ObjectiveTo survey on the health-related knowledge in cadres, in order to regulate corresponding health management strategies. MethodsQuestionnaires were used to collect data of 816 examinees who accepted physical examination in our hospital between June and July 2014. Factors affecting health examination service efficiency were identified to formulate a scale and a questionnaire for surveying examinees' preparatory status before examination and general information. The correlation between their preparatory status and demographic features was analyzed. The results were used to support management decision-making. ResultsOf the 816 examinees, 396 had a score over 6 points (48.5%, well prepared) and 420 had 6 points or below (51.5%, poorly prepared). The male preparation before examination was significantly poorer than the female (χ2=4.318, P=0.038). ConclusionWe should strengthen the knowledge education for cadres before physical examination.
Objective To explore the effect of kidney transplantation on chronic prostatitis-like symptoms. Methods A total of 300 male renal transplant recipients between January 2015 and January 2017 were collected in the study. All recipients received the questionnaire survey of the National Institute of Health-Chronic Prostatitis Symptom Index (NIH-CPSI) preoperatively and at 3 months after transplantation. The score and relevant risk factors were statistically analyzed. Results A total of 210 recipients (70.0%) completed questionnaire effectively, in whom 150 (71.4%) had preoperative and 90 (42.9%) had postoperative chronic prostatitis-like symptoms, respectively. In the 210 patients, the preoperative and postoperative pain score was 6.57±3.12 vs. 3.57±3.16 (P<0.001), voiding score was 3.71±2.38vs. 3.29±2.66 (P=0.116), quality of life score was 7.57±1.60 vs. 5.14±2.75 (P<0.001), and the total NIH-CPSI score was 17.86±3.81vs. 12.00±6.65 (P<0.001), respectively. The severity of chronic prostatitis-like symptoms was alleviated significantly after kidney transplantation. Conclusion Kidney transplantation can alleviate the chronic prostatitis-like symptoms significantly, and improve the quality of life in uremia patients.
Objective To investigate the diabetic knowledge of primary hospital doctors and diabetes patients, and to explore the way to improve the capability of primary hospitals in preventing and treating diabetes. Methods Between January 2013 and June 2014, we set questionnaires to learn the profiles of diabetes knowledge of 328 internal and general medicine doctors including 43 chronic disease management workers from fifteen township hospitals and two community health centers, 152 doctors from village clinics, and 575 diabetes patients in Xindu District of Chengdu City. We made questionnaires for doctors and patients respectively to investigate their knowledge on diabetes and blood sugar control in the patients. Finally, we made plans to train doctors in primary hospitals according to the results of the investigation. Results For township hospitals, 328 questionnaires were given out with 319 retrieved, and the valid retrieval rate was 97.3%; 152 questionnaires were given out to village doctors and 149 were retrieved, with a valid retrieval rate of 98.0%; and we gave out 575 questionnaires to the diabetes patients and retrieved 539, with a valid retrieval rate of 93.7%. Primary hospitals were insufficient in their drug varieties. Among doctors in township hospitals, 7.8% had bachelor’s degree, 53.6% had received post-secondary education, and 38.6% had received secondary vocational education. Most of the village doctors had not received any professional medical education, among whom, 89.9% had a certificate of village doctors and 10.1% had a certificate of assistant doctors. The diabetes questionnaire score of primary hospital doctors was low, while the score of chronic disease management workers was relatively higher (P<0.05). For diabetes patients, medical investment was inadequate, treatment rate was low, common sense of diabetes was insufficient, and glycosylated hemoglobin control rate was only 13.5%. Conclusions Diabetes patients in primary hospitals have a poor disease control, which is probably associated with the insufficient publicity and education from doctors. It is necessary to train primary hospital doctors at all levels. In order to get the best therapeutic effect, we advocate that diabetes should be managed by doctors of chronic disease management, although they should receive systematic training for a long time.
