Objective To investigate the effect of training courses of evidence-based medicine (EBM) on the knowledge, skill, attitude and behavior of medical postgraduates and to explore the barriers to evidence-based practice (EBP), so as to provide knowledge to improve further EBM teaching and EBP. Methods A total of 110 medical postgraduates of Sichuan University who selected EBM courses in the autumn semester of 2004 were given questionnaires that combined both open and closed questions. The KAB (knowledge, attitude and behavior) of EBM and barriers to EBP were compared before and after the training courses. Results Differences were observed in KAB of EBM and barriers to EBP after the training courses, compared to the assessments done before the courses. In “Knowledge”: there was a significant increase in the understanding of specific terms in EBM after the training courses (75% of the items showed a statistically significant improvement). This was especially marked for “absolute risk”, “systematic review”, “meta-analysis” and “publication bias” (Plt;0.01). We also found an improvement in familiarity with medical search engines (Plt;0.05). In “Attitude”: the mean scores for most items (55%) were relatively high both before and after the training courses (gt;4), and a significant improvement was observed in 2 items. These were “Strong evidence is lacking to support most of the interventions I use with my patients” and “EBP needs to take into account patient preferences” (Plt;0.01). The mean scores of 2 items were relatively low both before and after the training courses (lt;3). These were “the adoption of EBP places an reasonable demand on physical therapists” and “EBP does not take into account the limitations of my clinical setting”. Another 2 items had mean scores close to 5: “I need to increase the use of evidence in my daily practice” and “I am interested in learning or improving the skills necessary to incorporate EBP into my practice”. In terms of “Behavior”: the medical postgraduates continued not to think highly of the use of literature after the training courses. About 60% of the postgraduates did not read any literature related to their specialties at all. Although searching of MEDLINE and other electronic databases was relatively frequent (gt;6 times/month: 60.3% before training and 65.7% after training), using professional literature and research findings in the process of clinical decision-making was not equal (gt;6 times/month: 29% before training and 35.1% after training). No significant difference was observed in applying clinical practice guidelines before and after the training courses. As for “Barriers”: the postgraduates considered “poor ability to critically appraise literature” as the most important barrier both before and after the training courses. The second and third most important barriers were different compared to after the training courses. The barrier of “lack of research skills” was larger than that of “lack of information resources” before the training courses, but after that the course, the order of these was reversed. Conclusion The knowledge of medical postgraduates increased significantly after the current training courses of EBM. Some improvement was also found in attitude and behavior. The top three barriers to EBP were “Poor ability to critically appraise literature”, “Lack of information resources”, and “Lack of research skills”
目的 了解社区人群对脑卒中危险因素及症状的知晓现状。 方法 随机抽样调查1 208名居民及112名医务人员的人口学特征、对危险因素及预警信号的知晓现状及其影响因素、信息来源及需求情况。 结果 90.1%、100.0%的居民及医务人员可辨识高血压是卒中的危险因素，而社区居民及医务人员对年龄、糖尿病、吸烟等危险因素的认识比例分别为65.0% 和85.0%，且对危险因素的控制策略缺乏了解。87.4%、100.0%社区居民及医务人员将一侧肢体的活动障碍作为卒中的第一大预警信号，其次为头晕、步态不稳、头痛、言语困难、视物模糊。卒中知识得分的单因素及多因素分析示：大学文化、已婚且在职的居民及高学历的医务人员对卒中信息的了解程度高。卒中信息的获取途径依次为电视、社区医生/讲堂、报纸、杂志、网络。 结论 西部城市社区人群卒中知识知晓率低，开展针对低学历医务者的卒中培训及低学历、独居及退休人员的居民讲堂是改善现状的必要途径。同时也为政府建立有效的院前早期识别及快速转诊技术提供了依据。Objective To assess the baseline knowledge of risk factors and warning signs of cerebral apoplexy in communities. Methods A total of 1 208 inhabitants and 112 medical personnel were selected by systematic sampling. The questionnaire included social-demographic data, knowledge of cerebral apoplexy risk and warning signs and influencing factors, the sources and requirement of information about cerebral apoplexy. Results Hypertension was a risk factor in 90.1% of residents and 100.0% of medical personnel. Age, diabetes and smoking were identified as the risk factor in 65.0% of medical personnel and 85.0% of residents. Medical therapy of risk factors was insufficient. The most common warning signs of cerebral apoplexy was hemiplegia, the following were vertigo, ataxia, headache, aphasia and double vision. Stepwise multiple regression analyses showed that residents who had higher educational background, spousal, workers and community worker with higher educational background had higher knowledge scores of cerebral apoplexy. The main sources of information about cerebral apoplexy were television, doctors, newspaper, magazine and network. Conclusions At present, the urban community residents in west China are lacking in knowledge about cerebral apoplexy. Going forward, targeted educational residents and medical workers should be directed at those who was highly educated, living alone, and retired. It is also provide a theoretical basis for establishing a prehospital identification and transfer treatment system based on community in developing countries.
