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Objective:To investigate the status of work performance among rural doctors in Shanxi province and the factors related to their performance.Methods:From July to September 2019, 528 rural doctors in Shanxi province were selected by multi-stage stratified cluster sampling for the survey. Their job competency, job performance, psychological capital and burnout were evaluated. The structural equation model was used to construct the job performance analysis based on post competency.Results:The total score of post competency of rural doctors in Shanxi province was (188.6±20.3), and the total score of job performance was (71.3±11.5), both of which were in the middle level. The structural equation model was well fitted [goodness-of-fit index (GFI)=0.958, normal fix index (NFI)=0.920, adjusted goodness-of-fit index (AGFI)=0.910, root mean square error of approximation (RMSEA)=0.076]. Post competency, psychological capital and job burnout had direct effects on job performance ( P<0.05), with influence coefficients of 0.64, 0.35 and -0.25, respectively. Job competency indirectly affected job performance through psychological capital and job burnout ( P<0.05). Conclusion:The study suggest that higher post competency would facilitate to improve the work performance of rural doctors.
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Objective@#To evaluate the medical services of tertiary hospitals in Shanxi province from the perspective of patients and provide references for improving the quality of medical services.@*Methods@#From April to December 2018, 1 358 patients at 8 tertiary hospitals in Shanxi province were selected for the survey of medical service quality evaluation scale based on patient experience, while the status quo of patient experience in tertiary hospitals in Shanxi province was evaluated, and the multivariate mixed linear model was constructed based on the three-level model of hospital-department-patient to analyze the relevant factors of patient experience. If the quantitative data conform to the normal distribution, it was expressed as ±s. Otherwise, it was expressed as M(QR).@*Results@#The patient experience score was 626±126, which was in the middle level. Whether the hospital was directly affiliated to the teaching hospital, and patient factors(marriage, occupation, education, medical insurance, number of hospital stays, etc.)were the main factors that affect the patient experience score(P<0.05).@*Conclusions@#Through the investigation, the influence characteristics of patients′ medical experience were discussed to improve the medical service and the overall service level.
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Objective:To evaluate the medical services of tertiary hospitals in Shanxi province from the perspective of patients and provide references for improving the quality of medical services.Methods:From April to December 2018, 1 358 patients at 8 tertiary hospitals in Shanxi province were selected for the survey of medical service quality evaluation scale based on patient experience, while the status quo of patient experience in tertiary hospitals in Shanxi province was evaluated, and the multivariate mixed linear model was constructed based on the three-level model of hospital-department-patient to analyze the relevant factors of patient experience. If the quantitative data conform to the normal distribution, it was expressed as ± s. Otherwise, it was expressed as M(QR). Results:The patient experience score was 626±126, which was in the middle level. Whether the hospital was directly affiliated to the teaching hospital, and patient factors(marriage, occupation, education, medical insurance, number of hospital stays, etc.)were the main factors that affect the patient experience score( P<0.05). Conclusions:Through the investigation, the influence characteristics of patients′ medical experience were discussed to improve the medical service and the overall service level.
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Previous studies have shown that postoperative cognitive dysfunction (POCD) is related to multiple factors including age, postoperative trauma, inflammation, postoperative pain, and anesthesia, among which postoperative pain is thought to play an important role in the development of POCD. This review summarizes the recent findings in the study of the role of postoperative pain in the pathogenesis of POCD in light of nerve injuries, neural remodeling and stress, and the progress in the prevention and treatment of POCD in elderly patients. It is of vital important to assess the postoperative pain and formulate adequate analgesic regimens for effective prevention and management of POCD to protect the brain functions of elderly patients.
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Aged , Humans , Cognitive Dysfunction , Inflammation , Pain, Postoperative , Therapeutics , Postoperative ComplicationsABSTRACT
Objective To evaluate the efficacy and safety of combined therapy with 89Sr for treating skeletal-related events of prostate cancer. Methods Databases including PubMed,MEDLINE,EMBASE,the Cochrane library,CNKI,CBM and Wanfang were systematically searched since 89Sr was first reported in 1976 to September 2015 to include the randomized controlled trials (RCTs) of the combined therapy with 89Sr for skeletal-related events of prostate cancer.The statistical analysis was performed using Review Manager Version 5.2. Results A total of 18 RCTs involving 1 280 patients were analyzed.The results of meta-analysis indicated:there were statistically significant differences in the pain relief rate [OR=4.71,95%CI(3.34, 6.62),P<0.000 1],decrement rate of bone metastasis[OR=3.63,95%CI(2.60,5.09),P<0.000 1] and improvement rate of life quality [OR=2.16,95%CI(1.16,4.02),P<0.05].Progression-free survival of patients in experimental group was significantly longer than that in control group [HR=0.84,95%CI(0.73,0.97),P=0.02].No significant difference was found in overall survival [HR=0.82,95%CI(0.65,1.02),P=0.07].There were no significant differences in the incidence of adverse events [OR=1.46,95%CI(0.98,2.17),P>0.05]. Conclusion Combined therapy with 89Sr has better efficacy and comparable safety profile compared with standard therapy.However,the quality and sample size of the included studies are limited,so more high-quality and large-sample RCTs are needed to verify the validity.
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Objective To investigate the cause and treatment experience for traumatic renal subcapsular hematoma.MethodsThe data of eleven cases with traumatic renal subcapsular hematoma were reviewed.four cases were caused by external injury,and seven cases were iatrogenic,including four cases of postESWL patients,two cases of post-ureteroscopic lithotripsy patients and one case after percutaneous renal biopsy.The patients were treated with conservative treatment,percutaneous drainage of the hematoma and surgical exploration,respectively.Results Four cases received conservative treatment,six cases received percutaneous drainage of the hematoma,and one case received surgical exploration.Seven of the ten cases who received conservative treatment or percutaneous drainage of the hematoma were continuously followed up for 1 to 3 years.They recovered well without complications such as renal hypertension,renal function impairment,hydronephrosis and renocortical pyogenic infection.One case was performed nephrectomy due to severe trauma and hemorrhage during the surgical exploration.ConclusionTraumatic renal subcapsular hematoma usually occurs after flank abdomen injury,iatrogenic injury such as ESWL,ureteroscopic lithotripsy and percutaneous renal biopsy.CT and ultrasound examination are the major means to diagnose traumatic renal subcapsular hematoma and determine the severity.Optimistic prognosis can be obtained after conservative treatment and percutaneous drainage of the hematoma.Surgical exploration should be avoided as far as possible.