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OBJECTIVE To construct the integrated pharmaceutical care model of in-hospital pharmaceutical care+out-hospital pharmacy outpatient service for patients with lower extremity artery disease （LEAD）， so as to improve patients’ disease self- management ability， and the efficacy and safety of therapy. METHODS The in-hospital pharmaceutical care and out-hospital pharmacy outpatient service model was constructed for LEAD patients， including pharmaceutical evaluation， self-management ability education， and pharmacy follow-up， to perform long-term management of patients. Totally 65 LEAD patients admitted to the vascular surgery department of our hospital， receiving pharmacist management， from September， 2021 to December， 2022 were selected as the study objects， and pharmacists conducted in-hospital pharmaceutical care+continuous out-patient management. The efficacy indicators， safety indicators， and patients’s disease self-management ability indicators were compared before and after 3 months of pharmacist management. RESULTS After 3 months of pharmacists’ participation in the management of 65 patients， Fontaine stage decreased in 55 patients， there was the significant difference in Fontaine stage before and after management （P＜ 0.001）. The proportion of patients who completely followed the guidelines for medication increased from 63.1% to 96.9%； the incidence of small bleeding was reduced by 7.7% after pharmacists’ management. The scores of Morisky medication compliance and patients’ disease self-management ability were higher than 3 months ago （P＜0.001）. Patient proportion with “good” medical satisfaction increased by 18.4%. CONCLUSIONS The in-hospital pharmaceutical care and out-hospital pharmacy outpatient service model of LEAD patients can effectively improve patients’ disease self-management ability， and improve the efficacy and safety of therapy.
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Objective:To investigate the status quo and influencing factors of health self-management ability of scientific and technological workers in Shanxi Province.Methods:This study was a cross-sectional study. Using the general situation questionnaire and the adult health self-management ability evaluation scale, 467 scientific and technological workers who received physical examination in the First Hospital of Shanxi Medical University from January 2022 to September 2022 were investigated by questionnaire, and their height, weight, body mass index, fasting blood glucose, blood lipids and blood uric acid were collected on the day of physical examination. Multiple linear regression analysis was used to explore the influencing factors of health self-management ability, and Pearson and Spearman correlation analysis was used to analyze the correlation between health self-management ability and examination items.Results:The total score of health self-management ability of 467 scientific and technological workers was (153.7±16.5). The results of multiple linear regression showed that the type of medical insurance, self-assessment of health status, staying up late, and sleep quality were independent influencing factors of health self-management ability ( R2=0.141, adjusted R2=0.120, F=6.771; P<0.001). Health self-management ability was positively correlated with high-density lipoprotein ( r=0.114), behavioral subscale was positively correlated with high-density lipoprotein ( r=0.107), environmental subscale was negatively correlated with uric acid ( r=-0.103), triglyceride ( r=-0.118), and positively correlated with high-density lipoprotein ( r=0.129), and cognitive subscale was negatively correlated with triglyceride ( r=-0.125), all of which were statistically significant ( P<0.05). Conclusions:The ability of health self-management of scientific and technological workers in Shanxi Province belongs to the upper middle level, which is affected by the type of medical insurance, the self-assessment of health status, staying up late, and the quality of sleep. It is suggested that the ability of health self-management of scientific and technological workers can be improved by strengthening their health beliefs, providing a more convenient working environment, reducing the frequency of staying up late, and improving their sleep quality.
