Objective:To analyze the value of continuous care for patients with hypertensive intracerebral hemorrhage(HICH).Methods:A total of 80 patients with HICH who visited our hospital from January 2024 to December 2024 were...Objective:To analyze the value of continuous care for patients with hypertensive intracerebral hemorrhage(HICH).Methods:A total of 80 patients with HICH who visited our hospital from January 2024 to December 2024 were selected as samples and randomly divided into two groups.The observation group received continuous care,while the control group received routine care.The Functional Independence Measure(FIM),Symptom Checklist-90(SCL-90),and complications were compared between the two groups.Results:The FIM score of the observation group was higher than that of the control group(P<0.05).The SCL-90 score of the observation group was lower than that of the control group(P<0.05).The incidence of HICH complications in the observation group was lower than that in the control group(P<0.05).Conclusion:The application of continuous care in HICH nursing can enhance patients’independent living skills outside the hospital,optimize their psychosocial adaptation,and is safe and efficient.展开更多
Independent living and freedom of choice are closely linked to the social inclusion of PwD(Persons with Disabilities)in society.The paper reports on a recent study focused on investigating and understanding the needs ...Independent living and freedom of choice are closely linked to the social inclusion of PwD(Persons with Disabilities)in society.The paper reports on a recent study focused on investigating and understanding the needs and desires of persons with intellectual disabilities,with reduced mobility and with visual impairments while performing daily activities in order to design user-friendly and inclusive home environments for their life project.The case study concerns an apartment on the ground floor of a building well embedded in a neighborhood urban and social context.It was selected by Anffas Trentino Onlus to train young adults in independent living.Anffas is the National Association of Families of People Intellectual and/or Relational Disabilities,present and operating throughout Italy.Since 2008,important projects have been promoted by Anffas Trentino Onlus aimed at stimulating a personal and housing autonomy in PwD for“during and after us”,or rather when there are no more family members to take care of them.The design process involved a representative focus group of end users.With them and some Anffas staff components,it was possible to implement a participatory design process by sharing and verifying needs,desires,expectations.This approach was adopted in order to jointly develop a design proposal for a new inclusive apartment changing the paradigm from design for to design with,and building awareness both in the end users and designers.展开更多
FOR many years, learning how to weave cloth was a type of compulsory education for girls living in cotton-growing areas; the skill was usually handed down by their mothers or grandmothers. After the girls got married,...FOR many years, learning how to weave cloth was a type of compulsory education for girls living in cotton-growing areas; the skill was usually handed down by their mothers or grandmothers. After the girls got married, spinning and weaving for their families would become their lifetime work. The girls in the photo, however, were not those home weavers, but students of the Women Department of the Industrial School in Rugao County, Jiangsu. The photo records the transformation in展开更多
To the Editor:We read with great interest the article by Yang et al.[1]evaluating the effects of postoperative serum total cholesterol(s TC)changes on early allograft dysfunction and survival after living donor liver ...To the Editor:We read with great interest the article by Yang et al.[1]evaluating the effects of postoperative serum total cholesterol(s TC)changes on early allograft dysfunction and survival after living donor liver transplantation(LDLT).By the multivariate regression analysis,they showed that patients with s TC<1.42 mmol/L on postoperative day 3 had 4.08-fold and 2.72-fold greater risks of展开更多
The purpose of this qualitative study, conducted in Thailand, was to identify strategies for older adults to live alone happily, with dignity, security, and independence. Purposive sampling techniques were used to rec...The purpose of this qualitative study, conducted in Thailand, was to identify strategies for older adults to live alone happily, with dignity, security, and independence. Purposive sampling techniques were used to recruit participants from 12 provinces throughout Thailand. The sample included three groups： older Thai people living alone （n = 1,087）, clinician who working with Thai older adults （n = 149）, and administrators working in aged care and support services in Thailand （n = 83）. Data were collected using structured interview guides. Content analysis was used to identify and