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September 2017, Volume 20, No.26 Abstracts

 Interpretation of Screening for Obesity in Children and Adolescents of US Preventive Services Task Force Recommendation Statement 2017

GAO Jie,QI Jian-guang*

Department of Paediatrics,Peking University First HospitalBeijing 100034,China

*Corresponding authorQI Jian-guangChief physicianAssociate professorE-mail:qjg2006@126.com

    Abstract  Obesity in children and adolescent has become a serious public health problem.In 2017,the US Preventive Services Task Force updated the recommendation statement on Screening for Obesity in Children and Adolescents based on a number of studies in recent years.The recommendation suggested that clinicians screen for obesity in children and adolescents 6 years and older,and offer comprehensive,intensive behavioral interventions.In this paper,we interpret the recommendation to provide some advice on obesity screening and intervention in Chinese children.

    Key words  ObesityChildScreeningBody mass indexGuidebooks

 

Advances and Challenges in Self-management in Stroke Patients

WANG Miao

School of Nursing,Wannan Medical College,Wuhu 241002,China

    Abstract  At present,self-management has been a hot area of research in chronic disease management.More and more researches on self-management in stroke patients have been conducted at home and abroad.We reviewed the assessment tools,associated factors,intervention models for self-management in stroke patients worldwide,hoping to provide a basis for improving the self-management ability in stroke patients in China.

    Key words  Stroke;Self-managementReview

 

Intervention Effect of Hospital-community-based Health Management Pattern in Populations at High Risk for Stroke

WANG Qian1,ZHI Xiao2*,WU Peng1,HE Xiao-ci1,WANG Yan-feng1,SUN Ke-pin1ZHANG Ting3

1.Department of High Risk Screening and Prevention for Stroke,the Second Hospital of Hebei Medical University,Shijiazhuang 050000,China

2.Department of Internal Medicine,the Second Hospital of Hebei Medical University,Shijiazhuang 050000,China

3.Yuandong Community Health Service Centre,Shijiazhuang 050000,China

*Corresponding author:ZHI Xiao,Associate chief physician;E-mail:zhixiao2007@163.com

    Abstract  Objective  To develop a hospital-community-based health management pattern in populations at high risk for stroke and to investigate its effect on the awareness level of the knowledge related to stroke prevention and treatment and health behaviors in such populations.Methods  The 186 participants at high risk for stroke were selected via a baseline survey conducted in 1 196 permanent residents aged 40 or older conveniently sampled from a community in Shijiazhuang during March 2016 to March 2017.Based on the random number table,they were divided into intervention group and control group with 93 cases in each.Patients in both groups received the conventional health education,those in the intervention group additionally received services of hospital-community-based health management pattern,including services delivered by a two-level multidisciplinary health management team,daily health risk assessment,establishment of electronic health records,dynamic follow-up and individual intervention,health education through WeChat platform and salons and lectures based on "menu" themes.The awareness level of knowledge related to stroke and health behaviors in both groups were evaluated by Knowledge Related to Stroke Prevention and Treatment Questionnaire and the Chinese version of Health-promoting Lifestyle Profile (HPLP ) 12 months after intervention.Results  Compared with those in the control group,participants in the intervention group achieved higher total scores of Knowledge Related to Stroke Prevention and Treatment Questionnaire and scores of all of its subscales (awareness of stroke risk factors,awareness of knowledge about stroke prevention,awareness of early symptoms of stroke,awareness of treatment for the unexpected stroke),and they had higher scores of all the subscales(health responsibility,exercise,nutrition,stress management,interpersonal support and self-actualization) of HPLP (P0.05).Conclusion  The hospital-community-based health management pattern is contributive to the improvement of the awareness level of knowledge about stroke prevention and health behaviors among populations at high risk for stroke,which is worth learning and promoting.

