ObjectiveTo understand the treatment status and economic burden of convulsive epilepsy patients in Hailin City, Heilongjiang Province, who had received an epilepsy management program that was terminated for 6 years, and to estimate the long-term effect of the epilepsy management program.MethodsFollow up the 234 patients in the program of epilepsy prevention and management in rural areas at the end of December 2011 by standardized questionnaire and interview.ResultsAmong the 234 patients who received antiepileptic drugs (AEDs) and follow-up management at the end of epilepsy prevention and management program in rural areas, 172 patients received Phenobarbitone (PB) and 62 patients received Sodium valproate (VPA). 86 patients completed the survey. Among them, 46 (53.49%) were still taking original drugs, 31 (36.05%) changed to other AEDs, 9(10.47%) gave up the treatment due to the closure of the program. The treatment costs of patients in adherence group were also lower than that of other patients, and the average cost was only 43.61% of that of the replace group. There were statistical significant differences in annual household income, drug costs, offset seizure frequency and current seizure frequency between the two groups.ConclusionThe epilepsy management program had remarkable long-term effects and short-term effects, it had advantages in treatment effect and reducing drug costs. It could be recommended throughout rural China.
ObjectiveThe purpose of this study was to offer new suggestions for current clinician training under the guidance of the Healthy China 2030 policy by investigating the patients’ needs.MethodsThis study surveyed adult outpatients from West China Hospital of Sichuan University between March and July, 2019 and February and May, 2020 by self-constructed questionnaires to investigate the expectation and requirements of outpatients towards medical professionals.ResultsA total of 430 questionnaires were distributed, and 402 of them (93.5%) were collected and included in this study. All questionnaire respondents expected that medical graduates should have outstanding expertise and ethical standard. The majority valued qualities such as physical and mental health (90.05%), a bachelor’s degree or higher (73.88%), knowledge on disease control and prevention (61.69%), knowledge on health care (91.29%), ability to continuously update current knowledge (70.65%), and excellent communication (71.14%) and teamwork (62.44%) skills. In addition, most patients expected that new health care providers to possess humanitarianism and professional dedication relevant traits, and could improve diagnoses and treatments via research activities. Patients’ demand for abilities such as disease control and prevention, health care, and integrative cooperation between traditional Chinese medicine and modern medicine significantly increased after the COVID-19 pandemic (P<0.05).ConclusionsNowadays, to provide health care services which meet the needs of the public, clinicians are expected to have qualities such as outstanding expertise, humanity, research and knowledge-updating skills, disease control and prevention, health care management, and capability to take the advantages of traditional Chinese medicine and modern medicine.
Objective To investigate the awareness and clinical needs of wearable artificial kidney among maintenance hemodialysis (MHD) patients, and to analyze the related influencing factors. Methods MHD patients were recruited from 2 tertiary hospitals in Sichuan province between April and June 2021. The convenient sampling method was used to select patients. The factors influencing the awareness and demand of MHD patients for wearable artificial kidney were analyzed. Results A total of 119 MHD patients were included. The awareness of wearable artificial kidney among the patients was mainly “never heard” (61 cases) and “heard” (58 cases). Most MHD patients (60 cases) were willing to use and participate in clinical trials in the future. The results of logistic regression indicated that the cost on household economy and treatment effect on life quality were the influencing factors for MHD patients’ awareness of wearable artificial kidney (P＜0.05). The average duration of single dialysis and the impact of treatment on working or studying were the influencing factors for MHD patients’ needs of wearable artificial kidney (P＜0.05). Conclusions The awareness of wearable artificial kidney is low among MHD patients. However, most MHD patients showed great interest in the wearable artificial kidney after preliminary understanding, suggesting that the future clinical application of wearable artificial kidney has great demand.
ObjectiveTo investigate the job satisfaction, emotional state and related factors of medical staff participating in online consultation of West China Internet Hospital during the COVID-19 epidemic.MethodsThrough literature review and expert consultation (Delphi method), the questionnaire was developed, and the online consulting medical staff of West China Hospital of Sichuan University were invited to conduct the questionnaire survey from 26 January to 19 June 2020, and finally the statistical analysis was summarized.ResultsA total of 132 valid questionnaires were retrieved. Of the 132 subjects, 127 people (96.2%) expressed satisfaction or special satisfaction with the online consulting office format; 103 respondents (78.0%) said that online consulting did not affect or completely did not affect the work and life; 81 people (61.4%) consulted online more than 5 days a week, and 108 people (81.8%) worked within 2 hours a day; the vast majority (97.7%) of the research subjects were satisfied with the content of the training materials and the related support work of the coordination group. Only 29 (22.0%) of the study participants believed that the epidemic caused negative emotions, mainly due to the severity of the epidemic.ConclusionThe online consulting medical staff are satisfied with the office form, training materials and coordination work group of the COVID-19 epidemic, and think that it does not affect their work and life. 22.0% of medical staff have negative emotions, and the severity of the epidemic is the main reason.
