The care for the diabetic patient and family repercussion

This study aimed to understand the repercussions in the family of the care offered after the implementation of a diabetes education program. We interviewed six relatives of diabetes patients from a university center in Ribeir?o Preto-SP, Brazil, in 2007. Thematic data analysis made it possible to identify three themes: relatives recognize that the Center constitutes a differential for adherence to the food plan, physical activity and medication; the Center is acknowledged as an educative space to get together and control diabetes; the patient as an element that multiplies and expands the knowledge about diabetes in the family. The results indicate that the education program favorably affected the family, expanding its knowledge repertoire about treatment, and that the family core's support is fundamental in treatment adherence.     

糖尿病患者血中载脂蛋白含量和SOD水平与其并发症的关系

目的为了解糖尿病血管病变与载脂蛋白(APO)含量及超氧化物歧化酶(SOD)活性、过氧化脂质(LPO)的关系.方法对48例非胰岛素依赖性糖尿病(NIDDM)患者和60例同龄的对照组进行检测分析.结果NIDDM患者的ApoA-I、T-SOD CuZn-SOD、Mn-SOD均明显降低,APOB、LPO均显著增高,P均＜0.01;NIDDM并发症的发生率与APOB水平、LPO含量呈正相关,r分别为0.8851、0.8805,P＜0.01,与APOA-I水平、T-SOD、CuZn-SOD活性呈负相关,r分别为-0.613、-0.8392、-0.5374、P＜0.01.结论提示NIDDM时机体存在脂质过氧化作用增强可能是引起并发症的重要原因之一.     

糖尿病患者血中载脂蛋白含量和SOD水平与其并发症的关系

目的 为了解糖尿病血管病变与载脂蛋白(APO)含量及超氧化物歧化酶(SOD)活性、过氧化脂质(LPO)的关系。方法 对48例非胰岛素依赖性糖尿病(NIDDM)患者和60例同龄的对照组进行检测分析。结果 NIDDM患者的ApoA-I、T-SOD CuZn-SOD、M_n-SOD均明显降低,APOB、LPO均显著增高,P均<0.01;NIDDM并发症的发生率与APOB水平、LPO含量呈正相关,r分别为0.8851、0.8805,P<0.01,与APOA-I水平、T—SOD、CuZn-SOD活性呈负相关,r分别为—0.613、-0.8392、-0.5374、P<0.01。结论 提示NIDDM时机体存在脂质过氧化作用增强可能是引起并发症的重要原因之一。     

Using a healthcare matrix to assess patient care in terms of aims for improvement and core competencies

BACKGROUND: In 2001, the Institute of Medicine (IOM) recommended six Aims f or Improvement; the dimensions of quality describe a health care system that is safe, timely, effective, efficient, equitable, and patient centered. In 1999, the Accreditation Council of Graduate Medical Education (ACGME) adopted six core competencies that physicians in training must master if they are to provide quality care. A Healthcare Matrix was developed that links the IOM aims for improvement and the six ACGME Core Competencies. The matrix provides a blueprint to help residents to learn the core competencies in patient care, and to help faculty to link mastery of the competencies with improvement in quality of care. HEALTHCARE MATRIX: The Healthcare Matrix is a conceptual framework that projects an episode of care as an interaction between quality outcomes and the skills, knowledge, and attitudes (core competencies) necessary to affect those outcomes. For example, an anesthesiology resident used the Healthcare Matrix for a complex 18-hour episode of care with a life-threatening situation. ONGOING WORK AND RESEARCH AGENDA: Collecting and analyzing a series of matrices provides the foundation for systematic change in patient care and medical education and a rich source of data for operational and improvement research.     

Distance from practice moderates the relationship between patient management involving nurse telephone triage consulting and patient satisfaction with care

The ESTEEM trial was a randomised-controlled trial of telephone triage consultations in general practice. We conducted exploratory analyses on data from 9154 patients from 42 UK general practices who returned a questionnaire containing self-reported ratings of satisfaction with care following a request for a same-day consultation. Mode of care was identified through case notes review. There were seven main types: a GP face-to-face consultation, GP or nurse telephone triage consultation with no subsequent same day care, or a GP or nurse telephone triage consultation with a subsequent face-to-face consultation with a GP or a nurse. We investigated the contribution of mode of care to patient satisfaction and distance between the patient׳s home and the practice as a potential moderating factor. There was no overall association between patient satisfaction and distance from practice. However, patients managed by a nurse telephone consultation showed lowest levels of satisfaction, and satisfaction for this group of patients increased the further they lived from the practice. There was no association between any of the other modes of management and distance from practice.     

Assessment of diabetic patient management at primary health care level]

OBJECTIVE: The characterization of diabetic patients seen at a primary health care clinic. METHODS: The case notes of 3,024 families were searched by means of a cross-sectional study for patients 30 to 75 years of age with a diagnosis of diabetes mellitus who had had a medical consultation during the previous five years. These patients were interviewed at their homes and were asked to come to the health center for physical examination and a plasma glucose test using glucosylated hemoglobin (GH). RESULTS: The prevalence of diabetes was 4%. The typical diabetic patient was a white women, > or = 50 years of age, from a family with a monthly income < or = 3 minimum wages. Compliance with GH was observed in 70% of the patients. Diet therapy was followed by less than one third of the patients and only one fifth were engaged in regular exercise. Nearly 70% were undergoing drug therapy (oral hypoglicemic agents or insulin); of these, only 15% used insulin. Most of the patients (66%) who agreed to have the GH test showed normal or fair glucose blood levels. CONCLUSIONS: Great efforts should be made by health teams to enhance diabetic patient education in order to promote compliance with recommendations regarding diet and exercise.