目的 调查国内养老机构痴呆照护服务现状,为今后国内进一步推进养老机构痴呆照护服务的发展提供可借鉴的依据。方法 2024年1月1日至3月31日以全国养老机构为研究对象, 采取两阶段分层抽样, 随机抽取国内15个省、自治区、直辖市的养老机构, 采用网络问卷调查方法对抽取的养老机构管理人员进行问卷调查。结果 共回收线上调查问卷443份, 经过去重和排除无效问卷, 最终得到的有效问卷为412份, 有效率为93%。调查发现有313家（76%）机构有收住痴呆患者, 养老床位规模为100~299张的养老机构占比最高。小规模的养老机构中,民办民营机构收住痴呆患者的比例高于公建公营机构。有181家机构设置了痴呆照护专区。床位数在300张以上的养老机构中设立痴呆照护专区的比例高于中、小规模的养老机构。结论 本调查较客观地呈现了我国养老机构痴呆照护服务开展的现状, 大规模的养老机构提供痴呆照护服务的能力更高, 设置痴呆照护专区的机构更能满足痴呆患者多层次、多样化的照护需求。目前国内仍存在专业化的痴呆照护服务供给不足、照护人员短缺等现象, 急需国家加强顶层设计, 促进行业健康发展。
Objective To explore the current situation of cognitive care services in nursing homes in China, and provide reference for further promoting the development of cognitive care services in nursing homes in China．Methods From January 1 to March 31, 2024, a two-stage stratified sampling was carried out to randomly select pension institutions in 15 provinces, autonomous regions and municipalities directly under the central government across the country, and a questionnaire survey was conducted on the nursing homes．Results A total of 443 online questionnaires were recovered in this survey, and 412 valid questionnaires were obtained after eliminating duplicated and invalid questionnaires, with an effective rate of 93%．In this survey, 76% of the institutions admitted the elderly with dementia, and the nursing homes with 100-299 beds accounted for the highest proportion．Among the small-scale nursing homes, the proportion of the elderly with dementia in private institutions is significantly greater than that in public institutions．There were 181 nursing homes with special cognitive care areas．The proportion of cognitive care area in nursing homes with more than 300 beds was significantly greater than that in medium and small scale nursing homes．Conclusions This survey Objectively presents the current situation of the development of cognitive care services in nursing homes in our country．Large-scale nursing homes have a higher capacity to provide cognitive care services．Nursing homes that set up special areas for cognitive care can better meet the multi-level and diversified care needs of the elderly with dementia．At present, there are still insufficient supply of professional cognitive care services and shortage of nursing personnel in China．It is urgent for the country to strengthen top-level design and promote the healthy development of the industry．
目的 调查江西省南昌市东湖区孕妇2022—2024年碘营养状况与盐碘监测情况，为区域干预提供依据。方法 将江西省南昌市东湖区划分为东、南、西、北、中5个片区，每个片区随机抽取一个街道（管理处），于每年5月份随机抽取各街道（管理处）20名孕妇，每年共抽取100名孕妇，3年共计300名孕妇，采集其尿液样本和家中食用盐样本检测碘含量，以统计学方法进行分析。结果 3年来孕妇家庭食用盐碘含量中位数为23.02 mg/kg，碘盐覆盖率为98.67%，碘盐合格率为95.33%，3年的食用盐碘含量比较差异有统计学意义（H=38.545，P＜0.05）。孕妇的尿碘水平中位数为115.15 μg/mL，3年来孕妇的尿碘水平中位数均低于150 μg/mL，有62.67%的孕妇碘缺乏，3年间的尿碘水平比较差异有统计学意义（H=9.392，P＜0.05），其中2024年的尿碘水平中位数为140.00 μg/mL，校正后高于2022年（Z=2.693，P＜0.0167）和2023年（Z=2.590，P＜0.0167）。Spearman相关性分析结果显示孕妇尿碘水平与盐碘含量及碘盐质量均无相关性（均P＞0.05），孕妇碘营养状况与盐碘含量及碘盐质量均无相关性（均P＞0.05），孕妇尿碘水平与碘营养状况正相关（rs=0.857，P＜0.05），盐碘含量与碘盐质量正相关（rs=0.314，P＜0.05）。结论 江西省南昌市东湖区2024年孕妇碘缺乏有所改善，但整体形势严峻，超半数的孕妇碘缺乏，食用碘盐基本符合国家消除碘缺乏病标准，但仍需改进。卫生部门要强化孕妇碘营养监测，向孕妇科普碘缺乏病知识，增强补碘意识，促其科学补碘。盐业监管部门需加大监管，严控碘盐质量，确保东湖区居民食盐合格。
Objective To investigate the iodine nutrition status of pregnant women and iodined salt monitoring in Donghu District，Nanchang City，Jiangxi Province from 2022 to 2024，and provide a basis for regional intervention．Methods Donghu District was divided into five areas：East，South，West，North，and Central．A street（management office）was randomly selected from each area，and 20 pregnant women were randomly selected from each street（management office）in May each year．A total of 100 pregnant women were selected each year，for a total of 300 pregnant women over three years．Urine samples and household salt samples were collected to detect iodine content，and statistical analysis was conducted．