Subjects: Medicine, Pharmacy >> Preventive Medicine and Hygienics submitted time 2024-06-12 Cooperative journals: 《中国全科医学》
Abstract： Background Follow-up is a necessary step in the management of chronic disease patients. Cloud follow up as a new form of follow-up may improve the quality of follow-up. However，there is currently a lack of patient-oriented evaluation tools for cloud follow-up service quality. Objective To develop a scale for evaluating the service experience of chronic disease patients in cloud follow-up and to examine its reliability and validity，in order to provide a tool for evaluating the quality of cloud follow-up services. Methods Guided by the Service Quality （SERVQUAL） evaluation model，the scale was developed by using methods including literature review，semi-structured interview，expert consultation. During August to October 2022，a survey was conducted among chronic disease patients （n=480） discharged from a tertiary hospital and lived under the network of a community service center in Hangzhou，China. Item analysis and tests of reliability and validity were test on the developed scale. Results The developed scale for evaluating the service experience of chronic disease patients in cloud follow-up had 37 items distributed in 5 dimensions. Patients' perceptions and expectations to each item were evaluated simultaneously. The overall Cronbach's α coefficient of the developed scale was 0.962，with split-half reliability of 0.732 and test-retest reliability of 0.844.The content validity index of the scale was 0.980. The correlation coefficient between the scale and satisfaction scores was 0.754（P<0.01）. Confirmatory factor analysis showed good fit of the scale. The factor loading coefficients of the scale items ranged from 0.514 to 0.988（P<0.001），the composite reliabilities of the dimensions ranged from 0.947 to 0.987，and the average variance extracted（AVE）ranged from 0.693 to 0.947. The correlation coefficients between dimensions were all smaller than the square root of the corresponding AVE. Conclusion The scale for evaluating the service experience of chronic disease patients in cloud follow-up，developed in this study，demonstrated good reliability and validity. It can be used to evaluate the experience of chronic disease patients in cloud follow-up services.
Subjects: Management Science >> Science ology and Management Subjects: Information Science and Systems Science >> Methodology of System Engineering Subjects: Statistics >> Economic Statistics submitted time 2024-06-12
Abstract： Social economy and population development are inseparable. Population imbalance originates from the incoordination of economic and social development, and it will also hinder the development of economy and society. Traditional methods of studying this issue often separate the causal relationship between the two, usually limited to the induction of macro data, ignoring the internal mechanism behind residents’ decision-making. Due to the inability to deduce the differences in decision-making faced by heterogeneous residents under different policy environments, it is impossible to accurately quantify policy results. In order to make up for the above shortcomings, this paper uses the principle of microeconomics utility maximization as the basis, combined with the concept of real marriage and childbirth, and uses the idea of intelligent micro-element model to construct a simulation system of residents’ economy and marriage and childbirth decision. The residents in this system are complex and adaptive. This paper first divides the resident utility function into three parts: economic utility, spouse utility and offspring utility. Under the condition of multi-class constraints, through optimization Utility, simulating the decision-making of heterogeneous residents such as different age groups, wealth endowments, wage rates, family status and expectations. Subsequently, the realistic rationality of the system’s deduction is verified at the micro and macro levels. Since the system can simulate and deduce the decisions and interactions of residents consistent with reality, it can not only observe the structural phenomena emerging from micro to macro through this system, but also explain from micro factors to macro causality, and can measure the effect of policies, making up for the shortcomings of traditional economic models and providing a new paradigm for economic research in the era of big data.
