Researches in evidence-based medicine have provided important evidence for family planning doctors to guide their clinical practice. With examples of clinical researches, the practical methods of evidence-based medicine in family planning service are discussed in this paper.
ObjectiveTo systematically review the willingness rate of Chinese residents to renew family doctors contract services. MethodsPubMed, Web of Science, EMbase, ScienceDirect, CNKI, WanFang Data and VIP databases were electronically searched to collect cross-sectional studies related to the willingness of Chinese residents to renew family doctors contract services from inception to November 2021. Two reviewers independently screened literature, extracted data, and assessed the risk of bias of the included studies. Meta-analysis was then performed by using Stata 16.0 software. ResultsA total of 23 cross-sectional studies involving 22 629 subjects were included. The results of meta-analysis showed that the willingness rate of Chinese residents to renew family doctors contract services was 84.2% (95%CI 80.0% to 88.3%). The results of subgroup analysis showed that contracted residents who were surveyed in 2011 to 2015 (85.7%), living in eastern (87.0%) and urban (84.7%), above age 60 (88.5%), females (85.1%), non-married (86.5%), with primary school and below education level (91.4%), with employee medical insurance (84.5%) and residents medical insurance (85.2%), not working (77.9%), with high and medium levels of health status (84.5%), with chronic diseases (86.7%), preferred to consult general diseases in primary health care institutions (89.5%), and walking to nearby community health service institutions requiring less than 30 minutes (86.9%) had a relatively high willingness to renew contracts. The contracted residents whose health status improved (91.0%), medical expenses reduced (91.5%) and medical portability improved (88.4%), more satisfied with contracted services (85.3%), more trusted in contracted doctors (87.9%), knowing family doctors’ name (86.7%) and contact information (84.2%) and enjoying visiting medical service (79.7%), telephone follow-up (79.6%), and health files establishment (80.1%) were more willing to renew contracts. ConclusionCurrent evidence suggests that the willingness of Chinese residents to renew family doctors contract services is high, however, it remains to be improved. Due to the limited quality and quantity of the included studies, more high-quality studies are needed to verify the above conclusion.
ObjectiveTo explore the family function on patients with depression and its influential factors, in order to provide a basis for family support treatment for the patients.
MethodsA total of 122 depressed patients from Mental Health Center of West China Hospital between February 2012 and June 2013, and one of their family members were chosen to be the study subjects. Another 122 non-clinical controls and one of their family members were recruited from a community near Sichuan University were regarded as the controls. All the subjects were asked to finish the Quality of Life Enjoyment and Satisfaction Questionnaire (Q-LES-Q), the Multidimensional Scale of Perceived Social Support (MSPSS), and the Family Assessment Device (FAD). Additionally, the patients received a diagnostic interview to provide the features of their depression.
ResultsThe general average score of Q-LES-Q in families with depressed patients was significantly lower than that in the control families (t=-6.243, P<0.01). The general average score of each dimension in FAD for families with depressed patients was significantly higher than that for control families (t=3.644, 3.872, 2.694, 3.369, 5.369, 4.941, 5.241; P<0.01). According to FAD health division scoring, the unhealthy proportion in terms of communication, emotional reaction, emotional link, behavioral control and general function for families with depressed patients was significantly higher than that for control families (χ2=6.778, 23.698, 26.580, 39.875, 17.123, 10.712; P<0.05). The Q-LES-Q scores and the five FAD dimensional scores (except role and affective involvement) were negatively correlated (r=-0.388, -0.188, -0.200, -0.276, -0.370; P<0.05). The scores of perceived social support for families with depressed patients had significant positive correlations with the scores of all FAD dimensions except affective involvement (r=0.363, 0.345, 0.244, 0.418, 0.328, 0.457; P<0.05). The risk factors for unhealthy family function included: female (OR=1.141, P<0.05), poor education (OR=0.948, P<0.01), first-episode (OR=1.416, P<0.05), suicidal attempt (OR=1.014, P<0.05), incomplete suicide (OR=1.367, P<0.01) and depression episode number (OR=1.035, P<0.05).
ConclusionDepression is associated with impaired family function in Chinese families. Female, poor education, first episode of depression, suicidal attempt, incomplete suicide and depression episode number are the influential factors for family function on patients with depression.
