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Objective:To explore the effect of whole-process management mode based on "Internet + nursing service" in the management of children with concealed penis.Methods:This study adopted a quasi-experimental research method. A total of 383 children with concealed penis who were hospitalized in the Third Department of Urology of Hunan Provincial People′s Hospital from January 2018 to August 2021 were convenient selected. According to the sequence of admission, 195 children admitted from January 2018 to May 2020 were set as the control group, and 188 children admitted from June 2020 to August 2021 were set as the observation group. The control group was received conventional treatment and nursing, but the observation group was received whole-process management mode based on "Internet + nursing service". The length of hospitalization, incidence of complications after discharge, anxiety of the children′s parents and satisfaction of the doctors, the specialist & nurse sharing and the children′s parents were compared between the two groups.Results:Finally, 186 and 193 children were included in the observation group and the control group, respectively After the intervention, in the observation group, the length of hospitalization, anxiety score of the children′s parents, difference of anxiety score of the children′s parents, satisfaction content of the doctors, satisfaction effect of the doctors, satisfaction content of the specialist & nurse sharing, satisfaction effect of the specialist & nurse sharing, satisfaction content of the children′s parents and satisfaction effect of the children′s parents were (4.30 ± 1.35) d, (35.08 ± 3.17) points, (19.14 ± 4.35) points,(4.57 ± 0.54) points, (4.71 ± 0.49) points, (4.75 ± 0.50) points, (5.00 ± 0.00) points, (4.60 ± 0.49) points, (4.65 ± 0.49) points; in the control group, the scores were (5.50 ± 1.41) d, (44.79 ± 3.30) points, (9.22 ± 3.67) points, (3.71 ± 0.49) points, (4.00 ± 0.58) points, (3.50 ± 0.58) points, (3.25 ± 0.50) points, (3.54 ± 0.59) points, (3.64 ± 0.67) points. The differences between the two groups were statistically significant ( t values were -23.94-29.19, all P<0.05). The complication rates of the observation group and the control group were not statistically significant ( χ2=0.64, P>0.05). Conclusions:The whole-process management mode based on "Internet + nursing service" is beneficial to shorten the length of hospitalization, relieve the degree to anxiety of the children′s parents, improve the satisfaction of the doctors, the specialist & nurse sharing and the children′s parents, and accelerate the rehabilitation of children, which is worthy of clinical promotion.
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Objective:To explore the application effect of Internet-based hospital-institution linkage care management model in elderly care for the elderly of dementia.Methods:The research was a quasi-experiment study. A total of 80 elderly people of dementia from three combined medical and nursing institutions, Beijing Fangshan District Mental Health Care Hospital, Beijing Jinhai Hospital of Traditional Chinese Medicine, and Beijing Yiciyuan Nursing Care Center, were selected as the research objects by convenient sampling. The elderly people of dementia enrolled from May to August 2021 served as the control group, and elderly people of dementia enrolled from September to December 2021 served as the experimental group, with 40 cases in each group. Conventional management methods were taken in the control group, while Internet-based hospital-institution linkage care management model was taken in the experimental group. Before the intervention, at 3 months of intervention, the Mini-Mental State Examination (MMSE), Barthel index (BI) and Cohen Mansfield agitation behavior inventory (CMAI) were used to evaluate the cognitive function, activities of daily living and agitation behavior of two groups.Results:A total of 78 cases were included, including 39 cases in the experimental group and 39 cases in the control group, respectively. Before intervention, there was no significant difference in scores of MMSE, BI, and CMAI in the two groups of elderly people with dementia ( P>0.05). After 3 months of intervention, the score of MMSE in the experimental group was (17.36±5.67) points, which was higher than (15.05 ± 2.70) points of the control group, and the difference was statistically significant ( t=2.13, P<0.05). The score of CMAI in the experimental group was (34.18 ± 4.37) points, which was lower than (37.13 ± 5.06) points of the control group, and the difference was statistically significant ( t=2.76, P<0.05). There was no significant difference in BI scores ( t=0.13, P>0.05). Conclusions:The Internet-based hospital-institution linkage care management model improves the cognitive function and agitated behavior of the elderly with dementia in medical-nursing institutions.
