Objective To analyze the clinical effect of comprehensive community intervention in the adjuvant therapy for women with mild to moderate stress urinary incontinence.Methods From April to December in 2016,a total of 60 women with mild to moderate stress urinary incontinence were recruited by putting up posters in Fangzhuang Community Health Service Center,Fengtai District,Beijing,and they were divided into community group and hospital group according to the recruitment order,each of 30 cases. Women in hospital group received biofeedback combined with electrical stimulation treatment in Gynecology and Obstetrics Clinic,Peking Union Medical College Hospital,while women in community group received comprehensive community intervention(as adjuvant therapy)based on biofeedback combined with electrical stimulation treatment in Fangzhuang Community Health Service Center,Fengtai District,Beijing;both groups continuously intervened and followed up for 12 weeks.Leakage volume of 1-hour urinal pad test and Incontinence Quality of Life Scale(I-QOL) score before intervention,8 and 12 weeks after intervention were compared between the two groups.Results During follow-up,11 cases in hospital group lost,while no one in community group lost;lost rate of follow-up in community group was statistically significantly lower than that in hospital group(P<0.05). There was significant interaction between time and method in leakage volume of 1-hour urinal pad test and I-QOL score(P<0.05);main effects of time and method were significant in leakage volume of 1-hour urinal pad test and I-QOL score(P<0.05). After 8 and 12 weeks of intervention,leakage volume of 1-hour urinal pad test in community group was statistically significantly less than that in hospital group,respectively,while I-QOL score in community group was statistically significantly higher than that in hospital group,respectively(P<0.05).Conclusion &nbsp;Based on biofeedback combined with electrical stimulation treatment,comprehensive community intervention(as adjuvant therapy)can effectively improve the treatment compliance and quality of life,reduce the urinal leakage volume in women with mild to moderate stress urinary incontinence.

社区居家养老是一项治理养老难题的社会福利政策,各地区在实践中均取得了一些积极成果和可供借鉴的经验.方庄社区卫生服务中心围绕贯彻落实北京市、丰台区两级为民办实事项目,全面开展居家养老提升工程,以老年人居家养老的现实需求为导向,围绕居民个人及家庭健康需求组织服务,以人工智能、电子数据、互联网及物联网技术为支撑,整合社区资源为辖区老年人提供精细化、精准化、可及性的医疗服务,探索形成了基于智慧家庭医生优化协同(IFOC)模式的社区居家养老医疗服务模式.本文主要对该模式进行介绍,并分析其优势和尚存问题,从而为社区居家养老服务政策的制定提供参考与建议.

目的:探讨基于IFOC模式,从医养结合的角度构建的居家养老服务一体化平台,在目标人群中开展治疗及疾病相关护理、出院后恢复期康复治疗、生活照料和精神慰藉医疗相关服务;分析IFOC模式在社区居家养老服务中运用效果.方法:运用回顾性研究方法,调取北京市丰台区某两家社区卫生服务中心2016年3-11月签订家庭医生式服务协议且有居家医疗护理服务需求的240例患者作为研究对象,翻阅和查看240例患者的一般信息、居住状况、主要疾病和健康状况及所接受的居家康复护理指导等资料进行收集,通过半结构式访谈,了解联合辖区地段居委会、志愿者服务团队工作人员共同进行入户访视后,患者对提供的医疗服务模式、医护人员以往慢病管理经历和对服务满意度的评价.结果:调查显示,240例入组患者均系慢性病患者且签订家庭医生式服务协议,均为慢病管理平台规范管理的患者;全科医生根据服务类型填写居家养老医疗服务入户评估记录表,其中治疗型服务人次数共计727人次,占总服务率的52.04％;康复型服务人次数共计270人次,占总服务率的19.33％;舒缓照顾型服务人次数共计400人次,占总服务率的28.63％;接受访谈的患者对家庭医生服务团队上门提供的医疗护理服务整体过程总体满意.结论:IFOC模式下开展医疗服务巡诊及个案护理计划有利于解决目标人群居家养老时存在的医疗、护理及康复等需求,使患者无论在何处养老均能享受优质便捷的医疗服务,同时提高了居家带病患者的生存质量和对医疗护理服务的满意度,为保障老年人健康奠定了基础;社区卫生服务机构与辖区地段居委会加强合作,明确岗位职责,健全评估和管理机制,提高了医疗养老资源利用效率,加强了机构间的信息交流和资源的有效利用,逐步赢得居家老年人的信任,为居家养老医疗服务发展奠定基础.

Through many years of exploration and practice,the role definition of family doctors,support of " Internet+ " and artificial intelligence technology,the cooperation within family doctor team (one - to - one cooperation of family doctors and nurses),and labor division and collaboration among general practice and specialist as well as other medical institutions, Fangzhuang Community Health Service Centre in Fengtai of Beijing thus achieves a new model of people - centered and intelligent resource coordination and service optimization among family doctors. This model has improved the service capacity of community health service institutions and the efficiency of various service sectors,saved the resources of social health services,improved the self - awareness of residents participating in health management,which can provide references for the development of " Internet+ family doctor" service and the implementation of hierarchical diagnosis and treatment.

Objective To explore the effect of individual guidance and group activities on women with stress urinary incontinence in community. Methods Forty-seven women with stress urinary incontinence in a certain community health service center in Beijing were divided into observation group with 24 cases and control group with 23. Patients in observation group received individual guidance and participated in group activities while those in control group received individual guidance only. Pelvic floor muscle exercise adherence, pelvic floor muscle strength, urine leakage test in urine pad within 1h, quality of life were assessed in the 7th week and 12th week respectively. Results There was statistical significance in the comparison of pelvic floor muscle exercise adherence and type I pelvic floor muscle strength in the 7th week in two groups (P<0.05) and in the 12th week, there was statistical significance in the comparison of pelvic floor muscle exercise adherence, type II pelvic floor muscle strength and quality of life (P<0.05). Conclusion When compared with individual guidance, the combination of individual guidance and group activities is effective for the improvement of pelvic floor muscle exercise adherence, and pelvic floor muscle strength then the improvement of quality of life.

Objective To investigate the status and influencing factors of stress urinary incontinence among community prenatal and postnatal females.Methods A tatal of 101 3-year-after-delivery women from one community of Beijing were recruited and investigated with the Short Term of International Consultation on Incontinence Questionnaire(ICIQ-SF).Results Among all the famales,41.58% of them once had stress urinary incontinence during pregnancy or after delivery.The influencing factors of postpartum stress urinary incontinence were age and delivery mode.Conclusion It is common for community women to have stress urinary incontinence,and it is necessary to develop health education for this disease in the community,popularize the disease knowledge and promoting the prevention and treatment.