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Objective:To explore the effect of patient engagement on medication safety for patients with chronic disease through a systematic review.Methods:Relevant randomized controlled trials of patient engagement on medication safety were searched from PubMed, EMBASE, The Cochrane Library, CNKI, Wanfang and VIP database. The literature was screened according to inclusion and exclusion criteria, and data extraction and literature quality evaluation was conducted on the selected literature.Results:A total of 15 eligible studies was included. Most of the studies occurred in outpatient and home settings, and the subjects were patients with chronic diseases. Patient engagement strategies can be divided into three categories: (1) patient engagement in medical decision-making; (2) patient engagement in medication adjustment; (3) patient engagement in medication management. The outcomes of medication safety included medication adherence, medication knowledge, medication beliefs, adverse events and medication errors. Intervention strategies for patients to actively engage in medication safety significantly improved patients′ medication knowledge and beliefs, but did not improve medication adherence of patients.Conclusion:Promoting patient active engagement is an effective intervention measure to improve patients ′ perception of medication safety. Due to the limited quality and quantity of the included studies, more high-quality studies are needed to verify the above conclusions.
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Objective:To investigate the quality issues of community home care service in Beijing.Methods:A study on quality of community home care service was conducted from March to May in 2021 in six urban districts of Beijing, and 10 community health service centers were selected as study sites by purpose sampling method. The quality issues of home care service were studied by observing the process of 17 home care services, interviewing medical staff and reviewing relevant medical documents.Results:The study extracted 3 structural quality problems and 6 process quality problems of home care service. The structural quality problems included unclear service scheduling and insufficient qualification of the personnel; lacking special transportations; and lacking home health service standards in some centers. The process quality problems included incomplete material preparation, wearing jewelry during medical procedures, no physical check-up before procedures, not strictly following the aseptic principle in the operation, not properly disposing medical wastes, wrong or missing filling of medical documents.Conclusions:There are some problems in the implementation of community home care service in Beijing, such as insufficient medical personnel and material resources, unclear service scheduling, lack of unified medical service standards, and insufficient quality management. Therefore, these problems should corrected to ensure the quality of community home care services in Beijing.
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Patient medication safety is a global concern. Patient participation in the medication process can effectively reduce the occurrence of medication errors. Assessing the patient′s ability to participate in medication safety is conducive to identify problems in the participation process; therefore, to provide reference for corresponding intervention measures and further improve patient participation ability. This article introduces the currently used measurement tools of patient participation in medication safety, and provides reference for improving measurement index system in China.
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A quality assessment tool for home care is an indicator system used to evaluate the quality of home care service. The unified and standardized quality indicators for home care can not only help to judge the quality of home care service, but more importantly, it can help identify the gaps and problems in the process, so as to improve the quality of home care service. This article summarizes some of the advanced assessment tools that have been internationally applied for the home health care and to discuss the direction for development of the assessment tools in China.
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Objective@#To determine health risk behaviors and cluster patterns among adolescents from four minorities in rural of Wuling mountainous area, and to provide a reference for health education for adolescents in ethnic minority areas.@*Methods@#Totally 4 162 teenagers from 8 rural middle schools of Xiangxi Tujia and Miao Autonomous Prefecture, Dong Autonomous County of Tongdao, Huaihua, Bai Minority Village of Sangzhi County, Zhangjiajie, were selected with multi-stage stratified random cluster sampling and surveyed with a questionnaire to collect information on health risk behaviors from September to October, 2018. Cluster patterns of health risk behaviors were analyzed by sex by two-step cluster method.@*Results@#The occurrence rates of the behaviors of the adolescents from four minorities of smoking, drinking, walking violations, unsafe swimming, fighting, suicide idea, feeling lonely constantly, frequent sleeplessness, depression, internet addiction were 18.9%, 31.0%, 49.6%, 32.3%, 28.6%, 18.3%, 16.3%, 12.4%, 16.3%, 6.7% respectively, among which the highest occurrence rates were Tujia teenagers’ fight(31.4%), Miao teenagers’ unsafe swimming(45.1%), Dong teenagers’ drinking(34.8%), Bai teenagers’ walking violation(52.9%). And the differences were statistically significant(P<0.05). Among the lowest risk group, there were 322 male students (16.4%) and 496 female students (22.5%); Among the moderate low group, there were 377 male students (19.3%) and 536 female students (24.3%); Among the implicit behavior high risk group, there were 518 male students (26.5%) and 758 female students(34.4%);Among the explicit behavior high risk group, there were 741 male students (37.8%) and 414 female students(18.8%). 23.1% of teenagers engaged in four or more types of health risk behaviors, with male higher than that of female(χ2=183.52, P<0.01), and the rate of Miao teenagers (28.2%) was the highest.@*Conclusion@#Health risk behaviors among minority adolescents in Wuling rural areas are prevalent and varied in ethnicity. Clustering of explicit risk behaviors in boys and implicit risk behaviors in girls were obvious. The hierarchical guidance and comprehensive intervention should be carried out on the basis of the characteristics of different minority teenagers’ health risk behaviors.
