Caracterización y evaluación de adherencia al programa Get With The Guidelines en pacientes con insuficiencia cardíaca aguda en un hospital de Bogotá, 2016-2018: Cohorte HUN-ICA

Introducción: la adherencia a estándares de manejo en insuficiencia cardiaca como la iniciativa Get With the Guidelines (GWTG) de la AHA puede disminuir los reingresos y mortalidad. Objetivo: describir las características clínicas de pacientes hospitalizados por insuficiencia cardiaca aguda y evaluar la adherencia a estándares de práctica clínica del programa "Get With The Guidelines", en un hospital universitario de Bogotá. Materiales y métodos: estudio observacional de la cohorte retrospectiva HUN-ICA correspondiente a 493 pacientes adultos hospitalizados entre abril 2016 y diciembre 2018 por insuficiencia cardiaca aguda, se registraron variables clínicas, tratamiento, mortalidad, reingresos y se evaluó adherencia a estándares de calidad del programa GWTG. Resultados: 52,1 % de la población fueron mujeres con una media de edad 75 años y el 67,8 % con FEVI >40 %. La etiología más común fue hipertensiva 58,5 % y la mayor causa de descompensación infecciosa (28,8 %). Aumentó la adherencia al uso de betabloqueadores en pacientes con fracción de eyección reducida al egreso de 46 % respecto al ingreso y al uso de antagonistas de receptor mineralocorticoide en pacientes con FEVI reducida de 61,1 %. Discusión: la cohorte evaluada presentó un perfil hemodinámico, clínico y adherencia en el manejo similar a cohortes nacionales. Las dosis subóptimas de la medicación al egreso justifican la necesidad de clínicas ambulatorias de insuficiencia cardíaca. Conclusiones: Se encontró menor adherencia para uso y dosis óptimas de betabloqueadores y antagonista mineralocorticoide que la de la cohorte GWTG, con incremento del uso de terapia farmacológica entre el ingreso y el egreso hospitalario.

Introduction: adherence to management standards in heart failure such as the AHA´s Get With the Guidelines-Heart failure initiative can reduce readmissions and mortality. Objective: To describe the clinical characteristics of patients hospitalized for acute heart failure and to assess adherence to program quality standards of the Get With The Guidelines Program in a university hospital in Bogotá. Methods: observational, descriptive and retrospective HUN-ICA cohort study. 493 adult patients hospitalized for acute heart failure, between April 2016 to December 2018. Clinical variables, treatment, mortality, readmissions and adherence to program quality standards defined by the GWTG program criteria were evaluated. Results: 52,1 % of the population were women, mean age was 75 years, (67,8 %) cases of heart failure with LVEF > 40 %. The most common etiology of heart failure was hypertensive (58,5 %). The most frequent etiology of decompen- sation was infectious (28,8 %). Adherence to beta-blockers use increased in patients with reduced ejection fraction at discharge of 46 %, and to the use of mineralocorticoid receptor antagonists in 61,1 %, compared to admission. Discussion: the evaluated cohort presented a hemodynamic, clinical profile and adherence similar to colombian cohorts. Suboptimal doses of medication upon discharge justify the need for outpatient heart failure clinics. Conclusions: lower adherence for use and optimal doses of beta-blockers and mineralocorticoid receptor antagonists than GWTG cohort was found, with increased use of guidelines recommended pharmacological therapy between hospital admission and discharge.

Effect of Triangle hierarchical management among community patients with hypertension / 预防医学

Objective@#To evaluate the effect of Triangle hierarchical management among community patients with hypertension, so as to provide insights into the improvements of standardized hypertension management.@*Methods@#Patients with newly diagnosed hypertension from 2 community health service centers in Qiantang District of Hangzhou City by the end of 2020 were randomly assigned to the conventional group and the Triangle group. Patients in the conventional group were given health management services according to the requirements of basic public health service standard for one year, while patients in the Triangle group were given Triangle hierarchical management. The blood pressure, self-management behaviors, treatment compliance, smoking, alcohol consumption and exercise were collected using the self-management behavior scale, treatment compliance scale and self-designed questionnaires, and were compared before and after intervention with analysis of covariance and generalized estimation equations.@*Results@#Totally 200 patients with hypertension were recruited, including 100 patients in the conventional group and 100 patients in the Triangle group. There were no significant differences between the two groups before implementation of interventions in terms of gender, age, educational level or occupation (P>0.05). The reduction in blood pressure, increase in the score of treatment, diet, exercise and living habitat management and the total score of self-management behaviors, increase in the score of adherence to medication regimens, daily living management behaviors, smoking and alcohol consumption preference and the total score of treatment compliance, and increase in the number of patients with normal standard of quitting smoking, quitting alcohol consumption, exercise and blood pressure were significantly higher in the Triangle group than in the conventional group after intervention (P<0.05). @*Conclusions @#Triangle hierarchical management may increase the treatment compliance, improve the self-management behavior and facilitate hypertension control among hypertensive patients, which may be popularized for health management among community patients with hypertension.

Compliance and factors influencing the treatment of diabetes mellitus in patients with mental disorders in a tertiary general hospital in Nantong / 公共卫生与预防医学

Objective To analyze the compliance and influencing factors of patients with mental disorders complicated with diabetes treatment in a third-class general hospital of Nantong City, and to provide theoretical basis for improving the compliance of patients with mental disorders complicated with diabetes treatment. Methods Among of 148 patients with mental disorders combined with diabetes admitted to our hospital from January 2021 to June 2022 were selected and divided into poor compliance group and good compliance group according to the investigation of diabetes treatment compliance. The blood glucose control of the two groups was compared, and clinical data of patients were collected from the medical record system. The independent risk factors affecting the compliance of patients with mental disorders and diabetes were analyzed. Results The levels of FBG, PBG and HbA1c in poor compliance group were significantly lower than those in good compliance group (P<0.05). The results showed that poor cognition of the disease (OR=2.649), paranoid psychosis (OR=0.371), low self-awareness and attitude score (OR=0.618), poor blood glucose control (OR=2.914) were independent risk factors affecting the compliance of patients with mental disorders and diabetes mellitus (P<0.05). Conclusion The compliance of patients with mental disorders combined with diabetes in the treatment of diabetes is not high and the control of blood sugar is not good. Mental health service outlets should be added to actively control the blood sugar of patients, focusing on paranoid mental patients and strengthening the publicity and education of guardians, which can improve the treatment compliance of patients and contribute to the prognosis of patients.

