ObjectiveTo systematically review the willingness rate of Chinese residents to renew family doctors contract services. MethodsPubMed, Web of Science, EMbase, ScienceDirect, CNKI, WanFang Data and VIP databases were electronically searched to collect cross-sectional studies related to the willingness of Chinese residents to renew family doctors contract services from inception to November 2021. Two reviewers independently screened literature, extracted data, and assessed the risk of bias of the included studies. Meta-analysis was then performed by using Stata 16.0 software. ResultsA total of 23 cross-sectional studies involving 22 629 subjects were included. The results of meta-analysis showed that the willingness rate of Chinese residents to renew family doctors contract services was 84.2% (95%CI 80.0% to 88.3%). The results of subgroup analysis showed that contracted residents who were surveyed in 2011 to 2015 (85.7%), living in eastern (87.0%) and urban (84.7%), above age 60 (88.5%), females (85.1%), non-married (86.5%), with primary school and below education level (91.4%), with employee medical insurance (84.5%) and residents medical insurance (85.2%), not working (77.9%), with high and medium levels of health status (84.5%), with chronic diseases (86.7%), preferred to consult general diseases in primary health care institutions (89.5%), and walking to nearby community health service institutions requiring less than 30 minutes (86.9%) had a relatively high willingness to renew contracts. The contracted residents whose health status improved (91.0%), medical expenses reduced (91.5%) and medical portability improved (88.4%), more satisfied with contracted services (85.3%), more trusted in contracted doctors (87.9%), knowing family doctors’ name (86.7%) and contact information (84.2%) and enjoying visiting medical service (79.7%), telephone follow-up (79.6%), and health files establishment (80.1%) were more willing to renew contracts. ConclusionCurrent evidence suggests that the willingness of Chinese residents to renew family doctors contract services is high, however, it remains to be improved. Due to the limited quality and quantity of the included studies, more high-quality studies are needed to verify the above conclusion.
ObjectiveTo explore the prevalence of anxiety symptoms and its related factors among the family caregivers of the disabled elderly. MethodsA cross-sectional survey based on convenience sampling was conducted among family caregivers between November and December, 2013 in Dongcheng district in Beijing. The Self-rating Anxiety Scale (SAS) and the Social Support Rating Scale (SSRS) were used to evaluate caregivers' anxious symptoms and social support status respectively. The degree of functional impairment of the elderly was measured by Barthel index. ResultsA total of 243 family caregivers took part in the study including 88 males and 155 females. The average age of the family caregivers was (60±1.7) years old, ranging from 25 to 85. The prevalence rate of anxiety was 29.2% reported by family caregivers. The average score of SAS was 35.6±8.6. The risk factors of caregivers' anxiety included Barthel index score ≤20 (OR=1.51), SSRS score ≤33 (OR=4.56), no time to relax (OR=1.57) and poor health status caregivers feeling (OR=3.48). ConclusionA relative high level of anxiety exists in family caregivers for the disabled elderly. Caregiver anxiety is a complex process, influenced by diverse care receiver and caregiver characteristics.
Objective To research whether systemic family therapy is a useful intervention for behavioral problems. Methods Two hundred and seventy six children who were in the fourth grade of elementary school were assessed by family dynamics questionnaires and their parents were tested by Achenbach Child Behavioral Checklist. Fifty-seven children with behavioral problems were divided into two groups: 20 children and their parents agreed to receive systemic therapy for four weeks and 37 children and their parents who refused this therapy formed the control group.All children and their parents were reassessed after four months. Data were analyzed by SPSS 11.5. Results The characteristics of family dymanmic and children’s behavior improved significantly after systemic therapy. The "depressing and hostile family" at mosphere became "harmonious and open" (P=0.000) and this was also significantly better than the control group after therapy(P=0.000). "Self-differentiation of family members" was significantly improved after therapy (P=0.000) and also was significantly better than the control group after therapy (P=0.005). "Patient is helpless victim" changed to "Patient can do something" (P=0.000) and this was significantly better than the control group after therapy (P=0.003) . Total CBCL score decreased in the treatment group after therapy (P=0.003 for father, P=0.000 for mother). Compared with the control group. Total CBCL score also showed decreases (P=0.033 for father, P=0.014 for mother). Conclusions The techniques of systemic family therapy are practical and effective methods to intervene children’s behavioral problems.