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Objective@#To understand current situation and influencing factors of school bullying among left-behind and non left-behind students in vocational colleges in western Hunan, and to provide reference for the prevention and control of campus bullying in vocational colleges in poverty-stricken areas.@*Methods@#A multi-stage stratified random cluster sampling method was used to select 1 241 students from higher vocational colleges in Xiangxi for questionnaire survey. The survey included basic demographic characteristics, health-related behaviors and school bullying. Associcted factors were compared among students with and without school bullying by using the χ2 test and Logistic regression.@*Results@#The reported rate of school bullying in vocational colleges was 41.82%. The reported rate of left-behind students (45.05%) was higher than that of non-left-behind students (39.21%). The difference was statistically significant (χ2=4.29,P<0.05). Multivariate unconditional Logistic regression showed that male students and good parental relationship negatively associated with school bullying among left-behind students(OR=0.55，0.47). While rural students, 5 years of senior vocational, smoking, drinking, and game addiction were positively associated with school bullying among left-behind students(OR=1.93,2.57,2.51,3.95,4.73); good relationship with mothers was associated with less school bullying(OR=0.40), while smoke, drinking and game addiction was associated with more school bullying among non left-behind students(OR=1.86,2.32，3.81)(P<0.05).@*Conclusion@#School bullying among students in higher vocational colleges in western Hunan is highly prevalent. The reporting rate among left-behind students is higher than that of non-left-behind students. Due to different factors, joint intervention measures by government, schools and families should be carried out as soon as possible.
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Objective To investigate the effect of improving immunity in the treatment of chronic brucellosis,and to analyze and evaluate its clinical curative effect.Methods A patient with chronic brucellosis was treated with Mongolian medicine combined with chemical drugs to enhance immunity.The clinical symptoms,serological antibodies,Brucella DNA and immune function were compared before and after treatment.The specific antibody against Brucella in serum was detected by tube agglutination test (SAT) and tiger red plate agglutination test (RBPT).Brucella DNA in serum and blood cells was detected by PCR,and the peripheral blood lymphocyte subsets were detected by flow cytometry.Immuno-luminescence technique was used to detect serum immunoglobulin and complement components.Results After treatment,the clinical symptoms such as cold back,fatigue,and joint pain disappeared completely,and the results of serum specific antibodies against Brucella were SAT 1 ∶ 50 (++)and RBPT (+) with no changes before and after treatment,and the results of cells and serum were both negative after treatment though the results of DNA detection of Brucella were cell positive and seronegative before treatment.The results of immunological function test showed that γδT cells decreased to 9.50％ after treatment compared to 14.00％ before treatment,and the percentage of monocytes and Treg cells were 5.59％ and 7.33％ after treatment,which were higher than 3.35％ and 4.72％ of before treatment,and the level of complement C3 was 0.79 g/L before treatment and 0.91 g/L after treatment that was returned to normal reference range (0.88 ～ 2.01 g/L).Conclusion The patients with chronic brucellosis can improve their clinical treatment by improving immunity.
