养老机构术后远程医养结合体系的构建及评价

顾叶春; 郑万琼; 张益明; 黄佳佳; 余小敏; 温蒙蒙; 许虹波

doi:10.16766/j.cnki.issn.1674-4152.002875

养老机构术后远程医养结合体系的构建及评价

doi: 10.16766/j.cnki.issn.1674-4152.002875

1.
浙江中医药大学附属温州中西医结合医院普外科，浙江温州 325000
2.
温州医科大学护理学院，浙江温州 325035

基金项目:

浙江省卫生健康科技计划项目 2021KY1081

详细信息

通讯作者:
许虹波，E-mail：xhb@wmu.edu.cn

中图分类号: R197.7
计量
- 文章访问数: 154
- HTML全文浏览量: 57
- PDF下载量: 4
- 被引次数: 0
出版历程
- 收稿日期: 2022-02-19
- 网络出版日期: 2023-04-20

Construction and evaluation of remote integrated medical care and pension service system for postoperative patients in pension institutions

1.
General Surgery Department, Wenzhou Intergrated Traditional Chinese and Western Medicine Hospital Affiliated to Zhejiang Chinese Medical University, Wenzhou, Zhejiang 325000, China

摘要

摘要: 目的为养老机构术后患者构建远程医养结合体系，并分析其应用价值。方法 2018年1月—2021年6月，招募50例养老机构老年术后患者，按3∶ 2的比例随机分成实验组(30例)和对照组(20例)。实验组出院后接受远程医养结合体系服务，对照组则按传统方案分别接受“医”和“养”的服务。出院1个月后，分别评价2组的就诊次数、医疗费用、术后恢复情况、焦虑抑郁及满意程度。结果实验组的就诊次数较对照组少[0(0，1)次vs. 1(0，2)次，Z=-2.133，P=0.033]。2组的医疗费用差异无统计学意义[0(0，138.93)元vs. 112.20(0，291.70)元，Z=-1.413，P=0.158]。实验组无切口感染患者，对照组有1例，2组差异无统计学意义(χ²=1.531，P=0.216)。2组均无切口出血、切口裂开、再入院及再手术患者。2组间的体力状况差异无统计学意义(72.33±9.35)分vs. (70.00±9.18)分，t=0.871，P=0.388)。2组间的体重变化差异无统计学意义[1.20(0.30，1.73)kg vs. 0.75(0.10，1.10)kg，Z=-1.737，P=0.082]。实验组的焦虑、抑郁得分均较对照组低[(35.04±7.36)分vs. (39.69±8.08)分，t=-2.103，P=0.041；(37.92±7.22)分vs. (42.88±6.46)分，t=-2.477，P=0.017]。实验组对医疗服务、心理慰藉、科普宣传及日常照护的满意程度均较对照组高(均P < 0.05)；2组对文化娱乐的满意程度差异无统计学意义(P>0.05)。结论远程医养结合体系能够为养老机构老年术后患者提供更好的医疗服务，如减少就诊次数、提供更好的心理慰藉及更好的科普宣传等，同时也能促进日常照护的完善。
- 养老机构 /
- 术后 /
- 医养结合
Abstract: Objective To construct a remote integrated medical care and pension service system for postoperative patients in pension institutions and analyze its application value. Methods A total of 50 postoperative patients who were ready to go back to pension institutions were recruited from January 2018 to June 2021, and randomly divided into experimental group (30 cases) and control group (20 cases) according to the ratio of 3∶ 2. After being discharged, the experimental group received remote integrated medical care and pension services, and the control group received medical care and pension services according to traditional scheme. One month after discharge, the number of visits, medical expenses, postoperative recovery, anxiety, depression and satisfaction levels were evaluated. Results The number of visits of the experimental group were less than that of the control group [0(0, 1) vs. 1(0, 2), Z=-2.133, P=0.033]. No significant difference in medical expenses was found between the two groups [0 (0, 138.93) yuan vs. 112.20 (0, 291.70) yuan, Z=-1.413, P=0.158]. There was no wound infection in the experimental group and 1 case in the control group, with no significant difference (χ²=1.531, P=0.216). There were no patients with incision bleeding, incision dehiscence, readmission and reoperation in the two groups. There was no significant difference in physical strength between the two groups [(72.33 ± 9.35) points vs. (70.00 ± 9.18) points, t=0.871, P=0.388]. There was no significant difference in weight change between the two groups [1.20 (0.30, 1.73) kg vs. 0.75 (0.10, 1.10) kg, Z=-1.737, P=0.082]. The anxiety and depression scores of the experimental group were lower than that of the control group [(35.04±7.36) points vs. (39.69±8.08) points, t=-2.103, P=0.041; (37.92±7.22) points vs. (42.88±6.46) points, t=-2.477, P=0.017]. The experimental group had higher satisfaction with medical services, psychological comfort, science popularisation and publicity and daily care than the control group (all P < 0.05). No significant difference in cultural entertainment satisfaction was detected between the two groups (P>0.05). Conclusion The remote integrated medical care and pension service system can provide efficient medical services for postoperative patients in pension institutions, such as reduced number of medical visits, better psychological comfort and science popularisation and publicity, and can also promote the improvement of daily care.
- Pension institutions /
- Postoperative /
- Integrated medical care and pension services system