Results Over the past three years，the median iodine content in the cooking salt consumed by pregnant women’s families was 23.02 mg/kg，the iodized salt coverage rate was 98.67%，and the iodized salt qualification rate was 95.33%．There were differences in the iodine content of cooking salt in the three years（H=38.545，P＜0.05）．The median urinary iodine level of pregnant women was 115.15 μg/mL．In the past three years，the median urinary iodine levels of pregnant women were all lower than 150 μg/ml，and 62.67% of pregnant women were iodine-deficient．There were differences in the urinary iodine levels in the three years（H=9.392，P＜0.05）．Among them，the median urinary iodine level in 2024 was 140.00 μg/mL，which was significantly higher than that in 2022（Z=2.693，P＜0.0167）and 2023（Z=2.590，P＜0.0167）after correcting the significance level．Spearman correlation analysis results showed that there was no correlation between the urinary iodine level of pregnant women with the iodine content and quality of iodized salt（all P＞0.05），and there was no correlation between the iodine nutritional status of pregnant women with the iodine content and quality of iodized salt（all P＞0.05）．The urinary iodine level in pregnant women is positively correlated with their iodine nutritional status（rs=0.857，P＜0.05），and the iodine content in salt is positively correlated with the quality of iodized salt（rs=0.314，P＜0.05）．Conclusions In 2024，the iodine deficiency among pregnant women in Donghu District，Nanchang City，Jiangxi Province was improved，but the overall situation is still severe．More than half of pregnant women were iodine-deficient．The consumption of iodized salt basically met the national standards for eliminating iodine deficiency disorders，but still needed to be improved．The health department should strengthen the monitoring of iodine nutrition among pregnant women，popularize knowledge about iodine deficiency disorders to pregnant women，enhance their awareness of iodine supplementation，and promote their scientific iodine supplementation．The salt industry supervision department needs to strengthen supervision，strictly control the quality of iodized salt，and ensure that the cooking salt of residents in Donghu District is qualified．
目的 调查良性前列腺增生（BPH）患者对前列腺手术的接受意愿,并分析其影响因素。方法 采用问卷调查法,于2021年3月—2022年10月选取中山大学附属第一院惠亚医院收治的133例BPH患者为研究对象。由调查者床边发放问卷,并当场收回。结果 调查共发放问卷133份,回收有效问卷130份,有效率为97.74%。单因素分析结果显示,经济负担、医保报销、BPH程度、住院陪护、了解BPH对自身的危害等因素与患者接受手术意愿相关（P<0.05）。Logistic多因素回归分析显示,患者的经济负担、医保报销及已存在BPH并发症是影响患者接受手术意愿的因素（P<0.05）。结论 本区域BPH患者由于经济、医保及已存在BPH并发症的问题,直接影响了接受前列腺手术的意愿,不仅影响患者的生理健康,也影响生活质量及家庭和睦关系,应加大疾病认知宣传力度,组建患者互助团体,促进居民对BPH疾病及手术的了解,提高该类患者的生活质量。
Objective To investigate the willingness of patients with benign prostatic hyperplasia（BPH）to accept prostate surgery and analyze its influencing factors．Methods A questionnaire survey method was used to select 133 patients with BPH admitted to a hospital from March 2021 to October 2022．The questionnaires were distributed and collects by the investigator at the bedside．Results A total of 133 questionnaires were distributed during the survey and 130 valid questionnaires were collected,with an effective rate of 97.74%．The results of single factor analysis showed that factors such as financial burden,medical insurance reimbursement,degree of BPH,hospitalization accompaniment,and understanding of the harm of prostate hyperplasia were significantly related to patients’ willingness to receive surgery,with statistical significance（P<0.05）．Logistic multifactor regression analysis showed that the patient’s financial burden,medical insurance reimbursement,and existing BPH complications were factors that affected the patient’s willingness to receive surgery．Conclusion sBPH patients in local region have financial burden,medical insurance and existing complications of BPH,which directly affect their willingness to undergo prostate surgery．Those factors not only affect the patients’ physical health but also affect the quality of theirlife and harmonious thier family relationships． Awareness of the disease should be increased to promote publicity,and patient mutual aid groups should be started to improve residents’ understanding of BPH disease and surgery and improve the quality of patients’life．
