Objectives To evaluate pulmonary physicians’knowledge level about prevention and treatment of chronic obstructive pulmonary disease( COPD) in some urban areas in China. Methods A total of 258 pulmonary physicians were interviewed face-to-face in 24 hospitals from July to October in 2006. The questionnaire included the knowledge of COPD, prescriptions at initial visit and follow-up, pulmonary function test monitoring, assessment and intervention in stable COPD, knowledge and evaluation of the commonly used medicines, the effects of smoking cessation and adopted measures, as well as the knowledge of treatment prospects and patients’ education. Results Eighty-eight percent of pulmonary physicians considered themselves knowledgeable on COPD, and 95% were familiar with the severity classification. Most of them knew about GOLD and Chinese Guideline of Prevention and Treatment to COPD, and paid attention to chest X-ray and pulmonary function test during diagnosis. The standards in evaluation of stable COPD patients were not well understood, and 92% of physicians claimed for pulmonary function test in stable stage. Seventy-nine percent of physicians actively suggested the patients quit smoking. The prescription for COPD patients at iniative and maintenance therapy met the guideline on the whole, but the mucolytic agents were appreciated too much and used too frequently. Thirty-three percent of physicians took it necessary to treat stable COPD,and 69% believed that pharmacotherapy for stable COPD could rersult in satisfactory quality of life.Conclusions In some big cities in China, the pulmonary physicians have good knowledge about COPD. But long-term prevention and intervention, especially in pharmacotherapy, are still unsatisfactory.
ObjectiveBased on the off-label drug use (OLDU) record application of alprostadil injection (Lipo-PGE1) which was the only one rejected in the Guangdong General Hospital in 2013, we retrospectively investigated all the background information of inpatients' OLDU of Lipo-PGE1 in 2012, so as to provide references for intervention of OLDU and effect evaluation. MethodsAccording to OLDU in dose record application of clinical departments, we summarized medical orders about inpatients' use of Lipo-PGE1 during hospitalization in 2012 and analyzed OLDU situation according to drug labels. Then, we summarized situation of drug use in all departments, analyzed OLDU incidence in dose, calculated prescribed daily dose (PDD) and drug use density (DUD) in each department to evaluate the degree of OLDU in dose. Resultsa) A total of 106 576 medical orders involving 8 620 case-times were analyzed. According to the data of cases, medical orders and drug use amount, the OLDU incidences were 34.43%, 25.16% and 41.37%, respectively. Lipo-PGE1 was used in every clinical department in this hospital and OLDU occurred in 69.44% departments (25/36). b) According to the number of medical orders, there were 6 departments with the OLDU incidence in dose > 50% and 5 departments with the OLDU incidence in dose during 50% to 20%. c) The average of PDD of the whole hospital was 12.77 μg. A total of 25 departments' PDDs were off-label, and 10 departments' PDDs were above the average level of the whole hospital. The ICU's PDD was the highest, with 2.35 times more than label dose. d) The PDD in each department was not directly proportional to DUD, which indicated the degree of OLDU in dose was not directly proportional to use intensity. This may be caused by different disease burdens in departments. ConclusionLipo-PGE1 is widely used in the Guangdong General Hospital where OLDU in dose occurs commonly. Since PDD and DUD reflect different contents, the two indicators should be combined to monitor OLDU.
ObjectiveTo investigate the use of anti-hypertensive drugs among hypertension patients in examination medical center. MethodThis was a cross-sectional survey. Data of 3 000 cases of medical examination center health records from December 2012 to December 2013 were sampled, and 1 310 patients with hypertension were screened for analysis of medication. ResultsIn the 1 310 hypertension patients, 959 used antihypertensive drugs before, among whom 423 (44.11%) accepted only one anti-hypertensive drug and 536 (55.89%) accepted compound anti-hypertensive drugs or combined medicine. In patients of the previous kind, calcium channel blocker classes of antihypertensive drugs were used the most (n=244, 25.44%). Among the second kind of patients, 359 (37.43%) were treated with a two-compound drug or a combination of two drugs, and most of them used the combination of calcium channel blocker with angiotensin receptor blocker or calcium channel blocker with angiotensin converting enzyme inhibitor. ConclusionsThe current using of anti-hypertensive drug is in accordance with the recommendation of anti-hypertensive treatment guidelines in some way, but there are still some gaps between real clinical practice and guidelines.