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Objective:To compare and analyze the application of anti-vascular endothelial growth factor (VEGF) drugs for intravitreal injection in the real world before and after the establishment of one-stop intravitreal injection center, as well as the advantages and disadvantages of different management modes.Methods:A retrospective clinical study. A total of 4 015 patients (4 659 eyes) who received anti-VEGF drugs for ocular fundus diseases at the Tianjin Medical University Eye Hospital from July, 2018 to June, 2022 were included in the study. There were 2 146 males and 1 869 females. The ocular fundus diseases in this study were as follows: 1 090 eyes of 968 patients with wet age-related macular degeneration (wAMD); 855 eyes of 654 patients with diabetic macular edema (DME); 1 158 eyes of 980 patients with diabetic retinopathy (DR); 930 eyes of 916 patients with macular edema secondary to retinal vein occlusion (RVO-ME). A total of 294 eyes of 275 patients with choroidal neovascularization secondary to pathological myopia (PM-CNV); 332 eyes of 222 patients with other fundus diseases. A total of 13 796 anti-VEGF needles were injected. A total of 1 252 patients (1 403 eyes) from July 2018 to June 2020 were regarded as the control group. From July 2020 to June 2022, 2 763 patients (3 256 eyes) who received anti-VEGF treatment in the intravitreal injection center were regarded as the observation group. The total number of intravitreal injection needles, the distribution of anti-VEGF therapy in each disease according to disease classification, the proportion of patients who chose the 3+ on-demand treatment (PRN) regimen and the distribution of clinical application of different anti-VEGF drugs were compared between the control group and the observation group. The waiting time and medical experience of patients were investigated by questionnaire. χ2 test was used to compare the count data between the two groups, and t test was used to compare the measurement data. Results:Among the 13 796 anti-VEGF injections in 4 659 eyes, the total number of anti-VEGF drugs used in the control and observation groups were 4 762 and 9 034, respectively, with an average of (3.39±3.78) and (2.78±2.27) injections per eye ( t=6.900, P<0.001), respectively. In the control and observation groups, a total of 1 728 and 2 705 injections of anti-VEGF drugs were used for wAMD with an average of (5.14±4.56) and (3.59±2.45) injections per eye, respectively; a total of 982 and 2 038 injections of anti-VEGF drugs were used for DME with an average of (4.36±4.91) and (3.24±2.77) needles per eye, respectively. Additionally, a total of 942 and 2 179 injections of anti-VEGF drugs were injected for RVO-ME with an average of (3.98±3.71) and (3.14±2.15) injections per eye, respectively; a total of 291 and 615 injections of anti-VEGF drugs were injected for PM-CNV with an average of (3.31±2.63) and (2.99±1.69) injections per eye, respectively. A total of 683 and 1 029 injections of anti-VEGF drugs were injected for DR with an average of (1.60±1.26) and (1.41±1.05) injections per eye, respectively. The clinical application and implementation of "3+PRN" treatment were as follows: 223 (66.4%, 223/336) and 431 eyes (57.2%, 431/754) in the wAMD ( χ2=8.210, P=0.004), 75 (33.3%, 75/225) and 236 (37.5%, 236/630) eyes in the DME ( χ2=1.220, P>0.05), and 97 (40.9%, 97/237) and 355 eyes (51.2%, 355/693) in the RVO-ME ( χ2=7.498, P=0.006), 39 (44.3%, 39/88) and 111 eyes (53.9%, 111/206) in the PM-CNV ( χ2=2.258, P>0.05), respectively. In addition, the results of the questionnaire survey showed that there were significant differences between the control and observation groups regarding the time of appointment waiting for surgery ( t=1.340), time from admission to entering the operating room on the day of injection ( t=2.780), time from completing preoperative treatment preparation to waiting for entering the operating room ( t=8.390), and time from admission to discharge ( t=6.060) ( P<0.05). Conclusions:The establishment of a one-stop intravitreal injection mode greatly improved work efficiency and increased the number of injections. At the same time, the compliance, waiting time, and overall medical experience of patients significantly improved under centralized management.