develop the study findings. Most of the older Thai people living alone were single, widowed or divorced with few wanting to remain living alone. The large majority of participants needed government assistance to manage their activities of daily living including access to health and public services. Participants wanted aged care and support services to assist with their living arrangements, organise community activities, and provide home visits. Moreover, they wanted their families to visit them and provide financial support and care for them when they were ill. These older adults experienced living alone positively and negatively. Some participants felt proud, dignified, and independent. Other participants felt that living alone resulted in poorer health status, particularly emotional problems, especially for those who were not living alone by choice. These participants reported feeling lonely, bored, irritated, sad, and sorrowful. This group of older Thai adults had limited interaction with their families and the wider community. From this study, four strategies were identified to assist older Thai adults to live alone happily, safely and with a sense of dignity, security, and value. These strategies are： ensuring individual choice, maintaining family support, developing community value, and advocating for over-arching government policy support of aged care. A high number of older adults live alone in Thailand and this presents a big challenge for both these individuals and the community in which they live. If this important group in Thai society is to live alone happily and successfully, it needs to be additional assistance to ensure they are supported by families, communities, and government departments.展开更多
Background: Self-care tasks or activities of daily living (ADL)’s performance are often disrupted after an older adult sustains an injury or illness, which can be a determining factor for discharge placement after ho...Background: Self-care tasks or activities of daily living (ADL)’s performance are often disrupted after an older adult sustains an injury or illness, which can be a determining factor for discharge placement after hospitalization, or it can determine the level of assistance required after discharge from a skilled nursing facility (SNF). We believe that comprehensive rehabilitation can improve a patient’s overall functioning during their short term stay in SNFs. The purpose of this study is to determine if an individual’s level of independence improved after admission to a skilled nursing facility and procurement of rehabilitation services. Methods: This study retrospectively reviewed 4612 nursing home patients in California who underwent rehabilitative services at skilled nursing facilities to determine how the patients responded to their environments, therapy interventions, and any other additional supportive measures. The records of patients who were admitted for short-term rehabilitation were reviewed in a blinded fashion, looking specifically at Section GG of the Minimum Data Set (MDS). Self-Care Section GG scores recorded by rehabilitative staff provide objective data and measure patients’ levels of assistance that were required. Each activity is scored from 1, being completely dependent, to 6, being entirely independent, with varying levels of assistance with scores in between. The admission scores versus the discharge scores can be compared to determine if a patient improved their level of functioning upon discharge. Results: Utilizing the Pearson’s correlation coefficient, a strong correlation of improvement in ADL performance on Section GG between the admission and discharge scores was identified, implying significant improvement in functional independence upon discharge. The average percent improvement for Managed Care patients was ~35.4% and ~39.4% for Medicare patients. Conclusions: The results support the benefits of rehabilitation services in skilled nursing facilities, and the data suggests that admission scores can be used as a predictive tool for functional outcomes.展开更多
Background: Cesarean section is one of the most common surgeries performed worldwide and its consequences and complications represent a major public health concern. The policy of enhanced recovery after surgery has be...Background: Cesarean section is one of the most common surgeries performed worldwide and its consequences and complications represent a major public health concern. The policy of enhanced recovery after surgery has been implemented after cesarean section to optimize perioperative care. Enhanced recovery also aims to reduce the length of hospital stay, which might imply substantial healthcare savings. Rising hospital costs are one of the factors in early discharge. Patients & Methods: This was a prospective cohort study. 