    Key words  StrokeHospital-community-based health managementHealth knowledgeHealth behaviorPrimary prevention

 

Development and Effects of Collaborative Health Management Model for Community Patients with Disabilities due to Stroke

SUN Qiu-xue1,LYU Yu-mei1*,ZHANG Wen-yue2,ZHAO Shou-mei2,SUN Li-li1,LI Juan1,XU Hai-lian1

1.School of NursingHarbin Medical UniversityDaqing,Daqing 163319,China

2.People's Hospital of DaqingDaqing 163316,China

*Corresponding authorLYU Yu-meiAssociate professorE-mail438866749@qq.com

    Abstract  Objective  To development a collaborative health management model for community patients with disabilities due to stroke,and evaluate its management effects.Methods  This study was conducted between January and June 2016.By convenience sampling,from 2 communities in Daqing,we enrolled 60 participants with disabilities due to stroke who returned to home after receiving treatment from hospitals or community health service centersstations and equally divided them into the control group (n=30) and the management group(n=30) based on the random number table.Patients in both groups received regular family visit and community-based health education,and those in the management group additionally received the collaborative health management model of servicespersonalized rehabilitation management,emotional management,information-based management,and patient self-management by a collaborative health management teamresearchers,rehabilitation therapists,psychologists,and community health service center managers.The effects of intervention achieved in both groups were assessed by surveying the patients by the Modified Barthel IndexMBI,Self-rating Depression ScaleSDS,General Self-efficacy ScaleGSES,APGAR Scale and Functional Activities QuestionnaireFAQbefore intervention,3 and 6 months after intervention.Results  Repeated measures analysis of variance showed that,intervention method and duration of intervention exerted significant main effects as well as notable interaction effects on the scores of MBI,SDS,GSES,APGAR and FAQP0.05.Simple effects analysis demonstrated that,the scores of MBI,GSES and APGAR were higher while those of SDS and FAQ were lower in the management group than in the control group at the end of 3 and 6 months of interventionP0.05.In the control group,the scores of MBI varied by the assessing timeP0.05,while those of SDS,GSES,APGAR and FAQ did notP0.05.In the management group,the scores of MBI,SDS,GSES,APGAR and FAQ varied by the assessing timeP0.05.Conclusion  By using the collaborative health management model,improved activities of daily living,family function,ameliorated defective functional activity can be achieved in community patients with disabilities due to stroke.Therefore,it is of great clinical significance for the development of community-based health management services.

    Key words  StrokeDisabled personsCollaborative health managementRehabilitationDepression

 

Exploration and Suggestions for Information-based Stroke Screening in High-risk Community-dwelling Population

GU Jing-chun,LI Qin,GU Yi-qin*

Zhijiang West Road Community Health Service Center,Shanghai 200070China

*Corresponding authorGU Yi-qin,Attending physicianE-mailqinqincyy@163.com

    Abstract  Building an integrated information platform for the screening,management and follow-up of stroke is of important significance for regional stroke prevention and treatment.In this paper,we introduced the flow path of the system for screening,prevention and treatment of stroke in community-dwelling population in Shanghai,and the interfacial design of information-based stroke screening system in high-risk community-dwelling population in Shanghai.Moreover,based on the practical experience in screening and intervening,we put forward solutions to the problems existing in the information-based stroke screening system in high-risk community-dwelling population,in order to further improve the informationalized building and standardize the flow path of screening stroke in community-dwelling population.

    Key words  StrokeHigh-risk populationScreeningCommunity health service

 

Effect of Relaxation Therapy on the Frequency of Pacemaker Adverse Events and Mental Conditions in Patients with Mental Disorders Following Implantable Cardioverter-defibrillator Discharges

LIU Wei-yi1, YU Lin-na2, HUA Bao-tong1, JING Pan1, PU Li-jin1*

1.Department of Cardiology, First Affiliated Hospital of Kunming Medical University, Kunming 650032,China

2.Kunming Medical University, Kunming 650500,China

*Corresponding authorPU Li-jinAssociate professorMaster supervisorE-mail:plj330@126.com

