1.Case management based on the ICF vocational rehabilitation core set
Chi Wood WOO ; Mang Kit NG ; Tsz Ying CHAN ; Yaru YANG
Chinese Journal of Rehabilitation Theory and Practice 2025;31(2):209-217
ObjectiveTo develop a systematic case management model based on the International Classification of Functioning, Disability and Health (ICF) Vocational Rehabilitation Core Set (VR-CS) and explore its application pathways and efficacy in vocational rehabilitation. The 13 core categories of VR-CS are applied in vocational rehabilitation case management practices, utilizing comprehensive functional assessments to design and implement structured and individualized case management plans. This, in turn, seeks to enhance individuals' vocational independence, social participation and overall quality of life. MethodsThis study adopted a combined approach of theoretical research and empirical case analysis. Based on the 13 core categories of VR-CS, a comprehensive vocational assessment was conducted across three dimensions: body function and structure, activities and participation, and environmental factors. The study theoretically analyzed how to develop and implement holistic and individualized vocational rehabilitation plans, along with dynamic monitoring processes. Three types of typical vocational rehabilitation cases were examined, including individuals with major depressive disorder, high-functioning autism and mild cognitive impairment, to illustrate the evidence and effectiveness of VR-CS-based case management. ResultsThe VR-CS-based case management method, grounded in the ICF bio-psycho-social model, constructed an integrated and individualized case management system. This system combined the assessment and analysis of vocational rehabilitation needs, goal setting and planning, multidisciplinary team intervention, individualized interventions, process monitoring and dynamic adjustments, return-to-work activities, and long-term follow-up services.The case management model developed through VR-CS demonstrated significant and systematic efficacy in promoting vocational independence and social participation. This study provided a detailed analysis of the primary methods and steps involved in designing and implementing case management and elaborates on the practical applications of this model from the three representative cases. At the body function and structure level, case management included the evaluation of energy and drive functions (b130), high-level cognitive training (b164), and the enhancement of exercise tolerance (b455). Case management focused on accurately setting short- and long-term goals around functional limitations and needs. Dynamic monitoring during interventions ensured timely adjustments to intervention measures. This process improved physical endurance and cognitive function, enhanced sustained work capacity in complex vocational environments. At the activities and participation level, the focus was on skill acquisition (d155), stress management and psychological adjustment (d240), and the cultivation of complex interpersonal communication abilities (d720). Individuals engaged in regular professional skills training, role-playing and simulated work scenarios to progressively enhance vocational adaptability and social interaction skills. Through this process, individuals acquired practical skills, gradually boosting self-efficacy and vocational confidence, thereby facilitating the reshaping of their social roles. At the environmental and personal factors level, case management pathways involved active participation from immediate family (e310), positive shifts in societal attitudes (e460), and the effective utilization of health and employment policy resources (e580, e590). By integrating social and community resources comprehensively, the program created a more inclusive and supportive rehabilitation environment. By designing and implementing systematic case management programs, individuals showed significant improvements in psychological well-being, vocational adaptability and social interaction skills. The majority of cases achieved stable employment or continued participation in social activities following the intervention. ConclusionVR-CS provides a systematic, multidimensional and person-centered case management framework. This framework applies the bio-psycho-social model, analyzing individuals' primary functional impairments and vocational rehabilitation needs from the perspectives of body functions, psychological states and environmental factors. On this basis, a comprehensive, targeted and holistic case management plan is developed and implemented. The VR-CS-based case management approach not only enhances vocational capabilities but also improves overall quality of life and social adaptability.
2.Comparison of the effects of Cox regression analysis model and decision tree model in identifying risk factors for the occurrence of hypertension in the elderly
Yaru LI ; Nan WANG ; Zhiwen GE ; Zhengli SHI ; Zhongxin HONG
Journal of Public Health and Preventive Medicine 2024;35(4):24-27
Objective To explore the risk factors for the occurrence of hypertension in middle-aged and elderly residents in China using the Cox regression analysis model and decision tree model, and compare the differences between the two methods. Methods The 2011-2015 China Health and Retirement Longitudinal Study data were used. The study investigated the risk factors for hypertension using both a multivariate Cox regression model and a decision tree model. Results The results showed that the incidence rate of hypertension between 2011-2015 was 22.79%. Both the Cox regression model and decision tree model identified age, education level, body mass index, and diabetes as risk factors for hypertension. The Cox regression model also identified drinking status as a risk factor, while the decision tree model identified gender and marital status as additional risk factors. The area under the curve (AUC) suggested that the Cox regression model and decision tree model had comparable ability to predict hypertension. Conclusions The risk factors for hypertension include gender, age, education level, marital status, alcohol consumption, body mass index, and history of diabetes. The effectiveness of the hypertension prediction model established based on Cox regression model and decision tree model results is not different.
