Objective To assess the effect of a new educational model for evidence-based medicine (EBM), which is called "2+N" model with the main characteristic of classroom teaching plus volunteer practice. Methods Questionnaire survey was conducted to collect data. Results There were averagely 39 volunteers participated in this activity per year, with an increasing trend. Most of them were sophomore and junior undergraduates from different specialties in medical filed. All participates acquired a better understanding of EBM knowledge; more than 60% of them could handle data searching, collecting and assessing by themselves in the end of the activity. Conclusion Our five years’ experience of EBM education practice for medical students suggested that the new educational model has a promising future.
ObjectiveTo develop a survey questionnaire on preferences and values regarding perineal injury prevention measures during pregnancy and conduct reliability and validity tests. MethodsCombining literature reviews, qualitative interviews, and expert consultations, we summarized key elements of perineal injury prevention during pregnancy and synthesized the best evidence. Through multiple discussions within the core working group, a survey questionnaire on preferences and values regarding perineal injury prevention measures during pregnancy was formulated. Using convenience sampling, pregnant women were recruited, and a pre-survey was conducted using the questionnaire. Pre-survey results were analyzed using item analysis and reliability and validity testing methods to validate and refine the questionnaire. ResultsThe questionnaire was compiled based on the theory of evidence-based decision-making. The initial version of the questionnaire was developed by combining systematic evaluation, network meta-analysis, and semi-structured interviews. The questionnaire was modified and improved through expert consultation, group discussion, and pre-investigation, which ensured that the questionnaire had good reliability, validity, and practicability. The Cronbach's α coefficient was 0.87, the split-half reliability was 0.71, and the content validity index was 0.97 of the survey questionnaire. ConclusionThe present version of the perineal injury preventive measures preference and values questionnaire has good reliability, validity, and practicability. It can serve as a valuable tool for investigating preferences and values related to perineal injury prevention during pregnancy.
Objective To get the information about the cognition and attitude towards organ transplantation and donation in inpatients. Methods The inpatients were investigated by using a self-designed questionnaire，including general data，cognition and attitude towards organ transplantation and donation. The influence factors of organ transplantation and donation were analyzed by SPSS 18.0. Results A total of 1 000 questionnaires were delivered，973 returned，the effective questionnaire was 906，and the effective rate was 93.1%. In 906 valid questionnaires，788 （87.0%） patients knew organ transplantation；189 （20.9%） patients had transplanted relatives；511 （56.4%） patients were willing to accept the organ transplant surgery，226 （24.9%） patients did not want，169 （18.7%） patients did not know；490 （54.1%） patients agreed to donate organ，173 （19.1%） patients disagreed，243 （26.8%） patients did not know. The age，education，occupation，knowing organ transplants，and with organ transplanted relatives or not had significant influences to the willingness towards organ transplantation and donation （P＜0.01）. The gender had no effect on organ transplantation （P=0.727） and donation （P=0.935） concerned issues，but the age，education，knowing organ transplantation，and with organ transplanted relatives or not had significant influences on it （P＜0.01）. Most concerned factors about organ transplantation were as follows：with an available organ for transplantation 〔28.7% （260/906）〕，postoperative quality of life 〔23.0% （208/906）〕，risk of surgery 〔21.5%（195/906）〕，surgery costs 〔19.5% （177/906）〕，and postoperative rejection 〔7.3% （66/906）〕. Most concerned factors about organ donation were as follows：the reasonable usage of donated organs 〔57.4% （520/906）〕，attitude of relatives 〔23.8% （216/906）〕，and donation compensation 〔17.6% （159/906）〕，and others 〔1.2% （11/906）〕. According to the way of organ donation，403 （44.4%） patients were willing to accept donation after cardiac death （DCD），257 （28.4%） patients accept donation after brain death，246 （27.2%） patients accept living organ donation. The gender，education，and occupation had significant influences on the way of organ donation （P＜0.05），but age，knowing organ transplantation，and with organ transplanted relatives or not had no effects on it （P＞0.05）. Conclusions The lack of propaganda and the high costs of transplantation surgery are the main factors restricting the acceptance rate of organ transplantation. Over time，with continuous improvement of universal education and strengthening the publicity of organ transplantation，the acceptance rate will show a constant increase in the trend. By now，the most accepted way of organ donation is DCD in inpatients. The establishment of a reasonable organ allocation and compensation system is a corner stone to promote organ donation.
