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.

Application and research progress of different chronic disease management models in rheumatoid arthritis in China / 中国实用护理杂志

The chronic disease management of rheumatoid arthritis has been popularized and applied in China. This article will review the application and research progress of different chronic disease management models, including chronic care mode, chronic disease self-management, transitional care mode, community-based chronic disease management, and "internet + chronic disease management" in rheumatoid arthritis patients in China, and compare the advantages and disadvantages of different intervention models, in order to provide a theoretical basis for exploring the chronic management of rheumatoid arthritis under different regional medical resources.

Atención colaborativa para depresión y prevención de suicidio: una intervención viable en el sistema de salud mexicano / Collaborative care for depression and suicide prevention: a feasible intervention within the Mexican health system

Resumen: México enfrenta un enorme desafío para atender los trastornos mentales, con la depresión como uno de los principales contribuyentes a los años de vida ajustados por discapacidad (AVAD) y el aumento de las tasas de suicidio. Estos desafíos se combinan con la escasez de recursos y asignación ineficiente de fondos. Si bien no hay una solución mágica a corto plazo, discutimos experiencias actuales que podrían usarse para brindar una mejor atención primaria en salud mental. Nos centramos en depresión y conducta suicida argumentando que la atención colaborativa es un modelo factible y replicable, enfatizando la capacitación del personal no especializado para que se convierta en administrador de casos y brinde atención primaria en salud mental. México está experimentando un proceso de cambios, incluido el surgimiento de la atención médica universal, por lo que es el momento para que la atención en salud mental sea más transversal, disponible y científicamente probada.

Abstract: Mexico faces an enormous challenge in attending mental health disorders with depression rising as one of the five main contributors to disability adjusted life years (DALYs) and increasing suicide rates. These challenges are coupled with a dearth of resources and an inefficient allocation of the meager funds. While no magical bullet is available to ameliorate this situation in the short term, here we discuss current concepts and experiences that could be used in Mexico to deliver better primary mental health care. We focus on depression and suicidal behavior and argue that collaborative care is a feasible and replicable model, emphasizing the importance of training non-specialized primary care personnel to become case managers and provide primary mental health care. Mexico is currently undergoing a process of changes, including the emergence of universal health care. The time seems right to make mental health care more transversal, widely available and scientifically proven.

Associations between primary health care strategies and outcomes of mental disorders

Objective: To investigate associations between the percentage and severity of mental disorders (MD) and three different primary health care (PHC) strategies in Brazil: traditional care (TC), the Family Health Strategy (FHS), and FHS with shared mental health care (FHS+SC). Methods: Random samples were selected from three different areas of a Brazilian city. Each area was served by a different PHC strategy (TC, FHS, or FHS+SC). Five mental health professionals, blinded to the type of PHC strategy delivered in each area, conducted interviews using the Mini International Neuropsychiatric Interview (MINI) and other specific instruments to assess the prevalence and severity of MD. Results: 530 subjects were interviewed. The TC strategy was significantly associated with a higher percentage of MD when compared to FHS and FHS+SC. These results were not affected by adjustment for sociodemographic variables. The difference in prevalence of MD between the two FHS areas (with and without SC) was not statistically significant. No significant differences in MD severity were observed across the three PHC strategies. Conclusion: Areas covered by FHS showed a lower percentage of MD than those covered by TC. Presence of SC did not influence the prevalence of MD, suggesting that mental-health training of FHS teams may have minimized the influence of SC.

Componentes do apoio matricial e cuidados colaborativos em saúde mental: uma revisão narrativa / Components of matrix support and collaborative mental health care: a narrative review

Resumo Cuidados colaborativos entre saúde mental e atenção primária são efetivos em melhorar desfechos de saúde. O apoio matricial tem semelhanças com cuidados colaborativos pouco exploradas na literatura. Este artigo compara os dois modelos e analisa o apoio matricial a partir de evidências sobre cuidados colaborativos. Revisão narrativa. Componentes de cada modelo (atividades e dimensões) foram identificados e comparados. Evidências sobre cuidados colaborativos informaram análise de componentes semelhantes do apoio matricial. Foram identificadas dimensões do apoio matricial - suporte educacional, cuidado especializado, regulação, cogestão - e dos cuidados colaborativos - cuidado multiprofissional, comunicação sistemática, cuidado estruturado, suporte organizacional. A principal semelhança entre os modelos está nas atividades colaborativas diretas em torno de problemas clínicos, relacionadas a efetividade em estudos sobre cuidados colaborativos. Atividades colaborativas diretas são ponto positivo do apoio matricial. Cuidado estruturado e suporte em nível organizacional devem ser encorajados. Futuros estudos devem refinar as categorias propostas e explorar seu uso para desenvolvimento do apoio matricial.

