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社区与医院双向转诊制度的建立和服务的开展 总被引:2,自引:0,他引:2
目的 为理顺医院与社区之间的关系 ,降低医疗费用、方便患者就近就诊、提高社会效益和经济效益。方法 建立了医院和社区之间一系列快捷的转诊制度和流程 ,成立双向转诊办公室专职机构和人员 ,实行每日出入院患者资料的收集和转诊管理 ,落实治疗、保健、康复服务 ,健康教育服务 ,加强双向转诊跟踪服务。结果 提高了社区居民对社区医疗服务的信任 ,巩固了患者的治疗效果 ,降低了患者的治疗费用 ,缩短了治疗时间 ,增加了医院的社会效益和经济效益。结论 双向转诊需要进一步开展更扎实的工作 相似文献
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目的探讨系统健康教育在骨科慢性疼痛性疾病患者中的应用效果。方法随机选取本院2013年3月~2015年3月收治的骨科慢性疼痛性疾病患者86例作为研究对象。按照硬币法原则,将其随机分成常规护理组和观察组,两组患者均为43例。常规护理组患者给予常规护理,观察组患者在常规护理的基础上给予系统性健康教育,比较两组患者治疗后疼痛程度和抑郁、焦虑情绪评分。结果观察组护理后疼痛率为13.95%,常规护理组护理后疼痛率为32.56%,观察组疼痛率低于常规护理组,差异具有统计学意义(P0.05);在抑郁和焦虑量表评分上,观察组患者抑郁(SDS)、焦虑(SAS)量表评分分别为(36.58±4.36)分、(41.29±5.63)分,均低于常规护理组,有统计学意义(P0.05)。结论系统性健康教育应用于骨科慢性疼痛性疾病患者护理过程中,与常规护理方式相比效果较好。不仅能够有效减轻患者身体疼痛,还可以缓解患者的紧张、抑郁、焦虑情绪,值得临床推广应用。 相似文献
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目的:了解双向转诊中慢性病病人的下转现状及影响因素。方法:应用自行设计的“慢性病病人下转现状调查问卷”对成都市4所三级医院200例慢性病病人进行调查。结果:分别有11.5%、37.5%的病人有下转经历和愿意下转。病人不愿意下转的主要原因为基层医疗技术水平低。基层医疗机构首诊、已签约家庭医生、有下转经历、信任基层医疗技术对慢性病病人的下转意愿有影响(P<0.05)。结论:慢性病病人的下转率、下转意愿均较低。下转意愿受多种因素影响,应从宣传教育、政策完善、加强基层医疗服务建设等方面促进慢性病病人合理下转。 相似文献
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调查显示,我国糖尿病年患病率为6%,糖尿病患者已达4000万例,糖尿病的防治已成为我国亟待解决的重要公共卫生问题。基层社区卫生服务系统在糖尿病的检查筛选以及监控方面具有重要作用[1]。2007年8月在湖北省中山医院全面托管的荣华崇仁街社区卫生服务中心开展糖尿病规范化管理工作,经过实践,效果良好。现总结如下。 相似文献
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门诊与社区开展健康教育的探讨 总被引:6,自引:1,他引:5
根据病人和社区人群的需求,我院门诊开展了以科普知识教育,专科知识教育,社区人群健康教育为主要内容,以计划性教育,随机性教育,示范性教育,由点带面教育为主要方式的多种形式的健康教育,健康教育的实践使我们体会到,要搞好健康教育,护士应注重整体素质地提高,掌握教学和沟通技巧,重视信息的反馈。只有这样,门诊社区的健康教育才能卓有成效地展开。 相似文献
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国内外社区健康教育与社区护理情况简介 总被引:7,自引:2,他引:5
社区健康教育是指以社区为单位,以整个社区人群为对象,以促进这个社区的居民健康为目的,开展综合性的健康教育,规划社区健康教育的战略目标,组织发动全社会开展关心自己的健康问题的讨论,积极参与本社区健康规划的制定与实施,提高自我保健意识,优先开展健康教育,健康促进和 相似文献
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目的:探讨社区管理对慢性疼痛患者生活质量的影响。方法:以慢性疼痛为目标筛查某社区慢性疼痛患者68例,将其随机分为观察组和对照组各34列。观察组采取由社区护士指导,社工、患者及家属共同参与的护理模式,对照组由社康中心常规镇痛治疗。3个月后采用简式疼问卷表以及简式健康相关生活质量问卷评定效果。结果:观察组患者的慢性疼痛改善情况及生活质量均优于对照组,两组比较差异有统计学意义(P<0.05)。结论:由社区护士指导,社工、患者及家属共同参与的护理模式能改善患者健康信念,保持乐观情绪,积极配合治疗,有效减轻疼痛,提高生活质量,值得进一步推广应用。 相似文献
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王蓓 《临床和实验医学杂志》2006,5(10):1640-1641
目的 使人们重视并了解心脑血管病发病的危险因素以及如何预防和避免这些危险因素。方法采用随机抽样调查法:时社区240例人群进行的心脑血管病发病危险因素的调查。结果社区中人群存在心脑血管病的不在少数。心脑血管病不仅与高血压病密切相关,而且还于遗传、高血脂、糖尿病、超重、烟酒等危险因素密切相关。结论对社区35岁以上人群有高血压的病人或无高血压但有其他心脑血管病危险因素的人群进行全方位的社区卫生服务,并定期进行健康教育与健康指导,使人们逐步重视心脑血管病发病的危险因素,从而使心脑血管病的发病率降到最低点。 相似文献
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冠心病是一种慢性进展性的心血管系统疾病 ,系多种危险因素作用于不同的环节所致 ,主要有高血压、高血脂、吸烟、肥胖、糖尿病[1] 。这些因素很大程度上与不健康的生活方式有关 ,如高盐及高脂饮食、吸烟、酗酒、缺乏体育活动等 ,所以 ,冠心病的预防重点放在危险因素的干预阶段 相似文献
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目的调查社区慢性腰背痛患者自我效能水平并分析其影响因素。方法 2014年4月至2015年1月,便利抽样法选取南京市玄武区、栖霞区、河西新区以及常州市天宁区等8个社区的慢性腰背痛患者157例为研究对象,采用一般情况调查表、长海痛尺、慢性病管理自我效能感量表、简易应对方式问卷、简明健康状况量表、中文版恐惧-回避行为量表、社会支持评定量表和综合医院焦虑抑郁量表对其进行调查。结果慢性腰背痛患者自我效能得分为(6.55±1.89)分。患者对于腰背痛感觉描述中使用频率最高的是"痉挛牵扯痛"、"持续固定痛"和"腰痛"。不同婚姻状况及文化程度患者的自我效能评分的差异均有统计学意义(均P0.05)。慢性腰背痛患者自我效能与其当前疼痛、积极应对、生理功能、生理职能、躯体疼痛、总体健康、活力、社会职能、情感职能、情感健康、恐惧-回避信念总分、社会支持总分、焦虑得分和抑郁得分等14个变量均具有相关性(均P0.05)。多元线性回归结果显示,生理职能、总体健康、社会支持和积极应对是慢性腰背痛患者自我效能的主要影响因素。结论建议相关部门针对社区慢性腰背痛患者自我效能的主要影响因素制定相关政策,从而提高其自我效能水平。 相似文献
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Vittal R. Nagar Pravardhan Birthi 《Journal of pain & palliative care pharmacotherapy》2015,29(1):48-50
