In recent two decades, the incidence and severity of medical disputes have been dramatically increasing in China which has a negative influence for patients, doctors and hospitals. It must be seriously regarded that 80% of the medical disputes are caused by the bad attitude of health care professionals, ethical problems, and poor communication skill with patients. Chinese health care professionals should be aware of how to establish a good doctor-patient relationship. The development of evidence-based medicine (EBM) will help us bridge a gap between medical science and clinical practice, revise our opinions, update our knowledge and improve our service. Cooperation with the Chinese Evidence-Based Medicine Center (CEBMC), and the Chinese Medical Doctor Association (CMDA) will help doctors practice legally and in an evidence-based manner so as to protect both rights of patients and doctors.
Objective To seek the best evidence on communication between physicians and patients so as to improve the physician-patient relationship in China. Methods We used the key words ‘physician-patient relationship’ and ‘communication’ to identify related systematic reviews and meta-analyses, and then evaluated them with the Overview Quality Assessment Questionnaire (OQAQ) checklist. Results Seventeen studies were included for final evaluation. According to the OQAQ checklist, the score range of the study quality was 3 to 9. 41.29% (7/17) of the included studies scored 7 to 9, 23.5% (4/17) scored 6, and 35.3% (6/17) scored 3 to 5. Factors influencing physician-patient communication primarily included communication targets, time, contents, and approaches. Conclusion There are not enough studies on physician-patient communication in China. We need to identify the problems affecting communication behavior, encourage patients to express their preferences, choose appropriate training strategies, and make timely evaluation so as to better satisfy the needs of patients and physicians.
Ultrasound Medicine has been through a rapid development during the past half century and has become an indispensable discipline for prophylactic medicine and clinical practice. Nowadays, the needs for ultrasound medicine diverse which leads to many challenges to the existing ultrasound physician scanning - diagnostic mode, including labor-intensiveness for the ultrasound physician, lacking of hierarchical management, contradiction of quality and quantity, irrational allocation of medical resources, and so on. This paper discussed several issues including the current situation of ultrasound education, domestic and western ultrasound work mode, necessity for ultrasound physician- sonographer integrated work mode, as well as the feasibility of standardized sonographer training. Combined with the experience of the West China Hospital, explore a Chinese way to carry out sonographer education and training program and try out ultrasound physician-sonographer integration mode.
Objective To evaluate the effect of physician-nurse-pharmacist collaboration on cardiovascular disease risk factors in diabetes patients. Methods Randomized controlled trails (RCTs) on collaboration among physicians, nurses and pharmacists for reducing cardiovascular disease risk factors in diabetes patients were collected from Cochrane Central Register of Controlled Trials, Medline (Ovid SP), Embase, China Knowledge Resource Integrated Database, VIP and WanFang. We screened the retrieved studies according to the inclusion and exclusion criteria, evaluated the quality of included studies, and then performed meta-analysis with the Cochrane Collaboration’s Revman 5.3.0 software. Results Seven RCTs were included. The results of meta-analysis showed that the change in glycosylated hemoglobin A1c, systolic blood pressure, diastolic blood pressure and low density lipoprotein-cholesterol were significantly reduced in the collaboration group than in usual care group [SMD=–0.39, 95%CI (–0.56, –0.21),P<0.000 1;SMD=–0.30, 95%CI (–0.43, –0.18),P<0.000 01;SMD=–0.37, 95%CI (–0.64, –0.11),P=0.006;SMD=–0.11, 95%CI (–0.16, –0.06),P<0.000 1]. Conclusions Collaboration among physicians, nurses and pharmacists is effective for reducing cardiovascular disease risk factors in diabetes patients. But its long-term efficacy still needs to be confirmed by performing higher quality, large sample RCTs with long-term follow-up.