Peer Review Status:
Awaiting Review
Subjects: Medicine, Pharmacy >> Preventive Medicine and Hygienics submitted time 2024-06-11 Cooperative journals: 《中国全科医学》
Abstract： Background With the precipice decline of the birth population and the successive adjustment of the fertility policy in China，it is inevitable to re-examine the breadth and depth of maternal and infant health care services. Also，it has posed great challenges to the community health service institutions，which are the important suppliers of maternal and infant health care services. Objective To investigate the current status of maternal and infant health services in Shanghai communities，in order to provide suggestions and evidence for upgrading the level of primary care services for mothers and infants. Methods From August 2022 to April 2023，using purposive sampling method，the study selected 5 community health centers in the central district of Shanghai，in which in-depth personal interviews were conducted with 10 maternal and infant health service providers during participatory observation；organized a focus group interview with 12 primary health workers in the urban-rural fringe areas. In addition，8 obstetrics staff from tertiary hospitals participating the construction of obstetrics and gynecology medical consortium，were invited to conduct 2 focus group interviews to obtain information from different perspectives.The data were analyzed using the content analysis method. Results A total of 4 themes and 11 sub-themes were extracted:（1） some health care projects are poorly implemented （inadequate mental health care，ineffective contraceptive guidance，and difficulties in implementation of traditional Chinese medicine health care）；（2） health talent team construction needs to be strengthened （inadequate human resources，limited professional knowledge and skills，poor motivation to work，and little role of the family physician teams）；（3） the implementation process is challenging （difficulty in cross-district management and low participation of residents）；（4） the services integration need to be improved （deviation in the positioning of higher level medical institutions and insufficient coordination among agencies）. Conclusion At present，maternal and infant health care in Shanghai communities is still facing various challenges. It is necessary to make full use of the opportunity of medical union construction to strengthen talent training and establish an innovative human resource management model. At the same time，when strengthening the top-level design and clarifying the division of tasks between the various tiers of medical institutions，the performance assessment and incentive mechanism should be improved to truly stimulate the morale and service enthusiasm of community maternal and infant health service providers. Multiple measures should be taken to effectively enhance the quality of service and meet the needs of current health care tasks.
Subjects: Dynamic and Electric Engineering >> Electrical Engineering submitted time 2024-06-11
Abstract： With the large-scale integration of renewable energy and grid-following power electronic devices, system voltage support strength decreases, thus threatening the system’s safe and stable operation. In the homogeneous scenario where power electronic devices integrated into the system have the same dynamics, a theoretically rigorous and highly stable quantitative method for quantifying system voltage support strength can be formed based on the generalized short-circuit ratio(gSCR) and the device or station critical short-circuit ratio(SCR0) In the heterogeneous scenario where power electronic devices integrated into the system have weakly different dynamics, system voltage support strength can be quantified by the first-order approximation of gSCR and SCR0, based on some special characteristics of devices and power grid. However, there is a lack of unified derivation principles and calculation methods. To this end, this paper focuses on quantifying voltage support strength under small-signal stability and discovers that the multi-infeed system can be approximately decoupled into multiple low-dimensional systems. On this basis, this paper proposes the concept of eigen-subsystem and its calculation method and interprets their physical significance. Based on the concept of eigen-subsystems, the derivation principle and calculation method of gSCR and SCR0 are given. Additionally, the specific calculation methods for indices are provided when considering grid-following converters under non-rated operating conditions, reverse active power output and grid-forming devices. Finally, the effectiveness of the principles and methods is verified in several cases.
Nursing experience of auricular point sticking combined with acupoint application for the treatment of intestinal flatulence in a patient with postoperative acute appendicitis
Subjects: Other Disciplines Subjects: Other Disciplines submitted time 2024-06-11
Abstract：
This article summarizes the nursing experience of a patient with postoperative intestinal flatulence in acute appendicitis treated with auricular point sticking combined with acupoint application. In this case, by giving the intervention of auricular point sticking combined with acupoint application therapy for the treatment of intestinal flatulence in a patient after laparoscopic appendectomy, which effectively improved the symptoms of intestinal flatulence.
