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.
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 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.
ObjectiveTo develop the questionnaire and test its reliability for investigating route, prevention, and control of SARS-CoV-2 infection in medical staffs.MethodsThis questionnaire was development based on the COVID-19 relevant guidelines, official documents issued by the National Health Committee of the People's Republic of China, and published studies. The development group performed repeated discussions and drafted the first questionnaire, then performed expert consultation and revised the draft according to their suggestions. Eventually, some frontline medical staffs were invited to carry out pre-test investigation of the questionnaire and test its reliability.ResultsThe first draft included 48 items; 18 experts were invited in the first round questionnaire and 10 experts in the second round questionnaire. The positive coefficient of experts in these two rounds was both greater than 75%, and the authority coefficient of experts' opinions was greater than 0.70. The variation coefficient of these items was between 0.00 and 0.35, the coordination coefficient of experts was 0.193 (P<0.05). The experts of above two rounds put forward 14 suggestions for text modification or adjustment options of some items; after the development group held repeatedly discussions, a total of 8 items were performed secondary consultation and finally reached consensus. The final questionnaire included two domains of questionnaire before and after confirmed diagnosis. The domain "before confirmed diagnosis" covered 4 sections and 29 items involving infectious cause, plan and knowledge of prevention and control, and psychological symptoms. The domain "after confirmed diagnosis" covered 5 sections and 21 items, included symptoms, treatment, and psychological status after diagnosis; impact on the surrounding environment and people, and awareness of protection after infection. The pre-test results showed that the total items were considerably numerous, some items were difficult to understand, some laboratory results and treatment conditions were ambiguous, etc. After modification and re-testing, the test-re-test reliability of each domain was between 0.74 and 0.93, and the overall re-test reliability of the questionnaire content was 0.82.ConclusionsThis research has developed a questionnaire for investigating infection process, prevention and control of SARS-CoV-2 infection in medical staff, and the items considered two domains prior to and after confirmed diagnosis. The reliability and practicability of the questionnaire are acceptable.
Objective To investigate the current leadership status of public hospital pharmacies, and to provide evidence and suggestions for further improving the performance of public hospital pharmacies. Methods According to our conception of the key characteristics of leadership, we designed a questionnaire to investigate leadership practices among 306 managers and pharmacists working in 74 public hospital pharmacies. We used percentage and proportion for statistical description. Results (1) Over 70% of participants thought that public pharmacies lacked independent decisiveness; power was distributed; and elections were democratic. (2) Nearly 60% thought that public pharmacies lacked effective communication and awareness of service. (3) Nearly 70% thought that leader’s abilities were not exceptional. (4)There were not obvious advantages or disadvantages among the leaders. (5) Half trusted the leaders and thought there should be no change. Conclusion Public hospitals should grant more power to pharmacies to implement effective leadership.
ObjectiveTo evaluate the reasonableness of anticoagulation management strategy in patients after mechanical heart valve replacement. MethodsAll patients were followed and registered continually at outpatient clinic from July 2011 to February 2013, with a minimum of 6 months after surgery. Targeted international normalized rate (INR) 1.60 to 2.20 and warfarin weekly dosage adjustment were used as the strategy of anticoagulation management. Except bleeding, thrombogenesis and thromboembolism, time in therapeutic range (TTR) and fraction of TTR (FTTR) were adopted to evaluate the quality of anticoagulation management. ResultsA total 1 442 patients and 6 461 INR values were included for data analysis. The patients had a mean age of 48.2±10.6 years (14-80 years) and the following up time were 6 to 180 months (39.2±37.4 months) after surgery. Of these patients, 1 043 (72.3%) was female and 399 (27.7%) was male. INR values varied from 0.90-8.39 (1.85±0.49) and required weekly doses of warfarin were 2.50-61.25 (20.89±6.93 mg). TTR of target INR and acceptable INR were 51.1% (156 640.5 days/306 415.0 days), 64.9% (198 856.0 days/306 415.0 days), respectively. FTTR of target INR and acceptable INR were 49.4% (3 193 times/6 461 times), 62.6% (4 047 times/6 461 times). There were 8 major bleeding events, 7 mild bleeding events, 2 thromboembolism events, and 2 thrombogenesis in the left atrium. ConclusionIt is reasonable to use target INR 1.60-2.20 and warfarin weekly dosage adjustment for patients after mechanical heart valve replacement.
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.
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 understand the attitude of xinjiang medical workers towards national essential drugs and the requirements and suggestions about training, so as to provide necessary baseline information for spreading the application of Essential Medicine List (EML) in Xinjiang. Methods A questionnaire designed by Chinese Evidence-Based Medical Center was distributed for a face-to-face survey. The data were double-input by EpiData 3.1 with double checks, and statistically analyzed by EXCEL with constituent ratio as the statistical index. Results A total of 80 questionnaires were distributed and then retrieved with 100% recovery rate. Respondents employed in six public hospitals at or above the county level and in six community health service centers as well. a) The accuracy of 80 respondents about the basic concepts of essential drugs, serviceable range of EML, and the relationship between EML and basic medicare drug list were 72.6%, 89.5% and 17.8%, respectively; b) 33.8% (27) of the respondents always firstly considered using the essential medicine in their prescription, and 22.5% (18) of the respondents considered using essential drugs in most cases; c) EML were welcome loy 35% (28) of the respondents; d) The problems of practicing EML issued by respondents were the following in order: doctors’ awareness of essential drugs and prescribing habit of doctors, the safety and effectiveness of essential drugs, lower income, patients’ awareness of essential drugs and preference to medication, and the applicability of the essential medicine list; e) The main approaches to getting information about essential drugs were academic seminars (37 person-time, 46.2%), professional journals (27 person-time, 33.8%) and documents (25 person-time, 31.2%); f) There were 46 respondents who had participated in EML training once or twice; g) The total EML training or learning time of 34 respondents (42.5%) was less than one week; and h) Respondents suggested that, the training objects should be medical personnel, pharmacists and administrators; the training contents should be rational drug use, formularies and the use of essential drugs, drug policy, and the effectiveness of integration of the traditional Chinese medicine and western medicine; the training methods should be theoretical teaching and online learning; and the training place should be hospitals, homes or offices. Conclusion It is extremely urgent to improve doctors’ awareness of EML and strengthen the training of usage, and to conduct the research on EML applicability and effectiveness evaluation, financial subsidies, medical staff income, purchase and reimbursement problems.