ABSTRACT
Objective:To compare the patient-centered doctor-patient communication skills in anesthesiologists with different working experience and genders.Methods:The second and third year residents who had been trained as residents in the Department of Anesthesiology in our hospital from September 2017 and September 2018 and senior physicians who had worked for 10-15 yr in our hospital, were recruited to perform a preoperative interview in a standardized patient counter.Consultation and Relational Empathy (CARE) measure was used to assess the communication skills among senior physicians, residents, and anesthesiologists of different genders.The residents also took the objective structured clinical examination (OSCE) and theory examination.Results:Thirty-six residents and 20 senior physicians were included.There was no significant difference in the CARE measure score between residents and senior physicians and in the total CARE measure score between residents who received doctor-patient communication training at the stage of medical students and those who did not ( P>0.05). Compared with the residents in the second year, the listening ability score and decision-making ability score were significantly decreased ( P<0.05), and no significant change was found in the scores for the other items in the residents in the third year ( P>0.05). Compared with residents, the listening ability scores were significantly increased, and the caring ability scores were decreased ( P<0.05), and no significant change was found in the scores for the other items in senior physicians ( P>0.05). There was no difference in CARE measure scores between the male and female anesthesiologists.The resident′s CARE measure score was positively correlated with the annual OSCE score ( r=0.486, P<0.05), and there was no correlation between the resident′s CARE measure score and annual theoretical examination grade ( r=0.308, P>0.05). Conclusion:Senior anesthesiologists with more clinical experience are not superior to the junior residents in patient-centered communication skills, and the doctor-patient communication skills of residents are not related to their medical theoretical grade.Moreover, there is no significant difference between male and female anesthesiologists in terms of doctor-patient communication skills before surgery.Therefore, training of patient-centered doctor-patient communication skills should be strengthened at all levels of anesthesiologists.
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Objective To investigate the resident performance on preoperative anesthetist visit in Beijing hospitals,thereby providing introduction for further training.Methods A self-designed questionnaire was distributed among the anesthesia residents who were receiving anesthesia residency training in Beijing through WeChat.The questionnaire covers geographic data of the residents,information on preoperative visit and existing training program.Results160 questionnaires were reclaimed.History-taking and physical examination were not comprehensive in many residents,the nature of surgery was not evaluated by most residents.The capacity of risk assessment and risk informing were not competent in many residents.The most desired training methods for preoperative visit were scenario simulation and bedside observation.Conclusions Scenario simulation with standard patient may have a promising prospect in preoperative anesthetist visit training.
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Objective To investigate the effects of different doses of gabapentin on streptozotocin (STZ)-induced diabetic neuropathic pain in rats.Methods Male SD rats aged 6 weeks weighing 180-200 g were used in this study. Diabetes ntellitus ( DM) was induced by intraperitoneal STZ 60 mg/kg and confirmed one week later by blood glucose =16.7 mmol/L before breakfast. The DM rats were randomly divided into 4 groups ( n = 6 each) : gabapentin groups received intraperitoneal gabapentin 30, 60 and 120 mg/kg twice a day (at 9:00 am and 3:00 pm) for 3 weeks respectively and control group received intraperitoneal normal saline 0.6 ml instead of gabapentin. The paw withdrawal threshold to von Frey filament stimulation was measured before and at 30, 60, 120, 180, 240 min after first gabapentin injection and once a week for 3 weeks. Results After gabapentin 60 and 120 mg/kg, the paw withdrawal threshold to mechanical stimuli was significantly increased and lasted for about 4 h. The analgesic effect peaked at 60 min after IP gabapentin injection. Normal saline and gabapentin 30 mg/kg had no significant analgesic effect. The degree of analgesia was significantly decreased at day 14 and 21 of treatment with gabapentin 60 and 120 mg/kg as compared with that at 60 min after gabapentin injection. Conclusion The hyperalgesia and allodynia in rats with diabetes mellitus can be effectively reversed by gabapentin 60 and 120 mg/kg,while long-term use of gabapentin can induce drug tolerance.