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This study aimed to explore the correlation between traditional Chinese medicine(TCM) and reduced risk of readmission in patients having rheumatoid arthritis with hypoproteinemia(RA-H). A retrospective cohort study was conducted on 2 437 rheumatoid arthritis patients in the information system database of the First Affiliated Hospital of Anhui University of Chinese Medicine from 2014 to 2021, and 476 of them were found to have hypoproteinemia. The patients were divided into TCM users and non-TCM users by propensity score matching. Exposure was defined as the use of oral Chinese patent medicine or herbal decoction for ≥1 month. Cox regression analysis was performed to explore the risk factors of clinical indicators of rheumatoid arthritis. Additionally, the use of TCM during hospitalization was analyzed, and analysis of association rules was conducted to investigate the correlation between TCM, improvement of indicators and readmission of patients. Kaplan-Meier survival curve was plotted to compare the readmission rate of TCM users and non-TCM users. It was found the readmission rate of RA-H patients was significantly higher than that of RA patients. By propensity score matching, 232 RA-H patients were divided into TCM group(116 cases) and non-TCM group(116 cases). Compared with the conditions in the non-TCM group, the readmission rate of the TCM group was lowered(P<0.01), and the readmission rate of middle-aged and elderly patients was higher than that of young patients(P<0.01). Old age was a risk factor for readmission of RA-H patients, while TCM, albumin(ALB) and total protein(TP) were the protective factors. During hospitalization, the TCMs used for RA-H patients were mainly divided into types of activating blood and resolving stasis, relaxing sinew and dredging collaterals, clearing heat and detoxifying, and invigorating spleen and resolving dampness. The improvement of rheumatoid factor(RF), immunoglobulin G(IgG), erythrocyte sedimentation rate(ESR), C-reactive protein(CRP) and ALB was closely related to TCM. On the basis of western medicine treatment, the application of TCM could reduce the readmission rate of RA-H patients, and longer use of TCM indicated lower readmission rate.
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Middle Aged , Aged , Humans , Medicine, Chinese Traditional , Drugs, Chinese Herbal/therapeutic use , Retrospective Studies , Patient Readmission , Arthritis, Rheumatoid/drug therapy , Hypoproteinemia/drug therapyABSTRACT
@#Telephone follow-up is one of the important ways to follow up patients. High-quality follow-up can benefit both doctors and patients. However, clinical research-related follow-up is often faced with problems such as time-consuming, laborious and poor patient compliance. The authors belong to a team that has been committed to the study of patient-reported outcomes for a long time. The team has carried out long-term follow-up of symptoms, daily function and postoperative complications of more than 1 000 patients after lung cancer surgery, and accumulated certain experience. In this paper, the experience of telephone follow-up was summarized and discussed with relevant literatures from the aspects of clarifying the purpose of clinical research follow-up, understanding the needs of patients in follow-up, and using follow-up skills.
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Objective:To explore the effect of nurse-led management model in adherence of patients with obstructive sleep apnea hypopnea syndrome (OSAHS) who underwent non-invasive mechanical ventilation.Methods:92 patients with severe OSAHS diagnosed by polysomnography(PSG) and treated with non-invasive mechanical ventilation in Tianjin medical university general hospital from September 2019 to August 2020 were enrolled. The patients were divided into intervention group (45 cases) and control group (47 cases) by random number table. Then, basing on routine treatment and subsequent visit, the patients in intervention group received regular telephone follow-up interviews within one week of ventilator purchasing, and the interview was based on a standard telephone follow-up manuscript designed by Duffy and lasted for six months. The patients in control group received routine nursing treatment and regular subsequent visit, and were not followed up by telephone, but were encouraged to have telephone consultation. The Epworth sleepiness scale(ESS) scores of the two groups before and after the intervention and the compliance of non-invasive mechanical ventilation of the two groups after the intervention were compared.Results:After the intervention, the ESS scores of the two groups were lower than those before the intervention ( P<0.001), and the ESS scores of the intervention group were lower than those of the control group ( P<0.001). After the intervention, the compliance of noninvasive mechanical ventilation in the intervention group was better than that in the control group ( P<0.001). Conclusions:The nurse-led management model in combination with telephone follow-up can improve the sleepiness of patients and the adherence of using non-invasive mechanical.