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OBJECTIVE@#To investigate the mechanism of self-efficacy between self-management ability and self-management behavior and its differences among patients with different disease courses through mediation tests.@*METHODS@#In the study, 489 patients with type 2 diabetes who attended the endocrinology departments of four hospitals in Shanxi Province and Inner Mongolia Autonomous Region from July to September 2022 were enrolled as the study population. They were investigated by General Information Questionnaire, Diabetes Self-Management Scale, Chinese version of Diabetes Empowerment Simplified Scale, and Diabetes Self-Efficacy Scale. Mediation analyses were performed using the linear regression model, Sobel test, and Bootstrap test in the software Stata version 15.0 and divided the patients into different disease course groups for subgroup analysis according to whether the disease course was > 5 years.@*RESULTS@#In this study, the score of self-management behavior in the patients with type 2 diabetes was 6.16±1.41, the score of self-management ability was 3.99±0.74, and the score of self-efficacy was 7.05±1.90. The results of the study showed that self-efficacy was positively correlated with self-management ability (r=0.33) as well as self-management behavior (r=0.47) in the patients with type 2 diabetes (P < 0.01). The mediating effect of self-efficacy accounted for 38.28% of the total effect of self-management ability on self-management behaviors and was higher in the behaviors of blood glucose monitoring (43.45%) and diet control (52.63%). The mediating effect of self-efficacy accounted for approximately 40.99% of the total effect for the patients with disease course ≤ 5 years, while for the patients with disease course > 5 years, the mediating effect accounted for 39.20% of the total effect.@*CONCLUSION@#Self-efficacy enhanced the effect of self-management ability on the behavior of the patients with type 2 diabetes, and this positive effect was more significant for the patients with shorter disease course. Targeted health education should be carried out to enhance patients' self-efficacy and self-management ability according to their disease characteristics, to stimulate their inner action, to promote the development of their self-management behaviors, and to form a more stable and long-term mechanism for disease management.
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Humans , Diabetes Mellitus, Type 2/therapy , Self Efficacy , Self-Management , Blood Glucose Self-Monitoring , Blood Glucose , Self CareABSTRACT
As the special subject of the applicant for registration of medical device, the research and development institutions have insufficient conditions and abilities to become medical device registrants, and there are certain difficulties in the actual registration application process, such as not clearing the certification path for the research and development institutions to hold the certificate. In view of the existing problems, by comparing the path of medicine research and development institutions to become medical device registrants and combining with the actual medical device industry to give relevant suggestions, including improving quality management over the whole life cycle of medical devices, quality and safety responsibility ability of research and development institutions, establishing the registration and certification path of research and development institutions, supporting laws and regulations, etc., so as to ensure that the research and development institutions become medical device registrants successfully.
Subject(s)
Research , CertificationABSTRACT
Objective:To develop an evaluation index system for the management ability of general practice team leaders in community health service centers.Methods:Based on literature review, key insider interviews and other methods, the framework and indicator pool for management capability of general practice team leaders were formed. Two rounds of Delphi consultations with 15 experts were conducted from July to October 2021, and the evaluation index system of general practice team leaders' management ability established.Results:All 15 experts had at least 5 years of work experience, including 10 engaging in clinical general practice, 3 in public health and 2 in community management. The response rates for the two rounds of expert consultation was 15/15, and the expert authority coefficient was 0.84, with Kendall's W coefficient of 0.35 ( P<0.001) and 0.46 ( P<0.001), respectively. Finally, the evaluation index system of the management ability of general practice team leaders was established, which consisted of 5 primary indicators (personal quality, special business management, organizational management, teaching and research management, strategy and culture building), 11 secondary indicators and 37 tertiary indicators. Conclusions:The management capability evaluation index system general practitioner team leaders of the community health centers has been established in this stu, which may be used for the training and selection of general practice team leaders in the community health centers.
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Objective:To explore the influence of health education based on Information-Motivation-Behavior Skills (IMB) model on the self-management of fistula in patients with autogenous arteriovenous fistula (AVF) plasty.Methods:A total of 112 patients undergoing AVF plasty from October 2020 to October 2021 were selected and divided into 2 equal group by the random number table method. The control group used usual care and health education. The observation group implemented a health education intervention based on the IMB model .Repeated-measures ANOVA were used to compare the difference of self-efficacy, self-management ability of AVF between before, 4, 8, and 12 weeks after intervention.Results:Before the intervention, there were no significant differences between the two groups about the scores of AVF scale and the general self-efficacy scale (all P>0.05). After 4 weeks, 8 weeks and 12 weeks of intervention, the total scores of Self-management ability of AVF were (56.27 ± 6.12), (64.51 ± 4.40) and (73.53 ± 3.60), which were significant higher than those of in the control group (49.38 ± 4.50), (57.93 ± 6.70) and (59.36 ± 5.28)( t=6.73, 6.06, 16.44, all P<0.05). Conclusion:Health education based on IMB model can improve the self-management ability and self-efficacy of patients undergoing AVF plasty with a more long-term impact on patients.
