An adapted collaborative care model to manage co-morbidities of depression and chronic non-communicable diseases in Rwanda

Background The World Health Organization has recommended the implementation of the Collaborative Care Model in all countries to manage the comorbidities of depression and chronic non-communicable diseases. In Rwanda depression is major problem not only among patients with chronic illnesses but also in general population considering the unique history of war and genocide in Rwanda. Purpose The purpose of this paper is to describe the process of adaptation and testing of the Collaborative Care Model in the Rwandan healthcare context. Methods The larger study used the Action Research design with mixed method ­sequential explanatory design. A research-practice partnership method and an iterative process was used to adapt and test the Collaborative Care Model. Qualitative content analysis was used to analyse the data. Results Four structural components to the model were adapted including the addition of a registered nurse to the team, relocation of the model to the district level, consultation with a psychiatrist every 3 months and involvement of community health workers. The evaluation indicated that the model was applicable and acceptable. Conclusions Initial evaluation of the Adapted Collaborative Care Model shows promise in Rwanda. Implementation of this model in other Rwandan districts is warranted.

Application of collaborative care model in patients with postthrombotic syndrome/ / 中国实用护理杂志

Objective:To explore the application of collaborative care model on patients with postthrombotic syndrome.Methods:From March 2020 to March 2021, 98 patients with postthrombotic syndrome admitted to the vascular surgery ward of The First Affiliated Hospital of Zhengzhou University were selected as the research objects by convenient sampling method. Among them, 49 patients were admitted to the hospital from March to August 2020 as the control group to implement routine care; 49 patients from October 2020 to March 2021 were considered as the experimental group to implement the collaborative care model. The differences in the level of postthrombotic syndrome, quality of life were compared between the two groups before and after intervention.Results:The Villalta clinical score at discharge, 1 month after discharge, and 3 months after discharge was (6.90 ± 1.39), (6.88 ± 0.67), (5.67 ± 1.44) points respectively, (7.63 ± 1.35), (7.45 ± 1.46) and (7.08 ± 1.43) points, respectively, the difference was significant ( t=2.66, 2.50, 4.87, all P<0.05); the questionnaire scores of Venous Insufficiency Epidemiological and Economic Studies-the Quality of Life/Symptom in the experimental group (VEINES-QOL/SYM) were (49.39 ± 4.00), (52.21 ± 4.64), (57.39 ± 4.44) points, higher than the control group of (46.99 ± 3.93), (48.60 ± 4.13), (51.48 ± 3.73) points, the difference was significant ( t=-2.99, -4.06, -7.14, all P<0.05). Repeated measures ANOVA results showed time, intergroup and interaction effects in 2 groups were significant ( F values were 3.53 to 73.15, P<0.05). Conclusions:The collaborative care model can improve the clinical symptoms of patients with postthrombotic syndrome, and the quality of life of patients. It has certain reference significance for the nursing of patients with postthrombotic syndrome.

Prevention effect of collaborative care model-based continuous nursing on the postpartum posttraumatic stress disorder / 中国实用护理杂志

Objective@#To explore the effectiveness of collaborative care model-based continuous nursing on the postpartum posttraumatic stress disorder(PPTSD), to provide reference for postpartum clinical nursing.@*Methods@#A total of 100 cases of postpartum puerpera in Beijing Luhe Hospital of Capital Medical University were assigned to the intervention group and the control group according to the random number table method with 50 cases each. In the control group, patients received continuous nursing, however, collaboration care model-based continuous nursing care was carried out in the intervention group. The PPTSD status and psychological resilience between the two groups was assessed by Posttraumatic stress Checklist-Civilian version (PCL-C) and Connor-Davidson Resilience Scale (CD-RISC), respevtively.@*Results@#Before intervention, symptoms scores and total scores of PCL-C and CD-RISC between the two group was no statistical difference (P>0.05). After intervention, the scores of increased arousal symptoms (7.22±1.09), avoidance/numbing (9.77±2.41), re-experiencing symptoms (5.66±1.17) and PCL-C total scores (22.64±3.02) were significantly decreased in the intervention group compared to the control group (8.32 ± 1.05), (11.46 ± 2.87), (6.36 ± 1.25), (26.14 ± 3.27), and there were significant differences between the two groups (t=2.899-5.559, all P<0.01). However, the scores of tenacity (24.90 ± 4.83), strength (14.91 ± 2.25), optimism (7.18 ± 1.61) symptoms and CD-RISC total scores (46.99 ± 6.30) were remakedly increased in the intervention group compared to the control group (23.22 ± 2.69), (13.61 ± 1.75), (6.14 ± 0.91), (42.97 ± 3.30), there were significant differences between the two groups (t=2.154-4.011, P<0.05 or 0.01).@*Conclusions@#Collaboration care model-based continuous nursing care can promote the psychological resilience and alliviate PPTSD.

