scholarly journals Transitional Care for Patients with Portal Hypertension:A multicenter study of intervention for patients post-TIPS

Author(s):  
Yin Xu ◽  
Zhong-Min Wang ◽  
Ru-Mei Yang ◽  
Ling Wang ◽  
Xiao-Yan Fei ◽  
...  

Abstract Background:To explore the application effect of multicenter transitional nursing in patients post-TIPS.Methods:A total of 368 patients who underwent TIPS were randomly allocated to the control or intervention group. Patients in the control group received conventional care, and patients in the intervention group received conventional care combined with transitional care. The Child-Pugh scores, blood ammonia levels, compliance behavior, medication compliance, and adverse event incidence rates in the two groups were compared at 1, 3, 6, 9 and 12 months post-TIPS.Results:Repeated measures analysis of variance showed significant group effects 1, 3, 6, 9 and 12 months post-TIPS in the compliance behavior scores of the two groups. The intervention group had significantly higher compliance behavior scores than the control group 1, 3, 6, 9 and 12 months post-TIPS. The incidence of postoperative adverse events in the intervention group was significantly lower than that in the control group 12 months after TIPS. The group effects, time effects and group*time interaction revealed significant differences in the Child-Pugh scores 1, 3, 6, 9 and 12 months post-TIPS between the two groups and significant differences in blood ammonia levels 9 months after TIPS.Conclusions:Post-TIPS transitional care interventions increased patients’access to scientifically informed nursing, significantly improved patients’compliance behavior and health, and decreased the incidence of postoperative adverse events.

2019 ◽  
Author(s):  
Weiwei Hou ◽  
Yin Xu ◽  
Qijiang Wan ◽  
Xiaoyan Fei ◽  
Gui-xiang Qian ◽  
...  

Abstract AIM To evaluate the efficacy of transitional care interventions of multidisciplinary teams for patients with cirrhosis post-TIPS. METHODS 68 patients undergone TIPS were randomly allocated to control or intervention group. Patients in control group received conventional care, patients in the intervention group received conventional care combined with transitional care. The compliance behavior, incidence of HE and shunt dysfunction, Child-Pugh scores and ammonia of two groups were compared at 1,3,6 and 12 month post-TIPS. RESULTS Repeated measures analysis of variance showed significant group effects from 1,3,6 and 12 month post-TIPS for compliance behavior scores of the two groups. Intervention group had significant higher compliance behavior scores than control group 1, 3 and 6 month post-TIPS respectively. The incidences of HE the intervention group were significantly lower than control group12 months after TIPS.The incidences of shunt dysfunction in the intervention group were significantly lower than control group 12 months after TIPS. The group effects ,time effects and group*time interaction showed no significant difference in Child-Pugh scores and blood ammonia between the two groups. CONCLUSION Post-TIPS transitional care interventions increase the accessibility of patients to scientifically informed nursing, significantly improve patients’ compliance behavior and health, decrease the incidence of HE and shunt dysfunction. KEW WORDS Transjugular intrahepatic portosystemic shunt (TIPS); Transitional care; Compliance behaviors; Hepatic function.


2019 ◽  
Author(s):  
Weiwei Hou ◽  
Yin Xu ◽  
Qijiang Wan ◽  
Xiaoyan Fei ◽  
Gui-xiang Qian ◽  
...  

Abstract BACKGROUND To evaluate the efficacy of transitional care interventions of multidisciplinary teams for patients with cirrhosis post-TIPS. METHODS 68 patients undergone TIPS were randomly allocated to control or intervention group. Patients in control group received conventional care, patients in the intervention group received conventional care combined with transitional care. The compliance behavior, incidence of HE and shunt dysfunction, Child-Pugh scores and ammonia of two groups were compared at 1, 3, 6 and 12 month post-TIPS. RESULTS Repeated measures analysis of variance showed significant group effects from 1, 3, 6 and 12 month post-TIPS for compliance behavior scores of the two groups. Intervention group had significant higher compliance behavior scores than control group 1, 3 and 6 month post-TIPS respectively. The incidences of HE the intervention group were significantly lower than control group 12 months after TIPS. The incidences of shunt dysfunction in the intervention group were significantly lower than control group 12 months after TIPS. The group effects, time effects and group*time interaction showed no significant difference in Child-Pugh scores and blood ammonia between the two groups. CONCLUSION Post-TIPS transitional care interventions increase the accessibility of patients to scientifically informed nursing, significantly improve patients’ compliance behavior and health, decrease the incidence of HE and shunt dysfunction. TRIAL REGISTRATION www.clinicaltrials.gov; identifier: NCT02877953(08/23/2016) KEY WORDS Transjugular intrahepatic portosystemic shunt (TIPS); Transitional care; Compliance behaviors; Hepatic function.