Objective To investigate the current status of multi-disciplinary team (MDT) in outpatient clinics of medical institutions in Sichuan, and to provide reference for further promoting the MDT model in outpatient clinics. Methods In November 2022, questionnaires were distributed to the outpatient management personnel of Sichuan Outpatient Management and Medical Quality Control Center from various medical institutions. The questionnaire included the basic information of the survey subjects and medical institutions, the current status of outpatient MDT work, the current status of operation and management, and the internal and external influencing factors of MDT development. Results A total of 106 questionnaires were received, of which 104 were valid. There were 70 hospitals that had provided outpatient MDT services, with a development rate of 67.31%, mainly concentrated in the past 5 years. A total of 60 hospitals (85.71%) had established MDT related systems, but only 14 hospitals (20.00%) had carried out relevant quality evaluation work. Among the 104 outpatient management personnel surveyed, 83.65% believed that the external factor affecting the development of outpatient MDT was the lack of correct understanding of MDT by patients, and 78.85% believed that the internal factor affecting the development of outpatient MDT was the low participation enthusiasm of departments and doctors. Conclusions The outpatient MDT in Sichuan is still in its early stages of development, and the outpatient MDT model has not yet been unified in terms of establishment standards, organizational methods, operational management, and fee standards. In the future, relevant departments and medical institutions still need to work together to promote its sustainable development.
Objective To investigate the current situation of sterile supply management in primary healthcare institutions in Pudong New Area of Shanghai, analyze the existing problems, and provide a scientific basis for formulating and implementing follow-up improvement measures. Methods The primary healthcare institutions in Pudong New Area were surveyed from June to July 2024. The contents of the questionnaire included the nature of the institution, sterile supply mode, personnel, facilities and equipment configuration, quality monitoring and sterile supply management. Results A total of 71 valid questionnaires were collected, including 25 public institutions and 46 non-public institutions; 29.6% used the sterile supply mode outside the hospital, and 70.4% used the sterile supply mode inside the hospital. In primary healthcare institutions with in-hospital sterile supply mode, part-time staff accounted for 46.1%, staff under the age of 40 accounted for 69.5%, professional qualification holding rate was high (94.3%), and their education was mainly junior college (60.3%). Healthcare institutions were all equipped with steam sterilizers, and the configuration rate of cleaning and disinfection machines (92.0%) were high, but the configuration rate of water treatment and drying equipment (70.0%), information traceability system (48.0%) and low-temperature sterilizers (10.0%) were low. Disinfection and sterilization quality monitoring had been widely carried out (96.0%), but the cleaning quality monitoring rate was low (88.0%). The implementation rate of multiple requirements exceeded 96%, but the utilization rate of information traceability system was low (36.0%). The proportion of primary healthcare institutions with out-of-hospital sterile supply mode that conducted quality monitoring, requested quality reports and carried out on-site inspection on the goods provided by the service provider were less than 80%. The proportion of healthcare institutions with full-time personnel, contaminated equipment collection and temporary storage room and sterile goods handover and distribution room did not exceed 80%, and the utilization rate of information traceability system was also less than 50%. Conclusions There are still deficiencies in personnel allocation, equipment and facilities, quality monitoring and system implementation of sterile supply management in primary healthcare institutions in Pudong New Area.
ObjectiveTo investigate the incidence, severity and longitudinal trajectories of symptoms at various time points in the perioperative period of lung cancer patients, and to provide scientific basis for clinical staff to implement predictive nursing and dynamic management of symptom clusters. MethodsA prospective longitudinal investigation was conducted. The patients with lung cancer who underwent thoracoscopic lung surgery in four wards of the Department of Thoracic Surgery in our hospital were investigated by face-to-face and telephone follow-up before surgery, 1-2 days after surgery, on the day of discharge and 2 weeks after discharge. The investigation tool was the revised Chinese version of MD Anderson Symptom Inventory lung cancer specific module. Results A total of 192 patients with lung cancer were included in this study, including 59 males and 133 females, with an average age of (55.68±11.01) years. There were two symptom clusters (respiratory-gastrointestinal and emotional/psychological-disturbed sleep symptom clusters) before surgery, three symptom clusters (respiratory, gastrointestinal, and emotional/psychological-disturbed sleep symptom clusters) 1-2 days after surgery, three symptom clusters (pain-fatigue-emotional/psychological, respiratory, and gastrointestinal symptom clusters) on the day of discharge, and two symptom clusters (pain-fatigue-respiratory and respiratory symptom clusters) 2 weeks after discharge. The composition of symptoms was different in each time point during perioperative period. ConclusionThere are four symptom clusters in patients with lung cancer during perioperative period, which are pain-fatigue-disturbed sleep symptoms, gastrointestinal symptoms, respiratory symptoms and emotional/psychological symptoms. The symptom clusters of lung cancer patients at different time points are relatively stable, but the symptoms within the symptom clusters show dynamic changes. Medical staff should attach great importance to and continuously monitor the dynamic changes of perioperative symptom groups of lung cancer patients, do relevant education and nursing in advance, and timely adjust the management plan according to the symptom group evaluation results.
