Bao Dong-Ying, Wu Lin-Yan, Cheng Qi-Yan
Department of Cardiology, Jiangyin Hospital of Traditional Chinese Medicine, Jiangyin 214400, Jiangsu Province, China.
Department of Endocrinology, Jiangyin Hospital of Traditional Chinese Medicine, Jiangyin 214400, Jiangsu Province, China.
World J Clin Cases. 2024 Jul 16;12(20):4065-4073. doi: 10.12998/wjcc.v12.i20.4065.
The Comprehensive Geriatric Assessment (CGA) was introduced late in China and is primarily used for investigating and evaluating health problems in older adults in outpatient and community settings. However, there are few reports on its application in hospitalized patients, especially older patients with diabetes and hypertension.
To explore the nursing effect of CGA in hospitalized older patients with diabetes and hypertension.
We performed a retrospective single-center analysis of patients with comorbid diabetes mellitus and hypertension who were hospitalized and treated in the Jiangyin Hospital of Traditional Chinese Medicine between September 2020 and June 2022. Among the 80 patients included, 40 received CGA nursing interventions (study group), while the remaining 40 received routine nursing care (control group). The study group's comprehensive approach included creating personalized CGA profiles, multidisciplinary assessments, and targeted interventions in areas, such as nutrition, medication adherence, exercise, and mental health. However, the control group received standard nursing care, including general and medical history collection, fall prevention measures, and regular patient monitoring. After 6 months of nursing care implementation, we evaluated the effectiveness of the interventions, including assessments of blood glucose levels fasting blood glucose, 2-h postprandial blood glucose, and glycated hemoglobin, type A1c (HbA1c); blood pressure indicators such as diastolic blood pressure (DBP) and systolic blood pressure (SBP); quality of life as measured by the 36-item Short Form Survey (SF-36) questionnaire; and treatment adherence.
After 6 months, the nursing outcomes indicated that patients who underwent CGA nursing interventions experienced a significant decrease in blood glucose indicators, such as fasting blood glucose, 2-h postprandial blood glucose, and HbA1c, as well as blood pressure indicators, including DBP and SBP, compared with the control group ( < 0.05). Quality of life assessments, including physical health, emotion, physical function, overall health, and mental health, showed marked improvements compared to the control group ( < 0.05). In the study group, 38 patients adhered to the clinical treatment requirements, whereas only 32 in the control group adhered to the clinical treatment requirements. The probability of treatment adherence among patients receiving CGA nursing interventions was higher than that among patients receiving standard care (95% 80%, < 0.05).
The CGA nursing intervention significantly improved glycemic control, blood pressure management, and quality of life in hospitalized older patients with diabetes and hypertension, compared to routine care.
综合老年评估（CGA）在中国引入较晚，主要用于门诊和社区环境中调查和评估老年人的健康问题。然而，关于其在住院患者，尤其是老年糖尿病和高血压患者中的应用报道较少。
探讨CGA对住院老年糖尿病和高血压患者的护理效果。
我们对2020年9月至2022年6月期间在江阴市中医医院住院治疗的糖尿病和高血压合并症患者进行了一项回顾性单中心分析。在纳入的80例患者中，40例接受了CGA护理干预（研究组），其余40例接受常规护理（对照组）。研究组的综合方法包括创建个性化的CGA档案、多学科评估以及在营养、药物依从性、运动和心理健康等领域的针对性干预。然而，对照组接受标准护理，包括收集一般和病史、预防跌倒措施以及定期患者监测。在实施护理6个月后，我们评估了干预措施的有效性，包括评估血糖水平（空腹血糖、餐后2小时血糖和糖化血红蛋白A1c（HbA1c））；血压指标，如舒张压（DBP）和收缩压（SBP）；通过36项简短调查问卷（SF-36）测量的生活质量；以及治疗依从性。
6个月后，护理结果表明，与对照组相比，接受CGA护理干预的患者在空腹血糖、餐后2小时血糖和HbA1c等血糖指标以及DBP和SBP等血压指标方面均有显著下降（P<0.05）。包括身体健康、情绪、身体功能、总体健康和心理健康在内的生活质量评估显示，与对照组相比有明显改善（P<0.05）。在研究组中，38例患者遵守了临床治疗要求，而对照组中只有32例遵守了临床治疗要求。接受CGA护理干预的患者治疗依从性的概率高于接受标准护理的患者（95% 对80%，P<0.05）。
与常规护理相比，CGA护理干预显著改善了住院老年糖尿病和高血压患者的血糖控制、血压管理和生活质量。
