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Background Follow-up is a necessary step in the management of chronic disease patients. Cloud follow-up as a new form of follow-up may improve the quality of follow-up. However, there is currently a lack of patient-oriented evaluation tools for cloud follow-up service quality. Objective To develop a scale for evaluating the service experience of chronic disease patients in cloud follow-up and to examine its reliability and validity, in order to provide a tool for evaluating the quality of cloud follow-up services. Methods Guided by the service quality evaluation model, the scale was developed by using methods including literature review, semi-structured interview, expert consultation. During August to October 2022, a survey was conducted among chronic disease patients (n=480) discharged from a tertiary hospital and lived under the network of a community service center in Hangzhou, China. Item analysis and tests of reliability and validity were test on the developed scale. Results The developed scale for evaluating the service experience of chronic disease patients in cloud follow-up had 37 items distributed in 5 dimensions. Patients' perceptions and expectations to each item were evaluated simultaneously. The overall Cronbach's α coefficient of the developed scale was 0.962, with split-half reliability of 0.732 and test-retest reliability of 0.844. The content validity index of the scale was 0.980. The correlation coefficient between the scale and satisfaction scores was 0.754 (P

BackgroundIt's necessary to pay urgent attention to the quality of the integration of medical treatment-nursing-rehabilitation in the service promotion process, especially the evaluation from the perspective of patients is lacking.ObjectiveTo investigate patients' perspective on the quality of integration of medical treatment-nursing-rehabilitation for chronic disease patients in the community in Hangzhou, to provide help for improving the quality of such services.MethodsA questionnaire survey was conducted from June to September 2020 with 550 chronic disease patients selected by convenient sampling method from the service population of 10 community health centers in five major urban districts (Jianggan, Gongshu, Xihu, Shangcheng, and Xiacheng Districts) of Hangzhou, Zhejiang Province, for collecting their general demographic information, and diseases and treatment-related information, as well as experience of receiving integration of medical treatment-nursing-rehabilitation (using the Chinese version of SERVQUAL Scale consisting of effectiveness, responsiveness, reliability, communication and empathy) .ResultsA total of 525 (95.5%) of the respondents returned responsive questionnaire. Among 525 patients with chronic diseases, 165 (31.4%) were satisfied with integration of medical treatment-nursing-rehabilitation. The patients' total average score of the service perception (5.14±0.44) did not reach their expected level (6.80±0.01) . From high to low the scores of each dimension were reliability (5.69±0.87) , effectiveness (5.43±0.85) , empathy (5.13±1.81) , communication (4.86±1.53) , responsiveness (4.77±0.98) . There was tiny difference among the scores of each dimension of the service expectation. The largest gap between perception and expectation was responsiveness (-2.01±0.14) and the smallest was reliability (-1.11±0.17) . Excluding the 20 "other" respondents in the satisfaction survey, a total of 505 respondents were analyzed by Spearman rank correlation. The results showed that the patients' service satisfaction was positively correlated with the service perception level in terms of total average score (rs=0.741, P

The problem of health and pension in an aging society is becoming increasingly acute. Under the promotion of Chinese policy of combining medical care with nursing care and the hierarchical diagnosis and treatment system. Hangzhou City, Zhejiang Province, has pioneered integrated medical-elderly-nursing services to meet the healthcare needs of an aging society. The initial effects of the services have been shown, but there are so many influencing factors associated with the delivery. And the relevant influencing factors are lack of systematic and comprehensive analysis. Therefore, summarizing the factors associated with the implementation of the services and described them in terms of five aspects (intervention characteristics, outer setting, inner setting, characteristics of individuals, process) with the help of Consolidated Framework for Implementation Research. The major facilitators to implementing IMSs were as follows: diversified and individualized services, close and long-term cooperation between the healthcare institution delivering IMSs and other institutions in the regional medical consortium, clear determination of the duties of each member in the service team, incentives from hospital or other institutions. The major barriers were: lack of flexibility and ignoring individual characteristics in delivering some services, for example, health management; inadequate levels of diagnosis and treatment; insufficient workers, equipment, and drugs.

