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ObjectiveTo determine the risk factors associated with hypoglycemia in community patients with type 2 diabetes mellitus（T2DM）. MethodsA case-control study was performed among 914 patients with T2DM and no medical history of hypoglycemia were selected in the Diabetes Unit of Tongji University School of Medicine Affiliated Anting Community Health Center in 2018. A total of 196 patients with T2DM who had ≥1 hypoglycemia event in the past 12 months were presented as the case group， and 718 patients who did not have any hypoglycemia event during the same period were included as the control group. Medical history， medication， life style， and related factors were collected. Multivariate logistic regression analysis was used to determine the risk factors associated with hypoglycemia. ResultsHistory of coronary heart disease ［adjusted odds ratio（aOR）=2.077， 95% CI： 1.293-3.337］， renal disease （aOR=4.775， 95% CI： 1.537-14.830）， and previous insulin use （aOR =1.765， 95%CI： 1.147-2.716） significantly increased the risk of hypoglycemia， while angiotensin converting enzyme inhibitors（ACEI）（aOR =0.127， 95%CI： 0.044-0.366） and β-receptor blockers （aOR =0.271， 95%CI： 0.119-0.616） decreased the risk of hypoglycemia among diabetic patients. ConclusionIncidence of hypoglycemia in community patients with diabetes is high. History of coronary heart disease and kidney disease， and previous insulin use may increase the risk of hypoglycemia， which warrants further attention by community general practitioners.
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Objective@#To discuss the effect of self-efficacy on patients with coronary heart disease cured in general practice department based on Hospital-Community-Patient Integrated Nursing Mode.@*Methods@#From January to April in 2018, 106 patients (51 males and 55 females) with coronary heart disease hospitalized in general practice of hospital were selected as subjects of study. Random number table method was used to divide the patients into control group and intervention group, 53 cases in each group. The intervention group adopted the hospital-community-patient integrated nursing model, while the control group adopted the traditional health education mode after discharge. Self-efficacy evaluation was conducted before intervention, 3 months after intervention and 6 months after intervention.@*Results@#The total score of self-efficacy in the two groups was higher than that before intervention, but the increase in the intervention group was significantly better than that in the control group, the difference was statistically significant (F=34.681, P < 0.01). The total scores of self-efficacy in intervention group were(30.35±2.58), (33.59±2.68) points respectively 3 months and 6 months after intervention, which were higher than (28.95±2.42), (29.10±2.12) points in control group. The difference was significant (t = 3.702, 13.494, P < 0.01).@*Conclusion@#Hospital-community-patient integrated nursing model is superior to traditional health education model after discharge, which can significantly improve the self-efficacy of patients with coronary heart disease discharged from general practice department.
ABSTRACT
Objective To discuss the effect of self-efficacy on patients with coronary heart disease cured in general practice department based on Hospital-Community-Patient Integrated Nursing Mode. Methods From January to April in 2018, 106 patients (51 males and 55 females) with coronary heart disease hospitalized in general practice of hospital were selected as subjects of study. Random number table method was used to divide the patients into control group and intervention group, 53 cases in each group. The intervention group adopted the hospital-community-patient integrated nursing model, while the control group adopted the traditional health education mode after discharge. Self-efficacy evaluation was conducted before intervention, 3 months after intervention and 6 months after intervention. Results The total score of self-efficacy in the two groups was higher than that before intervention, but the increase in the intervention group was significantly better than that in the control group, the difference was statistically significant (F=34.681, P < 0.01). The total scores of self-efficacy in intervention group were (30.35 ± 2.58), (33.59 ± 2.68) points respectively 3 months and 6 months after intervention, which were higher than (28.95 ± 2.42), (29.10 ± 2.12) points in control group. The difference was significant (t =3.702, 13.494, P<0.01). Conclusion Hospital-community-patient integrated nursing model is superior to traditional health education model after discharge, which can significantly improve the self-efficacy of patients with coronary heart disease discharged from general practice department.
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OBJECTIVE: To improve the control rate of cancer pain and the satisfaction of community patients with cancer pain. METHODS: A multidisciplinary team was built, which included community public health workers, clinical pharmacists, community physicians and tracking pharmacists. Pharmaceutical care was provided to patients with cancer pain in the community, and the effects of pharmaceutical care were evaluated. RESULTS: The clinical pharmacists provided 52 times of pharmaceutical care to 17 patients, 224 cases of medication problems were discovered, and 337 pieces of medication suggestions were made. After receiving pharmaceutical care, the scores of the most severe pain, the mild pain and the average pain in the past 24 h decreased from(9.12 ± 1.34), (5.53 ± 1.46) and (7.24 ± 1.99) to (4.71 ± 1.36), (1.18 ± 0.95) and (2.41 ± 1.18) (P < 0.01), respectively. The percentage of good medication compliance increased from 0% to 64.7% (P < 0.01). The influence of pharmaceutical care on patients included"helping understand the drugs", "taking medicine on time", "reducing adverse drug reaction", "establishing correct concept of medication" and"reducing medical costs", which got scores of (4.35 ± 0.49), (4.53 ± 0.51), (4.00 ± 0.61), (4.29 ± 0.59), and (3. 76 ± 0.66), respectively. For"convenience of pharmaceutical care", "pharmacist ability", "pharmacists' attitude", "symptom improvement" and"improvement of the quality of life", the patients gave scores of (4.06 ± 0.66), (4.24 ± 0.44), (4.20 ± 0.40), (4.41 ± 0.71) and (4.29 ± 0.47), respectively. CONCLUSION: The problems in the drug treatment in community patients with cancer pain are numerous and complex. Pharmaceutical care can reduce the problems, improve the control rate of cancer pain, and increase the community patients' satisfaction on the management of cancer pain. The patients give positive evaluation to the pharmaceutical care.