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In recent years, with the rapid development of Chinese domestic surgical robot technology and the expansion of the application market, the "industry-university-research-medicine" collaborative innovation transformation mode has gradually developed and formed. Medical institutions play an important role in multi-party cooperation with enterprises, universities, and research institutes, as well as in product planning, technology research and development, achievement transformation, and personnel training. On the basis of reviewing the current situation of the development of the "industry-university-research-medicine" collaborative innovation transformation mode of domestic surgical robots, this study explores the multiple roles played by medical institutions in this mode and challenges, further putting forward corresponding recommendations.
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Humanos , Robótica , Universidades , Medicina , Indústrias , TecnologiaRESUMO
Objective:To construct an index system for evaluating the development of research-oriented disciplines in medical institutions, and to provide a basis for guiding the superior disciplines towards international high-level disciplines.Methods:Through literature research and expert discussions, the basic framework of the research-oriented disciplines development evaluation system was established. The final version of the index system was determined using the Delphi method and expert interviews, and the weights of each index were established using the hierarchical analysis method.Results:After consultation, the framework of 5 first-class indexes, 16 second-class indexes, and 51 third-class indexes was finally constructed for the evaluation system of research-oriented discipline development, and the weights of indexes at different classes were calculated. The high-frequency terms " research mechanism construction" , " research team construction" and " representative research results" extracted from the expert interviews echoed the results of the weighting calculation.Conclusions:The evaluation system for research-oriented disciplines constructed in this study is relatively reasonable, scientific, reliable, and operable. The construction of the index system adapts to the characteristics of the development of research-oriented disciplines, with guiding significance for enhancing the development of research-oriented disciplines.
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Objective:To survey the practice of hospice care and influencing factors among health providers in Shanghai.Methods:From November to December in 2019, a sampling survey on the practice of hospice care was conducted among 2 982 health providers from 217 institutions in 16 districts of Shanghai by using the self-designed scale.Results:The overall behavior frequency of hospice care in health providers was between "occasionally" (3 points) and "often" (4 points). The item score was (3.7±0.9), and the total score was (52.1±10.0). In the aspect of building a good relationship with patients and family(77.7%, 2 317/2 982), the participants had the highest work-practice(46.4%, 1 383/2 982). However, they practiced less in recommending the hospice care institutions to terminal patients. In terms of work-practice, the average score in male providers, those with education of undergraduate and above, those being married (including divorced or widowed), medical staff, those with associated senior titles, with witness of dying, or those currently working in the hospice care service department was higher.Conclusions:The hospice care work-practice of health providers in Shanghai is generally satisfactory, however, there is still some discrepancy among health providers with various characteristics. To further improve quality of hospice care, it is necessary to strengthen policy implementation, to encourage multidisciplinary team cooperation and carry out various forms of professional training for health providers.
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Objective:To investigate the attitude of health providers towards hospice care in Shanghai,and analyze the related influencing factors.Methods:From November to December 2019,a questionnaire survey on the attitude towards hospice care was conducted among 7 074 health providers from 223 medical institutions in 16 districts of Shanghai.Results:A total of 7 027 valid questionnaires were recovered, with an effective recovery rate of 99.3%. The total score of attitude to hospice care was (91.9±11.6),the average score of items was (3.7±0.5). The highest score rate was "perception of the benefits for the quality of life promotion" (87.08%),and the lowest score rate was "perception of the threats from the worsening conditions of advanced patients" (60.88%).Health providers who were doctors ( B=-1.207), nurses ( B=-0.912), those without witness of dying or end-of-life patients ( B=-1.417), those without involving in hospice care services ( B=-1.203), and not willing to participating in hospice care ( B=-7.849) had lower attitude scores (all P<0.05). Conclusions:The survey indicates that health providers in Shanghai have a positive attitude towards hospice care,but the initiative to engage in hospice care service is not high. It is necessary to conduct targeted training of relevant professional knowledge to enhance the attitude and enthusiasm to hospice care among health providers.