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Objective @#To investigate the spatial distribution and the influencing factors of hypertensive patients aged 45 years and above,and to provide evidence for the prevention and control of hypertension among middle-aged and elderly population.@*Methods @#Multi-stage stratified random sampling method was used to collect 150 counties（cities or districts）from 30 provinces（municipalities or autonomous regions）from CHARLS database in 2015 according to the per capita GDP in different areas. Then the probability proportionate to size sampling method was used to select three villages（neighborhood committees）,80 families were randomly selected from each village（neighborhood committees）,and residents aged 45 years and above were interviewed. Spatial analysis was based on the vector map of China's provincial boundaries,Geoda and ArcGIS 10.2 software were used to analyze the prevalence and influencing factors of hypertension at provincial levels.@*Results @#The health data of 14 880 people aged 45 years and above in 28 provinces（municipalities or autonomous regions）were obtained,including 4 203 patients with hypertension（28.25%）and 5 408 people with pre-hypertension（36.34%）. The results of local spatial analysis showed that the clustering regions of hypertension patients were in northeast and eastern parts of China. The results of spatial regression analysis showed that males,age of 80 years and above and overweight were the main risk factors for hypertension（all P<0.05）,which had greater influence on the middle part of China,north and northeast of China,and the east and north of China,respectively.@*Conclusion @#Males,age of 80 years and above and overweight were the main risk factors for hypertension in middle-aged and elderly population in China. The main prevention and control areas of hypertension were eastern and northeast China.
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Objective@#To evaluate the effects of the intervention based on WeChat on blood pressure control in patients with essential hypertension. @*Methods@#The databases of CNKI，Wanfang，VIP，PubMed and the Cochrane Library were researched for the literatures about effects of the intervention based on WeChat on blood pressure control in patients with essential hypertension published from 2011 to 2018. These papers were retrieved and evaluated according to inclusion and exclusion criteria. Stata 12.0 software was used for meta analysis.@*Results@#Eleven out of 880 papers were included into meta analysis. There were 1 174 cases，with 587 cases in the experimental group and 587 cases in the control group. The results of the meta analysis showed that compared with traditional health intervention method，the intervention based on WeChat significantly reduced the level of systolic blood pressure（WMD=14.77，95%CI：11.76-17.77）and diastolic blood pressure（WMD=8.17，95%CI：5.67-10.67）of hypertensive patients. Subgroup analysis showed that the longer the intervention，the better the effects（P<0.05）. @*Conclusion@#The intervention based on WeChat is more helpful than traditional health intervention for blood pressure control of patients with essential hypertension.
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Objective To study the clinical features of upper gastro-intestinal hemorrhage in aged patients and provide information for timely and reasonable treatment for these patients. Methods The clinical data of 100 aged patients with upper gastro-intestinal hemorrhage (group A) were analyzed retrospectively. As control, 101 cases of non-aged patients with the same condition were selected for comparison ( Group B). Results The main cause of upper gastro-intestinal hemorrhage in aged patients was peptic ulcer(39% ) ,but the rate of hemorrhagein gastric ulcer(24. 00% ) was higher than that of duodenal ulcer(15. 00% ). However, in the non-aged patients,duodenal ulcer caused higher chance of upper gastro-intestinal hemorrhage than gastric ulcer. Aged group has higher complications ( 70.00% ) , which was significantly higher than that in non-aged group ( 24.75% ) ( x2 = 41. 27, P < 0. 01). Haematemesis occurred more frequently in aged group ( 28.00% ) thanthat of 7.92% in the non-aged group(x2 = 13.78 ,P <0.01). Most patients in aged group received NSAIDs and anticoagulant to treat complications. Conclusion The primary cause of upper gastrointestinal haemorrhage in aged patients was peptic ulcer,with relatively high incidence in gastric ulcer patients,and frequent incidence of haematemesis and complications. Aged patients were recommended to receive PPI therapy.
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Seasickness is a leading factor causing reduction in battle efficiency, and psychological factor is one of the important factors influencing the development and progression. This article reviews the mechanism, affecting factors, predictive indications, prevention and treatment of seasickness from a psychological perspective, in an attempt to provide psychological guidelines for military training, enhance the anti-seasickness ability of military staff and decrease its incidence.