Objective To explore the factors which influence the doctor-patient relationship and to provide evidence to help decision makers improve hospital management and construct a harmonious doctor-patient relationship. Methods Discharged patients of West China Hospital from 2003-2006 were randomly selected and asked to complete a specially designed questionnaire. Results In total, 8 000 questionnaires were distributed and 2 526 were returned. The retrieval rate was 31.57%. The responses showed that non-medical factors have became the main factors affecting the doctor-patient relationship (91.8%). Other important factors included medical cost (21.5%) and doctor-patient communication (11.51%). Conclusion We should boost hospital management level, train non-medical staff, save costs and improve doctor-patient communication.
Objective To provide references for the rational allocation of health personnel in rural hospitals through understanding the status of health human resources of rural hospitals in remote and poor areas of Sichuan Province. Methodes This study used cluster sampling method, combined with questionnaire survey and qualitative interviews. A total of 711 health workers of 29 rural hospitals in Pengzhou and Baoxing of Sichuan Province were interviewed. SPSS16.0 was used for descriptive analysis.Results The average age of rural hospitals health personnel in remote and poor areas of Sichuan Province was 30 years old. Post-secondary education accounted for 58.12%, and Bachelor degree or above accounted for 7.2%. The number of medium and senior professional titles account for 8.4 %. The ratio of doctors to nurses was 1:0.55. In the survey of health workers, those doctors with practice (assistant) license accounted for 38.5%, and those without any qualification occupied 27.1 %. Conclusions The professional titles of medical personnel of rural hospitals in remote and poor areas in Sichuan province are generally low. The distribution of professional categories is irrational. The staff in charge of prevention and care are inadequate. There exist a large number of unqualified medical workers. Therefore, the government should increase the investment in rural health and take measures to stabilize the team structure, introduce the talented, and strengthen the training for health personnel of rural hospitals to improve their overall quality.
Objective To investigate the diabetic knowledge of primary hospital doctors and diabetes patients, and to explore the way to improve the capability of primary hospitals in preventing and treating diabetes. Methods Between January 2013 and June 2014, we set questionnaires to learn the profiles of diabetes knowledge of 328 internal and general medicine doctors including 43 chronic disease management workers from fifteen township hospitals and two community health centers, 152 doctors from village clinics, and 575 diabetes patients in Xindu District of Chengdu City. We made questionnaires for doctors and patients respectively to investigate their knowledge on diabetes and blood sugar control in the patients. Finally, we made plans to train doctors in primary hospitals according to the results of the investigation. Results For township hospitals, 328 questionnaires were given out with 319 retrieved, and the valid retrieval rate was 97.3%; 152 questionnaires were given out to village doctors and 149 were retrieved, with a valid retrieval rate of 98.0%; and we gave out 575 questionnaires to the diabetes patients and retrieved 539, with a valid retrieval rate of 93.7%. Primary hospitals were insufficient in their drug varieties. Among doctors in township hospitals, 7.8% had bachelor’s degree, 53.6% had received post-secondary education, and 38.6% had received secondary vocational education. Most of the village doctors had not received any professional medical education, among whom, 89.9% had a certificate of village doctors and 10.1% had a certificate of assistant doctors. The diabetes questionnaire score of primary hospital doctors was low, while the score of chronic disease management workers was relatively higher (P<0.05). For diabetes patients, medical investment was inadequate, treatment rate was low, common sense of diabetes was insufficient, and glycosylated hemoglobin control rate was only 13.5%. Conclusions Diabetes patients in primary hospitals have a poor disease control, which is probably associated with the insufficient publicity and education from doctors. It is necessary to train primary hospital doctors at all levels. In order to get the best therapeutic effect, we advocate that diabetes should be managed by doctors of chronic disease management, although they should receive systematic training for a long time.