目的 探讨健康教育对提高高血压病患者健康知识及建立健康生活方式的影响。 方法 2011年8月－12月对社区中100例高血压病患者进行系统的健康教育，观察其健康知识和生活方式的改变情况。 结果 健康教育前后其健康知识得分由（10.48 ± 0.82）分提高到（17.10 ± 1.21）分，亚类健康责任、饮食和运动得分也明显提高，差异有统计学意义（P＜0.05）；健康生活方式得分由教育前的（18.65 ± 1.38）分提高到教育后的（25.91 ± 2.25）分，差异有统计学意义（P＜0.05）。 结论 在社区对高血压病患者开展长期、系统的健康教育能有效提高他们的健康知识，促进其建立健康的生活方式。
To explore the focus and trends in real-world studies in Chinese through knowledge mapping method, databases CNKI, VIP, Wanfang and Sinomed were retrieved, with 1 757 relevant articles published before September 30rd, 2020 finally included, whose bibliographical records were imported into NoteExpress to avoid duplication and check relativity. VOSviewer, a bibliometric analysis tool, was used to analyze their development. It was found that real-world studies have mainly taken shape after 2010, in which traditional Chinese medicine research plays an important role. China Journal of Chinese Material Medica was the leading journal with 120 papers, the China Academy of Chinese Medical Sciences the most contribution institution with 338 papers, and Xie Yanming from the institution the most contribution author with 250 papers. This study helps clinicians and researchers in better understanding the evolution of real-world research over more than two decades in China.
ObjectiveTo investigate the status of knowledge, attitude, and practice of patient identification in nurses, and provide a basis for clinical managers to carry out targeted training.MethodsA total of 3 696 nurses of tertiary, secondary, and primary hospitals in Guizhou Province were recruited and investigated for the status of knowledge, attitude, and practice of patient identification with a questionnaire by using convenient sampling in May 2019.ResultsThe scores of identification knowledge, attitude, and practice of the 3 696 nurses were 47.87±6.10, 27.39±3.15, and 57.19±4.86, respectively. Logistic regression analysis showed that the higher the educational level was, the higher the score of nurses’ knowledge of patient identification was [odds ratio (OR)=1.592, 95% confidence interval (CI) (1.084, 2.338), P=0.018]; the higher the personal monthly income was, the more positive the nurses’ attitude towards patient identification was [OR=1.570, 95%CI (1.005, 2.453), P=0.048].ConclusionsThe general situation of patient identification in nurses is good, but there are still differences among nurses with different characteristics. It is suggested that managers should pay special attention to the training of nurses with low educational level and low income, make them master the knowledge of patient identification, at the same time, improve their enthusiasm and standardize their behavior, so as to ensure the safety of patients.
Objective To investigate the villagers’ cognitive degree of health knowledge in Gaolan county, Gansu province, so as to explore new methods to promote health education and spread health knowledge in rural areas. Methods Through non-random sampling methods, the questionnaires were distributed to the residents in Shagang village, Manwan village and Yanzi village, and the data were then statistically analyzed by using Epidata 3.1 and Excel 2003 softwares. Results A total of 290 questionnaires were distributed and retrieved with 100% valid rate. Only 23% of the surveyed had physical examination in the last one year; 75% thought they were lack of health knowledge; 92% would like to obtain health knowledge in regular; 86% thought lack of health knowledge was the reason of their or their relatives’ diseases; 74% obtained health knowledge by watching TV; 59% went to their village clinic first when suffering from mild symptoms of common diseases; and only 6% did exercises in their leisure time. Conclusion Most people in rural areas don’t pay enough attention to their health condition and are lack of high-quality health knowledge resources as well as consciousness of physical training. So it is not only necessary to strengthen health education, but also urgent to promote physical and mental health education in rural areas.
