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ObjectiveTo visualize the international research hotspots and frontiers of primary healthcare workers burnout during the COVID-19 pandemic based on CiteSpace. MethodsPublications from January 1 2020 to November 1 2022 were retrieved from the web of science core collection database. Annual published articles， keyword co-occurrence， cluster analysis and emergent word evolution were analyzed. Using CiteSpace 5.8.R3 and Excel 2017， visualized knowledge graphs and the data tables were generated. ResultsA total of 411 articles were included with a still upward trend. The top 4 institutions with the largest number of papers were Harvard Medical Scchool （14 studies）， University of Melbourne （11 studies）， Stanford University （9 studies）， and Monash University （9 studies）. High-frequency words of hot areas covered job satisfaction， occupational burnout， and mental health. Meanwhile the words environment （0.38） and social support （0.13） had high betweenness centrality. A total of 9 clusters were formed. Risk factors and supporting strategies were put in place most focused frontiers. ConclusionThe number of papers in the field of primary healthcare workers burnout is on the rise， the international research hotspots are expanding and the predictors of burnout are prominent. From an international perspective， the study provides further reference for Chinese primary healthcare staff job burnout research.
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Objective:To investigate the intention of medical students to be vaccinated against COVID-19 and to analyze the influencing factors.Methods:A self-filled electronic questionnaire survey was conducted among medical students from a medical school in Shanghai randomly selected from June 21 to 29, 2021. The questionnaire contained items of basic information, intention for COVID-19 vaccination, awareness of COVID-19 prevention measures and awareness of COVID-19 vaccine. Logistic regression was used to analyze the influencing factors.Results:The average age of the 966 respondents was (20.4±2.9) years, and 63.6% (614/966) of them were female;23.7% (229/966) of them had family members or relatives who had participated in anti-pandemic work or volunteer service;90.6% (875/966) of the respondents expressed they were very willing or willing to be vaccinated against COVID-19. The majority of the respondents thought that “COVID-19 infection is very serious” (94.3%, 911/966), “good protection can effectively prevent COVID-19 infection” (92.4%, 893/966), and “they can fully implement all kinds of protection measures” (73.5%, 710/966). About half of the respondents (51.8%, 501/966) knew about the adverse reactions and contraindications of COVID-19 vaccine. The low protected capability (47.4%, 458/966), short duration of protection (50.6%, 489/966), and many side effects (48.7%, 470/966) were the major concerns about COVID-19 vaccine. Logistic regression analysis showed that people thought that “COVID-19 infection is very serious” ( OR=5.30, 95 %CI:2.60-10.81, P<0.001), thought that “good protection can effectively prevent COVID-19 infection” ( OR=2.46, 95 %CI:1.26-4.81, P=0.009), thought that “they can fully implement all kinds of protection measures” ( OR=2.55, 95 %CI:1.53-4.25, P<0.001) were more willing to receive COVID-19 vaccination. While those concerned about vaccine quality did the opposite ( OR=0.29, 95 %CI:0.13-0.65, P=0.003). Conclusions:Medical students have a high intention of vaccination against COVID-19. The vaccine-related knowledge quality should be emphasized in future publicity to further enhance the intention of COVID-19 vaccination.
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Objective:To investigate the awareness rate of " 1+ 1+ 1" contracted residents in the outer suburbs of Shanghai on the extended prescription policy of the family doctor contract service, and to analyze the influencing factors.Methods:From March to May, 2021, the cluster random sampling method was used to select one community health service center in Fengxian district, Shanghai, and a smart voice telephone assistant survey was conducted among the contracted residents aged 18 and above in the area, to understand their awareness of the extended prescription policy. χ2 Test was used for single factor analysis on the influence of different factors on the policy awareness of the contracted residents, while a multivariate analysis was performed by binary logistic regression, presenting P<0.05 as statistically significant. Results:A total of 13 495 " 1+ 1+ 1" contracted residents were surveyed via phone calls. Their awareness rate of extended prescription policy was 67.5% (9 115/13 495), while those with higher awareness rates were patients with ≥2 chronic diseases (92.3%), patients with 1 chronic disease (88.5%) and those aged 81 and above (88.4%). Logistic regression analysis showed that age, marital status, the number of chronic diseases and signing duration were all independent factors influencing the awareness of extended prescription policy (all P<0.05), while whether the residents were key population groups presented no significant influence on the awareness of extended prescription policy ( P=0.431). Conclusions:The awareness rate of " 1+ 1+ 1" contracted residents in the outer suburbs of Shanghai to the extended prescription policy needs to be further improved and publicity should also be strengthened to extend the policy benefit coverage.