HTML全文

表 1 2组接受手术治疗的养老机构老年人基线资料比较

Table 1. Comparison of baseline data between the two groups of elderly people receiving surgical treatment in nursing homes

组别	例数	性别(例)		年龄(x±s，岁)	文化程度			慢性疾病(例)
组别	例数	男性	女性	年龄(x±s，岁)	高中及以上	初中	小学及以下	高血压	糖尿病	其他
实验组	30	17	13	72.13±4.64	5	11	14	10	7	3
对照组	20	12	8	70.95±4.77	3	5	12	6	5	1
统计量		0.055^a		0.873^b	0.786^c			0.579^a
P值		0.815		0.387	0.432			0.901
注：^a为χ²值，^b为t值，^c为Z值。

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表 2 2组接受手术治疗的养老机构老年人体力状况和体重变化

Table 2. Physical status and body weight changes of the elderly in the nursing home receiving surgery in the two groups

组别	例数	体力状况(x±s, 分)		体重变化[M(P₂₅, P₇₅), kg]
组别	例数	出院时	出院后	体重变化[M(P₂₅, P₇₅), kg]
实验组	30	64.00±8.55	72.33±9.35	1.20(0.30，1.73)
对照组	20	65.50±8.87	70.00±9.18	0.75(0.10，1.10)
统计量		0.599^a	0.871^a	-1.737^b
P值		0.552	0.388	0.082
注：^a为t值，^b为Z值。

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表 3 2组接受手术治疗的养老机构老年人焦虑和抑郁评分比较(x±s, 分)

Table 3. Comparison of anxiety and depression scores of the elderly receiving surgery in two groups of nursing homes (x±s, points)

组别	例数	SAS		SDS
组别	例数	出院前	出院后	出院前	出院后
实验组	30	46.71±8.69	35.04±7.36	49.42±9.00	37.92±7.22
对照组	20	45.13±8.36	39.69±8.08	47.94±6.80	42.88±6.46
t值		0.640	2.103	0.625	2.477
P值		0.525	0.041	0.535	0.017

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表 4 2组接受手术治疗的养老机构老年人满意度评分比较[M(P₂₅, P₇₅), 分]

Table 4. Comparison of satisfaction scores of the elderly receiving surgery in the two groups [M(P₂₅, P₇₅), points]

组别	例数	医疗服务	心理慰藉	科普宣传	日常照护	文化娱乐
实验组	30	3.00(3.00, 3.00)	2.00(1.00, 2.25)	2.00(1.00, 3.00)	3.00(3.00, 4.00)	1.00(1.00, 2.00)
对照组	20	2.00(1.00, 2.00)	1.00(0.25, 2.00)	1.00(1.00, 1.00)	3.00(2.00, 3.00)	1.00(1.00, 2.00)
Z值		-4.655	-2.197	-3.288	-2.357	-0.522
P值		< 0.001	0.028	0.001	0.018	0.602

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