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The standardized residency training of general practice is a complex project, the functional departments of the training base should play an active role for its management. The functional department of education in Zhongshan Hospital constantly explores its position and role, connects relevant departments vertically and horizontally to provides management and service for general practice residency training. That means that it should not only to provide advice for leadership decision-making, but also coordinate with all functional departments of the training base. The department has participated in the teaching management and supervision, educational research and training quality control, and accomplished positive results in general practice residency training for last 35 years.
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Objective:To construct an evaluation scale for post competence of family doctors based on knowledge-skill-management model.Methods:The evaluation dimensions and indicators for post competency of family doctors were preliminarily developed through literature review, internal group meeting and brainstorming, and in-depth interviews of experts. And 16 experts in the fields of general practice and health management were invited for 2 rounds of Delphi consultation from December 2020 to April 2021. A competency evaluation scale for family doctors based on the dimensions of knowledge, skills and management was finally constructed.Results:The age of the experts was (47.9±7.3) years with a working experience of (24.6±7.8) years. The Cronbach′s α of the questionnaires was 0.891 and the KMO was 0.844. The positive coefficients for 2 rounds of expert consultation were 100%; the familiarity level of experts was 0.86 and authority level was 0.89 in the first round consultation, and those were 0.84 and 0.90 in the second round consultation. After 2 rounds of consultation, the coordination coefficient of expert opinions in the knowledge and skill dimensions was>0.5, and that in the management dimension and overall evaluation system was>0.3. After discussion 2 indicators were deleted in the first round of consultation. The finally constructed family doctor post competency evaluation scale included 3 dimensions, 8 secondary indicators and 61 tertiary indicators. Conclusion:Through the Delphi consultation, we have successfully constructed an evaluation scale for post competence of family doctors based on the three dimensions of knowledge, skills and management.
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Objective:To compare the breadth of condition coverage, accuracy of suggested conditions and appropriateness of urgency advice of the 8 symptom assessment mobile applications (APPs) available on the Chinese market.Methods:The APPs were assessed using 200 primary care vignettes and were measured against the vignettes′ standard. The primary outcome measures were proportion of conditions covered by an APP, proportion of vignettes with the correct primary diagnosis,and proportion of safe urgency advice.Results:For APPs assessed,condition-coverage was from 29.0%(58/200)to 99.5%(199/200), top-3 suggestion accuracy was from 8.5%(17/200) to 61.5%(123/200), the proportion of safe urgency advice was from 84.8%(167/197) to 99.5% (198/199).Conclusions:The APPs showed a wide range of coverage, safety performance and condition-suggestion accuracy. Symptom assessment APPs with good performance could be used by general practitioners as supporting tools. However, even symptom assessment APPs with excellent performance need to be further assessed in a real clinical environment.
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Objective:To explore the effect of family doctor-specialist dual-contract service model on the management of type 2 diabetic patients in the community.Methods:Two hundred patients with type 2 diabetes mellitus (T2DM)who were treated in Changfeng Community Health Service Center between February 2019 and January 2021 were selected as the study objects by cluster sampling method. Patients were randomly divided into study group and control group with 100 cases in each group. The control group was managed with the conventional family doctor contract service, and the study group was managed with the family doctor-specialist double contract service. After one year of management, the fasting blood glucose, 2 h-postprandial blood glucose, glycosylated hemoglobin, diet control, blood glucose monitoring, medication compliance, exercise and other health behaviors, quality of life and satisfaction of patients were compared between two groups.Results:After intervention, fasting blood glucose, 2 h-postprandial blood glucose and glycosylated hemoglobin in the study group were significantly lower than those in the control group ( t=10.29, 8.49, 7.99, all P<0.05); the health related behaviors such as diet control, exercise behavior, blood glucose monitoring, and medication compliance in the study group were significantly better than those in the control group ( t=9.78, 6.72, 39.81, 7.88, all P<0.05); the quality of life in patients of study group was higher than that of the control group ( P<0.05); the satisfaction rate in study group was higher than that of control group (90.0% vs. 69.0%, χ 2=6.39, P=0.031). Conclusion:Compared with conventional family contract service model, the double contract service improves patient self-management, helps to reduce the blood glucose level and gains high patients′ satisfaction, which is worth promoting and applying in the management of type 2 diabetic patients in the community.