Objective To understand the attitude of xinjiang medical workers towards national essential drugs and the requirements and suggestions about training, so as to provide necessary baseline information for spreading the application of Essential Medicine List (EML) in Xinjiang. Methods A questionnaire designed by Chinese Evidence-Based Medical Center was distributed for a face-to-face survey. The data were double-input by EpiData 3.1 with double checks, and statistically analyzed by EXCEL with constituent ratio as the statistical index. Results A total of 80 questionnaires were distributed and then retrieved with 100% recovery rate. Respondents employed in six public hospitals at or above the county level and in six community health service centers as well. a) The accuracy of 80 respondents about the basic concepts of essential drugs, serviceable range of EML, and the relationship between EML and basic medicare drug list were 72.6%, 89.5% and 17.8%, respectively; b) 33.8% (27) of the respondents always firstly considered using the essential medicine in their prescription, and 22.5% (18) of the respondents considered using essential drugs in most cases; c) EML were welcome loy 35% (28) of the respondents; d) The problems of practicing EML issued by respondents were the following in order: doctors’ awareness of essential drugs and prescribing habit of doctors, the safety and effectiveness of essential drugs, lower income, patients’ awareness of essential drugs and preference to medication, and the applicability of the essential medicine list; e) The main approaches to getting information about essential drugs were academic seminars (37 person-time, 46.2%), professional journals (27 person-time, 33.8%) and documents (25 person-time, 31.2%); f) There were 46 respondents who had participated in EML training once or twice; g) The total EML training or learning time of 34 respondents (42.5%) was less than one week; and h) Respondents suggested that, the training objects should be medical personnel, pharmacists and administrators; the training contents should be rational drug use, formularies and the use of essential drugs, drug policy, and the effectiveness of integration of the traditional Chinese medicine and western medicine; the training methods should be theoretical teaching and online learning; and the training place should be hospitals, homes or offices. Conclusion It is extremely urgent to improve doctors’ awareness of EML and strengthen the training of usage, and to conduct the research on EML applicability and effectiveness evaluation, financial subsidies, medical staff income, purchase and reimbursement problems.
ObjectiveTo understand patients’ cognition of third-party mediation model for medical disputes, analyze the factors influencing the trust of patients on third-party mediation, and propose recommendations for building third-party mediation mechanisms.
MethodsFrom November 2013 to April 2014, we referred past literature to design a relevant questionnaire on the cognition of third-party mediation for medical disputes. Patients who had reached the end of the treatment were surveyed by random cluster sampling. The raw data were put into the computer for statistical analysis by SPSS 18.0.
ResultsAfter giving out 500 questionnaires, we acquired 486 effective questionnaires. The result showed that 61.52% of the patients knew of third-party mediation; 55.35% of the patients considered that thirdparty mediation should be set in and supervised by the court or judicial administrative department; if the mediation failed, 57.41% of the patients chose to resolve the dispute through legal channels, and 67.90% of the patients tended to confirm the force of mediation conclusion by arbitration; 70.58% of the patients considered that mediators should have professional background of medicine and law; 73.05% of the patients tended to take conclusions of forensic identification as the basis for mediation; 64.81% of the patients were biased to take Tort Liability Act as the basis for determining the compensation; 53.70% of the patients believed that financial allocations could solve the fund problems of third-party mediation, while 38.48% of the patients thought the funds should be provided by insurance companies; 91.15% of the patients thought the medical institutions should purchase medical liability insurance, and 54.32% of the patients thought insurance companies should not intervene the process of meditation. Conclusions Government should provide financial allocations to ensure the funds of third-party mediation. Besides, medical insurance should be brought in as a supplement. Medical institutions should purchase medical liability insurance to solve problems caused by medical disputes. Third-party mediation should be set in and supervised by the court or the judicial administrative department. Mediators should have professional background of medicine and law. Conclusions of forensic identification should be the basis for third-party mediation.
Objective To evaluate the control status and knowledge level about disease in asthmatic patients in region level cities of Shaanxi province for effect appraisal of patient education. Methods Eight hospitals were selected from six region level cities, where questionnaire survey was completed in out-patients with asthma ( ≥14 years old) . Results A total of 523 patients completed the questionnaire with a ratio of male to female of 1∶1. 14, and an average age of ( 44. 3 ±15. 5) years old. The percentage of controlled,partly controlled and uncontrolled by self-evaluation was respectively 26. 4% , 52. 4% and 11. 1% . 48% insisted on using inhaled corticosteroids ( ICS) . The average score was 17. 88 ±4. 43 by asthma control test ( ACT) . The first three medicines used daily were ICS ( 26. 6% ) , sustained-release theophyline ( 25. 2% )and combination ICS/ long-acting β2 -agonists ( 21. 8% ) . 12. 6% had no medicine and 5. 2% used nonorthodox medicines. 68. 6% patients had omen before exacerbation, and those were sneezing, chest distress and cough. 73. 6% knew asthma is a disease of airway inflammation, and 33. 3% selected ICS as the leader medicine. Only 32. 1% attended the lecture about asthma in hospitals and 85. 0% longed for such education. Conclusions The control status and knowledge level about disease in asthmatic patients in cities still need to be improved in Shaanxi province, and too much work need to be done in order to realize the total control in all patients.