Objective To investigate the prevalence and related factors of primary palmar hyperhidrosis in adolescents in Yangzhou. Methods On-site questionnaire survey was performed on students selected by cluster random sampling from the two colleges and two high or middle schools, with each class as a unit. Data were collected through the questionnaire to make the diagnosis and severity grading. Results A total of 3 487 copies of the questionnaire were distributed in the survey and 3 299 were finished, among which 3 083 were effective with an effective rate of 88.41%. Among them, 1 358 respondents were males and 1 725 were females; 933 were middle school students, 809 high school students, and the remaining 1 341 college students. According to the diagnostic criteria, 104 respondents were diagnosed with palmar hyperhidrosis with an overall prevalence of 3.37%. There were 60 (4.41%) males and 44 (2.55%) females. Although the prevalence of palmar hyperhidrosis in males was higher than that of females (χ2=8.130, P<0.05), severe palmar hyperhidrosis was more often to be observed in females than in males, and females were also more likely to have hyperhidrosis in other parts of the body. In addition, the age of the first onset of the disease was mainly 10 to 20 years old and 36.54% of the patients had a family history. Conclusion The prevalence of palmar hyperhidrosis in adolescents in Yangzhou was 3.37%, and there is a significant difference in the gender. The palmar hyperhidros is often accompanied by hyperhidrosis symptoms of other parts of body, and the disease shows an obvious genetic predisposition.
ObjectiveTo understand the cognition and mediation tendencies of health care workers in terms of third-party mediation for medical disputes, analyze the factors influencing the trust of both doctors and patients on third-party mediation, and propose suggestions on building third-party mediation mechanisms for medical disputes. MethodsBetween August and December 2012, we made the cognition questionnaire on third-party mediation for medical disputes based on the past medical literature, and the knowledge of doctor-patient relationship as well as third-party mediation agency's organizational structure (including locations and management authorities), staffing, mediation basis, validity sources and fund ensuring. We performed the random cluster sampling survey on all health care workers in five hospitals of different levels. The original data were put into the computer for statistical analysis by SPSS 18.0. ResultsThe knowledge of health care workers on third-party mediation was high. They believed that the best place for solving medical disputes should be the court or judicial administrative department, and the management authorities should be health administrative departments. In case of mediation failure, the majority of health care staff chose to continue to solve the dispute through legal channels. For the effectiveness of mediation conclusion, most health care workers tended to believe in the form of arbitration. They thought that mediators should have professional background of medicine and law; the majority of those surveyed doctors tended to accept forensic conclusions as a basis for mediation. For determining the compensation, doctors were in favor of Applicable Regulations for Medical Malpractice. Over 40% of medical staff believed that third-party mediation should be financed by government financial allocation, and more than half of the medical staff believed that it should be paid by the insurance company. ConclusionThird-party mediation should be set in and managed by the court or judicial and administrative departments. Mediator group should be formed by professionals of law and medical sciences. In the mediation process, it is recommended that the focus of controversy should be identified by forensic identification in order to form a clear division of responsibilities and high mediation efficiency. We recommend that the government introduce in financial allocations at all levels on the basis of medical liability insurance system, and force medical institutions to purchase medical liability insurance through the regulations of law, in order to provide funding support for the operation of third-party mediation organizations. Meanwhile, medical liability insurance companies should be operated under strict supervision to avoid their interference on the mediation work.
Objective To analyze caring ability and its associated factors among baccalaureate nursing students, so as to put forward suggestions for improving students’ caring ability. Methods A cross-sectional study was used to investigate baccalaureate nursing students’ caring ability and its associated factors in 4 nursing departments of medical universities in Sichuan province. Results The grade of overall status quo of students’ caring ability was 189.72±19.57, and the mean item scores of different subscales showed that patience was highest and courage was lowest.Two variablescould explain the differences in baccalaureate nursing students’ caring ability: relationship with mother and clinical practice. Conclusion Our study suggests that students’ caring ability could be improved by practicing caring and increasing their exposure to clinical practice. Our findings also suggest that school, society and family are all involved in the cultivation of caring ability.
Objective To investigate the cognition degree and clinical use of new COPD classification system of 2011 GOLD in respiratory specialists, and further analyze the reasons of failing to clinical use. Methods Respiratory specialists from 42 hospitals in Chongqing were investigated through questionnaire survey. The questionnaire contains two parts. The first part contains nine questions about the knowledge of 2011 GOLD new COPD classification system and its clinical use. The second part contains six questions about the reasons of failing to clinical use of the COPD classification system. Results A total of 204 valid questionnaires were recovered. More than 90% respiratory specialists had understood the new COPD classification system with different degree, and believed it is suitable for clinical use. More than twothirds respiratory specialists knew well the ways about CAT and mMRC, but only 24% specialists were using these ways. The main reasons of failing to clinical use were as follows: 60% specialists believed the pulmonary function test can evaluate the COPD classification, and 66. 7% specialists were limited by short visit time. The cognition degree and clinical use of the new COPD classification systemin the specialists from third grade A class hospitals was better than those from the other hospitals. But the difference was not significant among specialists with different professional title.Conclusion Respiratory specialists in Chongqing knew well about the new COPD classification systemin 2011 GOLD, but did not use it widely in clinical works due to the complicated operation of the new COPD classification system.
