ObjectiveTo compare the application of self-made tumble risk factors assessment scale before and after its revision in patients with mental disorder, in order to guide the clinical work. MethodsWe retrospectively analyzed the clinical data of 2 209 patients with mental disorders who were discharged from the hospital between January 1, 2012 and December 31, 2013. All the patients in our hospital underwent the assessment by "table of tumble risk factors for hospitalized patients and nursing measures" within one hour of admission. A total score of 4 or higher meant high tumble risk, and the standardized intervention measures were taken immediately. In 2013, the assessment scale was revised, and binocular vision disorder, low compliance or communication disorders, restlessness were added as risk factors for tumble. The difference among patients with a tumble score of 4 or higher between the year of 2012 and 2013 was compared and analyzed. ResultsIn 2012, 52 patients had a tumble score of 4 or higher, among whom there were 16 males and 36 females; 35 were younger than 65 years old and 17 were older than 65 years. There were 25 patients with organic mental disorders, 10 with spirit obstacle caused by active substance, 12 with schizophrenia, and 5 other cases. In 2013, 154 patients' tumble score was 4 or higher, among whom there were 58 males and 96 females; 142 were younger than 65 years old and 12 were older than 65. Organic mental disorders occurred in 22 patients, 8 had spirit obstacle caused by active substance, 120 had schizophrenia, and there were 4 other cases. In 2013, the number of patients with a tumble score of 4 or higher were significantly more than that in 2012 and young patients with schizophrenia were also significantly more than in 2012 (P<0.05). There were two cases of tumble adverse events, while no adverse events occurred in tumble in 2013. ConclusionCognitive impairment, low compliance, communication barriers and restlessness are high risk factors for tumble in patients with mental disorders. Correct evaluation and early intervention can effectively prevent the occurrence of tumble.
The interaction mechanism between mental disorders and diabetes is complex, involving genetics, endocrine metabolism, inflammation, oxidative stress and other aspects, which makes it difficult to treat patients with mental disorders complicated by diabetes. Such patients mostly use drugs and non-drug interventions to relieve symptoms of mental disorders and improve blood sugar levels, but the mechanism of mental disorders and diabetes needs to be systematically summarized and needs practical means to intervene. This article starts with the pathogenesis of diabetes and then describes the interaction mechanism of schizophrenia, bipolar disorder, depression and diabetes in detail. Finally, the intervention measures for patients with mental disorders complicated by diabetes are summarized, which aims to provide a reference for medical staff engaged in related work.