Questions from patients about pain conditions, pain treatment, and responses from authors are presented to help educate patients and make them effective self-advocates. The topics addressed in this issue are renal or kidney failure and chronic pain management with opioids, morphine, and oxycodone effect in the body over a period of time. This includes process of absorption, distribution, localization in tissues, biotransformation and excretion in chronic kidney disease, expected side effects and recommendations. 相似文献
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《Journal of pain & palliative care pharmacotherapy》2013,27(2):152-156
ABSTRACTChronic pain is one of the most common reasons for patients to seek medical care. Chronic pain results in substantial economic losses and remains one of the most costly conditions in modern western society. In 1991, costs were estimated to be approximately $65 billion annually, comparable to the cost of treating diabetes. Persistent chronic pain and the use of advanced interventional and pharmacological treatments often leads to complex social and psychological maladaptations, health care overutilization, as well as many other substantial direct and indirect costs. Thus, the proper treatment of chronic pain involves intense multidisciplinary management, including pharmacological, behavioral, and psychological interventions. Few studies have assessed the total economic cost of chronic pain. However, many of the chronic pain treatments do not alleviate pain symptoms for most patients and lead to unsuccessful application of resources. The economic consequences of inadequately treated chronic pain translates into lost work days, overutilization of health care resources (excess hospitalizations, and surgical procedures and inappropriate medications) and other out-of-pocket patient expenses. Increasing emphasis on diagnosis and treatment of chronic pain places more importance on the need for efficient and coordinated management of patient with chronic pain. The management of chronic pain is remarkably complex and resource intensive. Therefore, a clear need exists for intensive pharmacoeconomic investigations, specifically evaluating costs related to chronic pain and the associated treatment modalities. Additionally, evaluation of the costs related to chronic pain would measure the economic burden of chronic pain, including an estimate of the amount that could potentially be saved if chronic pain patients are optimally managed. 相似文献
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For 2 weeks following surgery, 55 patients with preexisting chronic pain (CP) reported daily postoperative pain with movement and at rest. Of these, 30 CP patients used opioid pharmacotherapy for CP management and 25 did not. We modeled pain resolution in each patient using a linear fit so that each patient yielded 2 scores for each pain rating: 1) an intercept, or initial level of pain, immediately after surgery; and 2) a slope, or rate of pain resolution. The patients not using opioid pharmacotherapy had a mean pain with movement intercept of 5.4 and a slope of −.20, while the patients using opioid pharmacotherapy had a significantly higher mean intercept of 7.68 (P = .001) and a slope of −.21, sustaining higher pain levels over days. The opioid pharmacotherapy patients had the same rate of pain resolution as the other CP patients, and both groups resolved their pain more slowly than normal surgery patients. Preexisting CP may predispose a patient undergoing surgery to a slower rate of postoperative pain resolution. Chronic pain patients who use opioids share this predisposition but in addition, they are at risk for markedly higher postoperative pain across the entire pain resolution trajectory.