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The Xidu Community Health Service Center has become the first general practice outskirt teaching site of Shanghai Zhongshan Hospital since May 2015; the Fudan University Shanghai Medical College Xidu General Practice Clinical Teaching and Training Base was formally established in May 2018. For last 6 years, with the cooperation with Zhongshan Hospital the Xidu Community Health Service Center has participated in teaching and training of general practice residents and general practitioners, which also greatly promoted the development of clinical service, disease prevention and scientific research of the center itself. This article introduces the "Fudan-Xidu" integrated model and its experiences in general practice teaching, focusing on the background, the organization, teaching implementation, achievements and future prospects, to provide a reference for talent training of general practice in grassroots institutions.
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In order to improve the quality of clinical teaching, Xidu Community Health Service Center of Shanghai Fengxian District established a teaching clinic for training of general practitioners in 2015. The clinic served as a suburban teaching station of Department of General Practice of Zhongshan Hospital, a tertiary university hospital. This article introduces the implementation methods, achievements, practical experiences and work prospects of the clinic. The issues of system evaluation and the generalization of this teaching model for training of general practitioners are also discussed in the article.
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Objective:To assess the concept and clinical practice of general practitioners in community health service centers (CHCs) on the use of antiplatelet drugs (APD) to prevent cardiovascular diseases(CVD).Methods:Based on the eastern, western, southern and northern regions of the country, 350 CHCs were selected from 11 cities across the country with stratified sampling method for study sites, and one general practitioner was selected from each CHC. The questionnaire survey was conducted from March 12 to April 20, 2018 among 350 participants. The content of the questionnaire included the situation of CVD patients, application of APD in primary/secondary prevention of CVD (schemes and regimes), the prescription concept of APD, and influencing factors.Results:Total 350 valid questionnaires were recovered. The survey showed that among all patients general practitioners routinely took care, 46% (30%, 60%) were hypertensive patients; 96.6% (338/350) of the general practitioners said that they had carried out primary prevention, mainly for patients with hypertension, diabetes, dyslipidemia or carotid artery plaque, and 34% (20%, 45%) of the patients had taken primary prevention drugs; the use of APD only accounted for 47% (35%, 60%) , among which 87% (80%, 95%) was aspirin. The main impediments were lack of awareness of disease from patients[ (8.0±1.4) points] and lack of awareness of primary prophylaxis from general practitioners[ (7.3±1.4) points]. The survey also showed that 28% (20%, 35%) and 17% (10%, 20%) patients were diagnosed as coronary heart disease and stroke, respectively; 83% (80%, 95%) of patients with coronary heart disease or stroke used APD for secondary prophylaxis; for coronary heart disease patients, 82% (70%, 95%) taking aspirin or clopidogrel, 18% (5%, 30%) taking aspirin and clopidogrel for 11 months; for stroke patients, 85% (80%, 95%) taking aspirin or clopidogrel, 15% (5%, 20%) taking aspirin and clopidogrel for 9 months. Compared with clopidogrel, aspirin had a relatively high score for clinical experience (8.3±1.1) and reasonable cost of treatment (8.3±1.3) .Most coronary heart disease patients (68%±15%) and stroke patients (70%±17%) took APD regularly. The lack of knowledge of disease [(8.4±1.1) points] and awareness of regular medication [(8.2±1.2) points] were the main factors affecting compliance of patients.Conclusion:The use of APD in primary prevention of CVD for general practitioners is insufficient, and there is still a big gap between the standardization and the practice in secondary prevention; in particular, the selection of APDs and treatment course should strictly follow the guidelines.
