Chronic disease is a major threat to human health. Fundus disease has become a major ophthalmic disease affecting daily life. Although great breakthroughs have been made in the treatment, compared with other chronic disease management, the management of patients with fundus disease is still in its infancy. To strengthen the management exploration of patients with fundus diseases, establish a management model of fundus diseases and strive to improve patients' awareness of fundus diseases and adherence to treatment and follow-up are the great challenges at present. All ophthalmic centers should strengthen patient education, establish a regional cooperation network, support the construction of grassroots medical capacity, cultivate talents, enhance training, promote the standardized treatment of fundus diseases, standardize fundus imaging inspection and diagnosis, and promote the homogeneous construction of diagnosis and treatment of chronic fundus diseases. We will accelerate the construction of a hierarchical diagnosis and treatment system and the ability to link consultation and referral. Through systematic management and intervention of fundus diseases, a large number of patients with fundus diseases will receive early screening, diagnosis, standardized continuous treatment and systematic management, and improve the quality of life of patients with fundus diseases.
At present, the health management of chronic diseases in China is still in its infancy. In the face of an increasingly large group of patients with chronic diseases, large general public hospitals often lack a systematic and standardized chronic disease continuity management system. In order to solve the problem of patients’ medical difficulties, popularize the hospitals’ innovative medical services, and promote the professional development of clinical departments, taking the continuous health management model of chronic diseases constructed by West China Hospital of Sichuan University as an example, this paper introduces the background, organizational structure and service process of the system construction in turn. The purpose is to build a new health service model of “smart hospital”, and also provide a reference for the construction of standardized chronic disease management system in hospitals, which will lay a foundation for further constructing a top-down chronic disease whole process system linked with communities and hospitals in the later stage.
长期以来人们一直将吸烟, 包括吸烟成瘾看作是一种习惯, 并没有将其视为一种疾病。这样使得戒烟变得很困难和复杂。吸烟之所以长期广泛流行并造成十分严重的社会经济危害, 原因包括一系列生物、心理、社会因素, 其中最重要的原因是由于香烟烟雾中的尼古丁是一种可以使人成瘾的物质, 使得吸烟人产生烟草依赖。1998 年世界卫生组织正式提出烟草依赖是一种慢性病, 列入国际疾病分类( ICD-10,F17. 2) 。这在吸烟与控烟历史上具有划时代的意义, 将会使控烟工作从此进入一个与以往不同的时代。
The new coming era has brought great challenge to present health service model, and the development of new science and technology had improved the reconstruction of medical system and model. With the guidance of evidence-based management and participation of model technology, this paper provides an explanation of the new health service model containing new health management, clinical medicine, chronic disease management and elder care which cover the whole life cycle, so as to implement the " Health China” strategy and develop a whole life cycle health service system for all residents with necessary, high quality, and affordable prevention, treatment, rehabilitation and health promotion.
Objective To investigate the current status of health promoting lifestyle in maintenance hemodialysis (MHD) patients and to explore its correlation with chronic illness resource utilization. Methods Patients who underwent outpatient MHD in the Hemodialysis Room of the Department of Nephrology, West China Hospital, Sichuan University between January and March 2023 were selected. Patients were surveyed using the General Information Questionnaire, Chronic Illness Resource Survey, and Health Promoting Lifestyle Profile-Ⅱ Revise. Results A total of 158 patients were surveyed. MHD patients scored 103.37±18.52 on health promoting lifestyle, and 68.95±14.14 on chronic illness resource utilization. The Pearson correlation analysis results showed that there was a positive correlation between the chronic illness resource utilization and the total score of health promoting lifestyle in MHD patients (r=0.765, P<0.001), as well as scores in all dimensions (P<0.05). The results of multiple linear regression analysis showed that the main caregivers being parents [non-standardized partial regression coefficient (b)=8.150, 95% confidence interval (CI) (0.804, 15.497), P=0.030], weekly dialysis times [b=10.701, 95%CI (2.787, 18.615), P=0.008], and chronic illness resource utilization [b=0.936, 95%CI (0.800, 1.072), P<0.001] were influencing factors for health promoting lifestyle. Conclusions MHD patients have an average health promoting lifestyle, and ideal chronic illness resource utilization. Hemodialysis nurses can take targeted measures to enhance chronic illness resource utilization and health promoting lifestyle in MHD patients, which can further improve the quality of life of MHD patients.