ObjectiveTo explore the effect of family-school-hospital application in continuous nursing care for children with epilepsy. Methods120 children with epilepsy admitted to Children's Hospital Affiliated to Jiangnan University from January 2021 to October 2022 were randomly divided into two groups, each with 60 cases. The control group received routine care, while the experimental group received family-school-hospital continuous care. Compare the awareness of epilepsy knowledge, disease control effectiveness, medication compliance, negative emotions, physical and mental status, and quality of life before and after nursing between the families of two groups of children with epilepsy. ResultsAfter 2 months of nursing care, the scores of family members' knowledge of epilepsy in the experimental group were higher than the control group (P<0.05). The effect of disease control in the experimental group was better the control group (P<0.05). The drug compliance of the experimental group was higher than the control group (P<0.05). The quality of life score in the intervention group was higher than the control group (P<0.05). ConclusionThe application of family-school-hospital in the continuous care of children with epilepsy can improve their family members' awareness of epilepsy knowledge, effectively control the disease, improve medication compliance, improve negative emotions and physical and mental conditions, and thus improve the quality of life of children.
ObjectiveTo explore the relationship between hand grip strength and depression and the moderating role of monthly household income level between grip strength and depression of community-dwelling female patients with type 2 diabetes.MethodsFrom March to June 2021, 3 communities in Chengdu were selected by convenience sampling method, and elderly female patients with type 2 diabetes were randomly selected from these communities. The patients were investigated through a self-made demographic and disease-related questionnaire and the Geriatric Depression Scale-15, and their grip strength was measured by a grip meter. The Process V3.3 plugin in SPSS 25.0 software was used to test the moderation effect.ResultsA total of 389 elderly female patients with type 2 diabetes were enrolled in this study. Spearman correlation analyses indicated that the grip strength was negatively correlated with the depression score (rs=?0.125, P=0.014), and positively correlated with the monthly household income level (rs=0.157, P=0.002); the depression score was negatively correlated with the monthly household income level (rs=?0.147, P=0.004). The results of the moderating effect showed that grip strength and monthly household income level could independently affect the patients’ depression scores [unstandardized partial regression coefficient (b)=?0.254, P=0.002; b=?1.552, P=0.009], and the interaction item of grip strength and monthly household income level was statistically significant for depression scores (b=0.065, P=0.031).ConclusionThe hand grip strength of community-dwelling elderly female patients with type 2 diabetes can negatively predict the level of depression, and the monthly household income level has a moderating effect between grip strength and depression.
ObjectiveTo collect and analyze the clinical data and quality of life of hemophilic children, understand the present condition of these patients in Sichuan Province, and analyze related influencing factors. MethodWe retrospectively analyzed the clinical data of hemophilic children treated in our hospital from January 1, 2008 to May 30, 2015. ResultsThere were 92 child patients from Sichuan Province with a median age of 9.6 years old (ranging from 3.6 to 18.0). There were 87 cases (94.6%) of hemophilia A and 5 (5.4%) of hemophilia B; the number of light cases was 4 (4.3%), of moderate cases was 67 (72.8%), and of severe cases was 21 (22.9%); eighteen (19.6) of the patients had family history. First bleeding episode occurred at a median age of 11 months (0-48 months). Mild bleeding occurred in 23 cases (25.0%), moderate bleeding in 31 cases (33.7%), and severe bleeding in 38 cases (41.3%). First bleeding site was mainly the mucous membrane of the skin, followed by the joint muscles. Fist joint bleeding occurred at a median age of 18 months (2-107 months). Forty-six patients (59.0%) had severe joint damage during the course of the disease. Intracranial hemorrhage occurred in 4 patients (4.3%), among whom 3 were cured and discharged from the hospital, and 1 had neurological sequelae. Median diagnostic age was 12 months (0-120 months). Sixty-two (67.4%) were diagnosed in a short period of time, 9 (9.8%) in a mediate period of time, and 21 (22.8%) in a long period of time. Forty (43.5%) of the patients had been given sufficient coagulation factors, while all the others had not received sufficient replacement therapy. Fifty-six (60.9%) children had received prophylactic treatment. First prophylaxis was administrated at a median age