Objective:To analyze the positive impact of pharmaceutical care in the ophthalmology perioperative period on the rational use of antibiotics.Methods:A total of 115 patients who underwent ophthalmological surgery betwe...Objective:To analyze the positive impact of pharmaceutical care in the ophthalmology perioperative period on the rational use of antibiotics.Methods:A total of 115 patients who underwent ophthalmological surgery between March and June 2023 were selected as the control group,receiving routine medication management.Another 115 patients who underwent ophthalmological surgery between July and October 2023 were selected as the observation group,receiving pharmaceutical care.The rationality of medication use,mastery of medication knowledge,medication compliance,and adverse reaction rates were compared between the two groups.Results:The observation group had higher rationality of medication use,higher scores for mastery of medication knowledge,higher medication compliance,and a lower adverse reaction rate compared to the control group(P<0.05).Conclusion:The combination of antibiotic therapy and pharmaceutical care in the ophthalmology perioperative period can improve the rationality of medication use,enhance patients’mastery of medication knowledge,increase their medication compliance,and prevent adverse reactions to antibiotics.展开更多
Background:The Transitional Care Model(TCM)for nursing care has yet to be implemented in China despite its success in Western countries.However,rapid social changes have demanded an upgrade in the quality of nursing c...Background:The Transitional Care Model(TCM)for nursing care has yet to be implemented in China despite its success in Western countries.However,rapid social changes have demanded an upgrade in the quality of nursing care;in 2010,the Chinese government has acknowledged the need to implement the TCM in China.Objective:This study has the following objectives:(1)perform a thorough review of the literature regarding the development and implementation of the TCM in China's Mainland within the past 5 years;(2)provide a comprehensive discussion of the current status,problems,and strategies related to the implementation of the TCM in China's Mainland;and(3)suggest strategies pertaining to the future of the TCM in China.Design:The current pertinent literature is systematically reviewed.Data sources:Systematic and manual searches in computerized databases for relevant studies regarding the TCM led to the inclusion of 26 papers in this review.Review methods:Abstracts that satisfied the inclusion criteria were reviewed independently by the two authors of this manuscript,and discrepancies were resolved through discussion.The same reviewers independently assessed the paper in its entirety for selected abstracts.Results:The present English literature reviewrevealed a paucity of updated information about the development and implementation of the TCM in China's Mainland.Nevertheless,the dramatic growth of the TCM in the past 5 years has had a vital impact within the society and in nursing development.This review also revealed numerous issues regarding the focus of the TCM.Overall implications for practiceandrecommendations for future researchare discussed.Conclusion:Despite the potential of this nursing model to have a successful and beneficial impact in China's Mainland,it remains an under-researched topic.Further research on education and training as well as premium policies for nurses under the TCM are needed.展开更多
Purpose:To evaluate the efficacy of the Seamless Transfer of Care Model(STCM)to improve readmission occurrence of patients withstroke.Methods:The sample was comprised of fifty-nine subjects with stroke who were hospit...Purpose:To evaluate the efficacy of the Seamless Transfer of Care Model(STCM)to improve readmission occurrence of patients withstroke.Methods:The sample was comprised of fifty-nine subjects with stroke who were hospitalized in the geriatric and neurology departments of a large university hospital in China.Subjects were allocated to an STCM group(n=30)or a routine care(control)group(n=29).Results:Compared with the control group,the STCM group had a higher quality of life(p<0.05),higher compliance(p<0.05)and a lower readmission rate(p<0.05).Conclusion:Based on our results,the application of the STCM in Chinese stroke patients can improve quality of life and compliance,and reduce readmission rate.展开更多
In this review,we discuss the chronic care model(CCM)in relation to the diabetes pay-for-performance(P4P)program in Taiwan.We first introduce the 6 components of the CCM and provide a detailed description of each of t...In this review,we discuss the chronic care model(CCM)in relation to the diabetes pay-for-performance(P4P)program in Taiwan.We first introduce the 6 components of the CCM and provide a detailed description of each of the activities in the P4P program implemented in Taiwan,mapping them onto the 6 components of the CCM.For each CCM component,the following three topics are described:the definition of the CCM component,the general activities implemented related to this component,and practical and empirical practices based on hospital or local government cases.We then conclude by describing the possible successful features of this P4P program and its challenges and future directions.We conclude that the successful characteristics of this P4P program in Taiwan include its focus on extrinsic and intrinsic incentives(i.e.,shared care network),physician-led P4P and the implementation of activities based on the CCM components.However,due to the low rate of P4P program coverage,approximately 50%of patients with diabetes cannot enjoy the benefits of CCMrelated activities or receive necessary examinations.In addition,most of these CCM-related activities are not allotted an adequate amount of incentives,and these activities are mainly implemented in hospitals,which compared with primary care providers,are unable to execute these activities flexibly.All of these issues,as well as insufficient implementation of the e-CCM model,could hinder the advanced improvement of diabetes care in Taiwan.展开更多
