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Objective:To explore the application value of online and offline interactive teaching combined with three-dimensional quality theory mutual evaluation in the standardized residency training of general practitioners.Methods:Twenty-four general practitioners who were trained in The Second Hospital of Tianjin Medical University from January 2019 to December 2019 were selected as the control group, receiving traditional teaching; another 22 residents who were trained from March 2020 to February 2021 were selected as the observation group, taking online and offline interactive teaching combined with mutual evaluation of three-dimensional quality theory. After the training, the theoretical knowledge, skill operation and case analysis assessment scores, clinical ability and teaching satisfaction were compared between the two groups. SPSS 25.0 software was used for t test and rank sum test. Results:There was no significant difference in the scores of theoretical knowledge assessment, operation skills assessment, and case analysis assessment between the two groups before the training. After the training, the scores of the two groups were all increased, and the observation group had higher scores than the control group ( P<0.05). There was no significant difference in the scores of each dimension in the Direct Observation of Procedural Skills (DOPS) scale between the two groups before training, while after training, the scores of each dimension in the DOPS scale of the two groups were increased ( P<0.05), and the scores in the observation group were higher than those in the control group. The difference of mutual evaluation results after the training between the two groups was statistically significant, and the results of the observation group were higher than those of the control group ( P<0.05). Conclusion:The application of online and offline interactive teaching combined with mutual evaluation of three-dimensional quality theory in the standardized residency training of general practitioners can help improve the theory, skill practice, case analysis assessment performance and clinical ability of residents, and also obtain higher teaching satisfaction.
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Objective:To examine the relative importance of four emotion regulation strategies (i.e. cognitive reappraisal, expressive suppression, rumination and mindfulness) in explaining job burnout and depression of nurses.Methods:We conducted a cross-sectional study with questionnaires for 1 037 nurses from two general hospitals. Maslach Burnout Inventory-Human Service Survey (MBI-HSS), the Patient Health Questionnaire-9 (PHQ-9), Emotion Regulation Questionnaire (ERQ), Ruminative Responses Scale (RRS) and Short Inventory of Mindfulness Capability (SIM-C) were assessed.Results:Dominance analysis revealed that in terms of job burnout, rumination, cognitive reappraisal and mindfulness could explain 41.38% (0.132/0.319), 30.09% (0.096/0.319) and 28.53% (0.091/0.319). In terms of depression, rumination and mindfulness could explain 68.6% (0.362/0.528)and 24.43% (0.129/0.528).Conclusions:Rumination and mindfulness were important predictors of job burnout and depression of nurses. This study indicates that reducing ruminative responses and enhancement of mindfulness are the important approach to reduce nurses′ job burnout and depression.
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Objective@#To examine the relative importance of four emotion regulation strategies (i.e. cognitive reappraisal, expressive suppression, rumination and mindfulness) in explaining job burnout and depression of nurses.@*Methods@#We conducted a cross-sectional study with questionnaires for 1 037 nurses from two general hospitals. Maslach Burnout Inventory-Human Service Survey (MBI-HSS), the Patient Health Questionnaire-9 (PHQ-9), Emotion Regulation Questionnaire (ERQ), Ruminative Responses Scale (RRS) and Short Inventory of Mindfulness Capability (SIM-C) were assessed.@*Results@#Dominance analysis revealed that in terms of job burnout, rumination, cognitive reappraisal and mindfulness could explain 41.38% (0.132/0.319), 30.09% (0.096/0.319) and 28.53% (0.091/0.319). In terms of depression, rumination and mindfulness could explain 68.6% (0.362/0.528)and 24.43% (0.129/0.528).@*Conclusions@#Rumination and mindfulness were important predictors of job burnout and depression of nurses. This study indicates that reducing ruminative responses and enhancement of mindfulness are the important approach to reduce nurses′ job burnout and depression.
