ObjectiveTo explore the relationship between the impairment of empathy and anxiety and depression in patients with epilepsy. MethodsAll the patients were collected in the Neurology Department of the First Affiliated Hospital of DaLian Medical University from March 2015 to January 2016, included 93 cases of adult patients with epilepsy and 100 cases of normal control group, all of them were given the test of HAMA, HAMD, MoCA and IRI-C.To analyze the relationship between the ability of empathy and anxiety and depression in patients with epilepsy, in the difference seizure type, frequency and duration of onset. Results1.Compared with the control group, the patients with epilepsy showed impaired ability of dissociative empathy, which was impaired cognitive empathy and emotional empathy, anxiety and depression were also significantly higher than those in the control group, the difference was significant.2.Different types:2.1 GTCS:cognitive empathy:no GTCS, pure GTCS group, SGS group, there were no significant differences between the three groups of empathy scores, emotional empathy, the SGS group had decrease in cognitive empathy with no GTCS, anxiety and depression more serious.There was no difference in cognitive empathy between the SGS group and the pure GTCS group, but the anxiety and depression of the SGS group were significantly serious than those of the pure GTCS group.There was no significant difference between no GTCG group and GTCS group in cognitive empathy, anxiety and depression.There was a significant negative correlation between emotional empathy and anxiety and depression in group SGS.There was no correlation between GTCS and pure GTCS group scores and anxiety depression.2.2CPS:CPS group were worse than those of the non CPS group, and the anxiety and depression were higher than those of the non CPS group.The total score of empathy, emotional empathy and anxiety and depression were significantly negatively correlated.There was no correlation in non CPS group.3.Different seizure frequency:high frequency group empathy scores, cognitive empathy lower in low frequency, anxiety and depression is more serious; empathy and anxiety and depression emotion has showed a significant negative correlation, no correlation between empathy scores, cognitive empathy and anxiety and depression.There was no correlation between empathy scores, cognitive empathy, emotional empathy and anxiety and depression.4.Different onset period:>5 years, empathy scores, cognitive empathy were lower than ≤5 years group and anxiety depression was more serious; emotional empathy and anxiety and depression was negatively related, no correlation between empathy score and cognitive empathy and anxiety and depression. ConclusionsEmpathy ability, cognitive empathy injury, emotional empathy retention declined in adult patients with epilepsy.Anxiety and depression were more severe in adult patients with epilepsy.There is negatively correlated in emotional empathy and anxiety and depression in patients with epilepsy, the scores of cognitive empathy and anxiety and depression have no correlation.The types of epilepsy, seizure frequency, age of onset is associated with cognitive empathy and anxiety and depression in epilepsy, and affect the correlation between empathy and anxiety and depression.
ObjectiveTo explore effective evaluation tools as well as systems of medical service capability related to total payment control of medical insurance. MethodsCombining references and using the Delphi method, the evaluation indicators of total payment control of medical insurance were screened and identified. Then, based on analytic hierarchy process, a weight questionnaire was designed and weighted coefficients of all-level indicators were also calculated. ResultsWe proposed a mathematical model to evaluate medical service capability related to total payment control of medical insurance using three types of primary evaluation indicators and seventeen types of secondary evaluation indicators with their weighted coefficients. ConclusionThe establishment of the evaluation systems of medical service capability in medical institutions could objectively reflect medical service capability to some extent, and provide references on total payment control of medical insurance for medical insurance agencies.
Objective To evaluate the level of nursing competence of clinical nurses and determine its influencing factors so as to provide scientific information for nursing human resource management. Methods A cross-sectional survey was conducted on 1 042 nurses from 8 hospitals by using the Nursing Competence Scale. Results The mean score of nursing competence was 73.99±9.81. Factors influencing the nursing competence included personal interest in nursing, working experience, working position, educational background, hospital level, teaching activities and marital status. Conclusion The surveyed clinical nurses have been equipped with basic nursing competence, however, still needs to be improved. The nursing human resource management should be based on nurses’ competence.
