| BackgroundCompare to physical,chemical,and biological factors.the behavioral, social, and environmental factors have became the main pathogenic factors in post-medical era.and the main disease types have became chronic degenerative diseases instead of infectious and dystrophic diseases.Modern biological-psychological-social medical model has been recognized by the global medicine world.since it was put forward by G-L-Engle in1977.To adapt to the requirements of the times.this advanced medical model shows lots of advantages and strong vitality.However.due to various reasons,it did not play a due role in reality.First, the influence of the old medical model still exists.and the simple biological-medical model is dominant largely.Such as medical personnel focus on disease treatment instead of prevention in service, pay more attention to disease and ignore the patients;Emphasis on biological, physical, chemical factors in the etiology, ignore psychological and social factors;Emphasis on the role of drugs.surgery in treatmentneglect the effect of psychological, environmental, and social factors;Emphasis on diagnosis and treatment in service functions,ignore psychological, life, culture, social services;The cooperation of medical personnel is not harmonious enough.which is failed to make full use of the overall force,and is not conducive to the improvement of the quality of medical care;The setup of hospital departments pursue the excessively meticulous division,which is failed to make full use of the health resources. Second, the lag of the medical management model,there is not a suitable and perfect management mechanism to implement the modern biological-psychological-social medical model.Especially how to really achieve prevention and active medical treatment which cover all the factors in the new medical model.Holistic medicine management model is a new medical thought and concept which is enlightened by medical wholism and guided by biological-psychological-social medicine model.It reflects the system thinking and wholism in medicine.No.181hospital of PLA follows the intergration trend in the development of contemporary medicine,to rethink and position the mode and function of medical service, after more than10years of research and practice,the holistic medicine management model was put forward.The quantitative assessment of inpatients as one of the important modules of holistic medicine management model,it implements the patient-centered concept,emphasizing that human being is a physical, psychological,social,nutritional,spiritual and cultural entity, correcting the previous wrong idea of emphasizing on diseases and physiology.ignoring patients and psychology;It pays attention to nutrition guidance,implementation of psychological assessment and intervention, and social support evaluation,innovating the cognitive assessment of disease.To provide a multiple, multi-level,whole course,and full range of services for the patients.ObjectiveThe quantitative assessment of inpatients implements the patient-centered concept,and make the medical personnel establish the holistic concept.The various assessment of physiology,psychology,society,nutrition and cognition etc,which lay the foundation of providing the optimal diagnosis and treatment for patients.One of the purposes of this research is to explore the interdisciplinary collaboration in clinical medicine,the combining form and method of practicing biological,psychological and social factors in disease diagnosis and treatment. Second.through a series of investigation and data analysis,statistics the specific conditions of the assessment.and sum up the overall effect after implemented the quantitative assessment of inpatients.Third, further enrich and perfect the system of quantitative assessment in holistic medicine management model.provide valuable advice and reference to optimize the operating procedures of assessment and explore assessment of specific patients.MethodCollected information when asking medical history for the first time in hospital,supplemented and corrected during ward round,inpatients who accorded with the condition of assessment(over18years old.normal consciousness,correct expression)completed the assessment of psychological status,social support,nutriture and cognition of disease,based on which the clinicians can analyse comprehensively combing with physical disease to make an holistic conclusions by using the form of clinical holistic assessment.Sampled the medical records of inpatients of six clinical departments which have completed the quantitative assessment during January2011to June2011in No.181hospital of PLA for simple random sampling.Simple random sampling is the most basic sampling method,including repeated sampling and non-repeated sampling.There are three specific methods of the simple random sampling: first,direct sampling, that is selected directly at random from a population sample,which was using in this investigation.Second, the draw. Third.random number and-chart.The statistical methods used in this study include:descriptive statistics, chi-square test analysis.Descriptive statistical analysis is to analyze the various features of a set of data,in order to describe the various features and overall characteristics of sample.There are many projects in descriptive statistical analysis, the commonly used, such as Mean, standard deviation, median, frequency distribution, normal and skewed distribution and so on.The chi-square test is mainly used in the independent test of the interactive classified data,the contingency table test;also applies to class variable and the relevant statistics of them.ResultsThe sampling focused on internal medicine departments, the majority of patients have complex disease constitution,in822inpatients,who has two,three or more diseases are in the majority,35.5%and39.8%respectively.There was significant difference in distribution of case classification of patients from different age groups, the CD rates in department of cardiology,geriatrics and neurology are higher,which were66.0%,65.7%and61.1%respectively.The incidence of abnormal psychological status of inpatients was37.3%,there was significant difference in assessment result of psychological status of patients from different departments,the lowest proportion of abnormal psychological status was the digestive respiratory medicine,26.4%,followed by cardiology,28.4%;the highest proportion of abnormal psychological status was oncology,51.8%,followed by neurology,38.9%.The incidence of abnormal social support of inpatients was33.1%,the lowest proportion of abnormal social support was cardiology,20.2%,followed by digestive respiratory medicine,22.1%; he highest proportion of abnormal social support was oncology,49.5%,followed by nephrology,36.7%;scores of assessment of psychological status and social support were significantly negatively correlated.The incidence of malnutrition of inpatients was38.9%,the lowest proportion of malnutrition was geriatrics,27.1%,followed by oncology,35.5%; the highest proportion of malnutrition was digestive respiratory medicine,46.0%,followed by nephrology,42.2%;there was significant difference in body mass index groups between different genders.and different age groups.Of822inpatients.the proportion of poor,general and good cognition of disease were28.0%,51.7%,20.3%respectively.ConclusionThere was a higher incidence of abnormal psychological status of inpatients,and the incidence of abnormal psychological status was quite different between different departments. Scores of assessment of psychological status and social support were significantly negatively correlated.good social support is conducive to mental and physical health.There was a higher incidence of malnutrition of inpatients,assessing the nutritional status of patients timely can help clinicians and nutritionists to develop appropriate programs of nutritional treatment,which is beneficial to promoting rehabilitation of patients and improving prognosis.The incidence of malnutrition of inpatients, was quite different between different departments,genders and age groups.The cognitive level of disease of inpatients should be further improved,to promote the application of prescription of health education,enhancing the cognitive level of disease is beneficial to promoting the rehabilitation and improving the quality of life of patients. |
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