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Objective:To survey the status of antihypertensive therapy knowledge and hypertension management among general practitioners in community health centers (CHCs) in China.Methods:Based on the eastern, western, southern and northern regions of the country, 350 CHCs were selected from 11 cities across the country with stratified sampling method for study sites, and one general practitioner was selected from each CHC. The questionnaire survey was conducted from March 12 to April 20, 2018 among 350 participants. The content of the questionnaire included the proportion of hypertensive patients in the consultation, treatment target rate, antihypertensive drugs and protocol, the medication compliance, follow-up, blood pressure self-measurement, and the impact of hierachical medical system on CHC.Results:Total 350 valid questionnaires were recovered. The survey showed that: (1) Among the patients treated by general practitioners, 46% (30%, 60%) were hypertensive patients including 41% (40%, 55%) with primary hypertension and 42% (40%, 50%) with secondary hypertension; 72% (60%, 80%) of the patients had comorbidities, including dyslipidemia, diabetes, and coronary heart disease. (2) Western medicine was the main antihypertensive treatment [90% (82%, 100%) ], calcium channel blockers were the most commonly used antihypertensive drug [46%(30%,60%)], the therapeutic protocol was mainly single agent [35% (25%, 50%) ]or free combination [50% (40%, 60%) ]; the stable(9.1±0.8), long-acting (9.0±0.9) and high standard reaching rate (8.1±1.1) antihypertensive drugs were first considered, and the standard reaching rate of hypertension treatment was 61% (50%, 75%) . (3) The regular follow-up rate, adherence to blood pressure self-test rate and long-term regular medication rate was 60%(50%,70%), 51%(40%,70%) and 65%(50%,70%), respectively. The factors affecting patients′ compliance were history of cardiovascular diseases (8.4±1.1)and patients′ cognition of disease(8.3±1.1). General practitioners believed that the positive effects of the hierarchical diagnosis and treatment system include helping to establish a closer relationship with patients [62.6% (219/350)] and improving patient compliance for community preferential reimbursement policies[58.6% (205/350) ]. The challenges faced by CHC included higher patient expectations [52.8% (185/350)] and increased outpatient visits [52.6% (184/350)]. Insufficient diagnostic equipment [68.3% (239/350)], inadequate dispensing [52.3% (183/350)] and other issues restricted the development of CHC, and the clinical competence of general practitioners [51.7% (181/350)] need to be improved.Conclusion:Patients with hypertension account for about half of the total number of visits in community health service centers, and most of them are comorbid with cardiovascular and cerebrovascular diseases or risk factors. The long-term treatment compliance and self-management of blood pressure need to be further improved.
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A pilot mixed assessment method was used to evaluate the clinical and teaching ability of general practitioners (GPs) in a suburban district of Shanghai. In December 2018, 29 GPs from 20 community health centers in a suburban district of Shanghai were assessed by a mixed method consisting of 3 domains and 8 stations for one day. The average age of GPs was (37.8±4.7) years and 22 were females (75.9%). In 3 domains, the average score (66.8±9.7) and qualified rate (75.9%) of clinical thinking abilities were the lowest. In 8 stations, the average score [(53.8+13.4) points] and qualified rate (34.5%) of adult SOAP medical record writing station were the lowest. The average score of pediatric outpatients consult station of GPs with<15 years of community work experience was higher than that of GPs with >15 years of work experience [(68.6+10.2) vs. (58.5+9.4), t=2.787, P<0.05]. There was no significant difference in the scores among GPs with different teaching years and titles. The average scores of clinical thinking ability domain ( t=2.115) and adult outpatient consult station ( t=3.410); in the clinical operation ability domain the ophthalmoscopy and readings ( t=3.816) and otoscopy and reporting station ( t=2.286); clinical teaching abilities ( t=2.618) and simulated educational situation station ( t=2.452) and mini lectures station ( t=2.802) of GPs in the community teaching base were higher than those in non-community teaching base (all P<0.05). Mixed assessment method can be used as one of the important means for GPs′ ability assessment. The community teaching bases have effectively improved the clinical and teaching abilities of GPs in suburban areas, however, the clinical thinking abilities of them are still weak.