Treatment compliance and risk and protective factors for suicide ideation to completed suicide in adolescents: a systematic review

Objective: To review the literature regarding adolescent suicide risk and explore the associations between treatment compliance (expressed as a concept including measured adherence to treatment and/or mental health service utilization) and risk and protective factors for suicidal behavior (SB), as well as the association between treatment compliance and reattempts. Methods: PubMed, LILACS, and Google Scholar were searched using the following terms: (adolescent*) AND (suicide*) AND (risk factor OR protective factors) AND (treatment compliance OR treatment attrition OR treatment adherence OR treatment drop out OR treatment retention OR mental health utilization). We retrieved studies that focused on the relation of treatment compliance to risk and protective factors for SB and that had only adolescent samples. Results: Of 4,841 articles, 30 original articles were selected for review. Most studies indicated high mental health service (MHS) utilization and poor treatment adherence by SB patients. Social minority status and conduct disorder were associated with less treatment adherence, while female sex, parental perceived need for treatment, and major depression were associated with greater treatment adherence. Inpatient and intensive emergency care after SA and family interventions improved MHS utilization and treatment compliance. However, we found no substantial protective effect of treatment compliance against reattempts. Conclusion: Effective treatment planning for compliance requires considering psychopathology, treatment planning, and social, familial, and individual factors.

Clínica y tratamiento de la diabetes tipo 2 en adultos jóvenes en un hospital colombiano / Clinical presentation and treatment of type 2 diabetes in young adults in a Colombian hospital

Resumen Introducción: la diabetes mellitus tipo 2 (DM2) es el tipo más común de diabetes la cual ocurre generalmente en adultos, sin embargo, hay reportes que la describen en adolescentes y adultos jóvenes. Objetivo: describir las características clínicas y el tratamiento de la diabetes tipo 2 en adultos jóvenes en un hospital colombiano. Material y métodos: estudio de corte transversal entre el 2017 y 2019, que incluyó pacientes adultos jóvenes entre 18 y 40 años con DM2, que fueron atendidos en el Hospital Santa Mónica de Dosquebradas, Colombia. La unidad de análisis fueron las historias clínicas. Se incluyeron variables sociodemográficas, clínicas, farmacológicas y control metabólico (HbAlc < 7.0%). Se realizaron análisis descriptivos y se aplicó una regresión logística binaria (p< 0.05). Resultados: se identificaron 124 pacientes de los cuales 83 (70.0%) cumplieron criterios de inclusión, con una edad media de 33.7 ± 5.3 años. Unos 28 pacientes eran obesos (33.7%). Además, 21 pacientes (25.3%) presentaron control metabólico. Los fármacos más usados fueron metformina en 64 pacientes (77.1%), seguido de las insulinas en 46 pacientes (55.4%). Se estableció que 51 de estos (61.4%) presentaron adherencia al tratamiento. No hubo pacientes con terapia triple como estrategia terapéutica. Los pacientes con retinopatía diabética presentaban una probable asociación con tener control de la enfermedad en el momento del estudio (P=0.048, OR:0.130; IC95%:0.017-0.987). Conclusiones: los pacientes adultos jóvenes presentan pobre control metabólico y uso frecuente de insulinas. (Acta Med Colomb 2021; 46. DOI: https://doi.org/10.36104/amc.2021.1902).

Abstract Introduction: type 2 diabetes mellitus (T2DM) is the most common type of diabetes, generally occurring in adults. However, there are reports which describe it in adolescents and young adults. Objective: to describe the clinical characteristics and treatment of type 2 diabetes in young adults in a Colombian hospital. Materials and methods: a cross-sectional study from 2017 to 2019 which included young adult patients between 18 and 40 years old with T2DM who were seen at Hospital Santa Mónica in Dosquebradas, Colombia. The unit of analysis was the medical charts. Sociodemographic, clinical, pharmacological and metabolic control (HbA1c < 7.0%) variables were included. Descriptive analyses were performed, and binary logistic regression was applied (p<0.05). Results: 124 patients were identified, 83 (70.0%) of whom met the inclusion criteria, with a mean age of 33.7 ± 5.3 years. Some 28 patients were obese (33.7%). In addition, 21 patients (25.3%) had metabolic control. The most frequently used medications were metformin in 64 patients (77.1%), followed by insulin in 46 patients (55.4%). It was determined that 51 of these patients (61.4%) were compliant with treatment. No patients received triple therapy as a therapeutic strategy. Patients with diabetic retinopathy had a probable association with having the disease controlled at the time of the study (P=0.048, OR:0.130; 95%CI:0.017-0.987). Conclusions: young adult patients have poor metabolic control and frequent use of insulins. (Acta Med Colomb 2021; 46. DOI: https://doi.org/10.36104/amc.2021.1902).