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The provision of hospice care can improve the quality of life for terminal patients. Currently the measurement tools for knowledge, attitudes and practices(KAP)of hospice care providers have been developed and widely used internationally. This article reviews the measurement scales and relevant factors for KAP of hospice care to provide reference for further studies. The databases of CNKI, Wanfang data, PubMed, Web of Science databases, Google and Baidu search engines were systematically searched. According to the retrieval strategy, 42 literatures were finally included for analysis. The development of measurement scales and influencing factors about KAP of medical staff were reviewed from the included studies. It appeared some mature scales have been applied in different extent, or available for interpretation into different language versions. Most of researches adopted quantitative tools to measure medical staff's KAP on hospice care. The current researches conducted in China mainland showed a change on target population from nurses to specialized doctors and from a single group to multidisciplinary medical team. In the future, it would be more focusing on multidisciplinary team mainly comprised of general practitioners, nurses and social workers. Till recently, there is little literature evidence for study of the characteristics of localization.
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Objective:To investigate the current training needs of hospice care among health providers in Shanghai.Methods:Based on the B.S. Bloom classification of educational objectives,a questionnaire on the training needs of hospice care for health providers in Shanghai was developed. From November to December 2019,a questionnaire survey on the training needs of hospice care was conducted among 7 074 health providers in 223 medical institutions in Shanghai.Results:A total of 7 027 valid questionnaires were recovered, with an effective recovery rate of 99.3%. The training needs of health providers in Shanghai exceeded 71.0% for all items,with the average score of (2.58±0.63). The degree of training needs in each dimension ranges from high to low were knowledge(2.59±0.64), action(2.57±0.68) and motion(2.56±0.70). The top three training needs were“living will and law”(80.5%,5 660/7 027),“social work methods for hospice care”(75.3%, 5 290/7 027)and“stress and adaption in hospice care services”(75.1%,5 279/7 027). Female health providers(2.61±0.62), administrators, medical personnel and other post workers(2.68±0.56),those with junior professional title(2.61±0.62), with no witness of dying process(2.65±0.58),and those without participating in hospice care service(2.68±0.55)had higher training needs( P<0.05). Conclusion:The training needs of hospice care for health providers are very high in all hospitals. It is suggested to conduct stratified and targeted training for health providers in different positions and institutions according to the different training needs of hospice care.
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Objective:To investigate the knowledge level of hospice care and the related influencing factors among health providers in Shanghai.Methods:From November to December 2019,a questionnaire survey on the hospice care knowledge was conducted among 7 074 health providers from 223 registered hospice care clinics or institutions in 16 districts of Shanghai.Results:A total of 7 027 valid questionnaires were recovered, with an effective recovery rate of 99.3%. Among the 7 027 responders, there were 1 460 males (20.8%) and 5 567 females (79.2%) with an mean age of (36.9±9.3) years; 2 682 nurses (38.2%) and 2 442 doctors (34.8%); 5 065 (72.1%) from community health service centers; 2 982 (42.4%) involving in hospice care services and 4 039 (57.5%) willing to work in hospice care. The average score of hospice care knowledge was (8.9±2.6), and the average accuracy for questions was 59.0%. Health providers had the highest awareness rate for the composition of hospice care professional team (93.9%, 6 597/7 027) and the lowest awareness rate for the emotional commitment in hospice care service (16.6%, 1 165/7 027). Health providers with junior colleges degree ( B=-0.429), vocational college degree and below ( B=-0.544), nurses ( B=-0.652), working in suburban areas ( B=-0.278), social office ( B=-0.891), without witness of dying process of end-of-life patients ( B=-0.329), not involving in hospice care services ( B=-0.283), and not willing to participating in hospice care ( B=-0.820) had low knowledge scores ( P<0.05). Conclusions:The overall level of hospice care knowledge of health providers in Shanghai is generally at a medium level, and the training of hospice care knowledge should be strengthened for the better development of hospice care.