158 patients met the inclusion criteria of the study, 81 patients were discharged after 48 hours and 77 patients were discharged after 24 hours. All patients received the same postoperative care and instructions. All the study participants received a phone call 1, 3, and 5 days after discharge to objectively assess the activities of daily living through Katz index of independence in activities of daily living. All patients were offered a postpartum visit 1 week after discharge during which the wound was assessed by the Southampton wound assessment scale. Moreover, other maternal complications such as mastitis, puerperal sepsis, or pyelonephritis were assessed and cases who were readmitted were documented. Initiation of successful breastfeeding and neonatal readmission were reported as well. Results: 158 patients met the inclusion/exclusion criteria of the study. There was no significant difference between the two arms of the study regarding baseline characteristics. Katz index of independence showed that the resumption of activities of daily living after CS was similar in both arms of the study on days 1, 3 and 5 after discharge. Time till the passage of flatus and stool after the cesarean section was significantly shorter among the early discharge arm (9.31 VS 14.68, p value < 0.001 & 13.25 VS 24.82, p value < 0.001 respectively). Maternal readmission was not significantly higher among the early discharge arm and at the 1-week postpartum visit, objective wound assessment by Southampton wound scoring assessment was made and there was no significant difference between the two arms of the study. Initiation of successful breastfeeding, and neonatal readmission were similar in both groups. Conclusion: The policy of early discharge can be adopted in low-risk cases scheduled for elective uncomplicated CS provided that the mother and the neonate are in good general condition and proper instructions regarding red flag manifestations are given.展开更多
Background: Mobility in older adults can be impaired after acute illness or hospitalization, and the level of severity can be used as a predictor of one’s ability to return to independent living. Patients are often r...Background: Mobility in older adults can be impaired after acute illness or hospitalization, and the level of severity can be used as a predictor of one’s ability to return to independent living. Patients are often referred to skilled nursing facilities in hopes of improving their mobility. We wanted to prove that rehabilitative services at Skilled Nursing Facilities improve overall outcomes. Methods: We conducted a retrospective analysis of data from 4612 patients admitted for short-term rehabilitation in a large nursing home chain in California. Our aim was to determine whether patients’ mobility scores, as measured by rehabilitative staff, significantly improved by time of discharge compared to their scores at admission. Mobility scores were rated from 1 to 6, with 1 being the most dependent on aid and 6 being the most independent, over a variety of tasks at admission and compared to scores at discharge. Pearson’s correlations were performed to determine if there were significant relationships in the data: the Pearson’s correlation coefficient was used to describe the relationships between patient admission to a skilled nursing facility and medical improvement upon discharge. Results: The study demonstrated a statistically significant improvement in patients’ mobility scores upon discharge, with Medicare insured patients showing on average 57% improvement and Managed Care insured patients showing on average 59% improvement. Additionally, admission scores appeared to be predictive of the patient’s outcome at discharge. Conclusions: The values and consistency of improvement support the use of acute rehabilitative services in skilled nursing facilities. An equation can be formulated that evaluates patients’ estimated mobility statuses upon discharge from facilities based on their conditions on their arrivals. With this, new interventions can be studied and compared to the current standard of care by using these measurements. They can determine if further improvements can be made to increase patient outcomes.展开更多
文摘Objective:To analyze the value of continuous care for patients with hypertensive intracerebral hemorrhage(HICH).Methods:A total of 80 patients with HICH who visited our hospital from January 2024 to December 2024 were selected as samples and randomly divided into two groups.The observation group received continuous care,while the control group received routine care.The Functional Independence Measure(FIM),Symptom Checklist-90(SCL-90),and complications were compared between the two groups.Results:The FIM score of the observation group was higher than that of the control group(P<0.05).The SCL-90 score of the observation group was lower than that of the control group(P<0.05).The incidence of HICH complications in the observation group was lower than that in the control group(P<0.05).Conclusion:The application of continuous care in HICH nursing can enhance patients’independent living skills outside the hospital,optimize their psychosocial adaptation,and is safe and efficient.