The rapid global outbreak of coronavirus disease 2019(COVID-19)and the surge of infected patients have led to the verge of exhaustion of critical care medicine resources worldwide,especially with regard to critical ca...The rapid global outbreak of coronavirus disease 2019(COVID-19)and the surge of infected patients have led to the verge of exhaustion of critical care medicine resources worldwide,especially with regard to critical care staff.A holistic care model on time-sharing management for severe and critical COVID-19 patients is proposed,which includes formulation of individualized care objectives and plans,identification of care tasks in each shift and making detailed checklist,and management of quality of care.This study was conducted in the COVID-19 treatment center of Harbin,Heilongjiang Province.The data collected from the treatment center were recorded and analyzed.From the results we can deduce that it is especially suitable for non-intensive care unit(non-ICU)nurses to adapt care management mode of ICU as soon as possible and ensure the quality and efficiency of care during the epidemic.The holistic care model on time-sharing management for severe and critical cases with COVID-19 proposed based on our daily work experiences can assist in improving the quality and efficiency of care,thus reducing the mortality rate of patients in ICU.展开更多
As the prevalence of diabetic retinopathy continues to be on the rise, the Chronic Care Model (CCM) offers a transformative, patient-focused approach for efficient diabetic retinopathy care, emphasizing the need for u...As the prevalence of diabetic retinopathy continues to be on the rise, the Chronic Care Model (CCM) offers a transformative, patient-focused approach for efficient diabetic retinopathy care, emphasizing the need for urgent and innovative strategies in the United States. The model integrates community resources, healthcare organizations, self-management support, delivery system design, decision support, and clinical information systems. Addressing challenges and solutions, the model emphasizes proactive and preventive measures, collaborative multidisciplinary care, technological integration, and overcoming resistance to change. This paper proposes the utilization of the Chronic Care Model (CCM) as a possible public health framework for comprehensive management of diabetic retinopathy in the United States. Implementing the CCM offers a comprehensive approach to diabetic retinopathy care, addressing both individual and systemic factors, essential for improving public health outcomes.展开更多
Objective: To study the application effect of the family collaborative care model on elderly patients with type 2 diabetes mellitus and its influence on self-care ability. Methods: The elderly type 2 diabetes mellitus...Objective: To study the application effect of the family collaborative care model on elderly patients with type 2 diabetes mellitus and its influence on self-care ability. Methods: The elderly type 2 diabetes mellitus patients (400 cases) treated in our hospital between March 2020 and July 2023 were divided into two groups by randomized grouping method;the control group received the conventional nursing program, while the observation group received the family collaborative nursing model. Blood glucose level, self-care ability, and quality of life were compared between the groups. Results: The blood glucose level of the observation group was lower than that of the control group (P < 0.05). The self- care ability and quality of life scores of the observation group were higher than those of the control group (P < 0.05). Conclusion: The family collaborative care model for elderly patients with type 2 diabetes mellitus can promote their self- care ability, improve the effect of glycemic control, and improve their quality of life, and is suitable for further promotion and application.展开更多
Background: Social capital has been described as a person’s sense of belonging as a result of the number and type of relationships she/he has, in which trust and reciprocity are especially important. Aim: To illumina...Background: Social capital has been described as a person’s sense of belonging as a result of the number and type of relationships she/he has, in which trust and reciprocity are especially important. Aim: To illuminate older persons’ experiences of social capital and depressive ill-health after implementation of the CCM. Methods: Data were collected from nine participants resident in two districts of Norway by means of individual in-depth interviews. A qualitative hermeneutic analysis was performed. Results: Two overall themes, desire for a guardian and a wish for independence despite being dependent, and two themes emerging from the analysis. The first theme—searching for protection was based on three sub-themes overwhelmed by the emotional pain of other people, a sense of exclusion and worries about the future, while the second theme—the need for a relationship with trustworthy persons comprised two sub-themes, namely, emotional pain was not understood and powerlessness to change the situation. The result of this study highlights the need for greater understanding on the part of healthcare professionals of how older persons manage their social relationships. Healthcare professionals require more knowledge about how negative self-beliefs held by older persons suffering from emotional pain, which can lead to reduced ability to trust other people. Another consequence is that fear of being dependent on other people can result in unwillingness to admit the need for help. Conclusion: This study highlights the lack of social capital in older persons who suffer from depressive ill-health. The implementation of the CCM does not appear to improve the situation. Older persons need to be more aware of their social needs and productive interactions in order to protect themselves and obtain support from their social network.展开更多
This study aimed to clarify the changes in nurses’ cognition about the rate and likelihood of implementation of daily ethical nursing items used in pediatric care before and after attending online workshops using the...This study aimed to clarify the changes in nurses’ cognition about the rate and likelihood of implementation of daily ethical nursing items used in pediatric care before and after attending online workshops using the Pediatric Nursing Care Model (PNCM). A 1.5-hour online workshop was held twice over two weeks. A total of nine nurses participated in the program. These online workshops using PNCM helped achieve the original goals and the results revealed a positive outcome of the workshops. We should devise an educational program to arouse participants’ interest and comprehension to make the most of online competency.展开更多