目的 了解成都市社区老年慢性病患者对关爱的感知和需求，为更好地关爱老年慢性病患者提供依据。 方法 于2011年8月－10月采用随机抽样和问卷调查的方法，对成都市玉林社区、二仙桥社区、草堂街社区和驷马桥社区的180名老年慢性病患者的关爱感知和需求进行调查，并根据调查结果提出相应对策。 结果 180例老年慢性病患者中有98.89%能感受到关爱，1.11%自觉缺乏关爱；感知到的关爱主要来源于家庭成员,占91.01%，其次来源于亲戚朋友和邻居，占7.87%，最少来源于单位同事，占1.12%。关爱需求主要为家人团聚、关心体贴、尊重理解、日常照顾和心理情感支持、帮助解决困难、给予经济资助、提供情感支持等；护理关爱需求以尊重理解排在首位，其次是慢性病日常护理、慢性病的防治、老年保健和慢性病基本知识等。 结论 加强对社区卫生服务人员的能力培训，强化尊老爱老家庭氛围和社会风气，提高老年慢性病患者的关爱感知，有效地为老年慢性病患者提供关爱，更好地促进他们的健康。
Diabetic retinopathy (DR) is the leading cause of blindness in the working-age population, and it is a key ocular fundus disease that needs to be paid attention to in the next five years according to the "14th Five-Year" Plan for Eye Health. Promoting the systematic management of DR and constructing the chronic disease management system are the key to the next step of national eye health work. It is necessary to further improve the management mode of the whole course of DR patients with chronic eye disease through the joint action of medical security system at all levels, including strengthening supporting policies of primary medical institutions, optimizing medical service mode and process, strengthening scientific education to improve patients' and doctors' disease cognition, and updating authoritative Chinese DR guidelines to standardize diagnosis and treatment. It is hoped that the low vision and blindness caused by DR in China can be greatly reduced after the implementation of the "14th Five-Year" Plan for Eye Health.
Objective To estimate healthy life expectancy of residents aged 30 and above in Jianyang, Sichuan province, and comprehensively evaluate the health status of the population, so as to provide reference and basis for the formulation of health-related public policies. Methods The population data, death data and health status data of Jianyang city in 2018 were collected, and the self-rated health life expectancy and life expectancy without chronic diseases of residents aged 30 and above were calculated by Sullivan method, and their proportion in life expectancy was calculated. Results A total of 4 482 residents aged 30 years and above were included in Jinyang city, of whom 3 989 were self-rated healthy, accounting for 89.00% of self-rated health, and 1 988 were suffering from chronic diseases, with a chronic disease prevalence rate of 44.36%. In the age group of 30-64, the self-rated health life expectancy of women was significantly higher than that of men (P<0.05), and in the age group of 40-44, the life expectancy without chronic diseases of women was significantly lower than that of men (P<0.05), and the differences were not statistically significant when comparing different genders in other age groups (P>0.05). With the increase of age, the proportion of residents’ self-rated health and the proportion of life expectancy without chronic diseases in healthy life expectancy gradually declined. Conclusions The chronic disease has become the main factor affecting the health of middle-aged and elderly population, especially female population. It is suggested that active measures should be taken to deal with chronic diseases and the elderly health support system should be strengthened to improve healthy life expectancy of residents in Jianyang city.
With the increasing burden of chronic diseases, the issue of comorbidities has become increasingly important. In practice, patients with comorbidity of chronic diseases struggle to access continuous and integrated healthcare experiences. This article introduces the construction of the referral management system for comorbidity of chronic diseases based on “internet plus” in West China Hospital of Sichuan University. By formulating a standardized and convenient referral process and using artificial intelligence to optimize the referral platform, it creates a referral system for comorbidity of chronic diseases suitable for the hospital’s clinical workflows, makes reasonable use of the resources of the return pool, and improves the referral efficiency. After the implementation of the comorbidity referral system, patient satisfaction has increased, providing new ideas and reference experience for the management of comorbidity of chronic diseases for other medical institutions.
ObjectiveTo explore the prevalence and risk factors of hypertension and diabetes in floating population in Hubei province, so as to provide reference for the prevention of chronic disease of floating population. MethodA multi-stages sampling was performed among six counties in Hubei province in 2012, according to the different occupations. A questionnaire survey was conducted to collect the demography, sociology and health-related behavioral characteristics of subjects. Then a univariate analysis and a multivariate analysis were conducted by SPSS 20.0 software. ResultsA total of 1 800 individuals were surveyed, and the prevalence of hypertension and diabetes in floating population was 22.7% and 4.9%, respectively. Univariate analysis indicated that significant associations were found between hypertension and such factors as age, occupations, smoking and life satisfaction (all P values < 0.05); and significant associations were found between diabetes and such factors as occupations, educational level and BMI (all P values < 0.05). The results of further logistic regression analysis showed that age (OR=2.194, 95% CI 1.940 to 2.483, P=0.001) and life satisfaction (OR=0.291, 95% CI 0.248 to 0.341, P=0.002) were independent risk factors of hypertension, and educational level (OR=3.219, 95%CI 2.016 to 7.565, P=0.011) and gender (OR=0.568, 95% CI 0.323 to 0.999, P=0.049) were independent risk factors of diabetes. ConclusionsThe prevalence of hypertension and diabetes are relative high in floating population of Hubei Province. Increasing age and low life satisfaction are independent risk factors of hypertension in floating population, while male and low educational level are independent risks factors of diabetes.