RESUMO
Objective:To understand the implementation status of case-based payment among healthcare provid-ers and their cognition on the matter. Methods:Semi-structured interview was conducted on 30 purposely selected staff from 9 hospitals in Chengdu. Results:After one-year implementation of case-based payment, hospitals at different level carried out the policy vigorously:executed corresponding expense control measures and management. Neverthe-less, the proportion of cases that were paid with case-based payment was low, moreover the inclusion criteria for case was of disunity and the formulation of the expense standard was ambiguous to some extent. Conclusion:Certain achievements were accompanied with problems, so it is essential to refine reimbursement standards, improve case-based payment, make clear the inclusion criteria for case and extend the covering range of case-based payment in Chengdu. In addition, the medical insurance agency should strengthen the supervision of healthcare providers,and guide them to set up effective incentive mechanism.
RESUMO
<p><b>OBJECTIVE</b>To explore the psychometric performances and applicability of SF-36v2 in assessment quality of life among urban residents in Chengdu.</p><p><b>METHODS</b>During Oct. to Dec., 2012, 2 186 adult urban residents with clear mind and well self-express were recruited in the study by multistage stratified cluster sampling method in Chengdu urban area. The survey questionnaires included general health condition and quality of life, which was adopted the SF-36v2. Internal consistency reliability, test-retest reliability and construct validity were all analyzed as indicators of the psychometric performance.</p><p><b>RESULTS</b>The survey released 2 186 questionnaires, with 2 182 ones returned and 2 178(99.8%) met the data standard. The scores of 8 scales in SF-36v2, including physical function (PF), role-physical (RP), bodily pain (BP), general health (GH), vitality (VT), social function (SF), role-emotion (RE) and mental health (MH), were 89.15 ± 17.56, 85.18 ± 22.52, 76.64 ± 17.80, 64.13 ± 19.56, 70.39 ± 17.31, 86.43 ± 17.35, 87.79 ± 19.24 and 80.61 ± 13.49, respectively; the floor effects were 0.28%, 0.41%, 0.23%, 0.28%, 0.09%, 0.05%, 0.14% and 0.23%, respectively; and the ceiling effects were 51.38%, 60.60%, 58.08%, 0.83%, 2.94%, 50.32%, 64.00% and 3.95%, respectively. The item-convergent validities were all achieved the standard (r = 0.40) except the item MH5 (Have you been happy?), and the total scaling success rate of item-convergent validity was 97.14%. The scales' success rates of item-discriminant validities for the SF, VT and MH scales were 93.75%, 56.25% and 97.50% respectively, while the rates of others were 100.00% and the total success rate was 96.43%. The internal reliability ranged from 0.724 to 0.974 across all the scales, except for SF (r = 0.603) and VT (r = 0.697). The two-week test-retest reliability ranged from 0.610 to 0.845. Within factor analysis, two common factors were confirmed, separately representing physical health and mental health, altogether contributing 64.4% of the total variance.</p><p><b>CONCLUSION</b>As a revised version of SF-36v1, the SF-36v2 seemed to be more preferable in layout for questions and answers and could reduce the ceiling and floor effect. Additionally, it also showed comparatively well reliability and validity. And thereby we believed the SF-36v2 could be applied to assess the life quality among urban residents in Chengdu.</p>
Assuntos
Adulto , Humanos , China , Coleta de Dados , Análise Fatorial , Inquéritos Epidemiológicos , Psicometria , Qualidade de Vida , Reprodutibilidade dos Testes , Projetos de Pesquisa , Inquéritos e Questionários , População UrbanaRESUMO
Objective To understand the protection knowledge and practice to cope with common respiratory infection in senior middle school students in Chengdu ,and to provide basis for carrying out school health education and the establishment intervention model of respiratory infection .Methods A self-administered questionnaire was conducted among 2 237 senior one students in two senior middle schools in Chengdu .Results In terms of basic knowledge of common respiratory diseases ,47 .47% of the students had adequate total awareness scores .Respiratory diseases cognitive knowledge was not comprehensive enough .Especially for the under-standing of certain knowledge ,there was misunderstanding .The awareness rates for prevention of respiratory diseases and the treat-ment of behavior were high ,and they were 87 .54% and 71 .43% ,respectively .Conclusion The senior middle school students in Chengdu have some education demand of respiratory disease ,and schools should strengthen publicity and health education .