目的：了解ICU病房地震傷員的功能障礙的特點，為臨床康復治療提供依據。方法：運動功能評定應用MMT方法；運用關節角度尺評定關節活動度（ROM）；利用被動關節活動法評定肌張力、痙攣評定選用改良的Ashworth分級法；坐位平衡和站位平衡采用平衡反應試驗評定；日常生活活動（ADL）能力選用國際通用的Barthel指數量表評定。由我科研究生作為評定人員。結果：①ICU病房地震傷員以骨折患者為主,占70%，神經系統損傷占20%，擠壓綜合癥和肺挫傷各占5%；②女性骨折比例高于男性，為11∶3；神經系統損傷沒有多大差異；截肢和癱瘓的患者中，男性高于女性，比例分別為4∶1和3∶2；肺部感染以女性更為明顯，為7∶1；③47.6%的地震傷員關節活動受限（評定21人），93.3%的肌力下降（評定15人），15.8%肌張力下降（評定19人），36.8%肌張力增高（評定19人），30.0%的坐位平衡下降（評定10人），96.4%站立平衡下降；④ADL能力100%受限（評定20人），其中洗澡、修飾、如廁、平地行走45 m、上下樓梯受限均為100%，95%地震傷員進食能力下降，90%穿衣能力受限，35%大便失禁，60%小便控制能力下降，多數使用導尿管，95%地震傷員床椅轉移能力下降；⑤40%出現肺部感染。結論：關節活動度受限、肌力下降、肌張力異常、平衡功能障礙、ADL能力受限及肺部感染是ICU地震傷員主要功能障礙。早期康復介入、維持和改善關節活動度、肌力訓練、減張和牽伸訓練、平衡訓練、呼吸訓練、站立和行走訓練及ADL能力訓練應當作為康復治療的基本原則和方法。
總結華西醫院門診部在2008年反“藏獨”,“5·12”汶川大地震,保“奧運”期間有效的應急措施。回顧性分析了在突發事件發生時實施應急管理、常規管理雙軌運作的對策,探討用科學發展觀加強區域性綜合醫院門診部應急能力建設的策略,為日后門診應急工作的組織和實施提供參考。
Objective To explore the effectiveness of neoadjuvant chemotherapy on postoperative risk of colorectal cancer by use of estimation of physiologic ability and surgical stress （E-PASS）. Methods A total of 161 patients with colorectal cancer according to the inclusion criteria from January 2009 to December 2009 in West China Hospital of Sichuan University were analyzed retrospectively，who were assigned to neoadjuvant chemotherapy group （NC group, 78 patients） and non-NC group （83 patients）. The postoperative risk of each group was assessed by the E-PASS scale including preoperative risk score （PRS），surgical stress score （SSS），and comprehensive risk score （CRS）. Results The baseline of two groups had no significant difference （P＞0.05）. The postoperative complication incidence of two groups had no significant difference either （P＞0.05）， which was 10.26% （8/78） in the NC group，and 7.23% （6/83） in the non-NC group. The PRS was 78.42 in the NC group and 83.42 in the non-NC group （P=0.497）. The SSS was 80.77 in the NC group and 81.22 in the non-NC group （P=0.951）. The CRS was 80.74 in the NC group and 81.24 in the non-NC group （P=0.976）. The accuracy of the postoperative risk assessment was 70 cases and 78 cases in the NC group and non-NC group，respectively. There was no significant difference of accuracy between two groups （P=0.325）. Conclusions Neoadjuvant chemotherapy does not increase the risk of patients with colorectal cancer after operation，and the results suggest that E-PASS scale can provide a more accurate assessment of neoadjuvant chemotherapy in patients with surgical risk.
ObjectiveTo construct the general practice tutors’ ability system in community training bases under the background of hospital-community integrated teaching of general practice.Methods From January to April 2021, literature analysis, expert group consultation, in-depth interview and questionnaire survey were conducted to construct the grass-roots general practice tutors’ ability system, and exploratory factor analysis method was applied, using main component analysis to extract the competency elements. Results There were 4 first level indicators and 20 second level indicators in the system, among which the first level indicators were personal characteristics and professionalism, teaching and research ability, basic level clinical practice ability, and base organization management ability. Conclusion This research enriches the indicators and connotations of the general practice tutors in community training base of general practice, and provides empirical research basis for the selection, ability training and performance evaluation of tutors in community practice bases of general practice medicine.