Adherencia a medicación antineoplásica oral en oncología pediátrica. Estudio multicéntrico / Adherence to oral antineoplastic agents in pediatric oncology. A multicenter study

Objetivo. Determinar la adherencia de pacientes oncológicos pediátricos a la medicación oral del mantenimiento y conocer sus creencias sobre la medicación.Población y métodos. Durante 2018-19, se recogió información de padres, adolescentes y oncólogos en seis hospitales públicos pediátricos de la Argentina. Se administraron cuestionarios de adherencia (Simplified Medication Adherence Questionnaire) y de creencias sobre la medicación (Beliefs About Medicines Questionnaire). Se consideró adherente a quien refirió tomar la medicación sin saltear dosis y respetando el tiempo de ayuno.Resultados. N = 203 pacientes. La adherencia informada por los padres fue del 75 %; la estimada por los oncólogos, del 82 %, y la referida por adolescentes, del 45 %. Las variables que mostraron asociación con la adherencia fueron solvencia económica, diagnóstico, hospital tratante, cantidad de hijos a cargo, tratamientos oncológicos realizados y existencia de obstáculos en el cumplimiento. Esta muestra no percibía los medicamentos como dañinos, pero consideró que se los utilizaba abusivamente. La mayoría percibía la necesidad de tomar la medicación antineoplásica para mantener/recuperar la salud, pero también expresó preocupaciones. La percepción sobre la medicación fue similar entre los padres y los adolescentes, y no se asoció con el nivel de adherencia.Conclusiones. La adherencia informada por los padres en esta muestra fue del 75 %. Los padres y los pacientes percibían la medicación como necesaria y manifestaron preocupaciones vinculadas al tratamiento

Objective. To determine the adherence to oral maintenance medication among pediatric cancer patients and know their beliefs about medications.Population and methods. Information was obtained from parents, adolescents, and oncologists from six public children's hospitals of Argentina during 2018 and 2019. Questionnaires on adherence (Simplified Medication Adherence Questionnaire) and beliefs about medication (Beliefs About Medicines Questionnaire) were administered. Patients were considered adherent if they referred taking their medication without missing a dose and complying with fasting time.Results. N = 203 patients. Parent-reported adherence was 75 %; adherence estimated by oncologists, 82 %; and that referred by adolescents, 45 %. The outcome measures associated with adherence were financial solvency, diagnosis, treating hospital, number of children under the care of the caregiver, cancer treatments received, and presence of barriers in compliance. Sample subjects did not perceive medications as harmful, but considered they were overused. Most subjects perceived the necessity to take antineoplastic agents to maintain or recover their health, but also expressed their concerns. The perception about medication was similar between parents and adolescents, and was not associated with the level of adherence.Conclusions. In this sample, parent-reported adherence was 75 %. Parents and patients perceived a necessity for medication and expressed their concerns about treatment.

Application of multimedia combined with health education manuals in asthma children / 中国实用护理杂志

Objective:To observation the application of multimedia combined with health education manuals in asthma children.Methods:A total of 192 asthma children who were admitted to Haikou Hospital of the Maternal and Child Health between January and December 2019 were enrolled. They were divided into observation group and control group by random number table method, 96 cases in each group. The control group was given routine health education based on oral education, while observation group was additionally given multimedia intervention. Both groups were continuously intervened for 4 weeks. After intervention, treatment compliance was evaluated. The health behaviors and quality of life before and after intervention in both groups were recorded. Both groups were followed up after 6 months of intervention. The number of cases with acute asthma attacks, and number of re-admission and hospitalization cases due to asthma in both groups were statistically analyzed.Results:The compliance of observation group was significantly better than that of control group in terms of quantitative medication on time, inhaler usage and recording asthma diary ( Z values were 9.809, 10.082, 10.287, P<0.05). After intervention, health behaviors such as keeping away from allergens, medication following doctor's advice, paying attention to keep warm, diet control, exercise training and inhaler usage in observation group were significantly higher than those in control group ( χ 2 values were 5.169-19.006, P<0.05). After intervention, scores of symptoms, activities and emotion, and total score of Pediatric Asthma Quality of Life Questionnaire (PAQLQ) in observation group were (48.52±7.46), (25.16±4.83) (110.32±20.64) and (36.57±5.64) points, significantly higher than (42.17±7.12), (18.65±3.72), (29.86±5.48) and (85.06±16.23) points in control group ( t values were 6.146-10.463, P<0.05). During follow-up, the incidence rates of acute asthma attack, re-admission and re-hospitalization due to asthma in observation group were 21.89% (20/91), 15.38% (14/91), 9.89% (9/91), which were lower than 39.33% (35/89), 23.58% (29/89), 25.84% (23/89) in control group ( χ 2 values were 6.381, 7.321, 7.833, P<0.05). Conclusion:The multimedia combined health education manuals can effectively improve treatment compliance, health behaviors and quality of life in asthma children, and reduce incidence of asthma related events.

Effect of ear acupoint pressure pills combined with psychological intervention on psychological status and quality of life of patients with rectal cancer undergoing chemotherapy / 中国实用护理杂志

Objective:To explore the effect of ear acupoint pressure pills combined with psychological intervention on the psychological status and quality of life of patients with rectal cancer undergoing chemotherapy, provide the reference for patients with rectal cancer undergoing chemotherapy.Methods:A total of 220 patients with rectal cancer who received chemotherapy in Mianyang Central Hospital from August 2017 to October 2019 were selected as the research subjects. Random number table method was used to divide 220 patients with rectal cancer into observation group (110 cases) and control group (110 cases). Observation group was given ear acupoint pressure pills and psychological intervention, while control group was given psychological intervention only. The Self-rating Anxiety Scale (SAS) and Self-rating Depression Scale (SDS) were used to evaluate mental state; the European Cancer Research and Treatment Organization (EORTC) Quality of Life Questionnaire-Core 30 (QLQ-C30) was used to evaluate the quality of life.Results:There was no significant difference in the score of SAS, SDS and quality of life before intervention between the two groups( P>0.05). The SAS and SDS scores of the observation group after intervention were 46.47±4.00 and 46.33±3.17, which were lower than the control group (52.87±4.02, 51.03±4.18), and the differences were statistically significant ( t values were 11.836, 9.396, P<0.05). After intervention, the scores of physical function, physiological function, psychological function and social function in the observation group were 61.38±7.46,65.28±7.04, 62.20±8.15 and 75.21±9.05, respectively, which were all higher than those in the control group (56.41±6.01, 57.25±4.31, 57.26±7.94 and 64.82±8.40), and the differences were statistically significant ( t values were 4.554 -10.203, P<0.05). Conclusions:Ear acupoint pressure pills combined with psychological intervention can improve the psychological status and quality of life of patients with rectal cancer treated with chemotherapy and improve treatment compliance.

