Community Health Service Stations Research Articles

The relationship between 25-hydroxy vitamin D and serum asprosin in patients with type 2 diabetes in the community

ObjectivesThis study aimed to investigate the link between 25-hydroxy vitamin D and serum asprosin in individuals with type 2 diabetes within the community. The goal was to provide a foundation for clinical interventions.MethodsBetween November 2019 and July 2021, data from 463 patients with type 2 diabetes were consistently gathered at a community health service station in Southeast Shanxi Province. General information and laboratory metrics were compiled, including serum asprosin levels. The participants were categorized based on three serum asprosin quantiles, allowing for a comparison of various factors among the groups. The correlation between serum asprosin levels and other factors was analyzed. Employing a general linear model, the connection between 25-hydroxy vitamin D and serum asprosin levels was studied. Utilizing three quantiles of 25-hydroxy vitamin D, serum asprosin was treated as the dependent variable, while 25-hydroxy vitamin D served as the independent variable for linear regression analysis.ResultsAs serum asprosin increased, there were gradual increments in age, disease duration, SBP, BMI, WC, creatinine, and SUA levels (P<0.05). Conversely, HbA1c, HDL-C, GFR, and 25-hydroxy vitamin D levels exhibited gradual declines (P<0.05). Age, 25-hydroxy vitamin D, SUA, creatinine, and LDL-C emerged as independent influencing factors for serum asprosin. Across the 1st to 3rd 25-hydroxy vitamin D quantiles, elevated 25-hydroxy vitamin D levels correlated with a gradual reduction in mean serum asprosin (P<0.05).ConclusionSerum asprosin levels demonstrate an inverse correlation with 25-hydroxy vitamin D levels in community-dwelling individuals with type 2 diabetes. Serum asprosin levels might independently contribute to 25-hydroxy vitamin D levels.

Cross-sectional study of the association between burnout and work overload and work-life imbalance among medical personnel in Liaoning, China: role of specialty

ObjectivesBurnout is common among medical personnel in China and may be related to excessive and persistent work-related stressors by different specialties. The aims of this study were to assess the...

Analysis of the Effectiveness of Clopidogrel Combined with Aspirin in the Treatment of Coronary Heart Disease in Community-Dwelling Elderly

Objective: To analyze the combined therapeutic effect of clopidogrel (CLO) and aspirin (ASP) on coronary heart disease (CHD) in community-dwelling elderly. Methods: Thirty elderly patients with CHD who were admitted to the Xinxin Community Health Service Station, Pangzhuang Street, Quanshan District, Xuzhou City, from November 2020 to November 2022 were selected and randomly grouped into an observation group and a control group, with 15 cases in each group. The observation group was given the combination of CLO and ASP and the reference group was given only ASP. The total effective rate and other treatment indicators between the two groups were compared. Results: The total effective rate of the observation group (93.33%) was higher than that of the reference group (60.00%) (P < 0.05). The adverse drug reaction rate (13.33%) and long-term cardiovascular adverse event rate (6.67%) of the observation group were lower than those of the reference group at 46.67% and 40.00% respectively, (P < 0.05). Before treatment, the two groups had no difference in the quality-of-life scores (P > 0.05). After treatment, the quality-of-life scores of the observation group were higher than those of the reference group (P < 0.05). Conclusion: CLO combined with ASP improved the therapeutic effect of community-dwelling elderly patients with CHD, reduced adverse reactions during medication, prevented adverse cardiovascular events, and comprehensively improved the patient’s quality of life.