Peer Review Status:Awaiting Review
Subjects: Nursing >> Nursing submitted time 2024-06-11
Abstract： This article summarizes the clinical effect of traditional Chinese medicine enema combined with traditional Chinese medicine hot poultice technology in the treatment of abdominal distension in a patient with severe acute pancreatitis, and analyzes the unique advantages and characteristics of traditional Chinese medicine enema and traditional Chinese medicine hot poultice technology in the treatment of abdominal distension. This case is based on the use of conventional comprehensive treatment in Western medicine, including oxygen therapy for gastrointestinal decompression, nutritional support for anti infection, improvement of microcirculation, inhibition of pancreatic juice secretion, etc. The symptomatic treatment of abdominal distension has not shown significant relief effects. Traditional Chinese medicine has achieved good clinical results by using traditional Chinese medicine enema combined with traditional Chinese medicine hot pouches to treat abdominal distension, reducing patient pain, hospitalization days and medical costs, and increasing patient comfort and satisfaction.
Peer Review Status:Awaiting Review
Subjects: Medicine, Pharmacy >> Preventive Medicine and Hygienics submitted time 2024-06-11 Cooperative journals: 《中国全科医学》
Abstract： Background Multimorbidity pose challenges to older adults' health services. It is of great importance to explore its impact on health services utilization in the elderly. The Chinese Multimorbidity-Weighted Index（CMWI）has been developed to measure the burden of multimorbidity in Chinese middle-aged and elderly，but there is a lack of cohort studies on the association between CMWI and health service utilization. Objective To explore the association between burden of multimorbidity and utilization of health among older adults，which provides scientific evidence for improving the intervention and management of older adults' patients with multimorbidity. Methods From December 2021 to January 2024，taking Sihui City of Zhaoqing City，Guangdong Province as an example，the electronic health records of residents from 2017 to 2021 were collected from the city's national health information platform to establish a natural population cohort for health examination of the elderly. We used the time of the first health examination in this period as the baseline，the CMWI was used to measure individual's baseline burden of multimorbidity .We use the negative binomial regression to analyze the association between individual's CMWI respectively and the total number of outpatient visits，chronic disease-related outpatient visits，total number of hospitalizations and chronic disease-related hospitalizations during the follow-up period. Results Among the total 39 989 participants，there were 14991（55.18%）cases of multimorbidity，and the CMWI was 1.3（0，2.3）. During an average 1 268 days follow-up period，26141 people（65.37%）had used outpatient services，the number of total outpatient visits and chronic disease-related outpatient visits was 2（0，6）and1（0，4）.7 332（18.34%）had used hospitalization services，the number of total hospitalization and chronic disease-related hospitalization was 0（0，0）and 0（0，0）. Age，genders，education levels and CMWI varied significantly by the utilization of health（P<0.05）. The residential type varied significantly by the utilization of outpatient services（P<0.05）but no by utilization of inpatient services（P>0.05）. After adjusting the covariates of age，gender，residence and education levels，negative binomial regression analysis showed that CMWI was a risk factor on the increase of health service utilization in the elderly（IRR>1）. For each unit increase in CMWI，the total number of outpatient visits increased by 1.210（95%CI=1.196~1.224），the number of chronic disease-related outpatient visits increased by 1.276（95%CI=1.259~1.292），the total number of hospitalizations increased by 1.277（95%CI=1.244~1.312），and the number of chronic disease-related hospitalizations increased by 1.286（95%CI=1.252~1.321）. Conclusion CMWI is a risk factor for the increase of health service utilization in the elderly，and the number of health service utilization in the elderly increases with the increase of CMWI. More attention should be paid to the burden of multi-chronic diseases in the elderly，so as to provide scientific basis for improving the intervention and management of multi-chronic diseases in the elderly in China.
Subjects: Library Science，Information Science >> Literature Work submitted time 2024-06-11
Abstract： Abstract: Purpose/Significance To systematically review the research trends of new quality productivity, deeply discuss the research hotspots and frontier issues, and reveal the research direction of new quality productivity. Method/Process CiteSpace software was used to analyze the research literature on new quality productivity. Result/Conclusion The results show that the research hotspots of new quality productivity are concentrated in the fields of scientific and technological innovation, digital economy, future industry, innovation-driven, data factors, etc. With the deepening of the research on new quality productivity and the continuous expansion of application fields, research institutions should continue to strengthen the theoretical and practical research on new quality productivity in the economic and social development, encourage multi-sectoral, multi-field and multi-disciplinary cross-research, and constantly optimize production relations to realize the transformation of old and new driving forces.
