ObjectiveTo analyze responsiveness of Chinese version of Neck Outcome Score (NOOS-C) and provide a reliable measure to assess intervention effect for patients with neck pain.MethodsCross-cultural adaptation of NOOS was performed according to the Beaton’s guidelines for cross-cultural adaptation of self-report measures. Eighty patients with neck pain were recruited between September 2016 and May 2017. Those patients were assessed using NOOS-C and Chinese version of Neck Disability Index (NDI) before and after intervention. And 71 patients completed those questionnaires. The statistic differences of the score of each subscale and the total scale before and after intervention were evaluated by paired-samples t test. Internal responsiveness was determined by effect size (ES) and standardized response mean (SRM) based on the calculated difference before and after intervention. External responsiveness was analyzed by Spearman correlation coefficient.ResultsThe differences in symptom subscale, sleep disturbance subscale, participating in everyday life subscale, every day activity and pain subscale, and the scale between before and after intervention were significant (P<0.05) except for mobility subscale (P>0.05). The difference of NDI-C before and after intervention was –12.11%±17.45%, ES was 0.77, and SRM was 0.69. The difference of NOOS-C before and after intervention was 13.74±17.22, ES was 0.83, and SRM was 0.80. Spearman correlation analysis revealed that the relativity about NOOS-C and NDI-C before and after intervention were both negative (r=–0.914, P=0.000; r=–0.872, P=0.000).ConclusionNOOS-C’s responsiveness is good.
Objective To investigate problems in applying clinical epidemiology and evidence-based medicine in the field of dentistry in China. Method In early April of 2001, about 200 copies of a questionnaire were sent to chief editors of dental journals, directors and famous experts of the university dental schools and/or dental departments of the provincial/metropolitan hospitals located in the mainland of China. The sent back questionnaires were summarized and analysized. Results At the end of June, 2001, 40 replies from the experts of 12 universities and one metropolitan dental hospital were received. The main points are summarized as following: EBM in China is at starting stage of "anti-illiteracy" campaign. There are 6 out of 12 universities having delivered clinical epidemiology courses to postgraduates (2 to undergraduates), only 3 added lectures on evidence-based medicine to dental students and/or professionals, only one university held intensive training courses on EBM to clinicians. In dental practice there are still scram dentists making decisions simply by experiences. In the research practice some dentists are eager for quick success, and instant benefits, ignoring, scientific design aid quality control of the studies. Randomized controlled clinical trials are seldom appeared in Chinese dental journals. To popularize EBM in all dental clinicians is important for them to use and produce the best evidences. Conclusions EBM in dental field of China is at starling stage. Collection and dissemination of best dental evidences in dental professionals is a key to raise the dental care levels in China.
Objective To investigate the validity of estimating American Spinal Injury Association Impairment Scale (AIS) grade with a bowel-routine based self-administered questionnaire for assessment of sacral sparing after spinal cord injury (SCI).Methods The 5-item SCI sacral sparing self-report questionnaire was administrated to SCI inpatients from August 2014 to July 2016, followed by an standardized digital rectal examination. Question 1 (perceiving the tissue), Question 2 (identifying the water temperature as warm or cold), Question 3 (perceiving the inserted finger), and Question 4 (perceiving the inserted enema tube) tested the sensory sacral sparing, and Question 5 (holding the enema for more than 1 min) evaluated the voluntary anal sphincter contraction. Based on the answers from each participant, the sensory and motor sacral sparing was implied, and an estimated AIS grade (AIS A, AIS B, or AIS C/D) was recorded. Agreement of the estimated AIS grade and the actual AIS grade according to the physical examination was analyzed. Sensitivity, specificity, and Youden’s index of the questionnaire for estimating completeness of injury were calculated.ResultsA total of 102 SCI patients were enrolled. The general agreement of estimated and actual AIS grades was good (κ=0.681, P<0.001). For the estimation of a complete injury, both the sensitivity (87.10%) and the specificity (100.00%) of this questionnaire were high, with a Youden’s index of 0.87. For the estimation of a motor complete injury, the sensitivity increased (92.00%) while the specificity decreased slightly (75.00%), with a Youden’s index of 0.67.ConclusionsThe validity of this self-report questionnaire for estimation of AIS grade is good. In some situations, it could be considered as an alternative tool for the estimation of sacral sparing as well as the AIS grades within SCI individuals, especially when repeated anorectal examinations are not feasible.