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Introduction: Our palliative care staff began the support activity in opioid introduction for outpatients with cancer at Komaki City Hospital in March 2018, because it was difficult to make them understand about proper use of opioid analgesics and misinterpretation about abuse at the time of opioid introduction in outpatient settings. This study aimed to evaluate the effects of the activity (patient education on pain control, telephone follow up, and assessment of the symptom). Method: Outpatients with cancer receiving strong opioids for pain relief from January 2017 to March 2019 were eligible. We retrospectively investigated the difference of the variables between baseline and after the activity as follows; the ratios of prescribing immediate-release opioids, antiemetics, and laxatives when opioids were prescribed and side effects due to opioid analgesics appeared. Results: The study included 122 patients. The prescribing ratios of immediate-release opioids antiemetics and laxatives all increased from 90.7 to 98.5%, from 63.0 to 70.6%, and from 61.1 to 70.6%, respectively. The side effect incidence due to opioids with STAS-J 2 or more decreased from 12 (22.2%) to 9 (13.2%). Discussion: The activity could contribute to the provision of drug treatments and counselling needed for opioid therapy.
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Objective To explore the long-term symptom development in functional bowel disorders (FBD) and the effects of lactose-restricted diet on the symptoms.Methods From January 2008 to December 2010,805 patients with FBD were included.Among them 245 patients who completed lactose hydrogen breath test and the lactose intake exceeded median value (48.75 g/month) were followed up with telephone interview.The changes of gastrointestinal symptoms,lactose intake and anxiety/ depression status of the patients were observed.Chi-square test,t test and inspection rank test were performed for statistically analysis.Binary Logistic regression analysis was used for influence factors analysis.Results Among 805 patients with FBD,there were 432 (53.7％) mild patients and 373 (46.3％) severe patients.The proportions of female patients,patients with gastrointestinal disease history (gastroenteritis,ulcers,chronic diarrhea etc.),anxiety,depression and irritable bowel syndrome (IBS) of severe patients were all higher than those of mild patients (50.4％,188/373 vs 40.3％,174/432;53.6％,200/373 vs 43.5％,188/432;29.5％,110/373 vs 16.9％,73/432;32.2％,120/373 vs 21.5％,93/432;77.2％,288/373 vs 45.1％,195/432),and the differences were statistically significant (x2 =8.60,0.90,18.10,22.10 and 8.20,all P＜0.05).Among 245 FBD patients included in telephone follow-up,144 cases (58.8％) were successfully followed up (follow-up group) and the follow-up duration was five to seven years.Since the first visit,some diseases have been detected including five cases of colonic polyps,three cases of ulcerative colitis (UC),three cases of gallbladder common bile duct stones,two cases of H.pylori-related peptic ulcer,one case of digestive tract hemorrhage and one case of chronic pancreatitis.The frequency scores of abdominal pain,abdominal distension,hard stools and loose stools were all lower than initial status (0 (0 to 1) vs 5 (3 to 6),0 (0 to 1) vs 3 (0 to 5),0 (0 to 0) vs 0 (0 to 1),0 (0 to 2) vs 2 (1 to 3));the general sensation improved compared with that of initial status (2(1 to 2) vs 3(3 to 4)),and the differences were statistically significant (Z=11.23,7.82,2.19,8.42 and 11.49,all P＜0.05).During follow-up,anxiety/depression symptoms of patients in follow-up group were improved (4 (3 to 4) vs 3 (3 to 4),1 (1 to 1) vs 2 (1 to 2));and the differences were statistically significant (Z=-5.81 and 5.06,both P＜0.01).The median value of lactose intake was decreased compared with before in follow-up group (27.0 g/month (3.0 g/month to 99.8 g/month) vs 135.1 g/month (91.6 g/month to 238.6 g/month));and the difference was statistically significant (Z=-0.14,P＜ 0.01).Lactose-restricted diet could improve the gastrointestinal symptoms including abdominal pain,bloating,loose stool and overall feelings of patients,and the differences were statistically significant (x2 =6.09,5.46,10.04 and 6.40,all P＜0.05).Conclusions Over time,there is still possibility that FBD developed into organic diseases.So the patients still needed close follow-up.Lactose-restricted diet could improve the symptoms of FBD.