Effect of Internet continuity nursing on the psychological status and adverse reactions of the colorectal cancer patients receiving oxaliplatin chemotherapy / 中国实用护理杂志

Objective:To explore whether Internet continuous nursing can reduce anxiety and depression, chemotherapy-induced peripheral neuropathy, improve treatment compliance and reduce adverse reactions in patients with colorectal cancer undergoing oxaliplatin chemotherapy.Methods:A total of 69 patients with colorectal cancer in the Department of oncology, General Hospital of Northern War Zone from July 2019 to June 2020 were selected and divided into the observation group (34 cases) and the control group (35 cases) by random digits table method. The control group was given conventional nursing mode, and the observation group was given Internet continuity nursing mode. All patients were followed up to 3 months after the end of chemotherapy. The basic information, treatment anxiety and depression, chemotherapy-induced peripheral neuropathy, compliance, incidence of adverse reactions and patient satisfaction of the two groups were compared.Results:There was no significant difference in the anxiety and depression before and after chemotherapy, chemotherapy-induced peripheral neuropathy after chemotherapy( P>0.05). After 3 months of chemotherapy, the anxiety and depression and chemotherapy-induced peripheral neuropathy were (20. 97± 3.46),(14.27 ± 1.14) points in the observation group, and (24. 99 ± 1.11),(18.16 ± 2.55) points in the control group, the differences were statistically significant ( t values were 3.80, 5.09, P<0.05). In the control group, there were 19 cases of regular review, 20 cases of persistent chemotherapy, 21 cases of disease awareness, 21 cases of scientific diet, 19 cases of psychological compliance and 19 cases of self-protection. In the observation group, there were 28 cases of regular review, 29 cases of persistent chemotherapy, 30 cases of disease awareness, 28 cases of scientific diet, 30 cases of psychological compliance and 28 cases of self-protection. The treatment compliance in the observation group were significantly higher than those in the control group (χ 2 values were 4.186-9.657, P<0.05). In the control group, there were 7 cases of peripheral neurotoxicity, 2 cases of acute laryngopharyngeal paresthesia, 18 cases of gastrointestinal reaction and 4 cases of hematotoxicity. Fourteen cases of gastrointestinal reaction in the observation group. The incidence of adverse reactions in the observation group was lower than that in the control group, and the difference was statistically significant ( χ2 value was 8.26, P<0.05). In the control group, 6 were very satisfied, 27 were satisfied and 2 were good.The observation group was very satisfied and satisfied with 16 people and 18 people. The satisfaction in the observation group was higher than that in the control group, and the difference was statistically significant ( Z value was 1.853, P<0.05). Conclusions:Internet continuous nursing can effectively reduce the anxiety and depression of patients and chemotherapy-induced peripheral neuropathy, improve the treatment compliance of patients, reduce the adverse reactions after medication, and improve the quality of life of patients, which is worthy of application and promotion.

Effects of rehabilitation exercise on exercise tolerance and cardiovascular risk factors in patients with non-acute coronary syndrome after interventional therapy: A randomized controlled trial / 中国胸心血管外科临床杂志

@#Objective    To investigate the effects of rehabilitation exercise on exercise tolerance and cardiovascular risk factors in patients with non-acute coronary syndrome (non-ACS) after interventional therapy. Methods    A total of 102 patients with coronary heart disease and non-ACS in our hospital from December 2018 to June 2019 were selected and randomly divided into a control group (n=51, 30 males and 21 females with an average age of 56.1±4.8 years) and a trial group (n=51, 34 males and 17 females with an average age of 55.1±4.9 years). The control group received routine treatment, while the trial group received regular supervised rehabilitation exercise on the basis of routine treatment. Patients were followed up for 6 months to compare the differences in cardiovascular risk factors (blood pressure, blood lipid, fasting blood glucose), 6-minute walking distance (6MWD), adverse lifestyle changes and treatment compliance between the two groups after treatment. Results    The difference of 6MWD between the two groups was statistically significant (P<0.05). In the trial group, 6MWD increased after intervention compared with that before intervention, and the difference was statistically significant (P<0.05). Comparison of total cholesterol (TC), high density liptein cholesterol (HDL-C), low density liptein cholesterol (LDL-C) and fasting blood glucose in the trial group before and after intervention showed statistically significant differences (P<0.05). The differences in TC, HDL-C and LDL-C in the control group before and after intervention were statistically significant (P<0.05). It was statistically significant in dietary compliance rate, smoking cessation rate and alcohol cessation rate between the two groups (P<0.05); the differences in the dietary compliance and drug compliance of the trial group before and after intervention were statistically significant (P<0.05). Conclusion    Regular supervised rehabilitation exercise can significantly improve the exercise tolerance and cardiovascular risk factors of non-ACS patients after coronary intervention treatment, so as to improve the quality of life and long-term prognosis of non-ACS patients, which is worthy of clinical application.

Relación entre nivel de adherencia al tratamiento y apoyo social en pacientes con falla cardiaca / Relationship between Treatment Adherence Level and Social Support in Patients with Heart Failure / Relação entre nível de adesão ao tratamento e suporte social em pacientes com insuficiência cardíaca