Objective To identify the perception of pain among breast cancer patients and their quality of life, and to assess the influence of pain on their quality of life. Methods We did a cross-sectional study. A face-to-face survey was administered to 200 breast cancer patients, using two scales: Chinese Cancer Pain Assessment Tool (CCPAT) and European Organization for Research and Treatment of Cancer Core Quality-of-Life Questionnaire (Version 3) [EORTIC QLQ-C30]. Results Among the 200 breast cancer patients, 84 suffered from pain, while 116 did not. In regard to quality of life, the scores of physical function, role function and social function were higher among women without pain than among those in the pain group (Plt;0.05). There were no significant differences in scores of emotional function, cognitive function and global quality of life between the two groups (Pgt;0.05). There was a significant negative correlation between pain and quality of life in the pain group, the non-pain group and the whole sample (r=–0.731, Plt;0.001). Conclusion Pain has negative effects on physical function, role function and social function of breast cancer patients. The exacerbation of pain is associated with a decreased global quality of life for breast cancer patients.
ObjectiveTo investigate the burden of disease in Xinjin county of Chengdu city from 2009 to 2010. so as to provide baseline data for the study on the healthcare service system. MethodsThe prevalence of diseases among outpatients and inpatients in Xinjin county was collected and then analyzed using Microsoft Excel 2003 and SPSS 13.0 software. Resultsa) The numbers of out-patient and in-patients with the top 20 diseases had been increased by 106.8% and 43.2%, respectively in 2010 than those in 2009. According to International Statistical Classification of Diseases (ICD)-10, the diagnosis of the diseases involved in 11 types of diseases among outpatients. For out-patients, the top 3 categories were diseases of respiratory, digestive systems and injury, poisoning and certain other consequences of external causes, accounting for 85.06% and 82.69% of total diseases in 2009 and 2010, respectively. Among them, upper respiratory infections, acute bronchitis and superficial injury cumulatively accounted for 61.61% in 2009 and 59.53% in 2010. b) The diagnosis of the diseases involved in 12 types of diseases among in-patients. For in-patients, the top 4 categories were diseases of the respiratory system, pregnancy, disease during childbirth and puerperium, digestive and the circulatory systems. Among them, the diseases of the respiratory system accounted for 53.55% and 50.82% in 2009 and 2010, respectively. The top 4 diseases among in-patients were acute bronchitis, chronic bronchitis, COPD, and acute gastritis, accounting for 48.12% and 49.54% cumulatively in 2009 and 2010. Meanwhile, the prevalence of hypertension and diabetes increased dramatically into the top 10 diseases. c) The acute diseases were mainly distributed in township hospitals, while the chronic diseases were mainly distributed in county-level hospitals. ConclusionThe major burden of diseases is the diseases of the respiratory, digestive and circulatory diseases in Xinjin county of Chengdu city from 2009 to 2010. The chronic diseases are mainly distributed in county-level hospitals, while the acute diseases are mainly distributed in township hospitals or community healthcare centres. The common diseases are relatively stable which provide better conditions for the selection and use of the essential medical services and essential medicine list.
ObjectiveTo investigate the oral health status of three to five year-old Uygur and Han children in Yining region of Xinjiang Uygur Autonomous Region, so as to provide scientific basis of corresponding countermeasures. MethodsA stratified, multistage and cluster sampling method was used to select 1 000 three to five year-old preschoolers from urban and rural districts in Yining region of Xinjiang Uygur Autonomous Region. The dental caries rate and oral health situation of included children by age, sex, nationality, and region were analyzed. ResultA total of 965 children were included. The response rate was 96.5%. The prevalence of deciduous dental caries was 81.24% with the mean DMFT score of 4.44. There were significant differences in levels of caries among different age groups, the prevalence of dental caries and mean DMFT score increased gradually as the children were growing up (P<0.05). The rate of filling teeth was 1.66%, and untreated caries was 98.34%. Maxillary deciduous central incisors and mandibular deciduous molar were most prone to decay. There were significant different oral hygiene status and malocclusion levels between the Uygur and Han, urban and rural districts, different age groups (all P values <0.05). ConclusionThe oral health status among three to five year-old preschoolers is not optimistic in Yining region of Xinjiang Uygur Autonomous Region. Integrated treatment and preventive programs are urgently needed.