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Objective:To evaluate effect of telephone follow-up combined with written instruction on compliance and Helicobacterpylori (H.pylori) eradication in patients with H.pylori infection.Methods:A total of 160 H.pylori positive patients were randomly divided into an experimental group and a control group (n=80 in each group).Ml the patients got the guide instruction named the guidance of clinical medication for H.pylori infection patients before the treatment.The patients in the experimental group were added individualized follow-up with telephone.The compliance,eradication ofH.pylori,adverse events,and satisfaction were compared between the 2 groups.Results:The eradication rate of H.pylori in the perprotocol analysis for the experimental group and control group were 64.4％ (47/73) and 56.5％(35/62),respectively (P=0.380),while in the intention-to-treat analysis,the rates were 58.8％ (47/80) and 43.8％ (35/80,P=0.082),respectively.The compliance rate in the experimental group was significantly higher than that in the control group (91.3％ vs 77.5％,P＜0.05).There was significant difference in patients' satisfaction in good ones (75.3％ vs 51.6％) and poor ones (5.5％ vs 21.0％) between the 2 groups (P＜0.05).There were 11 patients in the experimental group and 36 patients in the control group,who appeared adverse reactions such as nausea,bad breath,abdominal distention,poor appetite,and defecation habit change during the process of eradicating H.pylori,but the occurrence rate in the experimental group was obviously lower than that in the control group (15.1％ vs 58.1％,P＜0.05).Conclusion:The telephone follow-up cannot increase the H.pylori eradication rate,but it can improve compliance and satisfaction for the patients and relieve adverse effects.
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Objective To investigate the positive influence of telephone follow-up on primiparas′exclusive breastfeeding during puerperal period. Methods By using convenience sampling method, 90 primiparas were selected who had given birth in the integration ward of our hospital from October to December 2015 as the control group, and 60 primiparas were selected who had given birth in the integration ward of our hospital from December 2015 to January 2016 as the experimental group. For the experimental group, every 2 weeks, a telephone follow-up was executed according to primiparas′parturition time after leaving hospital. For the control group, telephone follow-up was not executed. The influence of periodic telephone follow-up on primiparas′ exclusive breastfeeding was observed. Results The exclusive breastfeeding rate of primiparas in the experimental group was increased as the telephone follow-up was executed. It was up to 91.7%(55/60) 6 weeks since parturition. The exclusive breastfeeding rate of primiparas in the control group was 71.1% (64/90). The difference was significant (χ2=9.28, P<0.01). Conclusions Periodic telephone follow- up according to necessity provides breastfeeding publicity and guidance after parturition, maintaining the continuous education and caring for the primiparas after leaving hospital which efficiently increased the pure breastfeeding rate of primiparas during puerperal period.
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Propósito:El objetivo de esta investigación fue determinar la efectividad de una estrategia de seguimiento telefónico asociado a mensajes de texto en la capacidad de agencia de autocuidado en pacientes con hipertensión arterial. Metodología:Se desarrolló un estudio clínico aleatorizado en 119 usuarios de la Fundación Oftalmológica de Santander-FOSCAL. En el diseño se conformaron dos grupos, un grupo intervención y un grupo control que fueron equivalentes en los procedimientos durante el estudio y se realizó la clasificación de manera aleatoria mediante Excel realizado por una persona externa al staff del estudio, con el siguiente esquema:Grupo intervención y Grupo control, en el cual se le aplicó la pre y post prueba (medición de la capacidad de agencia de autocuidado mediante el instrumento antes y después del seguimiento y el contacto telefónico y mensajería de texto al grupo intervenidocon un periodo de 2 meses. El instrumento que se utilizó fue Capacidad de agencia de autocuidado en pacientes hipertensos. Los datos fueron analizados Por el Software Stata Versión 11.0, para su respectivo análisis. Resultados:La capacidad de agencia de autocuidado de los pacientes hipertensos en el estudio posterior a la intervención de contacto telefónico y mensajería de texto demostró significancia con cambios importantes en las variables clínicas, cambios en los estadios de la hipertensión, mayor conocimiento de la enfermedad, actividad física, búsqueda en la orientación por el profesional de salud, alimentación saludable, mayor apoyo familiar.