Objective To investigate the decision-making situation of doctors in the township hospitals in Gaolan, Gansu province, and to discuss its scientificity and rationality. Methods Self-designed questionnaire was adopted to investigate the clinical decision-making situation of 108 doctors from 7 township hospitals in Gaolan county. The investigation contained three parts as follows: basic information of respondents, general information of clinical decision-making evidence, and comparison between respondents’ decision-making situation and current best clinical evidence. Results Among the total 108 questionnaires distributed, 89 valid were retrieved. The feedback showed that 79% of the doctors diagnosed and treated patients in accordance with medical textbooks; 53% took curative effect into consideration in the first place; 33% failed to consider patients’ willingness properly when making clinical decisions; and 52% made clinical therapy regimen for common diseases based on the evidence which was different from that in BMJ published Clinical Evidence. Conclusion While making clinical decisions, doctors in the township hospitals do not adequately refer to the best clinical evidence as their decision-making basis, and fail to take patients’ value and willingness into consideration properly. It is necessary to promote the concept of evidence-based medicine and spread the best evidence in the township health departments.
Objective?To investigate the current status of new clinical medical postgraduate students on their learning goals and expectation of employment, and to provide the evidence and suggestions for improving the management of medical postgraduates’ training. Methods?We designed the questionnaire to investigate the current status of learning goals and expectation of employment of new clinical medical postgraduate students of Lanzhou University. We issued 164 questionnaires and took back 164 ones, among which 157 were effective, with the effective rate of 95.7%. Results?(1) The proportion of the postgraduates with working experience was less than 50%, and most of these worked in the municipal and county hospitals. (2) The 78.3% of them considered that clinical and research abilities were of the same importance. (3) The 65.6% of them expected to get Medical Science Degree; (4) The 96.8% of them wanted, after graduation, to engage in clinical work or the work in which clinical affairs and research were equally important, and only 3.2% hoped to engage in research-oriented work; (5) Although clinical skills and research capabilities of the first-year medical postgraduates were very poor at their entrance to the graduate school, their expectations of employment were very high. Conclusion?(1) The improvement and innovation of medical postgraduates’ clinical and research training are urgently needed. (2) The publicity and supporting policies should be enhanced for Clinical Medicine Degrees, and the postgraduates should be guided to comply their own expectations with social needs properly.
ObjectiveTo understand the cognition and mediation tendencies of health care workers in terms of third-party mediation for medical disputes, analyze the factors influencing the trust of both doctors and patients on third-party mediation, and propose suggestions on building third-party mediation mechanisms for medical disputes.
MethodsBetween August and December 2012, we made the cognition questionnaire on third-party mediation for medical disputes based on the past medical literature, and the knowledge of doctor-patient relationship as well as third-party mediation agency's organizational structure (including locations and management authorities), staffing, mediation basis, validity sources and fund ensuring. We performed the random cluster sampling survey on all health care workers in five hospitals of different levels. The original data were put into the computer for statistical analysis by SPSS 18.0.
ResultsThe knowledge of health care workers on third-party mediation was high. They believed that the best place for solving medical disputes should be the court or judicial administrative department, and the management authorities should be health administrative departments. In case of mediation failure, the majority of health care staff chose to continue to solve the dispute through legal channels. For the effectiveness of mediation conclusion, most health care workers tended to believe in the form of arbitration. They thought that mediators should have professional background of medicine and law; the majority of those surveyed doctors tended to accept forensic conclusions as a basis for mediation. For determining the compensation, doctors were in favor of Applicable Regulations for Medical Malpractice. Over 40% of medical staff believed that third-party mediation should be financed by government financial allocation, and more than half of the medical staff believed that it should be paid by the insurance company.
ConclusionThird-party mediation should be set in and managed by the court or judicial and administrative departments. Mediator group should be formed by professionals of law and medical sciences. In the mediation process, it is recommended that the focus of controversy should be identified by forensic identification in order to form a clear division of responsibilities and high mediation efficiency. We recommend that the government introduce in financial allocations at all levels on the basis of medical liability insurance system, and force medical institutions to purchase medical liability insurance through the regulations of law, in order to provide funding support for the operation of third-party mediation organizations. Meanwhile, medical liability insurance companies should be operated under strict supervision to avoid their interference on the mediation work.
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.