Perspective
This is an observational rather than a randomized controlled study, and as such is less definitive. Nonetheless, these findings are consistent with those of animal studies showing that prolonged exposure to opioids can produce opioid-induced hyperalgesia. Patients with opioid pharmacotherapy for chronic pain who undergo surgery merit special attention for acute pain management. 相似文献17.
Carlton Dampier Tonya M. Palermo Deepika S. Darbari Kathryn Hassell Wally Smith William Zempsky 《The journal of pain》2017,18(5):490-498
Pain in sickle cell disease (SCD) is associated with increased morbidity, mortality, and high health care costs. Although episodic acute pain is the hallmark of this disorder, there is an increasing awareness that chronic pain is part of the pain experience of many older adolescents and adults. A common set of criteria for classifying chronic pain associated with SCD would enhance SCD pain research efforts in epidemiology, pain mechanisms, and clinical trials of pain management interventions, and ultimately improve clinical assessment and management. As part of the collaborative effort between the Analgesic, Anesthetic, and Addiction Clinical Trial Translations Innovations Opportunities and Networks public-private partnership with the U.S. Food and Drug Administration and the American Pain Society, the Analgesic, Anesthetic, and Addiction Clinical Trial Translations Innovations Opportunities and Networks-American Pain Society Pain Taxonomy initiative developed the outline of an optimal diagnostic system for chronic pain conditions. Subsequently, a working group of experts in SCD pain was convened to generate core diagnostic criteria for chronic pain associated with SCD. The working group synthesized available literature to provide evidence for the dimensions of this disease-specific pain taxonomy. A single pain condition labeled chronic SCD pain was derived with 3 modifiers reflecting different clinical features. Future systematic research is needed to evaluate the feasibility, validity, and reliability of these criteria.
Perspective
An evidence-based classification system for chronic SCD pain was constructed for the Analgesic, Anesthetic, and Addiction Clinical Trial Translations Innovations Opportunities and Networks-American Pain Society Pain Taxonomy initiative. Applying this taxonomy may improve assessment and management of SCD pain and accelerate research on epidemiology, mechanisms, and treatments for chronic SCD pain. 相似文献18.
Bart Morlion MD Heribert Walch MD Gabriel Yihune MD Ans Vielvoye‐Kerkmeer MD PhD Zuzana De Jong PhD José Castro‐Lopes MD PhD Michael Stanton‐Hicks MB BS Dr. Med FRCA ABPM 《Pain practice》2008,8(6):473-480
Chronic pain is a debilitating condition with a multidimensional impact on the lives of patients, their families and communities. The public health burden of chronic pain is gathering recognition as a major healthcare problem in its own right and deserves closer attention. The challenge in treating chronic pain is to provide effective clinical management of a complex, multifaceted set of conditions that require a coordinated strategy of care. Epidemiological data and patient surveys have highlighted the areas of pain management that might be improved. These include a need for better understanding and documentation of the symptoms of chronic pain, standardized levels of care, improved communication among clinical personnel and with patients, and an updated education program for clinicians. For these reasons, new strategies aimed at improving the standards of pain management are needed. The Pain Associates' International Network (P.A.I.N.) Initiative was set up to devise practical methods for improving the quality of pain management for patients. These strategies have recently been put into practice through a number of activities: P.A.I.N. Workshops are meetings of international pain management professionals dedicated to discussing current management strategies and producing consensus recommendations for improving standards of care; P.A.I.N. Quality is a unique software program designed to help treating clinicians to document patient data and derive effective treatment plans; P.A.I.N. Online provides a web site forum for discussion of pain management topics; and P.A.I.N. Management is a clinician education program providing up‐to‐date training in pain management. 相似文献
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《The Journal for Nurse Practitioners》2019,15(8):583-587
Chronic low back pain (CLBP) is a condition that commonly consumes many resources and creates economic burden for the health care system. Evidence-informed care is crucial to guide management and prevent unnecessary procedures, including diagnostic imaging. Conservative therapy is currently recommended as the first-line and the most cost-effective treatment. Antibiotic therapy and surgical procedures are considered last resort treatment options for CLBP. The aim of this article is to summarize CLBP options for nurse practitioners (NP). 相似文献
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《The Journal for Nurse Practitioners》2021,17(6):753-756
This case challenge presents an elderly female living in a long-term care facility who has chronic right flank pain associated with chronic nephrolithiasis and frequent urinary tract infections. Acute on chronic flank pain can be a symptom of gastrointestinal or urologic issues, which further complicates treatment. Acute flank pain requires timely access to diagnostic equipment to ensure the most accurate and timely diagnosis. 相似文献