Abstract Collaborative care between mental health and primary care is effective in improving health outcomes. The matrix support has similarities with collaborative care little explored in the literature. This article compares the two models and analyzes the matrix support from evidence on collaborative care. Narrative review. Components of each model (activities and dimensions) were identified and compared. Evidence on collaborative care informed analysis of similar components of matrix support. The dimensions of the matrix support - educational support, specialized care, regulation, co-management - and collaborative care - multiprofessional care, systematic communication, structured care, organizational support - were identified. The main similarity between the models lies in the direct collaborative activities around clinical problems which is related to effectiveness in collaborative care studies. Direct collaborative activities are a positive aspect of matrix support. Structured care and support at the organizational level should be encouraged. Future studies should refine the proposed categories and explore their use for the development of matrix support.

Initiation of pharmacist–psychiatrist collaborative patient education in ambulatory care settings of a tertiary care teaching hospital in south India

The aim of this study is to initiate the pharmacist–psychiatrist collaborative patient education in ambulatory caresettings. A prospective cohort study was conducted in psychiatry out-patient department of a tertiary care teachinghospital over a period of 6 months. All the eligible patients were enrolled, and the necessary information was collected.The collected data were analyzed for medication adherence by using medication adherence rating scale and healthrelated quality of life by using the World Health Organization Quality of Life questionnaire. Student t-test was usedto analyze the results at p-value <0.05. A total of 210 patients were analyzed and followed for a period of 6 months.When compared to the baseline values, a significant improvement in medication adherence and quality of life witheach follow-up at p-value <0.05 was observed. The study results have evidently proven that pharmacist–psychiatristcollaborative approach could significantly improve patient education and related clinical outcomes.

O apoio matricial na Atenção Primária em Saúde no município do Rio de Janeiro: uma percepção dos matriciadores com foco na Saúde Mental / The matrix support in primary health care in Rio de Janeiro municipality: the matrix workers' perception in Mental Health

Resumo Os cuidados adequados em saúde mental são considerados um desafio para a saúde pública. A integração desses cuidados com a Atenção Primária à Saúde (APS) é a principal estratégia segundo a OMS. Nesta direção, no Brasil, a criação do Núcleo de Apoio à Saúde da Família (NASF) foi um avanço, composto por uma equipe multidisciplinar que tem como principal ferramenta de trabalho o apoio matricial. O objetivo deste estudo foi analisar e explorar as percepções do trabalho dos matriciadores de saúde mental do município do Rio de Janeiro. Trata-se de uma pesquisa qualitativa, que usou grupo focal integrado à técnica do aquário, com 26 matriciadores de oito áreas programáticas. A análise de conteúdo se deu pela Análise Estruturada. Foi possível identificar questões que versam sobre os dilemas da formação de profissionais para APS e Saúde da Família, concepções diversas sobre apoio matricial, os impactos para profissionais e pacientes de questões sobre violência e sobrecarga de trabalho, além do suporte da gestão. Concluiu-se que, embora o NASF tenha apresentado avanços importantes na atenção à saúde, ainda é preciso haver uma integração maior dos profissionais e usuários para maior clareza do trabalho dos matriciadores, visando a um fortalecimento das ações no âmbito do SUS.

