention based on theory of planned behavior on muscle attenuation and balance of the elderly with sarcopenia. MethodsFrom September, 2022 to February, 2023, 124 elderly people with sarcopenia were conveniently sampled from Lishuiwan Community and Shuxiangyuan Community in Shijiazhuang City, Hebei Province. According to the coin toss, 62 elderly people from Shuxiangyuan Community were designated as control group, and 62 elderly people from Lishuiwan Community were as intervention group. The intervention group implemented the intervention based on the theory of planned behavior, including behavior attitude, behavior, subjective norms, perceived behavior control and behavior awareness; the control group maintained their original lifestyle, for twelve weeks. Before and after intervention, the grip strength, time of Five-Times-Sit-to-Stand Test, relative appendicular skeletal muscle index (RASM), 6-minute walking speed and the score of Berg Balance Scale (BBS) were compared. ResultsAfter intervention, the grip strength, RASM, 6-minute walking speed, and the score of BBS significantly increased, and the time of Five-Times-Sit-to-Stand Test shortened in the intervention group (|Z| > 6.257, |t| > 28.643, P < 0.001), and they were better in the intervention group than in the control group (|Z| > 2.288, |t| > 3.177, P < 0.05). ConclusionThe intervention based on theory of planned behavior can effectively relieve the muscle attenuation of the elderly with sarcopenia, and improve their balance ability.
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Objective:To explore the current status and influencing factors of polypharmacy burden in inpatient with elderly comorbidity.Methods:Convenience sampling method was used to select 393 in patients with elderly comorbidity of multiple medications who were hospitalized in North China University of Science and Technology Affiliated Hospital from September 2020 to January 2021 as the research object, using the general situation questionnaire, the Living with Medicines Questionnaire (LMQ), the Perceived Social Support Scale (PSSS), the Medication Compliance Scale (Morisky Scale) to investigate. Descriptive analysis of general data characteristics and polypharmacy burden scores were performed, and t-test, variance analysis, and multiple linear stepwise regression analysis were used to analyze influencing factors. Results:The polypharmacy burden for inpatient with elderly comorbidity was (136.95 ± 22.34) points, and the score rate was 70.23%, which was at a moderately high level. Multi-factor analysis showed that age, education level, personal monthly income, the number of illnesses, the number of medications, the duration of medication, social support, and medication compliance were independent factors influencing polypharmacy burden in inpatient with elderly comorbidity ( R 2=0.821, adjusted R 2=0.818, F=220.65, P<0.001). Conclusions:The polypharmacy burden in inpatient with elderly comorbidity is at a moderately high level. It is recommended that medical staff should develop individualized nursing interventions to reduce the polypharmacy burden for the factors that affect the burden of multiple medications for this population.
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Objective To explore the effect of mindfulness decompression therapy on the house-bound elders with depression. Methods By the stratified random sampling method,screening 1 371 more than 60 year old people in the community,86 cases housebound elders with depression were randomly divided into intervention group and control group. Intervention group received mindfulness decompression therapy in-tervention,and control group with blank control. The housebound state assessment scale and the Geriatric Depression Scale (GDS) were evaluated before intervention,4 weeks after intervention and 8 weeks after in-tervention. Results During the intervention period,3 cases were dropped out,83 cases were all included (41 cases in the intervention group and 42 cases in the control group). There was no significant difference between the two groups in the general situation before the intervention (P>0. 05),and the balance between the two groups was comparable. After intervention,the total score of housebound (8. 4±2. 0) and the total score of depression (12. 2±4. 3) in the intervention group were lower than those in the control group,and the differences were statistically significant(P<0. 05). Conclusion Mindfulness-based stress reduction can ef-fectively improve the depression and housebound condition of the elderly.
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Objective To investigate the effect of self efficacy and coronary heart disease knowledge on health literacy of young and middle-aged patients with coronary heart disease.Methods Investigation was conducted among 500 patients using general questionnaire,chronic health literacy scale,self-efficacy scale and coronary heart disease knowledge questionnaire.Results The score of health literacy for young and middle-aged patients was (97.76± 15.45),and 57％ of the patients had good health literacy.Self-efficacy and coronary heart disease knowledge were positively correlated with health literacy (r=0.301,r=0.309;P＜ 0.05).Multiple regression analysis showed that self-efficacy (β=0.210),coronary heart disease knowledge (β=0.226) were significant factors of health literacy(both P＜0.01).Conclusion The self-efficacy and coronary heart disease knowledge have impact on the health literacy.The more self-efficacy and coronary heart disease knowledge,the higher health literacy.