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Objective:To investigate the characteristics of posttraumatic stress disorder (PTSD) symptom and posttraumatic growth (PTG) in the patients with burns during rehabilitation, and the relationships among PTSD symptom, PTG, neuroticism and resilience.Methods:A cross-sectional study was carried out among 110 patients with burns during rehabilitation.The PTSD Check-list-Civilian Version (PCL-C), Posttraumatic Growth Inventory (PTGI), Five Factors Inventory-Neuroticism Subscale (FFI-N) and the 10-item Connor-Davidson Resilience Scale (CD-RISC) were used.Result:A significant effect of different groups of marital status (F=5.66, P=0.019), annual household income (F=7.97, P=0.006), and neuroticism (F=34.24, P＜0.001, Partial η2=0.259) on PCL-C scores.A significant effect of different groups of gender (F=6.44, P=0.013) and resilience (F=14.87, P＜0.001, Partial η2=0.132) were significant for PTG scores.There existed a significant interaction between neuroticism and resilience on PTG (F=4.47, P=0.037, Partial η2=0.044).Conclusion:Being married, low annual household income, and high levels of neuroticism were associated with high PTSD symptom levels.Being female and high levels of resilience were associated with high PTG levels.Resilience moderated the effect of neuroticism on PTSD symptoms.
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Objective The aim of the longitudinal was to explore the level of posttraumatic growth (PTG) and the effect on rehabilitation outcome in patients who received renal transplant. Methods A questionnaire survey was carried out in patients after renal transplant in one month (T1) and six months (T2) in China during hospitalization. PTG was measured by the Posttraumatic Growth Inventory (PTGI), depression by the Patient Health Questionaire (PHQ-9), anxiety by the Generalised Anxiety Disorder Questionaire (GAD-7). Totally 180 patients were recruited, and 160 completed the follow-up measure. Data were analyzed using IBM SPSS 20.0. Results There were 88.3% (158/180) patients reported positive PTG in T1, and 94.3% (151/160) in T2. The mean score of posttraumatic growth at T1 and T2 had no significant difference (T1:77.96 ± 16.36,T2:79.54 ± 17.58;t=-1.302,P=0.195). PTG was not significant to the recovery of physical symptoms (χ2Creatinine=0.504,P=0.841,χ2recover=0.609,P=0.777, χ2complication=6.131,P=0.150), while it affected the incidence of anxiety (χ2=7.541, P=0.021), but not related with the incidence of depression (χ2=3.926,P=0.130). Conclusions There is no difference in the level of PTG in time. PTG has no obvious effect on body health recovery for patients with renal transplantation after six months, while for the mental health, PTG has no effect on depression symptoms, but can reduce the occurrence of anxiety symptoms.
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Objective To explorepredictive factors of psychological stress reaction of medical staff members with blood-occupational exposure and to provides scientific basis for the hospital administrators toprovide psychological support and interventionfor medical staff members with blood-occupational exposure. Methods Seventy-eight medical staff members with blood-occupational exposure were recruited as participants. The Socio-demographic Questionnaire, Posttraumatic Stress Disorder Checklist-5, the Perceived Stress Scale, the Hospital Anxiety and Depression Scale, the Ruminative Responses Scale and the Emotion Regulation Questionnaire were used to evaluate the participants' psychological stress reactionat different stages and the styles of their emotion regulation. Correlation analysis and Hierarchical Regression analysis were used to analyze the predictive factors of psychological stress reaction of medical staff members with blood-occupational exposure. Results Ruminative thinking and emotion regulation can predict the psychological stress reaction of medical staff members with blood-occupational exposure at different stages. Conclusions According to the psychological stress reaction and ruminative thinking of medical staff members with blood- occupational exposure, psychological intervention should be implemented within one month to decrease the psychological trauma of medical staff members with blood-occupational exposure.