Collaborative care model improves self-care ability, quality of life and cardiac function of patients with chronic heart failure

Chronic heart failure (CHF) is a common chronic disease that requires much care. This study aimed to explore the effects of collaborative care model (CCM) on patients with CHF. A total of 114 CHF patients were enrolled in this study, and were randomly and equally divided into two groups: control and experimental. Patients in the two groups received either usual care or CCM for 3 continuous months. The impacts of CCM on the self-care ability and quality of life were assessed using self-care of heart failure index and short form health survey 12, respectively. Further, cardiac function was assessed by measuring left ventricular ejection fraction (LVEF) and the level of N-terminal pro-B-type natriuretic peptide (NT-proBNP), and by the 6-min walking test. Clinical and demographic characteristics of patients in the control and CCM groups were statistically equivalent. Compared with usual care, CCM significantly enhanced self-care abilities of patients with CHF, including self-care maintenance, self-care management and self-care confidence (all P<0.05). The physical and mental quality of life was also significantly improved by CCM (P<0.01 or P<0.05). Compared with usual care, CCM significantly increased the LVEF (P<0.01), decreased the NT-proBNP level (P<0.01), and enhanced exercise capacity (P<0.001). In conclusion, CCM improved the self-care, quality of life and cardiac function of patients with CHF compared with usual care.

Effect of collaborative care model on the post natal psychological state of the elderly primiparas / 现代临床护理

Objective To investigate the effect of collaborative nursing model on psychological states of the elder primiparas. Methods Toally 146 elder primiparas were randomly divided into experiment group ( n = 76 ) and control group ( n = 70 ) . The control group was nursed conventionally and the experiment group received intervention of collaborative nursing . The two groups were compared in terms of anxiety and depression (P<0.01). Results The difference was statistically significant before intervention and after the intervention within each group. The scores on anxiety and depression in the experiment group were significantly lower than those of the control group after intervention (P<0.01). Conclusion Collaborative nursing model can improve the psychological state of the elderly primiparas and improve the quality of holistic nursing in the department of obstetrics and gynecology.

Application of collaborative care model in the rehabilitation intervention of COPD patients / 现代临床护理

Objective To investigate the effect of collaborative care model(CCM)on the rehabilitation of nursing intervention of COPD(chronic obstructive pulmonary disease)patients.Methods Sixty COPD patients treated in the community clinics were equally divided into control and experiment group and the former received routine nursing and the latter CCM. After nursing intervention, the two groups were compared in terms of pulmonary function and quality of life.Result After intervention, the experiment group was better in pulmonary function and the score by SF-36QOL was higher than that of the control group(P<0.001).Conclusion CCM helps the improvement of pulmonary function of COPD patients and therefore enhances the quality of life.

Effects of collaborative care model for the negative mood and quality of life of lung cancer patients / 中国实用护理杂志

Objective To study the effects of collaborative care model on the negative mood and the quality of life of lung cancer patients. Methods Sixty patients were randomized into the observation group and the control group with 30 cases in each.The control group only received usual care,the observation group Was treated with collaborative care,encouraging patients and their families to participate in health care.Using SDS、SAS、activities of daily living(ADL)scale and St.George's Respiratory Question-naire(SGRQ)to evaluate the effects ofthe patients in both groups on admission and one months after the discharge.Results One months after the discharge,the scores of anxiety and depression among the observation group were lower than those of the control group;ADL grade and quality of life score in the observation group compared with the control group were significantly improved,the difference was statistically significant. Conclusions Application of collaborative care management can improve the state of anxiety and depression,reduce hospitalization time and medical costs as well as improve quality of life.