Objective To investigate the current status of management and operation in the public hospital pharmacies, and to provide the evidence and suggestions for improving the performance of the public hospital pharmacies. Method According to the principles and methods of business diagnosis, we designed the questionnaire to investigate the ideas of management and operation among 306 managers and pharmacists working in 74 public hospital pharmacies. We used percentage and proportion for statistical description. Result (1) Over 70% participants understood the strategic positioning, brand and development of hospital pharmacy. They had very b senses of innovation and risk awareness, and the comprehensive understanding to the risk and competitive factors. (2) Over 60% considered that the public pharmacies lacked in the awareness of the market competition and crisis, clear management plans as well as the active adaptation to market changes. They were also short of professional dedication and innovation capacity. (3) 52% thought that there was promising future of the public hospital pharmacies. Conclusion The public hospital pharmacies urgently needs the improvement and innovation of the management idea and models.
Objective To investigate the current situations of human resource management in the public hospital pharmacies, and to provide the evidence and suggestions for improving the performance of the public hospital pharmacies. Methods According to the principles and study methods of human resource management, we designed the questionnaire to investigate the human resource management among 307 managers and pharmacists working in 74 public hospital pharmacies. We used percentage and proportion for statistical description. Results 56% participants considered that the public pharmacists had professional qualities. Nearly 73% considered that there were good interpersonal relationship; 45% wanted to do present job. Nearly 75% thought that the mechanism of performance appraisal should be consummated. About 63% considered that the learning and training was not fitting and proper. 63%thought they could not develop their ability and talent. Conclusion The human resource management system in public pharmacies should be improved.
ObjectiveTo investigate the prevalence and associated factors of diabetic retinopathy (DR) among diabetic residents in Longyan of Fujian Province. MethodsA investigative research. From January 2022 to December 2023, a total of 10 061 diabetic patients enrolled in the chronic disease follow-up management system from 112 towns and sub-districts in 7 counties and districts of Longyan of Fujian Province were selected as the target population. A questionnaire survey, routine physical examination, vision test, and non-mydriatic fundus photography were conducted. A total of 762 cases with missing height, weight, blood pressure, fasting plasma glucose (FPG), and diabetes duration, and 507 cases with unclear fundus photography were excluded, resulting in 8 792 cases included in the final statistical analysis. DR diagnosis and classification were based on the 2019 International Clinical Classification of DR. The prevalence of DR was calculated for single-eye or double-eye DR cases as 1 case; the more severe eye was used for DR grading in double-eye DR cases. Statistical analysis was performed by grouping based on the presence or absence of DR and dividing into age groups ≤67 years and >67 years. χ2 test was used to analyze factors associated with prevalence; binary multivariate logistic regression analysis was employed to identify influencing factors of DR. ResultsAmong the 8 792 cases, 888 (10.1%, 888/8 792) were diagnosed with DR (DR group), and 7 904 (89.9%, 7 904/8 792) had no DR (non-DR group). Compared to the non-DR group, the DR group showed significant increases in FPG (Z=−12.448), diabetes duration (Z=−18.936), systolic blood pressure (Z=−4.237), diastolic blood pressure (Z=−2.881), and body mass index (BMI) ≥24 kg/m² (P＜0.001). Significant differences were also found between the two groups in hypertension (χ2=11.450), hyperlipidemia (χ2=5.100), kidney disease (χ2=7.039), family history of diabetes (χ2=5.025), and regular medication use (χ2=66.034) (P＜0.05). There were 4 688 cases in the ≤67 years group and 4 104 in the ＞67 years group. In the ≤67 years group, significant differences in DR prevalence were found for FPG levels (χ2=111.754), diabetes duration (χ2=231.658), BMI (χ2=12.404), systolic blood pressure (χ2=17.912), regular medication use (χ2=40.727), hyperlipidemia (χ2=6.816), and hypertension history (χ2=6.775) (P＜0.05). In the >67 years group, significant differences in DR prevalence were found for FPG levels (χ2=59.916), diabetes duration (χ2=128.362), systolic blood pressure (χ2=5.183), regular medication use (χ2=22.097), kidney disease (χ2=6.251), and family history of diabetes duration (χ2=4.967) (P＜0.05). No significant differences in DR prevalence were found based on sex, education level, smoking history, alcohol consumption, exercise habits, heart disease history, or other family disease history (P＞0.05). Logistics regression analysis results show that patients aged ＞67 years, FPG [odds ratio (OR)=1.074, 95%confidence interval (CI) 1.046-1.102], diabetes duration (OR=1.088, 95%CI 1.071-1.106), systolic blood pressure (OR=1.007, 95%CI 1.001-1.013), and kidney disease (OR=3.617, 95%CI 1.268-10.320) were identified as risk factors for DR (P＜0.05). In patients aged ≤67 years, FPG (OR=1.088, 95%CI 1.067-1.110), diabetes duration (OR=1.108, 95%CI 1.091-1.125), and systolic blood pressure (OR=1.008, 95%CI 1.003-1.013) were identified as independent risk factors for DR (P＜0.05), while BMI ≥24 kg/m² (OR=0.934, 95%CI 0.908-0.965) was a protective factor for DR (P＜0.05). Age, regular medication use, hypertension, and hyperlipidemia were identified as potential confounding factors for DR occurrence. ConclusionsThe prevalence of DR among diabetes patients in Longyan of Fujian Province, is 10.1%. FPG, diabete duration, and systolic blood pressure are independent risk factors for DR, while age, regular medication use, hypertension, and hyperlipidemia are potential confounding factors for DR occurrence.