Contextualizing the revised Patient Perception of Patient-Centeredness (PPPC-R) scale in primary healthcare settings: a validity and reliability evaluation study

BackgroundAn English version of the Patient Perception of Patient-Centeredness (PPPC) scale was recently revised, and it is necessary to test this instrument in different primary care populations.AimThis study aimed to assess the validity and reliability of a Chinese version of the PPPC scale.DesignA mixed method was used in this study. The Delphi method was used to collect qualitative and quantitative data to address the content validity of the PPPC scale by calculating the Content Validity Index, Content Validity Ratio, the adjusted Kappa, and the Item Impact Score. Confirmatory factor analysis (CFA) and exploratory factor analysis (EFA) were used to assess the construct validity of the PPPC scale through a cross-sectional survey. The internal consistency was also assessed.Setting/participantsIn the Delphi consultation, seven experts were consulted through a questionnaire sent by email. The cross-sectional survey interviewed 188 outpatients in Guangzhou city and 108 outpatients in Hohhot City from community health service centers or stations face-to-face.ResultsThe 21 items in the scale were relevant to their component. The Item-level Content Validity Index for each item was higher than 0.79, and the average Scale-level content validity index was 0.97 in each evaluation round. The initial proposed 4-factor CFA model did not fit adequately. Still, we found a 3-factor solution based on our EFA model and the validation via the CFA model (model fit: {chi }^{2}=294.573, P < 0.001, RMSEA = 0.044, CFI = 0.981; factor loadings: 0.553 to 0.888). Cronbach's α also indicated good internal consistency reliability: The overall Cronbach's α was 0.922, and the Cronbach's α for each factor was 0.851, 0.872, and 0.717, respectively.ConclusionsThe Chinese version of the PPPC scale provides a valuable tool for evaluating patient-centered medical service quality.

Association between serum asprosin and diabetic peripheral neuropathy in patients with type 2 diabetes mellitus in the community.

This study aimed to investigate the relationship between serum asprosin level and diabetic peripheral neuropathy (DPN) in community patients with type 2 diabetes mellitus (T2DM). A total of 498 patients with T2DM were recruited from Zhuoma Community Health Service Station and Chengbei West Street Community Health Service Center in Changzhi City of Shanxi Province between November 2019 and July 2021. Their height, weight, and body mass index (BMI), as well as fasting plasma glucose (FPG), glycosylated hemoglobin (HbA1c), triglyceride (TG), and serum asprosin levels, were analyzed. Patients were divided into the DPN group (n = 329) and the non-DPN group (n = 169) according to the presence or absence of DPN. The t-test, Mann-Whitney U test, and χ² test were used to compare the indicators between the two groups. Pearson or Spearman correlation analysis was used to evaluate the correlation between serum asprosin and other clinical data. Multivariate logistic regression analysis was used to analyze the influencing factors of DPN. Compared with the non-DPN group, the DPN group had higher serum asprosin (p < 0.05). The prevalence of DPN gradually increased according to the tertiles of asprosin (56%, 67%, and 75%; p < 0.05). Multivariate logistic regression analysis showed that after adjustment for covariates, patients with asprosin concentrations between 295.4-367.0 pg/ml and concentrations > 367.0 pg/ml had a higher risk of diabetic neuropathy compared than those with asprosin levels < 295.4 pg/ml (p < 0.05). Serum asprosin was found to be positively correlated with DPN, and it resulted as an influencing factor for DPN in patients with T2DM in the community. With the increase of asprosin, the risk of DPN also increased.

Study on the effect of community legal consciousness health management on cognitive function of senile patients