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Objective:To investigate the effect of problem-oriented nursing intervention in the self-management rehabilitation of patients with coronary heart disease after percutaneous coronary intervention (PCI).Methods:A total of 128 patients with coronary heart disease undergoing PCI operation in Changzhou Second People′s Hospital from January 2019 to January 2021 were selected and randomly divided into the observation group and the control group with 64 cases in each group. The control group was given routine self-management intervention, and the observation group was given problem-oriented self-management intervention. After 6 months of intervention, the indicators of self-management ability, cardiac function, and quality of life were compared between the two groups.Results:After 6 months of intervention, the observation group actually completed 58 cases, and the control group actually completed 62 cases. Before the intervention, there were no significant differences between the two groups in the scores of coronary self-management ability scale, cardiac function index and Seattle Angina Questionnaire ( P>0.05). Six months after intervention, the scores of disease knowledge management, symptom management, first aid management, daily life management, bad addiction management, treatment compliance, and self-management ability in the observation group were 16.34 ± 2.36, 13.36 ± 2.42, 12.26 ± 2.23, 17.45 ± 2.74, 16.52 ± 2.45, 12.16 ± 2.15, 103.54 ± 14.32, which were significant higher than those of in the control group, 14.32 ± 2.45, 12.45 ± 2.23, 10.75 ± 2.32, 16.05 ± 2.45, 15.24 ± 2.53, 10.36 ± 2.24, 94.09 ± 13.36 ( t=2.14-4.59, all P<0.05). After six months of intervention, the left ventricular end-systolic diameter (LVESD) and the left ventricular end-diastolic diameter(LVEDD) were (34.39 ± 6.75) mm and (52.60 ± 6.31) mm, which were significant lower than those of the control group, (38.56 ± 6.52) mm and (55.79 ± 5.74) mm ( t=3.52 and 2.90, both P<0.05). Left ventricular ejection fraction (LVEF) and left ventricular short-axis shortening rate (FS) in the observation group after 6 months intervention were (44.25 ± 3.65)% and (23.86 ± 2.41)%, which were significant higher than those of in the control group, (39.24 ± 3.52)% and (22.26 ± 2.51)%( t=7.65 and 3.56, both P<0.05). Six months after the intervention, the scores of the degree of body limitation, angina pectoris, stable angina pectoris attack degree, treatment satisfaction, disease cognition degree, quality of life score in the observation group were 73.09 ± 8.13, 68.21 ± 10.15, 74.10 ± 4.45, 79.36 ± 8.21, 76.53 ± 9.43, 72.26 ± 9.12, which were significant higher than those of in the control group, 64.15 ± 8.11, 59.38 ± 10.23, 63.51 ± 5.23, 62.45 ± 8.16, 67.68 ± 9.20, 63.44 ± 8.65 ( t=4.74-11.91, all P<0.05). Conclusion:Problem-oriented nursing intervention is helpful to promote the development of self-management ability of patients with coronary heart disease after PCI, promote the recovery of postoperative cardiac function, and improve the quality of life of patients.
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ObjectiveTo explore the effect of home visit based on empowerment education on psychotic symptoms， self-management ability and well-being of schizophrenia patients in home rehabilitation. MethodsA total of 87 cases of schizophrenia patients who met the diagnostic criteria of International Classification of Diseases， tenth edition （ICD-10） and were recovering at home in Caiba town， Yibin city from January to July 2021 were selected by random sampling method as research subjects. They were divided into experimental group （n=43） and control group （n=44） according to the random number table method. The two groups received routine family visits， and the experimental group received family visits based on empowerment education. The intervention cycle of the two groups was 6 months. Before and after the intervention， the severity of psychotic symptoms， self-management ability and well-being of the patients in the two groups were assessed with the Brief Psychiatric Rating Scale （BPRS）， the Schizophrenia Self-Management Instrument Scale （SSMIS） and the Index of Well-Being Scale （IWB）. ResultsAfter intervention， the intra group comparison showed that the BPRS score in the experimental group was lower than that before the intervention （t=4.550， P<0.01）， the SSMIS scores in both groups were higher than those before intervention （t=-17.107， -6.367， P<0.01）， and the IWB score in the experimental group was higher than that before intervention （t=-9.239， P<0.01）. The comparison between groups showed that the BPRS score of the experimental group was lower than that of the control group， and the SSMIS and IWB scores were higher than those of the control group （t=-3.899， 10.564， 9.690， P<0.01）. ConclusionThe implementation of family visit based on empowerment education may help to improve the psychotic symptoms of home rehabilitation schizophrenia， and improve their self-management ability and well-being.