Objective: To study and expound the clinical value and effect of comprehensive holistic nursing model in ICU patients with severe pneumonia. Methods: In this study, 40 patients with severe pneumonia in the intensive c...Objective: To study and expound the clinical value and effect of comprehensive holistic nursing model in ICU patients with severe pneumonia. Methods: In this study, 40 patients with severe pneumonia in the intensive care unit admitted to the Department of Intensive Care Medicine of Dangyang People's Hospital from February 20, 2021 to December 20, 2021 were divided into groups by blind selection. Twenty patients were included in each group. The control group received routine nursing and the experimental group received comprehensive nursing intervention. The clinical vital signs, improvement time of clinical symptoms, blood gas, length of hospital stay, degree of inflammation and nursing satisfaction were compared between the two groups according to the actual situation. Results: After this analysis, compared with the control group, the experimental group had significantly lower respiratory rate and heart rate, PaCO2, increased mean arterial pressure and PaO2, shortened clinical symptom improvement time and hospital stay, and significantly reduced IL-6, IL-8 and TNF-α. Compared with the reference group, the overall nursing satisfaction was more recognized (P<0.05). The data between groups have the value of statistical validation reference. Conclusion: Comprehensive holistic nursing for ICU patients with severe pneumonia can comprehensively improve the indicators and symptoms, reduce the level of inflammation, shorten the length of hospital stay, improve nursing satisfaction, and can be widely used in clinical practice.展开更多
Objective: to explore the application effect of MDT nursing model in type 2 diabetes care. Methods: 80 patients with type 2 diabetes were selected and divided into control group and test group according to the random ...Objective: to explore the application effect of MDT nursing model in type 2 diabetes care. Methods: 80 patients with type 2 diabetes were selected and divided into control group and test group according to the random number method. 40 patients in each group had routine care intervention, and MDT care mode was added on the basis of routine care to compare the relevant indicators of the two groups. Results: we found that the patients in the MDT care model were better than those in terms of blood glucose index, self-care ability and quality of life, with significant differences (P <0.05). Conclusion: with the help of MDT care model, the indicators of type 2 diabetes patients can be effectively improved, making patients gain high clinical efficacy, and improve patients self-care ability and quality of life, which is worth popularizing in clinical practice.展开更多
Objective: To analyze the impact of an integrated extended care model on improving the quality of life of elderly patients with Type 2 Diabetes Mellitus (T2DM). Methods: A total of 176 patients admitted to the hospita...Objective: To analyze the impact of an integrated extended care model on improving the quality of life of elderly patients with Type 2 Diabetes Mellitus (T2DM). Methods: A total of 176 patients admitted to the hospital from March 2015 to February 2018 were selected and randomly assigned to an observation group and a control group, with 88 patients each. The control group implemented conventional nursing interventions, and the observation group carried out an integrated extended-care model. The level of glycemic control, quality of life, and daily medication adherence between both groups were compared. Results: The observation group showed significant improvement in the level of glycemic control, and their fasting blood glucose, 2-hour postprandial blood glucose, and glycated hemoglobin levels were significantly lower as compared with those in the study group (P < 0.05). The quality of life of the patients in the observation group was higher than that of the control group (P < 0.05). The observation group had a higher compliance score (95.48 ± 7.45) than the control group (81.31 ± 8.72) (t = 8.909, P < 0.05). Conclusion: The integrated extended care model allows patients to receive comprehensive and individualized nursing services after discharge, which improves the effect of drug therapy and the quality of life of patients.展开更多
Background: In paternalistic models, healthcare providers’ responsibility is to decide what is best for patients. The main concern is that such models fail to respect patient autonomy and do not promote patient respo...Background: In paternalistic models, healthcare providers’ responsibility is to decide what is best for patients. The main concern is that such models fail to respect patient autonomy and do not promote patient responsibility. Aim: To evaluate mental healthcare team members’ perceptions of their own role in encouraging elderly persons to participate in shared decision-making after implementation of the CCM. The CCM is not an explanatory theory, but an evidence-based guideline and synthesis of best available evidence. Methods: Data were collected from two teams that took part in a focus group interview, and the transcript was analysed by means of qualitative thematic analysis. Results: One overall theme emerged—Preventing the violation of human dignity based on three themes, namely, Changing understanding and attitudes, Increasing depressed elderly persons’ autonomy and Clarifying the mental healthcare team coordinator’s role and responsibility. The results of this study reveal that until recently, paternalism has been the dominant decision-making model within healthcare, without any apparent consideration of the patient perspective. Community mental healthcare can be improved by shared decision-making in which team members initiate a dialogue focusing on patient participation to prevent the violation of human dignity. However, in order to determine how best to empower the patient, team members need expert knowledge and intuition.展开更多
AIM To determine if our health system's integrated model reflects sustained virologic response(SVR) outcomes similar to those in clinical trial data, maximizes adherence, and averts drug interactions.METHODS Subje...AIM To determine if our health system's integrated model reflects sustained virologic response(SVR) outcomes similar to those in clinical trial data, maximizes adherence, and averts drug interactions.METHODS Subjects with chronic hepatitis C had their medical records reviewed from November 1st, 2014 through March 1st, 2016. Patients eligible for treatment were entered into an integrated care model therapy algorithm. The primary outcome was SVR12 based on intention to treat(ITT) analysis. Inclusion criteria consisted of both treatment na?ve and experienced patients over the age of 18 who were at least twelve weeks post-therapy completion with any genotype(GT) or METAVIR score. Secondary outcomes included adherence, adverse events, and number of drug interaction interventions.RESULTS At the time of analysis, 133 patients had reached twelve weeks post therapy with ITT. In the ITT analysis 70 patients were GT 1a, 26 GT 1b, 23 could not be differentiated between GT 1a or 1b, 8 GT 2, 4 GT 3, and 2 patients with multiple genotypes. The ITT treatment regimens consisted of 97 sofosbuvir(SOF)/ledipasvir(LDV), 8 SOF/LDV and ribavirin(RBV), 7 SOFand Simeprevir(SMV), 6 3D and RBV, 1 3D, 11 SOF and RBV, and 1 SOF, peg interferon alpha, and RBV. The overall SVR12 rate was 93% in the ITT analysis with a total of 6 patients relapsing. In patients with cirrhosis, 89% obtained SVR12. All 33 patients who were previous treatment failures achieved SVR12. Drug-drug interactions were identified in 56.4% of our patient population, 69 of which required interventions made by the pharmacist. The most common side effects were fatigue(41.4%), headache(28.6%), nausea(18.1%), and diarrhea(8.3%). No serious adverse effects were reported.CONCLUSION Dean Health System's integrated care model successfully managed patients being treated for hepatitis C virus(HCV). The integrated care model demonstrates high SVR rates amongst patients with different levels of fibrosis, genotypes, and HCV treatment history.展开更多