2017 ◽  
Vol 61 (4) ◽  
pp. 236-243 ◽  
Author(s):  
Rebecca Goe ◽  
Catherine Ipsen ◽  
Stacey Bliss

Digital career literacy encompasses the skills needed to find and maintain employment in the modern job market. Unfortunately, many state vocational rehabilitation (VR) professionals report feeling unprepared to help their consumers with digital career literacy tasks. To address this gap, we developed and tested five training webinars with VR professionals in Montana, Alabama, and Washington. We randomly assigned VR offices to intervention or control group. VR professionals in the intervention group received access to the training webinars. We collected survey data at baseline and 4 months after the intervention’s conclusion ( n = 136). A repeated measures ANOVA showed significant group by factor effects in counselor preparedness to use online tools during the VR process (intervention group: M1 = 24.41, SD1 = 7.62; M2 = 28.76, SD2 = 7.27; control group: M1 = 25.94, SD1 = 8.64; M2 = 27.21, SD2 = 9.14); F(1, 124) = 5.957, p = .016. A McNemar nonparametric test indicated that more VR professionals in the intervention group reported using LinkedIn at the 4-month follow-up, as compared with the control group ( p = .039). There were no significant changes in use of other online tools. This may relate to administrative policies that do not provide clear guidelines for using online tools in the counseling process.


2016 ◽  
Vol 23 (6) ◽  
pp. 595-604 ◽  
Author(s):  
Jae Hyoung Cho ◽  
Hun-Sung Kim ◽  
Seung Hyun Yoo ◽  
Chang Hee Jung ◽  
Woo Je Lee ◽  
...  

Introduction The aim of this study was to improve the quality of diabetes control and evaluate the efficacy of an Internet-based integrated healthcare system for diabetes management and safety. Methods We conducted a large-scale, multi-centre, randomized clinical trial involving 484 patients. Patients in the intervention group ( n = 244) were treated with the Internet-based system for six months, while the control group ( n = 240) received the usual outpatient management over the same period. HbA1c, blood chemistries, anthropometric parameters, and adverse events were assessed at the beginning of the study, after three months, and the end of the study. Results There were no initial significant differences between the groups with respect to demographics and clinical parameters. Upon six-month follow-up, HbA1c levels were significantly decreased from 7.86 ± 0.69% to 7.55 ± 0.86% within the intervention group ( p < 0.001) compared to 7.81 ± 0.66% to 7.70 ± 0.88% within the control group. Postprandial glucose reduction was predominant. A subgroup with baseline HbA1c higher than 8% and good compliance achieved a reduction of HbA1c by 0.8 ± 1.05%. Glucose control and waist circumference reduction were more effective in females and subjects older than 40 years of age. There were no adverse events associated with the intervention. Discussion This e-healthcare system was effective for glucose control and body composition improvement without associated adverse events in a multi-centre trial. This system may be effective in improving diabetes control in the general population.


BMJ Open ◽  
2021 ◽  
Vol 11 (2) ◽  
pp. e037999
Author(s):  
Martina Rimmele ◽  
Jenny Wirth ◽  
Sabine Britting ◽  
Thomas Gehr ◽  
Margit Hermann ◽  
...  