ObjectiveTo analyze the epidemiological characteristics and factors and detection ways of leprosy in Zhushan county in Hubei province, so as to provide scientific basis for developing measures to treat and prevent leprosy after basic elimination.
MethodsWe summarized the detection rate, incidence and prevalence of leprosy in Zhushan county in Hubei province during 1955-2012; compared the stage when detecting leprosy, deformity/disability rates and costs according to different detection ways; and conducted descriptive epidemiological analysis.
ResultsLeprosy outbreak distribution in Zhushan county in Hubei province covered 17 villages/towns, of which patients were the most in 4 southeast villages/towns. Among 123 cases of patients with leprosy, the youngest aged 4, the oldest aged 74, and the patients aged 20-39 were the most (42.28%); the sex ratio were 1.73 to 1 (male to female); most patients were peasants (83.74%); the main infection sources were family members and neighbours (45.53%, respectively); economic level, health and living condition were the main factors relevant to the prevalence of leprosy; and applying tests in people with foci contact history detected the most patients with leprosy on early stage, which caused the lowest deformity/disability rates.
ConclusionWe should consistently strengthen the training of medical personnel; improve medical personnel ability of detecting leprosy; take tests for people with foci contact history and tracking as active detection ways; monitoring patients' family members as well as close contacts during 10-year latent period; and conduct timely tracking, so as to in time detect, isolate, and treat patients with leprosy, reduce the incidence of deformity/disability, and control the transition of leprosy.
Objective To investigate the rehabilitation status of patients with cerebral apoplexy at different ages six months after discharge from hospital. Methods Using the Barthel Index, the Modified Rivermead Mobility Index, the Zung Self-rating Depression Scale, and a self-designed rehabilitation exercise questionnaire, we conducted a cross-sectional investigation on the daily living ability, mobility, depression, and self-rehabilitation exercise of 207 stroke patients six months after discharge, who were discharged from the Rehabilitation Department of West China Hospital of Sichuan University between April 2017 and July 2019. The rehabilitation status of young and middle-aged (≥20 and <60 years old) stroke patients and elderly (≥60 years old) stroke patients were compared. Results There were 91 elderly patients and 116 young and middle-aged patients. Six months after discharge, the incidences of dysfunction in daily living ability (97.8% vs. 90.5%; χ2=4.598, P=0.032) and depression (51.2% vs. 36.2%; χ2=4.043, P=0.044) were higher in the elderly patients than those in the young and middle-aged patients, and the mobility score (26.38±9.77 vs. 29.47±10.60; t=2.154, P=0.032) and the proportion of patients taking self-rehabilitation exercise (93.4% vs. 100.0%; χ2=5.708, P=0.017) were lower in the elderly patients than those in the young and middle-aged patients. Conclusions In the process of continued rehabilitation nursing, different rehabilitation nursing measures should be implemented according to different ages, focusing on elderly stroke patients, and strengthening the supervision and promotion of rehabilitation training of daily living ability and mobility, psychological nursing and self-rehabilitation exercise compliance of elderly patients.
Objective To investigate critical thinking disposition inventory on medical students to offer evidence for building a medical education model with core competency as guide, evidence-based medicine as carrier and lifelong learning as purpose. Methods Chinese Version of Critical Thinking Disposition Inventory was used to investigate the current status of critical thinking of 617 medical undergraduates and graduates of Sichuan University. Results The average total score was more than 280 points. Average total scores of medical students in different educational systems from high to low were 309 points (eight-year-program), 298 points (postgraduates), 287 points (seven-year-program) and 286 points (five-year-program), respectively. The scores of three items including “seek truth”, “systematicity” and “confidence” were lower than 40 points in students both of five-year-program and seven-year program. There was no significant difference in total scores and each item between genders and varied ages. Conclusion The main factors which influence critical thinking in medical students of China include education idea, teaching atmosphere, teaching methods and teaching evaluation system.