3.Reconstruction of comprehensive vocational rehabilitation service process based on ICF: conceptual framework and approaches
Chi Wood WOO ; Mang Kit NG ; Tsz Ying CHAN ; Yaru YANG
Chinese Journal of Rehabilitation Theory and Practice 2024;30(12):1383-1390
ObjectiveTo reconstruct the vocational rehabilitation service process based on the framework and tools of the International Classification of Functioning, Disability and Health (ICF), to establish a systematic and standardized vocational rehabilitation service system to achieve the integrated development of vocational rehabilitation and other rehabilitation services, and to improve the overall rehabilitation effect and quality of life of people with disabilities. By establishing a systematic and standardized vocational rehabilitation service system, it provides function-oriented, holistic rehabilitation services for the whole person. MethodsThis study adopted the ICF framework and tools to conduct a systematic analysis of the vocational rehabilitation process. Based on this, according to the functional characteristics and systematic application of ICF-based tools, a vocational rehabilitation process was constructed, including functional assessment and rehabilitation goal setting, rehabilitation plan formulation, implementation of multidisciplinary intervention, outcome evaluation and quality of life assessment, and long-term follow-up and support. ResultsBased on the ICF framework and the application of ICF tools, according to the characteristics and nature of work of vocational rehabilitation institutions for persons with disabilities, a five-step vocational rehabilitation process was constructed. The main activity content of each process was defined in detail, and the ICF tools used and the methods of application were determined. The reengineering of the vocational rehabilitation process significantly improved the efficiency and quality of multidisciplinary comprehensive rehabilitation. The ICF framework and tools were the conceptual framework and platform for communication and collaboration among multidisciplinary teams. According to different vocational rehabilitation processes, the normative application of ICF-based tools ensured the development and implementation of scientific and effective rehabilitation intervention programs. The use of ICF-based tools also integrated vocational rehabilitation with other rehabilitation services, and achieved synergy among different rehabilitation services and different rehabilitation institutions. ConclusionThis study reengineered the vocational rehabilitation process based on the ICF framework, and constructed an ICF-based vocational rehabilitation process including the following five key processes, namely functional assessment and rehabilitation goal setting, formulating personalized and holistic rehabilitation plan, multidisciplinary team implementing comprehensive intervention strategies, evaluations of outcome and quality of life, and long-term follow-up and support services. Using the ICF framework and tools, the vocational rehabilitation service process of rehabilitation institutions has been reengineered, and an integrated rehabilitation service system has been constructed to provide a function-oriented comprehensive rehabilitation model, so that people with disabilities could receive whole-person rehabilitation services throughout their life cycle. Establishing a common language and tools based on ICF can effectively improve communication and collaboration among professionals, and also provide standardized tools for cross-institutional service integration, which is conducive to achieve smooth collaboration and information sharing among different rehabilitation institutions, ensuring the smooth transition of people with disabilities between different rehabilitation stages and institutions, and ensuring the coherence and integrity of the rehabilitation process.
