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This article summarized the overview of diagnosis related groups (DRGs), the necessity of comprehensively popularizing and applying DRGs in specialized hospitals and general hospitals, the different methods and effects of nursing human resource allocation based on DRGs in specialized hospitals and general hospitals at home and abroad, and analyzed the different challenges and opportunities faced by DRGs in the implementation of human resource allocation in two types of hospitals. According to the types and characteristics of hospitals, this paper put forward some corresponding suggestions and prospects for the future, such as intelligent human resource prediction system and the construction of information sharing platform, so as to provide reference for the comprehensive promotion of DRGs in different types of hospitals in China.
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Objective:To construct a comprehensive, systematic and quantifiable quality evaluation index system for blood purification care in ICU.Methods:The contents of the evaluation index system for blood purification care in ICU were determined by reviewing the literature, discussion of the research group and two rounds of Delphi expert consultation.Results:The response rate of the two rounds of experts was 100%. The authoritative coefficients of the two rounds of experts were 0.908 and 0.965 respectively. The coordination coefficient of the indicators of the second round of consultation results was 0.210-0.292, P<0.05 or 0.01. The quality evaluation index system for blood purification care included 3 first-class indicators, 16 second-class indicators, and 56 third-class indicators. Conclusions:The enthusiasm, authority, concentration of opinions and degree of coordination of the consulting experts are relatively high. The constructed evaluation system for the quality of blood purification care indicators can be used for reference in the implementation, training and quality control.
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Objective To systematically evaluate the effectiveness of different nursing interventions for female overactive bladder, and to provide evidence- based evidence for nursing intervention for overactive bladder in women. Methods PubMed, Cochrane Library, Embase, ScienceDirect and CNKI,Wanfang database and CBM comprehensively by computer and included in the literature of nursing intervention for female overactive bladder patients. Results Four randomized controlled trials were included, a total of 426 participants were in, the intervention group was 214 participants, control group was 212 participants, the results of the study showed that pelvic floor muscle training,health education,psychological nursing intervention can improve patients with overactive bladder symptoms and enhance the quality of life. Conclusion Nursing intervention for women with overactive bladder is an effective way to control symptoms such as frequent micturition and urgency,improve bladder overactivity symptoms and enhance quality of life.
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Objective To analyze the patients′ psychological resilience level of postpartum pelvic floor dysfunction and to explore the influencing factors, in order to provide the scientific basis for patients′psychological intervention. Methods A cross-sectional survey was conducted on 208 patients of postpartum pelvic floor dysfunction by using the Connor-Davidson Resilience scale(CD-RISC), Positive and Negative Affective scales(PANAS) and Medical Coping Modes questionnaire(MCMQ, which includes "confrontation","acceptance-resignation"and"avoidance"). Results The score of psychological resilience of 208 patients was (53.64 ± 12.29)points, differences in age, family monthly income, living locations, delivery methods and delivery times reached a statistically significant level(F=15.287,5.731,t=-2.571,-15.911,-2.922,all P<0.05). Patients′psychological resilience level had significant positive correlation with positive emotions(P<0.01)and"confrontation",and it had negative correlation with"acceptance-resignation"(P<0.01).Age,living locations, delivery methods, positive emotions and "acceptance- resignation" are the forecast factors of psychological resilience, which can explain 69.6% of total variation. Conclusions Patients of postpartum pelvic floor dysfunction have low levels of psychological resilience, which associated with positive emotions and medical coping modes. Therefore, nursing staffs should pay attentions to the patients′ psychological status, develop individualized psychological guidelines,implement psychological intervention and health education,in order to improve the level of patients′resilience and improve their living quality.
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The cardiovascular disease has become one of the important chronic health problems for humans. At present, the research on the traditional risk factors of cardiovascular disease has been studied from the relevance to the mechanism. In this paper, the recent progress of the traditional risk factors of CVD and the impact mechanism are reviewed in order to provide a basis for the prevention, treatment and nursing of cardiovascular diseases.