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The global efforts aimed at preventing and controlling HIV infections have made remarkable progress. With the continuous accumulation of clinical evidence and the development of antiviral drugs, the treatment of HIV/AIDS has entered an era of chronic disease management. However, it has also brought about many challenges. Currently, some areas in prevention, control and management of HIV infection need to be further improved, and the long-term management model currently in use need to be further refined in China. The comprehensive whole-course management mode for HIV/AIDS, which is proved as effective and efficient means, should be widely recognized and vigorously promoted in order to provide reference and assistance for the clinical management of HIV infection in China.
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Objective:To explore the application effect of pre-hospital information publicity and education management model in patients with gastrointestinal tumors.Methods:The inpatients with gastrointestinal tumors who made an appointment in the outpatient department of the Affiliated Hospital of Qingdao University were randomly divided into 225 cases in the control group and 226 cases in the experimental group. The control group was treated according to the routine process, the experimental group implemented pre hospital information education and management, and the patients were individually assessed and health education through the official account of WeChat, Heals mobile education system, telephone communication and WeChat group.Results:After the implementation of pre-hospital information management model, the anxiety and depression scores of patients in the experiment group were (55.89 ± 15.53) and (56.19 ± 17.87), which were significantly better than those in the control group, (60.84 ± 15.42) and (62.28 ± 19.67) ( t = 3.40, 3.43, both P<0.01). The awareness rate of admission related knowledge (74% to 93%) and satisfaction with pre-hospital publicity and education management in the experimental group were also higher than control group ( χ2 values were 5.84-20.28, all P<0.05). The hospitalization rate of patients in the experimental group was 91.15%(206/226), which was significantly higher than that in thecontrol group, 81.78%(184/225), the difference was significant ( χ2 = 8.47, P<0.01). The secondary hospitalization rate in the experimental group was 8.41%(19/226), which was significantly lower than that in the control group, 19.11% (43/225)( χ2 = 10.90, P<0.01). Conclusion:The pre-hospital information publicity and education management model can improve the awareness rate of patients′ admission related knowledge, improve patients′ satisfaction with pre hospital publicity and education management, reduce the secondary hospitalization rate and shorten the average preoperative hospital stay, which is worthy of further promotion and application in clinic.
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Objective:By optimizing the fund management mode, a scientific research management platform with high efficiency can be created, which can innovate the vitality of scientific research and improve the level of scientific research management.Methods:Applying the scientific research fund management model based on information platform interconnects each system and forms a new fund management model.Results:The fund management mode based on the information platform standardizes the business process, reduces the risk of internal control and facilitates the scientific researchers and financial personnel to control and manage the quality of scientific research.Conclusions:The fund management mode based on the information platform achieves the management goals of improving work efficiency, standardizing business process, strengthening internal control and innovating scientific research vitality by integrating system resources and business process.
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Objective:To observe the construction of mobile health management model for elderly patients with coronary heart disease, and to conduct empirical research.Methods:A total of 86 elderly patients with coronary heart disease treated in Henan Provincial People's Hospital from January 2019 to January 2021 were selected.They were randomly divided into 2 groups: the control group receiving routine intervention(n=43), and the observation group receiving mobile health management mode as an add-on to routine interventions(n=43).After 3 months of intervention in control versus observation groups, angina, readmission risk factors were assessed, and status of target criteria for low-density lipoprotein cholesterol(LDL-C), resting heart rate, systolic, and diastolic blood pressure as readmission risk factors were evaluated.Before and 3 months after intervention, the self-care ability of patients was evaluated.Results:Number of angina pectoris attacks was less in observation(0.53±0.18)than in control group(0.64±0.15)( t=3.079, P=0.003).Duration of the angina pectoris was shorter in observation(2.72±0.40)min than in control group(3.06±0.55)min, ( t=3.278, P=0.002).Rate of achieving effectiveness of indicators for the risk factors of readmission was higher in observation group than in control group as following data: LDL-C(90.7% and 72.1%, χ2=4.914, P=0.027), resting heart rate(95.4% and 81.4%, χ2=4.074, P=0.044), systolic blood pressure(86.1% and 60.5%, χ2=7.182, P=0.007)and diastolic blood pressure(88.4% and 67.4%, χ2=5.472, P=0.019).The scores of self responsibility, health knowledge, self-care skills and self-concept were higher in the observation group than in the control group, with a statistical significant difference(all P<0.05). Conclusions:The construction of mobile health management model and its application in elderly patients with coronary heart disease are beneficial to improve the symptoms of angina pectoris, reduce the risk factors of readmission and improve the ability of self-care of patients.
