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Objective:To formulate a ladder type early activity program in order to provide a theoretical and practical basis for improving the current activity status of tumor patients with pulmonary embolism.Methods:This research was conducted experimentally. A total of 92 tumor patients diagnosed as pulmonary embolism from January 1, 2021 to March 31, 2022 in Sichuan Cancer Hospital were divided into control group and experimental group with 46 cases each by random number table method. In the control group, a routine activity program was carried out, and the patients were confined to bed for 7 days. The experimental group obtained the best evidence of early pulmonary embolism activity plan through evidence-based nursing, formed a nurse-led ladder type early pulmonary embolism activity team, and finally constructed and implemented the ladder type early activity plan. The mortality rate, new thrombosis in ICU for 3 days and 7 days, length of stay in ICU and patients′ comfort were compared between the two groups.Results:The mortality rates within 30 days after the diagnosis of pulmonary embolism were 4.35% (2/46) and 2.17% (1/46) respectively in the control group and the experimental group, with no significant difference between the two groups ( χ2=0.35, P>0.05). The rates of new thrombosis were 15.22% (7/46) and 26.09% (12/46) in the control group, and 4.35% (2/46) and 4.35% (2/46) in the experimental group, respectively at 3 and 7 days after ICU admission, with a significant difference between the two groups at 7 days after ICU admission ( χ2=8.43, P<0.05). The length of stay in ICU and the score of General Comfort Questionnaire (GCQ) were (15.74 ± 11.11) days and (64.30 ± 15.54) points in the experimental group, respectively, while those in the control group were (11.07 ± 5.63)days and (73.84 ± 11.73) points, respectively. The difference between the two groups was statistically significant ( t=-2.55, -3.32, both P<0.05). Conclusions:The evidence-based ladder type early activity program for patients with pulmonary embolism caused by tumor will not increase the mortality of patients, but can ensure the safety of patients, reduce the incidence of new thrombosis and the length of ICU stay, improve the comfort of patients during the treatment of pulmonary embolism. It is worthy of clinical application.
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Objective:To explore the application effect of formative assessment combined with Ladder type teaching on the teaching of standardized training of nephropathy and endocrinology.Methods:A total of 39 residents who rotated in the Department of Nephrology and Endocrinology, Sichuan Science City Hospital from March 2019 to March 2020 were included in the control group and were taught routinely, and another 42 residents who rotated from April 2020 to April 2021 were classified as a research group and were given formative assessment and Ladder type teaching. The out-department assessment results between the two groups were compared, and the mini-clinical exercise evaluation (Mini-CEX), normal performance assessment and 360-degree evaluation results of the research group when entering and exiting the department were compared. The students' satisfaction with teaching between the two groups was also compared. SPSS 24.0 was used for t test, chi-square test and rank sum test. Results:The scores of theory, skill manipulation and case analysis in the research group were higher than those in the control group, and the differences were statistically significant ( P<0.05). The Mini-CEX score, usual performance assessment score and 360-degree evaluation score in the research group when exiting the department were all higher than those when entering the department, with statistically significant difference ( P<0.05). There were significant differences in the grades distribution of teaching satisfaction degrees between the two groups ( P<0.05), and the total satisfaction rate of the research group was higher than that of the control group. Conclusion:The use of formative assessment combined with Ladder type teaching in the standardized training of nephropathy and endocrinology can significantly improve the scores of the residents and their clinical comprehensive literacy, and increase the satisfaction of teaching, with great value of popularization and application.
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@#<p style="text-align: justify;"><strong>BACKGROUND:</strong> The School of Health Sciences (SHS), University of the Philippines Manila, established in 1976 offers a one-of-its kind ladder-type, community-based curriculum in health sciences.</p><p style="text-align: justify;"><strong>OBJECTIVE:</strong> This study described the SHS curriculum and how it contributed to the transformative scale-up of the education of health professionals in the Philippines.</p><p style="text-align: justify;"><strong>METHODS:</strong> This study is a concurrent transformative mixed method design. Data were collected concurrently through interviews of university officials, faculty, students, alumni, communities, and partners as well as observations of review classes and office activities. Quantitative data were collected from school records and performance ratings of students. From the data emerged the basic principles of primary health care and community-based education and they were juxtaposed to describe transformative learning of SHS students and faculty.</p><p style="text-align: justify;"><strong>RESULTS:</strong> All of the 3,481 students admitted from 1976 came from geographically isolated and depressed areas; more than 95% of the graduates are still in the country and chose to serve the communities. The school's ladder-type, community-based curriculum produced competent midwives, nurses, and physicians. SHS did not just transform its students but also the faculty, communities, its partner local, national, and international agencies, and changed the landscape of community-based education in the region.</p><p style="text-align: justify;"><br /><strong>CONCLUSION</strong>: SHS produced health professionals who chose to serve the communities. It continues to evolve to institutionalize primary health care and community-based education.</p>
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Objective To make ladder type health education combined with the PDCA cyclemanagement used to daily care of patients with chronic heart failure, then investigated its effect of the quality of life of patients and improving cardiac function in action. Methods Selectd 80 cases of patients with chronic heart failure form January 2012 to Jan-uary 2013, then they were randomly divided into control group and experimental group, patients of control group re-ceived routine nursing and health education group, patients of experimental group received ladder type health education combined with the PDCA cyclemanagement, after observation period, compared cardiac function and the quality of life of two groups. Results The patients of experimental group'cardiac function and the quality of life were better than con-trol group after the ladder type health education with PDCA Cyclemanagement treatment had significant difference (P<0.05). Conclusion Ladder type health education combined with the PDCA cyclemanagement not only can improve heart function, but also improve the quality of life of patients, it can be applied appropriately.