目的 评估产后女性的认知功能,并分析其认知功能受损的特点,以及分析可能的影响因素。方法 病例组选取健康单胎足月顺产初产妇、二胎产妇,对照组选取一般资料匹配的未生育女性,选用蒙特利尔认知评估(Montreal Cognitive Assessment Test,MoCA)北京版、伯明翰认知评估量表(Birmingham Cognitive Screen test,BCoS)普通话版评估认知功能。结果 实际入组病例组80例产妇,均完成MoCA量表,共42例产妇完成BCoS量表,对照组30例均完成MoCA、 BCoS评估。产妇组(80例)MCA得分为(26.26±2.28)分,低于未生育女性对照组MoCA分数(27.47±1.28)分(P<0.05),产妇组认知障碍发生率为30%高于对照组6.7%(P<0.05)。初产妇组MoCA分数(26.52±2.13)分,认知障碍发生率为26%,二胎产妇组MoCA分数(25.83±2.49)分,认知障碍发生率为36.7%,两者对比无明显差别(P>0.05)。产妇组(80例)在MoCA量表视空间与执行功能分项得分低于对照组(P<0.01);产妇组BCoS评分在故事瞬时回想、苹果删除总数、听觉注意、规则转换、手势模仿5个分项低于对照组(P<0.05)。产妇的受教育年限、分娩镇痛麻醉、总产程时间是产后认知功能下降的影响因素(P<0.05)。结论 ①产后妇女可能发生认知功能障碍,但初产妇与二胎产妇的认知障碍发生率无明显差别。②MoCA量表可以用于产妇产后认知功能筛查,BCoS量表可做为全面评估产妇产后认知功能的工具,产妇产后认知受损主要在视空间、注意力、执行功能(实践与行动能力)、记忆力领域。③产妇的受教育年限、分娩镇痛麻醉、总产程时间是产后认知功能下降的影响因素。
Objective To evaluate the cognitive function of postpartum women, and analyze the characteristics of cognitive dysfunction and the possible affecting factors. Methods The case group selected healthy single-born full-term primiparae (50 cases) and second birth parturient (30 cases), and the control group (30 cases) selected non-fertile women with general data matching. The Montreal Cognitive Assessment Test (MoCA) Beijing version and Birmingham Cognitive Screen test(BCoS) were used to evaluate cognitive function. Results Of the 80 cases in the case group, all completed the MoCA test, only 42 cases completed the BCoS test. The 30 cases in the control group all completed the MoCA and BcoS.The MoCA score of the case group (80 cases) was (26.26±2.28), which was lower than that of the control group (27.47±1.28) (P<0.05). The incidence of cognitive impairment in the case group was 30%, higher than the control group 6.7% (P<0.05). The MoCA score of the primiparae group was (26.52±2.13); the incidence of cognitive impairment was 26%; the MoCA score of the second birth parturient group was (25.83±2.49); the incidence of cognitive impairment was 36.7%.There was no significant difference in the MoCA score and the incidence of cognitive impairment between primiparae and second birth parturient (P> 0.05).The case group had lower scores on visual space and executive function of MoCA test than the control group (P<0.01).The score of BCoS test in the case group was lower than that in the control group in the five items of the instantaneous recall item of the story, apple deletion, auditory attention, Birmingham rule conversion and gesture imitation (P<0.05).The years of education, labor analgesia, and the total duration of labor were the factors that affected the cognitive function of postpartum women (P<0.05). Conclusion ①Postpartum women may have cognitive dysfunction, but there was no significant difference in the incidence of cognitive impairment between primiparae and second birth parturient group. ②The MoCA test can be used for the screening of cognitive impairment of postpartum women, and the BCoS test can be used as a tool to comprehensively evaluate the cognitive function of postpartum women. The cognitive impairment of postpartum women was mainly in the fields of visual space, attention, executive function (practice and action ability), and memory. ③The years of education, labor analgesia, and the total duration of labor were the factors that affect the cognitive function of postpartum women.
