ABSTRACT
Objective:To investigate the effect of the application of "internet +" disease management based on the AISAS model on the young and middle-aged patients after PCI therapy.Method:A total of 90 young and middle-aged patients hospitalized in cardiological department of the First Affiliated Hospital of University of Science and Technology of China (Anhui Provincial Hospital) were enrolled between June 2018 to October 2019, and they were randomly divided into observation group and control group with 45 cases in each group. Patients in the control group received telephone follow-up while "internet +" disease management based on the AISAS model was applied in the observation group. The drug therapy compliance, acquisition of the disease knowledge, quality of life, anxiety and depression levels, return to workand incidence of cardiovascular events.Results:One year after the intervention, the drug therapy compliance score, disease-related knowledge score, quality of life score, SAS and SDS scores of the observation group were 7.55±1.21, 7.29±1.27, 701.17±74.86, 32.55± 4.31, 34.74±4.16, the scores of patients in the control group were 6.48±1.56, 6.12±1.94, 670.58±65.29, 41.72±4.33, 40.79±4.17. The difference was statistically significant ( t value was 2.066-11.203, P<0.05). The comparison between the return of the patients and the incidence of cardiovascular events in the two groups was statistically significant ( χ2 value was 5.031, 11.275, P<0.05). Conclusion:This management model can increase the knowledge of disease PCI postoperative patients, improve their quality of life, make patients return to society earlier, and promote the improvement of the quality of continuous nursing service.
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Objective To establish an IT-based follow-up platform, and to explore its application effect in patients with ischemic stroke.Methods By constructing a follow-up model and a recurrence risk warning model for ischemic stroke patients, such a follow-up platform was established.Thanks to the retrospective comparative and analysis method, we built a study group comprising ischemic stroke patients discharged since the platform and a control group comprising 228 such patients discharged prior to the platform.These two groups were followed up by means of IT-based manner and traditional paper-based manner respectively at the first,third,sixth,ninth,and twelfth months since their discharge.These patients were analyzed in terms of their medication adherence,activities of daily living and recurrence rate.Results One year after the follow-up,32 cases were lost of contact in the study group and 42 cases from the control group.Medication adherence of the study group was higher than that of the control group at the sixth month (2.72 ±0.62), ninth month(2.86 ±0.37)and twelfth month(2.83 ±0.40)after discharge, with the differences being statistically significant(P <0.05).The recurrence rate of the study group at the ninth months(6.38%)and twelfth months(10.21%)after follow-up was lower than that of the control group,a difference being statistically significant(P<0.05).The difference of BI scores between the two groups was not statistically significant(P>0.05).Conclusions The IT-based follow-up platform could improve the medication adherence of ischemic stroke patients,and reduce the recurrence rate of ischemic stroke,but the effect of improving activities of daily living was still not significant.
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Objective To explore the effects of two methods of air-impact on clearing the subglottic secretion in patients with intubation.Methods A simple random sampling method was used to select 106 patients underwent mechanical ventilation through oral tracheal intubation in intensive medicine department from September 2016 to October 2017.The recruited patients were divided into two groups by the random number table,53 patients in Group A were treated with breath-holding key of a ventilator,combined with air-bag inflation and deflation,and 53 patients in Group B were treated with simple breathing apparatus combined with manual technique to clear subglottic secretion.The incidence of ventilator-associated pneumonia(VAP),amount of cleared subglottic secretions,difference of vital signs before and after operation,number of coughing,in vitro training time and operation time were compared between groups.Results The intention-to-treat ana]ysis(ITT) showed that the incidence of VAP in Group A and B were 7.55％ and 5.66％,the per-protocol analysis(PP) showed that the incidence of VAP in Group A and B were 3.92％ and 3.85％,and there was no significant difference between groups(P＞0.05);the amount of cleared subglottic secretions in two groups were (8.31±0.82) ml,(7.97±1.12)ml,and there was no significant difference (P＞ 0.05);but vital signs before and after operation,number of coughing,in vitro training time and operation time in Group A were lower than those in Group B,and the differences were statistically significant(P＜0.05).Conclusion Two methods of air-impact can both effectively reduce the incidence of VAP,but using breath-holding key of a ventilator combined with airbag inflation and deflation has less influence on vital signs,which patients can better tolerate and medical staff can master and cooperate more easily.
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Objective To investigate the effect of optimizing rescue time for patients with acute st-elevation myocardial infarction (STEMI) in the hospital. Methods A retrospective analysis of the clinical data of 133 patients with ST-elevation myocardial infarction who were hospitalized in the first affiliated hospital of university of science and technology of china during July,2016 to June,2017 was performed. Timeline in the rescue, the result of coronary reperfusion and satisfaction degree of patients were analyzed. Results The rapid evaluation time (F=2.609, P=0.046),emergency handling time(F=7.581, P=0.032), login and logout time (F=5.667, P=0.017)and visit-ballon time (F=8.942, P=0.007) were shortened quarter by quarter . The average time of each project in the four quarters showed a statistically significant difference. The difference of TIMI classification of coronary flow reperfusion among the four quarters was statistically significant (H=8.402, P=0.038). The satisfaction degree of each quarter showed a statistically significant difference (the third quarter of 2016:94.68±2.38, the fourth quarter of 2016:96.72± 5.10, the first quarter of 2017:97.23 ± 7.64,the second quarter of 2017:98.36 ± 4.86;F=7.891,P=0.048). Conclusions Enhancing timeliness of emergency care can remarkably shorten rescue time, improve satisfaction degree of patients and help to improve the success rate of emergency treatment for patients with STEMI.