Introduction:Having a primary care usual source of care(USC)is associated with better population health outcomes.However,the percent of adults in the United States(US)with a usual primary care provider is declining.We...Introduction:Having a primary care usual source of care(USC)is associated with better population health outcomes.However,the percent of adults in the United States(US)with a usual primary care provider is declining.We sought to identify factors associated with establishing a USC at an urgent care clinic or emergency department as opposed to primary care.Methods:We analyzed data from 57,152 participants in the All of Us study who reported having a USC.We used the Andersen Behavioral Model of Health Services Use framework and multivariable logistic regression to examine associations among predisposing,enabling,and need factors,according to the source of usual care.Results:An urgent care clinic,minute clinic,or emergency department was the source of usual care for 6.3%of our sample.The odds of seeking care at this type of facility increased with younger age,lower educational attainment,and better health status.Black and Hispanic individuals,as well as those who reported experiencing discrimination in medical settings or that their provider was of a different race and ethnicity,were also less likely to have a primary care USC.Financial concerns,being anxious about seeing a provider,and the inability to take time off from work also increased the likelihood of having a non‐primary care USC.Conclusions:Improving the rates of having a primary care USC among younger and healthy adults may be achievable through policies that can improve access to convenient,affordable primary care.Efforts to improve diversity among primary care providers and reduce discrimination experienced by patients may also improve the USC rates for racial and ethnic minority groups.展开更多
BACKGROUND Cox health behavior interventions combined with psychological care have the potential to improve recovery outcomes and psychological well-being in patients with hypertensive cerebral hemorrhage accompanied ...BACKGROUND Cox health behavior interventions combined with psychological care have the potential to improve recovery outcomes and psychological well-being in patients with hypertensive cerebral hemorrhage accompanied by mental disorders.AIM To explore the impact of combining the Cox Health Behavior Interaction Model with multifaceted psychological nursing in patients with hypertensive intracerebral hemorrhage(ICH)complicated by mental disorders and to provide a reference for the nursing intervention in patients with hypertensive ICH.METHODS Overall,128 patients with hypertensive ICH complicated by mental disorders who were admitted to the Affiliated Hospital of Nantong University between January 2022 and December 2024 were divided into groups using a random number table.The control group(n=64)received multifaceted psychological nursing,and the observation group(n=64)received the Cox Health Behavior Interaction Model intervention based on multifaceted psychological nursing.The mental state,psychological resilience,self-efficacy,and quality of life of the two groups were compared.RESULTS Post-intervention,the mental states of anxiety and depression in the observation group(38.82±3.67 points and 35.14±2.75 points,respectively)were lower than those in the control group(46.96±5.12 points and 41.36±3.71 points,respectively),and the psychological resilience levels(tenacity,self-improvement,and optimism)were higher than those in the control group(P<0.05).Postintervention,the General Self-Efficacy Scale score in the observation group(31.75±2.75 points)was higher than that in the control group(26.76±2.93 points),and the physical health-and social and mental health-related quality of life were both higher than those in the control group(P<0.05).CONCLUSION Combining the Cox Health Behavior Interaction Model with multifaceted psychological nursing for patients with hypertensive ICH and mental disorders relieves anxiety and depression and improves resilience,self-efficacy,and quality of life.展开更多
Objective:To investigate the clinical effects of parental participation in nursing under the Interaction Model of Client Health Behavior(IMCHB)model in neonatal hypoxic-ischemic encephalopathy(HIE).Methods:The First A...Objective:To investigate the clinical effects of parental participation in nursing under the Interaction Model of Client Health Behavior(IMCHB)model in neonatal hypoxic-ischemic encephalopathy(HIE).Methods:The First Affiliated Hospital of Gannan Medical University included 46 newborns with HIE admitted from October 2021 to October 2023 into the study population.They were divided into a control group and an observation group according to the random number table method,with the control group adopting routine nursing,and the observation group implementing parental participation in nursing under the IMCHB model.The indicators of physical,intellectual,and psychomotor development of the two groups were compared before and after nursing.Results:The physical,intellectual,and psychomotor development of the observation group was higher than that of the control group after 3 months of nursing,and the difference was statistically significant(P<0.05).Conclusion:The implementation of the IMCHB model of parental participation in the clinical care of HIE neonates can further promote their physical,intellectual,and psychomotor development.展开更多