4.The mechanism of imatinib on the regulation of lipopolysaccharide-induced acute lung injury in mice through the Nrf2/HO-1 signaling pathway
Duanyang LI ; Yaru LIU ; Zhiqing ZHOU ; Hong YANG ; Xiaolong ZONG ; Zhenyu LI
Chinese Journal of Emergency Medicine 2024;33(8):1104-1109
Objective:To evaluate the effect of imatinib on the endotoxemia-induced acute lung injury in mice.Methods:Sixty SPF male, 8-12 weeks, C57BL/6 mice were randomly (random) divided into 4 groups ( n=15 each): control group (group C), imatinib group (groupⅠ), endotoxemia group (group LPS) and imatinib + endotoxemia group (group I+LPS). The endotoxemia model of acute lung injury was established. After 24 hours, the mice were sacrificed. The pathological changes of lung tissues were evaluated, the lung injury scores were calculated, and the wet/dry ratios of lung tissues were measured. ELISA was used to detect the levels of tumor necrosis factor-α (TNF-α) and interleukin-6 (IL-6) in serum. Detection kits were used to analyze the levels of malondialdehyde (MDA), glutathione (GSH), catalase (CAT), superoxide dismutase (SOD) and the ratio of reduced glutathione to oxidized glutathione (GSH/GSSG) in lung tissues; The expression levels of phosphorylated nuclear factor-kappa B (p-NF-κB), nuclear factor-erythroid 2-related factor 2 (Nrf2) and heme oxygenase-1 (HO-1) in lung tissues were analyzed by western blotting. Results:Compared with the group C, the wet/dry (W/D) ratio of lungs [(3.47±0.41) vs. (5.58±0.47)], lung injury scores [(1.25±0.89) vs. (10.25±1.75)], and the levels of TNF-α and IL-6 in serum increased in the group LPS ( P<0.05). The levels of SOD, CAT, GSH and GSH/GSSG decreased, the level of MDA increased, and the expression of p-NF-κB, Nrf2 and HO-1 protein up-regulated ( P<0.05). Compared with the LPS group, the W/D ratio of lungs [(5.58±0.47) vs.(4.62±0.38)] and lung injury scores [(10.25±1.75) vs. (7.00±1.31)] in the I+LPS group decreased ( P<0.05), and the levels of TNF-α and IL-6 in the serum decreased ( P<0.05). In lung tissues, the levels of SOD, CAT, GSH and GSH/GSSG increased (all P<0.05), the level of MDA decreased (all P<0.05), the expression of p-NF-κB protein decreased, and the expression of Nrf2 and HO-1 protein increased ( P<0.05). Conclusions:Imatinib improves sepsis-induced acute lung injury in mice, and the mechanism of actions behind may be related to the inhibition of oxidative stress.
5.Current situation and relevant factors of evidence-based nursing competence of oncology nurse specialists
Yaru ZHANG ; Hong YANG ; Yuhan LU ; Qi CHEN
Chinese Journal of Modern Nursing 2024;30(2):222-227
Objective:To explore the current situation of evidence-based nursing competence of oncology nurse specialists and its influencing factors, so as to provide reference for conducting oncology nurse specialist training courses.Methods:From October 12th to 20th, 2022, convenience sampling was used to select oncology nurse specialists from Beijing as the research subject. The survey was conducted using the General Information Questionnaire, Oncology Nurse Specialists ' Cognition and Training Questionnaire on Evidence-based Nursing, Evidence-based Nursing Competence Scale, Nurse Innovative Behavior Scale, short versions of the Evidence-based Practice (EBP) Beliefs Scale, the EBP Implementation Scale, and the EBP Organizational Culture and Readiness Scale. Single factor analysis and multiple linear regression were used to explore the influencing factors of evidence-based nursing competence of oncology nurse specialists. Results:A total of 183 oncology nurse specialists were included. The scores of evidence-based nursing competence and innovative behavior of nurses were 53 (39, 65) and 30 (25, 33) respectively. The scores of the EBP Beliefs Scale, the EBP Implementation Scale, and the EBP Organizational Culture and Readiness Scale were 9 (8, 10), 9 (7, 9), and 9 (6, 9), respectively. Multiple linear regression analysis showed that the main influencing factors of evidence-based nursing competence of oncology nurse specialists were nurse innovation behavior, evidence-based practice organizational culture and readiness, frequency of reading specialized literature, and duration of evidence-based nursing training ( P<0.05), which could explain 34.6% of the total variation. Conclusions:The evidence-based nursing competence of oncology nurse specialists needs to be improved. It is recommended that hospitals or nursing managers create an excellent research atmosphere, encourage innovation, enrich evidence-based database resources, and carry out evidence-based nursing training and practice to enhance nurses ' evidence-based nursing competence.