Objective To get known about the employment intentions to primary health service organizations (PHSO) among medical students in North Sichuan Medical College, and to assess its main influencing factors, so as to provide scientific evidence for occupational guidance in medical colleges, as well as talent introduction and retention in PHSO. Methods By cluster sampling method, medical undergraduates and college students in North Sichuan Medical College were investigated using a self-designed questionnaire from April to October, 2010. EpiData 3.1 and SPSS 16.0 software were used for inputting data and analyzing respectively. Results a) Among 900 questionnaires distributed, 870 were reclaimed (response rate 96.7%). b) Nearly 60% of medical students thought their own professional development was “average”, with following intentions after graduation in order: employment first and then postgraduate entrance exam, employment, postgraduate entrance exam; and 85% of medical students were more willing to work in medical institutions above level-2 in city or county. c) More than 70% of medical students’ employment intentions to PHSO were “average”, and “unwilling”, etc.; the main influencing factors were personal development space, salary and welfare, and comprehensive strength of hospital, etc. d) More than 90% of medical students “Do not know” or “generally” understood the related national preferential policies. Conclusion Government, PHSO and universities should take measures together and increase policy advocacy and infrastructure investment, so as to encourage medical students to work in PHSO.
Objective To investigate the current situations of human resource management in the public hospital pharmacies, and to provide the evidence and suggestions for improving the performance of the public hospital pharmacies. Methods According to the principles and study methods of human resource management, we designed the questionnaire to investigate the human resource management among 307 managers and pharmacists working in 74 public hospital pharmacies. We used percentage and proportion for statistical description. Results 56% participants considered that the public pharmacists had professional qualities. Nearly 73% considered that there were good interpersonal relationship; 45% wanted to do present job. Nearly 75% thought that the mechanism of performance appraisal should be consummated. About 63% considered that the learning and training was not fitting and proper. 63%thought they could not develop their ability and talent. Conclusion The human resource management system in public pharmacies should be improved.
ObjectiveTo investigate the prevalence and associated factors of diabetic retinopathy (DR) among diabetic residents in Longyan of Fujian Province. MethodsA investigative research. From January 2022 to December 2023, a total of 10 061 diabetic patients enrolled in the chronic disease follow-up management system from 112 towns and sub-districts in 7 counties and districts of Longyan of Fujian Province were selected as the target population. A questionnaire survey, routine physical examination, vision test, and non-mydriatic fundus photography were conducted. A total of 762 cases with missing height, weight, blood pressure, fasting plasma glucose (FPG), and diabetes duration, and 507 cases with unclear fundus photography were excluded, resulting in 8 792 cases included in the final statistical analysis. DR diagnosis and classification were based on the 2019 International Clinical Classification of DR. The prevalence of DR was calculated for single-eye or double-eye DR cases as 1 case; the more severe eye was used for DR grading in double-eye DR cases. Statistical analysis was performed by grouping based on the presence or absence of DR and dividing into age groups ≤67 years and >67 years. χ2 test was used to analyze factors associated with prevalence; binary multivariate logistic regression analysis was employed to identify influencing factors of DR. ResultsAmong the 8 792 cases, 888 (10.1%, 888/8 792) were diagnosed with DR (DR group), and 7 904 (89.9%, 7 904/8 792) had no DR (non-DR group). Compared to the non-DR group, the DR group showed significant increases in FPG (Z=−12.448), diabetes duration (Z=−18.936), systolic blood pressure (Z=−4.237), diastolic blood pressure (Z=−2.881), and body mass index (BMI) ≥24 kg/m² (P＜0.001). Significant differences were also found between the two groups in hypertension (χ2=11.450), hyperlipidemia (χ2=5.100), kidney disease (χ2=7.039), family history of diabetes (χ2=5.025), and regular medication use (χ2=66.034) (P＜0.05). There were 4 688 cases in the ≤67 years group and 4 104 in the ＞67 years group. In the ≤67 years group, significant