A contextual review of models for chronic care was done to develop a context-adapted chronic care model-based service delivery model for chronic conditions including diabetes.The Philippines was used as the setting of...A contextual review of models for chronic care was done to develop a context-adapted chronic care model-based service delivery model for chronic conditions including diabetes.The Philippines was used as the setting of a low-to-middle-income country.A context-based narrative review of existing models for chronic care was conducted.A situational analysis was done at thegrassroots level,involving the leaders and members of the community,the patients,the local health system and the healthcare providers.A second analysis making use of certain organizational theories was done to explore on improving feasibility and acceptability of organizing care for chronic conditions.The analyses indicated that care for chronic conditions may be introduced,considering the needs of people with diabetes in particular and the community in general as recipients of care,and the issues and factors that may affect the healthcare workers and the health system as providers of this care.The context-adapted chronic care model-based service delivery model was constructed accordingly.Key features are:incorporation of chronic care in the health system's services; assimilation of chronic care delivery with the other responsibilities of the healthcare workers but with redistribution of certain tasks; and ensuring that the recipients of care experience the whole spectrum of basic chronic care that includes education and promotion in the general population,risk identification,screening,counseling including self-care development,and clinical management of the chronic condition and any co-morbidities,regardless of level of control of the condition.This way,low-to-middle income countries can introduce and improve care for chronic conditions without entailing much additional demand on their limited resources.展开更多
Depression in later life is an underrepresented yet important research area. The aim of the study was to explore depressed older persons’ need for and expectations of improved health services one year after implement...Depression in later life is an underrepresented yet important research area. The aim of the study was to explore depressed older persons’ need for and expectations of improved health services one year after implementation of the Chronic Care Model (CCM). A qualitative evaluative design was used. Data were collected through individual interviews with older persons living in Norway. The qualitative content analysis revealed two themes: The need to be safeguarded and Expectation of being considered valuable and capable. Evaluation of the improvement in care with focus on the CCM components showed that the most important components for improving the depressed older person’s daily life were: delivery system re-design, self-management support, productive interaction and a well-informed active patient. The findings highlight the need for a health services designed for persons suffering from chronic ill-health, where the CCM could serve as a framework for policy change and support the redesign of the existing healthcare system. We conclude that older persons with depression need attention, especially those who have been suffering for many years. The identified components may have implications for health professionals in the promotion of mental healthcare.展开更多
As global populations become increasingly aged,existing elderly care models are proving insufficient.The development and application of nursing robots have shown potential in addressing the challenges of elder care in...As global populations become increasingly aged,existing elderly care models are proving insufficient.The development and application of nursing robots have shown potential in addressing the challenges of elder care in aging societies.This perspective outlines current state and potential applications of nursing robots in promoting healthy aging.Given this background,a networked intelligent elderly care model for nursing robots,which integrates technologies such as big data,artificial intelligence,the Internet of Things,and nursing robotics,is proposed.This model would synergistically combine elderly health monitoring,capability assessment,and intelligent allocation functions to revolutionize global elderly care practices and promote healthy aging.展开更多
Within the new model of integrated medical and elderly care services,elderly-related data manifest a composite rights structure that integrates both public and private law dimensions.The granular and multi-dimensional...Within the new model of integrated medical and elderly care services,elderly-related data manifest a composite rights structure that integrates both public and private law dimensions.The granular and multi-dimensional nature and heightened sensitivity of such data,combined with the inherent vulnerability and dependency of elderly-related data subjects,render the regulatory landscape particularly complex.Existing mechanisms for data circulation reveal deficiencies,including fragmented legal norms,indeterminate allocation of data ownership,and supervisory inadequacy.This paper conducts a doctrinal inquiry into the legal relationships among multiple stakeholders across three principal dimensions:data service authorisation,data transmission and operation,and data supervision and safeguard.It proposes a regulatory framework based on a dual-track mechanism-combining top-down harmonisation of existing legal provisions with bottom-up implementation of data trusts-supported by a comprehensive oversight architecture involving government agencies,public interest organisations,and industry associations.This framework is intended to ensure the effective protection of the rights and interests of digitally vulnerable elderly individuals.展开更多
