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ABSTRACT Objective: To evaluate the effect of ginger with P6 acupressure in preventing and treating chemotherapy-induced nausea and vomiting (CINV) in cancer patients. Method: A total of 172 participants were randomly divided into the control, ginger, acupressure, and joint groups, who were hospitalized in the Affiliated Hospital of Xuzhou Medical University from February and September 2022. The baseline characteristics, nausea, vomiting, and retching, benefit finding, functional living index-emesis, treatment satisfaction, and adverse reaction, were used in data collection. Results: No significant difference was found in benefit finding and adverse reactions among the four groups (P > 0.05). Ginger significantly improved delayed CINV and function living index-nausea (P < 0.05) but had no significant effect on acute CINV, retching, and delayed vomiting, functional living index-emesis, and treatment satisfaction (P>0.05). Acute nausea and retching, delayed nausea, vomiting, and retching, functional living index-emesis, and treatment satisfaction were effectively improved in the acupressure and joint groups (P < 0.05). Conclusion: Ginger with P6 acupressure may contribute to improving CINV in patients undergoing chemotherapy.
RESUMEN Objetivo: Evaluar el efecto del jengibre con acupresión P6 en la prevención y tratamiento de las náuseas y vómitos (nviq) inducidos por la quimioterapia en pacientes con cáncer. Método: Se dividió al azar A un total de 172 participantes en los grupos control, jengibre, acupresión y conjunto, que fueron hospitalizados en el Hospital afiliado de la universidad médica Xuzhou entre febrero y septiembre de 2022. En la recolección de datos se utilizaron las características basales: náuseas, vómitos y náuseas, hallazgo de beneficios, índice de vida funcional, satisfacción con el tratamiento y reacciones adversas. Resultados: No se encontró diferencia significativa en el hallazgo del beneficio y las reacciones adversas entre los cuatro grupos (P >0.05). El jengibre mejoró significativamente las nviq diferidas y el índice de vida funcional (nausea) de forma significativa (P < 0.05), pero no tuvo un efecto significativo en las nvi, las náuseas y el vómito diferidos, la emesis del índice de vida funcional y la satisfacción con el tratamiento (P >0.05). Las náuseas agudas y las arcadas, las náuseas, los vómitos y las arcadas tardías, la medida del índice de vida funcional y la satisfacción con el tratamiento mejoraron efectivamente en los grupos de acupresión y articulares (P < 0,05). Conclusión: El jengibre con acupresión P6 puede contribuir a mejorar las nviq en pacientes sometidos a quimioterapia.
RESUMO Objetivo: Avaliar os efeitos da compressão do acuponto gengibre e Neiguan na prevenção e tratamento de náuseas e vômitos induzidos por quimioterapia em pacientes oncológicos. Métodos: Um total de 172 pacientes hospitalizados no Hospital Afiliado da Xuzhou Medical University de fevereiro a setembro de 2022 foram divididos aleatoriamente em grupo controle, grupo gengibre, grupo acuponto e grupo combinado. A recolha de dados incluiu principalmente dados basais, pontuação de náuseas, vómitos e vómitos, sensação de benefício da doença, índice de vida funcional, satisfação com o tratamento e efeitos adversos. Resultados: Não houve diferenças significativas no benefício da doença e efeitos adversos entre os quatro grupos (P >0,05). O gengibre melhorou significativamente o índice de vida funcional tardia e náusea (P < 0,05), mas não melhorou a NVI tardia e vómitos e vómitos retardados, o índice de vida funcional dos vómitos e a satisfação com o tratamento (P >0,05). Ambos os grupos de acuponto e combinação melhoraram náuseas agudas, vómitos, náuseas tardias, vómitos, vómitos, vómitos, índice de vida funcional e satisfação com o tratamento (P < 0,05). Conclusão: A acupuntura de gengibre e neiguan pode ajudar a melhorar a NVIQ em pacientes submetidos a quimioterapia.