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Objective To study the effect of WeChat follow-ups on the self-management ability and satisfaction of demand of the patients with home peritoneal dialysis. Methods We established a WeChat platform to implement the follow-ups to the patients with home peritoneal dialysis in our hospital. Sixty patients with regular peritoneal dialysis were enrolled. On the basis of the routine follow-ups at outpatient visits,telephone and family visits,the WeChat follow-ups were carried out.The comparison was carried out on the self-management ability and satisfaction of demand before the implementation and six months after the implementation. Results The total score and the scores on each dimension of the patients'self-management ability after the implementation were all significantly higher than those before the implementation (P<0.01).The patients'satisfaction of demand after the implementation was superior to the one before the implementation (P<0.01). Conclusion WeChat follow-ups improve the patients' ability in self-management and satisfaction of the patients'demand.
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Objective To describe the anxiety of caregivers and condition management of preschool asthma children ,and analyze the relation?ship between anxiety and disease management. Methods A total of 208 caregivers of asthma children from two hospitals in Shanghai were select?ed using convenient sampling,and surveyed by self?rating anxiety scale(SAS),condition management ability scale and condition management diffi?culty scale. Results The score of SAS were negatively correlated with the condition management ability and positively correlated with the condi?tion management difficulty. Hierarchical regression analysis showed that the model explained 26.6%amount and 35.1%amount of variation respec?tively. Conclusion The anxiety of caregiver of children with asthma may affect the disease management. Future interventions should be strength?ened on the caregivers'psychological problems,so as to improve disease management and control asthma more effectively.
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Objective To explore the effect of team-based outpatient education on blood pressure and self management ability of young and middle-aged patients. Methods About 88 cases of middle-aged and young people with high blood pressure from October 2015 to March 2016 were divided into two groups according to the random digit table, 44 cases in each group. The experimental group received team-based outpatient health education and the control group the routine health education. The two groups were compared in view of blood pressure and hypertension. Result The intervention group was significantly better in blood pressure and self-management ability as compared to the control group (P<0.01). Conclusion The team-based health education can help the young and middle-aged patients with good hypertension management and blood pressure control so that it improves the quality of life.
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Objective To discuss the application effect of fansclub informatization on the self-management of breast cancer patients. Methods A total of 240 breast cancer patients were equally divided into the experimental group and the control group by the random number table with 120 patients in each group. The control group was provided with routine health education, based on this, patients of the experimental group participated in the fans club. The compliance, tempering effect, readmission rate and the satisfaction degree were evaluated between the two groups one year later. Results A significant difference was observed between the two groups′ compliance (t=11.08, P<0.01), with the experimental group graded 69.27 ± 8.02 and the control group graded 48.76 ± 7.51. Moreover, in the experimental group, the angel of abduction, anteflexion, rear protraction, medial rotation, lateral rotation were respectively (170.13 ± 3.16)° , (172.45 ± 1.94)° , (46.71 ± 1.86)° , (81.30 ± 2.47)° and (85.18 ± 1.55)° ,which were significantly higher than the control group (125.16±1.93)°, (136.28±4.67)°, (34.63±2.68)°,(61.59±1.71)° and(85.18 ± 1.55)° (t=22.74-73.76,P<0.01). Further more, there were also remarkable differences (χ2=32.97, 54.21, 15.34, P<0.05) between the two groups on the consultative, readmission and the satisfaction degree, which in the experimental group were 91.67% (110/120), 81.67% (98/120), 96.67%(116/120), and in the control group were 55.83% (67/120), 47.50% (57/120), 84.17% (101/120). Conclusions The establishment of the fans club informatization remarkably improves the self-management of the breast cancer patients, which are worth popularizing.