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Objective To explore the needs of community pharmacy services in elderly hypertensive patients in the community, especially empty-nest elderly patients. Methods Elderly hypertensive patients living in Ouyang street were randomly selected and divided into empty-nest and non-empty-nest groups by cluster random sampling method. The basic information of the respondents, the frequency of hypertension monitoring, the taking of hypertensive drugs, and the taking of other drugs were compared and analyzed. Results In term of “blood pressure monitoring frequency”, the daily pressure measurement of the empty-nest group and the non-empty-nest group accounted for 33.6% and 19.3%, respectively. There was significant difference between the two groups (P<0.05).In term of “the varieties of hypertension drugs” and taking 3 kinds of hypertension drugs at the same times, the empty-nest group accounted for 28.8% and the non-empty-nest group accounted for 16.7%, and the difference between the two groups was significant (P<0.05)；In term of “the varieties of drugs” and taking 1-2 kinds of Chinese patent drugs at the same time, the empty-nest group accounted for 39.6% and the non-empty-nest group accounted for 26.0% , and the difference between the two groups was significant (P<0.05)。Conclusion Community elderly patients with hypertension, especially empty-nest elderly patients have an urgent need for community pharmacy services，Community pharmacy services personnel should provide personalized and targeted medication education and guidance to elderly patients, especially empty-nest elderly patients, to promote the rational drug use in elderly patients.
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Objective:To understand the current situation of appeals for rights and interests of medical staff in community health institutions and secondary/tertiary hospitals in Shanghai, for the suggestions on improving the job satisfaction and enthusiasm of medical staff.Methods:From September to November 2020, two community health service centers(stations), one secondary hospital and one tertiary hospital were selected from Jiading District, Pudong New Area and Jing′an District of Shanghai respectively. An online questionnaire survey was conducted among medical staff in medical institutions selected by stratified random sampling. The survey covered the main demographic information as well as 12 rights and interests demands, namely " salary promotion" among other. Descriptive analysis was performed on the data, and chi square test was used for comparison between groups.Results:1 759 valid questionnaires were recovered in this survey, and 1 654 medical employees(94.03%)reported a high degree of appeal for " salary promotion" . Compared with the medical staff in community health service centers(stations), the medical staff in secondary/tertiary hospitals reported higher demands for " training and study" " title appointment" and " academic promotion" , presenting a difference statistically significant( P<0.05). There were significant differences between doctors and nurses in " routine expense reimbursement" " staff recruitment" " professional title appointment" " children′s education" " cultural and recreational activities" and " opinion feedback channels" ( P<0.05). Conclusions:Salary promotion was the common demand of medical staff at all levels of medical institutions. Medical staff at secondary/tertiary hospitals had higher demands for career development. There were some differences in appeals for rights and interests between doctors and nurses. Medical institutions at all levels should continue to promote the reform of salary system, pay attention to the respective rights and interests of doctors and nurses, and improve their job satisfaction and enthusiasm.
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Objective:To analyze the work stress of medical staff at different medical institutions in Shanghai under the background of normalized prevention and control of 2019 novel coronavirus diseases(COVID-19), for evidence of relieving the work stress of medical staff.Methods:From September to November 2020, two community health service centers, one secondary hospital and one tertiary hospital were selected from each district of Jing′an District, Jiading District and Pudong New Area of Shanghai, totaling 12 medical institutions. The medical staff were selected by stratified random sampling. A self-designed questionnaire was used to conduct an online questionnaire survey on the work stress of medical staff. The survey data were analysied by descriptive analysis, and different groups were compared with chi square test.Results:1 422 valid questionnaires were obtained. There was a significant difference in self-rated routine work stress of medical staff between community health service centers and secondary/tertiary hospitals( P<0.001). The proportions of medical staff whose self-rated routine work stress was " quite stressed" or " very stressed" at community health service centers and secondary/tertiary hospitals were 39.77%(317)and 55.36%(346)respectively. There was a significant difference in self-rated COVID-19 prevention stress of medical staff between community health service centers and secondary/tertiary hospitals( P<0.001), the proportions of medical staff who considered the COVID-19 prevention was " quite stressed" or " very stressed" were 86.45%(689)and 76.48%(478)respectively. Conclusions:The overall work stress of medical staff at medical institutions in Shanghai was high.The prevention and control of COVID-19 increased the pressure of medical staff at all levels of medical institutions.
