ObjectiveTo systematically review the efficacy of discharge preparation service in elderly patients with chronic diseases.MethodsCNKI, WanFang Data, VIP, Web of Science, The Cochrane Library, PubMed and EMbase databases were electronically searched to collect randomized controlled trails (RCTs) on the discharge preparation service for elderly patients with chronic diseases from January, 2000 to January, 2019. Two reviewers independently screened literature, extracted data and assessed risk of bias of included studies, then, meta-analysis was performed by using RevMan 5.3 software.ResultsA total of 7 RCTs, involving 884 patients were included. The results of meta-analysis showed that: after the hospitalization preparation service, the incidence of acute complication (RR=0.38, 95%CI 0.15 to 0.98, P=0.04), patient compliance behavior (SMD=0.54, 95% CI 0.25 to 0.83, P=0.000 3), exercise capacity (SMD=2.65, 95%CI 0.25 to 5.04, P=0.03), and nursing satisfaction (SMD=0.71, 95%CI 0.10 to 1.33, P=0.02) significantly improved. However, there were no significant differences in emergency hospital admission for acute complications (RR=0.25, 95%CI 0.06 to 1.11, P=0.07), self-care ability (SMD=2.18, 95%CI −1.02 to 5.38, P=0.18), activity of daily living (ADL) (SMD=0.56, 95%CI −0.47 to 1.59, P=0.28).ConclusionsThe current evidence shows that after implementation of the discharge preparation service, the incidence of acute complication, compliance behavior, exercise ability, and service satisfaction of the elderly patients with chronic diseases are significantly improved. Due to limited quality and quantity of the included studies, more high-quality studies are required to verify above conclusion.
Objective To study the effectiveness, safety and tolerance of testosterone undecanoate （TU） in improving exhaustion and quality of life （QOL） of the elderly male patients with chronic disease in advanced stage. Methods Using a simple randomized controlled trial design, eighty patients were randomized into two groups. The treatment group took routine therapy and TU and the control group with routine therapy alone. Results 1. Baseline characteristics in both groups were similar. 2. The PADAM grade decreased, and the QOL scale increased in the treatment group （P〈0.05 ）. 3. Serum total testosterone in the treatment group rose, upper arm circumference and right hand grip improved （P〈0.05 ）. 4. There were no significant differences in adverse effects between both groups. Conclusions TU can improve the clinical health status in the elderly male patients with chronic disease in advanced stage and increase serum testosterone level, there is a satisfactory tolerances and few adverse reactions.
Objective To investigate the satisfaction of patients who signed up for chronic disease continuous health management services, so as to provide a theoretical basis for improving service quality. Methods We conducted an online anonymous survey by issuing an electronic questionnaire to all patients who met the inclusion criteria through the short message platform of the hospital from October 8th to 19th, 2021, and used χ2 test and logistic regression to compare the differences in satisfaction among different patients and explore the factors affecting satisfaction. Results A total of 3311 short messages were send out, and 816 valid copies of questionnaire were recalled. The total satisfaction was 77.3%, and the satisfaction before, during and after service were 86.0%, 75.2% and 73.7%, respectively. The items with low satisfaction included service pricing (58.9%), online follow-up (57.5%) and overall cost reduction (43.9%). There were significant differences in satisfaction among patients of different permanent addresses and health status (P<0.05). The multiple binary logistic regression analysis showed that the respondents in Chengdu city had lower satisfaction than those outside Sichuan province [odds ratio (OR)=0.377, 95% confidence interval (CI) (0.156, 0.908), P=0.030], and the respondents with poor, general, and good self-reported health status had lower satisfaction than those with very good self-reported health status [OR=0.196, 95%CI (0.067, 0.577), P=0.003; OR=0.165, 95%CI (0.058, 0.468), P=0.001; OR=0.317, 95%CI (0.108, 0.927), P=0.036]. Conclusions The patients’ satisfaction with chronic disease continuous health management services is at a high level. The next step should focus on service pricing and online follow-up, and strive to improve the service experience of people with low satisfaction.
At present, the health management of chronic diseases in China is still in its infancy. In the face of an increasingly large group of patients with chronic diseases, large general public hospitals often lack a systematic and standardized chronic disease continuity management system. In order to solve the problem of patients’ medical difficulties, popularize the hospitals’ innovative medical services, and promote the professional development of clinical departments, taking the continuous health management model of chronic diseases constructed by West China Hospital of Sichuan University as an example, this paper introduces the background, organizational structure and service process of the system construction in turn. The purpose is to build a new health service model of “smart hospital”, and also provide a reference for the construction of standardized chronic disease management system in hospitals, which will lay a foundation for further constructing a top-down chronic disease whole process system linked with communities and hospitals in the later stage.