Objective To compare quality of life for HIV infected people or AIDS patients and their family members of noninfected people in two counties (Zizhong and Zhaojue) with high AIDS morbidity and high HIV infective rates. Methods The quality of life for HIV infected people or AIDS patients and 162 of their family members and 97 people noninfected HIV/AIDS was measured by a questionnaire containing the generic quality of life inventory 74 (GQOLI-74) and the social support scale (SSS). Data were analyzed with SPSS. Results Total GQOLI-74 scores and each of the four dimensionality scores were significantly lower for HIV/AIDS people and their family members compared with noninfected people (total score for HIV/AIDS people 52.20 [9.41]; family members 60.46 [11.92]; noninfected people 66.36 [8.90] (Plt;0.01)). Scores for each of the disease status (physical function, psychological function, social function and material status) were all lower compared with noninfected people (all comparisons Plt;0.01). GQOLI-74 scores of HIV/AIDS people were significantly correlated with disease status and social support, but age, education level and substance abuse did not show significantly correlation. Conclusions The quality of life for HIV infected people or AIDS patients and their families is significantly lower than the general population, and this is particularly related to the severity of their disease and lack of social support.
Objective To investigate the family burden of depression inpatients, analyze the influencing factors and explore the approach to reduce the family burden. Methods On-the-spot investigation was conducted for the family members of 200 depression inpatients in Mental Health Center of West China Hospital of Sichuan University from January to December, 2008. Following questionnaires used for investigation were all self-scale and filled out by the family members: “Basic Information Scale of Patients and Family Members”, “Family Burden Scale of Patients with Depression” revised from Pai’s scale of “Burden on the Family of Disease” (scoring 0-48 points and covering 24 items under 6 dimensions, namely, financial burden, disruption of routine family activities, disruption of family leisure, disruption of family interactions, effect on physical health of family members, and effect on mental health of family members; rating each item on a 3-class scale, namely, zero for no burden, one for moderate burden, and two for severe burden) , and Xiao Shuiyuan’s “Social Support Scale” (10 items in total, a higher score indicates a better social support). SPSS 13.0 software was adopted to perform statistical analyses. Results The total score of family burden was 26.3±12.6, the positive answer rate of family burden was 100.0%, and the positive answer rate of the every dimension was above 80%. The score of family burden for parents and spouse was higher than that of children (Plt;0.05). The total score of social support was 40.22±9.06, and the correlation coefficient between family burden and family social support was –0.485 (Plt;0.001). Conclusion It is common for family members of depression patients to get family burden at different levels. The more social support family members get, the less the family burden is.
ObjectiveTo recognize the convulsion caused by hypoglycemia, and to analyze its genotype and clinical phenotype, so as to deepen the understanding of hyperinsulinemia.MethodFull exon detection were performed on 2 children with hypoglycemia and convulsions, who had been treated with antiepileptic drugs for 1 year in pediatric neurology department, Henan Provincial People’s Hospital in 2012 and 2014 respectively, but with poor curative effect.ResultABCC8 gene mutations were found in a child. The mutations located in Chromosome 11, with the nucleic acid changes of c.4607C>T (exon38) and the amino acid change of p.A1536V, rs745918247. The inheritancemode of ABCC8 gene could be autosomal dominant or autosomal recessive inheritance. Both of the parents were wild type on this genelocus. The gene mutation is associated with type 1 familial hyperinsulinemic hypoglycemia/nesidioblastosis. The other child was carrying GLUD1 gene mutation, witch is located in chromosome 10, with the nucleic acid changes of c.1498G>A (exon12) and the amino acid change of p.A500T. The inheritance mode of GLUD1 gene is autosomal dominant andthe child’s parents were both wild type. This gene mutationis associated with type 6 familial hyperinsulinemic hypoglycemia/nesidioblastosis. The 2 mutations have not been reported, which are new mutations.ConclusionMutations in these 2 gene loci may be the underlying cause of hypoglycemic convulsions, and are the best explanation for the poor convulsionscontrol of antiepileptic drugs.
Objective To understand the situation of commonly-used drugs, medical device and their storages in rural households among model well-off township hospitals in eastern, central and western China, and to provide the basis for the guidance of reasonably using and scientifically storing drugs. Methods The methods of combining simple random sampling and cluster sampling were used to investigate and analyze the situation of commonly-used drugs, medical device and their storages in 162 households from three well-off township hospitals in Shanghai, Zhejiang, and Sichuan provinces, respectively. Results The storage rates of commonly-used drugs of rural households in well-off towns were cold medicine (72.2%), wound paste (51.9%), cooling oil (39.5%), essential balm (36.4%), antihypertensive (27.8%), iodine tincture (14.2%), anti-diabetic drugs (13.0%) and other drugs (17.3%). The storage rates of medical devices were thermometer (50.0%), cotton swab (47.5%), sphygmomanometer (9.3%), injector (1.2%) and other devices (22.2%). A total of 66% of respondent families stored drugs and medical devices in a fixed drawer. Only 3.1% families stored drugs and medical devices in the special portable medical kit. Conclusion Rural families have a higher rate of household drugs among model well-off township hospitals in eastern, central and western China, and most drugs are OTC drugs. The storage rates of medical devices are not high. Many rural family-owned medical devices are linked with special chronic diseases in the family. A lot of rural families place drugs and medical devices randomly. There are many security risks, and it may affect the rational utilization of drugs.