BackgroundSenile asthenia is an old-age syndrome. Patients have increased vulnerability due to degenerative changes in the body and a variety of chronic diseases. Senile asthenia involves multiple bodily system functions of patients and is a pre-disease state. Its incidence shows an upward trend with the increase in the age. This study takes community health service as the breakthrough point to explore the role of community legal awareness health management in improving the cognitive function of elderly frail patients, hoping to provide references for improving the health level of elderly frail patients.Subjects and Methods660 elderly patients who were hospitalized at our hospital from June to December 2021 were selected as the study objects and were randomly divided into the management intervention group and the general group, with 30 cases each. Both groups of patients were given basic disease treatment and in-hospital rehabilitation guidance, while the management intervention group increased community legal awareness of health management services at community health service stations. The cognitive function of patients was evaluated by Mini Mental State Examination (MMSE). The senile weakness, cognitive function score, and quality of life of the two groups of patients were compared and analyzed.ResultsIt can be seen from the comparison of the cognitive function scores of the two groups of patients that the cognitive function level of the management intervention group is significantly higher than that of the conventional group. The cognitive function score of the management intervention group after treatment is 26.46±2.39 points, and that of the conventional group after treatment is 23.58±2.41 points. The difference between the two groups is statistically significant (P &lt; 0.05). As shown in Table 1.Table 1.MMSE scores of two groups of patients before and after treatmentModeManagement intervention groupGeneral grouptPBefore treatment22.54±2.3722.56±2.291.305&gt;0.05After treatment26.46±2.3923.58±2.416.398&lt;0.05t6.4542.743--P&lt;0.05&gt;0.05--ConclusionsCarrying out community legal awareness health management services can effectively improve the cognitive function level of the elderly and weak patients, and promote the improvement of the quality of life of the elderly and weak patients. Publicizing legal awareness to the elderly and weak patients and carrying out community health and health management services can help the elderly and weak patients solve their life problems in time. Legal awareness management education with disease prevention and health education can promote cognitive function training and improvement of the elderly and weak patients.

PS-C31-2: PRELIMINARY STUDY OF ANTIHYPERTENSIVE TREATMENT EFFECT ON EARLY EVENING ELEVATED BLOOD PRESSURE

Objective: The aim of this study is to retrospectively analyze the intervention effect of routine antihypertensive treatment on early evening elevated blood pressure (EEE) under community health service. Design and method: The ambulatory blood pressure monitoring (ABMP) data of hypertension patients was collected from YJY digital intelligence chronic disease monitoring and management platform from Jan 2019 to Nov 2021. The hypertension patients were from seven community health service stations and divided into treated group and untreated group according to their self-report. The age of each patient should be not less than 18 years old. The percentage of successful measurements for ABPM should not be lower than 70%. Only the first ABPM of one patient during this period was included. The EEE was defined as high average blood pressure from 6pm to 10pm (detailed definition and classification seen in Table). Results: 1. There were 171 pateints in treated group and 251 patients in untreated group. 2. According to EEE definition A, there are 120 EEE patients in treated group and 206 EEE patients in untreated group (X2 = 8.19059, P = 0.00421). 3. According to EEE definition B, there are 87 EEE patients in treated group and 125 EEE patients in untreated group (X2 = 0.04714, P = 0.82812). 4. According to EEE definition C, there are 101 EEE patients in treated group and 141 EEE patients in untreated group (X2 = 0.34705, P = 0.55579). 5. According to EEE definition X, there are 147 EEE patients in treated group and 224 EEE patients in untreated group (X2 = 1.0287, P = 0.21047). Conclusions: According to EEE definition A which indicated the absolute value increase of blood pressure, the detection rate of EEE was significantly lower in treated group than in untreated group. However, based on definition B and definition C, which compared EEE with morning blood pressure and afternoon blood pressure respectively, routine antihypertensive treatment provided by community health service didn’t obtain the significant reduction of EEE detection rate. This phenomenon that a considerable proportion of early evening blood pressure under antihypertension treatment was still higher than morning blood pressure or afternoon blood pressure might result in low compliance of hypertension management, dosage increase of antihypertension medication or multiple administration daily.

The roles of primary care doctors in the COVID-19 pandemic: consistency and influencing factors of doctor's perception and actions and nominal definitions

