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Objective:To investigate the prevalence of hyperuricemia (HUA), patients′ awareness of HUA, and related factors among elderly in community.Methods:The health check-up data of 6 897 residents aged over 65 years in Gumei Community of Shanghai were collected from January 2019 to January 2020. There were 1 156 subject with increased serum uric acid levels (HUA group) and 5 741 with normal uric acid levels (non-HUA group). The differences of clinical indicators between HUA group and non-HUA group were analyzed and the risk factors of HUA was determined by multivariate logistic stepwise regression. A questionnaire survey on the knowledge of HUA and the adoption of relevant health behaviors was conducted among HUA patients.Results:The overall prevalence was 16.8% (1 156/6 897) in this population. The prevalence in males was significantly higher than that in females[26.4%(842/3 195) vs. 8.5%(314/3 702), P<0.001); and the prevalence in females increased with age (χ 2=7.56, P=0.023). Body mass index(BMI), waist circumference(WC), total cholesterol(TC), triglyceride(TG), serum creatinine, alanine aminotransferase(ALT) and albumin/urine creatinine ratio(UACR) in the HUA group were significantly higher than those in the non-HUA group, while estimated glomerular filtration rate(eGFR) and high-density lipoprotein(HDL) were lower than those in the non-HUA group (all P<0.01). The prevalence of hypertension, decreased renal function, overweight or obesity, abdominal obesity, fatty liver and renal cyst in HUA group was significantly higher than that in non-HUA group (all P<0.01). High values of TG, low-density lipoprotein(LDL), WC, hypertension and fatty liver were risk factors for HUA( OR=1.14, 1.20, 1.03, 1.43, 2.19; P<0.01); while female gender, eGFR, HDL and glycosylated hemoglobin A1c(HbA1c) were protective factors for HUA( OR=0.32, 0.94, 0.65, 0.78; P<0.01). The questionnaire survey was conducted among 1 090 HUA patients, and the results showed that 73.2% (798 cases) were aware of the disease after the health check-up results released; only 30.9% (337 cases) knew the diagnostic criteria of HUA, 21.1% (230 cases) knew that HUA needed life-long follow-up care, 56.3% (614 cases), 49.2% (536 cases) and 47.9% (522 cases) thought that HUA should eat less seafood, broth and soya bean products, 17.0%(185 cases) were atcohol drinker and the awareness rates of above questions in patients with gout were higher than those in patients without gout ( P<0.05). Conclusion:The study shows that the prevalence of HUA among the elderly in Gumei community of Shanghai is high, and the HUA related knowledge levels and health behavior performance are not ideal, especially for HUA patients without gout, therefore health education should be strengthened for elderly residents in the community.
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Objective To investigate the effect of sensitive indicators of nursing quality in the management of elderly inpatients in neurology department. Methods A total of 160 inpatients in the department of neurology who were admitted between January 2016 and December 2017 were selected as study subjects. The patients were divided into pre-implementation (January to December 2016) and post-implementation (2017 Month-December) with 80 cases each. Traditional nursing Quality Management mode was adopted before implementation, and the management mode of nursing quality sensitive index was adopted after implementation. These two with priority improvement indicators, adverse events in nursing care, patient satisfaction and so on were compared. Results After the implementation, the correct rate of risk assessment, the implementation rate of nursing specifications, the correct rate of drug delivery, the rate of graded care execution, and the rate of individualized rehabilitation training were significantly higher than before implementation.The difference was statistically significant (χ2=4.103-5.769, P<0.05). The incidence rate of adverse events such as stress injury was 3.75% (3/80), which was significantly lower than that before implementation 20.0% (16/80). The difference was statistically significant (χ2=7.206, P<0.05). The patient satisfaction rate was 96.25%(77/80), which was significantly higher than 87.50% (70/80) before implementation.The difference was statistically significant (χ2=4.103, P<0.05). Conclusion The implementation of the sensitive index of nursing quality can improve the nursing quality of elderly inpatients in the department of neurology, reduce the occurrence of nursing adverse events and improve the satisfaction of patients.
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Objective To survey the prevalence of stress urinary incontinence(SUI)and related knowledge among postpartum women in Shanghai Melong district.Methods A questionnaire survey on the knowledge of stress urinary incontinence was conducted among 317 postpartum women who were home visited by Meilong Community Health Service Center between March 2017 and June 2017.The self-designed questionnaire included the general situation(age, height, weight, occupation, menstrual history), pregnancy and childbirth, and knowledge of SUI; the International Consultation on Incontinence Questionnaire Short form(ICIQ-SF)was also used.Total 317 questionnaires were distributed and 313 valid ones were retrieved(98.73%).Results The prevalence of SUI in the participants was 26.84%(84/313).Multivariate logistic regression showed that BMI≥24 kg/m2(OR=6.24, 95% CI: 3.41 -11.41), complicated metabolic syndrome(OR=9.84, 95% CI: 2.77 -34.96)and birth weight of previous child ≥4 kg(OR=0.09,95%CI:0.04-0.19)is independent risk factors for the development of SUI.The average SUI knowledge score was(10.39 +8.65)points, only 26.20%(82/313)of the participants knew Kegel training(score 5.99 ±1.60).The SUI knowledge level of postpartum women was associated with educational level(F=12.41),occupation(F=9.06), income(F=4.05), reproductive history(F=10.98)and presence of urinary incontinence symptom(F=22.31)(all P<0.05). Conclusion The knowledge level of maternal stress urinary incontinence in Meilong district is relatively low,and the publicity of SUI and pelvic floor rehabilitation knowledge should be enhanced for the pregnant women.
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Huacao Community Health Service Center has established an integrated chronic kidney disease (CKD) management system since 2015,which greatly improved CKD management in the community.From September 2016 to August 2017,4084 residents were screened by the family doctor team,975 were suspected to have CKD (23.87％),among whom 202 (20.72％) were referred to district CKD treatment center,and 197 (97.52％) were confirmed as CKD.The detection rate of suspected CKD among patients with hypertension and diabetes mellitus was the highest,which was much higher than that among outpatients and those with routine health check up.It is suggested that the integrated management of CKD should be widely implemented to cope with the prevalence of CKD,particularly for those with hypertension and diabetes.