文摘Introduction:Having a primary care usual source of care(USC)is associated with better population health outcomes.However,the percent of adults in the United States(US)with a usual primary care provider is declining.We sought to identify factors associated with establishing a USC at an urgent care clinic or emergency department as opposed to primary care.Methods:We analyzed data from 57,152 participants in the All of Us study who reported having a USC.We used the Andersen Behavioral Model of Health Services Use framework and multivariable logistic regression to examine associations among predisposing,enabling,and need factors,according to the source of usual care.Results:An urgent care clinic,minute clinic,or emergency department was the source of usual care for 6.3%of our sample.The odds of seeking care at this type of facility increased with younger age,lower educational attainment,and better health status.Black and Hispanic individuals,as well as those who reported experiencing discrimination in medical settings or that their provider was of a different race and ethnicity,were also less likely to have a primary care USC.Financial concerns,being anxious about seeing a provider,and the inability to take time off from work also increased the likelihood of having a non‐primary care USC.Conclusions:Improving the rates of having a primary care USC among younger and healthy adults may be achievable through policies that can improve access to convenient,affordable primary care.Efforts to improve diversity among primary care providers and reduce discrimination experienced by patients may also improve the USC rates for racial and ethnic minority groups.
文摘BACKGROUND Cox health behavior interventions combined with psychological care have the potential to improve recovery outcomes and psychological well-being in patients with hypertensive cerebral hemorrhage accompanied by mental disorders.AIM To explore the impact of combining the Cox Health Behavior Interaction Model with multifaceted psychological nursing in patients with hypertensive intracerebral hemorrhage(ICH)complicated by mental disorders and to provide a reference for the nursing intervention in patients with hypertensive ICH.METHODS Overall,128 patients with hypertensive ICH complicated by mental disorders who were admitted to the Affiliated Hospital of Nantong University between January 2022 and December 2024 were divided into groups using a random number table.The control group(n=64)received multifaceted psychological nursing,and the observation group(n=64)received the Cox Health Behavior Interaction Model intervention based on multifaceted psychological nursing.The mental state,psychological resilience,self-efficacy,and quality of life of the two groups were compared.RESULTS Post-intervention,the mental states of anxiety and depression in the observation group(38.82±3.67 points and 35.14±2.75 points,respectively)were lower than those in the control group(46.96±5.12 points and 41.36±3.71 points,respectively),and the psychological resilience levels(tenacity,self-improvement,and optimism)were higher than those in the control group(P<0.05).Postintervention,the General Self-Efficacy Scale score in the observation group(31.75±2.75 points)was higher than that in the control group(26.76±2.93 points),and the physical health-and social and mental health-related quality of life were both higher than those in the control group(P<0.05).CONCLUSION Combining the Cox Health Behavior Interaction Model with multifaceted psychological nursing for patients with hypertensive ICH and mental disorders relieves anxiety and depression and improves resilience,self-efficacy,and quality of life.
文摘Objective:To investigate the clinical effects of parental participation in nursing under the Interaction Model of Client Health Behavior(IMCHB)model in neonatal hypoxic-ischemic encephalopathy(HIE).Methods:The First Affiliated Hospital of Gannan Medical University included 46 newborns with HIE admitted from October 2021 to October 2023 into the study population.They were divided into a control group and an observation group according to the random number table method,with the control group adopting routine nursing,and the observation group implementing parental participation in nursing under the IMCHB model.The indicators of physical,intellectual,and psychomotor development of the two groups were compared before and after nursing.Results:The physical,intellectual,and psychomotor development of the observation group was higher than that of the control group after 3 months of nursing,and the difference was statistically significant(P<0.05).Conclusion:The implementation of the IMCHB model of parental participation in the clinical care of HIE neonates can further promote their physical,intellectual,and psychomotor development.
