Objective To observe the effect of medication compliance and self-efficacy of schizophrenia patients with diabetes by continuing self-management education. Methods A total of 60 patients with schizophrenia with diabetes diagnostic criteria were divided into experimental group (30 cases) and control group (30 cases) by the admission number, 2 groups received conventional drug treatment, the control group received general preaching health education pattern, were each issued a health education manual, with schizophrenia and diabetes health knowledge division, the test group on the basis of the continuation of the implementation of self-management education, followed up 12 months after discharge, compared 2 groups of patients with medication compliance and recurrence rate, with General Perceived Self-Efficacy Scale (GSES) assessment level of 2 groups of patients with self-efficacy, fasting blood glucose (FPG) was determined by automatic biochemical analyzer, 2 hours postprandial blood glucose (2 hPBG). Results Six months after discharge, 82.1%(23/28) cases were complete compliance, 14.3%(4/28) cases of partial compliance, 3.6%(1/28) cases of non-compliance, 55.2%(16/29)cases of the control group complete compliance, 27.6%(8/29) cases of partial compliance, 17.2%(5/29) cases of non-compliance, the differences between two groups were statistically significant (χ2=37.41, P<0.05). The 12 month test group of full compliance discharged 75.0%(21/28) cases, 14.3%(4/28) cases of partial compliance, 10.7%(3/28) cases of non-compliance, 31.0%(9/29) cases of the control group complete compliance, 31.0%(9/29) cases of partial compliance, 37.9%(11/29) cases of non-compliance, the test group compliance was higher than the control group (χ2=11.27, P<0.05). The score after 6 months and 12 months respectively for the test group general self-efficacy scored 35.32 ± 2.02, 34.18 ± 1.77, control group scored 24.03 ± 3.04, 22.48 ± 2.01, the differences between two groups were statistically significant (t=16.445, 23.304, P<0.01). After 6 months in test group FPG and 2 hPBG were (5.71 ± 1.05), (9.46 ± 1.37) mmol/L, control group were (7.79 ± 1.05),(12.28 ± 2.07) mmol/L, the differences between two groups were statistically significant (t=7.483, 6.023, P<0.01). 12 months after discharge in test group FPG and 2 hPBG respectively (5.89±1.13), (9.68±1.09) mmol/L, control group (9.14±1.19), (13.17±1.42) mmol/L, test group FPG and 2 hPBG were lower than the control group (t=10.550, 7.431, P<0.01). After 6 months and 12 months, the recurrence rate of experimental group were 7.1% (2/28) and 24.1% (7/29) respectively, and control group were 14.3%(4/28) and 44.8%(13/29), the recurrence rate of experimental group was lower than the control group, there was significant difference between 2 groups (χ2=4.326, 6.225, P< 0.05 or 0.01). Conclusions Self-management education can improve the medication compliance and self-efficacy, improve mental symptoms and sugar metabolism, and reduce the recurrence rate.

Objective To investigate the status quo of preoperative urination training in the selective neurosurgical patients and to analyze reasons and its nursing strategies.Methods A self-designed questionnaire was used to investigate the status of preoperative urination training from April 2016.and reasons were analyzedand the nursing strategies were proposed.Meanwhile.the status of preoperative urination training for patients from August 2016 with nursing strategies was analyzed.Results Only 54％ of the selective neurosurgical patients performed preoperative urination training.Though patients were aware of the necessity of preoperative urination training.attached little importance to preoperative urination training.Therefore,the overall compliance rate was low than nursing before,but increased to 89％ after nursing.Conclusion The patient's compliance can be greatly improved by normalizing preoperative urination training methods and processes.adding urination training related knowledge and health education forms and contents.monitoring efficacy of health education.