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In order to improve the quality of clinical teaching, Xidu Community Health Service Center of Shanghai Fengxian District established a teaching clinic for training of general practitioners in 2015. The clinic served as a suburban teaching station of Department of General Practice of Zhongshan Hospital, a tertiary university hospital. This article introduces the implementation methods, achievements, practical experiences and work prospects of the clinic. The issues of system evaluation and the generalization of this teaching model for training of general practitioners are also discussed in the article.
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Objective To apply objective structured teaching evaluation (OSTE) in teaching competence assessment for general practice preceptors in community training bases.Methods The teaching competency was assessed with OSTE for 28 general practice preceptors in Fengxian District of Shanghai in December 2017.The application of OSTE was evaluated with questionnaire among preceptors,examiners and standardized students(SS).Results Among 28 preceptors there were 23 females (82.1％),with an average age of (37.3±4.2) years.The average teaching duration was (2.8±2.1) years.In the five OSTE station,the highest total score was (88.1 ±2.7) points in the first station self-presentation,while the lowest was (70.8± 14.5) points of the second part physical examination feedback of the third station ambulatory care teaching.The total score in the fifth station (doctor-patient communication teaching) of participants with＜ 15 years of community practice was higher than those ≥15 years of community practice [(80.1±8.5) vs.(71.6± 7.1),t=2.092,P=0.007].Except"being able to adapt to this form of evaluation",the proportions of choosing "very good"were all more than 50％ in other 4 aspects.The overall willingness of "recommending OSTE as the main method to evaluate the teaching competence of GP trainers" was higher in examiners and SS than that inpreceptors (Z=2.836,P=0.005).Conclusion The innovative approach of OSTE has been widely recognized,but the professional capability,the cognition of general practice,the teaching competence and the willingness to use OSTE need to be strengthened for general practice receptors in community bases.
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One hundred and fifty diabetic patients,who received management by community family doctors and hospital consortium (1+1+1) team for at least 1 year,were enrolled from January 2017 to May 2017.After that they continued to receive the management for 1 more year by the team which were trained with TeamSTEPPS (team strategies and tools to enhance performance and patient safety).The management effect before and after TeamSTEPPS training was compared.After the TeamSTEPPS training,the team management ability was improved,so that the compliance of diabetic patients with medical advice,regular examination of blood glucose,regular follow-up assessment,health education,regular exercise and diet control were all better than before,and the differences were statistically significant (all P＜0.01).Fasting blood glucose,postprandial 2 h-blood glucose,glycosylated hemoglobin and LDL-C levels were all lower than before,and the achieved rate of the above indicators were also increased (P＜0.05).It is suggested that application of TeamSTEPPS in team training can effectively enhance the management ability for chronic disease of family doctors and improve compliance and clinical indicators of patients with diabetes under management.
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Objective To survey the requirement of objective structured teaching evaluation (OSTE) use for general practice (GP) trainers and the station design.Methods A questionnaire survey on the requirement of OSTE use was conducted among 161 hospital trainers and 110 community trainers from a national key GP trainers training workship in April 2016.The survey included basic information,OSTE use requirements,frequency of clinical teaching scenarios,and frequency of teaching methods.Results The survey showed that 86.3％(234/271) of trainers were willing to use OSTE for assessing teaching competence and 92.3％ (250/271) for training teaching competence.The proportion of “having been observed and being given feedback from superior trainers for teaching process” was higher in hospital trainers than that in community trainers [68.3％(110/161)vs.40.9％(45/110),x2=20.060,P＜0.001].In the part of frequency of teaching scenarios,the proportion of “often” plus “always” was higher in “instructing students to write the medical records” [64.6％(175/271)],“teaching doctor-patient communication skills” [60.9％(165/271)] and “observing students' consultation and giving feedback” [57.9％(157/271)];there were no significant differences in above questions between the two types of trainers (all P＞0.01).In the part of frequency of teaching methodS,the proportion of “often”plus “always”was higher in “clinical supervisor's report” [60.9％ (165/271)],“applied knowledge test” [52.4％(142/271)] and “problem-based learning” [38.0％(103/271)];there were no significant differences in above questions between the two types of trainers (all P＞0.01).Conclusion The requirements of assessment and training by using OSTE are strong in GP trainers.The OSTE stations should be designed based on the routine teaching scenarios and methods for both hospital trainers and community trainers without discriminations.
