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OBJECTIVE To evalu ate the effects of perimenopausal one-day outpatient multidisciplinary model on the cognition of women to menopause hormone therapy （MHT）. METHODS The perimenopausal one-day outpatient service opened by the Third Affiliated Hospital of Chongqing Medical University in 2017 was introduced ，which was participated by doctors ，pharmacists， nutritionists，music psychotherapists ，nurses and other multidisciplinary members to provide systematic ，all-round，humanistic and face-to-face group science popularization and education ，practical experience and Q&A for women in perimenopause or about to enter perimenopause （called“students”）. The students who participated in one-day outpatient service in 2020 were selected as the survey object ， and the questionnaire was CMEI2020KPYJ（ZAMM）00206] designed to analyze the understanding of perimenopausal syndrome，awareness rate of MHT ，willingness to use and concerns. RESULTS A total of 295 students completed the questionnaire. Compared with before participation ， after participated in one-day outpatient service ，the cognition level of the students were all improved significantly ，including perimenopausal age （96.61％ vs. 99.32％，P＝0.037），the importance of perimenopausal health care knowledge （91.19％ vs. 96.95％，P＜0.001），whether the perimenopausal syndrome needs treatment （88.47％ vs. 99.32％，P＜0.001），willingness to use MHT （70.59％ vs. 94.48％ ，P＜0.001），MHT treatment timing （60.50％ vs. 95.17％ ，P＜0.001），reducing the risk of cardiovascular disease （51.68％ vs. 96.55％ ，P＜0.001），delaying aging （69.75％ vs. 97.59％ ，P＜0.001），preventing osteoporosis（65.13％ vs. 97.59％），P＜0.001）；the medical staff were higher than the non-medical staff （P＜0.05）. Totally 90％ of the students said they had gained knowledge about the prevention and treatment of common diseases ，nutrition and guidance， psychological regulation guidance hormone therapy related knowledges and exercise methods ；the proportion of the students who were willing to use MHT for 1 to 5 years（31.09％ vs. 47.93％）increased significantly. The proportion of the students who concerned about the risk of thrombosis （60.24％ vs. 36.81％），weight gain （59.64％ vs. 14.84％）and life-long dependence （52.41％ vs. 18.13％）was significantly reduced ，but that of the students who concerned about cancer risk was not diminished. From 2017 to 2020，the utilization rate of MHT was increased from 2.22％ to 62.16％ in non-medical staff among the students. CONCLUSIONS The multidisciplinary model of perimenopausal one-day outpatient service can improve the awareness of MHT among perimenopausal women ，eliminate misunderstandings ，and increase the utilization rate of MHT.
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Objective:Objective To explore the special role of nutrition specialists in the one-day-care clinic of gestational diabetes mellitus (GDM), and provide a basis for strengthening the standardized construction of one-day-care clinic.Methods:It was a retrospective observation study that the pregnant women who participated in the one-day-care clinic of GDM in our hospital without nutrition specialists in November and December 2017 were divided into control group (177 cases), and who participated in the one-day-care clinic of GDM in our hospital with nutrition specialists in January and February 2018 were divided into observation group (307 cases). The differences of pregnancy outcomes between the two groups were compared after the propensity score matching.Results:176 pairs of patients were successfully matched with a 1:1 propensity score. The incidence of macrosomia in pregnant women with GDM in the observation group (2.8%) was significantly lower than that in the control group (8.5%) ( P=0.036). There were no significant differences in the weight gain during pregnancy, the gestational week of delivery and the incidences of insulin use, hypertension during pregnancy, preeclampsia, cesarean section, premature infants, premature rupture of membranes, umbilical cord around the neck, and fetal distress between the two groups ( P>0.05). Conclusion:Nutrition specialists are indispensable in the multidisciplinary cooperation of one-day-care clinic of GDM, and they play a key role in considerably lowering the prevalence of macrosomia in GDM pregnant women.
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Objective:To study the effect of one-day outpatient intervention on gestational diabetes mellitus (GDM) patients,and to explore the pregnancy outcome relevant to GDM patients and their fetus.Methods:The GDM patients were divided into two groups according to their own intention to the one-day outpatient.According to systematic sampling method,we chose 200 GDM patients from the above 2 groups,respectively.The 200 GDM patients in the control group were matched the observation group with the age and gestational age,then the pregnancy outcome was tracked.Results:The control level and success rate for the two hours blood sugar after breakfast and hemoglobin A1c (HbA1c) in the observation group were better than those in the control group (P<0.001).The maternal complication rate (46.50%) and neonatal complication rate (21.50%) in the observation group were lower than those in the control group (71.50%,41.50%;P<0.001).The maternal complications rate of fetal distress,premature and the neonatal complications rate of fetal macrosomia,neonatal respiratory distress syndrome (NRDS),low weight,congenital heart disease,neonatal pneumonia,and rate in neonatal NICU were significantly lower than those in the control group (P<0.05).Conclusion:One-day outpatient intervention could control blood sugar effectively,reduce the maternal and neonatal complications.It is worth promoting.