Objective To understand the new characteristics of clinical symptoms of patients with mild COVID-19 during the prevalence of SARS-CoV-2 Omicron, and provide basis for better prevention and treatment of COVID-19.Methods A cross-sectional retrospective study was conducted with WeChat questionnaire among medical staff with COVID-19 recently, who come from the Third Affiliated Hospital of Chongqing Medical University and The Second Affiliated Hospital of Army Medical University.Results A total of 630 valid questionnaires was received. 99.2% of infected people had been vaccinated against COVID-19. 2.4% of infected persons developed pneumonia and 2.1% were hospitalized. The most common symptoms after infection were coughing (89.7%), fever (83.0%), fatigue (84.1%), headache and dizziness (75.7%), muscle soreness (72.7%), sore throat (62.1%), nasal congestion and runny nose (60.6%), expectoration (71.6%), anorexia (58.0%) and taste loss (40.2%). The incidence of gastrointestinal symptoms and cardiovascular symptoms was relatively low (17.8% and 31.0% respectively). The severity of self-reported symptoms of most infected persons was moderate or severe. The proportion of serious symptoms reported was coughing (23.8%), sore throat (27.0%), headache and dizziness (17.9%). The severity of symptoms reported by young group (<35 years old) was significantly higher than that of older group (>35 years old). Fever was the highest at 38 to 39 ℃ (52.4%). 77.0% of fever sustained for 1 to 3 days. At the time of investigation, the viral detection turned negative in 60.6% of infected people, and the time of turning negative was mostly 7 to 10 days. More than half of the infected persons still had different symptoms, among which cough (43.7%) and fatigue (23.8%) were the most common.Conclusions Most subjects with mild COVID-19 infection have obvious upper respiratory tract and systemic symptoms, the most prominent is the high incidence of cough, which has become a new feature of omicron infection. And most of the infected people have moderate to severe symptoms, and the younger ones have more severer symptoms.
ObjectiveTo compare the effectiveness of radiofrequency ablation (RFA) combined with transilluminated powered phlebectomy (TIPP) vs. high ligation and stripping (HLS) combined with TIPP in patients with varicose veins of lower limbs.MethodsA retrospective analysis was made on the clinical data of 190 patients (206 limbs) of varicose veins of lower limbs who underwent surgical treatment in our hospital from December 2017 to July 2018, of them 88 patients (96 limbs) in RFA combined with TIPP group and other 102 patients (110 limbs) in HLS combined with TIPP group. The treatment effectiveness and quality of life was assessed with venous clinical severity score (VCSS) and chronic venous insufficiency questionnaire (CIVIQ-14) in three months and one year after surgery. Doppler ultrasound was used to evaluate the closure of great saphenous vein.ResultsBaseline characteristics were similar between the two groups (P>0.05). The RFA combined with TIPP group was better than the HLS combined with TIPP group in operation time, intraoperative bleeding, hospital stay time, postoperative bed time, resumption time of activities, as well as incidences of skin induration and limb numb (P<0.05). Occlusion rates of great saphenous vein in 3 months was 93.8% (90/96) in the RFA combined with TIPP group and 97.3% (107/110) in the HLS combined with TIPP group, and in one year was 91.7% (88/96) and 97.3% (107/110) respectively, there was no significant difference between the two groups at the same time point (P>0.05). The VCSS scores and CIVIQ-14 scores also improved significantly in two groups in 3 months and 1 year follow up (P<0.05), but there was no significant differences between the two groups at the same time point (P>0.05).ConclusionsRFA combined with TIPP is an effective method for the treatment of varicose veins of lower limbs. Compared with HLS, RFA has the same good effectiveness and quality of life, but it has the advantages of short operation time, rapid postoperative recovery, and less postoperative complications.
Objective To investigate the free influenza vaccination of health care workers in major departments and explore the possible influencing factors of influenza vaccination of staff. Methods In November 2021, a questionnaire survey was conducted among health care workers who received free influenza vaccination in 19 major departments of West China Hospital of Sichuan University, and the un-vaccinated workers’ information was obtained from the registration system of staff information. Multiple logistic regression model was used to analyze the possible influencing factors of free influenza vaccination. Results The coverage rate of centralized free influenza vaccination of staff in major departments was 32.7% (1101/3369). Multiple logistic regression analysis showed that workers who were female [odds ratio (OR)=1.853, 95% confidence interval (CI) (1.481, 2.318), P<0.001], with an educational background of high school or below [OR=4.304, 95%CI (2.484, 7.455), P<0.001], engaged in nursing work [OR=2.341, 95%CI (1.701, 3.221), P<0.001], and with 11 or more years of working experience [OR=2.410, 95%CI (1.657, 3.505), P<0.001] were more likely to inject influenza vaccine, and workers who had a bachelor’s degree were less likely to inject influenza vaccine. Conclusions The rate of free influenza vaccination among medical staff is low. In order to mobilize the enthusiasm of influenza vaccination among medical staff, it is necessary to analyze the characteristics of the population and take targeted measures to improve the level of vaccination among medical staff.
Objective To compare BODE index with GOLD staging for the severity evaluation in patients with chronic obstructive pulmonary disease ( COPD) . To investigate the relationship between BODE index and quality of life. Methods A total of 100 patients with stable COPD were enrolled. All participants were examined with lung function test and St George’s Respiratory Questionnaire ( SGRQ) for evaluation of quality of life. BODE index and it’s four components including body mass index( BMI) , airflow obstruction ( FEV1%pred) , dyspnea( MMRC) , and exercise capacity( 6MWD) were calculated. The participants were divided into four groups of severity using GOLD guidelines and BODE index quartiles. Results The associations between SGRQ total score and SGRQ subscales, and BODE index were significant( P lt;0. 01) .BODE index was a significant predictor of the quality of life, explaining 41. 3% of the total score of the SGRQ ( P lt;0. 01) . However, GOLD classification showed a correlation only with SGRQ activity score ( P lt;0. 05) but not with other SGRQ scores. There were significant differences in SGRQ total score and SGRQsubscales between different severity groups of BODE index( P lt;0. 01) . But there was no difference in SGRQ score between different severity groups of GOLD classification, except SGRQ activity score. Conclusion BODE scoring system is better correlated with the quality of life as assessed by the disease severity inpatients with COPD than the GOLD staging criteria.