Peer Review Status:Awaiting Review
Subjects: Psychology >> Management Psychology submitted time 2024-06-09
Abstract： With the increasing utilization of information communication technologies (ICT) in organizations, virtual communication has emerged as the predominant method of communication. In contrast to traditional face-to-face communication, the filtering of cues and the geographically distributed nature of virtual communication significantly diminish power cues and social norm constraints. More importantly, the inherent asynchronicity of virtual communication interrupts the process of power expression and acceptance. All these have a significant impact on the existing power configuration between supervisor and subordinate. However, limited research has focused on whether and how virtual communication affects traditional hierarchical power configuration. Drawing on the perspectives of identity self-construction and mutual construction, this study will examine the impact of technical cues, message exchange behavior, and virtual communication patterns on supervisor power expression and subordinate power acceptance, considering individual-, episodic-, and interpersonal-level. By integrating the perspectives and theories of organizational behavior, information systems, and communication disciplines, this study aims to contribute to the theoretical advancement of research on the utilization of ICT and hierarchical power configurations. Furthermore, it also aims to provide a theoretical foundation for the design of communication software and the implementation of hierarchical virtual communication practices.
Subjects: Psychology >> Management Psychology submitted time 2024-06-08
Abstract： The prevalence of anxiety and depression has escalated, prompting the current study to investigate the antecedents and coping strategies for these conditions in the digital media era. A theoretical framework grounded in affective events theory and social comparison theory is built to elucidate the relationships between social comparison and anxiety and depression, acknowledging that such relationships are contingent upon the influences of the social media environment. This review unveils that negative social comparison (upward comparison and downward assimilation comparison) exerts a deleterious impact on anxiety and depression, with social networking applications catalyzing these adverse effects. Conversely, emotional comparison (i.e., social comparison of emotions) and downward contrast comparison are positively associated with alleviated anxiety and depression, as online health communities fostered a supportive milieu for emotional comparison, thereby helping to mitigate these conditions. This study extends social comparison theory in the realm of emotion and identifies the affordance of online health communities for coping with anxiety and depression. The implications for the principles of design, management, and operation of such communities are further discussed.
Subjects: Mathematics >> Algebra and Number Theory submitted time 2024-06-08
Abstract： We give a kind of self-adjoint operator, whose spectrums are the set $S_ chi= {i( rho- frac{1}{2}) mid rho text{ is nontrivial zeros of $L$-function } L( chi,s) }$.
Peer Review Status:Awaiting Review
Subjects: Nuclear Science and Technology >> Radiation Physics and Technology submitted time 2024-06-07
Abstract： 本文介绍了一种超疏水性三聚氰胺（ME）海绵（ME-g-PLMA），该海绵通过高能辐射诱导的原位共价接枝长烷基十二烷基甲基丙烯酸酯（LMA）到ME海绵上，以实现高效的油水分离。所得的ME-g-PLMA海绵具有优良的孔隙结构，具有超疏水性（水接触角为154°）和超亲油性，可吸收高达自身重量66-168倍的各类油脂。所得到的ME-g-PLMA海绵可以通过连接泵连续分离水面上的浮油，或者通过重力驱动装置分离水下的浮油。ME-g-PLMA海绵在长期浸泡在不同的腐蚀性溶液中，多次反复吸油后，也能保持其高疏水性。所得改性ME-g-PLMA海绵具有优异的分离性能，在溢油清理方面具有巨大的潜力。
Peer Review Status:Awaiting Review
Subjects: Nuclear Science and Technology >> Nuclear Science and Technology submitted time 2024-06-07
Abstract： Computational Fluid Dynamics (CFD) technology can be used for nuclear reactor core to understand and predict the fine thermal-hydraulic status, to obtain the optimizing design and operation, and improve the safety. However, CFD analysis of reactor core faces challenges such as difficulty in modelling huge amount of meshes, large amount of calculations, time consuming and resource requirements, etc. Moreover, the universality of CFD technology for reactor types is poor so that it requires the whole analysis process again when the reactor type is changed. Based on the characteristics of reactor structure and coolant flow feature, this paper develops a CFD supporting technology that is "specific" to the reactor core and "common" to different reactor types, which can decompose the CFD computing burden and effectively reduce the fine mesh modelling and calculation analysis. It has been successfully applied to the CFD analysis of the reactor cores with full number and whole height of fuel assemblies, such as the reactor core with wire-wound rod bundle assemblies, spacer grid rod bundle assemblies and plate element assemblies.