In the context of controlling population development in a planned way,China entered an aging society in the early 21 st century.In this context,how to meet the needs of the elderly care and form an effective elderly c...In the context of controlling population development in a planned way,China entered an aging society in the early 21 st century.In this context,how to meet the needs of the elderly care and form an effective elderly care model has become a key problem to be solved urgently by local government departments.With the continuous advancement of the elderly care policy,the community-based elderly care has gradually become the mainstream and is in the stage of vigorous promotion.Taking the Gannan old revolutionary base area in Jiangxi Province as an example,this study puts forward"1+4+X"community-based elderly care model based on the policy system of community-based elderly care,the physical and mental health of the elderly,the material space and the construction of evaluation system,and explores how to promote the application of this community model efficiently in the form of industrialization,so as to drive the economic growth of the Gannan old revolutionary base area,promote the employment development and improve the community-based elderly care service.展开更多
文摘Objective:To analyze the positive impact of pharmaceutical care in the ophthalmology perioperative period on the rational use of antibiotics.Methods:A total of 115 patients who underwent ophthalmological surgery between March and June 2023 were selected as the control group,receiving routine medication management.Another 115 patients who underwent ophthalmological surgery between July and October 2023 were selected as the observation group,receiving pharmaceutical care.The rationality of medication use,mastery of medication knowledge,medication compliance,and adverse reaction rates were compared between the two groups.Results:The observation group had higher rationality of medication use,higher scores for mastery of medication knowledge,higher medication compliance,and a lower adverse reaction rate compared to the control group(P<0.05).Conclusion:The combination of antibiotic therapy and pharmaceutical care in the ophthalmology perioperative period can improve the rationality of medication use,enhance patients’mastery of medication knowledge,increase their medication compliance,and prevent adverse reactions to antibiotics.
文摘Background:The Transitional Care Model(TCM)for nursing care has yet to be implemented in China despite its success in Western countries.However,rapid social changes have demanded an upgrade in the quality of nursing care;in 2010,the Chinese government has acknowledged the need to implement the TCM in China.Objective:This study has the following objectives:(1)perform a thorough review of the literature regarding the development and implementation of the TCM in China's Mainland within the past 5 years;(2)provide a comprehensive discussion of the current status,problems,and strategies related to the implementation of the TCM in China's Mainland;and(3)suggest strategies pertaining to the future of the TCM in China.Design:The current pertinent literature is systematically reviewed.Data sources:Systematic and manual searches in computerized databases for relevant studies regarding the TCM led to the inclusion of 26 papers in this review.Review methods:Abstracts that satisfied the inclusion criteria were reviewed independently by the two authors of this manuscript,and discrepancies were resolved through discussion.The same reviewers independently assessed the paper in its entirety for selected abstracts.Results:The present English literature reviewrevealed a paucity of updated information about the development and implementation of the TCM in China's Mainland.Nevertheless,the dramatic growth of the TCM in the past 5 years has had a vital impact within the society and in nursing development.This review also revealed numerous issues regarding the focus of the TCM.Overall implications for practiceandrecommendations for future researchare discussed.Conclusion:Despite the potential of this nursing model to have a successful and beneficial impact in China's Mainland,it remains an under-researched topic.Further research on education and training as well as premium policies for nurses under the TCM are needed.
基金This study was supported by the Research Foundation of Fudan University(FNF201208)Health And Family Planning Commission Of Shanghai(201440090)and Minhang(2012MHZ028).
文摘Purpose:To evaluate the efficacy of the Seamless Transfer of Care Model(STCM)to improve readmission occurrence of patients withstroke.Methods:The sample was comprised of fifty-nine subjects with stroke who were hospitalized in the geriatric and neurology departments of a large university hospital in China.Subjects were allocated to an STCM group(n=30)or a routine care(control)group(n=29).Results:Compared with the control group,the STCM group had a higher quality of life(p<0.05),higher compliance(p<0.05)and a lower readmission rate(p<0.05).Conclusion:Based on our results,the application of the STCM in Chinese stroke patients can improve quality of life and compliance,and reduce readmission rate.
基金Ministry of Science and Technology in Taipei,No.106-2918-I-030-002.
文摘In this review,we discuss the chronic care model(CCM)in relation to the diabetes pay-for-performance(P4P)program in Taiwan.We first introduce the 6 components of the CCM and provide a detailed description of each of the activities in the P4P program implemented in Taiwan,mapping them onto the 6 components of the CCM.For each CCM component,the following three topics are described:the definition of the CCM component,the general activities implemented related to this component,and practical and empirical practices based on hospital or local government cases.We then conclude by describing the possible successful features of this P4P program and its challenges and future directions.We conclude that the successful characteristics of this P4P program in Taiwan include its focus on extrinsic and intrinsic incentives(i.e.,shared care network),physician-led P4P and the implementation of activities based on the CCM components.However,due to the low rate of P4P program coverage,approximately 50%of patients with diabetes cannot enjoy the benefits of CCMrelated activities or receive necessary examinations.In addition,most of these CCM-related activities are not allotted an adequate amount of incentives,and these activities are mainly implemented in hospitals,which compared with primary care providers,are unable to execute these activities flexibly.All of these issues,as well as insufficient implementation of the e-CCM model,could hinder the advanced improvement of diabetes care in Taiwan.