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Objective@#To understand the status quo and differences of the rights and interests of primary medical staff in a community, and to provide targeted suggestions for improving the rights of such staff.@*Methods@#From October to November 2018, a questionnaire survey was conducted on all the medical staff of 8 community health service centers in a district of Shanghai, and 562 valid samples were obtained.@*Results@#The primary medical staff had the highest demands for " pay rise" (4.783±0.598), " paid vacation" (4.569±0.873)and " additional reserve fund" (4.553±0.963); the lowest demands were placed on " education-based promotion" (3.797±1.382), " refresher training" (3.801±1.314), and " opinion feedback mechanism" (4.018±1.223). At the same time, the rights and interests of these staff in different occupational categories were significantly different(P<0.05)in " daily reimbursement" , " housing subsidy" , " refresher training" and " opinion feedback mechanism" .@*Conclusions@#The salary demands of the primary medical staff are the most obvious, and there are differences in the demands of medical staff in different occupational categories. It is suggested to establish a more reasonable salary system and pay attention to the differentiated appeals of different medical personnel.
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Objective Under the linkage reform of family doctor service and medical insurance payment ,to study the family doctors′ career cognitive and expectations in order to improve the endogenous power of the family doctor system development ,and push forward the reform with sustainable effects .Methods All the family doctors in Changning were surveyed. There were 154 family doctors surveyed in the first phase of 2013 ,and 143 in the second phase of 2016 .The data were subject to descriptive statistics .Results About 80％ of the family doctors had a clear understanding of the family doctor system in 2016 ,with the proportion of family doctors clearly understanding their duties risen from 55.26％ (84/152)in 2013 to 61.27％ (87/142)in 2016 .Self-assessment of their work value and professional reputation were more positive significantly .70％ of them believed their social status as above average. The proportion of family doctors who were very confident/confident" in the development of community health services and family doctor system increased from 31.72％ (46/145) to 47.20％ (59/125)and from 31.72％ (46/145)to 52.42％ (65/124)respectively .Conclusions The occupational cognition and career expectations of family doctors in Changning district have been significantly improved ,which can guide their behavior towards reform objectives and propel the family doctor system progress smoothly .
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Objective To evaluate the motivation effect of family doctors′ contracting service and health insurance compensation mechanism from the perspective of income change and income satisfaction of family doctors .Methods The situation about salary compensation plan reform and the change of income level and structure were learnt from interviews on the management personnel and questionnaire surveys of family doctors in 2013 and 2016 .The data were subject to descriptive statistics .Results The proportion of family doctors earning between 8000 and 10000 yuan in 2016 rose to 67.16％ (90/134 ) from 18.18％ (26/143 ) in 2013.11.72％ (15/128 ) of family doctors′contracting service fee amounted to over 50％ of their income. The number of family doctors who were dissatisfied with their income has fallen by 28.52％ .There were still 51.90％ (68/131)of the family doctors who were not satisfied with their income and 24.64％ (34/138)of them held the incentives of performance appraisal as a failure .Conclusions The income of family doctors has been greatly increased in the last three years.Contracting service fee plays a key role in motivating these doctors , but three risks also need to be prevented in the process of further reform .
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Objective To evaluate the present family doctors staffing and service capacity building in Changning under the linkage reform of contracting service and health insurance payment . Methods The staffing data of family doctors were collected from the 2013-2015 annual reports ,while the data on their qualifications ,training ,job stress and competence were collected from two follow-up investigations. These data were analyzed with descriptive statistics .Results in 2016 ,the number of family doctors totaled 27000 ,up to 2.75 doctors per 10000 people.Over 97％ of the family doctors were qualification certificated.More than half of the family doctors participated in the standardized training .68.80％ (97/141)of the family doctors complained overwork.More than 80％ of the family doctors have encountered technical problems with medical services .Conclusions The number and quality of family doctors in Changning have been greatly improved to satisfy contracting services of the residents to a minimal extent. However ,more family doctors are needed ,as they still face much work stress. The family doctors call for standardized training ,better payroll and incentive mechanism ,better career development and coordinated support mechanism ,as well as better team building for greater performance .