目的 探讨医养结合的中医药特色健康管理模式在老年糖尿病患者管理中的应用效果.方法 选取120例老年糖尿病患者.采用随机数字表法分为对照组和观察组,对照组采用科室常规实施的健康管理模式,观察组采用医养结合的中医药特色健康管理模式进行健康管理.统计两组干预前后各临床指标及糖尿病患者自我管理行为量表、糖尿病痛苦量表、糖尿病患者生存质量特异性量表评分.结果 干预后观察组较对照组血糖指标明显稳定,自我管理能力明显提高,糖尿病疼痛有一定程度缓解,生存质量明显改善(均P<0.01).结论 医养结合的中医药特色健康管理模式有利于老年糖尿病患者稳定血糖,提高自我管理能力,缓解糖尿病疼痛,改善生存质量.

As a country with the fastest population aging rate in the world, China’s existing elderly care and medical resources are not enough to meet the growing and complex needs of elderly care and health services. The Chinese government is actively promoting the integrated development of medical and elderly care institutions, but it has yet to give full play to the inexpensive and existing advantages of traditional Chinese medicine in the treatment of diseases and rehabilitation of the elderly, by sorting out the advantages of “TCM + intelligent pension” in medical expenses, pension costs, disease prevention, intelligent pension services, and so on. In view of the current problems existing in China’s pension, this paper mainly proposes to solve the pension dilemma in China from several aspects: improving the supervision and evaluation system, increasing capital investment, building a unified digital medical and pension service platform, and strengthening the talent training in the field of traditional Chinese medicine integration. The application of the “TCM + smart elderly care” system into the medical and elderly care service system is promoted to effectively improve the operation efficiency of the whole medical and elderly care service system and the satisfaction of elderly families.

国家心血管病中心公布的统计数据显示,高血压已成为我国心血管疾病最重要的危险因素,80％的急性脑卒中归因于高血压,且高血压患病率随年龄增加明显升高,年龄≥75 岁的老年人高血压患病率超过60％[1-2].2019年10月,中国心脏病学会第十届委员会高血压小组发布的研究报告显示,现阶段,我国高血压知晓率、治疗率和控制率仍处于较低水平,且多数患者高血压缺乏自我管理[3].国内外研究发现,社区防治是控制高血压最有效的路径[4-5].本研究以海口市社区卫生服务中心管理的高血压患者为例,通过调查问卷方式了解患者血压自测情况和影响因素,为社区高血压防治和有效管理提供参考.

As a country with the fastest population aging rate in the world, China's existing elderly care and medical resources are not enough to meet the growing and complex needs of elderly care and health services. The Chinese government is actively promoting the integrated development of medical and elderly care institutions, but it has yet to give full play to the inexpensive and existing advantages of traditional Chinese medicine in the treatment of diseases and rehabilitation of the elderly, by sorting out the advantages of "TCM + intelligent pension" in medical expenses, pension costs, disease prevention, intelligent pension services, and so on. In view of the current problems existing in China's pension, this paper mainly proposes to solve the pension dilemma in China from several aspects: improving the supervision and evaluation system, increasing capital investment, building a unified digital medical and pension service platform, and strengthening the talent training in the field of traditional Chinese medicine integration. The application of the "TCM + smart elderly care" system into the medical and elderly care service system is promoted to effectively improve the operation efficiency of the whole medical and elderly care service system and the satisfaction of elderly families.

目的 探究个体化护理联合饮食护理对心肌梗死支架术后并发心力衰竭患者遵医行为的影响.方法 回顾2018年1月至2019年12月心肌梗死支架术后并发心力衰竭患者87例的临床资料,按照护理干预方法不同分为2组,对照组43例给予常规护理干预,观察组44例给予个体化护理联合饮食护理,比较2组患者遵医行为、生活质量及营养状况情况.结果 观察组4个方面遵医行为评分、生活质量各维度评分均较对照组高,差异有统计学意义(P<0.05).观察组营养状况优于对照组,差异有统计学意义(P<0.05).结论 个体化护理联合饮食护理应用于心肌梗死支架术后并发心力衰竭患者护理中,能够提高遵医行为,改善营养状况,提高生活质量,值得推广.