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Objective To compare the effects of different local intervention temperatures of pressure ulcer on endoplasmic reticulum stress (ERS) and apoptosis in rats, and to provide an experimental evidence for clinical prevention and treatment of pressure ulcer. Methods The rat model of pressure ulcer was established by ischemia reperfusion, and a total of 40 SPF adult, male SD rats were divided into 4 groups: the sham group (anesthesia only, without other treatment), model group (ischemia at 22℃ for 1 h and reperfusion at 22℃ as one cycle, repeated for 5 cycles), high-temperature intervention group (ischemia at 22℃ for 1 h and reperfusion at 32℃ as one cycle, repeated for 5 cycles) and low-temperature intervention group (ischemia at 22℃ for 1 h and reperfusion at 12℃ as one cycle, repeated for 5 cycles). At the end of the experiment, muscle tissues at the sites under pressure of the rats were taken on ice. The pathological changes of skeletal muscle tissues were observed by HE staining. The expression levels of ERS-related proteins GRP78, caspase-12 and CHOP were detected by Western blot, and the expression of caspase-12 and CHOP was also observed by immunofluorescence. Moreover, apoptosis in the skeletal muscle cells was examined by TUNEL staining. Results Compared with the model group, skeletal muscle cell damages became more severe and apoptotic cells were increased in the high-temperature intervention group. Besides, the results of the immunofluorescence assay showed an increased positive expression of caspase-12 and CHOP, and the results of Western blot showed that the expression levels of GRP78, caspase-12 and CHOP were all higher than those of the model group (P＜ 0. 05). In contrast, skeletal muscle cell damages were alliviated and apoptotic cells were reduced in the low-temperature intervention group. Meanwhile, the positive expression of caspase-12 and CHOP was decreased, as shown by immunofluorescence, and all the expression levels of GRP78, caspase-12 and CHOP detected by Western blot were lower than the control group (P ＜ 0. 05). Conclusions Local low-temperature intervention can alleviate the pressure ulcer damages in rats through inhibition of the ERS-mediated apoptotic pathway. Local high-temperature intervention may exacerbate the pressure ulcer damages in rats by activating the ERS-mediated apoptotic pathway and promoting cell apoptosis. Local low-temperature intervention may be promising in clinical prevention and treatment of pressure ulcer.
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Objective Adenosine receptor agonist NECA has a certain myocardial protection, but the specific mechanism is not clear.This paper aimed to study the effect and mechanism of NECA inhibiting endoplasmic reticulum stress to against myocardial ischemia reperfusion injury in rats.Methods 56 Wistar rats of SPF grade were selected and divided into Sham group, I/R group, NECA group and TUDCA group through random number table method.We established the isolated rat heart ischemia reperfusion model by using the Langendorff device.Sham group: heart threaded but not ligated, Kerb-Henseleit buffer continuous infusion 170min;I/R group: heart stability 20min, ischemia 30min, reperfusion 2h;NECA group and TUDCA group: heart stability 20min, ischemia 30min, reperfusion 2h, perfusion solutions containing 0.1μmol/L NECA and 30μmol/L TUDCA were respectively given at 5min before reperfusion, and ended at 30min after reperfusion.Transmission electron microscope was used to evaluate alterations of the myocardial ultrastructures.Western blot analysis was used to detected the expression levels of endoplasmic reticulum stress IREl-XBPl signaling pathway marker protein IRE1α, XBP1s.Immunohistochemical staining was used to detect the expression of IRE1α.Results The results of transmission electron microscopy showed that most of the myofilament ruptured, sarcomere contracture deformation, visible mitochondrial vacuoles degeneration in I/R group, and injury in NECA group and TUDCA group were less than the I/R group, appeared as the filaments arranged more neat, sarcoma only had mild contracture.Immunohistochemical results showed that IRE1αpositive staining was not found in the sham group, and the area of positive staining of IRE1α in I/R group was significantly increased, while the NECA group and TUDCA group were significantly decreased.Compared to the Sham group, the expression level of IRE1α and XBP1s was significantly increased in I/R group(P<0.05);but compared with the expression level of IREα and XBP1s in I/R group(1.72±0.27, 0.97±0.19), the NECA group(1.14±0.16, 0.6±0.13) and the TUDCA(1.07±0.27, 0.58±0.15) group were significantly decreased(P<0.05).Conclusion NECA can reduce endoplasmic reticulum stress through inhibiting IREl-XBPl pathway to protect the myocardium.