Purpose: The objective of this research is to compare the effectiveness of followup telephone and text messages strategy against the conventional self-care in hypertension patients over self-care agency. Methodology: We conducted a randomized clinical study at the FundaciónOftalmológica de Santander-FOSCAL. 119 patients were randomly assigned in two equivalent groups to receive intervention of follow-up telephone and text messages strategy group against conventional care (control group). A pre and posttest of self-care agency were assessed (Using a descriptive instrument at the baseline and two months after). The instrument was used in hypertensive patients. The data were analyzed in Stata Software Version 11.0. Results: An intervention of follow-up telephone and text messages strategy in hypertensive patients showed significance with changes in clinical variables, changes in the stages of hypertension, increased knowledge of the disease, physical activity, guidance from the health professional, healthy eating, increased family support.
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Humans , Male , Female , Self Care , Text Messaging , Hypertension , Telephone , Exercise , Diet, HealthyABSTRACT
Objective To investigate the role of the QQ group follow up of nursing education on patients with nasopharyngeal carcinoma after radiotherapy in patients after they discharged. Methods Thirty patients with nasopharyngeal carcinoma hospitalized from January to December 2013 in our department were set as control group and another 30 patients with NPC hospitalized from January to December 2014 in our department were assined to in the experiment group. Patients of two group received health education before discharge . The controls were followed up on phone and the experimental group received QQ group follow up of education for one year, besides phone follow-up. The two groups were compared in terms of incidence of adverse reactions one year after discharge. Results One year after discharge , the incidences of side effects in the experiment group were lowered than those in the control group , and the differences were siguificant difference ( all P < 0 . 05 ) . Conclusion The QQ group follow up of nursing education can reduce the incidence of adverse reactions by radiotherapy after discharge.
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Objective To explore the application and effects of the specialized management of telephone follow-up in patients with tumor intermission of chemotherapy. Methods A total of 400 patients with tumor intermission of chemotherapy were randomly divided into the observation group and the control group with 200 cases in each group. Combined with the current general telephone follow-up and through the status of the investigation, content and process of specialized management of telephone follow-up in patients with tumor intermission of chemotherapy were designed and applied to the observation group. The control group did not implement the intervention except for the ordinary telephone follow-up. The two groups of patients were evaluated by self-designed questionnaire, the effect of follow-up and the satisfaction degree of the patients were evaluated. Results In the observation group (5 cases were lost to follow-up), the mental state steady, reasonable diet, moderate activity, understand medical medicine, law and adopt measures to prevent infection accounted for 73.85% (144/195), 74.36% (145/195), 67.69% (132/195), 80.51% (157/195) and 72.31% (141/195), 77.95% (152/195);while in the control group (8 cases were lost to follow-up), the proportion was 53.13% (102/192), 51.04% (98/192), 43.75%(84/192), 55.73%(107/192), 52.08%(100/192), 53.13%(102/192),χ2 values ranged from 16.84 to 27.41, P < 0.01. The satisfaction degree with follow-up time, health guidance and problem solutions during follow-up process of the observation group accounted for 67.69% (132/195), 69.23% (135/195), 86.15% (168/195), the proportion of the control group was 45.83% (88/192), 46.88% (90/192), 47.92%(92/192),χ2 values were 20.49, 49.01, 77.65 (P<0.01). Conclusions The specialized management of telephone follow-up will help to promote the treatment of patients with tumor intermission of chemotherapy of home care norms, improve the effect of follow-up and satisfaction.
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BACKGROUND: Patients were subjected to post-discharge follow-up (by telephone) in order to investigate the potential complications of outpatient general anesthesia or deep sedation that could develop in disabled dental patients discharged from the hospital. The ultimate aim of this study was to establish an appropriate response measure for such complications. METHODS: The caregivers of 79 disabled patients who underwent dental procedures under general anesthesia at our outpatient clinic were interviewed over telephone. Necessary care instructions were provided during the phone calls when required. The patient satisfaction level regarding the telephonic follow-up care was surveyed by additional telephone calls. RESULTS: Most of the patients did not suffer any serious complications; however, some reported fever and bleeding. The data obtained in this study can be utilized towards the development of caregiver education pertaining to the ambulatory general anesthesia of dental patients with disabilities. CONCLUSIONS: Additionally, we hope that the findings of this study will help minimize the effects of complications experienced by disabled dental patients undergoing ambulatory general anesthesia, as well as increase the overall patient satisfaction level.