目的 以问卷调查形式了解患者对就医现状及医患关系的认知度，以期为医疗机构管理者完善医疗服务行为，构建和谐医患关系提供参考依据。 方法 2009年8月－11月，采用自制问卷对6所不同医院因伤/病住院治疗终结患者进行调查，并对调查结果进行统计分析。 结果 大多数被调查者认为目前“看病贵”，且收入水平对医疗服务的选择有影响；医患信任程度与医患沟通呈正相关；被调查者对医患纠纷的认知主要来自于媒体的报导，且认为媒体报导是公正的。 结论 医疗机构管理者应强化医护人员“以人为本”的理念，加强医患沟通，以防范服务性医患纠纷；政府应深化医药卫生体制改革，以解决“看病贵”问题；媒体应加大力度宣传普及医疗相关法律法规及知识，以引导人民群众尽可能正确客观看待医疗结果，摒除不切实际的医疗高期待。
Objective To investigate human resource allocation in primary health care and the essential medical service and publ ic health service status in urban and rural areas in Chengdu, so as to provide basel ine data for the Special Healthcare Program of Comprehensive Reform for Coordinated and Balanced Urban-Rural Development in Chengdu. Methods We carried out a stratified (three circles in Chengdu) sampl ing of 7 township hospitals (rural hospitals) and community health service centers; and then performed secondary research based on a comparative analysis of relevant pol icies of the World Health Organization (WHO) and Chinese governments at all levels. Results According to the WHO and national average standards, the number of staff per 1 000 rural hospitals / centers health personnel of the 7 rural hospitals / centers occupied only 1%-22% of the global average standard. There was a very large gap between the number of staff and the number of personnel required, based on the size of the population that should be served in the administrative areas in 2006 or the number of cl inic patients in 2006. The primary healthcare personnel structure was irrational. For example, the constituent ratio of health technical personnel was 4% to 33% higher than the global average level, and the constituent ratio of (assistant) physicians was also 17% to 45% higher than the global average level. However, the ratio of nurses, laboratory workers, other health professionals, administrative and supporting personnel was generally lower than the global average level. Women dominated among the primary healthcare personnel, and people aged 45 years or below counted for more than 75% (except Bailu and Wangjiang rural hospitals/centers). People with an educational background of two-year college education or secondary education or below took up 70% to 90%; while those with an intermediate title or assistant /primary title accounted for 50% to 100%. The structure rational ity of distribution density, educational background and academic titles of healthcare personnel showed a decreasing trend from the first circle to the third circle in Chengdu city. Conclusion The primary health workers in the second and third circle have been overloaded with low incomes for some time. They are facing enormous challenges in their professional skills, service awareness, as well as difficulties in continuing education and professional title promotion. It is very difficult to provide qual ified "six in one" primary health care and publ ic health services in a long-term and stable manner. It is suggested that we enroll and train more skilled people for primary health care service, and provide continuing education chances for current health care personnel. We should also adopt a mechanism to select qual ified personnel based on their performance, and take measures to solve some of the problems faced by the grass-root health personnel, such as heavy work burden, low income, poor skill and promotion. This will help us to construct a stable and qual ified primary healthcare team.
ObjectiveTo survey on the health-related knowledge in cadres, in order to regulate corresponding health management strategies. MethodsQuestionnaires were used to collect data of 816 examinees who accepted physical examination in our hospital between June and July 2014. Factors affecting health examination service efficiency were identified to formulate a scale and a questionnaire for surveying examinees' preparatory status before examination and general information. The correlation between their preparatory status and demographic features was analyzed. The results were used to support management decision-making. ResultsOf the 816 examinees, 396 had a score over 6 points (48.5%, well prepared) and 420 had 6 points or below (51.5%, poorly prepared). The male preparation before examination was significantly poorer than the female (χ2=4.318, P=0.038). ConclusionWe should strengthen the knowledge education for cadres before physical examination.