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Humans , Acupressure , Drug Therapy , Vomiting , Zingiber officinale , NauseaABSTRACT
Objective:To explore the influencing factors and the weights for medical graduates to choose general practice and work in grassroots posts in China.Methods:On the basis of pre-investigation, the second interviews were conducted among medical students of grade two to established ahierarchical structure model. A survey was conducted with self-made questionnaire among 407 medical students of grade five from eight medical colleges selected by stratified random cluster sampling from January to June 2017. The influencing factors of choosing general practice choice as the future career were analyzed and the weights were calculated by analytic hierarchy process (AHP).Results:Total 395 valid questionnaires were received from 161 males and 234 females students. Under the general goal layer of influencing factors for medical graduates to choose general practice, the weights of the four first-level indicators were: career status and prospects for development (weight: 0.299), salary (weight: 0.294), family contribution (weight: 0.207) and professional interest (weight: 0.200). Among the secondary indicators of career status and prospects for development, job satisfaction had the highest weight (comprehensive weight: 0.073), followed by the work environment (comprehensive weight: 0.064), social status (comprehensive weight: 0.061), patterns of doctor-patient relationship in comprehensive care of general practice (comprehensive weight: 0.052), and work intensity had the lowest weight (comprehensive weight: 0.048). Among the five secondary indicators of professional interest, the weight of clinical practice was the highest(comprehensive weight: 0.066), followed by the guidance of theoretical teachers (comprehensive weight: 0.063). In the level 3 indicators in clinical practice, the attitude of general practice teachers to general practice had the higher weight than those teachers in other departments (the comprehensive weights were 0.037 and 0.030, respectively).Conclusion:Career status and development prospects and salary are the main influencing factors for medical students to choose general practice. Teachers′ guidance in clinical practice and theoretical study is the most critical factor for medical students to be interested in general practice.
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Objective To survey the employment intention of medical students of five-year program in China.Methods A self-administered questionnaire survey on the employment intention was conducted among grade-5 medical students of 5-year program in 8 medical schools from January to June 2017,395 participants (161 males and 234 females) were selected by stratified random cluster sampling method.Results The survey showed that 57.65％ (226/392) respondents would return hometown after graduation as their first choice,20.66％ (81/392) preferred to work in large cities,only 0.76％ (3/292) chose the Western and rural areas;20.05％ (78/389) responders were willing to be a general practitioner working at the community health center,56.55％ (220/389) did not decide,while 23.40％ (91/389) did not want to be general practitioner.Students from rural areas vs.from urban areas (24.30％ vs.15.08％),whose parents with lower educational level vs.higher educational level (30.62％ vs.25.71％),from medical school in Western regions vs.in Eastern regions (28.65％ vs.11.68％) were more willing to choose general practice(P＜0.05).Students who had clerkship or rotation of general medicine vs.who had not more like the specialty of general practice (27.63％ vs.15.66％,P＜0.05),but there was no significant difference in the employment intention to be a general practitioner (19.93％ vs.20.45％,P＞0.05).Students who knew grassroots employment policies were more willing to be general practitioners (25.48％ vs.13.02％,P＜0.05).Conclusion The survey shows that the employment intention to be a general practitioner is stronger than before among medical students.But it is still need to take necessary measures to attract more medical graduates to work as general practitioners in grass-roots communities.
