Collaborating sites for community-oriented integrated care and health promotion

Effects of Cognitive Nursing Combined with Continuous Nursing on Postpartum Mental State and Rehabilitation

Purpose

This study is aimed at exploring the effects of cognitive nursing combined with continuous nursing on postpartum mental state and rehabilitation.

Methods

Totally, 124 puerperas admitted to our hospital from January 2019 to January 2020 were selected and divided into a research group and a control group according to different nursing methods, with 62 cases in each group. The control group received routine care, while the research group received cognitive nursing combined with continuous nursing on this basis. The mental state, rehabilitation indicators, quality of life, incidence of complications, and nursing satisfaction were compared between the two groups after intervention.

Results

Before nursing, there was no statistically significant difference in the SAS and SDS scores between the two groups (P > 0.05); after intervention, the SAS and SDS scores of the two groups were significantly reduced, and those of the research group were lower than those of the control group (P < 0.05). After intervention, the time of the first breastfeeding, duration of lochia rubra, length of hospital stay, and score of uterine contraction pain of the research group were lower than those of the control group (P < 0.05); the psychological function, physical function, material life, and social function scores of the research group were higher than those of the control group (P < 0.05); the incidence of complications in the research group was 4.84%, lower than 20.97% in the control group (P < 0.05); the nursing satisfaction of the research group was 96.77%, which was significantly higher than 83.87% in the control group (P < 0.05).

Conclusions

Cognitive nursing combined with continuous nursing can effectively improve the mental state, shorten the length of hospital stay, increase the perceived well-being, and promote the physical rehabilitation in puerperas, which is worth promoting in clinical practice.

Community-Enhanced Social Prescribing: Integrating Community in Policy and Practice

The NHS Plan is introducing social prescribing link workers into GP surgeries in England. The link workers connect people to non-health resources in the community and voluntary sector, with the aim of meeting individual needs beyond the capacity of the NHS. Social prescribing models focus on enhancing individual wellbeing, guided by the policy of universal personalised care. However, they largely neglect the capacity of communities to meet individual need, particularly in the wake of a decade of austerity. We propose a model of community enhanced social prescribing (CESP) which has the potential to improve both individual and community wellbeing. CESP combines two evidence-informed models - Connected Communities and Connecting People - to address both community capacity and individual need. CESP requires a literacy of community which recognises the importance of communities to individuals and the importance of engaging with, and investing in, communities. When fully implemented the theory of change for CESP is hypothesised to improve both individual and community wellbeing.

Evaluating case studies of community-oriented integrated care

This paper summarises a ten-year conversation within London Journal of Primary Care about the nature of community-oriented integrated care (COIC) and how to develop and evaluate it. COIC means integration of efforts for combined disease-treatment and health-enhancement at local, community level. COIC is similar to the World Health Organisation concept of a Community-Based Coordinating Hub - both require a local geographic area where different organisations align their activities for whole system integration and develop local communities for health. COIC is a necessary part of an integrated system for health and care because it enables multiple insights into 'wicked problems', and multiple services to integrate their activities for people with complex conditions, at the same time helping everyone to collaborate for the health of the local population. The conversation concludes seven aspects of COIC that warrant further attention.

Towards a strategic alignment of public health and primary care practices at local levels - the case of severe and enduring mental illness

The rapidly increasing number of people who have long-term conditions requires a system of coordinated support for self-care throughout the NHS. A system to support self-care needs to be aligned to systems that support shared-care and community development, making it easier for the multidisciplinary teams who provide care to also help patients and populations to help themselves. Public health practitioners need to work closely with clinicians to achieve this. The best place to coordinate this partnership is a community-based coordinating hub, or local health community - a geographic area of about 50,000 population where different contributions to self-care can be aligned. A shared vision for both health and disease management is needed to ensure consistent messaging by all. A three tier system of shared care can help to combine vertical and horizontal integration. This paper uses severe and enduring mental illness as an exemplar to anticipate the design of such a system.