6.Risk Prediction Model for Radiation-induced Dermatitis in Patients with Cervical Carcinoma Undergoing Chemoradiotherapy
Hong YANG ; Yaru ZHANG ; Fanxiu HENG ; Wen LI ; Yumei FENG ; Jie TAO ; Lijun WANG ; Zhili ZHANG ; Xiaofan LI ; Yuhan LU
Asian Nursing Research 2024;18(2):178-187
Purpose:
Radiation-induced dermatitis (RD) is a common side-effect of therapeutic ionizing radiation that can severely affect patient quality of life. This study aimed to develop a risk prediction model for the occurrence of RD in patients with cervical carcinoma undergoing chemoradiotherapy using electronic medical records (EMRs).
Methods:
Using EMRs, the clinical data of patients who underwent simultaneous radiotherapy and chemotherapy at a tertiary cancer hospital between 2017 and 2022 were retrospectively collected, and the patients were divided into two groups: a training group and a validation group. A predictive model was constructed to predict the development of RD in patients who underwent concurrent radiotherapy and chemotherapy for cervical cancer. Finally, the model's efficacy was validated using a receiver operating characteristic curve.
Results:
The incidence of radiation dermatitis was 89.5% (560/626) in the entire cohort, 88.6% (388/438) in the training group, and 91.5% (172/188) in the experimental group. The nomogram was established based on the following factors: age, the days between the beginning and conclusion of radiotherapy, the serum albumin after chemoradiotherapy, the use of single or multiple drugs for concurrent chemotherapy, and the total dose of afterloading radiotherapy. Internal and external verification indicated that the model had good discriminatory ability. Overall, the model achieved an area under the receiver operating characteristic curve of .66.
Conclusions
The risk of RD in patients with cervical carcinoma undergoing chemoradiotherapy is high. A risk prediction model can be developed for RD in cervical carcinoma patients undergoing chemoradiotherapy, based on over 5 years of EMR data from a tertiary cancer hospital.
7.Construction of basic rehabilitation training course for family doctor teams serving for people with disabilities based on WHO rehabilitation competency framework
Xiulian YANG ; Jian QIN ; Yuantao XIAN ; Hongliang LIU ; Yaru YANG ; Youyu XIANG ; Jie LUO ; Shixun ZHONG ; Yu ZHONG ; Sujun ZHOU ; Hong SU ; Hongmei XIAO ; Xinjian ZHOU
Chinese Journal of Rehabilitation Theory and Practice 2023;29(11):1249-1260
ObjectiveTo develop basic training courses for family doctor teams for people with disabilities. MethodsUtilizing the methods and theories of the World Health Organization (WHO) rehabilitation competency framework (RCF), and referring to the WHO universal health coverage global competency framework, the rehabilitation competency characteristics of family doctor teams for people with disabilities in community settings were analyzed, and a basic training course system for these teams based on the RCF was developed. Results and ConclusionBased on RCF, a competency framework for family doctor teams serving people with disabilities has been constructed. The objectives, content and training course system for basic rehabilitation training has been established.
8.Interleukin-8 antagonist down regulates the adhesion and migration of retinal vascular endothelial cells by inhibiting the production of reactive oxygen species
Linni WANG ; Jingjing CAO ; Dongjun XING ; Rongguo YU ; Liying HU ; Yang YANG ; Chang LI ; Zhiqing LI ; Hui LI ; Yaru HONG ; Lijie DONG
Chinese Journal of Ocular Fundus Diseases 2023;39(11):913-917
Objective:To observe the effect of interleukin-8 (IL-8) on the adhesion and migration of retinal vascular endothelial cells (RCEC).Methods:A cell experiment. Human RCEC (hRCEC) was divided into normal control group (N group), advanced glycation end product (AGE) treatment group (AGE group), and AGE-induced combined IL-8 antagonist SB225002 treatment group (AGE+SB group). The effect of AGE on IL-8 expression in hRCEC was observed by Western blot. The effect of SB225002 on hRCEC migration was observed by cell scratch assay. The effects of SB225002 on leukocyte adhesion and reactive oxygen species (ROS) on hRCEC were detected by flow cytometry. Student- t test was performed between the two groups. Oneway analysis of variance was performed among the three groups. Results:Compared with group N, the expression level of IL-8 in cells of AGE group was significantly increased, with statistical significance ( t=25.661, P<0.001). Compared with N group and AGE+SB group, cell mobility in AGE group was significantly increased ( F=29.776), leukocyte adhesion number was significantly increased ( F=38.159, 38.556), ROS expression level was significantly increased ( F=22.336), and the differences were statistically significant ( P<0.05). Conclusion:IL-8 antagonist SB225002 may down-regulate hRCEC adhesion and migration by inhibiting ROS expression.