Introducción: La falla cardiaca (FC) es una de las enfermedades cardiovasculares con mayor índice de hospitalizaciones en la unidad de cuidado intensivo. En esta enfermedad es imperativo determinar aquellos factores asociados con el reingreso, como la adherencia al tratamiento y el apoyo social. Objetivo: determinar la relación entre la adherencia al tratamiento y el apoyo social de pacientes con falla cardiaca. Método: se realizó un estudio correlacional, con muestreo no probabilístico; el tamaño de la muestra fue de 64 pacientes con diagnóstico de FC. Para la medición del nivel de adherencia, se utilizó la escala para evaluación de comportamientos de adherencia con un alfa Cronbach de 0,72, para medir la percepción del apoyo social; se empleó la escala Medical Outcomes Study Social Supportsurvey (MOS) con una alfa de Cronbach de 0,94. Se realizó un análisis descriptivo y, para establecer la relación del nivel de adherencia con el apoyo social, se aplicó la prueba de independencia de distribuciones categóricas de Fisher. Resultados: Los participantes, en su mayoría, se encontraron adheridos al tratamiento (56,2%); el índice global de apoyo social (media: 76,18) y sus dimensiones se encontraron en un rango medio. En cuanto a la asociación entre la adherencia al tratamiento, el apoyo social emocional (p: 0,006336) y el apoyo afectivo (p: 0,03025), esta fue moderada. Conclusiones: Existe asociación entre la adherencia y el apoyo social, por lo que es fundamental que el profesional de enfermería incluya la evaluación e intervención del apoyo social previo al alta del paciente, para optimizar los niveles de adherencia.

Introduction: Hearth Failure (HF) is one of the cardiovascular diseases with higher numbers of admissions in the ICU. In these diseases, it is a must to determine the factors associated with re-admission like the treatment adherence and social support. Objective: To determine the relationship between treatment adherence and social support in patients with HF. Methods: A correlational study with non-probabilistic sampling was conducted. The sample size was 64 patients diagnosed with HF. To measure the adherence level, the adherence behavior evaluation scale with a Cronbach's alpha of 0.72 was used. To measure the social support perception, the Medical Outcomes Study Social Supportsurvey (MOS) with a Cronbach's alpha of 0.94 was used. A descriptive analysis was carried out and in order to determine how the adherence level is related to the social support, the Fisher's test for categorical distributions was applied. Results: Most of the subjects showed a level of frequently an adhered to the treatment (56.2%). The global index of social support was found with values in a mean range (mean: 76.18). The association between the treatment adherence, social support (p: 0.006336) and affective support (p: 0.03025) was moderate. Conclusions: There is an association between the treatment adherence and social support. Therefore, it is pivotal that the nurse include the evaluation and intervention of social support before the patient's discharge in order to optimize the adherence levels.

Introdução: A insuAciência cardíaca (FC) é uma das doenças cardiovasculares com maior índice de internações na unidade de terapia intensiva. Nesta doença é imperativo determinar os fatores associados à readmissão, como a adesão ao tratamento e o suporte social. Objetivo: determinar a relação entre adesão a tratamento e o suporte social de pacientes com InsuAciência Cardíaca. Método: foi realizado um estudo correlacional, com amostragem não probabilística e tamanho da amostra de 64 pacientes com diagnóstico de IC. Para mensurar o nível de adesão, utilizou-se a Escala para avaliação de comportamentos de adesão com alfa Cronbach de 0,72; para medir a percepção do apoio social, usou-se a escala Medical Outcomes Study Social Supportsurvey (MOS) com alfa de Cronbach de 0,94. Realizou-se análise descritiva e, para estabelecer a relação entre o nível de adesão e o suporte social, foi aplicado o teste de independência de distribuições categóricas de Fisher. Resultados: a maioria dos participantes encontrava-se em nível de adesão frequente ao tratamento (56,2%); o índice global de apoio social (média: 76,18) e suas dimensões se encontraram em um rango médio. Quanto à associação entre adesão ao tratamento, suporte social emocional (p: 0,006336) e suporte afetivo (p: 0,03025) foi moderada. Conclusões: Há associação entre adesão e suporte social, pelo que é fundamental que o proAssional de enfermagem inclua a avaliação e intervenção do apoio social antes da alta, para aperfeiçoar os níveis de adesão.

Calidad de vida relacionada con la salud en sujetos con VIH / Health-Related quality of life in people with HIV / Qualidade de vida relacionada à saúde em sujeitos com HIV

Introducción: Desde la identificación del VIH se ha avanzado en el desarrollo de tratamientos más seguros y eficaces que aseguren la sobrevida de los sujetos afectados, siendo el reto de los profesionales sanitarios el mejoramiento de la calidad de vida relacionada con la salud de estos. Objetivo: Analizar la calidad de vida relacionada con la salud de una muestra de pacientes con VIH de Buenos Aires, Argentina. Método: Estudio analítico, transversal y cuantitativo realizado durante los meses de enero a marzo de 2020. Participaron un total de 144 sujetos. Se administraron los cuestionarios SF-36 y Morisky Green. Resultados: La muestra estuvo comprendida mayoritariamente por hombres, solteros, sin hijos y con estudios universitarios. El 49,30 % presentaba una buena adherencia al tratamiento. La Función física fue la dimensión mejor evaluada (92,19), mientras que la Vitalidad fue la peor percibida (61,42). El componente mental fue el más afectado. El sexo femenino, nivel de estudios primario, edad más alta, tenencia de hijos y la presencia de complicaciones se asociaron a una peor calidad de vida. Conclusiones: Se hace importante implementar acciones tendientes a mejorar la adherencia al tratamiento de los pacientes y promover estilos de vida favorecedores de la salud. Asimismo, el abordaje de los sujetos ha de ser integral, considerando las dimensiones psíquica, emocional, social y espiritual como parte de las áreas de atención. La calidad de vida debe ser un indicador de seguimiento para los profesionales sanitarios.

Introduction: Since the HIV was identified, more efficacious and safer treatments have been developed in order to ensure survival of people with the virus. The challenge to the health professionals is to improve the quality of life in relation to these patients' health condition. Objective: To analyze the health-related quality of life in a sample of HIV patients from Buenos Aires (Argentina). Methods: It is a quantitative, cross.-sectional, analytical study conducted from January to March 2020. In total, 144 subjects took part in this study. Questionnaires SF-36 and Morisky-Green were applied. Results: Most of the sample consisted of male subjects, single, without children and with college education. The physical function evaluation reported the best values (92.19), while vitality showed the worse evaluation (61.42). The mental component was the most affected one. Female gender, low schooling, been older, having children and health complications were associated with a worse quality of life. Conclusions: It is quite important to implement actions intended to improve the treatment adherence among the patients and to encourage styles of life that favor their health. Likewise, health professional must approach these patients in a comprehensive way, considering the psychic, emotional, social and spiritual dimensions as a part of the healthcare. The quality of life must be taken as a follow-up indicator by the health professionals.