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Chronic diseases have grown into a major public health threat affecting social development. The traditional management of chronic diseases tends to characterize " prioritizing treatment and neglecting prevention" . In this study, big data application, knowledge management, knowledge service and other theories and methods in the information management discipline were put in practice of chronic disease management. Thanks to the construction of a multi-source and heterogeneous chronic disease database, a chronic disease health knowledge analysis platform and a chronic disease service application platform, the following objectives were achieved. These included the data interconnections between patients′ self-testing data and medical institutions′ data in chronic disease data management, the integration and accurate delivery of chronic disease health knowledge, and personalized and accurate services covering the whole process of chronic disease management, namely prevention, diagnosis, treatment and rehabilitation.Since August 2019, this management mode has been used to build a diabetes big data platform. By January 2022, 380 million pieces of diagnosis, treatment and management data were collected from about 2.16 million residents, with the accuracy rate of 97.46% and the integrity rate of 96.07%. Corresponding knowledge base and service platform were built, and personalized service was provided to diabetes patients. These measures improvd the awareness rate, treatment rate, treatment control rate, science popularization and communication rate covering both diabetes patients and community residents.
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With the deepening of China′s medical reform, in order to further improve the utilization efficiency of medical resources, public hospitals have actively explored the establishment of different forms of hospital groups, made many useful attempts in the group operation mode, and accumulated a lot of experience. Taking the group construction practice of Peking University Third Hospital as an example, the authors probed into effective implementation paths for group construction of public hospitals from the aspects of management mode, governance structure, resource sharing, homogeneous management among others. By creating a management model of compact hospital districts, compact community health service centers, and semi compact trusteeship branches, the group had constantly refined the development path of discipline construction, and promoted the comprehensive integration and development of medicine, education, research. On such basis, the group had paved a solid and effective path in the aspects of expanding the influence of the hospital, and promoting the implementation of hierarchical medical service, for references in high-quality development of public hospitals.
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As an advanced medical management mode, attending physician responsibility system is an important means for public hospitals to promote refined management. The authors analyzed the characteristics and problems of the three-level rounds system, sorted out the concept and feasibility of attending physician responsibility system, summarized the exploration and practice of the attending physician in China, and put forward some suggestions on the implementation path of attending physician in China by strengthening medical quality management, making fully reasonable use of hospital resources, carrying out " two permits" and improving the supporting management system of the attending physician.
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Objective:To establish a supportive and effective management mode of scientific research project application, promote the capacity building of scientific research in the hospital.Methods:Retrospective analysis was conducted on the national and provincial scientific research projects of Xinhua Hospital Affiliated to Shanghai Jiaotong University Medical School from 2010 to 2019, and the practical effect of " point to point" management mode of scientific research project application was evaluated.Results:The funding rate of Xinhua Hospital, especially national scientific research projects and provincial talents projects, was greatly improved by adoption of the multi-dimensional " point to point" management mode of scientific research project application. The number of national scientific research projects increased from 34 (26.02 million) in 2010 to 72 (51.0851 million) in 2019.The number of provincial talents projects increased from 5 (1.05 million) in 2010 to 26 (6.5 million) in 2019.Conclusions:The " point to point" management mode of scientific research project application plays an important role in promoting the overall funding rate. Enhancement of comprehensive capacity of hospital scientific research can be achieved by further improvement of this management mode, early initiation and arrangement of funding application depending on the " close partner" entity, emphasizing scientific research talents cultivation.
