RESUMEN
Objective:To construct a comprehensive evaluation index system for integrated health management service capacity of the close-knit medical consortium,and to provide an effective evaluation tool for promoting the construction of a close-knit medical consortium in China.Methods:Based on service chain theory,the initial index pool is established from four dimensions of service guarantee,service guidance,service provision and service evaluation through policy analysis,literature reading and field investigation.Delphi method is used to improve the evaluation indicators through two rounds of expert consultation,and the analytic hierarchy process is used to determine the weight of each indicator.Results:The constructed index system consists of 4 first-class indicators,11 second-class indicators and 50 third-class indicators.The weights of service guarantee,service guidance,service provision and service evaluation are 0.133,0.301,0.401 and 0.165 respectively.Conclusions:Based on the service chain theory,this study applies Delphi expert consultation method and the analytic hierarchy process and invites experts in relevant fields to carry out consultation,aiming at constructing a comprehensive evaluation index system for the integrated health management service capacity of the close-knit medical consortium with strong operability and scientific rationality,and providing an effective evaluation tool for promoting the construction of the close-knit medical consortium in China.
RESUMEN
Objective:To explore the effects of respiratory training on pulmonary and motor function for patients with Parkinson's disease. Methods:From January, 2018 to November, 2019, 60 inpatients with idiopathic Parkinson's disease from the Second Rehabilitation Hospital of Shanghai were randomly divided into control group (n = 30) and experimental group (n = 30). All the patients accepted routine rehabilitation, while the experimental group accepted respiratory training with Power Breathe in addition. They were measured the pulmonary function, and assessed with Unified Parkinson's Disease Rating Scale (UPDRS) part II and III, and modified Barthel Index (MBI) before and four weeks after treatment. Results:The scores of UPDRS II and III, and MBI improved in both groups after treatment (|t| > 2.550, P < 0.05), while the forced vital capacity (FVC), forced expiratory volume in the first second (FEV1) and maximum expiratory flow rate at 50% vital capacity (MEF50) increased in the experimental group (|t| > 2.838, P < 0.01), but did not in the control group (|t| < 1.058, P > 0.05). FVC, FEV1, MEF50, MBI score and UPDRS II score improved more in the experimental group than in the control group (|t| > 2.191, P < 0.05). Conclusion:Respiratory training can improve pulmonary function for patients with Parkinson's disease, to further improve their activities of daily living. No synergistic effect is found on motor function.