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Objective To investigate the influencing factors and their weights of professional choice among medical school graduates in Shanghai.Methods Base on literature review and interviews with medicine students in a university of Shanghai,a questionnaire of"employment intention for general practice in medical graduates"was developed.A questionnaire survey on influencing factors of general practice among five year medical students was conducted in the medical college of a university in Shanghai during May to June 2016.The weights of each factor were calculated with analytic hierarchy process(AHP). Results The valid questionnaires were retrieved from 14 male and 26 female students.The results showed that 53.8%(21/40)preferred Beijing, Shanghai, Guangzhou and other economically developed cities as future working place,and 38.5%(15/40)chose to go home town; for general practice 22.5%(9/40) chose"very like",70%(28/40)chose"like"and 7.5%(3/40)chose"not like"; only 10%(4/40) were willing to be a general practitioner, 55.0%(22/40)were depended on the working conditions of community health center,and 35%(14/40)were not ready to be a GP.AHP analysis showed that the weights of influencing factors were: the salary(0.380 2), the doctor-patient relationship(0.262 3),professional interest and occupation development prospects(0.220 4),social status and family contribution (0.137 1).Weight analysis for the affecting factors on professional interest and occupation development showed that the guidance of mentors in theoretical study and clinical practice were the major factors (comprehensive weight was 0.067 3 and 0.062 1,respectively),and the attitude GPs to general practice in community learning was more important(comprehensive weight was 0.042 5 and 0.019 6).Conclusion The willingness to be a general practitioner is not strong in the medical school graduates in Shanghai.It is important to improve the status and working conditions of general practitioners, and to strengthen education and guidance of the general practice in theoretical study and clinical practice for medical students.
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Objective To establish the weight of the evaluation index system for community teaching base of general practitioner ( GP ) standardized training .Methods The weight assignment of the evaluation index system for community teaching base of GP training was established by using analytic hierarchy process , based on the literature review and two rounds of Delphi consultation .Results The evaluation index system for community teaching base was composed of four first-class indexes , eight second-class indexes and 27 third-class indexes.Four first-class indexes were basic conditions (weight 0.1953), teaching conditions (weight 0.1381), teaching staff (weight 0.2761) and teaching practice (weight 0.3905).The top three second-class indexes were: teaching management (weight 0.1953), teaching assessment and evaluation (weight 0.1953), and teaching ability (weight 0.1841).All levels of index weights were satisfied with the consistency test , and the weights were acceptable .Conclusion Weight establishment improves the index selection system of community training base for GPs , having better rationality and operability , which may provide a rational assessment tool for community base of GP training in future.
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Objective To develop an index system for evaluation index system for community general practice teaching base.Methods A draft of evaluation index system for community general practice teaching base was preliminarily developed on the basis of literature research.Two rounds Delphi consultations with 32 experts of general practice were conducted between July 2014 and May 2015.The results of consultation were analyzed and the evaluation index system for community teaching base was established.Results In two rounds of Delphi consultation,the positive coefficients were both 100％,the authority coefficient of experts were 0.879 and 0.897,respectively,and the coordination coefficient were 0.165 and 0.204 (P ＜0.01).The established evaluation index system consisted of 4 first-class indexes,8 second-class indexes and 27 third-class indexes.Four first-class indexes were basic conditions,teaching conditions,teaching staff and teaching practice.Conclusion The established evaluation index system may be used to accredit community general practice teaching base and to improve the quality of general practitioner training.
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Objective To survey the status of knowledge and management capability on diabetic kidney disease (DKD) among general practitioners (GPs) in community health service centers (CHCs) of Shanghai.Methods A questionnaire survey was conducted among 152 GPs from 6 CHCs in 3 districts of Shanghai during May 2015 and March 2016.Results In the current survey,138 (90.8％) valid questionnaires of DKD knowledge and 152 (100.0％) valid questionnaires of DKD management capability were retrieved.The overall accuracy rate of DKD knowledge was 60.2％ (1 246/2 070);the accurate rates of epidemiology,diagnosis,treatment,and community management knowledge were 62.7％ (173/276),62.8％ (520/828),60.6％ (502/828)and 35.5％ (49/138),respectively.There were significant differences in accuracy rates of treatment related questions among GPs with different years of working (P =0.032 2);but no significant differences were observed in accuracy rates of 4 aspects related questions among GPs with different education and professional title (P ＞0.05).Among 152 participants,113 (74.3％) responded to conduct DKD screening in clinic work;97(63.8％) chose renal function,86 (56.6％) chose urine routine and 86 (56.6％) chose urinary microalbumin for screening,respectively.The top three answers to "how to intervene patients with DKD" were blood glucose control(107,70.4％),medication of ACEI or ARB (77,50.7％),and high-quality low protein diet (68,44.7％).Conclusion The knowledge and management capability on DKD among GPs in CHCs are insufficient.The capability of diagnosis and treatment of DKD should be improved by joint efforts of GPs,trainers,and community health administrators.