Subjects: Chemistry >> Nuclear Chemistry submitted time 2024-06-07
Abstract： Background: The Ir-192 brachytherapy source is a high dose rate gamma radiation source characterized by a high central dose rate and a rapid dose fall-off at the periphery. In clinical treatments, this dose distribution allows the Ir-192 source to effectively protect the normal tissues and organs surrounding the tumor. Objective To establish a detailed structural model of a domestically produced high-dose-rate Ir-192 brachytherapy source using Monte Carlo simulation software, based on the dosimetric parameters recommended by the American Association of Physicists in Medicine (AAPM) in TG43-U1, and to perform simulation calculations. Methods Using the Monte Carlo software, a detailed structural model of the domestically produced high-dose-rate Ir-192 brachytherapy source was established. The simulated dosimetric parameters included the dose rate constant Λ, air kerma rate per unit activity, radial dose function , and anisotropy function . Results The simulated dose rate constant was 1.105 cGy·h-1·U-1, with a difference of less than 1.2% from the literature values. Air kerma rate per unit activity was 9.788×10-8 UBq-1, with a difference of 0.23% from the literature values. The radial dose function was obtained for distances from 0.5 to 20 cm from the source axis, and an empirical formula was fitted. Conclusions The domestically produced Ir-192 source model established using the Monte Carlo software shows good consistency with the literature-reported dosimetric parameters, indicating that this model can be used for clinical practice applications of domestically produced Ir-192 sources and has certain guiding significance.
Subjects: Medicine, Pharmacy >> Clinical Medicine submitted time 2024-06-07 Cooperative journals: 《中国全科医学》
Abstract： Background Primary medical institutions，with the characteristics of comprehensive，continuous，coordinated，convenient and economical，play an important role in the diagnosis and treatment of common and frequently#2; occurring children's diseases，planned immunization and child health management，and lay a solid foundation for children's health services. It is essential to improve the quality of child health services for children under the management of family doctor contract. There are regional differences in the ability of children's health services at primary institutions in China. Therefore， accurate evaluation of the quality of children's health services at primary institutions is helpful to find problems in time and promote the development of children's health services at a higher level. Objective To assess the quality of community children's health services for contracted children，analyze the quality problems and optimization strategies，and provide international vision and decision-making reference for further improving the quality. Methods Taking a district of Chengdu as a typical case，three community health service centers with stronger child health service ability in the district were selected as the sample institutions， and the parents of children contracted by the sample institutions were surveyed with the online questionnaire on the quality of community child health service by using the Chinese version of primary care assessment tool （PCAT）. Results Totally，3 631 parents of contracted children were investigated. The total PCAT score of community child health service quality in the sample centers was（58.72 ± 13.43）. The dimensions with relatively high PCAT scores of community child health service quality includes "continuity"，"community first consultation （service availability and service use）" and "comprehensive service （service provision）"，while the dimensions "children and family-Centered"，"comprehensive （available services）" and "coordination （referral）" had low scores. Conclusion It is suggested to strengthen the supply of diagnosis and treatment services for common pediatric diseases in the community，unblock the referral mechanism of Pediatrics，strengthen the awareness of parents of contracted children to be included in the contracted service team to participate in diagnosis and treatment decisions，and pay attention to the health services for children with non local registered residence.