9.The Effect of Baduanjin on Sleep Quality of College Students with Yang Deficiency
Hong ZOU ; He XIAO ; Yaru WANG ; Jiaxing ZHU ; Shuo QI ; Jin HE ; Adili ALIMIRAN ; Wu LI
Chinese Journal of Sports Medicine 2023;42(12):948-952
Objective To observe the effect of Baduanjin on the sleep quality of college students with Yang deficiency.Methods Forty college students with Yang deficiency and sleep quality problems were randomly divided into a control group and a Baduanjin group,each of 20.Both groups received health education,while the Baduanjin group additionally practiced daily 60-minute Baduanjin at least 4 times a week for 10 weeks.Before and after the intervention,the Yang deficiency physical transfor-mation score and Pittsburgh sleep quality index(PSQI)of both groups were observed,and their correla-tion was analyzed.Results After the intervention,the average Yang deficiency physical transformation score of the Baduanjin group decreased significantly compared with before the intervention and the con-trol group at the same time point(P<0.01 for both).Moreover,after the intervention,the average total PSQI scores and scores of all dimensions except the sleep time and sleep efficiency of the Baduanjin group were significantly lower than those before that,and the control group at the same time point(P<0.05 for both).The total PSQI scores and scores except sleep time and sleep efficiency in the Baduan-jin group after the intervention were lower than those in the control group at the same time(P<0.05).However,no significant differences were found in all the measurements of the control group before and after the intervention(P>0.05).In addition,there was a significant positive correlation between the change in the Yang deficiency physical transformation score and the total PSQI in the Baduanjin group before and after intervention(P<0.05),but not in the control group.Meanwhile,the total effective rate of the Baduanjin group was significantly higher than the control group(P<0.05).Conclusion Practicing Baduanjin can effectively improve the sleep quality of college students with Yang deficiency and their biased Yang deficiency constitution,and their improvement is of positive correlation.
10.Application of ICF in occupational therapy: conceptual framework and approaches
Xiaolong YANG ; Yaru YANG ; Fubing QIU ; Fengyi GUO ; Kam Man WONG ; Lei CAO ; Tiantian ZHANG ; Weiqun SONG
Chinese Journal of Rehabilitation Theory and Practice 2022;28(6):621-629
ObjectiveTo study the conceptual framework and methodological system of the International Classification of Functioning, Disability and Health (ICF) in occupational therapy and its systematic implementation in clinical practice. MethodsBased on the ICF theory and the policy documents of the World Federation of Occupational Therapists, the conceptual framework of occupational therapy and the systematic implementation in clinical settings based on the ICF framework were analyzed. ResultsThis study constructed a conceptual framework and approach for occupational therapy based on ICF, and clarified the goals, principles, and implementation methods of integrated occupational therapy interventions in rehabilitation services. The goal of occupational therapy interventions was to improve the individual activity and participation through multidisciplinary and cross-cutting implementation of integrated occupational therapy programs to optimize functioning. Occupational therapy was based on the bio-psycho-social model, adhered to the principles of person-centeredness and functioning orientation, and implemented individualized intervention programs in different context. In clinical practice, it was recommended to follow ICF-based standardized process and systematically use World Health Organization Family International Classifications: functioning and unmet needs analysis using ICHI; functional classification, assessment and coding using ICF; disease classification, diagnosis and coding using ICD; intervention of occupational therapies using ICHI to build a systematic occupational therapy service system. ConclusionAn ICF-based occupational therapy concept and methodological system has been built, a comprehensive clinical occupational therapy implementation model has been established, the goal of activity and participation oriented occupational therapy interventions has been clarified, and the systematic, structured, standardized and refined level of occupational therapy has been enhanced.


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