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Objective:To investigate the effect of 1M3S nursing management mode combined with transcatheter arterial chemoembolization (TACE) on intestinal microecological distribution in patients with primary liver cancer.Methods:A total of 115 patients with primary liver cancer in Hai′an people′s Hospital from January 2017 to January 2020 were enrolled. Patients were divided into two groups according to the admission time. Patients ( n=56) receiving routine nursing care from January 2017 to December 2018 were set as control group, patients ( n=59) receiving 1M3S nursing management from January 2019 to January 2020 were set as observation group. Another 34 healthy individuals were set as healthy group from January 2017 to January 2020 in Hai′an People′s Hospital. The general data were collected in all three groups, and the serum levels of endotoxin (ET), alanine aminotransferase (ALT) and aspartate aminotransferase (AST) were detected. Fecal samples were collected, and 16S rDNA sequencing method was used to analyze the fecal flora structure and species relative abundance among groups, and alpha diversity was analyzed. Results:At the level of phylum, the dominant phylum of the three groups were Bacteroidetes, Proteobacteria and Firmicutes. After TACE, the ET, ALT and AST levels were (9.67±2.12) ng/L, (53.24±8.47) U/L, (55.48±8.15) U/L in the control group, (4.36±2.15) ng/L, (45.31±8.36) U/L, (47.25±8.21) U/L in the observation group ( t value was 13.328, 5.052, 5.392, P<0.05). Compared with the control group, there was an increase in the relative abundance percentage of Firmicutes( t value was 16.426, P<0.01) and Lachnospiraceae in the observation group ( t value was 4.527, P<0.01), and a decrease in the relative abundance percentage of Proteobacteria ( t value was 8.462, P<0.001) after intervention. Conclusions:TACE can affect the intestinal bacteria in patients with primary liver cancer, resulting in a decrease in the relative abundance of Proteobacteria, Lachnospiraceae, and an increase in the relative abundance of Firmicutes, while application of 1M3S nursing management mode can effectively reduce the level of endotoxin, improve liver function, and reduce the imbalance of intestinal flora caused by TACE.
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Objective To retrospectively analyze the results of neonatal diseases screening in Yichang from 2017 to 2019, understand the incidence and recall of the diseases, and explore the management mode of neonatal disease screening suitable for this region. Methods The subjects were newborns who were delivered in Yichang midwifery institutions from 2017 to 2019 and were screened for neonatal diseases. Heel blood of the newborns was collected for the screening of neonatal diseases, including congenital hypothyroidism (CH), phenylketonuria (PKU), G6PD deficiency, congenital adrenal hyperplasia (CAH) and thalassemia. Those newborns with positive initial screening were recalled for reexamination and confirmation. The recall rates of different diseases were compared by Chi-square test. Results There were 85 891 live births in Yichang area from 2017 to 2019, and 84 063 cases were screened for neonatal diseases, with a screening rate of 97.87%. A total of 6 043 cases were positive in the initial screening, of which 5,047 cases were recalled, with a recall rate of 83.52%. The recall rates of the traditional two diseases (CH and PKU) and the new three diseases (CAH, G6PD deficiency and thalassemia) were significantly different ( χ2= 197.93, P＜0.01). A total of 501 cases were diagnosed. The incidence rate of CH was 1/1,911, the incidence rate of PKU was 1/12 009, the incidence rate of CAH was 1/28 021, the incidence rate of G6PD deficiency was 1/1 121, and the incidence rate of thalassemia was 1/226. Conclusions The neonatal disease screening rate increased year by year in Yichang, but the recall rate of suspicious positive initial screenings decreased. It is necessary to explore a more suitable management mode for the five neonatal disease screenings in this region, improve the recall rate of children with positive screening, reduce the incidence of disabled children, and improve the quality of the birth population.
