Objective: to explore the role of family doctor responsibility model intervention on patients with severe mental disorders in the community. Methods: from January 2018 to December 2020, 60 patients with severe mental ...Objective: to explore the role of family doctor responsibility model intervention on patients with severe mental disorders in the community. Methods: from January 2018 to December 2020, 60 patients with severe mental disorder in community were randomly divided into two groups by double-blind method. Routine follow-up group was given routine intervention, and family doctor group was given family doctor responsibility model intervention on this basis. Compare the effectiveness of intervention. Results: the compliance of the family doctor group was higher than that of the routine follow-up group, the scores of quality of life, CAS of adaptation scale and brief psychiatric rating scale were better than that of the routine follow-up group, and the incidence of family psychoactive side effects was lower than that of the routine follow-up group, P < 0.05. Conclusion: the intervention effect of family doctor responsibility system for patients with severe mental disorders in community is accurate, which can improve the compliance, reduce the occurrence of psychotropic drug side effects, promote the quality of life of patients significantly improved, and improve the psychopathological symptoms and adaptability of patients, which is worth promoting.展开更多
BACKGROUND Percutaneous endoscopic gastrostomy(PEG)is a well-established,minimally invasive,and easy to perform procedure for nutrition delivery,applied to individuals unable to swallow for various reasons.PEG has a h...BACKGROUND Percutaneous endoscopic gastrostomy(PEG)is a well-established,minimally invasive,and easy to perform procedure for nutrition delivery,applied to individuals unable to swallow for various reasons.PEG has a high technical success rate of insertion between 95%and 100%in experienced hands,but varying complication rates ranging from 0.4%to 22.5%of cases.AIM To discuss the existing evidence of major procedural complications in PEG,mainly focusing on those that could probably have been avoided,had the endoscopist been more experienced,or less self-confident in relation to the basic safety rules for PEG performance.METHODS After a thorough research of the international literature of a period of more than 30 years of published“case reports”concerning such complications,we critically analyzed only those complications which were considered-after assessment by two experts in PEG performance working separately-to be directly related to a form of malpractice by the endoscopist.RESULTS Malpractice by the endoscopist were considered cases of:Gastrostomy tubes passed through the colon or though the left lateral liver lobe,bleeding after puncture injury of large vessels of the stomach or the peritoneum,peritonitis after viscera damage,and injuries of the esophagus,spleen,and pancreas.CONCLUSION For a safe PEG insertion,the overfilling of the stomach and small bowel with air should be avoided,the clinician should check thoroughly for the proper trans-illumination of the light source of the endoscope through the abdominal wall and ensure endoscopically visible imprint of finger palpation on the skin at the center of the site of maximum illumination,and finally,the physician should be more alert with obese patients and those with previous abdominal surgery.展开更多
文摘Objective: to explore the role of family doctor responsibility model intervention on patients with severe mental disorders in the community. Methods: from January 2018 to December 2020, 60 patients with severe mental disorder in community were randomly divided into two groups by double-blind method. Routine follow-up group was given routine intervention, and family doctor group was given family doctor responsibility model intervention on this basis. Compare the effectiveness of intervention. Results: the compliance of the family doctor group was higher than that of the routine follow-up group, the scores of quality of life, CAS of adaptation scale and brief psychiatric rating scale were better than that of the routine follow-up group, and the incidence of family psychoactive side effects was lower than that of the routine follow-up group, P < 0.05. Conclusion: the intervention effect of family doctor responsibility system for patients with severe mental disorders in community is accurate, which can improve the compliance, reduce the occurrence of psychotropic drug side effects, promote the quality of life of patients significantly improved, and improve the psychopathological symptoms and adaptability of patients, which is worth promoting.
文摘BACKGROUND Percutaneous endoscopic gastrostomy(PEG)is a well-established,minimally invasive,and easy to perform procedure for nutrition delivery,applied to individuals unable to swallow for various reasons.PEG has a high technical success rate of insertion between 95%and 100%in experienced hands,but varying complication rates ranging from 0.4%to 22.5%of cases.AIM To discuss the existing evidence of major procedural complications in PEG,mainly focusing on those that could probably have been avoided,had the endoscopist been more experienced,or less self-confident in relation to the basic safety rules for PEG performance.METHODS After a thorough research of the international literature of a period of more than 30 years of published“case reports”concerning such complications,we critically analyzed only those complications which were considered-after assessment by two experts in PEG performance working separately-to be directly related to a form of malpractice by the endoscopist.RESULTS Malpractice by the endoscopist were considered cases of:Gastrostomy tubes passed through the colon or though the left lateral liver lobe,bleeding after puncture injury of large vessels of the stomach or the peritoneum,peritonitis after viscera damage,and injuries of the esophagus,spleen,and pancreas.CONCLUSION For a safe PEG insertion,the overfilling of the stomach and small bowel with air should be avoided,the clinician should check thoroughly for the proper trans-illumination of the light source of the endoscope through the abdominal wall and ensure endoscopically visible imprint of finger palpation on the skin at the center of the site of maximum illumination,and finally,the physician should be more alert with obese patients and those with previous abdominal surgery.