differences in DR prevalence were found for FPG levels (χ2=111.754), diabetes duration (χ2=231.658), BMI (χ2=12.404), systolic blood pressure (χ2=17.912), regular medication use (χ2=40.727), hyperlipidemia (χ2=6.816), and hypertension history (χ2=6.775) (P＜0.05). In the >67 years group, significant differences in DR prevalence were found for FPG levels (χ2=59.916), diabetes duration (χ2=128.362), systolic blood pressure (χ2=5.183), regular medication use (χ2=22.097), kidney disease (χ2=6.251), and family history of diabetes duration (χ2=4.967) (P＜0.05). No significant differences in DR prevalence were found based on sex, education level, smoking history, alcohol consumption, exercise habits, heart disease history, or other family disease history (P＞0.05). Logistics regression analysis results show that patients aged ＞67 years, FPG [odds ratio (OR)=1.074, 95%confidence interval (CI) 1.046-1.102], diabetes duration (OR=1.088, 95%CI 1.071-1.106), systolic blood pressure (OR=1.007, 95%CI 1.001-1.013), and kidney disease (OR=3.617, 95%CI 1.268-10.320) were identified as risk factors for DR (P＜0.05). In patients aged ≤67 years, FPG (OR=1.088, 95%CI 1.067-1.110), diabetes duration (OR=1.108, 95%CI 1.091-1.125), and systolic blood pressure (OR=1.008, 95%CI 1.003-1.013) were identified as independent risk factors for DR (P＜0.05), while BMI ≥24 kg/m² (OR=0.934, 95%CI 0.908-0.965) was a protective factor for DR (P＜0.05). Age, regular medication use, hypertension, and hyperlipidemia were identified as potential confounding factors for DR occurrence. ConclusionsThe prevalence of DR among diabetes patients in Longyan of Fujian Province, is 10.1%. FPG, diabete duration, and systolic blood pressure are independent risk factors for DR, while age, regular medication use, hypertension, and hyperlipidemia are potential confounding factors for DR occurrence.
Objective To investigate the current situations of operation management and corporate culture in the public hospital pharmacies, and to provide the evidence and suggestions for improving the performance of the public hospital pharmacies. Methods According to the principles and study methods of operation management and corporate culture, we designed the questionnaire to investigate the operation management and corporate culture among 306 managers and pharmacists working in 74 public hospital pharmacies. We used percentage and proportion for statistical description. Results (1) Over 70% participants considered that the public pharmacies lacked in consciousness of service and quality and that they cooperated as their clear responsibilities. (2) Nearly 60% considered that the public pharmacies lacked in awareness of costs and efficiency. (3)Nearly 50% thought that they could not get information in time and communicate enough. (4) About 50% considered that the working processes needed improvement. (5) About 60% realized corporate culture promoted pharmacies.Conclusion Public hospital pharmacies need to improve operation management and foster unique corporate cultures to enhance comprehensive competitive strength.
ObjectiveTo investigate the current status of routine practice and perspective of anesthesiologists regarding ventilation strategies during cardiac surgery, and to analyze whether there is a gap between the clinical application and theoretical understanding of lung-protective ventilation (LPV) strategies. MethodsWe conducted a multi-institutional cross-sectional survey of anesthesiologists working at high-volume (>1000 cardiac procedures each year) Chinese hospitals. The electronic questionnaire was designed and distributed from September 2021 to February 2022. ResultsA total of 323 replies were collected and 297 (92.0%) replies were valid. Among the respondents, 84.8% (252/297) performed the combination of low tidal volume (VT), positive end-expiratory pressure (PEEP) and alveolar recruitment maneuver (ARM) during non-CPB period. The vast majority of respondents (90.6%, 269/297) ventilated patients with the VT of 6-8 mL/kg. 92.3% (274/297) of respondents applied PEEP, among those 57.9% (172/297) set a PEEP level <5 cm H2O. Most of the respondents (67.3%, 200/297) performed intraoperative ARM, and manual ARM was used by 86.2% (256/297) of anesthesiologists. During CPB, 89.9% (267/297) of respondents withdrew mechanical ventilation, and 29.6% (88/297) performed ARM. ConclusionThis national survey in China showed that the majority of anesthesiologists adopted LPV strategy with the combination of low VT, PEEP and ARM during cardiac surgery. Except VT, the intraoperative ventilator settings varied widely from one anesthesiologist to another. Meanwhile, there is a gap between the clinical practice and theoretical understanding of LPV.