    Abstract  Objective  To investigate the effect of relaxation therapy on the frequency of pacemaker adverse events and mental conditions in patients with mental disorders following implantable cardioverter-defibrillator(ICD) discharges.Methods  We enrolled 60 patients(26 males and 34 females) who received inpatient or outpatient treatment in Department of Cardiology and follow-up services delivered by ICD treatment, First Affiliated Hospital of Kunming Medical University, from June and November 2015 and randomized them into the experimental group and control group with 30(13 males and 17 females) in each based on the male to female ratio.Both groups received conventional drug therapy, the experimental group additionally received relaxation therapy for 6 monthes, including muscle relaxation training, imagination relaxation training, deep breathing relaxation training, silent relaxation training, twice daily,30 min per time.The number of pacemaker adverse events occurred in the 6-month period before and during the intervention were recorded using the Patient-Triggered Event Records(PTER) .Self-rating Anxiety Scale(SAS) and Self-rating Depression Scale(SDS) were filled before and after the intervention for assessing the mental disorders and intervention effect.Results  During the intervention period,3 and 2 cases dropped out of the control group and the experimental group, respectively.The number of pacemaker adverse events occurred in the control group during the 6-month period before the intervention was not significantly different from that occurred during the intervention period(Z=-0.472, P=0.637).However, in the experimental group, the number of pacemaker adverse events occurred during the intervention period was less than that occurred in the 6-month period before the intervention(Z=-3.172, P=0.002).The reduced number of pacemaker adverse events occurring in the 6-month period before and during the intervention period was more in the experimental group than that in the control group(Z=-2.475, P=0.013).After intervention, the degree of mental disorders was milder in the experimental group than in the control group, indicating better intervention effect was achieved in the experimental group(P0.05).The intervention effect was negatively correlated with the number of pacemaker adverse events in the experimental grouprs=-0.702P0.001.Conclusion  Relaxation therapy can reduce the number of pacemaker adverse events occurred in patients with secondary mental disorders after ICD discharges and improve their mental conditions.

    Key words  ArrhythmiaRelaxation therapy; Defibrillators, implantable; Pacemaker adverse event; Mental disorders

 

1Clinical Characteristics of Young and Middle-aged Patients with Acute ST-segment Elevation Myocardial Infarction

WANG Jia-yuWANG De-zhaoCHEN WeiHU Hong-yu*

Department of CardiologyBeijing Tiantan HospitalCapital Medical UniversityBeijing 100050China

*Corresponding authorHU Hong-yuAssociate chief physicianE-mailhuhongyucag@163.com

    Abstract  Objective   To analyze the clinical features of young and middle-aged patients with acute ST-segment elevation myocardial infarctionSTEMI.Methods  This retrospective study was conducted in Department of CardiologyBeijing Tiantan HospitalCapital Medical University.The enrolled participants were totaled 183 cases who were diagnosed as acute STEMI in 2016including patients who had acute STEMI occurring within 12 hand those who had acute STEMI occurring within 24 h but met the indications for emergency revascularization and underwent emergency percutaneous coronary interventionPCI.We reviewed their baseline datacoronary angiographic parameterslaboratory resultscardiac function and structural parametersand the incidence of major adverse cardiovascular events within 30 days after operation.Results  The participants were divided into the young and middle-aged group95 cases aged 60 and elderly group88 cases aged 60 based on age.The two groups had significant differences in sex distributionvisiting time after the onset of acute STEMIhistory of diabetesfamily history of premature coronary heart diseasesmoking index and BMIall P0.05.Compared with the elderly groupthe young and middle-aged group was found with higher ratio of treatment with tirofiban administered intravenouslylarger total dose of tirofiban administeredlower ratio of treatment with IABPhigher levels of serum TGTCLDL-Chigh-sensitive cardiac troponin Ihs-cTnI),creatine kinase isoenzymeCK-MB and BNPand lower levels of serum creatinine and Killip classall P0.05.The incidence of major adverse cardiovascular events and that of malignant arrhythmia occurring within 30 days after the surgery was lower in the young and middle-aged groupP0.05.Conclusion  Compared with the elderly groupthe young and middle-aged group can visit more timely after the onset of acute STEMIand they have milder lesions assessed by coronary angiographyhigher success rate of vascular recanalization and better prognosisso they should be actively involved in the interventional therapy for improving the prognosis.

    Key words   Myocardial infarctionCoronary angiographyAngioplastyballooncoronary

 

Mode of Healthcare Management Services Delivered by Medical and Elderly Care Institutions for Community-dwelling Elderly Patients with Coronary Heart Disease under the Situation of the Implementation of Hierarchical Medical System in China

ZHOU Xia1LIAO Sheng-wu2*YI Song1MIN Jing-xian1LYU Wei1,ZHANG Qi1,ZHANG Chun1

1.Department of Health ManagementNanfang HospitalSouthern Medical University,Guangzhou 510515China

2.Department of EmergencyNanfang HospitalSouthern Medical University,Guangzhou 510515China

*Corresponding authorLIAO Sheng-wu,Associate researcher;E-mail602057913@qq.com

   

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