Subjects: Medicine, Pharmacy >> Clinical Medicine submitted time 2024-06-07 Cooperative journals: 《中国全科医学》
Abstract： Background Population aging has heightened，raising concerns about elderly health. Oral frailty，a novel frailty phenotype in the elderly，directly impacts the quality of life. A thorough grasp of oral frailty's prevalence in the elderly is crucial for formulating effective preventive and interventional strategies. Objective To systematically evaluate the prevalence of oral frailty in the elderly. Methods The CNKI，Wanfang Data，VIP，CBM，PubMed，Web of Science，Embase，CINAHL and Cochrane Library databases were searched for literature related to the study purpose with a time limit of the construction of the database to 19 April 2024. Literature was independently screened，information extracted and quality assessed by 2 researchers， and Meta-analysis was performed using Stata 14.0 software. Results A total of 19 cross-sectional studies were included，with a total sample size of 11 776 cases and a risk of bias quality score of 6-9，all of which were of moderate or high quality. Meta#2;analysis showed that the prevalence of oral frailty in elderly people was 29.5%（95%CI=24.1%-35.2%），and the prevalence of pre-oral frailty was 47.9%（95%CI=40.5%-55.4%）. Subgroup analyses showed that the progressive increase in the prevalence of oral frailty in the elderly with advancing age. Higher prevalence rates of oral frailty were observed in individuals screened using the Oral Frailty Index-8，Chinese elderly，elderly females，residents of medical and nursing care facilities，those withouta spouse，living alone，smokers，and elderly individuals with primary school education or lower（P<0.05）. Conclusion The prevalence of oral frailty is high in the elderly，warranting particular attention to the oral health status of elderly individuals in China who are advanced in age，female，residing in medical and nursing care facilities，living alone without a spouse， smokers，and have lower educational levels.
Subjects: Management Science >> Science ology and Management Subjects: Information Science and Systems Science >> Basic Disciplines of Information Science and Systems Science Subjects: Statistics >> Science and Technology Statistics submitted time 2024-06-07
Abstract： With the rapid development of the digital economy, optimal decision-making for enterprises has become possible, laying the foundation for the digital transformation of enterprises.Traditional decision support systems often lack interpretability and adaptability, cannot integrate macro expectations with the multiple micro-endowments of the enterprise itself to make globally optimized decisions. To address these shortcomings, this paper starts from micro mechanisms and combines digital twin technology with the concept of Agent-Based Modeling (ABM) to construct
an intelligent-interactive-integrated decision support system. This system comprehensively considers key factors such as production resources, sales, inventory, loan interest rates, labor hire,expectations, etc., and under various constraints, aims to make multi-category production and
investment decisions to maximize profits. The system possesses high interpretability and interactivity. Through validation, the system is reliable and meets real-world expectations. From a micro perspective, this system provides quantified decision support for enterprise production and
investment; from a meso perspective, it can provide reference for industry policy formulationthrough further building industrial chains; at the macro level, it can serve as part of the macroeconomic complex system, coordinate with other sectors, deduce and predict the effects of different policies.
Peer Review Status:Awaiting Review
Subjects: Medicine, Pharmacy >> Clinical Medicine submitted time 2024-06-07 Cooperative journals: 《中国全科医学》
Abstract： Obstructive sleep apnea（OSA）is prevalent in the elderly population due to the weakened neuromuscular function of the upper airway and unstable respiratory regulation in the elderly. OSA is a risk factor for a variety of common chronic diseases，and affects cognitive function and multi-system organ function in the elderly. Therefore，it is essential to provide effective therapeutic interventions for OSA in the elderly. The Sleep Medicine Branch of the Chinese Geriatrics Society，as the initiator，organized domestic experts in related fields to repeatedly discuss the operation process，requirements，specific ways and methods of noninvasive positive pressure ventilation（NPPV）treatment for elderly OSA patients with reference to domestic and international clinical studies，and finally made this expert consensus，which is aimed at standardizing the treatment of NPPV in elderly OSA patients in China to provide a reference.