Testing Treatments is a book to help the public understand how to validate the efficacy of testing treatments and the possible bias and error in clinical trial, as well as to call for help to promote good study thus to improve the quality of health care. No matter for the first or the second edition, this book is very popular around the world, and its second edition has been translated into more than ten languages. To help the readers understand the content of the book, we established a website (www.testingtreatments.org) and other sibling sites in different languages. The website not only provided the full-texts to download, but also collected various popular science resources (videos, audios and cartoons) to help the readers assimilate more knowledge. The editors of all the different language websites have established an TTi Editorial Alliance to share experience and provide each other with mutual support, thus to promote health professionals, patients and public around the world to use reliable research to inform their health decisions.
ObjectiveTo explore the application and effect of clinical nursing pathway based on information-knowledge-attitude-practice (IKPA) theory in percutaneous renal needle biopsy.MethodsThis is a historical control study. A total of 460 patients who underwent percutaneous renal biopsy in West China Hospital of Sichuan University between April and December 2020 were prospectively recruited as the pathway group, and a clinical nursing pathway based on IKAP theory was implemented. By contrast, the data of 617 patients who underwent percutaneous renal biopsy and received routine care in the same hospital between April and December 2019 were retrospectively collected as the control group. The length of hospital stay, hospitalization expenses, the incidences of postoperative complications (macroscopic haematuria, perirenal hematoma, and acute urinary retention), the incidence of postoperative postural hypotension, and the management enrollment rate of chronic kidney disease patients were compared between the two groups.ResultsThe length of hospital stay [median (lower quartile, upper quartile): 8 (7, 11) vs. 8 (7, 12) d] and the hospitalization expenses [median (lower quartile, upper quartile): 7380.50 (6401.86, 8789.21) vs. 8167.00 (6816.50, 10044.50) yuan] were less in the pathway group than those in the control group, the incidences of postoperative macroscopic haematuria (1.52% vs. 6.97%) and perirenal hematoma (2.61% vs. 5.02%) were lower in the pathway group than those in the control group, the management enrollment rate of chronic kidney disease patients was higher in the pathway group than that in the control group (26.09% vs. 6.16%), and the differences between the two groups were statistically significant (P<0.05). The differences in the incidences of acute urinary retention (8.26% vs. 11.18%) and postoperative postural hypotension (0.00% vs. 0.81%) between the two groups were not statistically significant (P>0.05).ConclusionThe application of clinical nursing pathway in percutaneous renal needle biopsy can effectively reduce the length of hospital stay and hospitalization expenses, and improve the management enrollment rate of chronic kidney disease patients.
ObjectiveTo understand the levels of and influencing factors for knowledge of earthquake in the elderly population. MethodPeople who were older than 60 years in the earthquake area of Sichuan Province were surveyed by self-designed earthquake knowledge scale composed of 6 items with a point of 1-5 for each item between October and November 2013. The total score ranged from 6 to 30 points. ResultsUp to 1 509 elderly people participated the survey. The total score of earthquake knowledge was 13.33±4.85. The main resource for acquiring those knowledge was TV (76.87%). Occupation, education level, residency, marital status, residence, self-injury, health status, access to earthquake knowledge, and worrying about earthquake were related factors for their knowledge on earthquake (P<0.05). Regression analysis showed that the higher degree of education, having a spouse, living in city, more access to earthquake knowledge, worrying about earthquake were the promotion factors for earthquake knowledge preparedness. Self-injury, poor health were the factors that hindered the acquiring of earthquake knowledge preparedness. ConclusionsIt is necessary to train knowledge of earthquake for elderly people individually because they lack enough resources and tend to be affected by many factors.
ObjectiveTo investigate the community residents' awareness of knowledge on cardiovascular disease prevention and control and their access methods to relevant information. MethodsBetween June and August, 2013, the residents aged above 45 who came to community health center for diagnosis or treatment were investigated by questionnaires including the acknowledge of prevention for cardiovascular diseases and the access methods to relevant information. ResultsA total of 1 000 residents were involved in this study, including 394 (39.40%) males and 606 (60.60%) females aged from 45 to 98 with an average of 68.3±10.4. The highest rate of awareness of cardiovascular prevention knowledge was regular physical exercise (89.20%), followed by low salt diet (67.20%) and fried food (6.30%). The highest rate of access to the information was information provided verbally by doctors or nurses (77.50%), followed by television and radio (56.00%). ConclusionCommunity center should strengthen the health education of cardiovascular disease prevention and control. Health education should be practiced in an easy way for the residents.