Objective To investigate the satisfaction of patients who signed up for chronic disease continuous health management services, so as to provide a theoretical basis for improving service quality. Methods We conducted an online anonymous survey by issuing an electronic questionnaire to all patients who met the inclusion criteria through the short message platform of the hospital from October 8th to 19th, 2021, and used χ2 test and logistic regression to compare the differences in satisfaction among different patients and explore the factors affecting satisfaction. Results A total of 3311 short messages were send out, and 816 valid copies of questionnaire were recalled. The total satisfaction was 77.3%, and the satisfaction before, during and after service were 86.0%, 75.2% and 73.7%, respectively. The items with low satisfaction included service pricing (58.9%), online follow-up (57.5%) and overall cost reduction (43.9%). There were significant differences in satisfaction among patients of different permanent addresses and health status (P<0.05). The multiple binary logistic regression analysis showed that the respondents in Chengdu city had lower satisfaction than those outside Sichuan province [odds ratio (OR)=0.377, 95% confidence interval (CI) (0.156, 0.908), P=0.030], and the respondents with poor, general, and good self-reported health status had lower satisfaction than those with very good self-reported health status [OR=0.196, 95%CI (0.067, 0.577), P=0.003; OR=0.165, 95%CI (0.058, 0.468), P=0.001; OR=0.317, 95%CI (0.108, 0.927), P=0.036]. Conclusions The patients’ satisfaction with chronic disease continuous health management services is at a high level. The next step should focus on service pricing and online follow-up, and strive to improve the service experience of people with low satisfaction.
ObjectiveTo observe the effect of kinesio tape (KT) combined with progressive resistance training (PRT) in patients with subacromial impingement syndrome (SIS), and to explore whether the direction of KT affects the therapeutic effect of SIS.MethodsBetween May 2017 and March 2019, 90 participants with SIS in West China Hospital, Sichuan University were randomly divided into three groups, with 30 participants in each group. Participants were treated with KT combined with PRT, and the direction of the KT is from the proximal end of the rotator cuff muscles to the distal end in group A. Participants were treated with KT combined with PRT, and the direction of the KT is from the distal end of the rotator cuff muscles to the proximal end in group B. Participants were treated with PRT alone in group C. Visual Analog Scale (VAS) was used to evaluate the pain in patients at rest, during movement and at night; range of motion (ROM) of shoulder and the disabilities of the arm, shoulder and hand (DASH) outcome questionnaire were used to measure the physical function before treatment and after 1 week and 2 weeks.ResultsAfter 1 week of treatment, ROM of shoulder abduction, internal rotation and DASH scores in group A were significantly improved compared with those in group B and C (P<0.05). After 2 weeks of treatment, the nighttime VAS score, ROM of shoulder abduction, internal rotation and DASH score scores in group A were significantly improved compared with those in group B and C (P<0.05). The VAS score during movement, nighttime VAS score, ROM of shoulder (except external rotation) and DASH score in group A were significantly improved after 1 week and 2 weeks of treatment (P<0.05); and after 2 weeks of treatment, the nighttime VAS score, ROM of shoulder flexion and internal rotation in group B were significantly improved compared with those before treatment (P<0.05). After 2 weeks of treatment, the VAS score during movement, nighttime VAS score, ROM of shoulder (except external rotation) in group C were significantly improved compared with those before treatment (P<0.05).ConclusionKT combined with PRT is more effective than PRT alone in the treatment of SIS, and the therapeutic effect is related to the direction of the tape.
Objective To investigate the opinions of operating room nurse (ORN) on enhanced recovery after surgery (ERAS). Methods A questionnaire survey was performed among 215 ORNs in West China Hospital. There were 10 males and 205 females at age of 33.4±8.84 years. Results A total of 154 ORNs (71.6%) thought that we already had very good ERAS theory but we still needed more practice. Thirty-four ORNs(15.8%) thought that the application of ERAS was poor in our clinic comparing to other countries.A percentage of 84.2% (181/215) ORNs thought the criteria to judge whether the ERAS succeed or not should be average days of hospitalization, patients' feeling, and experience and social satisfactions. Besides, 78.1% (168/215) ORNs selected team building as the key point of ERAS success. There were 91.2% (196/215) ORNs who believed expert consensus and ERAS guide should be worked out and propagandized through academic forum or conference in order to popularize the ERAS. Conclusion The theory of ERAS has already been accepted by almost all the clinicians and team building is the best way to make ERAS work well.