基金Supported by The National Natural Science Foundation of China,No.81770276and Nn10 Program of Harbin Medical University Cancer Hospital and Scientific Research Project of Heilongjiang Health and Family Planning Commission,No.2018086.
文摘The rapid global outbreak of coronavirus disease 2019(COVID-19)and the surge of infected patients have led to the verge of exhaustion of critical care medicine resources worldwide,especially with regard to critical care staff.A holistic care model on time-sharing management for severe and critical COVID-19 patients is proposed,which includes formulation of individualized care objectives and plans,identification of care tasks in each shift and making detailed checklist,and management of quality of care.This study was conducted in the COVID-19 treatment center of Harbin,Heilongjiang Province.The data collected from the treatment center were recorded and analyzed.From the results we can deduce that it is especially suitable for non-intensive care unit(non-ICU)nurses to adapt care management mode of ICU as soon as possible and ensure the quality and efficiency of care during the epidemic.The holistic care model on time-sharing management for severe and critical cases with COVID-19 proposed based on our daily work experiences can assist in improving the quality and efficiency of care,thus reducing the mortality rate of patients in ICU.
文摘As the prevalence of diabetic retinopathy continues to be on the rise, the Chronic Care Model (CCM) offers a transformative, patient-focused approach for efficient diabetic retinopathy care, emphasizing the need for urgent and innovative strategies in the United States. The model integrates community resources, healthcare organizations, self-management support, delivery system design, decision support, and clinical information systems. Addressing challenges and solutions, the model emphasizes proactive and preventive measures, collaborative multidisciplinary care, technological integration, and overcoming resistance to change. This paper proposes the utilization of the Chronic Care Model (CCM) as a possible public health framework for comprehensive management of diabetic retinopathy in the United States. Implementing the CCM offers a comprehensive approach to diabetic retinopathy care, addressing both individual and systemic factors, essential for improving public health outcomes.
文摘Objective: To study the application effect of the family collaborative care model on elderly patients with type 2 diabetes mellitus and its influence on self-care ability. Methods: The elderly type 2 diabetes mellitus patients (400 cases) treated in our hospital between March 2020 and July 2023 were divided into two groups by randomized grouping method;the control group received the conventional nursing program, while the observation group received the family collaborative nursing model. Blood glucose level, self-care ability, and quality of life were compared between the groups. Results: The blood glucose level of the observation group was lower than that of the control group (P < 0.05). The self- care ability and quality of life scores of the observation group were higher than those of the control group (P < 0.05). Conclusion: The family collaborative care model for elderly patients with type 2 diabetes mellitus can promote their self- care ability, improve the effect of glycemic control, and improve their quality of life, and is suitable for further promotion and application.
文摘Background: Social capital has been described as a person’s sense of belonging as a result of the number and type of relationships she/he has, in which trust and reciprocity are especially important. Aim: To illuminate older persons’ experiences of social capital and depressive ill-health after implementation of the CCM. Methods: Data were collected from nine participants resident in two districts of Norway by means of individual in-depth interviews. A qualitative hermeneutic analysis was performed. Results: Two overall themes, desire for a guardian and a wish for independence despite being dependent, and two themes emerging from the analysis. The first theme—searching for protection was based on three sub-themes overwhelmed by the emotional pain of other people, a sense of exclusion and worries about the future, while the second theme—the need for a relationship with trustworthy persons comprised two sub-themes, namely, emotional pain was not understood and powerlessness to change the situation. The result of this study highlights the need for greater understanding on the part of healthcare professionals of how older persons manage their social relationships. Healthcare professionals require more knowledge about how negative self-beliefs held by older persons suffering from emotional pain, which can lead to reduced ability to trust other people. Another consequence is that fear of being dependent on other people can result in unwillingness to admit the need for help. Conclusion: This study highlights the lack of social capital in older persons who suffer from depressive ill-health. The implementation of the CCM does not appear to improve the situation. Older persons need to be more aware of their social needs and productive interactions in order to protect themselves and obtain support from their social network.
文摘This study aimed to clarify the changes in nurses’ cognition about the rate and likelihood of implementation of daily ethical nursing items used in pediatric care before and after attending online workshops using the Pediatric Nursing Care Model (PNCM). A 1.5-hour online workshop was held twice over two weeks. A total of nine nurses participated in the program. These online workshops using PNCM helped achieve the original goals and the results revealed a positive outcome of the workshops. We should devise an educational program to arouse participants’ interest and comprehension to make the most of online competency.