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Objective To evaluate the results of one-day care for gestational diabetes mellitus (GDM) and pregnancy outcome after application of new diagnostic criteria.Methods We retrospectively analyzed the clinical features of a GDM group (n=841) and a normal glucose metabolism group (n=3 043) who delivered in Department of Obstetrics and Gynecology,Peking University First Hospital between July 1,2011 and June 30,2012,to discuss the difference in maternal and newborn outcomes between these two groups,and to compare the maternal and newborn outcomes between the GDM one-day care group (study group,n=605) and non-GDM one-day care group (control group,n=236).Statistical analysis was performed by t test and x2 test.Results The average age of pregnant women with GDM was (31.5±4.2) years,which was higher than the normal glucose metabolism group (30.0±3.7) years (t=9.13,P＜0.01).The average age of the study group was (31.7±4.2) years,and the average age of the control group was (31.7±4.9) years,which was not a significant difference (t=2.32,P＞0.05).In the oral glucose tolerance test,fasting blood glucose level was (5.2±0.5) mmol/L,which was significantly lower than that in the control group (5.3±0.8) mmol/L (t=2.48,P＜0.05).The difference between 1 and 2 h glucose sugar levels did not differ significantly (P＞0.05) between the two groups.In the GDM and normal glucose metabolism groups of pregnant women,the incidence of macrosomia was 6.5％ (55/841) and 5.9％ (182/3 043),respectively,although the difference was not significant (x2=0.36,P＞0.05).In the GDM group,the rate of premature delivery was significantly higher than in the normal glucose metabolism group [preterm birth:10.1％ (83/841) and 7.4％ (225/3 043),x2=5.56; P＜0.05)].In the GDM group,gestational hypertension and mild pre-eclampsia were significantly more frequent than in the normal glucose metabolism group [gestational hypertension:4.2％ (35/841) vs 2.6％ (82/3 043),x2=4.85; mild pre-eclampsia:1.7％ (14/841) vs 0.9％ (26/3 043),x2=4.24; P＜0.05].The incidence of severe pre-eclampsia was 2.4％ (20/841) and 1.6％ (49/3 043),respectively,which was not significantly different (x2=2.22,P＞0.05) between the two groups.The rate of insulin use was 9.3％ (78/841) in the GDM group.In the study group,the rate of insulin use was 7.9％ (48/605),compared with 11.9％ (28/236) in the control group; this difference was not significant (x2=3.54,P＞0.05).In the study group,the incidence of macrosomia and hypertensive disorder complicating pregnancy (HDP) was similar to that in the control group [macrosomia:6.9％ (42/605) vs 5.3％ (13/236),respectively; x2=0.57; HDP:7.4％ (45/605) vs 9.9％ (24/236),x2=1.68; P＜0.05].The rate of premature delivery in the study group was significantly lower than in the control group [7.2％ (44/605) vs 16.0％ (38/236),x2=15.04,P＜0.05].In the study group,among the 561 cases of term birth,there were 42 cases of macrosomia.The average age of macrosomic and non-macrosomic pregnant women [(31.4±3.9) vs (31.7±4.2) years,t=4.27],pre-pregnancy body mass index [(23.5±3.9) vs (22.6±3.2),t=1.58],gestational weight gain [(16.1±5.6) vs (15.7± 11.4) kg,t=0.22] and pregnant weeks at visit to a one-day care clinic [(27.5 ± 4.3) vs (28.1 ± 2.8) weeks,t=0.86; P＞0.05] showed no significant differences.In women who delivered an infant with macrosomia,glycosylated hemoglobin levels in mid and late pregnancy were higher than in woman who did not deliver an infant with macrosomia [(5.6±0.4) ％ vs (5.4±0.4) ％,t=2.13,P＜0.05].Conclusions Through one-day care for GDM,the rate of preterm labor is reduced.This is a good model for group management of GDM women,and more efforts is required to improve its effect.
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PURPOSE: The purpose of this study was to determine the effects of surgery information service on one-day surgery patients' anxiety and satisfaction with nursing care. METHODS: The study used the nonequivalent control group time difference design. Sampling and measurement of the control group participants (n=30) was completed first. Later, participants in the experimental group (n=30) were sampled, intervened, and measured. The experimental group participants received the surgery information services twice: before and after the surgery, 20~30 minutes for each of the sessions. The anxiety was measured with the State-Trait Anxiety Inventory developed by Spielberger (1975), and modified by Kim & Shin (1978). The patient satisfaction with nursing care was measured with the Patient Satisfaction with Nursing Care Scale developed by La Monica and colleagues (1986), and modified by Shin (1999). The data was collected between February 1 and May 30, 2006. RESULTS: The results were as follows: 1) The level of anxiety in the experimental group was not significantly different from that in the control group. 2) The level of patient satisfaction with nursing care in the experimental group was significantly higher than in the control group (t=-4.53, p=.00). CONCLUSION: These findings suggested that the one-day vocal cord surgery information service could be a useful nursing intervention to improve patient satisfaction with nursing care, but not for controlling the anxiety of one-day surgery patients.
