| ObjectiveThrough the semi-structured interview,the existing problems,development needs and chronic diseases to be developed of the home care for chronic diseases in the PPP mode care institutions were understood,and the chronic diseases were selected.Then,through the literature research,the effective measures of home care for the elderly with chronic diseases in the community were understood,so as to construct the home care plan based on PPP mode for the elderly with chronic diseases in the community(the first draft).Five experts were invited to give guidance,and then through repeated modification and improvement,the final version of the home care plan based on PPP mode for the elderly with chronic diseases in the community was formed.Finally,community practice was carried out to verify the effectiveness and feasibility of the plan,so as to provide reference for the PPP mode care institutions to carry out home care for the elderly with chronic diseases.Methods1.Construction of the home care plan based on PPP mode for the elderly with chronic insomnia in the community(1)Semi-structured interview method: An interview team was set up,and an interview outline was drawn up based on the purpose of the study and the actual situation.6 principals of the PPP mode care institutions were interviewed.The recordings were recorded within 12 hours after the interviews,and the interview data were analyzed by Colaizzi’s seven-step analysis method.(2)Literature research method: Keywords and subject headings were combined to search related literatures at domestic and foreign common databases,Literature related to the elderly with chronic insomnia of was searched,and effective care measures were analyzed to lay a foundation for the construction of home care plan.(3)Expert guidance: An expert guidance meeting was held,and 5 experts from the fields of rehabilitation,acupuncture and massage,traditional Chinese medicine,and geriatric care were invited to guide the first draft of home care plan based on PPP mode for the elderly with chronic insomnia in the community,and then experts were invited to check and modify the electronic version of the plan after the meeting.2.Practice of the home care plan based on PPP mode for the elderly with chronic insomnia of in the communityThe home care plan based on PPP mode for the elderly with chronic insomnia of in the community is applied.The draw method is adopted to choose two communities in chengdu as practice research sites,and they were divided into the experimental group and the control group,then,76 elderly patients with chronic insomnia who met the study conditions were included by convenience sampling method.The experimental group adopted the home care plan based on PPP mode for the elderly with chronic insomnia in the community,the control group adopted the regular care plan for the elderly with chronic insomnia of in the community,and the intervention lasted for 6weeks.Before and after the intervention,data were collected by members of the research group,including the general data of patients,Pittsburgh Sleep Quality Index(PSQI),TCM symptom score,and The World Health Organization Quality of Life Questionnaire-BREF(WHOQOL-BREF),and SPSS 24.0 was used to compare the collated data within and between groups.Results1.Construction of the home care plan based on PPP mode for the elderly with chronic insomnia in the community(1)Semi-structured interview:6 principals of the PPP mode care institutions were interviewed,the existing problems,needs,orientation and role of institutions in carrying out home care for the elderly with chronic diseases were understanded,and the chronic diseases of this study were determined: chronic insomnia.(2)Literature research: Through literature review and analysis,we understand the research situation of the elderly with chronic insomnia in China and the current situation of home care research,and summarized 15 main effective care measures for the elderly with chronic insomnia.(3)Content of the plan:The plan is oriented to the needs of the PPP care institutions,it included the purpose,function,service content,technical standards,services included health guidance,disease consultation,rehabilitation and nursing technology,emergency services,referral,disease regulatory,and life care.This plan enriched the home care content of the elderly with chronic insomnia in community,and focused on the improvement of disease knowledge level and disease management ability of patients and their families.And the plan integrated TCM characteristics into disease regulatory,health guidance,disease consultation,rehabilitation and nursing technology and other aspects of the plan,so as to meet the diverse needs of the elderly with chronic diseases,and provided reference for PPP mode care institutions.2.Practice of the home care plan based on PPP mode for the elderly with chronic insomnia in the community(1)Baseline information:According to the inclusion and exclusion criteria,76 cases of elderly patients with chronic insomnia were finally included,including 38 cases in the experimental group and 38 cases in the control group.During the implementation of the project,3 cases of abscission in the experimental group and 4cases of abscission in the control group,and a total of 69 cases of chronic insomnia patients in the community completed this study.Before intervention,there were no statistically significant differences between the two groups in general conditions such as education level,marital status,living style,number of other chronic diseases,and payment method of medical expenses(P>0.05);and there were no statistical differences in PSQI score,TCM symptom score,quality of life and other sleep-related aspects(P>0.05).(2)Pittsburgh Sleep Quality Index information:After intervention,the PSQI scores of the experimental group and the control group were statistically different(P<0.05),and the score of the experimental group was lower than that of the control group.In the experimental group,there was statistically different in PSQI score before and after intervention(P<0.05),and the PSQI score of post-intervention was lower than that of pre-intervention;However,in the control group,there was no statistical difference in PSQI score before and after intervention(P>0.05).(3)TCM symptom score information:After intervention,the TCM symptom score of the experimental group and the control group were statistically different(P<0.05),and the score of the experimental group was lower than that of the control group.In the experimental group,there was statistically different in TCM symptom score before and after intervention(P<0.05),and the score of post-intervention was lower than that of pre-intervention;However,in the control group,there was no statistical difference in TCM symptom score before and after intervention(P>0.05).(4)Quality of life information:In the experimental group,there was statistically significant difference in the total score of quality of life before and after intervention(P<0.05),and the score of post-intervention was higher than that of pre-intervention,In the control group,there was no statistically significant difference in the total score of quality of life before and after intervention(P>0.05).In the experimental group,there were statistically significant differences in the scores of three aspects of physiology,psychology and environment before and after intervention(P<0.05),and the scores of post-intervention were higher than that of pre-intervention,in the field of social relations of the experimental group,there was no statistically significant difference before and after intervention(P>0.05).However,in the control group,there were no statistically significant differences in all fields before and after the intervention(P>0.05).ConclusionsThrough the semi-structured interview,the existing problems,development needs and chronic diseases to be developed of the home care for chronic diseases in the PPP mode care institutions were understood,and the chronic diseases were selected.And then combined with the literature research method and expert guidance to build the home care plan based on PPP mode for the elderly with chronic insomnia in the community,the construction method of the plans was reasonable,and the content was detailed and rich.Practice has proved that the home care plan based on PPP mode for the elderly with chronic insomnia in the community was helpful to improve the sleep quality and TCM symptoms of the elderly with chronic insomnia in the community,and was beneficial to improve the quality of life.It has strong feasibility and can provide reference for the PPP mode care institutions. |
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