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Objective:To explore the effect of narrative medicine course on the empathy ability and comprehensive ability training of residents in the standardized residency training in municipal hospitals.Methods:A narrative medicine group was set up in a municipal hospital, and a anarrative medical course of 2 months of narrative theory teaching and 4 months of clinical practice education was carried out among 42 residents. The Chinese version of the Interpersonal Response Index Scale (IRI-C) was used to measure the empathy ability at 4 time points (before intervention, 2 months after theory education, 2 months after practice, and 4 months after practice). The effect of narrative medicine courses was evaluated through the satisfaction questionnaire survey, parallel medical record writing and the first-time pass rate of Medical Practitioner Qualification Examination. SPSS 25.0 was used to analyze the variance of one-way repeated measurement.Results:The empathy ability of 42 residents was significantly improved. The empathy score after 2 months after practice was higher than that before intervention and after the theoretical course ( P < 0.05), while the empathy score after 4 months of practice was higher than that before intervention and after the theoretical course ( P < 0.05). The most popular theoretical teaching forms among residents were interactive theoretical teaching (64.29%, 27/42), video viewing (59.52%, 25/42), and situational simulation (52.38%, 22/42). The comprehensive abilities of parallel medical record writing and podium performance among residents were improved. Passing the Medical Practitioner Qualification Examination is a necessary condition for passing the residency training program. The first-time pass rate of the Qualification Examination for the residents was 72.00% (18/25), which was higher than that of the residents who were not recruited during the same period (64.71%, 11/17). Conclusion:Carrying out narrative medicine education is helpful to improve the empathy ability and comprehensive ability of training residents in municipal hospitals.
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Objective: The study aimed to identify potential components of the collaboration between hospital and community pharmacists from the perspective of pharmacists in municipal hospitals. Methods: Following a preliminary study, an online survey was conducted among pharmacy directors and those on an equivalent managerial level in municipal hospital pharmacies. The survey used a 5-point Likert scale with 32 items about the components of collaboration between hospital and community pharmacists. We performed an exploratory analysis and structural equation modeling of the data. Results: The analysis proposed a five-factor model (“Organizational climate,” “Information sharing system,” “Community support system,” “Interest in healthcare policy,” and “Understanding of healthcare policy”), which consisted of 17 items. Subsequent confirmation with structural equation modeling created a model with good fit (in terms of partial evaluation and overall goodness of fit) with a chi-square of 86.218, P-value of 0.564, goodness of fit index of 0.907, adjusted goodness of fit index of 0.857, and other good model fit indices (comparative fit index of 1.000 and root mean square error of approximation of 0.000). Discussion: This study identified two core universal concepts and three concepts adhering to the current medical context, that seem to guide the behavior of municipal hospital pharmacists─who are major players in community healthcare─in their collaboration with community pharmacists.
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@#Objective To explore the safety, feasibility and learning curve of video-assisted thoracoscopic surgery(VATS) in treatment of thoracic diseases. Method We retrospectively analyzed the clinical data of 591 patients of thoracic surgery in our hospital between September 2009 and September 2016. There were 378 males and 213 females at age of 14–82 years. Result All patients were successfully completed surgery. Twelve patients converted to open chest with conversion rate of 2.0%. Postoperative complications occurred in 24 patients (4.1%). Four patients died during the perioperative period, and mortality rate was 0.7%. The learning curve of VATS for lung cancer was about 25 patients. And the learning curve of video-assisted laparoscopy for resection of esophageal cancer was about 15 patients. Conclusion VATS is safety and feasible for the chest disease patients in municipal hospital, and is worthy to popularize.