IntroductionIn Germany, an efficient and feasible transition from hospital to home for older patients, ensuring continuous care across healthcare settings, has not yet been applied and evaluated. Based on the transitional care model (TCM), this study aims to reduce preventable readmissions of patients ≥75 years of age with a transitional care intervention performed by geriatric-experienced care professionals. The study investigates whether the intervention ensures continuous care during transition and stabilises the care situation of patients at home.Methods and analysesRandomised controlled clinical trial, recruiting between 25 April 2018 and 31 December 2019 in one German hospital in the city of Regensburg. The intervention group is supported by care professionals in the transition process from hospital to home for up to 12 months. Based on TCM, the intervention includes an individual care plan according to a patient’s symptoms, risks, needs and values. The plan is advanced in the domestic situation via personal visits and telephone contacts. All necessary care actions regarding, for example, mobility, residence adjustments, or nutrition, are initiated to be executed by ambulant care services, and are monitored, evaluated and adapted if necessary. In supervising the care plan, the care professionals do not administer active care services themselves but coordinate them. Patients and their caregivers are actively engaged in the care planning and execution. In contrast, the control group receives only usual discharge planning in the hospital and usual ambulatory care.The primary outcome is the all-cause readmission rate assessed using health insurance data within a follow-up of up to 12 months after hospital discharge. Secondary outcomes include care quality, mobility, nutritional and wound situation, and health-related quality of life. They are assessed at baseline, after 1 month, 3 months, 6 months, and at the end of study visit. Additionally, the economic efficiency of the intervention will be evaluated.Ethics and disseminationEthics approval for the trial was obtained from the Ethics Committee of the Friedrich-Alexander-Universität Erlangen-Nürnberg. Results will be published in peer-reviewed, open-access scientific journals and disseminated at national and international research conferences and through public presentations in the geriatric and healthcare community.Trial registrationClinicalTrials.gov identifier: NCT03513159.


Author(s):  
Federica Galli ◽  
Tommaso Palombi ◽  
Luca Mallia ◽  
Andrea Chirico ◽  
Thomas Zandonai ◽  
...  

The outbreak of coronavirus required adjustment regarding the delivery of interventions. Media literacy interventions are necessary to help people acquire relevant skills to navigate the complexities of media communications, and to encourage health-promoting behaviors. The present study aimed to promote a media literacy intervention regarding performance and appearance enhancement substances use in sports high school students. The COVID-19 contingency allowed us to evaluate whether online sessions can effectively promote greater awareness of media influence, a stronger sense of confidence in persuading others to deal with media messages, and healthier attitudes about PAES use among high school students. The study relied on an “intervention group” comprising 162 students (31.5% female) and a “control group” comprising 158 students (42% female). Data were analyzed through repeated measures of Group X Time MANOVA and ANOVA, demonstrating some degree of efficacy of the media literacy intervention. The “intervention group” reported higher awareness of potential newspapers’ influence and a significant increase in their sense of confidence in dealing with media influence compared to the “control group”. Findings support the efficacy of online media literacy programs to prevent doping consumption in adolescents.


2018 ◽  
Vol 7 (2) ◽  
pp. 116
Author(s):  
Budi Darmawan ◽  
Diyah Fatmasari ◽  
Rr. Sri Endang Pujiast

Background: Wet cupping, furthermore mentioned cupping, decreases blood pressures through the level of negative air pressures added by hydrostatics filtration pressure to reinforce the power of fluids filtration in capillaries. However, an appropriate negative air pressure to decrease blood pressure remains an uncertainty.Purpose: This study aimed to analyze negative air pressure differences on cupping in decreasing blood pressures in hypertensive patients.Methods: This is a quasi-experimental design conducted in three Community Health Centers in Langsa City, Aceh, Indonesia. The samples were 36 hypertensive males with age from 45 to 55, who were randomly stratified into two groups with cupping pressures 400 mbar (n=18) as the control group; and 540 mbar (n=18) as the intervention group. The cupping session was performed to each group on T1 (alkahil) point and in the middle line of both shoulders blade points. The systolic blood pressure (SBP) and diastolic blood pressures (DBP) were measured by validated automatic sphygmomanometer. The follow-up periods were one week and two weeks. The data were then analyzed by repeated measures ANOVA.Results: Cupping pressure of 400 mbar decreased the mean of SBP and DPB with a p-value of 0.450 and 0.026, respectively after two weeks of intervention. Meanwhile, cupping pressure of 540 mbar decreased the mean of SBP and DBP with a p-value of 0.006 and 0.057, respectively. Tests of within-subjects resulted in the p-value of 0.250 (SBP) and 0.176 (DBP) after two weeks of intervention. There were no significant differences in SBP and DBP between the intervention group and the control group.Conclusion: The cupping pressure between 400 mbar and 540 mbar could reduce blood pressure; however, the cupping pressure of 540 mbar yielded greater effect in decreasing blood pressure than the 400 mbar. Negative air vacuum pressure loads on cupping to decrease blood pressure should be considered between 400 to 540 mbar, and further studies are needed.


