ObjectivesTo analyze patients’ values and preferences on individualized medication of high-dose methotrexate so as to support the development of the practice guideline for clinical medication of high-dose methotrexate.MethodsA multicenter cross-sectional study involving patients with osteosarcoma or hematological malignancy in 7 hospitals was conducted by questionnaires to evaluate the perception and willingness on detection of gene polymorphisms (MTHFR C677T, MTHFR A1298C, ABCB1 C3435T and RFC1 G80A) related to methotrexate (MTX) and therapeutic drug monitoring (TDM) of MTX. SPSS24.0 software was used to analyze the data.ResultsA total of 124 patients were involved, including 40 (32.26%) with osteosarcoma and 84 (67.74%) with hematological malignancy. 106 (85.48%) and 117 (94.35%) patients agreed on detection of gene polymorphisms and TDM, respectively. There was a significant difference on preference towards TDM between patients with risk factors for MTX and patients in which risk factors for MTX were not discovered (76.19% vs. 95.08%, P=0.003). The ranking of factors that contributed to the two decision-making was consistent (P<0.01), and specific orders of factors were identical. The clinical efficacy was the primary factor (mean rank 3.45 for detection of genetic polymorphisms and 3.52 for TDM), followed by safety (mean rank 3.01 and 3.16, respectively) and comfort (mean rank 1.73 and 1.79, respectively). Cost (mean rank 1.39 and 1.31, respectively) was the least important factor.ConclusionsThe preferences of patients toward detection of gene polymorphisms and TDM were generally similar, with well acceptance. No significant differences were found on the preferences toward detection of gene polymorphisms. However, patients with or without risk factors for MTX may differ significantly when making decisions on TDM, which may impact on clinical decision-making of clinicians and clinical pharmacists. The perception and willingness of patients should be considered adequately during the development of clinical practice guidelines and clinical practice.
In 1984, according to the criteria of the classifieation for congenital hand deformity which wasput out by the International Hand Surgery Committee, we had made an investigation for congenitalhand deformity among 318066 newborns in Shanghai. It was found that the inctdence of a congenitalhand malformation was 0. 0808 percent among the total newborns. The congenital malformation ofthe thumb was 37. 74 percent of all deformities of the hand. According to the statistical analysis, we ...
Objective To provide references for the rational allocation of health personnel in rural hospitals through understanding the status of health human resources of rural hospitals in remote and poor areas of Sichuan Province. Methodes This study used cluster sampling method, combined with questionnaire survey and qualitative interviews. A total of 711 health workers of 29 rural hospitals in Pengzhou and Baoxing of Sichuan Province were interviewed. SPSS16.0 was used for descriptive analysis.Results The average age of rural hospitals health personnel in remote and poor areas of Sichuan Province was 30 years old. Post-secondary education accounted for 58.12%, and Bachelor degree or above accounted for 7.2%. The number of medium and senior professional titles account for 8.4 %. The ratio of doctors to nurses was 1:0.55. In the survey of health workers, those doctors with practice (assistant) license accounted for 38.5%, and those without any qualification occupied 27.1 %. Conclusions The professional titles of medical personnel of rural hospitals in remote and poor areas in Sichuan province are generally low. The distribution of professional categories is irrational. The staff in charge of prevention and care are inadequate. There exist a large number of unqualified medical workers. Therefore, the government should increase the investment in rural health and take measures to stabilize the team structure, introduce the talented, and strengthen the training for health personnel of rural hospitals to improve their overall quality.