Objective To explore the challenges of training workshops on Cochrane Systematic Review (CSR) in 2006–2008 and to identify strategies to meet better the needs of the participants. Methods We designed a quantitative survey for all participants and collected their feedback on the arrangements and challenges of the workshop, and on their needs. Results The overall response rate was 82.6% (138/167). The training on CSR evaluated more highly from 2006 to 2008. A total of 167 registered participants from 21 provinces in China took part, and 71.3% (119/167) of them were graduate students. Only 10.9 % (15/138) selected their topics before training. After training, most of the participants were satisfied with the arrangement of the workshop, and thought the most helpful contents were: meta-analysis and statistics 83.7% (113/135), trials selection, inclusion and extraction 79.4% (108/136), literature evaluation 78.1% (107/137), and results analysis and explanation 72.8% (99/136). Some participants desired more time for practical exercises and for advice on keeping track of the development of their reviews. Conclusion The training on CSR has been gradually improved in the past 3 years. Cochrane systematic reviews have become an important research topic for graduate students in this time in China. Most of the participants benefit from the CSR workshop. More time on exercises is needed and the trainees’ further development should be followed up.
Objective To investigate the knowledge level about pulmonary rehabilitation in respiratory physicians in Shanghai. Methods A self-designed questionnaire about pulmonary rehabilitation was sent to respiratory physicians in 18 tertiary-care referral hospitals of Shanghai from June to September 2011. Results A total of 237 valid questionnaires were collected. Accuracy rate of single-answer questions was(62.1±18.3)% , while correct rate of multiple-answer questions ( more than one answer) was ( 35.5±15.6) % . Neither working years nor doctor rank had correlation with accuracy of questionnaires. Conclusion The knowledge about pulmonary rehabilitation in respiratory physicians of Shanghai was poor. We need to strengthen the relevant training and continuing education.
Objective To investigate the attitudes of Chinese doctors towards the difficulties they have concerning the involvement of patients in decision-making about treatment. Method We surveyed 1 088 doctors at different levels (70% internal medicine, 22% general surgery, 8% gynecology) from 20 general hospitals and 5 university hospitals covering 25 provinces and cities in China, using a simple questionnaire, which we had developed. Results A total of 780 doctors returned the questionnaire and of these only 488 (62%) had completed it. The difficulties that doctors were most concerned about focused on lack of time (27%), expressing uncertainties to patients (15%), dealing with patients who have little medical knowledge (13%), eliciting patients’ preferences (12%), and establishing a stable relationship (9%). Conclusion Increasing their knowledge of patient involvement in making treatment decisions may reinforce appropriate attitudes towards this concept among doctors.
Objective To investigate the feedback of continuing medical education (CME) based on short message service (SMS) for village doctors in Gaolan County of Gansu Province, and to explore how to improve the efficiency of CME based on SMS. Methods A total of 75 village doctors were investigated with a questionnaire when attending the training program conducted by the Health Bureau of Gaolan County. Results A total of 75 valid questionnaires were collected back. The statistical analyses showed that 56% of the doctors received the majority of the messages sent to them, of whom, 98% could read the messages promptly, 81% saved the majority of the messages they received, 98% could read the saved massages occasionally, 25% transmitted messages to others, 93% thought that the messages might be helpful in varying degrees, 96% would like to continue receiving the messages in the future, 51% thought the biggest shortcoming of the messages was the poor relevance to their concern, and 70% wanted the most to receive short messages about clinical diagnosis and treatment. At present, 39% of the doctors thought the most convenient approaches to get the updated medical knowledge are attending the study or training program organized by higher authorities, while 37% thought those are reading short messages on the mobile, websites or papers. Conclusion The village doctors are willing to receive the short messages about the best clinical evidence. However, both the receiving rate and use rate of the short messages have yet to improve. A complete SMS transmission system and highly-relevant contents are regarded as important guarantees for improving the receiving rate and use rate.