Objective:To explore the neural mechanism of language dysfunction in patients with subacute stroke using functional near-infrared spectroscopy (fNIRS).Methods:Sixteen patients with non-fluent aphasia after subacute stroke (aphasia group), 16 patients with non-aphasia after stroke (non-aphasia group), and 16 healthy middle-aged and elderly subjects (control group) were enrolled into our study. The 6-min resting-state data of fNIRS were collected. Four language-related regions, Broca area, Wernicke area, dorso lateral prefrontal cortex (DLPFC), and supplementary motor area (SMA), were selected as regions of interest (ROIs), and the whole brain functional connection strength and functional connection strength in ROIs and between each two ROIs were analyzed by NirSpark software.Results:Compared with the control group (0.53±0.15) and non-aphasia group (0.47±0.12), the aphasia group had significantly decreased whole brain functional connection strength (0.29±0.14, P<0.05). Compared with the control group and non-aphasia group, the aphasia group had significantly decreased functional connection strength in the left Wernicke area, right Wernicke area, left Broca area, left SMA area, right SMA area and left DLPFC area ( P<0.05, FDR). Compared with the control group and non-aphasia group, the aphasia group had significantly decreased functional connection strength in the right Wernicke-left Wernicke area, right Wernicke-right Broca area, right Wernicke-left Broca area, right Wernicke-right DLPFC area, right Wernicke-left DLPFC area, right Wernicke-right SMA area, right Wernicke-left SMA area, left Wernicke-right Broca area, left Wernicke-left Broca area, left Wernicke-right DLPFC area, left Wernicke-left DLPFC, left Wernicke-right SMA area, left Wernicke-left SMA area, right Broca-left Broca area, right Broca-left DLPFC area, right Broca-right SMA area, right Broca-left SMA area, left Broca-right DLPFC area, left Broca-left DLPFC area, left Broca-right SMA area, left Broca-left SMA area, right DLPFC-left DLPFC area, right DLPFC-right SMA area, right DLPFC-left SMA area, left DLPFC-right SMA area, left DLPFC-left SMA area, and right SMA-left SMA area ( P<0.05, FDR). Conclusion:Abnormal functional connectivity strength of the whole brain and language-related key brain areas might be the neural mechanism of language dysfunction in patients with non-fluent aphasia after subacute stroke.

Objective To explore the effects of continuing self-management education in recovery of diabetic patients with depression. Methods A total of 75 diabetic patients with depression were selected and divided into intervention group (37 cases) and control group (38 cases) by place of residence. The two groups received routine health education, while the patients of intervention group additionally received continuing self-management education. The patients in two groups were followed up for 12 months. The intervention effects and blood sugar control of two groups were evaluated by the disease knowledge questionnaire, self-rating depressive scale ( SDS ) and Hamilton depression rating scale ( HAMD ) and WHO quality of life-BREF ( WHOQOL-BREF) questionnaire. Results At the end of 6th month and 12th month after discharge from hospital, the score of disease knowledge in the intervention group was higher than that in the control group. The SDS score, HAMD score, fasting blood glucose and 2 h postprandial blood glucose in the intervention group were lower than those in the control group. The psychological, physical, social and environmental scores of WHOQOL-BREF in the intervention group were higher than those in the control group. The differences between two groups were statistically significant (P<0. 01). Conclusions The continuing self-management education can increase the patients′health knowledge levels, improve the glucose metabolism, alleviate the symptoms of depression and improve the quality of life.

Objective To investigate the status quo of preoperative urination training in the selective neurosurgical patients and to analyze reasons and its nursing strategies.Methods A self-designed questionnaire was used to investigate the status of preoperative urination training from April 2016.and reasons were analyzedand the nursing strategies were proposed.Meanwhile.the status of preoperative urination training for patients from August 2016 with nursing strategies was analyzed.Results Only 54％ of the selective neurosurgical patients performed preoperative urination training.Though patients were aware of the necessity of preoperative urination training.attached little importance to preoperative urination training.Therefore,the overall compliance rate was low than nursing before,but increased to 89％ after nursing.Conclusion The patient's compliance can be greatly improved by normalizing preoperative urination training methods and processes.adding urination training related knowledge and health education forms and contents.monitoring efficacy of health education.