Objective To investigate evidence retrieval, appraisal, and reevaluation during evidence-based clinical decision making in China. Also, to analyze the related factors, so as to find the problems in the course of evidence-based clinical decision making and put forward corresponding solutions. Methods We searched Chinese Biomedical Literature Disc (CBM) and China Journal Full-text Database (Medical sciences) of the China National Knowledge Infrastructure (CNKI) to collect clinical evidence-based case reports. Relevant information was extracted from these reports by a selfdesigned investigation form.Then statistical analyses were performed. Results The search tools used in the course of evidence-based clinical decision making varied. The most frequently used were MEDLINE/PubMed (82.08%) and The Cochrane Library (60.38%). 30.63% of evidence-based case reports described the search strategy in detail, and 9.01% described how they modified their search strategy. All doctors evaluated the association between evidence and disease, but few of them integrated patient factors and relevant external factors when evaluating evidence. The scientific nature and validity of the evidence was evaluated in 74 evidence-based case reports (66.67%), and such evaluation was mainly based on the criteria of evidence grading (50.00%). Reevaluation was mentioned in 85.59% of evidence-based case reports. Conclusion In China, the application of evidence-based decision making varied in different clinical departments. Problems existed in the course of evidence retrieval, appraisal, and reevaluation. This revealed the low information diathesis level of doctors and their lack of evidence-based medicine knowledge. It is suggested that information education and evidence-based medicine education should be strengthened to improve doctors’ ability to use evidence-based clinical decision making. It is also recommended that the search tools, relevant search strategy, the modification of search strategy, and reevaluation on practice results of each case should be mentioned in evidence-based case reports.
ObjectiveTo understand the self management status of patients with ankylosing spondylitis (AS).
MethodsSixty inpatients and outpatients with AS in the Department of Rheumatology between December 2011 and December 2012 were selected as the study subjects by judgment sampling method. A self-made questionnaire was used for investigation.
ResultsThe self-management skills of 10.0% of the patients were poor, 78.3% were moderate and 11.7% were fine. The self-management skills of functional training and keeping healthy lifestyle were relatively poor. The factors with a score from the highest to the lowest were:the mental self-management, symptom management, keeping healthy lifestyle, and the self-management of functional training.
ConclusionsThe self-management skills of patients with ankylosing spondylitis range from moderate to relatively poor. Our results suggest that cultural factors and the course of disease may be the main influence factors for self-management skills of patients. Clinical medical personnel should know the situation of patients sufficiently, improve the processes of health education and take corresponding intervention measures to the lack of self management ability. By the above ways, we can improve the compliance obedience and the self-management skills of patients, then the patients' condition and living quality will be greatly improved.
Objective?To study the existent dietary hygiene behavior and attitude among college students and to provide references for further education and management. Methods?A self-designed dietary hygiene-related questionnaire based on the KAP (knowledge-attitude-practice) model was conducted in Sichuan University students, with a method of proportionate sampling classified by sex, grade, and major. Results?College students’ hygienic habits were not good enough. It indicated that only 7.8% of the students were concerned about Hygiene License and 30.7% of them held that tableware should be sterilized before using. Besides, only 21% of the students washed hands before meals, 14.9% believed that a health certificate was required for foodservice employees, more than 80% students may buy food on stalls sometimes. Conclusion?A majority of students have requirements for hygienic situations while dining, but they do not know clear specific health standards. A number of students are not used to washing hands before dining. Moreover, lack of hygienic awareness is emphasized when they are facing food with potential safety problems. It is very necessary to strengthen health education and to improve hygienic behaviors in college students.
Objective
To investigate the status of the knowledge, attitudes and intervention behaviors in medical professionals in the prevention and treatment of deep vein thrombosis (DVT), and explore the weak links in knowledge-attitude-practice of DVT.
Methods
From December 2017 to February 2018, a convenient sampling method was used to extract 158 medical professionals out of 204 medical professionals from Department of Orthopedics, West China Hospital of Sichuan University. The questionnaire included the general information and basic situation of DVT learning, the knowledge of DVT, intervention attitude and implementation of preventive measures. The survey involved orthopedic doctors, nurses, rehabilitation therapists and nutrition managers.
Results
A total of 158 questionnaires were distributed and 150 valid questionnaires were completed. The effective questionnaire recovery rate was 94.9%. The mean score of basic knowledge of DVT was 6.45±1.83, the mean score of risk factors was 13.29±3.38, the mean score of intervention attitudes was 9.57±0.78, and the mean score of prevention implementation was 23.33±5.85.
Conclusions
The knowledge-practice of DVT intervention in orthopedic medical staff is moderate, and the attitude of DVT intervention is better among medical staff. There are various characteristics and weaknesses in knowledge-practice. It is necessary to regularly carry out knowledge about DVT among medical staff to improve the professional level of medical staff to prevent and treat DVT.