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ObjectiveBy reviewing TCM research projects in Nanjing municipal hospitals from 2006 to 2010 (eleventh five-year plan), this study aimed to recognize the existing problems, put forward corresponding solutions, and help Nanjing municipal hospitals improve scientific research level.Methods Through field investigations and interviews with experts, this study set 139 research projects from 2006 to 2010 in 10 municipal hospitals in Nanjing as study samples. ResultsDuring 2006-2010, current situations in TCM research projects of Nanjing municipal hospitals were as follows:the number of TCM research projects was small, the research level was low, and the fund was little. TCM research resources were unevenly distributed;the overall quality of TCM human resources were not high;talent structure was unreasonable;great differences existed among different types of hospitals.ConclusionsDuring the eleventh five-year plan period, there were significant differences between TCM research projects and WM research projects in Nanjing municipal hospitals, such as the differences in number, level, fund and project channel. The study proposed that TCM research materials should be rationally allocated, related mechanisms should be perfected, the industrial structure should be optimized, and the pace of training and introducing TCM research human resources should be quickened, with a purpose of making contributions to TCM development in Nanjing.
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Context: It is now known that resident doctors registered for postgraduate studies are prone to work related stress and eventual burnout. Though stress can happen in any profession, reduced performance of resident doctors due to vocational stress could cause an increase in medical errors and thus affect the quality of life of the patients. Resident doctors at a Municipal hospital in India form a unique population as number of stresses they undergo are many and varied. Aims: To study the prevalence of work-related stress and its anticipated solutions among the resident doctors registered for postgraduate studies in clinical subjects at a tertiary Municipal hospital. Settings and Design: A stratified sampling cross-sectional survey was conducted at the Inpatient, Outpatient, and Intensive Care Units at a tertiary Municipal hospital in Mumbai, India. Material and Methods: Data collection was done using a validated 20-point questionnaire to assess the factors causing stress and their anticipated solutions. Statistical Analysis: Simple percentage analysis of stress questionnaire. Results: 71 resident doctors completed the survey. The major stressors in this cohort were inadequate hostel/quarter facilities (92.1%), and the need to perform extra duties (80.0%). Also, non-conducive environment for clinical training and studies (81.7%), inadequate study (78.9%) and break (81.2%), threat from deadly infections (74.6%), and overburdening with work (69.0%) were the other major stress causing factors. The perceived stress busters were good music (40.8%) and family and friends (40.8%). Eighty-seven percent of the respondents perceived regular physical exercise to be an effective mode of stress management and 83.8% expressed their need to have a simple therapeutic gymnasium established within the campus with a qualified trainer. Conclusions: There is a high level of work related stress among the resident doctors registered for postgraduate clinical studies at a tertiary Municipal hospital in Mumbai. One of the perceived stress busters is regular physical exercise that is structured and under supervision.
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Adult , Education, Medical, Graduate , Humans , India/epidemiology , Surveys and Questionnaires , Stress, Psychological/epidemiology , Stress, Psychological/etiology , Stress, Psychological/prevention & control , Stress, Psychological/psychology , Stress, Psychological/therapy , Students, Medical/psychology , Tertiary Care Centers , WorkABSTRACT
Objective To evaluate the efficacy of stroke rehabilitation unit in municipal hospitals during the acute phase of cerebral infarction.Methods 77 acute cerebral infarction patients were randomly assigned to stroke rehabilitation unit group and 73 to ordinary group.The NIH stroke scale(NIHSS),activities of daily living(ADL)Barthel index and average hospitalized time were compared in two groups before and after the treatment.Results The average NIHSS in two groups before treatment were 9.26 and 9.12 respectively(P＞0.05)but became 2.62 and 7.64 after treatment(P＜0.01).The average ADL Barthel index in two groups before the treatment were 52.04 and 53.16(P＞0.05)but 87.26 and 64.20 after the treatment(P＜0.01).The average hospitalized time in the two groups were 22.25 and 26.67 days(P＜0.05).Conclusion When stroke rehabilitation unit being applied in the acute phase of cerebral infarction,it showed positive results in the following aspects as:improving the neurological function,capabilities of managing daily life,and also shortening the days of hospitalization.