Objective To provide basic data for further application of national essential medicine list (EML) in Chengdu, through a survey of key-workers or persons, who attended the lecture of EML, in charge of village town hospitals or community medical service centers, and to find out their awareness of and attitudes to the essential medicine and requirements and suggestions for EML training. Methods Based on principles and methods of modern cognitive psychology, we designed the questionnaire and carried out the survey face to face. Two people input the data independently and verified them. Proportions were used to analyze the data through the Excel software. Results (1) The proportions ofcorrect answers to the questions of essential medicine conception, use range of EML and the relationship between EML and essential insurance medicines list were 89%, 91% and 87%, respectively. (2) 46% of the persons investigated (117 persons) chose “always consider preferentially using the essential medicine when prescribing”, 31% (81 persons) “consider using the essential medicine in most cases”. (3) 41% of the persons investigated (103 persons) chose “comparatively welcome” for the EML. (4) Problems of implementing EML in village town hospitals or community medical service centers, in the order of importance decreasing, were: “income and compensation”, “awareness of the essential medicine and prescribing habit of the doctor”, “patient’s cognition of essential medicine and preference to drug use”, “safety and effectiveness of the essential medicine”, “the applicability of essential medicine ” and “the purchase and delivery of essential medicine”, respectively. (5) The ways of getting information of essential medicine were 19.6% (187 person-time) through documents, 18.6% (177 persontime) through conferences and 15.3% (146 person-time) through lectures. (6) 60% of the persons investigated (154 persons) attended training of the essential medicine once or twice. (7) 77% of the persons investigated (196 persons) were trained for less than one week for essential medicine. (8) Requirements and suggestions on the training of essential medicine: 42% (71 person-time) enlarging the targeted people, 22% (38 person-time) increasing the training time,16% (27 person-time) improving practicability and specificity of training contents, 11% (18 person-time) diversifying training ways, 9% (15 persontime) requiring “training according to needs ” which addresses specific problems after investigation. Conclusion Training of essential medicine should be strengthened for medical workers in the village town hospitals or community medical service centers, and researches should be carried out on evaluation of EML applicability, performance of EML implementation, financial aiding, income of medical worker, procurement and reimburse, etc.
Objective In light of problems related to the accessibility and affordability of healthcare, we aimed to investigate the status and causes for the shortage of qualified health human resources in the rural and primary health care setting, and to propose solutions to these problems at the level of health policy system. Methods The principles and methods of evidence-based medicine were applied. We developed the study selection criteria on the basis of the proposed questions, and identified relevant literature from biomedical databases and other additional sources. We graded eligible studies, extracted data, and summarized the data to draw conclusions. In addition, we conducted a survey to refine the proposed solutions. Results We identified 147studies from PubMed and CNKI, of which 30were in English. After summarizing the information, and using knowledge about the human resources for health in primary healthcare in China, we proposed a model of resident doctor aid healthcare. The survey that we conducted to assess such a model included interviewees of top level policy makers, medical students and staff in medical universities. Most of the interviewees (85%) thought it was feasible to develop an aid healthcare system. Among those who disagreed, the lack of corresponding policy was the most common factor. Conclusions It is suggested that the government develop relevant policies and make an attempt to practice the aid healthcare system. Emerging problems could be identified and addressed in practice.