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.
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.
ObjectivTo investigate the incidence of depression and its etiological factors in patients with hypospadias after operation. MethodsFrom January to June 2015, we investigated the incidence of depression symptoms among patients with hypospadias after surgical treatment from January 1990 to December 1994 in Zhangzhou Affiliated Hospital of Fujian Medical University, and we matched them with mentally healthy adults of the same age to 1:1 ratio. Zung Self-Rating Depression Scale and Correlation Factor Questionnaire were used to investigate and analyze the related factors of depression symptoms between the patients with hypospadias and the healthy males. ResultsA total of 80 patients with hypospadias after surgical treatment and 80 healthy males as control were included. There were no significant differences in male secondary sexual development, testis development, serum testosterone levels and postoperative length and girth of the penis in two groups. The incidence rate of depression symptoms was 45.0% (16/80) in the hypospadias patients after operation, extremely significantly higher than 6.3% (5/80) in the control group (χ2=6.632, P=0.01). The result of multiple stepwise regression analysis showed that the main risk factors of depression symptoms were worries about dissatisfaction with penile and scrotal appearance (F=16.210 3, P=0.001), sexual satisfaction (F=4.621 2, P=0.036) and sexual function (F=4.103 2, P=0.043). ConclusionSymptoms of depression often occur in hypospadias patients after operation, and the major etiological factors are dissatisfaction with penile and scrotal appearance, sexual satisfaction and sexual function.
Objective To investigate the lung involvement in Chinese patients with systemic sclerosis ( SSc) and its functional impact. Methods 68 patients with SSc were enrolled in Scleroderma study of PUMCH ( Peking Union Medical College Hospital) . All the patients underwent high resolution computed tomography ( HRCT) , pulmonary function testing, 6-minute walk testing, and echocardiography. And 36 patients filled in the Saint George’s Respiratory Questionnaire ( SGRQ) for assessment of healthrelated quality of life. Results HRCT revealed interstitial lung disease ( ILD) in 52 ( 76. 5% ) patients, 20 out of them without respiratory symptoms. Reticular opacification, ground-glass opacity ( GGO) , traction bronchiectasis, and honeycomb were presented respectively in 80.8% , 73.1% , 59.6% , and 30.8% of patients with SSc-ILD. Fibrosis was the predominant HRCT finding, and pure GGO ( in the absence of reticulation or architectural distortion) was only present in 8 ( 15. 7% ) patients. 57 (83.8% ) patients presented with diffusion defect, with most of them having moderate to severe impairent. Reduced FVC or TLC presented in 20 ( 29.4% ) and 28 ( 41.2% ) of patients respectively. The significant correlation was observed between the DLCO and the extent of ILD on HRCT ( rs = -0.476, P =0.000) . DLCO showed significant correlations with all the four components of the SGRQ ( Plt;0.05) . Significant correlations were also observed among the SGRQ scores and SpO2 ( maximum desaturation) or Borg index. Stepwise multiple regression analysis confirmed that the DLCO, SpO2 , and Borg index contributed to the SGRQ. Conclusions Lung involvement in Chinese SSc patients is common and insidious. The HRCT features of SSc-ILD are predominant fibrosis plus GGO, indicating little reversibility. Thus HRCT should be performed routinely in newly diagnosed SSc patients for early screening of lung involvement. The lung function defect of SSc is characterized by reduced diffusing capacity, and DLCO show better correlations with HRCT abnormities or SGRQ than FVC or TLC. Thus DLCO is of great value for early detection or severity assessment of SSc-ILD. SGRQ can be used to examine the health related quality of life of SSc patients and may reflect severity of lung involvement.
ObjectiveTo evaluate the method quality of systematic reviews/Meta analysis published in nursing journals. MethodsWe retrieved Chinese Biomedical Literature Database, Chinese academic literature online publishing pool and Chinese Scientific Journals Database (the duration was from the beginning to August, 2013). The systematic reviews and Meta analysis published in nursing journals were included, and were evaluated by 10 items in OQAQ (Oxman-Guyatt Overview Quality Assessment Questionnaire). ResultsA total of 74 literatures were included in the analysis, including 17 systematic reviews and 57 Meta-analyses. It showed that the mean OQAQ score was 2.92±1.63. About 4.1%, 8.1%, 31.1%, 43.2%, 29.7%, 55.4%, 16.2%, 37.8%, and 60.8% studies stated literature research methods used to find evidence; had reasonably comprehensive search; avoided bias in the selection of studies by duplicate screening; reported the criteria used for assessing the validity of the included studies; concluded the findings by the data or analysis; provided a list of studies; assessed using appropriate criteria; reported the methods used to synthesis the findings; and combined the findings of the included studies appropriately. ConclusionThe systematic reviews/Meta analysis of the overall quality in nursing field is low. The search strategy, inclusion and exclusion criteria, quality assessment and data analysis is particularly prominent, researchers should conduct rigorous methodological training.
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 investigate the reading habits of authors of articles published in the Chinese Journal of Evidence-Based Medicine (CJEBM) and to compare the findings with those from other surveys. Methods A total of 512 questionnaires were sent to authors who had contributed to CJEBM over the past 7 years. Results A total of 129 questionnaires were returned (response rate 31.6%). The replies showed that the main purpose of reading literature was to keep up with the latest developments in medicine (94% of replies). The main reading material was medical journals (86%). Most respondents (57%) spent more than 3 hours a week reading journals. The biggest problem identified by authors was the lack of full text papers, but the first choice was the electronic versions of the literature. More than half of the authors (57%) said that they spent less time reading than in the past. Conclusion Effective reading of the medical literature is a basic requirement in the practice of evidence-based medicine. It is necessary and important for clinicians and healthcare providers to improve their reading skills and methods.
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 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.
ObjectiveTo investigate the problems in the use of quick-drying hand disinfectants and formulate intervention measures to improve the hand hygiene compliance of nursing staff.MethodsFrom February 2014 to June 2016, the hand hygiene compliance of nursing staff was continuously observed according to the hand hygiene observation table recommended by the World Health Organization. The questionnaire on the use of quick-drying hand disinfectants, which passed the reliability and validity test, was used to find out the reasons leading to the low compliance rate of hand hygiene among nurses, and pertinent interventions were formulated. From November 2016 to December 2017, intervention measures were gradually implemented throughout the hospital, and the hand hygiene compliance of nursing staff was continuously observed again. Then we compared the compliance rate of hand hygiene and the compliance rate of hygienic hand disinfection among nurses in the second quarter of 2016 (before intervention) with those in the last quarter of 2017 (after intervention).ResultsThe compliance rates of hand hygiene and hygienic hand disinfection among nurses before intervention were 62.15% and 49.77%, respectively, and those after intervention were 91.64% and 90.80%, respectively. The differences were statistically significant (P<0.05).ConclusionThe factors affecting the hand hygiene compliance of nursing staff are identified through questionnaires and targeted intervention measures have effectively improved the hand hygiene compliance rate of nursing staff.