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Humans , Ambulatory Care Facilities , Anesthesia, General , Caregivers , Deep Sedation , Education , Fever , Follow-Up Studies , Hemorrhage , Hope , Outpatients , Patient Satisfaction , TelephoneABSTRACT
Objective To investigate the influencing factors for post-discharge treatment compliance of patients with multidrug-resistant tuberculosis (MDR-TB).Methods MDR-TB patients who were hospitalized in a tubercu-losis hospital between November 2011 and January 2013 were chosen,post-discharge follow-up was conducted regu-larly through telephone call.Medicine-taking and re-examination of patients was inquired,factors influencing pa-tients’treatment compliance were analyzed.Results 299 patients were included in the study,the total treatment compliance rate was 81 .94% (n=245);249(83.28%)patients regularly took medicine,50(16.72%)didn’t regu-larly take medicine;254 (84.95%)were re-examined on time,45 (15.05%)were not re-examined on time;37 (12.37%)discontinued treatment,260 (86.96%)continuously treated till the survey deadline.Univariate analysis revealed that treatment compliance (including regular medication rate,timely re-examination rate,interrupted treat-ment rate,and total compliance rate)was significantly different among MDR-TB patients of different ages,education levels,treatment time,and with or without adverse reactions(all P <0.05 ).Logistic regression analysis revealed that treatment compliance of MDR-TB patients was negatively correlated with treatment time(β=-1 .47,Wald χ2=24.28,P <0.05)and adverse reactions(β=-2.02,Waldχ2 =24.24,P <0.05 ),while positively correlated with education levels(β=0.79,Wald χ2 =6.50,p <0.05 ).Conclusion Prolonged treatment time and adverse reactions can reduce the treatment compliance of MDR-TB patients,the higher education levels of MDR-TB patients have, the better treatment compliance they implement.
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Objective To investigate the effect of telephone follow-ups on medication compliance of elderly patients with coronary heart disease after percutaneous coronary intervention(PCI).Methods One hundred and sixty elderly patients with coronary heart disease undergoing PCI were randomly divided into control group(n=79)and experimental group(n=81).Conventional treatment with medication and telephone follow-ups per six months were administered to patients in control group after discharging from the hospital.Besides the same treatment as in the control group,8 telephone follow-ups were made within 12 months from discharging and additional follow-ups were performed if their medication compliance was poor.The two groups were compared in terms of medication compliance 12 months since discharging,and cardiovascular adverse events,readmission rates and restenosis rates within 1 year. Results The medication compliance in the experimental group was significantly better than that in the control group.The rates of cardiovascular adverse events,readmission and restenosis within 1 year were all significantly lower than those of control group(all P<0.05).Conclusion Telephone follow-ups can improve medication compliance of elderly patients with coronary heart diseases after PCI and thereby enhance the curative effects.
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Objective To analyze the telephone follow-up response rate and related factors in lung cancer patients thus to explore the countermeasures to increase the telephone response rate.Methods One thousand six hundred and eight post-surgery lung cancer patients were followed up by telephone interview,calculate response rates and analyze the impact factors on response rates of surgical patients. Results The lung cancer patients' overall response rate of one thousand six hundred and eight cases was 83.1%.Reservation phone type, phone number,family history of cancer are major factors affecting lung cancer patients' telephone followed up response rate(P<0.05). Conclusions Telephone follow-up of patients with lung cancer response rates is at a low level.To improve tumor response rates of follow-up and follow-up quality is a long and arduous task,requiring medical personnel continue to learn professional knowledge,summing up a reasonable follow-up methods,but also needing patients and their families to understand and cooperate.