Objective:To formulate the exercise training program during the perioperative nursing for Parkinson's disease patients with deep brain stimulation and evaluate its effect.Methods:From December 2017 to December 2018, the convenience sampling method was used to select 52 patients with Parkinson's disease who were planned to undergo deep brain stimulation in the Functional Neurosurgery Department of a ClassⅢ Grade A hospital in Nanjing as the research object. We formulated and implemented the exercise training program during the perioperative nursing. Before and after the implementation of the exercise training program, patients were evaluated with the Unified Parkinson's Disease Rating Scale (UPDRS) , Berg Balance Scale (BBS) and the 39-item Parkinson's Disease Questionnaire (PDQ-39) .Results:After the implementation of exercise training program, the total scores of UPDRS, BBS and PDQ-39 were (37.40±2.057) , (42.44±0.994) and (44.85±1.848) respectively, compared with those [ (40.71±2.187) , (39.96±1.093) and (51.63±2.297) ] before implementation, the differences were statistically significant ( P<0.01) . Conclusions:The perioperative exercise training program of deep brain stimulation for Parkinson's disease patients formulated in this study has improved and refined the content of perioperative exercise care, improved nursing safety management, patients' dyskinesias and patients' quality of life.

Objective To explore the effect of extended care on the social function of schizophrenia patients in community rehabilitation.Methods Eighty four cases of schizophrenia were randomly divided into intervention group (Beitang District,40 cases) and control group( Chong’an District, 41cases).All patients received regular drug treatment and health education, and got guildance when discharged.Patients in the intervention group were recived follow-up intervention and telephone interview for 12 months, and bulided the extended care data.Social Disability Screening Schedule ( SDSS ) was used to evalue the social function of patients, and relapse rate and readmission rate were compared between the two groups.Results When discharged 6 months and 12 months, medication adherence and medication management form of the patients in the intervention group were better than that in the control group, the relapse rates in the intervention group were 12.5%, 27.5%, and readmission rates were 7.5%, 17.5%,which lower than 34.1%, 58.5%,26.8%, 48.8%in control group, and the difference was significant (P<0.05).Total scores and partial factors scores of SDSS were lower in the intervention group when dischared 12 months (P<0.05).Conclusions Extended nursing intervention could improve the social function of patients, and reduce relapse rate and readmission rate.

Objective: To carry out the 4^th round of third-party evaluation on the implementation and effect of the 1^st year of the 2^nd Phase National Healthcare Improvement Initiative(abbreviated as Initiative)since 2015. Methods: The 4^th round of the evaluation survey adopted the same methods, organization and execution, and technical roadmap as the former three rounds of evaluations. Results: The 4^th round of evaluation was carried out from 18 March to 9 April, 2019 at 185 public hospitals in 31 provinces(autonomous regions, municipalities directly under the Central Government)and Xinjiang Production and Construction Corps.Facility survey, health professional survey and patient survey were conducted at each of the sample health facilities. A total of 120 782 valid questionnaires were collected from 144 non-psychiatric health facilities, 16 246 valid questionnaires were obtained from 41 psychiatric health facilities, and 252 cases of outstanding departments/hospitals in healthcare improvement were also collected. The average overall scoring of the 12 dimensions to assess Initiative implementation at 144 non-psychiatric health facilities was 84.4%. The overall outpatient satisfaction scoring was 91.1%, 96.7%for the inpatients. The overall inpatient satisfaction(family members inclusive) at 41 psychiatric health facilities was 93%. Areas remaining to be improved include day-surgery, telemedicine and medical social work. Compared with technical services, non-technical care should be further strengthened. The compensation, workload and work environment of the healthcare providers are still to be improved. Conclusions The implementation of the Initiative by health facilities has been greatly improved. The percentage of health facilities and patients who had positive perceptions of improved doctor-patient relationship has been increasing. Patient care experiences at public hospitals have been generally improved, and the implementation of promoting traditional Chinese Medicine practices also made progress. However, work satisfaction of healthcare providers was found to be rather low, compared to the high level of patient satisfaction.