目的 了解我区慢性阻塞性肺疾病(COPD)稳定期患者药物使用现状,为临床规范治疗COPD指明方向。方法 对在我院治疗的COPD患者采取问卷调查的方式对其稳定期自我用药情况进行调查分析,调查内容包括吸烟史、病程、稳定期用药的种类、用药方式等。结果 我区COPD患者稳定期治疗药物种类繁多,应用LABA/ICS、吸入LAMA比例较低,存在滥用口服抗生素及无指征使用口服激素等不规范用药情况。结论 我区COPD患者稳定期药物部分符合COPD指南推荐,但存在不规范用药。
目的 分析本科医学生对临床技能学培训课程的满意度,探索可提高临床技能学课程的改进措施。方法 抽取2015级不同专业医学生参加临床技能学课程的学生,通过问卷调查学生对培训课程的满意度。结果 临床技能学体系改革后,学生对临床技能学课程设置和老师的满意度都很高,对课程设置非常满意有18.31%,满意有58.03%,基本满意有21.69%,不满意的只有1.41%;对老师非常满意有36.9%,满意有49.86%,基本满意有12.68%,不太满意只有0.56%。结论 临床技能学可提高学生的临床综合能力和思维能力,可以持续的开展。
Objective To Through the analysis of the satisfaction surveys of clinical skills course, we aimed to make improvements on the teaching of clinical skills course. Methods With the method of stratified sampling, we chose medical students of different majors in the grade 2015 who attended the clinical skills course, and carried out the surveys of their satisfaction on the course. Results Students were satisfied with the design and the teaching of clinical skills course after the reform of clinical skills teaching. With the design of clinical skills course, 18.31% students were very satisfied, 58.03% were satisfied, 21.69% were basically satisfied, and just 1.41% were unsatisfied; With the teachers of clinical skills, 36.9% students were very satisfied, 49.83% were satisfied, 12.68% were basically satisfied, and just 0.56% were unsatisfied. Conclusion Clinical skills course may improve students' clinical comprehensive abilities and clinical thinking. It should be carried out continuously.
目的 分析全科医学教学中应用第三方满意度调查,结合学生需求的实践效果。方法 2016年3—12月接收全科医学学生者60例,按照常规方法进行,2017年3—12月全科医学学生62例,教学中应用第三方满意度调查结合学生需求方法,观察教学效果。结果 第二年时,学生期末考试总成绩、病例题成绩、实习报告成绩,课外自学时间、利用网络自学时间、与他人讨论学习时间,教学效果总体评分、课间实习评分均高于第一年,差异有统计学意义(P＜0.05)。结论 全科医学教学中应用第三方满意度调查结合学生需求方法后,可有效的提升教学效果,增强学生的自学能力及自学意识。
Objective To analyze the practical effect of applying the third party satisfaction survey to the needs of the students in the teaching of general medicine. Methods From March 2016 to December 2016, 60 cases of general practice medical students were enrolled. According to the routine method, 62 cases of general medical students from March 2017 to December 2017 were selected. Third party satisfaction survey and student demand method were applied in teaching, and the teaching effect was observed. Results In th second year, students' final exam scores, the total score, case questions internship report scores, extracurricular self-study time, self-study time, learning time, using the network to discuss with othersthe teaching effect of practice during the total score, all above were higher than the first year, there was significant difference (P<0.05). Conclusion The application of third party satisfaction survey combined with students' needs method in general practice teaching may effectively improve teaching effect; enhance students' self-learning ability and self-learning consciousness.
目的 了解广东省罗定市中小学教师的职业倦怠情况,为制定政策提供初步依据。方法 采用中文版Maslach职业倦怠量表(C-MBI)对罗定市42所中小学共590名毕业班教师进行评估。结果 受访者的情感衰竭(emotional exhaustion, EE)和知识枯竭(intellectual burnout, IB)因子分显著高于全国常模(P＜0.05),个人成就感降低(reduced personal accomplishment, PA)因子分显著低于全国常模(P＜0.01)。女性受访者的去个性化(depersonalization, DP)、EE和IB因子分均显著高于男性受访者,PA因子分显著低于男性受访者(P均＜0.01)。结论 广东省罗定市中小学毕业班教师的职业倦怠高于全国平均水平,女性教师的职业倦怠感高于男性教师。
Objective To investigate job burnout among primary and secondary teachers in Luoding city and to provide a preliminary basis for policy formulation. Methods We randomly selected 590 graduating class teachers from 42 primary and secondary schools in Luoding. The outcome variable of burnout was measured by the Chinese Maslach Burnout Inventory for primary and secondary school teachers (C-MBI). Results Emotional exhaustion (EE) score and intellectual burnout (IB) score in respondents were both significantly higher than the national norm used as reference (P＜0.05), reduced personal accomplishment (PA) score was significantly lower than the national norm (P＜0.01). The factor scores of DP, EE and IB were obviously higher in female respondents than that those in the male, while the score of PA was obviously lower (all P＜0.01). Conclusion The level of burnout in these teachers is significantly higher than the national average, and the burnout in female teachers is more serious.