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Objective:To analyze the problems existing in the management mode of clinical research coordinator (CRC) in the new context, propose improvement measures and analyze the effectiveness of improvement.Methods:Four types of stakeholders related to CRC, including investigators, clinical research associates(CRA), institutional managers and human subjects were investigated in regular monthly questionnaire survey on the basis of CRC management comparasionat home and abroad. The new CRC management countermeasures implemented by our institution in July 2020 were taken as the time node, and the data from January to June 2020 were taken as the pre-implementation group, and the data from July to December 2020 were taken as the post-implementation group. Compare the monthly scores of CRCs′ work effect for 30 projects in the institution before and after the implementation of such countermeasures.Results:The scores of CRCs′ working effectiveness were improved after the implementation of CRC management countermeasures, whcih including standardizing the entry of CRC, updating of the training and assessment mechanisms, conducting regular communication meetings and developing reward and punishment measures. The scores from investigators increased by 20.17%, scores from CRAs increased by 11.54%, scores from institutional managers increased by 14.26%, scores from subjects increased by 10.64%, and the total scores increased by 14.13%( P<0.01). Conclusions:Countermeasures to optimize CRC management taken by drug clinical trial institutions can significantly improve CRCs′ working effectiveness in multiple dimensions.
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With the publication of Registration and Classification of Traditional Chinese Medicine （TCM） and Application Data Requirements， the related management and technical documents of TCM with the same name and prescription need to be further studied and formulated. In this paper， the management mode and technical evaluation of TCM with the same name and prescription are discussed to provide reference for the formulation of management and technical documents of TCM with the same name and prescription. The issues to be discussed include which management mode to adopt， how to select the control drugs with the same name and prescription， whether the indication risk level should be divided， whether the indication should be limited to medium and low risk， and how to carry out the technical evaluation of similarity/consistency. From the perspective of technical document research and formulation， this paper mainly focuses on the technical level. However， there are still other theoretical possibilities in the management mode and technical evaluation of TCM with the same name and prescription. Therefore， this paper， as a preliminary summary of the management and technical evaluation of TCM with the same name and prescription， needs more scholars and industry experts to pay attention to and participate in this work.
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Objective To introduce and conduct effectiveness evaluation of peer-group level care and management mode in people living with HIV and AIDS(PLHAs)in Jing'an District, Shanghai. Methods We recruited PLHAs who were managed by Jing'an District and participated in the peer-group care activities from 2015 to 2016, and collected their data of general conditions, behavior, antiretroviral therapy, life quality, social support, mental status and medical modes, and then conducted effectiveness evaluation of the mode by multivariate logistic regression model and linear regression model. Results A total of 300 PLHAs were included with 150 cases in each group. PLHAs in target group had higher proportion of antiretroviral therapy[82.7%(124/150)and 64.7%(97/150)]. In addition, they got higher scores in mental health(48.5±9.2 and 43.9±10.6)and social support(28.7±8.2 and 24.8±6.6), and lower scores in depressive severity index(0.5±0.1)and avoidance of medical modes(16.1±3.0 and 17.0±2.5). Multivariate analysis showed that PLHAs in target group had less sex partners(zero partner, OR = 2.1, 95%CI:1.1-3.9;one partner, OR = 3.6, 95%CI:1.9-6.8)and increased condom use(no sex, OR = 5.3, 95%CI:2.4-11.7;complete use, OR = 10.6, 95%CI:4.7-24.1;random miss, OR = 5.1, 95%CI:1.8-14.8)in the last 12 months. Conclusion The effect of peer-group level care and management mode is significantly good in promoting behavior change, enhancing health concern and increasing antiretroviral therapy.