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Objective To investigate the levels of cancer related fatigue (CRF) and the correlations between CRF and serum inflammatory factors and hypothalamus-pituitary-adrenal (HPA) axis in patients with gastrointestinal cancer.Methods The CRF level was assessed by brief fatigue inventory (BFI).The level of C-reactive protein (CRP) was measured by immunoturbidimetry, and the level of cortisol was measured by electrochemiluminesence.The levels of interleukin (IL)-6, IL-1β, tumor necrosis factor-α (TNF-α), adrenocorticotropic hormone (ACTH) and norepinephrine (NE) were measured by enzyme-linked immunosorbent assay (ELISA).Results The average total score of CRF was 3.15±1.93, and the degree was mild to moderate, which was positively correlated with the CRP (r=0.321, P=0.000), TNF-α (r=0.265, P=0.000), NE (r=0.174, P=0.015) and ACTH (r=0.257, P=0.000), but was not correlated with the cortisol (r=0.033, P=0.652).Eastern Cooperative Oncology Group (ECOG) score (t=8.081, P=0.000), education (t=-4.244, P=0.000), treatment (t=4.563, P=0.000), time from diagnosis to sampling (t=3.453, P=0.001) and CRP (t=2.837, P=0.006) were important factors of CRF.Conclusion The CRF status is common in gastrointestinal cancer patients.The CRF is correlated with the NE and ACTH of HPA axis.Medical staff should pay attention to the inflammatory factors and hormone levels to improve the fatigue status and the quality of patients.
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Objective To discuss the accuracy of three-dimensional (3D) sonography in diagnosing arcuate uterus and septate uterus and propose a quantitative indicator in distinguishing arcuate uterus and septate uterus.Methods Ninety-six patients with suspected congenital uterine malformation underwent 3D sonography to assess uterine anomalies at Obstetrics and Gynecology Hospital of Fudan University from August 2011 to March 2013.Uterine coronal section was reconstructed and measured in onmi view imaging mode of 3D sonography.Then qualitative diagnosis and categorization was done.The results were compared with diagnosis of hysteroscopy,hysteroscopy combined with laparoscope to determine the sensitivity,specificity,positive predictive values,negative predictive values and total accuracy of 3D sonography in diagnosing arcuate uterus,partial and complete septate uterus respectively.The variable was created in coronal section of uterus constructed through 3D imaging mode to differentiate arcuate uterus from septate uterus.Results There were 33 cases (34.4％,33/96) of arcuate uterus,54 cases (56.2％,54/96) of partial septate uterus and 9 cases (9.4％,9/96) of complete uterus in 96 cases diagnosed by 3D sonography.The accuracy of 3D sonography in diagnosing arcuate uterus and septate uterus was 86.5％.We concluded that 3D sonography had 100％ sensitivity,82.9％ specificity,60.6％ positive predictive value and 100％negative predictive value in the diagnosis of arcuate uterus.The sensitivity of 3D sonography for diagnosis of partial septate uterus was 80.6％,the specificity was 100％,the positive predictive value was 100％,and the negative predictive value was 69.1％.The sensitivity,specificity,positive and negative predictive values of 3D sonography for detecting complete septate uterus were all 100％.The ratio of depth of uterine internal indentation and depth from uterine fundus to the top of intemal indentation was more than 50％ for septate uterus,while less than 50％ for most of the arcuate uterus.Conclusions The diagnostic efficiency of 3D sonography in specific uterine malformation is different.The new quantitative indicator maybe helpful in improving the accuracy of 3D sonography in diagnosing arcuate uterus and septate uterus.
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Fatigue is commonly experienced in patients with advanced kidney disease and associated with poor outcomes. The purpose of this review was to discuss the prevalence, assessment methods and contributing factors of fatigue in patients with end-stage renal disease (ESRD), and also examined possible interventions to improve fatigue and concludes by defining some future research directions.
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Subjective well-being,a comprehensive psychological index for evaluating the quality of life,is closely related to the physical and mental health of the elderly.At present,the mainly Methods for measuring subjective well-being in the elderly is scale. Subjective well-being assessment scales include generic scales and specific scales.Domestic elderly subjective well-being scales commonly imported from abroad.Specific scales for elderly are less in mainland China.This article will review the current research status for subjective well-being assessment scales in the elderly, in order to strengthen the localization research of specific scales and further provides reference for the clinical research of this topic.