To observe the clinical effect of ureklin and aspirin combined with rehabilitation training in patients with acute cerebral infarction. A total of 120 patients with acute cerebral infarction admitted to our hospital from January 2018 to January 2021 were randomly divided into control group and observation group. Both groups received conventional treatment. On this basis, the control group was treated with aspirin combined with rehabilitation training and the observation group was treated with aspirin combined with rehabilitation training and ureklin. The clinical efficacy after 2 w of treatment and safety during treatment of the two groups were counted and the level of serum cytokine, hemorheology, neurological function and quality of life were compared between the two groups before and after 2 w of treatment. After 2 w of treatment, the total effective rate of control group was lower than that of observation group (p<0.05). After 2 w of treatment, level of serum vascular endothelial growth factor and scores of activity of daily living and Barthel index in both groups were higher than before treatment and there was statistical difference between observation group and control group (p<0.05). After 2 w of treatment, levels of serum homocysteine, cystatin-C, plasma viscosity, platelet aggregation rate, hematocrit, fibrin and score of National Institutes of Health Stroke Scale in both groups were lower than those before treatment and there was statistical difference between observation group and control group (p<0.05). During treatment, the total incidence of adverse reactions in the observation group was 6.67 % and there was no significant difference between the observation group and the control group (11.67 %, p>0.05). Ureklin and aspirin combined with rehabilitation training could effectively improve the synthesis of serum cytokines, hemorheology and neurological function in patients with acute cerebral infarction and improve the quality of life of patients, with better clinical efficacy.

目的:分析OEC管理模式在老年病临床护理管理中的应用及效果。方法:选择2015年6月至2017年5月海南省老年病医院49名护理人员为研究对象，按OEC管理模式设立考核目标、考核单元、考核内容，确立考核指标体系、护理日清体系和奖励机制。比较OEC管理实施前后患者对护理工作的满意度和护理质量，评估OEC管理模式的实施效果。结果:OEC管理模式实施后，医院整体护理能力[(97.2±3.2)分]、病区护理管理能力[(96.1±5.4)分]、医疗文书管理水平[(97.8±2.8)分]、基础护理能力[(98.3±5.1)分]等护理工作质量以及患者满意度(97.2%)均明显高于实施前( t＝3.86、3.61、3.26、3.38，χ 2＝5.42，均 P<0.05)。 结论:OEC管理模式对提高老年病临床护理工作质量，实现护理的目标化和精细化管理有较明显的作用。

目的 探讨人文关怀护理模式提高晚期肿瘤患者生活质量的效果.方法 选取116例肿瘤晚期患者,随机分为人文关怀组和对照组,采取世界卫生组织生存质量测定量表(WHOQOL-BREF)和自制护理满意度调查问卷表分别对两组患者护理干预前后生活质量和满意度进行比较分析.结果 人文关怀组患者经过3个月人文关怀护理干预后,生理领域、心理领域、社会关系领域和环境领域等各项指标的评分结果明显增高(P<0.05),肿瘤晚期患者满意度明显高于对照组(χ2=21.473,P<0.01).结论 实施人文关怀护理模式能有效改善肿瘤晚期患者的生存质量,调整与改善患者精神状态,消除危险情绪应激,减轻患者痛苦.

近年来,随着海南国际旅游岛建设步伐的加快,老年人健康需求的逐步提升,海南省独特的地域、环境和气候优势,为"候鸟"式的养老服务提供了良好的发展机遇.但是,外来养老人口的急剧上升和相对欠完善的医养护服务体系之间存在着供需矛盾.如何有效发挥政府在养老服务领域资源整合方面的优势,最大程度地完善相关政策,优化相关服务流程,为医养护一体化服务体系的构建提供强有力的支持,实现养老资源的最优化配置是目前亟需解决的问题.

“医养融合”服务体是指整合养老机构与社区优质医疗服务资源，为老年人提供生活照料、文娱活动、健康咨询服务、健康检查服务、常见疾病诊疗、日常护理服务、大病康复以及临终关怀等服务的综合体，以满足日益增长的老年人“医养护一体化”服务需求。尽管老年人对“医养融合”服务需求较高，但涉及民政、卫生和社保等服务体系和政策间的合作与衔接不够通.，导致在建立老年人“医养融合”服务体过程困难和阻力较大〔1〕。其核心问题是政府相关政策未衔接、部门间利益关系未厘清、相应资源未整合，导致社会资本在投入“医养融合”服务体系建设存在诸多疑虑。本研究主要就社会办“医养融合”服务体的影响因素及解决路径进行分析。