目的:信息系统的改进应用是为确保急诊科预检分诊处将来能使医院对自然灾害事件的伤员救治时以最便捷、最快速的方式录入自然灾害事件伤员的信息资料和快速评估伤情，优先准确的将伤员按病情和就诊区域分类，以便畅通及时救治伤员；在治疗中和日后便于识别、查找、统计灾害事件伤员。方法:LIS（检验系统）+ RIS（影像系统）+ HIS（无纸化办公系统）三合一系统和增加自然灾害伤员的“录入信息资料”眉栏。结果:进一步改进信息网络应用系统后，能满足一般患者信息资料录入和自然灾害事件应急状况下的患者资料录入，实现电子病历和电子处方等信息网络系统，达到院内、科内资源共享。
The increasing deteriorative trend of doctor-patient relationship (DPR) have destroyed patient safety, doctor safety and social stability in China. DPR is a complicated social problem related to multidisciplinary and multi-factor interactions. A series of researches providing different views on how to improve DPR in China have been published in recently years. Evidence-based medicine (EBM) aims to deal with massive information by producing, synthesizing and disseminating evidence from complex interventions. We tried to explore the trait of DPR by EBM methods. We provided evidence on research trends, topics and methods by systematic database retrieval, classification by screening, and quality assessment. Through dissection, attribution, and visualization of interactions and relationships between factors, we provided an evidence-supported framework for improvement of DPR. We identified gaps, defects or deficiencies in existing research, and promoted further research. We continued to follow up the research and faced a challenge: Reflection and frustration in the process of establishing the quality evaluation system of qualitative research. We found that the study of complex humanities and social sciences by reference to evidence-based methodology might be: providing a structured, panoramic perspective for complex social problems on " de-fragmentation”, providing a framework for social governance through classification and hierarchy, and calling for a more tolerant attitude and more comprehensive application of methodologies.
ObjectiveTo construct a structural equation model of the mechanism of the role of medical humanities literacy in job competency and to conduct empirical analysis to verify the supporting role of medical humanities literacy in cultivating job competency. MethodsLiterature research was conducted to select the initial indicator system for medical humanities literacy and job competency, and then a conceptual model was constructed. Questionnaire data from four hospitals in Chengdu were collected. Through exploratory factor analysis, an indicator system for medical humanities literacy and job competency more suitable for the research population was obtained and the conceptual model was adjusted. Finally, the positive mechanism of medical humanities literacy on job competency was verified using confirmatory factor analysis (structural equation model). ResultsThe Cronbach's alpha coefficient of the overall questionnaire involved in the exploratory and confirmatory factor analyses was greater than 0.9, and the KMO values of the questionnaire were greater than 0.8, with a Bartlett's sphericity test P value less than 0.01, indicating good reliability and validity of the questionnaire. The model fit of the structural equation model met the requirements, with a chi-square degree of freedom ratio (CMIN/df) of 2.768, root mean square error of approximation (RMSEA) of 0.077, comparative fit index (CFI) of 0.891, normalized fit index (NFI) of 0.840, and incremental fit index (IFI) of 0.891. ConclusionThe improvement of individual characteristics in job competency is mainly influenced by medical humanities knowledge and spirit. The improvement of cognitive characteristics in job competency is mainly influenced by medical humanities knowledge and ability. The improvement of achievement characteristics in job competency is mainly influenced by medical humanities ability and spirit. The improvement of management characteristics in job competency is mainly influenced by medical humanities spirit.
With the advancement of thyroid tumor treatment concepts and the progress of standardized treatment processes nationwide, the 5-year survival rate of thyroid tumors in China has risen from 67.5% in 2003 to 84.3% in 2015. As China has been continuously enriching its treatment options for advanced thyroid cancer in recent years, gradually improving the standardized treatment system for early and intermediate thyroid cancer, enhancing multidisciplinary collaboration methods and concepts, and regularizing scientific statistics, the survival rate of thyroid tumors continues to improve. We still need to consider the future development direction and core driving force of China’s thyroid discipline, correctly view the “prosperous” stage of domestic thyroid discipline development, and actively review the future development direction of China’s thyroid discipline.
Objective A set of core index sets applicable to the treatment of ischemic stroke (IS) by traditional Chinese medicine (TCM) has been constructed to IS as a basis for final determination of core index sets. Methods The exploratory sequence design of mixed methods research (MMR) was used to conduct qualitative research first and quantitative research, and the research model of quantitative research was determined based on the qualitative research results. In the qualitative research stage, focus groups composed of TCM encephalopathy and neurology experts, core indicator set methodology experts, clinical pharmacists of encephalopathy and researchers with more than 10 years of experience were selected by purpose sampling method, and focus group meetings were held around the theme of "indicator domain, indicator hierarchy and indicator attribution". Based on the discussion results, the meeting further designed the quantitative research questionnaire. A questionnaire survey was conducted among medical professionals with TCM background nationwide from September 11 to October 11, 2023, using convenient sampling method. Results In the qualitative research stage, 11 categories of IS index domain were successfully divided, including functional impairment evaluation, imaging index, daily living ability evaluation, TCM therapeutic characteristic index and TCM intervention advantage index. In the quantitative research part, 50 valid questionnaires were collected from 23 hospitals in 13 provinces, with a recovery rate of 76.92%. The recovery rate of the second round was 100%. In the end, the initial list of IS indicators in different stages of disease course was developed. The acute stage included 43 second-level evaluation indexes, 8 third-level evaluation indexes and 87 fourth-level evaluation indexes under 8 index domains. The recovery period includes 45 second-level evaluation indexes, 8 third-level evaluation indexes and 72 fourth-level evaluation indexes under 10 index domains. The sequelae stage included 33 second-level evaluation indicators, 8 third-level evaluation indicators and 70 fourth-level evaluation indicators in 9 indicator domains. Conclusion Based on the exploratory sequence design of MMR, this study successfully divide the index domain that IS scientific, in line with the characteristics of the disease and can reflect the characteristics of the intervention effect of TCM, ensuring the scientific and applicability of the initial IS index list, and laying a solid foundation for the construction of a comprehensive, objective and practical core index set.