文摘Objective: To study and expound the clinical value and effect of comprehensive holistic nursing model in ICU patients with severe pneumonia. Methods: In this study, 40 patients with severe pneumonia in the intensive care unit admitted to the Department of Intensive Care Medicine of Dangyang People's Hospital from February 20, 2021 to December 20, 2021 were divided into groups by blind selection. Twenty patients were included in each group. The control group received routine nursing and the experimental group received comprehensive nursing intervention. The clinical vital signs, improvement time of clinical symptoms, blood gas, length of hospital stay, degree of inflammation and nursing satisfaction were compared between the two groups according to the actual situation. Results: After this analysis, compared with the control group, the experimental group had significantly lower respiratory rate and heart rate, PaCO2, increased mean arterial pressure and PaO2, shortened clinical symptom improvement time and hospital stay, and significantly reduced IL-6, IL-8 and TNF-α. Compared with the reference group, the overall nursing satisfaction was more recognized (P<0.05). The data between groups have the value of statistical validation reference. Conclusion: Comprehensive holistic nursing for ICU patients with severe pneumonia can comprehensively improve the indicators and symptoms, reduce the level of inflammation, shorten the length of hospital stay, improve nursing satisfaction, and can be widely used in clinical practice.
文摘Objective: to explore the application effect of MDT nursing model in type 2 diabetes care. Methods: 80 patients with type 2 diabetes were selected and divided into control group and test group according to the random number method. 40 patients in each group had routine care intervention, and MDT care mode was added on the basis of routine care to compare the relevant indicators of the two groups. Results: we found that the patients in the MDT care model were better than those in terms of blood glucose index, self-care ability and quality of life, with significant differences (P <0.05). Conclusion: with the help of MDT care model, the indicators of type 2 diabetes patients can be effectively improved, making patients gain high clinical efficacy, and improve patients self-care ability and quality of life, which is worth popularizing in clinical practice.
文摘Objective: To analyze the impact of an integrated extended care model on improving the quality of life of elderly patients with Type 2 Diabetes Mellitus (T2DM). Methods: A total of 176 patients admitted to the hospital from March 2015 to February 2018 were selected and randomly assigned to an observation group and a control group, with 88 patients each. The control group implemented conventional nursing interventions, and the observation group carried out an integrated extended-care model. The level of glycemic control, quality of life, and daily medication adherence between both groups were compared. Results: The observation group showed significant improvement in the level of glycemic control, and their fasting blood glucose, 2-hour postprandial blood glucose, and glycated hemoglobin levels were significantly lower as compared with those in the study group (P < 0.05). The quality of life of the patients in the observation group was higher than that of the control group (P < 0.05). The observation group had a higher compliance score (95.48 ± 7.45) than the control group (81.31 ± 8.72) (t = 8.909, P < 0.05). Conclusion: The integrated extended care model allows patients to receive comprehensive and individualized nursing services after discharge, which improves the effect of drug therapy and the quality of life of patients.
文摘Background: In paternalistic models, healthcare providers’ responsibility is to decide what is best for patients. The main concern is that such models fail to respect patient autonomy and do not promote patient responsibility. Aim: To evaluate mental healthcare team members’ perceptions of their own role in encouraging elderly persons to participate in shared decision-making after implementation of the CCM. The CCM is not an explanatory theory, but an evidence-based guideline and synthesis of best available evidence. Methods: Data were collected from two teams that took part in a focus group interview, and the transcript was analysed by means of qualitative thematic analysis. Results: One overall theme emerged—Preventing the violation of human dignity based on three themes, namely, Changing understanding and attitudes, Increasing depressed elderly persons’ autonomy and Clarifying the mental healthcare team coordinator’s role and responsibility. The results of this study reveal that until recently, paternalism has been the dominant decision-making model within healthcare, without any apparent consideration of the patient perspective. Community mental healthcare can be improved by shared decision-making in which team members initiate a dialogue focusing on patient participation to prevent the violation of human dignity. However, in order to determine how best to empower the patient, team members need expert knowledge and intuition.
文摘AIM To determine if our health system's integrated model reflects sustained virologic response(SVR) outcomes similar to those in clinical trial data, maximizes adherence, and averts drug interactions.METHODS Subjects with chronic hepatitis C had their medical records reviewed from November 1st, 2014 through March 1st, 2016. Patients eligible for treatment were entered into an integrated care model therapy algorithm. The primary outcome was SVR12 based on intention to treat(ITT) analysis. Inclusion criteria consisted of both treatment na?ve and experienced patients over the age of 18 who were at least twelve weeks post-therapy completion with any genotype(GT) or METAVIR score. Secondary outcomes included adherence, adverse events, and number of drug interaction interventions.RESULTS At the time of analysis, 133 patients had reached twelve weeks post therapy with ITT. In the ITT analysis 70 patients were GT 1a, 26 GT 1b, 23 could not be differentiated between GT 1a or 1b, 8 GT 2, 4 GT 3, and 2 patients with multiple genotypes. The ITT treatment regimens consisted of 97 sofosbuvir(SOF)/ledipasvir(LDV), 8 SOF/LDV and ribavirin(RBV), 7 SOFand Simeprevir(SMV), 6 3D and RBV, 1 3D, 11 SOF and RBV, and 1 SOF, peg interferon alpha, and RBV. The overall SVR12 rate was 93% in the ITT analysis with a total of 6 patients relapsing. In patients with cirrhosis, 89% obtained SVR12. All 33 patients who were previous treatment failures achieved SVR12. Drug-drug interactions were identified in 56.4% of our patient population, 69 of which required interventions made by the pharmacist. The most common side effects were fatigue(41.4%), headache(28.6%), nausea(18.1%), and diarrhea(8.3%). No serious adverse effects were reported.CONCLUSION Dean Health System's integrated care model successfully managed patients being treated for hepatitis C virus(HCV). The integrated care model demonstrates high SVR rates amongst patients with different levels of fibrosis, genotypes, and HCV treatment history.