Introdução: Desde a identicação do VIH houve avanços no desenvolvimento de tratamentos mais seguros e eficazes que garantam a sobrevivência dos sujeitos acometidos, sendo o desafio para os profissionais sanitários o melhoramento da qualidade de vida relacionada à saúde destes. Objetivo: Analisar a qualidade de vida relacionada à saúde de uma amostra de pacientes com HIV de Buenos Aires, Argentina. Método: Estudo analítico, transversal e quantitativo realizado durante os meses de janeiro a março de 2020. Participara um total de 144 sujeitos. Foram aplicados os questionários SF-36 e Morisky-Green. Resultados: a amostra foi composta principalmente por homens, solteiros, sem filhos e com estudos universitários. 49,30% tiveram boa adesão ao tratamento. A Função física foi a dimensão melhor avaliada (92,19), enquanto Vitalidade foi a pior percebida (61,42). O componente mental foi o mais afeitado. O sexo feminino, nível de escolaridade fundamental, idade mais avançada, tenência de filhos e presença de complicaçõesforam associadasà pior qualidade de vida. Conclusões: É importanteimplementarações que visem melhoraraadesão ao tratamento dos pacientes e promover estilos de vida saudáveis. Da mesma forma, a abordagem dos sujeitos deve ser integral, considerando as dimensões psíquica, emocional, social e espiritual como parte das áreas de atenção. A qualidade de vida deve ser um indicador de monitoramento para os profissionais sanitários.

The application effect of family-centered care mode in children′s health care / 中国实用护理杂志

Objective@#To study the application effect of family-centered care (FCC) model in children′s health care.@*Methods@#The data of 200 children who came to the hospital for outpatient care in our hospital were analyzed. They were divided into two groups according to the principle of random number. 100 cases in the control group were given traditional child health care, and 100 cases in the observation group were treated with FCC. Service care, comparing the implementation of child care services under different care modes.@*Results@#After the FCC model was used in the observation group, parents′ knowledge of children′s health knowledge (79.0±6.6), child care compliance 98.0% (98/100), health service effect 95.0% (95/100), nursing satisfaction 96.0% (96/100), the control group was (65.0±5.8), 88.0% (88/100), 80.0% (80/100), and 80.0% (80/100), respectively. There was statistical significance (t value was 15.934, χ2 value was 7.68, 16.50, 12.12, P<0.05). The neuropsychological development scores were evaluated in the two groups. The observation group had a large exercise score (90.9±6.2) and a fine action score (86.8±7.2), adaptability score (96.5±6.5), language score (89.2±2.5), and social development score (88.3±2.5). The control group was (88.2±6.0), (84.0±6.0), (94.0±4.8), (87.9±3.0), (87.0±2.5), and there were statistics between the two groups. Academic significance (t value was 2.253-3.329, P<0.05).@*Conclusion@#The implementation of the FCC model in children′s health care can improve children′s understanding of disease knowledge and child care compliance.

Patients’ knowledge of prescribed medication: a cross sectional study in a tertiary care centre, Mumbai

Background: Inadequate understanding by patients of medical prescription given to them adversely affects treatment compliance; which can result in treatment failure and increase the incidence of adverse effects. The study site is a tertiary care hospital in a metropolitan city and the patients attending here are particularly vulnerable in this regard both due to the heavy patient load in the outpatient department and their low socioeconomic status.Methods: This was a cross sectional study conducted in the pharmacy of K.E.M. Hospital, Mumbai over a period of 1 month. Study population included general outpatient department patients of the hospital. Patients were interviewed using a pre validated questionnaire and their knowledge of the prescription analysed under five key aspects including dose, timing, duration, side effects and purpose of each drug. Data was entered using Microsoft Excel and analyzed using SPSS 22 software.Results: The mean age of the population was 37.6, with a standard deviation of 12.4. A good overall knowledge of the prescription was present only in 12.4% patients. In 52% of patients, the level of knowledge ranged from ‘no knowledge to little knowledge’. Age and literacy had statistically significant associations with overall knowledge of prescription.Conclusions: There is a significant gap in prescription knowledge in the study population. Age and literacy of the patient has an effect on prescription knowledge.

El grado de alfabetización en salud y adherencia al tratamiento en pacientes con hipertensión arterial en un hospital nacional de Lima, Perú / The degree of health literacy and treatment compliance in patients with high blood pressure in a national hospital in Lima, Peru

RESUMEN Objetivos . Evaluar el nivel de alfabetización en salud y el grado de adherencia al tratamiento en pacientes hipertensos que acuden al consultorio externo en un hospital de Lima, Perú. Materiales y métodos. Se realizó un estudio transversal en 276 pacientes, quienes llenaron un cuestionario con características generales, el test de SAHLSA-50 y el test de Morisky-Green. Se utilizó la prueba de Chi Cuadrado para evaluar la asociación entre las variables independientes con la adherencia al tratamiento y con la alfabetización en salud. Resultados. Se encontró un 36% de inadecuada alfabetización sanitaria en salud y un 15% de adherencia al tratamiento. No se halló asociación entre estas variables (p=0,155). Hubo asociación entre ser jefe de familia (p=0,033) y tener pareja (p=0,044) con el grado de alfabetización en salud. Conclusiones. El porcentaje de alfabetización en salud fue similar al de estudios peruanos y latinoamericanos, y el grado de adherencia al tratamiento fue una de las más bajas reportadas. No se encontró asociación significativa entre éstas dos variables.