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The data of registered general practitioners (GPs) in Shanghai Pudong New Area from 2014 to 2017 were collected through literature review and institutional investigation.The status of registered GPs was analyzed longitudinally by the methods of descriptive statistics and comparative analysis.The total number of registered GPs in Pudong New Area was increased from 1 227 in 2014 to 1 469 in 2017 and increased by 19.7％,with an average annual growth rate of 6.18％.But the human resources of GPs in Pudong New Area were not sufficient and the recruitment of GPs in grass-roots increased slowly.GPs in community health service centers in remote rural areas steadily increased year by year,however,the uneven distribution still existed.The proportion of GPs with senior professional titles had steadily increased,but it was still low.
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The data of registered general practitioners (GPs) in Shanghai Pudong New Area from 2014 to 2017 were collected through literature review and institutional investigation. The status of registered GPs was analyzed longitudinally by the methods of descriptive statistics and comparative analysis. The total number of registered GPs in Pudong New Area was increased from 1 227 in 2014 to 1 469 in 2017 and increased by 19.7%, with an average annual growth rate of 6.18%. But the human resources of GPs in Pudong New Area were not sufficient and the recruitment of GPs in grass-roots increased slowly. GPs in community health service centers in remote rural areas steadily increased year by year, however, the uneven distribution still existed. The proportion of GPs with senior professional titles had steadily increased, but it was still low.
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Objective To learn the acceptance of rural community health workers (CHWs ) following the reform of rural health workers′team building in Pudong New Area.Methods 3 295 CHWs were surveyed with questionnaire for their acceptance of the incentive policies,and chisquare test analysis was used to analyze the differences among CHWs in individual areas.Results Over 80.0% of the CHWs reported that they were motivated by the incentive policies to improve their professional competence, medical service and organizational commitment;40.9% of them reported that the policies improved their social status;and 47.3% of them believed the policies could promote the rural areas to attract and retain talents.When a comparison was made of CHWs′feedbacks on different aspects,significant differences indicated that the proportion of CHWs′positive attitudes was the highest at remote rural communities. Conclusions The rural health workers′team building reform could promote incentive on the CHWs,yet with obvious regional differences.
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Objective To survey the career identity and satisfaction of family doctors in Pndong New Area of Shanghai municipality.Methods Two hundred and thirty four family doctors were selected with random sampling method from 6 community health centers in Pudong New Area of Shanghai.The survey on career identity and satisfaction was conducted using a self-designed questionnaire.Results The results showed that 37.2％ of participants were very satisfied (8.1％,19/234) or satisfied (29.1％,68/234) with their current career situation.The three lowest satisfaction factors were salary (14.1％,33/234),benefit and social insurance (27.3 ％,64/234),professional reputation and social status (20.9％ 49/234).Meanwhile,the three highest factors were quality of their leadeship (79.5％,186/234),interpersonal relationship(74.4％,174/234) and the institutional management (63.3％,148/234).The survey also showed that 44.5％ and 30.6％ of participants expected their monthly pay as 8 001-10 000 and 5 000-8 000 RMB; 39.1％ thought the current performance evaluation mechanism as effective,while 25.7％ thought the opposite.Conclusion The social status and salary level of family doctors need to be improved; there is also an urgent need to improve the performance evaluation mechanism and other supporting measures.
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Objective The aim of this study is to discuss the clinical teachers' behavior choices in the aspects of medical care,education and research,and explore the related factors by making an investigation.Methods This study adopts the method of Literature Review,interview and questionnaire investigation.Results 57.6％ of clinical teachers obviously felt enormous pressure,83.28％ of clinical teachers support the saying busy and time pressing is one of the most important facts; in view of the time allocation,the majority of the clinical teachers' arrangement is medical care ＞ research ＞ education or medical care ＞ education ＞ research.Conclusions Time and energy became the scarce resources for clinical teachers.On the other hand,the conflict relationship among medical care,education and research makes clinical teachers stand at the crossroads.The understanding of the relationship among medical care,education and research,and the policy environment are important factors when a clinical teacher was making a stand.