Abstract Appropriate Mental Health care is considered a public health challenge. Integrating this care with Primary Health Care (PHC) is the main strategy according to WHO. In this direction, the creation of the Support Center for Family Health in Brazil was an advance, made up of a multidisciplinary team that has as main work tool the Matrix Support. This study aimed to analyze and to explore the perceptions of the work of the Mental Health matrix workers of the city of Rio de Janeiro. It is a qualitative research that used the Focal Group along with the aquarium technique with matrix workers from eight programmatic areas. Content analysis took place through Structured Analysis. It was possible to identify questions related to the dilemmas of the training of professionals for PHC and Family Health, different conceptions about matrix support, impacts for professionals and patients on issues of violence and work overload, and management support. It was concluded that although the SCFH has presented important advances in health care, there is still a need for greater integration of professionals and users for greater clarity of the work of the matrix workers, aiming at strengthening SUS actions.

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 to Relieve Psychological Distress in Patients with Medically Inoperable Lung Cancer: Design and Rationale for a Clinical Trial

Psychological distress is common in lung cancer patients with a poor prognosis. The present study aims to investigate the efficacy of collaborative care for patients with newly diagnosed inoperable lung cancer in South Korea. The study is a three-arm parallel-groups non-randomized clinical trial with an active arm that includes distressed patients who receive collaborative care, one comparison arm that includes distressed patients who receive enhanced usual care, and another comparison arm that includes non-distressed patients. In total, 267 consecutive patients newly diagnosed with medically inoperative lung cancer will be recruited. The primary outcomes are the changes in Hospital Anxiety and Depression Scale-depression and the Distress Thermometer at 12 and 32 weeks after enrollment. Sub-analyses of patients in the active arm of the study will include a comparison of the efficacy of a combination of oral antidepressant (escitalopram) treatment and collaborative care versus that of collaborative care alone.

Violência urbana e saúde mental: desafios de uma nova agenda? / Urban violence and mental health: challenges of a new agenda?

Resumo O fenômeno da violência produz impactos importantes para o setor saúde, seja como fator de agravo à população, ou como barreira de acesso aos serviços. Este artigo é uma nota preliminar de pesquisa exploratória qualitativa. Faz uma revisão sucinta da literatura sobre violência urbana e agravos psicossociais, descreve e analisa o desenvolvimento das ações de saúde mental do Núcleo de Apoio a Saúde da Família (NASF), num contexto de violência. Conclui que, apesar das limitações, a iniciativa do NASF mostra-se valiosa, como vetor de cuidado à população e aos profissionais de atenção primária, e articulador das estratégias psicossociais no território.(AU)

Abstract The phenomenon of violence produces severe impact on health sector, as related to the population diseases and suffering as barrier of access for medical services. This article is a preliminary note of explorative qualitative research. The article performed a small literature review about urban violence and its psychosocial consequences, describes and analyses the mental health activities from supervision teams of Family Health Program (NASF) in a context of urban violence. Preliminary conclusions show that, despite limitations, the NASF initiative adds value, as support of care for population and professionals, and as a tool to integrate psychosocial strategies in the territory.(AU)

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 nursing on the quality of life and care ability of stroke patients / 现代临床护理

Objective To explore the effect of collaborative nursing on the quality of life and nursing of stroke patients. Methods Toally 84 care-givers for 84 stroke patients hospitalized during February 2014 to March 2016 were chosen. In the control group(hospitalized from Feburary 2013 to Feburary 2014), traditional nursing was carried out, while in the research group(hospitalized from March 2014 to March 2016), the collaborative care intervention was done. The comparisons were done between the two groups in terms of quality of life and care ability by the GHQ-28 quality of life scale assessment, family caregiver task inventory (FCTI) before the intervention and 4 weeks after the intervention. Results Before the intervention, the two groups had no significant differences in life quality and care ability (all P > 0.05). After the intervention, the scores on symptoms, anxiety, depression, insomnia and social dysfunction were all significantly higher than those of the control group (all P<0.05). The scores on the care role, strain, assistance, personal emotion control, family assessment and community resources, and adjustment of life to meet the care needs were all significantly lower than those of the control group (all P<0.05). Conclusions The collaborative care is effective in improving the quality of life of stroke patients. It can improve the care ability of the caregiver.