ObjectiveTo explore the prevalence of anxiety symptoms and its related factors among the family caregivers of the disabled elderly.
MethodsA cross-sectional survey based on convenience sampling was conducted among family caregivers between November and December, 2013 in Dongcheng district in Beijing. The Self-rating Anxiety Scale (SAS) and the Social Support Rating Scale (SSRS) were used to evaluate caregivers' anxious symptoms and social support status respectively. The degree of functional impairment of the elderly was measured by Barthel index.
ResultsA total of 243 family caregivers took part in the study including 88 males and 155 females. The average age of the family caregivers was (60±1.7) years old, ranging from 25 to 85. The prevalence rate of anxiety was 29.2% reported by family caregivers. The average score of SAS was 35.6±8.6. The risk factors of caregivers' anxiety included Barthel index score ≤20 (OR=1.51), SSRS score ≤33 (OR=4.56), no time to relax (OR=1.57) and poor health status caregivers feeling (OR=3.48).
ConclusionA relative high level of anxiety exists in family caregivers for the disabled elderly. Caregiver anxiety is a complex process, influenced by diverse care receiver and caregiver characteristics.
ObjectiveTo systematically review the satisfaction of Chinese residents with the contract services of family doctors. MethodsCNKI, WanFang Data, VIP, PubMed, Web of Science, and EMbase databases were electronically searched to collect cross-sectional studies related to the Chinese residents' satisfaction with the service of family doctors from January 2011 to May 2021. Two reviewers independently screened literature, extracted data, and assessed the risk of bias of included studies. Meta-analysis was then performed using Stata 14.1 software. ResultsA total of 42 cross-sectional studies were included. The results of meta-analysis showed that the overall satisfaction rate of residents with the contract services of family doctors was 77.7% (95%CI 73.7% to 81.7%). The results of subgroup analysis showed that the satisfaction rate of the male and female residents were 83.0% and 84.3%; <60 and ≥60 years old residents were 83.5% and 81.7%; junior high school or below, senior high school or technical secondary school, junior college or above educational level residents were 84.1%, 76.4% and 81.2%; the monthly income less than 4000 yuan and more than 4000 yuan residents were 78.5% and 79.3%; with and without diseases residents were 85.3% and 79.7%; with and without spouse residents were 80.6% and 82.4%; on and off the job residents were 77.7% and 73.9%; urban and rural residents were 78.7% and 80.0%; in 2011-2015 and 2016-2020 were 67.6% and 76.2%; eastern and western regions residents were 76.5% and 79.7%; relevant studies which were conducted by random sampling and nonrandom sampling were 80.5% and 73.5%. ConclusionsThere is still room for improvement in residents' satisfaction with family doctor contract service. Residents with different education levels, disease situations, on-the-job situations, time, regions and sampling methods have differences in their satisfaction with the contract services of family doctors.
ObjectiesTo investigate the impact of family nursing intervention on the quality of life in postoperative patients with benign prostatic hyperplasia (BPH). MethodsIn total, 60 consecutive patients who underwent BPH surgeries between December 2012 and January 2014 were enrolled and randomly assigned to receive either timely outpatient follow-ups and routine rechecks (control group) or nursing intervention of telephone call follow-ups and family visits by professional nurses (intervention group). Quality of life was assessed by international prostate symptom score (IPSS) and generic quality of life inventory-74 (GQOLI-74), and was compared before and after intervention between the two groups. ResultsThere were no statistically significant differences in GQOLI-74 scores of all dimensions at discharge between the intervention group and the control group (P>0.05). However, six months after discharge, GQOLI-74 scores of all dimensions were significantly different between the two groups (P<0.05), and were also significantly different from the scores at discharge in both groups (P<0.05). At discharge, IPSS scores were not significantly different between the two groups (P>0.05). Six months after discharge, IPSS scores of the intervention group (6.33±1.03) and the control group (7.83±0.94) were significantly different (P<0.05), and were also significantly different from the scores at discharge in the intervention group (7.93±1.31) and the control group (8.10±1.06) (P<0.05). Three patients in the control group (10.0%) were admitted into the hospital again due to bleeding, while there was no bleeding case in the intervention group. No such complications as urethrostenosis or urinary incontinence occurred in both groups. Conclusion Family nursing intervention improves effectively the quality of life in postoperative patients after surgeries for benign prostatic hyperplasia.