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Objective To evaluate the clinical competence training model for community general practitioners (GPs).Methods Total 759 Gps participated in clinical ability training course (training group) between July 2011 and October 2012.The course included lectures,group discussion,role play,simulation for theoretical teaching;and video demonstration,scene teaching and medical simulator for physical examination and surgical skill training.Other 703 Gps without participating in training course were selected as control group.The examination consisting of theoretical and clinical skill tests were carried out and the results were compared between two groups.Results The participants included 260 males (34.2％) and 499 females (65.8％) were with an average service year of 13.9 ± 7.0 and 72.8％ of them hold bachelor degree.There were no significant differences in gender composition,work seniority and educational level between the two groups (P ＞ 0.05).Before and after training the total scores of the training group were (67.39 8.57) and (73.62 ± 7.19) respectively,(68.67 8.31) and (65.73 ±9.02) respectively for the control group.Before training,the total score and theoretical results of control group were significantly higher than those of training group (all P ＜ 0.01),and there was no significant difference between the two groups in physical examination and operation skill.After training,the total scores and the individual scores (written examination,physical examination and operation skill) of training group were significantly increased,compared with those before training (all P ＜ 0.01),and those of control group (all P ＜ 0.01).Conclusions The clinical competences training model can improve the theoretical knowledge and clinical ability of community general practitioners.
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Objective To survey the current situation of teaching for general practitioners (GPs) in community health centers of Shanghai.Methods A questionnaire survey on the teaching situation was conducted among 742 GP mentors who attended a municipal training workshop during July to October 2012 in Shanghai.The items of the survey included general background,previous teaching experience and self-evaluation on teaching ability.Results Among 742 GP mentors receiving the survey,the average age was (37 ± 6) years old.49.8％ (366/734) of mentors expressed their willingness of teaching,and the main reason was that it may upgrade themselves,while learning from teaching (58.6％,419/715).Heavy work load,lack of teaching time (31.8％,378/1 187) and teaching experience (30.7％,364/1 187) were the main obstacles for teaching.Among 106 GP mentors who had teaching experience in community health center previously,79.2％ (80/101) made teaching plans,but only 8.9％ (9/102) often prepared syllabus.Teaching plans were made mainly according to the work needs in community health care (54.2％,52/96),the situation and demands students (29.1％,28/96) or requirement of syllabus (17.7％,17/96).The problems included lack of teaching experience (50.5 ％,50/99) and time (42.4％,42/99),monotonous instructional modality (24.1％,25/104),and weak operability of the syllabus (21.2％).The self-reported results showed that 14.4％ were not able to develop a teaching program and to execute,18.3％ were not able to use a variety of teaching methods,31.2％ were not able to engage in teaching for 1.5 days per week.Logistic regression analysis showed that mentors with higher education background (OR =2.027,P ＜ 0.05),community teaching experience (OR =3.069,P ＜ 0.05),higher self assessment of general personal quality and communication ability (OR =2.488,P ＜ 0.05),higher teaching ability (OR =2.399,P ＜ 0.05) and strong training wishes (OR =11.382,P ＜ 0.05) were more willing to engage in the teaching work.Conclusions Heavy work load,insufficiency of teaching capacity and experience are main problems for GP mentors in Shanghai community health centers.Educational theory and methods should be focus on teacher training so as to improve teaching abilities.