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Objective To investigate the effect of comprehensive management mode intervention in elderly patients with moderate/severe chronic obstructive pulmonary disease at stable stage. Methods A total of 150 elderly patients with stable-stage COPD were randomly divided into two groups, 75 in each group. The control group received routine medication, while the observation group was given comprehensive management mode intervention, including health education,rational medication, pulmonary rehabilitation training and psychological guidance. Both groups were treated for 12 months. Differences in lung function parameters, modified Medical Research Council (mMRC) dyspnea scale, COPD assessment test (CAT), 6-minute walk test (6MWT), and frequency of acute exacerbation of COPD (AECOPD) were compared between the two groups. Results: After treatment, FEV1/FVC and FEV1%pred of observation group（57.65±11.62%、61.83±13.50%）were higher than control group（52.38±13.24%、53.42±13.93%）(P0.05). Within 12 months of treatment, the frequency of AECOPD in the observation group was less than that in the control group (P<0.05). Conclusions: In the treatment of elderly patients with moderate/severe chronic obstructive pulmonary disease, comprehensive management mode intervention can help delay the deterioration of lung function, correct the difficulty of breathing, improve the quality of life, and reduce the number of AECOPD.
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Objective To summarize the practical experiences of Clinical Research Unit (CRU) platform established by Xinhua Hospital affiliated to Shanghai Jiao Tong University School of Medicine,provide reference for domestic institutions that have prepared or to prepare to establish CRU platform.Methods Oriented by demand,this platform has set up six modules including project management module,methodology support module,data management module,quality risk management module,project transformation module and training and international exchange module.Besides,it also establishes and improves the corresponding module system,quality assurance,technical support and information data platform system.Results With this platform,the enthusiasm of departments to carry out clinical research has been continuously enhanced,the talent pool of clinical research has been expanded;the awareness of clinical research cooperation has been improved and the international cooperation fields have been further extended;the number of clinical research projects and funding have increased rapidly.Conclusions CRU Platform in Xinhua Hospital affiliated to Shanghai Jiao Tong University School of Medicine provides all-dimensional technical support and whole-process informatization management to improve clinical research quality and efficiency.While learning from the advanced international concepts,we still need to explore and improve the platform construction and management mode in line with general research-oriented hospitals in China,further to enhance the academic research internationally.
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[Objective]To ascertain the status and related factors of antiretroviral therapy adherence and analyze the influence of management mode on adherence in HIV infected patients in Jing' an District, Shanghai. [Methods]We recruited 150 HIV infected patients who participated in the "peer group care"activities (target group) and those from another 150 patients who did not (control group) but received antiviral treatment during the period from 2015 to 2016 (221 cases in total) into the study. We collected data on general conditions, behavioral way, antiretroviral therapy adherence, life quality, social support, mental status and medical coping modes, and analyzed the related factors of antiretroviral therapy adherence by linear regression model. [Results]The 221 HIV infected patients were included, with 124 in target group and 97 in control group. The proportion of good antiretroviral therapy adherence was 86.0％, with 91.9％ in target group and 78.4％ in control group. Multiple analysis showed that the related factors of antiretroviral therapy adherence were management mode (β = 1.871, P < 0.001) , disposable income per month (β = 0.600, P = 0.001) , social support utilization (β = 0.174, P = 0.044) and yield attitude of medical coping modes (β =-0.153, P = 0.003). [Conclusion]Antiretroviral therapy adherence of HIV infected patients in Jing'an District should be further improved. "Peer group level care and management mode"could effectively promote the increase of antiretroviral therapy adherence; however, it should be improved and perfected in the aspects of its coverage and content.
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Objective: To explore the application of digital nursing management mode in the management of endoscope instruments of urological surgery. Methods: The digital nursing management mode was adopted to carry out management training for personnel of operation room, and improve management process for instrument of urological surgery, and fortify measurements of cleaning and maintaining for instruments. And the endoscope instrument error rate of pre-operation, missing parts number and doctors' satisfaction between pre and post implementation of digital nursing management mode were compared and analyzed. Results: The digital nursing management mode reduced the error rate of endoscopic instrument for department of urology surgery (x2=5.351, P<0.05), and reduced the number of missing parts (x2=4.033, P=0.05), and enhanced doctors' satisfaction(x2=67.944, P<0.01). Conclusion: Digital nursing management mode can strengthen the standardized management for endoscopic instrument of urology surgery, and reduce the error rate of endoscope instrument pre operation and number of missing parts, and effectively enhance the doctors' satisfaction. Therefore, it is worthy to be popularized and applied.