目的 调查新疆疏附县基层医务人员对男童外生殖器畸形的认知及筛查能力,为制定新疆少数民族地区医务人员培训计划提供数据支持。方法 采用自行设计的问卷调查表,对新疆疏附县人民医院、乡卫生院及村医进行问卷调查,确定其对男童外生殖器畸形的认知程度。采用SPSS 13.0进行数据分析,比较维、汉两族医务人员的认知差异。结果 发放调查问卷400份,收回有效问卷365份,占91.25%。调查发现,新疆疏附县基层医务人员对外生殖器畸形相关知识认知正确率超50%的占参与问卷调查的54.79%。其中男性21.92%,女性32.87%。汉族医务人员对外生殖器畸形相关知识认知正确率超50%的占参与问卷调查的汉族医务人员50%,维族约57.40%,统计分析显示差异无统计学意义(P＜0.05);有关外生殖器畸形相关知识获取途径中,未参加相关知识培训占61.64%,参加过培训者38.36%;在临床实践中主动筛查新生儿外生殖器畸形者86.30%,发现外生殖器畸形病例者27.39%。结论 新疆疏附县基层医务人员普遍缺乏男童外生殖器畸形相关诊疗知识,在实际工作中发现并恰当处置此类疾病的能力亦相对欠缺。因此提高新疆少数民族地区基层医务人员对男童外生殖器畸形的诊断和治疗能力非常必要。
Objective To survey on the recognition and diagnosis capability of frontline healthcare workers in boy's genital malformation in Shufu, Xinjiang. Thereby to provide data support for the healthcare workers training there. Methods We designed a questionnaire and carried out a survey in Shufu people's hospital, township clinics and village doctors. Based on SPSS 13.0 data analysis, we made comparison on recognition difference between the Han and Uygur healthcare workers. Results 400 questionnaires were handed out, among them 365 were valid which accounted for 91.25%. The survey showed that there were 54.79% survey participators whose recognition correct rate was over 50% in Shufu, Xinjiang (21.92% for man, 32.87% for woman), 50% Han healthcare workers whose recognition correct rate was over 50% and that of 57.4% in Uygur peers.There was no significant difference in statistics(P<0.05). It accounted for 38.36% that participating in training as the access to relevant knowledge of genital malformation,but 61.64% was not. In clinical practice, 86.3% of survey participators screen the possibility of newborn genital malformation. And 27.39% of screened newborn have genital malformation. Conclusion The frontline healthcare workers in Shufu, Xinjiang at large are short of diagnosis knowledge on boy's genital malformation, as a result that they are difficult to recognize and give proper treatment on such cases in practice. The status thereby shows that it is critical to improve the diagnosis and treatment capability of frontline healthcare workers in boy's genital malformation in Xinjiang ethnic group area.
目的 了解广州综合医院内分泌科门诊就诊者中抑郁焦虑障碍的患病率。方法 对广州市第一人民医院的内分泌科门诊就诊的患者进行横断面调查。采用医院焦虑抑郁量表(HADS)对105名入选的患者进行筛查,精神科医生对HADS≥8 分的患者进行国际神经精神科简式访谈问卷( MINI ) 的诊断性评估。结果 MINI诊断的抑郁障碍、焦虑障碍、抑郁和焦虑共病的患病率分别为3.80%、0.95%和2.86%。结论 抑郁和焦虑障碍是综合医院内分泌科门诊就诊者中的常见问题,但识别率和治疗率均不高。
Objective To investigate the prevalence rates of depressive and anxiety disorders of the endocrinology outpatients in a general hospital of Guangzhou. Methods A cross-sectional survey was conducted in the endocrinology outpatient department of Guangzhou First People's Hospital. A total of 105 outpatients were screened with hospital anxiety and depression scale(HADS). The patients with the HADS score of 8 and over were investigated and diagnosed by psychiatrists with the mini-international neuropsychiatric interview(MINI). Results The prevalence rates of MINI-diagnosed depressive disorder, anxiety disorder, and depressive-anxiety co-morbid disorders were 3.80%, 0.95% and 2.86%, respectively. Conclusion Depression and anxiety disorders are common problems in the endocrinology outpatient department of general hospitals,but few outpatients were well-diagnosed and treated.