ABSTRACT Objectives. To assess the level of health literacy and treatment compliance in high-blood pressure patients attending an outpatient clinic in a hospital in Lima, Peru. Materials and Methods. A cross-sectional study was conducted in 276 patients, who filled out a questionnaire with general characteristics, the SAHLSA-50 Test, and the Morisky-Green Test. The Chi-square test was used to assess the association between independent variables with treatment compliance and health literacy. Results. We found a 36% of inadequate health literacy and 15% treatment compliance. No association was found between these variables (p=0.155). There was an association between being a head of household (p=0.033) and having a partner (p=0.044) with the degree of health literacy. Conclusions. The percentage of health literacy was similar to that of Peruvian and Latin American studies, and the degree of treatment compliance was one of the lowest reported. No significant association was found between these two variables.

Ethical thinking and effect research of multiple comprehensive psychological intervention measures used in intensive care unit / 中国中西医结合急救杂志

Objective To discuss the ethical necessity and feasibility of implementing multiple comprehensive psychological intervention measures in intensive care unit (ICU), and to investigate the effect of the measures on treatment compliance. Methods The conscious adult patients hospitalized in emergency ICU (EICU) of the Second Affiliated Hospital of Xi'an Jiaotong University from 2015 to 2017 were enrolled, and divided into control group and intervention group according to random number table, with 40 patients in each group. Patients in control group were treated with routine care and routine diagnosis and treatment, and patients in intervention group were treated with the help of psychologists and with multiple comprehensive psychological intervention measures (including nursing care, medical treatment, family and management) based on routine care and routine diagnosis and treatment. After 5 days of intervention, the treatment compliance, the medical coping attitude and the mental health were assessed respectively using the Treatment Compliance Scale, the Medical Coping Modes Questionnaire (MCMQ) and the Symptom Checklist Scale (SCL-90), and then comparation were done between the two groups. Results After 5 days of intervention, 3 patients in the control group and 4 patients in the intervention group withdraw the study because of the change of illness, and at last 37 patients in the control group and 36 in the intervention group were enrolled. There was no significant difference in basic data such as gender, age, education level, disease, course of disease, the length of EICU stay, and acute physiology and chronic health evaluationⅡ (APACHEⅡ) score between the two groups. The scores of treatment compliance in intervention group was significantly higher than that in control group (2.89±0.67 vs. 2.32±0.91, P < 0.01). Compared with the control group, the "confrontation" dimension score of the MCMQ questionnaire in intervention group was significantly increased (19.75±2.08 vs. 18.62±2.65, P < 0.05), while the "avoidance" and"surrender" dimensions scores were significantly decreased (14.22±1.91 vs. 15.14±1.92, 8.83±1.54 vs. 9.73±2.10, both P < 0.05). In the SCL-90 scale, the scores of the 5 factors such as "somatization", "interpersonal sensitivity","depression", "anxiety" and "photic anxiety" in intervention group were significantly less than those in control group (1.59±0.38 vs. 1.81±0.37, 1.72±0.40 vs. 1.93±0.42, 1.76±0.32 vs. 1.92±0.29, 1.82±0.40 vs. 2.14±0.40, 1.44±0.30 vs. 1.60±0.38, all P < 0.05), while there was no significantly difference in the scores of the other 4 factors as "obsessive-compulsive symptoms", "hostile", "bigotry" and "psychoticism" between the two groups (all P > 0.05). Conclusion The multiple comprehensive psychological intervention measures used for ICU conscious patients could improve the treatment compliance, make the patients' medical coping attitude more active and improve the mental health of the patients, so it has ethical necessity and certain feasibility.

Relación entre los factores sociodemográficos y la calidad de vida en pacientes con lupus eritematoso sistémico / Relationship between sociodemographic factors and the quality of life in patients with systemic lupus erythematosus

El lupus eritematoso sistémico (LES) es una enfermedad autoinmune que puede tener repercusiones negativas en la calidad de vida (CV) de quienes la padecen. La CV puede verse influida por factores sociodemográficos (FSD) relacionados con la enfermedad en sí. Objetivo: Determinar la relación entre los FSD y la CV en pacientes con LES. Métodos: Estudio descriptivo, de corte transversal, de campo y observacional, donde se evaluaron 100 pacientes con diagnóstico de LES. Se emplearon dos encuestas: una para la recolección de datos sociodemográficos y el formulario de la Escala GENCAT. Resultados: La edad promedio fue 42,9 años ± 13,5, el sexo más afectado fue femenino con 93%, los años de estudio promedio fueron 11,4 años ± 4,4 y el tiempo de evolución del LES promedio fue 11,1 años ± 9,5. La CV según el formulario de la Escala GENCAT fue aceptable; la edad avanzada y mayor tiempo de evolución de LES se asoció con menor CV, y mayor escolaridad se asoció con mayor CV. Conclusiones: La CV fue aceptable según la Escala GENCAT, y se encontraron asociaciones entre la CV y edad, años de estudio y tiempo de evolución del LES que fueron estadísticamente significativas(AU)

Systemic lupus erythematosus (SLE) is an autoimmune disease that can have a negative impact on the quality of life (QoL) of those who suffer from it. QoL may be influenced by sociodemographic factors (SDF) related to the disease itself. Objective: Determine the relationship between the SDF and the QoL in patients with SLE. Methods: Descriptive, cross-sectional, field and observational study, where 100 patients with a diagnosis of SLE were evaluated. Two surveys were used: one for the collection of sociodemographic data and the GENCAT Scale form. Results: The average age was 42.9 years ± 13.5, the most affected sex was female with 93%, the average study years were 11.4 years ± 4.4 and the evolution time of the average SLE was 11.1 year ± 9.5. TheQoL according to the GENCAT Scale form was acceptable; the advanced age and longer time of evolution of SLE was associated with lower QoL, and higher schooling was associated with higher QoL. Conclusions: The QoL was acceptable according to the GENCAT Scale, and associations were found between the QoL and age, years of study and time of evolution of the disease, which were statistically significant(AU)

Compliance analysis of adjuvant therapy in elderly patients with breast cancer under case-management model / 上海交通大学学报（医学版）

