随着新时代老年人口数量和其占比的大幅度提升,失能老人与慢性病患者的规模也逐渐加大,对相关医养结合的服务要求不断提高.纵观当前国内医养结合下的服务医疗管理效率、资源利用率并不理想.传统的医养结合贯彻与实行是养老问题的难点与痛点,这种特殊的养老模式在落实方面依然存在着人才队伍建设难、筹资难、养老医疗融合难等问题,面对层层难题我们可以试图通过利用大数据的支持.以社区家庭的合作为服务的支点,整合各类社会资源,推出信息化和智能化的医养结合方案,搭建集线上与线下为一体的合作平台,在提升医养服务匹配度的同时,完善服务体系,真正实现智慧居家养老服务.
目的 探讨门诊护士自我控制能力综合培训干预效果. 方法 选择黑龙江省某三甲医院门诊护士43名,接受为期4个月的自我控制能力系列干预培训,比较干预前后自我控制能力(认知控制、情绪控制、行为控制、人际关系、职业素养五个维度及总分)和突发公共卫生事件应对能力,同时调查医师及患者于培训前后对护理工作满意度. 结果 门诊护士培训后自我控制能力、突发公共卫生事件应对能力均较培训前明显提高(P<0.05),培训后医生及患者满意率较培训前明显增高(P<0.05). 结论 对门诊护士自我控制能力进行干预培训能有效提高其应对突发公共卫生事件的综合能力,同时可提高医生和患者对护理工作的满意度.
Objective: To investigate the relationship between serum specific serine protease inhibitor (Vaspin), adipose triglyceride lipase (ATGL) and risk factors and severity of coronary heart disease (CHD) in elderly patients. Methods: One hundred and twenty-four CHD patients (CHD group) and 80 healthy subjects (NC group) were selected. The clinical data of the two groups were collected. CHD-related hematological parameters were measured on the second day after admission. Coronary angiography was performed to assess the extent of coronary artery stenosis with Gensini score. Other indicators were recorded in the NC group except Gensini score and the results were then analyzed. Results: (1) The systolic blood pressure, diastolic blood pressure, body weight, BMI, smoking index, alcohol index, salt intake in CHD group were higher than those in NC group (P ＜ 0. 05). (2) Vaspin, ATGL, INR, HDL-C of CHD group were lower than those of the NC group (P ＜ 0. 05). The levels of FIB, TC, TG, LDL-C, Lp (a), blood glucose in CHD group were higher than those of NC group (P ＜ 0. 05). No obvious coronary stenosis was found in NC group, and the improved Gensini score was 22. 86 ± 8. 09 in CHD group. (3) Levels of Vaspin and ATGL were negatively correlated with systolic blood pressure, diastolic blood pressure, body weight, BMI, smoking index, drinking index and salt intake (P ＜ 0. 05). (4) Vaspin and ATGL were negatively correlated with FIB, TC, TG, LDL-C, Lp (a), blood glucose, Gensini score (P ＜ 0. 05), but positively correlated with INR and HDL-C (P ＜ 0. 05). Conclusion: Vaspin and ATGL are closely related to the risk factors and the severity of coronary heart disease. Coronary heart disease risk factors may cause or aggravate the system disorder of body's sugar, lipid metabolism and coagulation, which may affect Vaspin and ATGL levels.Vaspin and ATGL may be a protective factor participating in the maintenance of metabolic balance.
