肺癌患者联合药物治疗间歇期症状评估问卷的修订及信效度评价

Revision of the Symptom Assessment Questionnaire for Lung Cancer Patients During Combined Drug Therapy Intervals and Testing of Its Reliability and Validity

:-
 
目的 修订肺癌患者联合药物治疗间歇期症状评估问卷,并评价其信效度。方法 以中文版安德森症状评估量表及肺癌特异性模块为基础,经文献分析、专家会议和认知性访谈形成测试版问卷。于2023年10-12月便利选取福州、莆田2所三级甲等医院278例肺癌患者进行调查,评价其信效度及偏倚风险。结果 修订后问卷含7个症状系统、60个条目,跳转式作答后实际作答21个条目。总问卷Cronbach's α系数为0.856,各维度为0.639~0.747;内容效度指数为0.81。验证性因子分析显示模型拟合尚可(χ2/df=2.366,RMSEA=0.070,CFI=0.858),各维度因子载荷、组合信度及平均方差提取量均达到可接受标准,区分效度良好。COSMIN-RoB评价结果为良好。结论 该问卷信效度良好,可用于评估肺癌患者联合药物治疗间歇期症状严重程度。
Objective To revise the Symptom Assessment Questionnaire for Lung Cancer Patients During Combined Drug Therapy Intervals and evaluate its reliability and validity. Methods Based on the Chinese version of the M. D. Anderson Symptom Inventory and its lung cancer-specific module, a preliminary questionnaire was developed through literature review, expert panel discussions, and cognitive interviews. From October to December 2023, a convenience sample of 278 lung cancer patients was recruited from two tertiary hospitals in Fuzhou and Putian, China. Reliability, validity, and risk of bias were evaluated. Results The revised questionnaire comprised seven symptom-system domains and 60 items, with 21 items completed through a skip-logic design. The overall Cronbach's α coefficient was 0.856, and the coefficients for each domain ranged from 0.639 to 0.747. The content validity index of the questionnaire was 0.81. Confirmatory factor analysis demonstrated an acceptable model fit (χ2/df = 2.366, RMSEA = 0.070, CFI = 0.858). Factor loadings, composite reliability, and average variance extracted of all domains met acceptable standards, indicating good discriminant validity. The overall risk of bias was rated as good according to the COSMIN Risk of Bias checklist. Conclusion The revised questionnaire demonstrated satisfactory reliability and validity and can be used to assess symptom severity in lung cancer patients during combined drug therapy intervals.
医院管理

《医疗保障基金使用监督管理条例》实施情况调查分析——以广东省为例

Investigation and analysis on the implementation of the “Regulation on the Supervision and Administration of the Use of Healthcare Security Funds” :Based on data from Guangdong Province

:248-256
 
       目的 了解《医疗保障基金使用监督管理条例》(以下简称《条例》)在广东省实施的情况,分析其存在的问题与挑战, 提出改进建议。方法 依据《条例》设计调查问卷,采用便利抽样方法 , 针对广东省医保基金相关监管人员和医院工作人员展开问卷调查, 并进一步围绕相关主题展开深度访谈, 以便更全面地了解《条例》的实施情况。结果 回收有效问卷1 473份, 数据分析显示《条例》的实施有效遏制了违规行为、提高了监管效率、落实了信用管理制度、促进了服务规范性与费用合理化, 但同时也存在着部分违规行为仍难以监管、政策培训效果欠佳、技术支撑能力薄弱等问题。结论 在持续推进现有各项监管举措的基础上, 需进一步细化《条例》的具体内容, 加大政策培训与宣传力度, 持续完善技术支撑手段, 以提升基金监管效能。
        Objective To understand the specific implementation of the “Regulation on the Supervision and Administration of the Use of Healthcare Security Funds”(hereinafter referred to as the “Regulations”)in Guangdong Province, analyze its existing problems and challenges, and propose improvement suggestions.Methods A questionnaire was designed based on the “Regulations”, and a convenience survey method was adopted to conduct questionnaire surveys among regulatory personnel related to medical insurance funds and hospital staff.Further in-depth interviews were conducted around relevant themes to gain a more comprehensive understanding of the implementation of the “Regulations.” Results The implementation of the “Regulations” has effectively curbed violations, improved regulatory efficiency, implemented a credit management system, and promoted service standardization and cost rationalization.However, challenges remain,such as difficulties in regulating certain violations, suboptimal policy training outcomes, and weak technical support capabilities.Conclusions On the basis of continuously advancing existing regulatory measures, it is necessary to further refine the specific content of the “Regulations” strengthen policy training and publicity efforts, and continuously improve information technology support methods to better enhance the effectiveness of fund supervision.
全科医学

低视力儿童三位一体综合康复干预治疗临床数据分析

Data Analysis of Intervention Treatment in Trinity Comprehensive Rehabilitation of Low Vision Children

:88-89
 
目的 研究低视力儿童“学校-社区-家庭”三位一体综合康复干预工作的具体效果。方法 2013年1月,选择广州市盲人学校新入学80名低视力儿童,随机分为两组,为期二年的跟踪研究。其中A组执行“学校-社区-家庭”三位一体综合康复干预,B组执行传统康复干预。就知识积累、心理健康、生活能力三个方面对两组儿童的具体数据收集,研究“学校-社区-家庭”三位一体综合康复干预与传统干预方式之间的区别。结果 A组低视力儿童较B组儿童的文化知识积累与生活能力训练成绩均有提高,两者差距在正常分布带内,A组低视力儿童的心理素质优于B组低视力儿童。A组低视力儿童的综合评价效果高于B组儿童。结论 低视力儿童“学校-社区-家庭”三位一体综合康复干预工作的具体效果优于传统康复干预方式。
临床护理

短时间内组建负压病房的护理管理探讨

Nursing Supervision of Organizing a Negative Pressure Ward at Short Time

:101-102
 
负压病房是救治呼吸道传染病病人的重要医疗设置,如何在短时间内完成负压病房的相关配置是考验护理组快速反应能力和有效组织能力。我院2014年收治了第一例人感染性H7N9禽流感合并ARDS和多器官功能衰竭病人,呼吸内科护理组在2小时内完成了负压病房的相关配置,包括抢救隔离设施、人员调配、医护协调、心理辅导等一系列工作,探索出一套应对爆发性呼吸道传染病的护理模式。
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