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Objective@#To examine the prevalence of depression and anxiety symptoms, and the related factors in family members of schizophrenic patients in a Shanghai community.@*Methods@#From March to May 2017, the family members of 206 schizophrenic patients registered in Xuhui district Kangjian community of Shanghai were enrolled in this cross-sectional survey. The participants were evaluated with Patient Health Questionnaire Self-rating Depression Scale (PHQ-9) and the Anxiety Screening Scale (GAD-7). The factors related to depression and anxiety symptoms were analyzed.@*Results@#The detection rates of depressive symptoms and anxiety symptoms in the family members of schizophrenia patients were 40.3%(83/206) and 37.9%(78/206), respectively.Univariate analysis showed that the relationship with the patient, education levels were the influencing factors of depressive symptoms (χ2=17.045, 9.702; P<0.01); while age, relationship with the patient, education levels were factors related to the occurence of anxiety symptoms (χ2=11.862, 22.042, 15.060; P<0.01). Multivariate regression analysis showed that the parents of patient was more prone to depressive symptoms than spouses (OR=2.861, P<0.01); higher education was more prone to be depressive than primary education (OR=10.071, P<0.01). Age group 18-40 years were more prone to anxiety than the age group ≥66 years (OR=0.060, P<0.05); sibling relationship is more prone to anxiety than spouse relationship (OR=10.018, P<0.01), followed by parental relationship (OR=7.467, P<0.01); higher education was more prone to anxiety than primary education (OR=5.119, P<0.05).@*Conclusions@#There is high prevalence of depression and anxiety symptoms in family members of schizophrenic patients, which is related to the relationship with the patient, the education level of family members and other factors.
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Objective To assess the needs and demand of continuing medical education(CME)for general practitioners(GPs)after completion of residency training.Methods A series of surveys were carried out from July 2015 to December 2015 using a questionnaire on needs and demands of CME among 152 GPs, who completed residency training in Zhongshan Hospital from September 2000 to July 2013. Results One hundred and fifty two valid questionnaires were received with a retrieval rate of 100%.Among 512 participants,53(34.9%)regarded CME as necessary,129(84.9%)were willing or very willing to receive CME,87(68.9%)stated that they were willing to receive CME even without credits,120 of them (78.9%)stated that the primary purpose of receiving CME was to update professional knowledge;87(57.2%)stated lack of certain knowledge and 52(34.2%)stated lack of certain skills to some extent;8(5.3%)thought that the previous CME they received did not completely meet their needs,105(69.1%) thought that it partially met their needs;136(89.5%)thought that only high level experts were suitable for CME teaching;the teaching methods they preferred were problem-based learning(PBL), followed by case study,clinical demonstration and instruction,and systematic lectures focused on common clinical problems;88(57.9%)preferred short term training with an average length of 5.01 days(91.4%,139/152);111 (75.0%)preferred CME course to be offered on both workdays and off hours.The factors influencing willingness to attend CME included length of time(87.5%,133/152),lack of suitable program(64.5%, 98/152),monotonous way of training, impractical training contents and its inconsistency with actual need (60.3%, 91/52).Conclusion The needs and demands of continuing medical education for GPs completing residency training are high.The results of this study would provide useful information for effective implementation of continuing medical education for GPs.