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Objective To explore whether emotion regulation mediates the relationship between occupational stress and job burnout in a large sample of nurses, in order to provide a targeted intervention. Methods Chinese Nurses Stressor Scale, Maslach Burnout Inventory-Human Services Survey, Emotion Regulation Questionnaire and Ruminative Responses Scale were used to investigate 602 nurses working in three tertiary hospitals in Jinan. SPSS 16.0 and AMOS 17.0 software were used to analyze the data. Results Job burnout were positively correlated with stressors, expression suppression and rumination (r=0.112–0.576, P<0.01), and negatively correlated with cognitive reappraisal (r=-0.277, P<0.01). Stressors were positively correlated with expression suppression and rumination (r = 0.140–0.403, P <0.01), and negatively correlated with cognitive reappraisal (r =-0.110, P < 0.01). Occupational stress could make a positive role on job burnout directly. Moreover, in the indirect approach, occupational stress could make a positive role on job burnout through the mediating role of cognitive reappraisal and ruminative, but not expression suppression. Conclusions Cognitive reappraisal and ruminative partially mediated the relationship between occupational stress and job burnout.
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Objective To probe into the relationship of the cumulative effect of childhood trauma types and symptoms of depression and anxiety among pregnancy women. Methods A total of 276 cases of pregnancy women were investigated by using Childhood Trauma Questionnaire (CTQ- SF), the Edinburgh Postnatal Depression Scale (EPDS) and the State-Trait Anxiety Inventory (STAI). Results The cumulative number of childhood trauma types were positively correlated with the scores of EPDS, state anxiety and trait anxiety (r=0.245, 0.262 and 0.292, P<0.01);the scores of CTQ-SF, EPDS, state anxiety and trait anxiety of multi-CTQ group were higher than that of non-CTQ group, as well as the positive rate of depression symptom and anxiety symptom (P<0.05 or 0.01);Logistic regression analysis showed that the cumulative number and accumulation group of CTQ may be predictors or risk factors of depression and anxiety of women during pregnancy, and existed cumulative effect. When the cumulative number of childhood trauma types more than two types, it increased 2.37 and 3.12 times likelihood of depression and state anxiety comparing to non-CTQ group. Conclusions It suggested that childhood trauma experience may be a risk factors of depression and anxiety during pregnancy, and exist cumulative effect.
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Objective:To probe into the status characteristics and the dynamic change trend of the psychological stress among medical staff at four time points after exposed to blood-borne pathogen.Methods:A longitudinal study was carried out among 78 medical personnel in this study,with 67 of hepatitis B virus,5 of hepatitis C virus,4 of HIV and 2 of treponema pallidum respectively.Perceived stress scale (PSS-4),Post-traumatic stress disorder Checklist-5 (PCL-5),Hospital anxiety and depression scale (HADS) were used to assess the psychological status,including perceived stress,post-traumatic stress symptom,anxiety and depression at the four times.Data analysis was performed using repeated measures analysis of variance (RMANOVA) and paired sample t test to explore time effect of the psychological stress reaction in the exposed population.Results:The scores of PSS-4,PCL-5,HADS-A,and HADS-D increased from exposure,and gained highest at one month after exposed,then gradually declined with time (Ps ＜ 0.05).Conclusion:It suggests that the levels of perceived stress,post-traumatic stress symptom,anxiety,depression may be the highest at one month after exposed.
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Objective To investigate the occurrence of posttraumatic stress disorder (PTSD) and the relationship between PTSD and emotional regulation strategies of mothers with neonates hospitalized in the neonatal intensive care unit (NICU). Methods One hundred and twenty-seven postpartum women with neonate hospitalized in the NICU were selected from a general hospital. All the cases were investigated by PTSD check list-Civilian version (PCL-C) and emotion regulation questionnaire (ERQ). Results The incidence of PTSD of postpartum women with neonate in NICU was 13.4%(17/127). The expressive suppression scores in positive PTSD group were (17.76±2.46) points,which were significantly higher than (14.16 ± 5.14) points in negative PTSD group (t=-4.659, P0.05). Conclusions The admission of neonates to the NICU is a stressful event for mothers, which could cause PTSD symptoms. PTSD has a closer relationship with expressive suppression, rather than cognitive reappraisal. Therefore, health workers should instruct mothers with neonates in NICU to regulate emotions by appropriate coping strategies, decreasing the possibility of psychological problems, promoting the mental health of women in the perinatal period.