Objective To survey the current difficulties and guidance expectations of postgraduate students of traditional Chinese medicine (TCM) in writing and publishing international journal papers, in order to optimize the teaching mode of international journal articles for TCM postgraduates. Methods By means of a questionnaire survey, TCM postgraduate students in China were selected as the survey objects from four aspects: basic information, current situation of thesis publication and writing, paper writing difficulties and current situation and expectation of course offering. SPSS 26.0 software was used for data analysis. Results A total of 2 874 valid questionnaires were collected. A total of 1 365 postgraduate students had plans to write international journal papers; 324 postgraduate students had published international journal papers as the first author. The degree of difficulty in writing was generally rated high by postgraduate students, and lack of writing skills and time were the main reasons for the low motivation of thesis writing. A total of 2 547 graduate students felt that guidance on writing papers for international journals was urgently needed, with literature search methods and clinical research methods and experimental design as the most needed guidance, and reviewers and supervisors as the most desired guides. Conclusion The number of TCM postgraduates who have plans to write international journal papers is small, the proportion of publications is low, and the demand for international journal paper guidance courses is high. It is suggested that standardized international journal paper guidance courses be offered to improve the system of cultivating scientific research ability.
Objective To evaluate the applicability of the cut-off points of different versions of the Asthma Control Questionnaire (ACQ) in the Chinese population and their consistency with the symptom control criteria of the Global Initiative for Asthma (GINA), so as to provide strategies for cut-off point selection in clinical practice. Methods Based on baseline data from a multicenter prospective cohort study, asthma patients who completed pulmonary function tests, GINA symptom control assessments, and the ACQ-7 questionnaire were included. Taking the GINA symptom control level as the gold standard, the Receiver Operating Characteristic Curve (ROC) was used to determine the optimal cut-off points of the ACQ for discriminating the GINA symptom control levels, and the consistency was analyzed by kappa statistics. Results Among 399 patients (58.9% female; mean age 44.5 ± 12.8 years), asthma symptom control, partial control, and uncontrolled rates were 61.7%, 27.6%, and 10.8%, respectively. ROC analysis revealed the following optimal cutoffs for identifying symptom control: ACQ-5 (0.5), ACQ-6Res (0.42), ACQ-6PFT (0.92), and ACQ-7 (0.93); for identifying uncontrolled symptoms: ACQ-5 (0.9), ACQ-6Res (1.08), ACQ-6PFT (1.42), and ACQ-7 (1.36). All corresponding areas under the ROC curve (AUC) exceeded 0.9. Consistency between ACQ and GINA symptom control levels was moderate (Fleiss’ κ = 0.453–0.531). Performance characteristics varied between traditional (0.75/1.5) and optimized cutoffs. After optimization, ACQ-5 emerged as the only version achieving balanced sensitivity-specificity (Youden index = 0.75) in dual tasks: ACQ-5 ≤ 0.5 demonstrated sensitivity (91%) and specificity (84%) for symptom control, while ACQ-5 ≥ 0.9 showed sensitivity (95%) and specificity (80%) for uncontrolled status. Conclusions Region-specific calibration of ACQ cutoffs enhances clinical utility in the Chinese population. A stratified application strategy is recommended: high-sensitivity cutoffs for initial screening to reduce underdiagnosis, high-specificity cutoffs for resource-constrained settings to minimize overtreatment, and optimized ACQ-5 cutoffs (≤0.5/≥0.9) for comprehensive management to balance sensitivity and specificity. Flexible combination of cutoff protocols tailored to screening objectives may optimize hierarchical asthma management.
Objective To investigate gastroenterologists’ evidence-based medicine (EBM) practice regarding awareness and application and relevant factors as well. Methods Gastroenterologists in hospitals with the level above other districts and counties in Jiangxi province were requested to take part in the survey using questionnaires from December 2010 to February 2011. Results a) Questionnaires were returned by 414 doctors with a response rate of 84.7%, among whom 55.1% respondents were males with the age of 43.2±15.9 years. b) Sixty-four percent respondents were familiar with EBM, which was independently correlated with working experience no less than 10 years (OR=2.32, 95%CI 1.47 to 3.67), from tertiary hospital (OR=1.81, 95%CI 1.12 to 2.93), specialists in gastroenterology (OR=1.74, 95%CI 1.06 to 2.85) and capability of manipulating endoscopy (OR=1.88, 95%CI 1.11 to 3.17). c) Of all the respondents, 53.1% accumulated clinical experience mainly from consensus/guideline, which was independently correlated with the age (OR=2.09, 95%CI 1.83 to 3.24), education level (OR=2.36, 95%CI 1.28 to 4.34) and capability of manipulating endoscopy (OR=2.10, 95%CI 1.29 to 3.42). d) Only 39.4% of doctors mainly depended on EBM to make clinical decision, which was independently correlated with the position (OR=2.38, 95%CI 1.57 to 3.61) and capability of making medical research (OR=1.63, 95%CI 1.05 to 2.55). Conclusion The awareness of EBM in gastroenterologists is fairly good while the practice of medicine is actually influenced by empirical medicine, especially in doctors with younger age, lower education level and lower position.