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Objective To survey the attitude to sexually transmitted disease(STD)testing among physicians in community health service centers(CHC)of 20 cities in China.Methods A cross-sectional survey using stratified random sample was conducted in September to December 2015, among 1 734 physicians from 158 CHCs in 20 cities of 6 provinces and 2 municipalities.Results The average age of participants was(39.7 ±10.6)years, the time for present position was(15.8 ±11.5)years, and 47.0%(799/1 700)were general practitioners(GPs).The survey showed that in the last month,8.1%(138/1 699)of the physicians contacted with the specific population of STD(sex worker,MSM,drug user, etc), and 18.3%(313/1 706)of them managed STD patients or provided services to suspected STD patients;62.0%(1 048/1 689)of them received the STD-related training previously;46.5%(784/1 686) thought the lack of training in STD testing as the biggest barrier for carrying out STD testing in CHC.As for the specific populations, 73.4%(1 241/1 692)of physicians thought that it was meaningful, 62.0%(1 043/1 683)of them worried about"have difficulty to deal with their STD clinically", and only 5.8%(97/1 683)of them expressed their"dislike of specific population".Conclusions Most physicians in CHCs believe that STD testing should be included in the routine tests, and it is feasible to carry out STD testing in CHCs.Lack of training is the main barrier for STD testing, so it is necessary to conduct STD testing related trainings in CHCs.
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Objective To compare the awareness, training and assessment of teaching competence between hospital and community general practice (GP) trainers. Methods A questionnaire survey on teaching competence was conducted among 161 hospital GP trainers and 110 community GP trainers in 2016 April. Results There were 96 male and 175 female participants with an average age of (30.4 ± 8.0) years. On the the awareness of teaching competence,the propotion of"very important"of"creating a quality teaching environment for students","knowing how to teach students","ability to teach students medical knowledge and skills", " feedback ability ", "showing the virtue of being a teacher" in hospital and community trainers were 47.8％(77/161) and 40.0％(44/110), 66.5％(107/161) and 59.1％(65/110), 71.5％(115/161) and 62.8％(69/110), 54.7％(88/161) and 52.7％(58/110), 65.2％(105/161) and 60.9 (67/110), respectively;there were no significant differences of all importance ratings between the two groups (all P>0.05). Hospital trainers had higher proportions of "having received teaching method training" [70.2％(113/161)vs. 50.0％(55/110),χ2=11.302,P=0.001] and"having received teaching training before practice teaching for the first time" [(45.3％(73/161)vs. 21.8％(24/110),χ2=15.735,P<0.001] than those of community trainers. The proportion of "having received teaching comptence evaluation" was higher in hospital trainers than that in community trainers [(60.9％(98/161)vs. 43.6％(48/110),χ2=7.810,P=0.004], but there were no significant difference in teaching comptence evaluation methods between two types of trainers (P>0.01). Conclusion The awareness of teaching competence is similar between hospital and community GP trainers, but the community trainers are lack of teaching competence training, and their teaching competence evaluation methods need to be improved.
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Objective To survey Introduction to General Practice course taking and knowledge of general practice among medical students in Fudan University.Methods A survey with self-designed questionnaire was conducted in June 2017 among medical students of 5 year program in Fudan University who had taken the course of Introduction to General Practice.Results One hundred and ninety seven questionnaires were distributed and 186 valid ones returned with a recovery rate of 94.42％.The survey showed that 95.16％ of participants (177/186)gained knowledge about the post of general practitioners (GPs) through community practice;97.31％ (181 / 186) thought community practice as necessary;92.47％ (172/186) were very satisfied or fairly satisfied with the community practice course;94.09％ (175/186)gained clear understanding of the duty of GPs through the course study;87.63％ (163/186)completely understood the required capabilities of a GP;74.19％ (138/186)said that the course had opened their mind;64.52％ (120/ 186) said that they had changed their views about general practice;63.44％ (118/186) said that they had acquired new knowledge.The participants also gave some suggestions regarding the content of community practice.Although 96.24％ of the students (179/186)thought that general practitioner had a bright career prospect,only 7 of them (3.76％)were willing to be GPs after graduation;meanwhile 161 of them (86.56％) were willing to be specialists.The main reasons of not willing to be a GP were "wish to be a specialists (82.61％,133/186)","the job was not challenging or difficult for career development (45.34％,73/186)" and "not paid well for GPs (45.34％,73/186)".Conclusion Although many students thought GP would have good career prospect,only few of them are willing to be a GP.How to attract more medical students to chose GP as their career should be paid high attention by education and health authorities.