ObjectiveTo discuss the application of Miller pyramid teaching method in the competency training of new nurses in hemodialysis room and evaluate the effect.MethodsFourteen new nurses in hemodialysis room adopting conventional teaching method from January 2017 to December 2018 were retrospectively selected as the control group; from January to December 2019, another 14 new nurses in hemodialysis room were prospectively selected as the trial group and Miller pyramid teaching method was adopted. After three months of training, the theory and operation of the two groups of new nurses were assessed, and the post competency was assessed by using the Competency Inventory for Registered Nurse, and the teaching satisfaction was assessed by using the self-designed questionnaire on the teaching effect satisfaction of new nurses in hemodialysis room. The data of the two groups were compared.ResultsThe theoretical examination score (91.54±5.89 vs. 83.86±6.45), operational examination score (96.89±3.65 vs. 90.58±5.15), score of Competency Inventory for Registered Nurse (186.66±4.89 vs. 163.76±6.89), and teaching satisfaction (4.56±0.72 vs. 3.56±0.97) in the trial group were all higher than those in the control group, the differences were statistically significant (P<0.05).ConclusionMiller pyramid teaching method is feasible to train the post competency of new nurses in hemodialysis room, which is helpful to improve the theoretical basis, operational skills, post competency, and teaching satisfaction of new nurses in hemodialysis room.
【摘要】 目的 觀察懸吊運動系統治療（sling exercise therapy， SET）聯合神經發育療法治療對痙攣型腦性癱瘓兒童肌張力及日常生活活動能力（activities of daily living，ADL ）的影響。 方法 2008年8月-2009年3月收治的40例雙下肢痙攣型腦性癱瘓兒童納入研究。根據隨機數字表法分為治療組與對照組，每組各20例。對照組與治療組均采用神經發育療法進行康復訓練，治療組在神經發育療法基礎上配合懸吊運動系統治療。觀察兩組患兒治療1、3個月時肌張力與ADL變化。 結果 治療1個月時，治療組患兒肌張力緩解明顯優于對照組（P＜0.05），3個月時，治療組肌張力緩解程度明顯優于對照組。兩組ADL評分比較，治療組ADL評分改善情況明顯優于對照組（P＜0.05）。 結論 懸吊運動系統治療聯合神經發育療法可明顯緩解痙攣型腦性癱瘓患兒童肌張力，提高ADL。【Abstract】 Objective To observe the effects of sling exercise therapy (SET) combined with neurodevelopmental therapy on muscle tension and activities of daily living (ADL) of children with spastic cerebral palsy. Methods Forty children with spastic cerebral palsy on bilateral lower limb were selected in our study. The children were randomly divided into a treatment group and a control group, 20 children in each group. Both the two groups were accepted rehabilitation training by neurodevelopmental therapy, while the treatment group was received SET as cooperate cure based on the neurodevelopmental therapy. The changes of muscle tension and ADL on the one and three months after treatment were observed. Results On the one and three months after treatment, the remission of muscle tension and improvement of ADL score were better than those in the control group, the differences were statistically significant(Plt;0.01). Conclusion SET combined with neurodevelopmental therapy can relieve the muscle tension, and improve the ADL of children with spastic cerebral palsy.
ObjectiveTo explore the characteristics of the criminal cases assessed by forensic psychiatry expertise in order to provide evidence for guiding forensic psychiatric practice, preventing and reducing criminal acts of patients with mental disorders. MethodsWe collected information of 3 720 criminal cases assessed in Forensic Psychiatry Department of Sichuan University, China from January 1997 to December 2011 by using the self-made questionnaire, and analyzed the demographic data, criminological characteristics and expert consensus of psychiatric diagnosis and legal ability. ResultsOut of 3 720 criminal cases, 3 211 (86.3%) were male, and 3 022 (81.2%) were between 18 and 45 years old. A total of 1 683 (45.3%) were married or remarried. A total of 3 178 (85.4%) were under junior middle school, and 3 221 (86.6%) were farmer or unemployed. Schizophrenia (46.7%), without psychosis (13.8%), mental retardation (9.6%) were the top three kinds of diagnosis. Homicide (42.7%), intentional injury (21.5%) and rape/indecency (8.1%) were the main crimes. A total of 1 616 (43.4%) were irresponsible, and 1 172 (31.5%) were with full responsibility. There was a significant correlation between the number of criminal cases in every year and years (rS=0.94,P=0.00), and significant correlation was also found between the percentage of mental disorder caused by drugs and years(rS=0.84,P=0.00), as well as the percentage of mental retardation and years(rS=0.72,P=0.00). ConclusionThe number of cases shows an increasing trend in forensic psychiatry assessment over years. Most of the suspects of criminal responsibility are young and middle-aged male with low level of education, farmer or unemployed. The top three diagnoses are schizophrenia, without psychosis and mental retardation.