RESUMO
Background: We aimed to assess the effect of life-cycle management on the satisfaction and health outcomes of children with chronic diseases and their parents, as well as the career benefits of healthcare workers. Methods: Participants were children with chronic diseases who received long-term treatment at the Three Gorges Hospital Affiliated to Chongqing University from January 2021 to November 2022. From the first admission, compare the children's disease onset, satisfaction and professional benefits of medical staff among "Medical and Nursing Integration" + "Internet plus"-based life cycle management group (n = 221, the experimental group), the routine management group (n = 53, the control group 1) and the "Medical and Nursing Integration" group (n = 67, control group 2). Results: The overall satisfaction of children in the experimental group (100 %) was higher than that in the control group 1 (98.11%) and control group 2 (98.51%). The times of second admission and third admission of patients in the experimental group were significantly lower than those in control group 1 were (both P<0.001) and control group 2 (both P<0.01). Nurses' sense of professional benefit, professional identity, and doctor's satisfaction with nurses in the experimental group were significantly higher than those in control group 1 (P<0.05, P<0.01, P<0.001) and control group 2 (all P<0.05). Conclusion: The application of "Medical and Nursing Integration" + "Internet plus"-based life cycle management in chronic disease nursing management can effectively improve the management on pediatric chronic diseases.
RESUMO
BACKGROUND/OBJECTIVE: Hip dysfunction in young population caused by developmental dysplasia of the hip, congenital hip deformity or femur head necrosis severely affect the quality of life of young patients, and total hip replacement is the current widely accepted standard therapy for hip function reconstruction in adults, but not for young patients. Alternative safe and effective surgical method for hip function preservation/reconstruction for young patients is lacking. Ilizarov hip reconstruction osteotomy was an alternative method for preserving hip function but the surgical procedures were rather complicated using discomforting ring fixation at the hip region that prevents its wider acceptance and application. Here we reported a modified Ilizarov hip reconstruction surgery for hip dysfunction/deformity correction in adolescent and young adults using femoral shaft osteotomy and simplified unilateral external fixation configuration at the hip region with satisfactory clinical outcomes. METHODS: This is a retrospective study with five male and twelve female patients aged from 10 to 34 years old (mean 20.6 years) including 11 developmental dislocations of the hip and 6 femoral head necrosis. Modified Ilizarov hip reconstruction y surgery was performed using single-arm triangular configuration, threaded half pins on the femur and multiple drill hole guide for osteotomy. The mechanical axis and limb length were corrected spontaneously during the subsequent limb lengthening process in all patients. Preoperative and postoperative gross appearance, radiography of the hip and hip function assessment scores were recorded and compared during the follow-up period. RESULTS: The mean follow-up period was 64.3 months (12-87 months). Satisfactory hip appearance, hip and knee functions were achieved in all patients, none resulted in hip replacement surgery at the follow-up period. The mean preoperative and postoperative Harris hip scores were 45.92 â± â19.41 and 87.16 â± â5.31, respectively (p â< â0.01). Pin-track infections occurred in four patients, treated successfully with wound dressing care and oral antibiotics. Restricted range of motion of the knee was observed in eight patients, all gradually overcome by active functional exercises. Osteotomy site fracture of the middle femurs after removing external devices occurred in two patients due to unexpected fall, and complete healing was achieved after plaster fixation. Complications such as fixation device failure, knee dislocation, vessel or nerve impairments did not occur. CONCLUSIONS: Modified Ilizarov hip reconstruction surgery significantly reduced the surgery time and discomforts to patients, avoided the disturbance of blood supply at the osteotomy sites. This modified method is a useful alternative for correction of hip deformities and reconstruction hip function in adolescent and young adults who are not suitable for conventional pelvis support surgery or hip replacement surgery. TRANSLATIONAL POTENTIAL STATEMENT: The modified Ilizarov hip reconstruction surgery provides an alternative for hip replacement surgery with satisfactory clinical outcomes. This procedure is minimally invasive, safe and simple, with few complications compared to conventional pelvis support surgery, and it may be the first choice of surgery for the management of hip dysfunction in adolescent and young adults.