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Objective To evaluate the application of TeamSTEPPS in training of community osteoporosis management team .Methods The TeamSTEPPS was applied for training of osteoporosis management team, and 1 513 residents aged ≥45 year were screened for osteoporosis in Kangjian community from January 2014 to March 2017.The identified patients with osteopenia and osteoporosis were intervened for one year.Cognitive level of the risk factors and symptoms associated with osteoporosis were assessed by questionnaires before and after the intervention .The bone density was examined at baseline and 6 months, 12 months after intervention.The effect of intervention was evaluated .Results A total of 467 patients (30.87%) with osteopenia and 476 patients (31.46%) with osteoporosis were detected .The cognitive levels of osteoporosis risk factors , including low calcium, vitamin D deficiency, lack of exercise, low weight, women menopause, matrilineal family history, smoking, excessive alcohol drinking and coffee drinking, were higher than those before intervention ( χ2＝62.909,78.742,59.974,50.478,29.512, 34.699,6.500,15.779,6.089,all P＜0.05).The awareness rates of symptoms , including lower back pain or body bone pain, shorter height and hunchback , low energy or nonviolent fracture , were also increased (χ2＝59.942,76.220,16.856,all P＜0.01).After intervention, the bone mineral density levels were increased compared to those before intervention (F＝530.28, P＜0.01 for osteopenia group; F＝339.51, P＜0.01 for osteoporosis group ); meanwhile, the differences were also significant between 6 months, 12 months after intervention and before intervention , between 12 months and 6 months after intervention (t＝-0.452,-0.968,-0.516,all P＜0.01 for osteopenia group; t＝-0.530,-1.045,-0.518, all P＜0.01 for osteoporosis group ).Conclusion The community osteoporosis management team trained by TeamSTEPPS can effectively improve the management levels of osteoporosis among residents in the community.
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Objective To survey the prevalence of stress urinary incontinence(SUI)and related knowledge among postpartum women in Shanghai Melong district.Methods A questionnaire survey on the knowledge of stress urinary incontinence was conducted among 317 postpartum women who were home visited by Meilong Community Health Service Center between March 2017 and June 2017.The self-designed questionnaire included the general situation(age, height, weight, occupation, menstrual history), pregnancy and childbirth, and knowledge of SUI; the International Consultation on Incontinence Questionnaire Short form(ICIQ-SF)was also used.Total 317 questionnaires were distributed and 313 valid ones were retrieved(98.73%).Results The prevalence of SUI in the participants was 26.84%(84/313).Multivariate logistic regression showed that BMI≥24 kg/m2(OR=6.24, 95% CI: 3.41 -11.41), complicated metabolic syndrome(OR=9.84, 95% CI: 2.77 -34.96)and birth weight of previous child ≥4 kg(OR=0.09,95%CI:0.04-0.19)is independent risk factors for the development of SUI.The average SUI knowledge score was(10.39 +8.65)points, only 26.20%(82/313)of the participants knew Kegel training(score 5.99 ±1.60).The SUI knowledge level of postpartum women was associated with educational level(F=12.41),occupation(F=9.06), income(F=4.05), reproductive history(F=10.98)and presence of urinary incontinence symptom(F=22.31)(all P<0.05). Conclusion The knowledge level of maternal stress urinary incontinence in Meilong district is relatively low,and the publicity of SUI and pelvic floor rehabilitation knowledge should be enhanced for the pregnant women.