文摘Independent living and freedom of choice are closely linked to the social inclusion of PwD(Persons with Disabilities)in society.The paper reports on a recent study focused on investigating and understanding the needs and desires of persons with intellectual disabilities,with reduced mobility and with visual impairments while performing daily activities in order to design user-friendly and inclusive home environments for their life project.The case study concerns an apartment on the ground floor of a building well embedded in a neighborhood urban and social context.It was selected by Anffas Trentino Onlus to train young adults in independent living.Anffas is the National Association of Families of People Intellectual and/or Relational Disabilities,present and operating throughout Italy.Since 2008,important projects have been promoted by Anffas Trentino Onlus aimed at stimulating a personal and housing autonomy in PwD for“during and after us”,or rather when there are no more family members to take care of them.The design process involved a representative focus group of end users.With them and some Anffas staff components,it was possible to implement a participatory design process by sharing and verifying needs,desires,expectations.This approach was adopted in order to jointly develop a design proposal for a new inclusive apartment changing the paradigm from design for to design with,and building awareness both in the end users and designers.
文摘FOR many years, learning how to weave cloth was a type of compulsory education for girls living in cotton-growing areas; the skill was usually handed down by their mothers or grandmothers. After the girls got married, spinning and weaving for their families would become their lifetime work. The girls in the photo, however, were not those home weavers, but students of the Women Department of the Industrial School in Rugao County, Jiangsu. The photo records the transformation in
文摘To the Editor:We read with great interest the article by Yang et al.[1]evaluating the effects of postoperative serum total cholesterol(s TC)changes on early allograft dysfunction and survival after living donor liver transplantation(LDLT).By the multivariate regression analysis,they showed that patients with s TC<1.42 mmol/L on postoperative day 3 had 4.08-fold and 2.72-fold greater risks of
文摘The purpose of this qualitative study, conducted in Thailand, was to identify strategies for older adults to live alone happily, with dignity, security, and independence. Purposive sampling techniques were used to recruit participants from 12 provinces throughout Thailand. The sample included three groups： older Thai people living alone （n = 1,087）, clinician who working with Thai older adults （n = 149）, and administrators working in aged care and support services in Thailand （n = 83）. Data were collected using structured interview guides. Content analysis was used to identify and develop the study findings. Most of the older Thai people living alone were single, widowed or divorced with few wanting to remain living alone. The large majority of participants needed government assistance to manage their activities of daily living including access to health and public services. Participants wanted aged care and support services to assist with their living arrangements, organise community activities, and provide home visits. Moreover, they wanted their families to visit them and provide financial support and care for them when they were ill. These older adults experienced living alone positively and negatively. Some participants felt proud, dignified, and independent. Other participants felt that living alone resulted in poorer health status, particularly emotional problems, especially for those who were not living alone by choice. These participants reported feeling lonely, bored, irritated, sad, and sorrowful. This group of older Thai adults had limited interaction with their families and the wider community. From this study, four strategies were identified to assist older Thai adults to live alone happily, safely and with a sense of dignity, security, and value. These strategies are： ensuring individual choice, maintaining family support, developing community value, and advocating for over-arching government policy support of aged care. A high number of older adults live alone in Thailand and this presents a big challenge for both these individuals and the community in which they live. If this important group in Thai society is to live alone happily and successfully, it needs to be additional assistance to ensure they are supported by families, communities, and government departments.
文摘Background: Self-care tasks or activities of daily living (ADL)’s performance are often disrupted after an older adult sustains an injury or illness, which can be a determining factor for discharge placement after hospitalization, or it can determine the level of assistance required after discharge from a skilled nursing facility (SNF). We believe that comprehensive rehabilitation can improve a patient’s overall functioning during their short term stay in SNFs. The purpose of this study is to determine if an individual’s level of independence improved after admission to a skilled nursing facility and procurement of rehabilitation services. Methods: This study retrospectively reviewed 4612 nursing home patients in California who underwent rehabilitative services at skilled nursing facilities to determine how the patients responded to their environments, therapy interventions, and any other additional supportive measures. The records of patients who were admitted for short-term rehabilitation were reviewed in a blinded fashion, looking specifically at Section GG of the Minimum Data Set (MDS). Self-Care Section GG scores recorded by rehabilitative staff provide objective data and measure patients’ levels of assistance that were required. Each activity is scored from 1, being completely dependent, to 6, being entirely independent, with varying levels of assistance with scores in between. The admission scores versus the discharge scores can be compared to determine if a patient improved their level of functioning upon discharge. Results: Utilizing the Pearson’s correlation coefficient, a strong correlation of improvement in ADL performance on Section GG between the admission and discharge scores was identified, implying significant improvement in functional independence upon discharge. The average percent improvement for Managed Care patients was ~35.4% and ~39.4% for Medicare patients. Conclusions: The results support the benefits of rehabilitation services in skilled nursing facilities, and the data suggests that admission scores can be used as a predictive tool for functional outcomes.