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Objective To investigate the capacity and training needs of the community general practice mentors in different areas of Shanghai.Methods General practice mentors from community health centers,who attended a municipal training program in Shanghai during July 2012 to October 2012,were participated in the survey with a self-designed questionnaire.The general condition,basic ability (clinical skill,teaching ability and professional development),motivation and needs of training were investigated.The factors affecting the willingness of training were analyzed.Results Among 742 mentors receiving the survey,259 were from the urban area,174 from rural-urban continuum and 309 from rural area.The academic degree in urban group was relatively higher:17 out of 257 (6.6％) holding master degree.The ratio of participants who had received standardized training in urban,rural-urban and rural areas was 33.2％,25.3％,37.4％,respectively.The personal quality and communication skills in urban group were significantly higher than those in rural-urban continuum and rural group (18.58 ± 2.49,17.89 ± 2.69,17.85 ±2.34,P ＜0.05).The clinical skill (12.31 ± 1.98,11.95 ±2.02,11.52 ± 1.81),teaching ability (11.99 ± 2.62,11.63 ± 2.86,11.12 ± 2.77) and professional development (6.42 ± 1.61,6.36 ± 1.55,5.61 ± 1.38) in urban group were all significantly poorer than those in other two groups.The main purpose of participation in training was to improve medical knowledge and clinical skills in three groups (70.8％,74.0％,80.4％,respectively),followed by the need for community teaching.The rural group has higher training requirements in improving clinical diagnosis and treatment ability (75.3％,80.1％,85.5％,respectively in three groups),doctor-patient communication ability (38.0％,44.0％,50.7％,respectively) and community preventive care ability (29.4％,30.7％,42.8％,respectively).The urban group had much more requirements in scientific research training (38.8％,34.9％,14.1％,respectively).Logistic regression analysis showed that doctors with supports from the leadership (OR =2.688,P ＜ 0.05) and with less working stress (OR =2.241,P ＜ 0.05) were more willing to participate in mentor training.Conclusion There are discrepancies in basic ability and training needs of community general practice mentors in different areas of Shanghai,so we should develop specific or targeted training program in the future.
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Objective To analyze the correlation of nonalcoholic fatty liver disease (NAFLD) with waist,hip circumference and body mass index in order to explore the prevention countermeasures.Methods The datum of routine physical examination and questionnaire survey among 2 503 employees of 12 enterprises in November 2013 were collected.The indexes of height,weight,waist circumference,hip circumference,blood pressure,blood lipid and blood glucose of the subjects were measured.The grouping was according to whether the subjects suffering from NAFLID.The correlation and epidemiological characteristics between each group and the risk factors of body weight,waist,hip circumference and body mass index were analyzed.Results 2 503 subjects were collected including 490 NAFLID patients (19.57％).The body weight and body mass index of NAFLID patients were significantly lower than those of the control group.The result of BMI classification showed that the subjects of the control group were overweight while the subjects with NAFLID were obesity.The waist circumference and hip circumference of NAFLID patients were significantly larger than that of the control group.Conclusions Larger waist and hip circumference and overweight are risk factors of NAFLID.Effective intervention measures,scientific control of body weight,rational diet,the strengthening of physical exercises should be taken in order to prevent and control the development of fatty liver.
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Objective To evaluate the effect of clinical competence training for general practitioners in Shanghai.Methods Total 759 general practitioners participated in clinical competence training from July 2011 to October 2012 in Shanghai.The theoretical and practical operation scores of all the 759 trainees were compared before and after the training and the influencing factors of training effect were analyzed.Results The trainees,including 260 (34.26％) males and 499 (65.74％) females,had average working experiences (13.6±7.1) years.The average total scores before and after training were(67.40 ±8.57)and (73.61 ±7.20) (t =17.96,P ＜ 0.01).The practical operation scores were improved more significantly,the average scores of physical examination before and after training were (12.90 ± 3.76) and (14.00 ±3.51),scores of clinical skill before and after training were (9.41 ±4.80) and (13.40 ±4.02) (t =6.31 and 19.01,P ＜ 0.01).Among seven items of physical examination test,scores of four items (cardiopulmonary examination,abdominal examination,neurological examination and thyroid examination) were significantly higher than those before training (P ＜ 0.05 or ＜ 0.01).Scores of all 7 items of clinical skill test were higher than those before training (P ＜ 0.01).The main factors influencing the effect of training were gender,educational background,score before training and type of practice (P ＜ 0.01 or ＜0.05).Conclusions The clinical competence of general practitioners can be improved after the training.The training contents should be optimized in consistent with conditions of community health and general practitioners in the future.