ObjectiveTo develop Knowledge attitude behavior and practice (KABP) health education path table, and to explore its application in health education of physician-nurse collaboration for children with epilepsy, and provide practical reference for health education of children with epilepsy.MethodsA convenient sampling method was used to select 94 family units of children with epilepsy and their main caregivers from the Department of Neurology in Hunan Children’s Hospital from September 2018 to March 2019. Divided into observation group and control group, 47 cases in each group. In the control group, the health care education was carried out by the conventional method of medical personnel’s one-way input of knowledge. The observation group conducted health education through interactive participation in the path of the health education path of KABP on the basis of regular health education. Then compared the effect of the health education between the two groups.ResultsAfter the intervention, the quality of life scores of the observation group were significantly higher than the control group (P<0.01). The relevant knowledge scores of main caregivers at 1 and 3 months after discharge were significant higher than those in the control group (P=0.008, P=0.001). The medication compliance scores of children with epilepsy at 1 and 3 months after discharge were significant higher than those in the control group (P=0.010, P=0.006).ConclusionsThe KABP health education pathway can improve the knowledge level of caregivers, as well as the medication compliance and quality of life of children with epilepsy.
After more than 10 years of development and construction, the continuous renal replacement therapy subspecialty of the Department of Nephrology of West China Hospital of Sichuan University has made outstanding achievements in the aspect of continuing education. This article discusses and summarizes the current training measures for continuous renal replacement therapy subspecialized refresher physicians in the Department of Nephrology of West China Hospital of Sichuan University, and introduces the training goals, training measures and training results. The purpose is to provide a summary of experience for the continuing education of continuous renal replacement therapy subspecialized refresher physicians, provide a reference for hospitals that plan to develop continuous renal replacement therapy subspecialized refresher physicians training, and assists in promoting the development of continuous renal replacement therapy subspecialized continuing education in China.
ObjectiveTo explore the current status of treatment adherence in patients with chronic kidney disease without dialysis and to analyze its influencing factors.MethodsThe patients who visited the Outpatient Department of Nephrology of West China Hospital of Sichuan University from September to December 2020 were taken as the research objects. Self-designed general information questionnaire, treatment adherence questionnaire, physician-patient communication satisfaction, health information seeking behavior questionnaire, and physician-patient concordance questionnaire were used to investigate, and path analysis was used to explore the influencing factors of treatment adherence.ResultsA total of 203 valid questionnaires were obtained. Treatment adherence score was (21.69±2.42) points, self-reported health status was (2.48±0.91) points, physician-patient concordance was (20.39±2.70) points, physician-patient communication satisfaction was (67.73±5.52) points, and health information seeking behavior was (13.17±2.65) points. Health information seeking behavior (r=0.214, P=0.002), physicians-patient concordance (r=0.494, P<0.001), physician-patient communication satisfaction (r=0.229, P=0.001) were positively correlated with treatment adherence. Self-reported health status was negatively correlated with treatment adherence (r=−0.225, P=0.001). Path analysis showed that physicians-patient concordance was the most influencing factor of treatment adherence (total effect=0.474).ConclusionHealth information-seeking behavior and physicians-patient concordance are important factors affecting treatment adherence in chronic kidney disease patients without dialysis. In order to improve treatment adherence of chronic kidney disease patients, healthcare providers can provide various ways to provide information, which can help make more disease-related health knowledge available to patients. Moreover, healthcare workers should also further explore ways to improve the concordance related to reaching agreement between doctors and patients on medical and treatment options.
Intravitreal drug injection is a treatment for common chronic fundus diseases such as age-related macular degeneration and diabetic retinopathy. The “14th Five-Year” National Eye Health Plan (2021-2025) recommends focusing on fundus diseases and improve the management mode of patients with chronic eye diseases. Therefore, it is imperative to explore how to further optimize the service process of intravitreal injection under the premise of guaranteeing patients' medical safety, to promote medical service efficiency and standardized management level and improve the medical experience of patients. Based on the quality control standard of vitreous cavity injection for retinopathy in China, Chinese fundus disease and related field experts developed the present expert consensus on the establishment of a one-stop intravitreal injection model and the management of its organization after a serious, comprehensive, and complete discussion, focusing on a standardized operation process, quality control, and safety management, providing more references for establishing a suitable intravitreal injection management model for ophthalmology and promoting the development of diagnostic and treatment models for fundus disease in China.