RESUMO
Objectives To learn about current public health education for undergraduate clinical students and to provide some references for developing suitable teaching way in the further.Methods Public health education for undergraduate clinical students in 11 medical colleges and universities and teachers' opinions on it were surveyed with the self-made questionnaire.Quantitative data were analyzed with descriptive statistic method.Results All the surveyed colleges and universities opened public health curriculum for undergraduate clinical students and 10 colleges and universities made public health course to be compulsory.The teaching contents were varied in different colleges and universities.Teachers who gave the public health courses proposed some suggestions on its reform.Conclusions Public health education for clinical students in different colleges and universities has both unity and diversity.It should develop new teaching model based on the training goal of public health education for undergraduate clinical students.
RESUMO
Objectives:To investigate appropriate approach of testing the interval feature of alternative answers in questionnaires.Methods:We calculated the total scores of the items within the same domain excluding the item that was under test, and then, identified the distances between the scores of the population who chose the different alternative answers of the test item. The short form 36 was used in the test. We surveyed a total of 2250 residents, with 2246 included in the final analysis.Results:This approach could find the deviated item in the questionnaire. The results of testing of the interval feature of alternative answers were consistent with the original design; however, the clustered items must have good construct validity.Conclusion:Using the items clustered in one domain to test the interval feature of alternative answers may possibly be an available simple approach, but we need more mathematics evidence to prove this assumption.
RESUMO
Objective: To provide standardized alternative answers with the feature of equal intervals in the quality of life assessment.Methods:We collected 131 questionnaires (123 for psychological test and 8 for quality of life assessment). The SPSS 10.0 was used to analyze the frequency distribution of the alternative answers used in these questionnaires.Results:The most commonly used design for alternative answers is five levels, which comprises 31.68% of the total designs, followed by four levels (21.99%) and three levels (13.35%). The words used in the alternative answer show great diversities.Conclusion:We recommend that the alternative answers be designed as five levels, it is better to apply commonly used words in the alternative answer and have a feature of equal interval.
RESUMO
<p><b>OBJECTIVE</b>To develop a non-pharmacotherapy program for patients with hyperlipidemia and assess its effectiveness.</p><p><b>METHODS</b>A cluster control trial was used. The experimental group was given non-pharmacotherapy for hyperlipidemia once a week for 6 weeks; the content of non-pharmacotherapy included the basic knowledge about hyperlipidemia, a guide of changing unhealthy diet and life-style. Patients were followed for once every two weeks in the department of out-patient. The control group received general care conducted by university clinicians, without the non-pharmacotherapy program. A self-completion questionnaire on hyperlipidemia-related knowledge level, questionnaires on diet and exercise, body weight, body height and the serum TG, TC were measured at entry point and at the end of 6 month.</p><p><b>RESULTS</b>One hundred and fifty-four patients in experimental group and 150 patients in control group completed the study. The non-pharmacotherapy group showed a significant increase of knowledge on hyperlipidemia in the experimental group comparing with the control group: the mean (sd) score of hyperlipidemia-related knowledge were 22.5 (4.8), 17.4 (4.2) (95% CI: 4.1, 6.1). The diet score and the proportion of regular physical activity had increased 27.20%, 21.78% respectively in experimental group. The mean (sd) of serum TG, TC and body mass index (BMI) for experimental group [2.0 (0.9) mmol/L, 5.4 (0.9) mmol/L, 23.4 (1.9)] lowered significantly comparing to those for control group [2.4 (0.9) mmol/L, 5.9 (1.0) mmol/L, 24.2 (3.0)].</p><p><b>CONCLUSION</b>Non-pharmacotherapy seemed to be an important intervention for the patients with hyperlipidemia. If same patients with hyperlipidemia failed to respond to non-pharmacotherapy, it is necessary to use pharmacotherapy. However, non-pharmacotherapy should be viewed as basic therapy.</p>