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Objective To explore the influence of telephone follow-up after discharge on the re-admission rate of patients with chronic heart failure.Methods In total,161 patients were randomly divided into the observation(n=81)and control group (n=80).All participants received conventional guidance following discharge from our hospital.The patients in the observation group were subject to telephone follow-up for 6 months and individualized caring intervention.The re-admission rates after 6 months after discharge between two groups were statistically compared.Result The re-admission rate in the observation group was 30.9%, significantly lower compared with 42.5% in the control group(P<0.05).Conclusion The telephone follow-up combined with individualized caring intervention can reduce the re-admission rate among the patients with chronic heart failure.
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Objective To investigate the influence of telephone follow-ups on the compliance of syphilis patients.Methods The 120 patients diagnosed with syphilis during February 2010 to December 2011 were randomly divided into experiment group and control group with 60 cases in each group.The control group was given disease-related education during outpatient visits,while the experimental group received nursing intervention by phone calls.The two groups were compared in respect of curative compliance. Result The curative compliance of the experiment group after follow-ups was significantly better than that of the control group (P<0.01).Conclusion The telephone follow-ups can significantly improve the curative compliance of syphilis patients,which can significantly prevent the spread of syphilis.
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Objective To explore the effects of family and telephone follow-up on quality of life of the patients with tota1 hip arthroplasty(THA).Methods One hundred and twelve patients with THA were randomly divided into experiment group and control group with 56 cases in each group.The experiment group was treated with rehabilitative instruction by family and telephone follow-up.The control group was treated with outpatient follow-up after leaving the hospital.The living quality in both groups were compared by the medical outcomes study 36-item short-form health survey(SF-36 QOL)one year after leaving the hospital.Results One-year after leaving the hospital,the total score and demension score of experiment group were better than those of the control group.There was significant difference between the control group and in experiment group(P<0.05).Conclusion Family and telephone follow-up is an effective implementation for THA patients to accomplish physiological functional recovery and promote the quality of life.
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Objective To investigate the effect of telephone follow-up on peripherally inserted central cathter(PICC) maintenance.Methods Two hundred and eighty-nine patients with PICC in our hospital from January to December 2010 served as the control group,given conventional health education on intubation,another 305 patients with PICC from January to December 2011 were set as the observation group,where telephone call follow-up was done on the basis of conventional health education on intubation. The two groups were compared in terms of timely catheter maintenance,catheter-related complications,accidental extubation and satisfaction.Result The observation group was significantly better than the control group in terms of timely catheter maintenance, catheter-related complications,accidental extubation and satisfaction (allP<0.05).Conclusion Telephone follow-up helps to improve patients compliance with PICC catheter maintenance,effectively control the complications and improve the quality of life and satisfaction degree.
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Objective To explore the effect of WeChat education and telephone follow-up on reducing depression incidence of primipara in stegmonth.Methods One hundred and six primiparas who have got labored were numbered by the order of discharge from hospital and ramdomized in equal number into observation group(n=53)and control group(n=53)by random digit table. Both groups were re-diagnosed on time and the observation group also received WeChat education and telephone follow-up in order to compare the depression incidence of primiparas in both groups.Result The depression incidence of the observation group was lower than that of the control group and before intervention with statistical difference(P<0.05).Conclusion A communication platform is established between nurses and primiparas by WeChat education and telephone follow-up with subsequent, dynamic and individualized management mode, which has improved self-nursing ability of primipara and reduced the depression incidence in stegmonth.
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Objective To investigate the satisfaction degree of family members of children patients with the quality of nursing by follow-up analysis using telephone.Methods We used the high quality nursing questionnaire as the follow-up investigation.311 parents of the discharged pediatric patients were enrolled in this study,and answered the questionnaire within 1 ～2 weeks after their children were discharged from hospital.Meanwhile,we collected specific comments through asking questions by telephone.Then we analyzed and summarized the results by the content analysis.Results We found the total satisfaction rate was 96.65％ and there were three levels after qualitative analysis on the specific recommendations:evaluation of the hospital system,evaluation of professional knowledge and skills of the medical workers,evaluation of the attitude of the medical workers.Conclusions The parents of pediatric patients are satisfied with the high quality nursing which has pediatric features.However,what the parents focused on had already beyond the scope of the high quality nursing itself.We should expand the concept of quality service to every aspect of the hospital work,in order to meet the needs of the parents of pediatric patients in the department of pediatrics.