Purpose: Coronary artery disease (CAD) patients frequently face readmissions due to suboptimal disease management. Prediction models are pivotal for detecting early unplanned readmissions. This review offers a unified assessment, aiming to lay the groundwork for enhancing prediction models and informing prevention strategies. Methods: A search through five databases (PubMed, Web of Science, EBSCOhost, Embase, China National Knowledge Infrastructure) up to September 2023 identified studies on prediction models for coronary artery disease patient readmissions for this review. Two independent reviewers used the CHARMS checklist for data extraction and the PROBAST tool for bias assessment. Results: From 12,457 records, 15 studies were selected, contributing 30 models targeting various CAD patient groups (AMI, CABG, ACS) from primarily China, the USA, and Canada. Models utilized varied methods such as logistic regression and machine learning, with performance predominantly measured by the c-index. Key predictors included age, gender, and hospital stay duration. Readmission rates in the studies varied from 4.8% to 45.1%. Despite high bias risk across models, several showed notable accuracy and calibration. Conclusion: The study highlights the need for thorough external validation and the use of the PROBAST tool to reduce bias in models predicting readmission for CAD patients. [ABSTRACT FROM AUTHOR]

Objective: To assess the association between interpregnancy interval (IPI) and gestational diabetes mellitus (GDM). Methods: Data of this retrospective cohort study were obtained from the National Vital Statistics System (NVSS) 2020. The participants were divided into different groups according to different IPI (<6, 6–11, 12–17, 18–23, 24–59 (reference), 60–119, ≥120 months). Multivariate logistic models were constructed to evaluate the association between IPI and GDM. Subgroup analysis was further performed. Results: A total of 1 515 263 women were included, with 123 951 (8.18%) having GDM. Compared with the 24–59 months group, the <6 months (odds ratio [OR] 0.64, 95% confidence interval [CI] 0.46–0.90, P = 0.009), 12–17 months (OR 0.96, 95% CI 0.94–0.98, P < 0.001), and 18–23 months (OR 0.94, 95% CI 0.93–0.96, P < 0.001) groups had a significantly lower risk of GDM, while the 60–119 months (OR 1.13, 95% CI 1.11–1.15, P < 0.001) and ≥120 months (OR 1.18, 95% CI 1.15–1.21, P < 0.001) groups had a significantly higher risk of GDM. No significant difference was observed in the risk of GDM between the 6–11 and 24–59 months groups (P = 0.542). The PI–GDM association varied across different groups of age, pre‐pregnancy body mass index, pre‐pregnancy smoking status, history of cesarean section, history of preterm birth, prior terminations, and parity. Conclusion: An IPI of 18–23 months may be a better interval than 24–59 months in managing the risk of GDM. Synopsis: A period of 18–23 months may be a better interpregnancy interval than 24–59 months in managing the risk of gestational diabetes mellitus. [ABSTRACT FROM AUTHOR]

The micronucleus test (MNT) is the most widely applied short‐term assay to detect clastogens or spindle disruptors. The use of flow cytometry (FCM) has been reported for micronucleated erythrocytes scoring in peripheral blood. The aim of this study was to develop a novel and practical protocol for MNT in rat peripheral blood by FCM, with the method validation. CD71‐fluorescein isothiocyanate and DRAQ5 were adopted for the fluorescent staining of proteins and DNA, respectively, to detect micronuclei. To validate the method, groups of male Sprague–Dawley rats (five per group) received two oral gavage doses at 0 and 24 h of six chemicals (four positive mutagens: ethyl methanesulphonate [EMS], cyclophosphamide [CP], colchicine [COL], and ethyl nitrosourea [ENU]; two nongenotoxic chemicals: sodium saccharin and eugenol). Blood samples were collected from the tail vein before and on the five continuous days after treatments; all of which were analyzed for micronuclei presence by both the manual (Giemsa staining) and FCM methods. The FCM‐based method consistently demonstrated highly sensitive responses for micronucleus detection at all concentrations and all time points for EMS, CP, COL, and ENU. Sodium saccharin and eugenol could be identified as negative in this protocol. Results obtained with the FCM‐based method correlated well with the micronucleus frequencies (r = 0.659–0.952), and the proportion of immature erythrocytes (r = 0.915–0.981) tested by Giemsa staining. The method reported here, with easy operation, low background, and requirement for a regular FCM, could be an efficient system for micronucleus scoring. The objective of this study was to develop a novel and practical protocol for the micronucleus test in rat peripheral blood by flow cytometry (FCM), followed by method validation. Male Sprague–Dawley rats were treated at 24‐h intervals by gavage with six chemicals (ethyl methanesulphonate [EMS], cyclophosphamide [CP], colchicine [COL], ethyl nitrosourea [ENU], sodium saccharin, and eugenol). The method reported here, with easy operation, low background, and requirement for a regular FCM, could be an efficient system for micronucleus scoring. [ABSTRACT FROM AUTHOR]