ABSTRACT
OBJECTIVE:To provide reference for developing effective interventions to self-medication and promoting reason-able self-medication. METHODS:Questionnaires were designed based on the modified Anderson's behavioral model of health ser-vices. By using cluster sampling,residents were randomly selected from 4 districts of Wuhan city to analyze the self-medication be-havior and its influential factors. RESULTS:Totally 204 questionnaires were sent and 199 were recovered with effective rate of 97.5%. The result showed 47.7% residents who perceived discomfort within 2 weeks medicated themselves,and the rate was high-er thansee the doctor. Among self-medication residents,the rate of mild disease,general and serious disease was separately 50.5%,46.3% and 3.2%. The length of illness<7 d and the length of illness ≥7 d accounted for 95.8% and 4.2%,separately. Cold and cough was the highest cost disease for self-medication. The reasons for selecting self-medication were:no need tosee the doctor(43.2%),trouble-saving(23.1%),high medical costs(14.6%),no time to see the doctor(14.6%). 54.1% residents acquired basic medication knowledge from the past experience,25.5% from other's recommendation,and the other from the inter-net,newspaper and magazines. As for the effect of self-medication in the past one year,75.4% residents considered most were ef-fective. 18.6%had suffered from ADR due to self-medication;the incidence of ADR in the residents reading the instruction was sig-nificantly lower than those not reading the instruction(P<0.05);the ratio of reading the instruction in residents with low education level was significantly lower than that with high education level(P<0.05). Single factor analysis showed that residents'choice of self-medication were significantly influenced by the marital status,education,monthly income,medicare,accessibility of medical institutions,the severity of disease and duration of illness(P<0.05). The proportion of self-medication for married group was sig-nificantly higher than unmarried group;the proportion of self-medication for low education level group was significantly higher than high education level group;the proportion of self-medication for low monthly income group was significantly higher than high monthly income group;the proportion of self-medication for group with business medical insurance or self payment was significant-close to medical institutions;the proportion of self-medication for mild disease group was significantly higher than serious disease group;the proportion of self-medication for length of disease≥7 d was significantly lower than length of disease<7 d. Results of multivariate analysis showed that severity of disease and length of disease were the important influential factors for the choice of self-medication(P<0.05). CONCLUSIONS:Self-medication is common in Wuhan city,and mainly for general and chronic dis-ease. Residents don't pay enough attention to reading the drug instructions. Self-medication is affected by various factors which has a certain health risks.
ABSTRACT
A systemic analysis of the origin,methods and characteristics of the health system classification theory systematically.Such classification originated in the Ideal Type by Marx Weber,and was deeply influenced by Esping Andersen′s welfare system.This classification is composed of two mainstream methods:the induction method which is based on properties of actual cases,and the deduction method which is based on reasoning from theoretical concepts.For the former,the theory was formed by observation and summarization of the laws of specific obj ects,while for the latter,a series of theory attributes are set based on given phenomena,with the attribute variables translated aggregately in the classification.As both share the same obj ective,yet with opposite advantages and risks,they should be combined appropriately as required in the study based in their application in China′s specifics.
ABSTRACT
Objective To analyze the performance evaluation framework and construction pathway model of international health system,and study the main theories,methods and laws of the framework construction systematically.Methods Descriptive systematic review was used to retrieve the literature, and the ideal type method was used to construct the critical pathway model,for a study of the frameworks.Results The performance evaluation framework is constructed by defining the five steps:the construction purposes,health system boundary,health system goal,health systems architecture,and health systems framework dimensions.Conclusions Purpose determines the function type of the framework,while the boundary and target determine the structure of the framework jointly.Generalized model of the health system structure and the narrowed model of the healthcare system are widely used in the health system performance evaluation.The construction of the bridge between obj ectives and structures of the health system is still faced with challenges.