Chronic kidney disease (CKD) has become a global public health problem because of its high prevalence, low awareness, poor prognosis, and high medical costs. Effective follow-up management can facilitate timely adjustment of the treatment of the CKD patients and delay the disease progression. The application of internet of things (IoT) technology in dynamic monitoring and telemedicine is helpful for the self-management of patients with chronic diseases, and can provide convenient, intelligent, and humanized medical and health services. In the future, with the rapid growth of demands of CKD management and innovations in information technology, new medical IoT industry will accelerate the intelligent development of CKD management. Multi-disciplinary and multi-industrial collaboration should be promoted to solve current challenges, such as evaluation of actual effectiveness, the system design and construction, and the accessibility of intelligent healthcare services, to ensure that IoT products can improve clinical outcomes, reduce medical expenditure, and lower disease burden.
ObjectiveUse information technology to establish an “Internet+” chronic disease management model to provide patients with a full process, seamless, and convenient services. Explore a new model of “Internet+” chronic disease management and care services in the region. Methods Patients with chronic diseases treated in Mianyang Central Hospital from May 2018 to April 2019 were selected. The patients were randomly divided into intervention group and control group according to the single and even number at the end of hospitalization number. The control group adopted the traditional chronic disease management mode, and the intervention group adopted the “Internet+” chronic disease management mode based on the patients’ needs. And select the nursing experts who provide “Internet+” online nursing services. Compared with the effective management before and after the implementation of “Internet+” chronic disease management, the number of patients with chronic diseases, clinical outcome indicators, the number of health education readings, the number of Internet nursing services, and the sense of professional benefit of nurses and other indicators, etc. Results A total of 143 patients were included, including 78 in the control group and 65 in the intervention group. A total of 28 nursing experts were investigated. The effective management rate of patients with chronic diseases was 78.7%. The WeChat public account “Slow Disease Window” has read nearly 90 000 person-times, and the Internet Hospital “Nursing Professional Online” has nearly 2 000 online nursing services. After participating in “Internet+” chronic disease management, the disease activity and functional status of chronic disease patients were significantly improved (P<0.05). Nursing professionals have a strong sense of professional benefits (P<0.05). Conclusions With the development of “Internet+” chronic disease management, a new mode of chronic disease management was explored to promote the management of chronic disease more convenient and efficient, so that the health education work can be homogenized, the clinical outcome of the patients was effectively improved. At the same time the career planning of nursing staff can be broadened.
Patients with chronic diseases usually face severe challenges during their transition from hospital to home, such as poor discharge preparation, the increased incidence of medical errors, insufficient self-care capability, and poor participation in healthcare decision, which can result in increased readmission and poor patient safety. This paper reviews the definition of transitional care, single-element transitional care intervention strategy, and multiple-element transitional care intervention strategy, in order to provide new insights into the development of effective and safe transitional care strategies in China.
This paper introduces the background and research design (including site of investigation, study population, baseline survey and follow-up monitoring), which belongs to the Precision Medicine Project of the National Key Research and Development Program of China.
Chronic disease is a major threat to human health. Fundus disease has become a major ophthalmic disease affecting daily life. Although great breakthroughs have been made in the treatment, compared with other chronic disease management, the management of patients with fundus disease is still in its infancy. To strengthen the management exploration of patients with fundus diseases, establish a management model of fundus diseases and strive to improve patients' awareness of fundus diseases and adherence to treatment and follow-up are the great challenges at present. All ophthalmic centers should strengthen patient education, establish a regional cooperation network, support the construction of grassroots medical capacity, cultivate talents, enhance training, promote the standardized treatment of fundus diseases, standardize fundus imaging inspection and diagnosis, and promote the homogeneous construction of diagnosis and treatment of chronic fundus diseases. We will accelerate the construction of a hierarchical diagnosis and treatment system and the ability to link consultation and referral. Through systematic management and intervention of fundus diseases, a large number of patients with fundus diseases will receive early screening, diagnosis, standardized continuous treatment and systematic management, and improve the quality of life of patients with fundus diseases.
ObjectiveTo explore the prevalence and risk factors of hypertension and diabetes in floating population in Hubei province, so as to provide reference for the prevention of chronic disease of floating population. MethodA multi-stages sampling was performed among six counties in Hubei province in 2012, according to the different occupations. A questionnaire survey was conducted to collect the demography, sociology and health-related behavioral characteristics of subjects. Then a univariate analysis and a multivariate analysis were conducted by SPSS 20.0 software. ResultsA total of 1 800 individuals were surveyed, and the prevalence of hypertension and diabetes in floating population was 22.7% and 4.9%, respectively. Univariate analysis indicated that significant associations were found between hypertension and such factors as age, occupations, smoking and life satisfaction (all P values < 0.05); and significant associations were found between diabetes and such factors as occupations, educational level and BMI (all P values < 0.05). The results of further logistic regression analysis showed that age (OR=2.194, 95% CI 1.940 to 2.483, P=0.001) and life satisfaction (OR=0.291, 95% CI 0.248 to 0.341, P=0.002) were independent risk factors of hypertension, and educational level (OR=3.219, 95%CI 2.016 to 7.565, P=0.011) and gender (OR=0.568, 95% CI 0.323 to 0.999, P=0.049) were independent risk factors of diabetes. ConclusionsThe prevalence of hypertension and diabetes are relative high in floating population of Hubei Province. Increasing age and low life satisfaction are independent risk factors of hypertension in floating population, while male and low educational level are independent risks factors of diabetes.