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Objective To investigate the effect of Omaha system on the self-management ability of patients with glaucoma after discharge, so as to provide evidence for the further development of glaucoma. Methods A total of 86 cases of glaucoma patients were divided into control group and observation group, each group of 43 cases, the control group was given routine discharge guidance and follow-up,the observation group was given continuous nursing care based on the Omaha system.The two groups of patients before and after the discharge of the last 3 days and the end of the 2 months of self-management ability score. Results There was no statistical significance in the life adjustment, functional health care,medical management of diseases level of 3 d before discharge from the hospital(P>0.05).The life adjustment,medical management of diseases level was(8.73±2.51),(20.86±1.55)points at 2 months after discharge in control group,which was higher than that at 3 d before discharge(6.07±1.62), (16.11 ± 3.35) points,there was significant difference(t=2.127, 2.867,P<0.05). The life adjustment, functional health care,medical management of diseases level was(11.25±1.48),(20.78±2.61),(26.74±1.26) points at 2 months after discharge in observation group,which was higher than that at 3 d before discharge (6.12±1.71),(13.62±3.22),(16.04±2.78)points,there was significant difference(t=4.215,3.544,5.328,P<0.05).There was significant difference in the life adjustment,functional health care,medical management of diseases level of 2 months after discharge between two groups (t=2.074, 4.064, 4.878, P<0.05). Conclusions Continuous care based on the Omaha system can improve the life management,functional health care,medical management and general self-management ability of patients with glaucoma.
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Objective To explore the correlations of coping styles with self-management practices and fear of recurrence in patients having undergone mastocarcinoma resection.Methods Toally 330 patients having received mastocarcinoma resection participated in the investigation by medical coping modes questionnaire (MCMQ),self management scale(SMS) and cancer worry scale (CWS).Pearson correlation analysis was integrated to analyze the correlations of coping style with self-management practices and fear of recurrence.Results The total scores by MCMQ,SMS and CWS were (79.10t7.62),(45.31±4.52) and (14.86±4.36),respectively.Pearson correlation analysis showed that there was a significant negative correlation of the coping styles with fear of recurrence,and a positive correlation with the self management(P＜0.001).The items of avoidance and yielding were both positively correlated with the fear of recurrence,while negatively correlated with the self management (P＜0.001).Conclusions The coping style and fear of recurrence are closely correlated.The staff in the community should take active measures to improve the coping styles to reduce the fear of recurrence of the patients who have received mastocarcinoma resection.
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Objective To analyze the factors which influence the present nursing management ability in the alliance and to provide theoretical evidences and methods to improve the management. Methods 120 nursing administrators from 7 hospitals in the alliance were selected in convenience sampling for the site survey with customized questionnaires on nursing management ability appraisal. Results The valid return rate of the questionnaires is 100%;the average score of all respondents is 82.84±10.10;the differences in nursing management between the leading hospital and its members are statistically significant (P <0.05)while the differences among the members are not.Conclusion The leading hospitals play a very important role in improving the nursing management ability and administration in the alliance,which should integrate and leverage leadership roles to develop high quality nursing management among the hospitals in the alliance.
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Objective To evaluate the influence of empowerment education on self-management ability and self-efficacy of patients with coronary heart disease (CHD).Methods 190 patients with CHD were randomly divided into the experimental group and the control group.And all patients were trained respectively according to corresponding health education plan of each group by professional worker.These patients filled out the Essential Information Questionnaire (EIQ),Self-Efficacy Integration Scale (SEIS) and Coronary Artery Disease Self-management Scale(CSMS) at baseline,3 months and 6 months after health education.The clinical indexes in two groups such as body mass index,waistline,blood pressure,blood glucose and blood lipid were contrasted.Results The score of self-management ability and the score of self-efficacy in the experimental group was significantly more than that of the control group in 3 months and 6 months after health education,and this difference between two groups still persisted 6 months after health education.However,the score of symptom-maintaining in the SEIS and self-management of addiction,emergency,lifestyle and knowledge of diseases in the CSMS appeared to drop in the control group.Conclusions Empowerment education can significantly improve and increase the self-management ability and self-efficacy of patients with CHD,and this function of empowerment education was proved more enduring than that of traditional health education.So,empowerment education will be a new style of health education in the new model of clinical medicine instead of traditional health education.