Effect of collaboration care model on diseases attitude and self-efficacy of patients with chronic hepatitis B / 中国实用护理杂志

Objective To investigate the effect of collaborative care model on diseases attitude and self-efficacy of patients with chronic hepatitis B. Methods Ninety-six cases of patients with chronic hepatitis B were selected. Forty-seven cases who were hospitalized from June 2015 to December 2015 were seemed as the control group, while 49 cases who were hospitalized from January 2016 to June 2016 were seemed as the collaboration group. Patients in control group were accepted routine care measures for chronic hepatitis B. Patients in collaboration group were accepted collaboration care measure on the basis of routine care, including patient assessment and collaboration care program development, health knowledge for patients and their families guiding and basic skills training, and psychological guidance intervention. Respectively, at admitting to hospital and after intervention 4 weeks, the diseases attitude of patients with chronic hepatitis B diseases, self-care ability and self-efficacy were assessed. Results There were no significant differences in attitude score, self-care ability score, self-efficacy score before intervention between two groups (P>0.05). They were improved after intervention compared with before intervention, the difference was statistically significant (t=3.197-25.376, P<0.01 or 0.05). The attitude in the face, avoid and give up score respectively in collaborative nursing group after intervention were (28.2±5.3), (9.8±4.2), (5.1±1.7) points, and (23.4±4.1), (14.1±3.8), (8.2±1.9) points in control group, the difference was statistically significant (t = 4.393, 4.220, 9.285, P < 0.01). The health knowledge of self-care ability, self-care skill, since the sense of responsibility, self-concept scale in collaborative nursing group after intervention were (48.2±3.4), (39.5±4.0), (33.1±5.5), (29.1±3.7) points, and (39.4±4.2), (30.2± 3.5), (24.7±4.8), (25.2±3.5) points in control group, the difference was statistically significant (t=5.137-11.286, P<0.01). The self-efficacy in each entry score and total score in collaborative nursing group were (3.4 ± 0.7), (31.5 ± 4.6) points and (2.8 ± 0.4), (20.7 ± 5.1) points in control group, the difference were statistically significant (t=5.288, 14.579, P<0.01). Conclusions Collaborative care model could help chronic hepatitis B patients to establish correct disease attitude, improve self-care ability and enhance self-efficacy.

La salud mental y la atención primaria en México. Experiencias de un modelo de atención colaborativa / Mental health and primary care in Mexico. Experience of the collaborative care model

Resumen: INTRODUCCIÓN: En México, existe poca experiencia en el desarrollo de modelos en atención primaria en salud mental. OBJETIVO: Estructurar y aplicar un modelo de atención colaborativa en salud mental, basado en evidencias científicas probadas en otros países. MÉTODO: Se diseñó un modelo acorde a las características del sistema de salud de la Ciudad de México. El modelo consistió en: la capacitación del equipo de salud para detectar posibles casos, la aplicación del instrumento de tamizaje (K-10), para el diagnóstico de depresión y ansiedad, así como realizar reuniones de atención colaborativa entre los médicos generales y el especialista en psiquiatría para la supervisión de casos. Se aplicó una entrevista de opinión a los médicos generales. RESULTADOS: Se capacitaron 104 profesionistas. Durante tres años se detectaron 830 (50.5%) posibles casos, se valoraron el 38% de éstos en sesiones de atención colaborativa entre el médico general y el psiquiatra. El 50% de las sesiones fueron suspendidas por motivos administrativos principalmente; la asistencia de los médicos generales y de los pasantes de medicina fue regular. DISCUSIÓN Y CONCLUSIÓN: El modelo de atención colaborativa entre el médico general y el especialista en este contexto puede funcionar. Sin embargo, se deben resolver algunas barreras administrativas, como la organización de los servicios y el número de programas que se desarrollan en el primer nivel de atención. Ante esta limitación, y dada la experiencia, se propone que los estudiantes de servicio social de medicina se involucren en este tipo de modelos, con el apoyo de los médicos generales.