ABSTRACT
Objective The aim of the study was to investigate the diabetic neuro-degeneration and its changes in neuroreaction to myocardial ischemia and reperfusion,by evaluation of the altera-tion of noxious thermal threshold and expression of substance P (SP),calcitonin gene related peptide (CGRP)in dorsal root ganglia in upper thoracic segments (T1-5 )in diabetic rats.Methods Thirty two male Sprague-Dawley rats,weighing 180-200g,were randomly divided into control group (group C)and diabetic group (group DM),1 6 rats in each group.rats in DM group were fed with high sug-ar-fat diet for 14 weeks and were given streptozotocin (STZ,35 mg/mg,i.p.)at the end of the 4 th week,to set up diabetes experimental model.The animals in control group were fed with standard la-boratory diet.Tail flick latency to thermal stimulation was measured weekly.At the end of 10 weeks after administration of STZ,diabetic rats (and rats in control group)were further divided into myo-cardial ischemia-reperfusion group (group IR)and sham operation group (group Sham).The left an-terior descending branch of coronary artery was occluded for 30 min followed by reperfusion for 120 min,establishing myocardial ischemia-reperfusion.The histological immunofluorescence assay and Enzyme-linked immunosorbent assay (ELISA)were carried out to evaluate the changes of the expres-sions of CGRP and SP in the dorsal root ganglia.Results The tail flick latency was significantly in-creased in group DM,compared to the group C (P < 0.01).The immunoreactive materials for CGRP and SP in the sensory neurons in dorsal root ganglia of upper thoracic segments (T1-5 )were markedly declined in group DM (P <0.01 or P < 0.05).Furthermore,levels of SP and CGRP were signifi-cantly lower in the DRG of the group IR after myocardial ischemia-reperfusion,compared to that in the group sham (P <0.01).Conclusion Diabetes causes sensory denervation and obvious reduction of expression of SP and CGRP in the sensory neuron innervating heart during myocardial ischemia-reper-fusion,indicating impairment of adaptive reactivity of neuro-endocrine function of cardiac sensory nerves.
ABSTRACT
Objectives:To investigate appropriate approach of testing the interval feature of alternative answers in questionnaires.Methods:We calculated the total scores of the items within the same domain excluding the item that was under test, and then, identified the distances between the scores of the population who chose the different alternative answers of the test item. The short form 36 was used in the test. We surveyed a total of 2250 residents, with 2246 included in the final analysis.Results:This approach could find the deviated item in the questionnaire. The results of testing of the interval feature of alternative answers were consistent with the original design; however, the clustered items must have good construct validity.Conclusion:Using the items clustered in one domain to test the interval feature of alternative answers may possibly be an available simple approach, but we need more mathematics evidence to prove this assumption.
ABSTRACT
Objective: To provide standardized alternative answers with the feature of equal intervals in the quality of life assessment.Methods:We collected 131 questionnaires (123 for psychological test and 8 for quality of life assessment). The SPSS 10.0 was used to analyze the frequency distribution of the alternative answers used in these questionnaires.Results:The most commonly used design for alternative answers is five levels, which comprises 31.68% of the total designs, followed by four levels (21.99%) and three levels (13.35%). The words used in the alternative answer show great diversities.Conclusion:We recommend that the alternative answers be designed as five levels, it is better to apply commonly used words in the alternative answer and have a feature of equal interval.
ABSTRACT
<p><b>OBJECTIVE</b>To identify the prevalence, incidence and trend of urinary incontinence in the elderly over a two-year period.</p><p><b>METHODS</b>We randomly selected 4187 elderly people using the State Electoral Data Base in South Australia. Questionnaire surveys were conducted in 1992 with a response rate of 53.4%. The following two surveys were conducted 12 and 24 months later. A total of 2087 elderly people completed all three surveys.</p><p><b>RESULTS</b>Urge incontinence had a higher prevalence rate, with 36.6% to 41.6% of the elderly having at least an occasional problem (with 7.5% to 9.6% having problems often), compared to 23.4% to 28.8% having at least an occasional problem with stress incontinence (with 3.3% to 5.0% having problems often). Combined incontinence and urge incontinence were more common than stress incontinence alone. The incidence rates of urge incontinence and stress incontinence were 19.8% (with 3.1% often) and 14.5% (with 1.9% often), respectively. The trends toward incontinence during the two-year period indicated increasing trends in the elderly.</p><p><b>CONCLUSION</b>Urinary incontinence is an important health problem in the elderly and our data show that it has an increasing trend for future.</p>