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Humans , Anxiety , Information Services , Nursing Care , Patient Satisfaction , Vocal CordsABSTRACT
One day surgery in children has been practiced for last 10 years in this institution. This study is to examine its safety and effectiveness for patients younger than 15 years old treated at the Department of Pediatric Surgery, Asan Medical Center, from September. 1996 to December, 2005. A total of 3,709 patients, 37 % of the total pediatric operations, are included in this retrospective study. The most prevalent ages were between 1 and 3 years olds (1,199 patients). Twenty patients were younger than 6 months, and they all had one day surgery safely. Operations were herniorrhaphy in 3,126 patients,followed by excisional biopsy, chemoport removal, and OK 432 injection. There were 12 cases (0.32 %) of unplanned admissions, 7 occurred within 6 months of one day surgery. Perioperative fever was the most common cause of admission in 4 cases. The related conditions of unplanned admission were bleeding in 2 cases and radical surgery in 2. One day surgery in this institution was easily accessible and safe. This is to the result of appropriate selection of patients, cooperation with anesthesiologists, adequate control of postoperative pain, and home care programs.
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Adolescent , Child , Child, Preschool , Humans , Ambulatory Surgical Procedures , Biopsy , Fever , Hemorrhage , Herniorrhaphy , Home Care Services , Pain, Postoperative , Picibanil , Retrospective StudiesABSTRACT
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Humans , Anxiety , Benzodiazepines , Conscious Sedation , Consciousness Disorders , Dentistry , Midazolam , Physical Stimulation , Surgery, OralABSTRACT
PURPOSE: An adequate pain control is one of important factors for obtaining good outcomes in the ambulatory basis of hemorrhoidectomy. There have been many methods for pain control after hemorrhoidectomy such as narcotics, various kinds of analgesics, etc. The aim of this study is to compare intraoperative internal anal sphincter injection of Ketorolac tromethamine and other two conventional methods for pain control. METHODS: A total of 56 patients with hemorrhoid grade III or IV underwent surgery between May and October 1999, and prospectively assigned to three groups in the consecutive order. The group was divided in Group 1: [Ketorolac tromethamine (Tarasyn) 60 mg intrasphincteric injection intraoperatively and 30 mg IM/prn?10 mg po/6hrs], Group 2: [No intraoperative injection and maintain pain control with Tarasyn 30 mg IM/prn/10 mg po/6hrs], and Group 3: [No intraoperative injection and maintain pain control with Pethidine (Demerol) 50 mg IM/prn and Ibuprofen 400 mg/Paracetamol 500 mg/Codeine 20 mg (Myprodol) po/8hrs]. The post operative data and pain scoring was performed on the questionnaire with Point box scale (BS-11) and Behavioral rating scale (BRS-6) each 24 hours during 5 days after surgery. RESULTS: There are 22 patients in the Group 1, 16 in the Group 2 and 18 patients in the Group 3. The median age of the Group 1 is 42.5, Group 2, 44.5 and Group 3, 45 years. The pain score on the first day after surgery in group 1 was significantly lower than group 2 (p0.05). CONCLUSIONS: Intraoperative internal anal sphincter injection of Ketorolac tromethamine shows a better pain control than conventional methods in early postoperative period. Therefore it might be helpful for patients to go home on the day after surgery, and strong pain killer to control pain after discharge will be needed.
Subject(s)
Humans , Anal Canal , Analgesics , Hemorrhoidectomy , Hemorrhoids , Ibuprofen , Ketorolac Tromethamine , Ketorolac , Meperidine , Narcotics , Postoperative Period , Prospective Studies , Surveys and Questionnaires , Tromethamine , Urinary RetentionABSTRACT
Objective To obtain fairly exact patient information before the implementation in an all-round way of the basic medical insurance system and find out about the current situation of the hospital, the needs of patients, etc. so as to predict the trends of outpatient sources after the implementation. Methods Using the status-quo whole sampling survey method, an imvestigation and analysis on the outpatient services for one day was made by means of questionnaires, including the sources of outpatients to the hospital, the form of medical security, the specialties involved, the aims of patients visits, and the spectrum of outpatient diseases. Results The investigation covered 3 806cases of outpatients during the whole day and involved 25 specialties. Conclusion Adoption of the new medical insurance system will produce some impact on the outpatient volume of the hospital. Under the new situation, it is imperative to take appropriate strategies and give play to the strong points of the hospital according to the demands of the market.