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Cardiovascular disease has become a major health problem facing human beings, and it is also the leading cause of death world wide.Now Cardiovascular disease risk factors have been found and many new complex risk factors (such as sleep, atmospheric pollution, social psychological factors, cortisol, C-reactiveprotein, homocysteine, age at menarche etc.) are put forward, which let people have a deeper understanding. In this paper, the recent advances in cardiovascular disease risk factors and influence mechanism are reviewed, so as to provide basis and support for cardiovascular disease in prevention, treatment and nursing.
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Cardiovascular disease has become a major health problem facing human beings, and it is also the leading cause of death world wide.Now Cardiovascular disease risk factors have been found and many new complex risk factors (such as sleep, atmospheric pollution, social psychological factors, cortisol, C-reactiveprotein, homocysteine, age at menarche etc.) are put forward, which let people have a deeper understanding. In this paper, the recent advances in cardiovascular disease risk factors and influence mechanism are reviewed, so as to provide basis and support for cardiovascular disease in prevention, treatment and nursing.
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Objective To assess the clinical significance of fetal pyelectasis and its changing in utero. Methods One hundred and ninty-seven isolated pyelectasis cases were retrospective reviewed from Jan 2012 to Jul 2014.Isolated pyelectasis was defined as a renal pelvis anteroposterior diameter (RPAPD)of ≥5 mm without other fetal anomaly in second trimester.Persistent or progressive pyelectasis was defined as a RPAPD of ≥10 mm before delivery.They were divided into two groups according to the size of renal pelvis in second trimester:group A (RPAPD 5 - 10 mm)and group B (RPAPD ≥ 10 mm).As the same,there were two groups after 32 weeks of gestation:group C (RPAPD < 10 mm)and group D (RPAPD ≥ 10 mm).Results Totally 1 54 cases were followed up.There were 1 88 cases (95.4%)in group A,with 41 cases lost,141 cases (95.9%)RPAPD <10 mm,6 cases (4.1 %)RPAPD ≥10 mm before delivery.There were 9 cases (4.6%)in group B,with 2 cases lost,remained 7 cases RPAPD ≥ 10 mm before delivery. Conclusions Although most of the fetuses with RPAPD 5 - 10 mm in second trimester will remain the same or resolved before delivery,those with RPAPD ≥ 10 mm may persistent or progress.Prenatal assessment of fetal renal pelvis may provide properly consultation.
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Objective To study the relationship of three-dimensional power Doppler ultrasonographic parameters and endocrine profile in different symptoms of patients with polycystic ovary syndrome(PCOS).Methods One hundred and forty nine women with PCOS were divided into two groups,which included obese PCOS(OB-PCOS) group and non-obese PCOS (NOB-PCOS) group.The ultrasonic parameters such as follicle number,ovarian average diameter,ovarian volume,stromal volume,follicle volume,vascularization index(Ⅵ),flow index(FI),vascularization flow index(VFI) were measured and compared.Serum levels of luteinizing hormone (LH),follicle stimulating hormone (FSH),progesterone (P),estradiol (E2),testosterone(T),prolactin (PRL),sex hormone binding globulin (SHBG),free androgen index (FAI),fasting plasma glucose (FPG),fasting insulin (FINS),homeostasis model assessment-IR(HOMA-IR) were also measured and compared.The correlation of the ultrasonic parameters and hormonal factors were analyzed.Results The follicle number,ovarian average diameter,ovarian volume,stromal volume,follicle volume,FI and VFI,FINS,HOMA-IR,FAI of OB-PCOS were significantly higher than those of NOB-PCOS (P ＜0.01 or 0.05),the FSH,SHBG were significantly lower than those of NOB-PCOS (P ＜0.05 or 0.01).In OB-PCOS group,the follicle number was significantly associated with FSH(r =0.771,P ＜0.01).The ovarian volume,stromal volume,FI and VFI were significantly associated with HOMA-IR(r =0.412,0.842,0.389,0.415,P ＜0.05 or 0.01),FI was significantly associated with FAI (r =0.812,P ＜0.01).In NOB-PCOS group,the follicle number,ovarian volume were significantly associated with FAI(r =0.472,0.552,P ＜0.05)..Conclusions There are some different characters in ultrasonography and endocrine parameters between obese and non-obese PCOS patients.