BackgroundAt the end of 2019, the Coronavirus Disease 2019 (COVID-19) pandemic broke out. As front-line health professionals, primary care doctors play a significant role in screening SARS-CoV-2 infection and transferring suspected cases. However, the performance of primary care doctors is influenced by their knowledge and role perception. A web-based cross-sectional survey was conducted to assess the consistency and influencing factors of primary care doctor's role perception and expert advice in the guidelines (regulatory definition).MethodsWe designed the questionnaire using “Wenjuanxing” platform, distributed and collected the questionnaire through WeChat social platform, and surveyed 1758 primary care doctors from 11 community health service stations, community health service centers and primary hospitals in Zhejiang Province, China. After the questionnaire was collected, descriptive statistics were made on the characteristics of participants, and univariate analysis and multivariate analysis were used to determine the relevant factors affecting their role cognition.ResultsIn the reporting and referral suspected cases and patients receiving treatment, most participants’ cognition of their roles were consistent with the requirements of guidelines. However, 49.54% and 61.43% of participant doctors were not in line with the government guidelines for diagnosing and classifying COVID-19 and treating suspected cases, respectively. Having a middle or senior professional title and participating in front-line COVID-19 prevention and control work is beneficial to the accurate role perception of diagnosis and classification of COVID-19, the reporting and transfer of suspected cases, and the treatment of suspected cases.ConclusionsPrimary care doctors’ role perceptions in the COVID-19 pandemic are not always consistent with government guidelines in some aspects, such as transferring and diagnosing suspected cases. Therefore, it is essential to guide primary care doctors in performing their duties, especially those with lower professional titles.

The productive efficiency of community health service stations in China: Taking Shandong province as a case

The present study evaluated the efficiencies of community health service (CHS) stations based on a survey of 1246 CHS stations, covering nine subcategories in 16 cities in Shandong province. Data envelopment analysis (DEA) was applied to investigate the overall efficiency, the technical and the scale efficiency of community health care resources. The results are, the overall efficiency was 9.47%, and the overall efficiency was generally higher in the central-west region than in the east. There were 23.27% of CHS stations showing technically efficient. The technical efficiency was higher in the east (31.11%) relative to the central-west (19.72%), and 72.71% of CHS stations had a technical efficiency higher than the regional average efficiency. The scale efficiency was 9.31% for CHS stations in Shandong province, being the decisive factor for overall efficiency, and 68.96% of CHS stations showed a scale efficiency above the regional average. Stations held by enterprises and universities, and extended by tertiary hospitals had lower efficiencies than other types of CHS stations. In conclusion, the CHS stations had low efficiencies in general, and scale inefficiencies were the main cause. Related suggestions to improve the efficiency are provided accordingly.

The application effect of internet technology on managing patients with hypertension in a medical center: A prospective case-control study.

Objectives:This study aimed to investigate the application effect of internet technology for managing patients with hypertension in a medical center.Methods:From December 2017 to December 2018, 400 patients with hypertension in two community health service stations affiliated to Beijing Shijitan Hospital (China) were enrolled in the present study. According to the alternating method, these patients were divided into a control group (routine medical hypertension management) and an e-intervention group (internet technical secondary hypertension management). Blood pressure levels after intervention in both groups, as well as blood pressure control, medication compliance, active health behaviors, and two-way referral rate were observed.Results:Following the interventions, blood pressure levels were significantly lower in the e-intervention group compared with the control group, and the proportion of good blood pressure control, medication compliance, active health behavior, and two-way referral were all significantly higher compared with the control group.Conclusion:The application of internet technology in medical associations may help to decrease patients’ blood pressure and improve the effective management of middle-aged and older patients with hypertension in communities.

Incidence and disease burden of community-acquired pneumonia in southeastern China: data from integrated medical resources