2019 ◽  
Author(s):  
Ali Bozorgi ◽  
Hamed Hosseini ◽  
Hassan Eftekhar ◽  
Reza Majdzadeh ◽  
Ali Yoonessi ◽  
...  

Abstract Background : Self-management of blood pressure is of great significance given the increasing incidence of hypertension and associated disabilities. With the increased use of mobile health in medicine, the present study evaluated the effect of the self-management application on patient adherence to hypertension treatment. Methods : This clinical trial was performed on 120 hypertensive patients who were provided with a mobile intervention for 8 weeks and followed-up to 24 th weeks. Data on the primary outcome (adherence to treatment) and secondary outcomes (adherence to the DASH diet, regular monitoring of blood pressure, and physical activity) were collected using a questionnaire and a mobile application, respectively. The inter-group change difference over time was analyzed using repeated measures ANOVA (General Linear Model). Results : The treatment adherence score increased by an average of 5.9 (95%CI: 5.0-6.7) in the intervention group compared to the control group. Scores of adherence to the low-fat and low-salt diet plans were 1.7 (95%CI: 1.3-2.1) and 1.5 (95%CI: 1.2-1.9), respectively. Moreover, moderate physical activity increased to 100.0 minutes (95%CI: 61.7-138.3) per week in the intervention group. Conclusion: The treatment and control of blood pressure require a multifaceted approach given its complexity and multifactorial nature. Considering the widespread use of smartphones , mhealth interventions can be effective in self-management and better patient adherence to treatments. Our results showed that this application can be used as a successful tool for hypertension self-management in patients attending public hospitals in developing countries. Trial registration: This study was registered in the Iran Randomized Clinical Trial Center under the number IRCT2015111712211N2 on 1 January 2016.


2020 ◽  
pp. 270-278

INTRODUCTION: The enhancement of nurses’ risk perception plays a significant role in their preparedness during disasters and emergencies. Therefore, this study aimed to investigate the effect of educational workshops on disaster risk perception in nurses METHODS: This randomized controlled field trial study included 62 nurses working at Razi Hospital, Birjand, Iran. The participants were divided into intervention and control groups. The intervention group was then requested to participate in a one-day intensive educational workshop based on the current national standards. The workshop content included a combination of lecturing methods, round-table exercises, and film display. The data were collected using the demographic characteristic form and researcher-made questionnaires measuring the nurses’ risk perception during disasters and emergencies. Subsequently, the data were analyzed using independent t-test, repeated measures analysis, and Bonferroni post hoc tests. FINDINGS: The mean total score of risk perception were significantly higher in the intervention group before, immediately, and two months after the workshop session, compared to those in the control group (P˂0.001). CONCLUSION: The implementation of nurses’ national preparation program during disasters and emergencies can result in an increase in the nurses’ risk perception during these events. Therefore, regarding the importance of nurses’ preparedness in confrontation with disasters and emergencies, it seems necessary to integrate the National Preparedness Program into the educational programs immediately after recruitment and in the form of in-service courses.


Author(s):  
Guilherme Henrique de Lima Matias ◽  
◽  
André dos Santos Costa ◽  
Romulo Maia Carlos Fonseca

Objective: To verify the effect of recreational soccer on bone mineral density and sarcopenia in the elderly. Methods: Fourteen elderly people aged 65.9 ± 3.4 years were selected. They were separated into two groups: the intervention group and the control group; the intervention group played recreational soccer for 12 weeks on two days of the week. Assessments were performed for bone mineral density and body muscle mass before and after the intervention. For statistical analysis, the repeated measures ANOVA with Bonferroni’s post hoc test was used. Results: After 12 weeks, there was a significant change in bone mineral density in the region of the total femur (p = 0.020). Analyzing the participants’ sarcopenia, no significant results were found after the intervention period. Conclusion: Playing recreational soccer causes a significant improvement in the total femur and maintains bone regions in the spine, whole body, and femoral neck. Also, it promotes a removal from the threshold for sarcopenia screening in the elderly.


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