Abstract: INTRODUCTION: In Mexico, there is scarce experience on the development of mental health primary care models. OBJECTIVE: The goal of this work was to structure and apply a collaborative care model in mental health based on scientific evidence proven in other countries. METHOD: A model complying with the characteristics of Mexico City's health system was designed. The model was composed of: training sessions for the health team to detect possible cases, application of a screening instrument (K-10), diagnostics of depression and anxiety, and collaborative care meetings, among general practitioners and the specialist (psychiatrist) to oversee cases. An opinion interview about the model was applied to general practitioners. RESULTS: One hundred and four professionals were trained. During the three years, 830 (50.5%) possible cases were detected; 38% of them were evaluated in collaborative care sessions between the general practitioners and the psychiatrist. Half the sessions were cancelled, mainly for administrative reasons. The assistance of medical practitioners and pregraduate medical education was regular. DISCUSSION AND CONCLUSION: A collaborative care model between the general practitioner and the specialist is feasible in this context. However, some administrative barriers -such as the organization of services and the number of programs developed at the primary care- should be solved, because there are other programs demanding from them the exclusiveness of time. In the light of this limitation, and given the collaboration in the project, it is proposed that pregraduate medical education students involve themselves in this type of models with the support of general practitioners.

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.

Study on the effect of collaborative care on job burnout and turnover intention among township hospital phy-sicians / 中华医院管理杂志

Objective To learn the burnout and turnover intention of physicians from township hospitals in Xi County,Henan province,for reference of health administrators and healthcare institution managers.Methods Cluster sampling method and qualitative interviews were used and all physicians from such hospitals were sampled for questionnaire survey in 2014,with 1 70 scales distributed.The questionnaire was the Markov Burnout Inventory generic version revised by Li Chaoping,and turnover intention questionnaire was that revised by Liang Kaiguang.Results 140 physicians from such hospitals were found with zero or low burnout (94.6%);Collaborative care in the county poses great positive effect on promoting professionalism and interpersonal relations, yet has limited positive impact on reducing workload and performance appraisal stress and increasing their income.Conclusion It is imperative to enhance training of managers of such hospitals for them to learn the appraisal method with organizational scale,and build a humanistic concern mechanism for physicians,for purposes of improving the organizational environment and minimize the burnout and turnover intention of the physicians.

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.

Effectiveness evaluation on the mode of Improving Mood-Promoting Access To Collaborative Treat-ment (IMPACT) for late-life depression / 上海预防医学

To discuss the effectiveness of the IMPACT mode for late-life depression . [ Methods] From Shanghai Pudong mental health network system , 60 cases of elderly depressions were cho-sen according to the criteria for case reqirement .Of the 60 cases , 30 were allocated into the intervention group who were treated with 18 months'IMPACT.The other 30 were included in the control group , who were treated with routine management for psychiatric rehabilitation .Depressive symptoms and medication compli-ance scores were compared and assessed at 6,12 and 18 months before and after intervention by using the hamilton depression scale ( HAMD) , self-rating depression scale ( SDS ) and the insight and treatment atti-tude questionnaire ( ITAQ) .Comparison was also made in re-hospitalization during intervention between the two groups .The patients'quality of life was analyzed and compared between the two groups by 36-items short form health survey (SF-36). [Results] The HAMD and SDS scores in intervention group were signifi-cantly lower than those in control group at 6,12 and 18 months after intervention (Pall<0.05).ITAQ scores were higher than those in control group (P<0.05).According to the SF-36 scores, the bodily pain, general health, vitality, social functioning and mental health scores in intervention group were extremely higher than those in control group (Pall<0.05).There was not one case of recurrence in intervention group , however, there were 6 cases of recurrence in the control group , the recurrence hospitalization rate being 20%(χ2 =6.67, P<0.05). [Conclusion] IMPACT mode for late-life depression could relieve depressive symptoms effectively , thus reducing the recurrence hospitalization rate and improving the quality of life for patients .

A brief review of research on chronic disease management based on collaborative care model in China / 中南大学学报(医学版)

Objective: To evaluate the situation for chronic disease management in China, and to seek the method for improving the collaborative management for chronic diseases in community. Methods: We searched literature between January 2008 and November 2013 from the Database, such as China Academic Journal Full-Text Database, and PubMed. The screening was strictly in accordance with the inclusion and exclusion criteria and a summary was made among the selected literature based on a collaboration model. Results: We got 698 articles atfer rough screen and ifnally selected 33. All studies were involved in patient’s self-management support, but only 9 studies mentioned the communication within the team, and 11 showed a clear team division of labor. Conclusion: Chronic disease community management in China displays some disadvantages. It really needs a general service team with clear roles and responsibilities for team members to improve the service ability of team members and provide patients with various forms of self-management services.