ABSTRACT Community-acquired pneumonia (CAP) is a lower respiratory tract infection. It is one of the commonest infectious diseases and the third leading cause of death worldwide. However, the epidemiological profiles of CAP in southeastern China are unknown. Data of inpatients and outpatients diagnosed with CAP from January 1, 2015 to December 31, 2020 were obtained from the National Healthcare Big Data in Fuzhou (Fuzhou Database). This database covers medical data from 37 hospitals and 159 community health service stations. The incidence rate, treatment pattern, and direct medical costs of CAP were assessed using clinical data. A total of 8,156,237 patients were enrolled, with a mean age of 33.72 ± 20.88 years. The overall incidence rate of CAP was 3.13 (95% confidence interval [CI]: 3.11–3.15) per 1000 person-years (PY), with 15.97 (95% CI: 15.85–16.08) per 1000 PY in children below 5 years old and 2.62 (95% CI: 2.57–2.66) per 1000 PY in the elderly ≥60 years. The cost per outpatient was $242.83 ± 341.62, and the cost per inpatient was $4,530.4 ± 9,151.68. The three most used therapeutic drugs in patients with CAP are cefotaxime, moxifloxacin, and azithromycin. In addition, despite the ability of both imported and domestic pneumococcal conjugate vaccines to reduce the incidence rate of CAP, the current vaccination coverage rates were relatively low. We suggest that more attention should be paid to the disease burden of CAP, especially due to its great economic burden in China.

Detecting response shift in health-related quality of life measurement among patients with hypertension using structural equation modeling

BackgroundOutcomes derived from longitudinal self-reported health-related quality of life measures can be confounded by response shift. This study was aimed to detect response shift among patients with hypertension attending a community-based disease management program.Methods240 consecutive consulting or follow-up patients with diagnosed hypertension were recruited. The Short Form 36-item Health Survey was self-administered at 12 community health service stations at baseline and four weeks after attending the program. The 4-step structural equation modeling approach assessed response shift.ResultsData from 203 (84.6%) patients were eligible for analyses (mean age 65.9 ± 10.8 years, 46.3% female). The results showed uniform recalibration of social functioning ({upchi}_{mathrm{SBdiff}}^{2}(1) = 22.98, P < 0.001), and non-uniform recalibration of role limitations due to physical problems ({upchi}_{mathrm{SBdiff}}^{2}(1) = 8.84, P = 0.003), and bodily pain ({upchi}_{mathrm{SBdiff}}^{2}(1) = 17.41, P < 0.001). The effects of response shift on social functioning were calculated as “small” (effect-size = 0.35), but changed the observed changes from improvement (effect-size = 0.25) to slight deterioration (effect-size = -0.10). After accounting for the response shift effect, the general physical health of participants was improved (effect-size = 0.37), while deterioration (effect-size = -0.21) in the general mental health was also found.ConclusionsRecalibration existed among patients with hypertension attending the disease management program. The interventions in the program might act as a catalyst that induced the response shift. We conclude that response shift should be considered in hypertension research with longitudinal health-related quality of life data.

Disease composition and epidemiological characteristics of primary care visits in Pudong New Area, Shanghai: a longitudinal study, 2016–2018

ObjectivesThis study aims to analyse the disease composition of primary care visits rather than specialist visits, the former of which had scarcely been studied. We adopted specific disease classification (International...

Study on calculating the curative care expenditure of injury in Gansu Province based on "A System of Health Accounts 2011"

Objective: To study the distribution and related factors of curative care expenditure (CCE) of injury in Gansu Province in 2017. Methods: Based on the "A System of Health Accounts 2011 (SHA 2011)", the curative care expenditure of injury in Gansu Province was calculated and analyzed. The five-stage stratified cluster sampling method was adopted to extract 149 medical and health institutions, 120 township hospitals (including community health service centers), 150 individual clinics and 600 village clinics (including community health service stations). The top-down allocation method was used to calculate the cost of injury treatment in Gansu Province, and the influencing factors were analyzed by multiple linear regression. Results: In 2017, the CCE of injury in Gansu province was 3.831 billion yuan, and the expense in general hospitals was 2.708 billion yuan. Among them, the cost of lower limb injury and head injury were 1.090 and 0.847 billion yuan. People aged 40 to 69 years old spent 1.901 billion yuan on injury treatment, and the CCE of injury treatment for men and women were 2.422 and 1.409 billion yuan respectively. The results of multiple linear regression showed that hospitalization expenditure was significantly associated with length of stay, operation, hospital grade, age, payment method and gender (P<0.001). Conclusion: The economic burden of injury in Gansu Province is relatively heavy, so it is necessary to focus on preventions for different groups and costly injury sites.