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Objective To evaluate the clinical effect of cytokine induced killer cellular immunotherapies ( CIK) on the patients with advanced lung cancer.Methods Peripheral blood mononuclear cell from 32 cases of patients with advanced lung cancer were isolated.Cells were cultured in DMEM supplemented with IFN-γ,IL-2,anti-CD3 monoclonal antibody and other cytokines,and transfused back into the patients in several times after 15 days of culture.Subsequently,we observed the size of tumor,the change of immunologic function by CIK treat-ment,the status of clinical symptoms,and the toxic and side effect.The clinical curative effect was also evaluated. Results The symptoms in 32 patients who received CIK therapy were reduced,and the side effects were light. Immunophenotype analysis showed that CD3 /CD4 coexpression were found in 34.4%patients,CD3 /CD8 co-expression in 68.2%,and CD3 /CD56 co-expression in 13.7% patients.CT images about 15 days after CIK cell transfusion showed that pleural effusion were decreased.Clinical evaluation effective rate was 56.0%,and disease control rate( CR +PR +SD) was 84.3%.Conclusion CIK cell immunotherapies of cancer patients can improve immunologic function of cancer patients and inhibit tumor growth and relieve the clinical symptom of patients,and improve the quality of life.
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Objective To conduct an investigation on diabetes nutrition knowledge, attitude and practice in outpatients with type 2 diabetes, understand the nutritional knowledge and dietary behaviors in patients with type 2 diabetes to guide individualized nutrition education. Methods The diabetes nutrition Knowledge, Attitude and Practice(KAP) questionnairewas designed based onChinese dietary guidelines (2007)andChinese diabetes medical nutrition therapy guidelines (2013). Data of out-patients with type 2 diabetes from January to March 2015 were collected. The method of investigation was face-to-face interview. Results Totally 915 patients were enrolled into this survey(male 495 and female 420). The mean BMI was (27.23 ± 3.18)kg/m2, glycosylated hemoglobin A1c (HBA1c) was (8.03 ± 2.17)%. Among the questions on knowledge, only on 4 questions the rate of awareness was over 80%, and there was a misunderstanding on diet, only 54.10%of diabetes patients believed that diabetes diet should be balanced and reasonable, rather than just limiting staple food and meat. Patients generally could realize the importance of diet for diabetes treatment. For questions on practice, the rate of reaching the standard generally was not over 80%. The rate of correct answers was not significantly different among different age groups, gender, and durations. There was a linear correlation between the rate of correct answers and glycosylated hemoglobin (P=0.043), the correlation coefficient was-0.258. The higher the rate of correct answers, the lower the level of glycosylated hemoglobin. Conclusion Outpatients with type 2 diabetes had good awareness level about diabetic nutritional knowledge and attitude but the awareness level of balanced diet needs to improve, the awareness rate on behavior was relatively low.
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Objective To examine the reliability and validity of the Chinese version of the Functional Assessment of Cancer Therapy-Cognitive Function (FACT-Cog) in Chinese women with breast cancer.Methods The Chinese version of the FACT-Cog was obtained by FACT.A total of 202 patients with breast cancer were investigated by convenient sampling survey.The reliability and validity of the scale were analyzed by the principal component analysis and Pearson correlation analysis.Results The Cronbach α of the Chinese version of the FACT-Cog was 0.96, and those of four dimensions were 0.87-0.96.The test-retest correlation coefficients for the Chinese version of the FACT-Cog were 0.45-0.73, P＜0.01.The four-factor structure of the Chinese version of the FACT-Cog was confirmed and accounted for 66.63％ of the total variance.The criterion-related validity of the Chinese version of the FACT-Cog were significantly related with those of anxiety, depression and fatigue,-(0.36～0.48),-(0.42～0.52), 0.48-0.59,P＜0.01.Conclusion The Chinese version of the FACT-Cog is valid, reliable, and appropriate for clinical and research use in Chinese women with breast cancer.