Objective
To investigate the evaluation of nursing students on nurse teachers’ teaching quality between lessons ofBasic Nursing, in order to provide references for the improvement of teaching methods and promotion of teaching quality.
Methods
Questionnaire survey was used to investigate nurse students on the evaluation of nurse teachers’ teaching quality in three different clinical practice stages between lessons ofBasic Nursing. SPSS 19.0 statistical package was used to analyze the data.
Results
In the 5-point scale, the average score of all items was (4.72±0.38) points, and the average scores of three dimensions including timely project completion and gains in the practice, nurse teachers’ teaching, and teaching environment and resources were respectively (4.71±0.44), (4.76±0.35), and (4.66±0.52) points. The three items with the highest scores were teachers’ theoretical knowledge, teachers’ professional quality, and helping nurse students analyze existing problems; while the three with the lowest scores were teaching methods, timely completion of the practice, and participation by other nurses during the teaching. There were significant differences among the three stages in practice gains, reasonability of practice arrangement, instructing the students to solve problems, proficiency and standardization of the operation demonstration, basic theoretical knowledge, flexibility and enlightenment of the teaching methods, attitudes of the nurse teachers, participation by other nurses during the teaching, and head nurse’s support (P<0.05).
Conclusions
To improve the quality of clinical practice teaching, nurse teachers, other nurses in the ward, head nurse and the whole department should make collective effort. Nurse teachers should pay more attention to the improvement of teaching methods and reasonable planning of clinical practice.
ObjectiveTo evaluate the burden of carbapenem-resistant Klebsiella pneumoniae (CRKPN) and carbapenem-resistant Escherichia coli (CRECO), two types of carbapenem-resistant Enterobacteriaceae (CRE), in pediatric patients in Jiangxi Province.MethodsA retrospective investigation was carried out for the distribution of CRKPN/CRECO in pediatric (neonatal group and non-neonatal group) and adult patients in 30 hospitals in Jiangxi Province from January 2016 to December 2018, and the changing trends and detection situations of different patients and types of hospitals were compared and analyzed.ResultsFrom 2016 to 2018, the annual resistance rates of Klebsiella pneumoniae and Escherichia coli to carbapenem in pediatric patients were 5.89%, 4.03%, and 4.24%, respectively, showed a downward trend (χ2trend=5.568, P=0.018). The resistance rate of Klebsiellae pneumoniae and Escherichia coli to carbapenem in neonatal group was higher than that in non-neonatal group (8.44% vs. 3.40%; χ2=63.155, P<0.001) and adult group (8.44% vs. 3.45%; χ2=97.633, P<0.001). In pediatric patients, the 3-year carbapenem resistance rate of Klebsiella pneumoniae was higher than that of Escherichia coli (9.10% vs. 2.48%; χ2=128.177, P<0.001). In non-neonatal pediatric patients, the 3-year resistance rate of Klebsiella pneumoniae and Escherichia coli to carbapenem in maternity and children hospitals was higher than that in general hospitals (4.35% vs. 1.36%; χ2=25.930, P<0.001). CRKPN/CRECO detected in pediatrics were mainly isolated from sputum (31.64%), blood (24.36%), urine (13.82%), and pus (8.36%).ConclusionAlthough the overall resistance rate of Klebsiella pneumoniae and Escherichia coli to carbapenem in pediatric patients showed a downward trend, that in neonatal patients was still high, and the monitoring and prevention and control measures of CRE should be strengthened in neonatal patients.
ObjectiveTo investigate the evening outpatient service demand in West China Hospital, in order to provide better service.
MethodsUsing self-questionnaire, we investigated 1 734 outpatients and the data were analyzed with SPSS 16.0 software.
ResultsA total of 90.7% of the surveyed patients reported that it was necessary to have evening outpatient service, 53.1% of the patients were willing to come to the hospital in the morning, and 4.2% prefer to come to the hospital in the evening.
ConclusionEvening outpatient service in large general hospitals is getting high social affirmation. It is helpful to those who are inconvenient or unwilling to come to the hospital during day time, and is a complement for day-time outpatient and emergency outpatient service. Consultation time and resource arrangement in the evening outpatient service should conform to the principle of rational allocation for hospital resources.