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Objective To study the effects of self-management of knee osteoarthritis (KOA) on the function and quality of life in old pa-tients. Methods From October 2011 to April 2012, 100 patients with KOA from 2 communities in Tangshan, Hebei were recruited, and were as control group and intervention group based on the community. The intervention group learned a KOA self-management course, which consisted of 6 classes of 1.5 to 2 hours, once a week, taught by health professionals. The control group read the KOA self-management hand-book only. They were measured with the Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) and Arthritis Impact Measurement Scale 2nd version-Short Form (AIMS2-SF) before and 6 months after intervention. Results The score of WOMAC and AIMS2-SF improved more in the intervention group than in the control group (P<0.05). Conclusion The KOA self-management program is effective on function and quality of life in old patients with KOA in community.
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@# Objective To investigate the exercises self-management in the old patients with knee osteoarthritis (KOA). Methods 296 KOA old patients were investigated with the questionnaire and the Self-management Behavior Scale. Results The time spent in stretching/strengthening exercise was (24.22±36.18) min a week. The time spent in aerobic exercise was (136.27±83.21) min a week. Body Mass Index (BMI), the level of education and home address were the main factors related with the exercise behavior. Conclusion The exercises selfmanagement would be improved in the old patients with KOA, with the support of interventions targeted the related factors.
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<p><b>OBJECTIVE</b>To explore the impact of isolated diastolic hypertension (IDH) on new-onset cardio-cerebral vascular diseases (CVD).</p><p><b>METHODS</b>This cohort study involved 101 510 participants who were employees of the Kailuan Group-a state-run coal mining company, in 2006 and 2007. Among them, 6 780 subjects were diagnosed with IDH, 35 448 subjects were diagnosed with high-normal blood pressure and 19 460 subjects were diagnosed with normal tension. However, none of them had the history of either cardio-cerebral vascular disease or malignant cancer. Cardio-cerebral vascular events including cerebral infarction, cerebral hemorrhage, acute myocardial infarction were recorded every 6 months during the follow-up (47.1 ± 4.8) period. Multivariable Cox proportional hazards regression models were used to analyze the risk factors of first-ever CVD events.</p><p><b>RESULTS</b>1) There were 675 CVD events occurred during the follow-up period. The incidence rates of CVD events (1.7% vs. 0.9%), cerebral infarction (1.0% vs. 0.6%) and cerebral hemorrhage (0.4% vs. 0.1%) were significantly higher in IDH group than that in the normal tension group (all P < 0.05). 2) After adjustment for other established CVD risk factors, the hazards ratios became 1.67 (95% CI: 1.28-2.17) for total CVD events and 1.59 (95% CI: 1.12-2.27) for cerebral infarction and 2.67 (95% CI: 1.54-4.65) for cerebral hemorrhage in the IDH group. 3). In stratified analysis on age, after adjustment for other established CVD risk factors, the hazards ratio was 2.22 (95% CI: 1.41-3.50) for cerebral infarction in lower 60 years old group, while the it was 7.27 (95% CI: 2.58-20.42) for cerebral hemorrhage in groups older than 60 years of age.</p><p><b>CONCLUSION</b>IDH was the independent risk factor for the total cardio-cerebral vascular events, on both cerebral infarction and cerebral hemorrhage. The predicted values of IDH for different CVD events were diverse on different age groups.</p>
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Adult , Female , Humans , Male , Middle Aged , Cardiovascular Diseases , Epidemiology , Follow-Up Studies , Hypertension , Proportional Hazards Models , Risk FactorsABSTRACT
Objective To study the reliability and validity of Chinese version of housebound scale in Chinese elderly people in community.Methods The housebound scale was amended and translated according to the Procedure of the European organization for Research and Treatment of Cancer (EORTC) Quality of Life Group.Include two scales,which is whether is housebound and the reason of housebound.The reliability and validity of Chinese version of housebound scale were tested in a sample of 860 Chinese elderly people in two communities among 127 communities in Tangshan from October 2012 to March 2013.Reliability was evaluated using the splithalf reliability and internal consistency.Validity was assessed by content validity,discriminate validity and construct validity.Results The Cronbach’s α coefficient of the first subscales was 0.743,the split-half reliability was 0.856,the convergent validity ratio was 0.960,and the scale had good discriminate validity (P ＜ 0.01).The Cronbach's αcoefficient of the second subscales was 0.853,the split-half reliability was 0.816,the convergent validity ratio was 0.910.Four factors body and mental factors,environmental factors,psychological and social factors,listening factors were extracted by a factor analysis,which explained 48.37％ of the total variance.The loading value of each items in their respective common factor ranged from 0.42 to 0.82.Conclusion The housebound scale has better reliability and validity,which is available for the evaluation of housebound amnong elderly people.