Community intervention in elderly patients with insomnia

Community intervention was conducted for 60 elderly patients with insomnia who attended the clinic of Sanlihe NO.1 Community Health Service Station of Yuetan Community Health Service Center from October 2016 to December 2016. Community intervention strategies included appointed visit to contracted family doctors, health counseling by specialists, lifestyle interventions, drug interventions, psychological interventions, individualized interventions, regular home visits and follow-up, self-management and referral to specialist service. After 1 year of community intervention, the differences of sleep quality self-assessment score [(29.77±7.20) vs. (28.62±6.79) ; t=7.48, P<0.01] and COOP/WONCA score [(17.38±3.35] vs. (16.00±3.09); t=8.69, P<0.01] before and after the intervention were statistically significant. Community intervention is helpful to improve the quality of sleep and life of the elderly insomnia patients. Key words: The elder; Insomnia; Community intervention

Understanding how to improve physicians\u2019 paradigms for prescribing antibiotics by using a conceptual design framework: a qualitative study

BackgroundAntimicrobial resistance (AMR) is a growing public health threat. Primary care physicians are important inducers of the overuse of antimicrobials and inappropriate prescribing. Augmented reality (AR) might provide a potential educational tool in health care. The aim of this study was to identify the need for education and expectations for AR-based education in the context of improving the rational use of antibiotics by primary care physicians in China.MethodsThe study used a qualitative approach based on face-to-face interviews with eleven physicians from three community health service centers and stations in China. We used a hybrid thematic analysis approach to analyze the interview data. A conceptual design framework, mobile augmented reality education (MARE), guided the work.ResultsThe physicians’ personal prescription paradigms included problems regarding the way they diagnosed and chose treatments and prescriptions. Although the physicians mentioned that they should not treat patients with antibiotics without proof of a bacterial infection, in practice, they often did not wait for necessary test results before they prescribed antibiotics. It was also revealed that they often experienced difficulties when trying to convince patients to follow non-antibiotic treatments. Physicians’ prescription of antibiotics was based on three different paths: if they thought there was a bacterial infection, if they thought preventing additional possible infections for the patient to be necessary; and if the patients requested antibiotics. The physicians expressed various learning needs for the rational use of antibiotics, and their expectations of an AR-based educational intervention included suggestions for contents, learning assets, learning environments and learning activities.ConclusionsThe results showed that the physicians were not only unfamiliar with national guidelines on the use of antibiotics and local AMR patterns but also had personal paradigm issues related to the physicians’ decision making. Moreover, the physicians provided meaningful insights into and expectations for possible AR-based education on AMR. In this article, we demonstrate how to apply the MARE framework to analyze the needs of educational interventions for rational use of antibiotics.

Effects of Baduanjin on dyspnea and activity tolerance among patients with stable chronic obstructive pulmonary disease

Objective To explore the effects of health Qigong Buduanjin on dyspnea and activity tolerance among patients with stable chronic obstructive pulmonary disease (COPD) . Methods From January to December 2015, 73 patients with stable COPD in Beijing Dongcheng District Dafangjia Community Health Service Station were selected by convenience sampling. All of the patients were divided into observation group (n=37) and control group (n=36) with the random number table. Patients of two groups all accepted drug therapy and health education. In addition, patients of control group did exercise such as walking, brisk walking, riding a bicycle, lifting dumbbell according to their habits and ability. On the basis of exercises of the control group, patients of observation group practiced health Qigong Buduanjin last 12 months. The modified version of the British Medical Research Council respiratory questionnaire (mMRC) and 6-minute walk distance (6MWT) were used to evaluated patients' dyspnea and activity tolerance before and after intervention. The number of patients who were admitted to hospital for equal or more than one time because of acute exacerbation was counted to evaluate the risk of increasing serious disease condition. Results At last, 35 patients in observation group and 31 patients in control group completed the study. After intervention, there were statistical differences in the level of mMRC, 6MWT and the risk of increasing serious disease condition between observation and control group (Z=-0.525, t=5.950, χ2=4.705; P<0.05) . Conclusions Health Qigong Buduanjin can reduce the severity of dyspnea of patients with stable COPD, improve patients' activity tolerance and reduce patients' risk of increasing serious disease condition. Key words: Pulmonary disease, chronic obstructive; Baduanjin; Dyspnea; Activity tolerance

