ObjectiveTo explore the application and effect of integration of doctors-nurses-therapists continuous nursing management in patients with spinal cord injury.MethodsThe patients with spinal cord injury from June to December 2018 in the Department of Rehabilitation Medicine of West China Hospital of Sichuan University were selected. A set of numbers was generated by a computer. And the patients were randomly divided into the trial group and the control group. Patients in the control group were given routine discharge continuous nursing management, and patients in the trial group adopted the integration of doctors-nurses-therapists continuous nursing management to implement post-discharge guidance. The activity of daily living (ADL), quality of life or psychological status of the two groups were compared at discharge and 3 months after discharge. The compliance, satisfaction and readmission rates between the two groups were also compared 3 months after discharge.ResultsA total of 60 patients were included, with 30 cases in each group. There was no significant difference in the scores of ADL, quality of life or Huaxi Xinqing index between the two groups (P>0.05). Three months after discharge, the score of ADL (71.65±1.87 vs. 62.70±2.29), quality of life (302.90±2.71 vs. 292.95±3.39), compliance rate of medication on time (86.67% vs. 63.33%), compliance rate of exercise on time (86.67% vs. 60.00%), compliance rate of follow-up visit on time (90.00% vs. 63.33%), compliance rate of reasonable diet (83.33% vs. 60.00%), and satisfaction (90.45±1.82 vs. 79.55±1.39) of patients in the trial group were higher than those in the control group (P<0.05). There was significant difference in Huaxi Xinqing index between the trial group and the control group (14.57±1.36 vs. 21.60±1.88, P<0.001). The readmission rate of the trial group was lower than that of the control group (6.67% vs. 26.67%), but the difference was not statistically significant (P>0.05). Three months after discharge, the ADL and quality of life in both groups were significantly different from those at discharge (P<0.001); the score of Huaxi Xinqing index in the control group was higher than that at discharge (t=-17.971, P<0.001), which in the trial group was also higher than that at discharge, but the difference was not statistically significant (t=-1.352, P=0.187).ConclusionThe integration of doctors-nurses-therapists continuous nursing management can effectively improve the ADL, quality of life and compliance of discharged patients with spinal cord injury, improve the mental state of patients, and improve patient satisfaction, which is helpful for the rehabilitation of patients with spinal cord injury outside the hospital.
Chronic kidney disease (CKD) is a public health issue of global concern, and nutritional management of CKD can improve the nutritional status of patients and slow down the progression of the disease. However, nutrition management is a complex scientific issue, and there are few clinical practices of nutrition management in CKD, so there is an urgent need for a theoretical framework of nutrition management to guide the construction of a scientific and standardized program. This review will systematically describe the relationship between nutrition and kidney disease, sort out the current status of nutrition management in CKD in China, introduce the experience of CKD medical and nursing nutrition integration in West China Hospital of Sichuan University, and provide thoughts for further improvement of standardized scientific formulation of nutrition management strategy.