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Objective To explore the correlation between adverse childhood experiences, personality characteris?tics and alcohol dependence. Methods A total of 102 patients with alcohol-dependence (Patients group) and 106 volun?teers (control group) were rated by the adverse childhood experience scale (ACEs) and the big five personality scale (BFP). Results The prevalence of ACEs are significant higher in patients group than in control group, especially regard?ing emotional abuse, physical neglect, witness violence and substance abuse. The patients group has lower scores of de?light, conscientiousness and higher scores of psychoticism. Psychoticism and parents abuse alcohol in childhood were the risk factors of alcohol dependence. Conclusions There is a correlation between alcohol dependence with their ACEs, per?sonality characteristics and parents abused substance. The psychoticism increase the risk of alcohol dependence.
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Objective To explore the relationship between adverse childhood experiences,negative emotions and interpersonal sensitivity.Methods Adverse Childhood Experiences Questionnaire (ACEQ),Depression Anxiety Stress Scale (DASS-21) and the Interpersonal Sensitivity Subscale of Symptom Check-List (SCL-90) were applied to investigate the 492 new enrolled medical students.Results Boys got higher ACEQ scores than girls; Compared with only-child,non-only-child scored higher in depression,interpersonal sensitivity; Compared with students from non-rural areas,those from rural areas got higher scores in depression,anxiety stress,interpersonal sensitivity.There existed significant differences of scores on ACEQ,depression,anxiety,stress,interpersonal sensitivity among children of fathers of different educational level; while differences of scores on depression,anxiety,interpersonal sensitivity among children of mothers of different education level were statistically significant.There were significantly differences of scores on depression,anxiety,stress,interpersonal sensitivity among participants with 0,1,2 and 3 or more ACEQ.The results of correlative analysis provided evidence that adverse childhood experiences,all the factors of negative emotions and interpersonal sensitivity were significantly positively correlative.The SEM suggested that adverse childhood experiences had an indirect effect on interpersonal sensitivity through negative emotions.Conclusions Adverse childhood experiences has a great influence on negative emotions and interpersonal sensitivity.Negative emotions has a completely mediating role between adverse childhood experiences and interpersonal sensitivity.
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Objective To investigate the prevalence of hyperuricemia (HUA) in the elderly in Tanggu Community of Tianjin,and to analyze the related factors.Methods The elderly inhabitants from one community of Tanggu in Tianjin were randomly selected and their serum uric acid (SUA)levels and metabolic syndrome (MS)-related indexes were examined.There were 622 subjects with complete data (260 men,362 women; mean age 67.4 ± 6.0 years).Results The standardized prevalence of HUA in the elderly in this community was 9.1％ in total,and 7.6％ in males,10.6％ in females,and there was no significant difference between males and females (P=0.281).The levels of SUA were (283.37 ± 78.69) μmol/L in total,(315.80 ± 74.39) μmol/L in males and (260.00 ±73.31) μmol/L in females,and the SUA level was higher in males than in females (P＜0.001).The levels of blood urea,creatinine (Cr),triglyceride (TG),body mass index (BMI) were higher in patients with HUA than in patients with normal serum uric acid (P=0.000,0.000,0.002,0.049respectively).The multiple factors regression analysis showed that the SUA level was positively correlated with the levels of blood urea,Cr,TG,low density lipoprotein cholesterol (LDL-C) (P=0.000,0.017,0.000,0.019) and was negatively correlated with the levels of high density lipoprotein cholesterol (HDL-C) and fasting blood glucose (P=0.000,0.001).Conclusions The prevalence of HUA in the elderly is lower in Tanggu Community of Tianjin than in other cities in China.The SUA level of the elderly is significant higher in males than in females.The lower kidney function,hypertriglyceridemia and higher LDL-C are the risk factors for HUA,while elevated HDL-C and fasting blood glucose are associated with the decreased SUA level.