Knowledge and attitude towards hierarchical medical system among patients in Beijing Xicheng district community health service centers

Objective To assess the knowledge and attitude towards hierarchical medical system among patients in Beijing Xicheng district health service centers. Methods A questionnaire survey was conducted between July and August 2016, among randomly-selected patients who were visiting health service in Beijing Xicheng district. Results A total of 2 770 patients were investigated. The percentage of patients who knew the hierarchical medical system was 62.2% (1 722/2 770). Logistic regression showed that the degree of knowledge was significantly correlated with the visit number in the recent year and the education levels of patients. The percentage of patients who had a positive attitude to the system was 89.5% (2 478/2 770). The main reasons for negative attitude to the system were worry about the delay of , inconvenience and fewer drugs in health service centers and weak capacity of health service centers . Logistic regression showed that the education level was negatively correlated with the attitude. In the case of mild illness, 2, 485 (89.7%) participants would chose community health service center or service station . Conclusions The knowledge of hierarchical medical system among patients in health institutions are moderately high, while most of them have positive attitude towards the system. The service capacity of health service institutions should be further improved, and publicity should be strengthened to improve the awareness of hierarchical medical system among residents. Key words: Community health service; Questionnaires; Dividing treatment by diagnosis

Factors associated with activities of daily living among the disabled elders with stroke

ObjectiveTo determine the factors associated with activities of daily living (ADL) among the disabled elders post-stroke. MethodsA total of 158 patients were chosen from community health service stations in eighteen regions of Tianjin city by convenience sampling from March to November in 2013. The Barthel Index (BI) and the short-form mini-nutritional assessment (MNA-SF) were used to evaluate the ADL, the nutritional status respectively. Statistical analysis was performed using independent sample t-test, one-way ANOVA, Pearson correlation and multiple linear regression analysis. Barthel ADL index was the main outcome. ResultsThe mean score of ADL was 50.50 ± 27.125. The multiple linear regression showed that the factors which had significant impact on ADL were stroke frequency, types of stroke, nutritional status, financial status, and age. ConclusionsDisabled elders with recurrent strokes, hemorrhagic stroke, dependent financial resources, older age, worse nutritional status and living with family had poorer stroke-related outcome. Healthcare providers can discover the high-risk groups of disability and implement individualized preventive interventions in accordance with the related factors.

Effectiveness analysis of self-care behavior intervention for elderly patients with diabetes mellitus in Yizhou rural community

Objective To explore the effectiveness of self-care intervention for elderly patients with diabetes mellitus in rural community. Methods We randomly selected 100 elderly patients with diabetes from January 2013 to December 2013 in rural community health service station in Yizhou, Guangxi Zhuang Autonomous Region. Individualized intervention of diabetes-related knowledge was delivered to patients. Fasting blood glucose and glycated hemoglobin were compared before and after the intervention. The effectiveness of intervention was investigated by diabetes self-care scale. Results Levels of fasting blood glucose [(5.91±0.10)mmol/L] and glycated hemoglobin [(4.62±0.14)%] from 100 patients were lower than those before the intervention after 1 year intervention (t=11.840, 12.379; P<0.01). After intervention, the total score of diabetes self-care scale was improved to (89.66±1.56) from (75.32±1.50) (t=-7.597, P<0.01). Conclusions Blood glucose can be effectively controlled by helping the rural elderly diabetic patients to learn about self-care. Key words: Diabetes mellitus; Elderly; Rural area; Intervention; Self-care; Effectiveness