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Objective To investigate the outcome of community seniors after 5 years of housebound, and the factors related with the out-come. Methods The housebound seniors confirmed 5 years ago in 5 communities in Tangshan were investigated with self-designed question-naire and elderly depression rating scale again. Results 42.1%of the 147 housebound seniors remained housebound. There was significance between the seniors housebound and non-housebound in the factors of population sociology, such as age, spoused, economic income, hous-ing floor, relationship with their children and social communication, and physical and psychological factors, such as health self-evaluation, loneliness and depression. Conclusion Seniors housebound in community may be reversible with some approaches of intervention.
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Objective To use self-efficacy theory to intervene patients with chronic obstructive pulmonary disease (COPD),and assess its efficacy on the self management level of COPD patients.Methods 106 COPD patients hospitalized in the respiratory department of a certain hospital from October 2011 to April 2012 were randomly divided into the control group and the intervention group.Each group consisted of 53 patients.Two groups of patients received routine respiratory treatment and nursing.But patients in the intervention group were also systematically intervened under the guidance of Bandura self-efficacy theory.The self-management level of both groups of patients were assessed before the treatment and six weeks after the treatment respectively.Results The self-management level of the intervention group were significantly better than that of the control group after intervention.Conclusions Self-efficacy theory can improve the self-management level of patients with COPD.
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BACKGROUND: Geriatric depressive disorder is a common psychological disorder in elderly people, and it can lead to the decline of various organic functions, and it also does great harm to elderly people and their family.OBJECTIVE: To investigate the influencing factors of depressive disorder in retired cadres and people, so as to provide basic evidence for enhancing the mental nursing in retired cadres and people and reducing the prevalence of geriatric depressive disorder.DESIGN: A sampling survey.SETTING: Department of Nursing, North China Coal Medical College.PARTICIPANTS: Between August and December 2002, 1 000 retired cadres and people living in the urban area of Tangshan city were investigated. There were 574 males and 426 females, aged from 60-88 years, the average age was 67.04 years, 851 of them were married, 10 were divorced and 139 had lost their spouses: the educational level was primary school and below in 159 cases, junior middle school in 362 cases, senior middle school in 280 cases, university and above in 199 cases.METHODS: The elderly people were investigated with the geriatric depression scale (GDS) and individual general information inventory by means of family visit. The investigative purpose and methods were introduced to the subjects before the investigation, and they all signed the informed consent, the form of without recording name was used. The strictly trained investigators were qualified by examination, which ensured the concordance of the investigative results. The pretesting was performed before the investigation to detect whether there were words,sentencesand items hard to understand, so as to avoid the information bias. The questionnaires were filled by the elderly people themselves or by the investigator if there was any difficulty for the elderly people in writing according to the their choice after reading the questions for them.in retired cadres and people of different age, gender and educational level:ferent marriage status.RESULTS: Totally 1 000 questionnaires were sent out, and 1 000 valid der was obviously higher in females than in males (27.0%, 18.6%, P ＜ 0.05).ple with the educational level of primary school and below, junior middle school, senior middle school, university and above were 33.9%, 22.1%,20.0%, 16.1% respectively, and it was decreased with the elevation of emarkedly higher in retired people than in retired cadres (25.4%, 13.6%,higher than in those having or had lost spouse (50.0%, 21.2%, 26.6%, P ＜ 0.05).CONCLUSION: The prevalence of depressive disorder is higher in retired cadres and people. More attentions should be given to the mental health care and social support of retired cadres and people, especially for the divorced ones.
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BACKGROUND: With the increase of senile population, it needs to further improve their mental health when improving their physical health. To study the depressive status of retired elderly people in order to provide basis for effective community nursing intervention.OBJECTIVE: To investigate and analyze the depression incidence among retired elderly people and conducted correlative factors analysis in order to improve the nursing service to aged people's mental health.DESIGN: Cross-sectional sampling study towards retired senior people.SETTING: Nursing department of a medical college.PARTICIPANTS: This study was completed in Nursing Department of North China Coal Medical College during September to December 2002. It conducted questionnaire survey to 1 000 retired people in Tangshan city by family visit. There were 574 male and 426 female who aged from 60 to 88years old with mean age of 67 years.METHODS: To adopt geriatric depression scale and general condition questionnaire investigation to individuals.MAIN OUTCOME MEASURES: Depression scale score, depression incidence and frequency of correlative factors RESULTS: Mild depression accounts for 17.2% while moderate and severe depression account for 5% among retired elderly people. There is close relationship between factors such as retired veterans, female, low education,lack of social support, empty life, lack of exercise and poor self-assessed health and depression incidence(x2 = 9.80 - 175.93, P ＜ 0. 05).CONCLUSION: The incidence of senile depression among retired elderly people is pretty high so that it is important to pay attention to mental care towards retried people when doing community nursing, especially to divorced, widowed, female and low educated retired people.