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Objective To examine the reliability and validity of the Chinese version of Moral Distress Scale for nurses.Methods Cross-cultural adaptation process was applied to translate and develop the Chinese version of Moral Distress Scale for nurses.238 nurses were selected to answer the scale to evaluate the reliability and validity of the scale.Results Content validity index of the Chinese version of Moral Distress Scale for nurses was 0.909.Construct validity of validity analysis:exploratory factor analysis of the items identified that the scale had 4 factors,explaining 54.583％ of the total variance.Reliability analysis:The Cronbach' α coefficients for the MDS-R dimensions were 0.846、0.724、0.738 and 0.566,and 0.879 for the total scale.The test-retest reliability coefficient for MDS-R was 0.802.Conclusions The Chinese version of Moral Distress Scale-Revised for nurses has good reliability and validity in the measurement of Chinese nurses.
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Objective To study the abnormalities of noninvasive urodynamios in early diabetes eystopathy (DCP) and provide diagnosis evidences in its early stage. Methods According to the disease course (less or more than 1 year), 85 patients with type 2 diabetes mellitus (T2DM) were divided into new lydiagnosed diabetic group and non-newly diagnosed diabetic group. Thirty healthy cases were involved in normal control group. All of them were checked with the technology of noninvasive urodynamics to measure maximal flow rate, average flow rate, the volume leading to first bladder sensation and residual urine volume. Results As to the 32 newly diagnosed diabetic group, maximal flow rate was (18.4±6.9) ml/s, and average flow rate was (10.6 ± 5.3) ml/s, 18 cases were detected to have bladder residual urine, with the average residual urine volume of (13.2 ± 17.3) ml, and the DCP detection rate was 56.2%(18/32). As to the 53 non-newly diagnosed diabetic group, maximal flow rate was (14.7 ± 6.6) ml/s, and average flow rate was (9.5±4.7) ml/s,38 cases were detected to have bladder residual urine, with the average residual urine volume of (19.3 ± 18.4) ml, and the DCP detection rate was 71.7%(38/53). There was no residual urine detected in normal control group. Their maximal flow rate was (25.7 ± 5.9) ml/s, and average flow rate was (18.0 ± 4.9)ml/s. Compared with that in normal control group, maximal flow rate, average flow rote and residual urine volume decreased in both newly diagnosed diabetic group and non-newly diagnosed diabetic group(P< 0.01). As compared with that in newly diagnosed diabetic group, maximal flow rate in non-newly diagnosed diabetic group decreased obviously (P< 0.05). Conclusions The abnormalities of urodynamics may happen in the early stage of diabetes, and maximal flow rate may be as the most sensitive index. With the new technology of noninvasive urodynamies, we DCP can be diagnosed in early stage and evaluated the function of bladder dynamically.
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Objective To investigate the prevalence of metabolic syndrome (MS) and its components among the elderly at Tanggu community in Tainjin. Methods The elderly inhabitants were drawn out randomly from one community at Tanggu in Tianjin to examine the MS-related indexes. There were 623 samples with complete data aged (67.4±6.0) years, including 261 males with mean age of (68.3±6.1) years and 362 females with mean age of (66.9±6.0) years. Diagnosis of MS was done by criteria of Chinese Medical Association Diabetes Branch in 2004. Results The standardized prevalence of MS for the elderly in the community was 18.5% with the highest risk group aged 60～69 years. Standardized prevalences of hypertension, high triglycerides, high blood sugar, overweight, obesity, low HDL-C were 49.5%, 38.8%, 25.3%, 42.0%, 4.2%, 3.0% in the elderly. Conclusions The prevalence of MS in the elderly is lower in Tanggu community in Tianjin than in Shanghai, Foshan in Guangdong, Qingdao in Shandong and Beijing city. The condition in female is more severe than in male, the highest prevalence occurs in hypertension, and overweight, high triglycerides and high blood sugar follow it, but few of them are obesity, low HDL-C is fewer too.
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Objective: To explore the relationship between internet overuse and time management disposition in middle school students. Methods: Using Diagnostic Questionnaire for Internet Addiction (YDQ), Time Management Disposition Scale (TMDS), we investigated 2620 middle-school students.Results:The incidence rate of internet overuse among middle school students was 2.4 %. The difference of time management disposition between internet overuse group and control group was significant(129.7?25.3/150.0?28.5,t=4.27, P