基金Supported by The Belgian Directorate for Development Cooperation through the Institute of Tropical Medicine,Antwerp
文摘A contextual review of models for chronic care was done to develop a context-adapted chronic care model-based service delivery model for chronic conditions including diabetes.The Philippines was used as the setting of a low-to-middle-income country.A context-based narrative review of existing models for chronic care was conducted.A situational analysis was done at thegrassroots level,involving the leaders and members of the community,the patients,the local health system and the healthcare providers.A second analysis making use of certain organizational theories was done to explore on improving feasibility and acceptability of organizing care for chronic conditions.The analyses indicated that care for chronic conditions may be introduced,considering the needs of people with diabetes in particular and the community in general as recipients of care,and the issues and factors that may affect the healthcare workers and the health system as providers of this care.The context-adapted chronic care model-based service delivery model was constructed accordingly.Key features are:incorporation of chronic care in the health system's services; assimilation of chronic care delivery with the other responsibilities of the healthcare workers but with redistribution of certain tasks; and ensuring that the recipients of care experience the whole spectrum of basic chronic care that includes education and promotion in the general population,risk identification,screening,counseling including self-care development,and clinical management of the chronic condition and any co-morbidities,regardless of level of control of the condition.This way,low-to-middle income countries can introduce and improve care for chronic conditions without entailing much additional demand on their limited resources.
文摘Depression in later life is an underrepresented yet important research area. The aim of the study was to explore depressed older persons’ need for and expectations of improved health services one year after implementation of the Chronic Care Model (CCM). A qualitative evaluative design was used. Data were collected through individual interviews with older persons living in Norway. The qualitative content analysis revealed two themes: The need to be safeguarded and Expectation of being considered valuable and capable. Evaluation of the improvement in care with focus on the CCM components showed that the most important components for improving the depressed older person’s daily life were: delivery system re-design, self-management support, productive interaction and a well-informed active patient. The findings highlight the need for a health services designed for persons suffering from chronic ill-health, where the CCM could serve as a framework for policy change and support the redesign of the existing healthcare system. We conclude that older persons with depression need attention, especially those who have been suffering for many years. The identified components may have implications for health professionals in the promotion of mental healthcare.
基金supported by the National Key Research and Development Program of China(Grant Nos.2022YFB3805805 and 2022YFB3805804 to G.T.,2023YFC3604300 to D.C.,and 2023YFC3604305 to H.S.)the National Natural Science Foundation of China(Grant Nos.T2425018 and 62175082 to G.T.)+2 种基金the Multidisciplinary Research Support Program of Huazhong University of Science and Technology(Grant No.2023JCYJ039 to G.T.)the Huazhong University of Science and Technology Double First-Class Funds for Humanities and Social Sciences(Sports Industry Research Center of Huazhong University of Science and Technology to G.T.)the China Postdoctoral Science Foundation(2023M731184 to M.Y.).
文摘As global populations become increasingly aged,existing elderly care models are proving insufficient.The development and application of nursing robots have shown potential in addressing the challenges of elder care in aging societies.This perspective outlines current state and potential applications of nursing robots in promoting healthy aging.Given this background,a networked intelligent elderly care model for nursing robots,which integrates technologies such as big data,artificial intelligence,the Internet of Things,and nursing robotics,is proposed.This model would synergistically combine elderly health monitoring,capability assessment,and intelligent allocation functions to revolutionize global elderly care practices and promote healthy aging.
文摘Within the new model of integrated medical and elderly care services,elderly-related data manifest a composite rights structure that integrates both public and private law dimensions.The granular and multi-dimensional nature and heightened sensitivity of such data,combined with the inherent vulnerability and dependency of elderly-related data subjects,render the regulatory landscape particularly complex.Existing mechanisms for data circulation reveal deficiencies,including fragmented legal norms,indeterminate allocation of data ownership,and supervisory inadequacy.This paper conducts a doctrinal inquiry into the legal relationships among multiple stakeholders across three principal dimensions:data service authorisation,data transmission and operation,and data supervision and safeguard.It proposes a regulatory framework based on a dual-track mechanism-combining top-down harmonisation of existing legal provisions with bottom-up implementation of data trusts-supported by a comprehensive oversight architecture involving government agencies,public interest organisations,and industry associations.This framework is intended to ensure the effective protection of the rights and interests of digitally vulnerable elderly individuals.
文摘In the context of controlling population development in a planned way,China entered an aging society in the early 21 st century.In this context,how to meet the needs of the elderly care and form an effective elderly care model has become a key problem to be solved urgently by local government departments.With the continuous advancement of the elderly care policy,the community-based elderly care has gradually become the mainstream and is in the stage of vigorous promotion.Taking the Gannan old revolutionary base area in Jiangxi Province as an example,this study puts forward"1+4+X"community-based elderly care model based on the policy system of community-based elderly care,the physical and mental health of the elderly,the material space and the construction of evaluation system,and explores how to promote the application of this community model efficiently in the form of industrialization,so as to drive the economic growth of the Gannan old revolutionary base area,promote the employment development and improve the community-based elderly care service.