Subjects: Medicine, Pharmacy >> Clinical Medicine submitted time 2024-06-07 Cooperative journals: 《中国全科医学》
Abstract： Background Research has linked the physical constitution of overweight/obese individuals to obesity， with a potential bidirectional association. Although FATmax intensity exercise can boost their fitness，the exact magnitude of this benefit needs further study. Objective Systematic evaluation is needed to assess the impact of FATmax intensity exercise on physical fitness indicators among overweight or obese populations. Methods Retrieve RCTs from PubMed，Web of Science，Ebsco，CNKI，VIP，Wanfang（January 2001 to January 2024） on FATmax exercise effects on body composition， cardiovascular endurance，lipid metabolism in overweight/obese patients. Evaluate quality with Cochrane tool，Meta-analyze with RevMan5.4.Results A total of 16 randomized controlled trials were included，including 568 overweight or obese patients. The Meta-analysis results showed that compared with the control group，the FATmax intensity exercise intervention group significantly improved body composition（BMI：WMD=-1.82，P<0.01；BFR：WMD=-2.86，P<0.01；WHR：WMD=-0.04，P<0.01）， cardiovascular endurance（VO2max：WMD=3.34，P<0.01），and lipid metabolism except for TC（TG：WMD=-0.24， P<0.01；HDL-C：WMD=0.14，P<0.01；LDL-C：WMD=-0.27，P<0.01）. Conclusion FATmax exercise benefits body composition，cardiovascular endurance，and lipid metabolism（except TC）in overweight/obese patients. Optimal results vary： ≥ 12 weeks，3-5 times/week，60-minute running for body composition；≥ 12 weeks，5 times/week，<60 minutes combined for VO2max； ≥ 12 weeks，3 times/week，60-minute running for TG； <12 weeks，4 times/week，60-minute combined for HDL-C；<12 weeks，4 times/week，>60-minute combined for LDL-C.
Subjects: Medicine, Pharmacy >> Clinical Medicine submitted time 2024-06-07 Cooperative journals: 《中国全科医学》
Abstract： Background Diabetes has a high incidence rate and many complications，which was an urgent public health problem，but the prevention and management is still not ideal. Objective To observe the effect of Three Division management on metabolic indicators and self-management levels of diabetes patients with different courses of disease. Methods One hundred and 81 type 2 diabetes patients from April 2021 to April 2022 were managed by the mode of Three Division management and followed up for more than 6 months. The patients were grouped according to the course of disease（Group A：course of disease<1 year；Group B：course of disease 1-5 years；Group C：course of disease 5-10 years；Group D： course of disease>10 years）；In outpatient，the three-division team composed of traditional Chinese medicine practitioners， endocrinologists and caregivers carries out comprehensive treatment such as physique identification，complication screening， medicine，food，exercises and emotion intervention；When patients are at home，the caregivers carry out intelligent management through intelligent Glucose meter equipment and mobile phone APP. We collected changes in blood glucose and body weight indicators in patients with different disease courses after six months of management. Additionally，we used a questionnaire to gather common issues in patient self-management and fill out the Summary of Diabetes Self-Care Activities Measure-6 （SDSCA-6）. Results Through the management of the Three Division management，Group A patients showed significant improvement in reducing fasting blood glucose and postprandial 2-hour blood glucose after the intervention（P<0.05）. The BMI and waist circumference of groups A，B，C，and D were all reduced compared to before the intervention（P<0.05）. Common dietary issues in patient self-management included an unreasonable dietary structure（38.12%），common exercise issues included insufficient exercise volume or intensity（36.46%），and common monitoring issues included insufficient monitoring（37.02%）. The self-management levels of groups A，B，C，and D in the four dimensions of "healthy eating" "self#2;monitoring" "adherence to medical advice" and "education and communication" all improved compared to before the intervention （P<0.001）. Conclusion The Three Division management can improve the self-management ability of diabetes patients and play a good comprehensive role in diabetes. Clinical practice should particularly emphasize the management of patients with a diabetes course of less than one year.
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