Objective: To investigate the current status of adjuvant therapy compliance in elderly breast cancer patients (≥65 years old) attended the case-management model and to analyze the impact of demographic characteristics and clinical features on adjuvant therapy compliance. Methods: This study enrolled 654 elderly early breast cancer patients who were treated in Ruijin Hospital and subsequently accepted case-management model between March 2013 and August 2016. Data on patients' compliance to adjuvant therapies which were designed by multidisciplinary treatment (MDT) were collected. The correlation of patients' adjuvant therapy compliance with demographic characteristics and clinical features were evaluated using χ2 test. The statistically significant variables were taken and the corresponding impact on adjuvant therapy compliance were further analyzed using multiple Logistic regression model. Results: In this study, 603 (92.20%) elderly breast cancer patients were treated with one or a combination of adjuvant therapies according to MDT discussion/recommendation. Overall patients' compliance to adjuvant therapy was 88.05%. 45.94% patients were required adjuvant chemotherapy, of which 91.34% patients complied in reality; 45.61% patients were required adjuvant radiotherapy, of which 88.73% patients complied in reality; 80.93% patients were required adjuvant endocrine therapy, of which 93.65% (median treatment duration 44.16 months) patients complied in reality; 12.94% patients were required adjuvant targeted therapy, of which 82.05% patients complied in reality. By number of adjuvant therapies that elderly early breast cancer patients were required, patients' compliance to one, two, three and four adjuvant therapies amounted to 94.30%, 83.68%, 87.20% and 60.00% respectively. The results from analysis of demographic characteristics and clinical features revealed that, age and number of adjuvant therapies had significant impact on adjuvant therapy compliance in elderly breast cancer patients (P<0.05). Furthermore, patients' education level showed strong correlation with patients' compliance to adjuvant chemotherapy and adjuvant radiotherapy (P<0.05). Additionally metastasis to lymph nodes impacted on patients' compliance to adjuvant chemotherapy (P<0.05). Conclusion: Case-management model is beneficial to improve adjuvant therapy compliance after surgery in elderly breast cancer patients. To further increase patients' compliance, more efforts should be invested to help patients older than 74 years old, with lower education level, negative lymph nodes and more types of comprehensive treatment.

Severe periodontitis complicated with oral lichen planus: A case report and literature review / 吉林大学学报(医学版)

Objective; To analyze the clinical manifestion and treatment method of one patient with severe periodontitis complicated with oral lichen planus, and to clarify the effect of combined treatment method and the importance of regular follow-up. Methods; The clinical manifestion of the patient was that the bilateral moral teeth had become looseness and the gum had bled for six months, and the patients had a history of oral lichen planus in gum for 2 years old. The probing depth (PD) of all the teeth was 5-6 mm and the attachment loss (AL) was 8-9 mm, with II °-IE "mobility and bleeding on probing (BOP) (+). The teeth was treated with the regular basis periodontal treatment combined with gingival triamcinolone acetonide injection treatment. When the inflammation situation remained stable, the delayed implantation was performed and the crown restoration treatment was done for 26, 27, 36 and 37. The splinting treatment was done for 31 and 41 II mobile teeth. The regular follow-up periods were 1 week, 2 weeks, 1 month, 3 months, and 6 months after treatment during periodontal maintenance. Results; After combined treatment and regular follow-up, the PD of both anterior and premolar were 4 mm, and the BOP was negative. The clinical symptom of oral lichen planus of the patient was relieved, and there were no symptoms of congestion and erosion on the gum. After the inflammation situation was controlled, the chewing function of the left molar region was restored by implantation rehabilitation. A 3-month-follow-up cycle and excellent treatment compliance were beneficial for the control of disease. The optimal follow-up period of gingival condition maintained best was once per 2 weeks. Conclusion: The combined treatment can relieve the clinical symptoms of the patient with severe periodontitis complicated with oral lichen planus. Regular follow-up and excellent treatment compliance are conducive to controlling the condition of disease.

Belief about medicines in patients with treatment-resistant depression and its influencing factors / 中华行为医学与脑科学杂志

Objective To explore the belief about medicines in patients with treatment-resistant de-pression ( TRD) and its influencing factors. Methods 106 patients with TRD were recruited to complete the survey of demographic characteristics,Hamilton Depression Scale-17 ( HAMD-17) and belief about Med-icine Questionnaire-Specific ( BMQ-S) . Results ①The score of BMQ-s was higher in TRD patients with medical insurance than that of patients with self-funded(rural social insurance(1.11±0.96),medical insur-ance(0.84±1.33),self expense(0.13±1.72),F=2.81,P<0.01).The score of BMQ-s was higher in TRD pa-tients with serious depression than that of patients with mild to moderate depression((1.07±1.19),(0.34± 1.41),t=2.77,P<0.01).The score of BMQ-s was higher in TRD patients with fewer episodes of depression than that of patients with more episodes of depression (0 time(1.10±0.99),once and twice(0.95±1.31),3 times and above(0.31±1.56),F=3.42,P<0.05).The score of BMQ-s was higher in TRD patients without stigma than those with stigma((1.03±1.21),(0.34±1.43),t=2.58,P<0.01).The score of BMQ-s was high-er in TRD patients with more knowledge about the antidepressant than that of patients with less knowledge (most of understanding(1.21±1.09),part of understanding(0.54±1.32),hardly understanding(0.33± 1.63) ,F=3.69,P<0.01) . The score of BMQ-s was higher in TRD patients without side effects of antidepres-sant than those with side effects ((1.04±1.24),(0.19±1.35),t=2.96,P<0.01). ②Stepwise multivariate linear regression analysis showed that payment methods,knowledge about the antidepressant,stigma about the antidepressant and episodes of depression were the influencing factors of BMQ-S in patients with TRD( all P<0.01) . Conclusion Different demographic characteristics and clinical features have different beliefs about antidepressant medication in patients with TRD.The payment methods,knowledge about the antidepressant, stigma about the antidepressant and episodes of depression are the influencing factors of BMQ in patients with TRD.