of 36 months (1-199 months), but 27 (48.2%) discontinued. The median score of the 29 retreated Disease Burden Scale was 22.7±11.6 (4-43), and among them, 11 (37.9%) could not care for themselves. Twenty-three participated in the assessment of social activity ability, among whom, 2 did not attend school, and 6 could not take part in the assessment because of school learning. Correlation analysis showed that there was no significant relationship between diagnostic timing and family history (P=0.795) or between diagnostic timing and areas they came from (P=0.495). However, significant association was found between diagnostic timing and the severity of first bleeding (r=0.392, P=0.035). Disease burden of family was significantly correlated with the number of target joints (r=0.370, P=0.048), and was not closely related with area, severity of bleeding, frequency of hemorrhage, medical insurance, or physical and social activities. ConclusionsThe general diagnosis and treatment condition of child hemophilia in Sichuan is relatively under-developed with a high prevalence of joint damage, poor quality of life, and high disease burden to the family. Improvement in the care of hemophilia children is urgently needed.
ObjectiveTo explore the effect of programmed family nursing intervention on medication compliance in hypertensive patients. MethodsA total of 160 patients with hypertension treated between August 2012 and July 2013 in our hospital were chosen to be our study subjects. They were randomly divided into two groups:control group (n=80) and trial group (n=80). Patients in the control group were given routine nursing intervention for six months, while those in the trial group received six-month programmed family nursing intervention. Then, we compared the effect of blood pressure control and medication compliance between the two groups. ResultsThe effect of blood pressure control and medication compliance in the trial group after the intervention was better than that in the control group, and the difference was statistically significant (P<0.05). ConclusionThe programmed family nursing intervention is better than the routine nursing intervention in terms of effect of blood pressure control and patients' medication compliance, and it is an effective nursing method for hypertensive patients.
Objective To investigate the family-dependence status in patients with tumor, and analyze the related factors of family dependence. Methods The self-made family-dependence scale was distributed to 432 patients with tumor to asses their family dependence status. Results The mean score of family-dependence was 40±5.8. A total of 198 cases (45.8%) were family-dependent, including 52 mild cases, 98 moderate cases, and 48 severe cases. The logistic regression analyses showed that sex (OR=3.873, P=0.022), age (OR=2.378, P=0.035), and personality type (OR=1.079, P=0.028) were the related factors of family-dependence. Conclusion More attention should be paid to patients with tumor about their family-dependence. After being instructed, the family members should use proper emotional expression method to provide family support to the patients with tumor. The female patients, older patients, and patients with dependent personality should be encouraged to improve their self-care ability to avoid family-dependence as possible as they can.
Objective To investigate the factors influencing the medication adherence among patients with diabetes signing family doctor service contract in Beijing urban areas, and provide the basis for improving the level of medication adherence. Methods A total of 320 patients with diabetes from four community health service centers in Beijing urban areas were selected to answer the questionnaires using convenient sampling from June to September 2015. Univariate analysis and binary logistic regression were used for the influencing factors analysis. Results A total of 320 questionnaires were distributed, and 317 valid questionnaires were recovered, in which the rate of high medication adherence was 54.6%. The results of logistic regression showed that the main impact factors on medication adherence were age [odds ratio (OR)=1.918, P=0.011)], degree of education (OR=2.462, P=0.008), knowledge related to diabetes (OR=1.773, P=0.027), adopting of family doctor service or not (OR=2.521, P=0.029) and social function status (P=0.003). Conclusions The family doctor service team should implement the practice of the family doctor service to ensure that the contracted residents can make full use of the family doctor services; and strengthen the follow-up and interventions for patients less aged or with low degree of education. For those with poor social function, more attention should be paid to their self-health management behavior to improve the level of patients’ compliance. As a result, the levels of blood glucose will be well controlled to reduce possibilities of complications and improve their health status and quality of life.