文摘Background: Cesarean section is one of the most common surgeries performed worldwide and its consequences and complications represent a major public health concern. The policy of enhanced recovery after surgery has been implemented after cesarean section to optimize perioperative care. Enhanced recovery also aims to reduce the length of hospital stay, which might imply substantial healthcare savings. Rising hospital costs are one of the factors in early discharge. Patients & Methods: This was a prospective cohort study. 158 patients met the inclusion criteria of the study, 81 patients were discharged after 48 hours and 77 patients were discharged after 24 hours. All patients received the same postoperative care and instructions. All the study participants received a phone call 1, 3, and 5 days after discharge to objectively assess the activities of daily living through Katz index of independence in activities of daily living. All patients were offered a postpartum visit 1 week after discharge during which the wound was assessed by the Southampton wound assessment scale. Moreover, other maternal complications such as mastitis, puerperal sepsis, or pyelonephritis were assessed and cases who were readmitted were documented. Initiation of successful breastfeeding and neonatal readmission were reported as well. Results: 158 patients met the inclusion/exclusion criteria of the study. There was no significant difference between the two arms of the study regarding baseline characteristics. Katz index of independence showed that the resumption of activities of daily living after CS was similar in both arms of the study on days 1, 3 and 5 after discharge. Time till the passage of flatus and stool after the cesarean section was significantly shorter among the early discharge arm (9.31 VS 14.68, p value < 0.001 & 13.25 VS 24.82, p value < 0.001 respectively). Maternal readmission was not significantly higher among the early discharge arm and at the 1-week postpartum visit, objective wound assessment by Southampton wound scoring assessment was made and there was no significant difference between the two arms of the study. Initiation of successful breastfeeding, and neonatal readmission were similar in both groups. Conclusion: The policy of early discharge can be adopted in low-risk cases scheduled for elective uncomplicated CS provided that the mother and the neonate are in good general condition and proper instructions regarding red flag manifestations are given.
文摘Background: Mobility in older adults can be impaired after acute illness or hospitalization, and the level of severity can be used as a predictor of one’s ability to return to independent living. Patients are often referred to skilled nursing facilities in hopes of improving their mobility. We wanted to prove that rehabilitative services at Skilled Nursing Facilities improve overall outcomes. Methods: We conducted a retrospective analysis of data from 4612 patients admitted for short-term rehabilitation in a large nursing home chain in California. Our aim was to determine whether patients’ mobility scores, as measured by rehabilitative staff, significantly improved by time of discharge compared to their scores at admission. Mobility scores were rated from 1 to 6, with 1 being the most dependent on aid and 6 being the most independent, over a variety of tasks at admission and compared to scores at discharge. Pearson’s correlations were performed to determine if there were significant relationships in the data: the Pearson’s correlation coefficient was used to describe the relationships between patient admission to a skilled nursing facility and medical improvement upon discharge. Results: The study demonstrated a statistically significant improvement in patients’ mobility scores upon discharge, with Medicare insured patients showing on average 57% improvement and Managed Care insured patients showing on average 59% improvement. Additionally, admission scores appeared to be predictive of the patient’s outcome at discharge. Conclusions: The values and consistency of improvement support the use of acute rehabilitative services in skilled nursing facilities. An equation can be formulated that evaluates patients’ estimated mobility statuses upon discharge from facilities based on their conditions on their arrivals. With this, new interventions can be studied and compared to the current standard of care by using these measurements. They can determine if further improvements can be made to increase patient outcomes.
