ABSTRACT
Volume overload or hidden lung congestion is emerging as a pervasive problem in end-stage renal disease (ESRD) patients on hemodialysis,which will lead to cardiovascular complications and impact the patients' life quality and survival time,so how to improve volume control in patients on hemodialysis is a urgent research hotspot.Recently,the ap plication of lung ultrasound for semi-quantitative assessment pulmonary congestion in patients on hemodialysis has received general concern.Lung ultrasound not only can detect excessive extravascular lung water in the early period of pulmonary congestion,but also can predict cardiac events and mortality in ESRD.Lung ultrasound is an effective,sensitive,real-time and non-invasive tool beside.The application and progresses of lung ultrasound in evaluation of pulmonary congestion in hemodialysis patients were reviewed in this article.
ABSTRACT
Objective To study application of Chinese general practice assessment questionnaire (GPAQ)consultation version 2.0 in evaluating patients' satisfaction with community health-care service (CHS).Methods First,origihal GPAQ consultation version 2.0 in English was translated into Chinese language by three experts in general practice/family medicine field,then translated it back into English,finally a Chinese version of GPAQ was formed.Ten medical doctors who were on duty on 25 April,2008 at each out-patient clinic from CHS of Daxing,Nancaiyuan,Yongning and Hancunhe were selected randomly as targets for evaluation of service satisfaction.A sample of the first 30 patients(1200 in total)aged more than 16 years who visited the clinic on that day were selected to fill out the Chinese GPAQ consultation version 2.0 to express their satisfaction with the medical doctors they visited,and reliability and validity of the questionnaire was then evaluated.Results Cronbach's alpha ranged 0.734 to 0.813 for each domain of the Chinese version of GPAQ2.0.and cumulated contribution of three common factors with the eigen-value more than one reached 58.722%.Scores of patients' satisfaction withreceptionists,access,continuity,doctor's communication skills andpatient enablement were significantly lower,as compared to those of national bench-mark in the United Kingdom,with t-values of -6.397,-11.729,-6.328,-59.871 and -2.210,and all P＜0.05.respectively.Conclusions The Chinese version of GPAO 2.0 achieves good reliability and modcrate validity,and can be used as an instrument for evaluating patient's satisfaction with quality of CHS in China as further revision in the future studies.