ObjectiveTo explore the quality of life (QOL) of rural cognitive function impaired elderly in Guangyuan city and analysis the influencing factors, in order to provide evidence for improving the QOL of rural cognitive function impaired elderly. MethodsBy stratified cluster sampling method, Mini-Mental State Examination (MMSE) was adopted in the cognitive function impaired screening in Guangyuan rural area of Sichuan province in 2012, then we used SF-12 questionnaire to evaluate the QOL of those rural elderly (more than 60 years old) whose cognitive function was impaired. ResultsA total of 270 rural cognitive function impaired elderly were selected from 735 old people. The results of QOL assessment showed that:the mean of physical component summary (PCS) was 37.93±11.55, and the mean of mental component summary (MCS) was 44.07±13.14. Gender, age, education levels, economic situation of the selfassessment, chronic disease, being engaging in physical labour and daily life care were correlated with the score of QOL. ConclusionIn order to improve their QOL, we should help the elderly with cognitive function impaired and focus on prevention and individual treatment; their special difficulties should be fully considered when making the policy of health care and social security.
Objective To explore the delay in help-seeking by breast cancer patients in Sichuan province. Methods A cross-sectional survey was performed in 327 patients with breast cancer from 7 first-level hospitals in Sichuan province, from July 2006 to January 2007. The following items were assessed: the time of symptom onset, the time of help-seeking, the time of definitive diagnosis, and the time of cancer treatment. The median times of patient delay, medical delay and total delay were computed. Results A total of 327 patients were surveyed and 312 questionnaires were distributed, with a response rate of 95%; 308 were retrieved, with a retrieval rate of 99%; and 283 were identified as valid, with a valid retrieval rate of 92%. The median time of total delay was 94 days, with an incidence of 50.2%; the median time of patient delay was 50 days, with an incidence of 35.7%; the median time of medical delay was 10 days, with an incidence of 16.7%.Conclusion Help-seeking delay by breast cancer patients is common in Sichuan province. Since patient delay contributes most to the total delay, it is important to control this portion.
ObjectivesTo investigate residents’ sensitivity towards basic public health services in Sichuan province, so as to provide advice on future improvement.MethodsUsing multistage stratified sampling and through consultation of the Sichuan province's basic public health service regulatory platform to select 40 equidistant samples from the five key population groups. Specifically, 200 individuals from each of the 21 cities were enrolled. Telephone survey was conducted to acquire residents’ awareness rate, satisfaction and compliance. Technique for order preference by similarity to an ideal solution (TOPSIS) was applied to comprehensively evaluate residents’ sensitivity of basic public health services.ResultsA total of 4 200 community residents who have accepted health managements in basic health care institutions were enrolled. The mean Cj value was 0.523 6. The No.4 city had the highest Cj value of 0.751 9, and the No.10 city had the lowest value of 0.276 3.ConclusionsThe residents’ sensitivity to basic public health services varies in 21 cities of Sichuan province. We should improve the quality of medical services in primary health care institutions and provide wide publicity to enhance the well-being and satisfaction of community residents. Government should improve the quality of medical services in primary health care institutions, and narrow the gap between different cities, so as to improve residents’ experience.
ObjectivesTo investigate the ability of emergency medical rescue personnel in Sichuan province to collect information and contact resources at rescue sites, and to provide evidence for emergency training and drills. MethodsThe rescue site of a batch of critically ill patients in public emergency was simulated. The cross-sectional survey was made on rescue personnel at the city (prefecture) and county level of Sichuan province. The rating scale of on-site information contact ability was used to evaluate their performance. Because the score distribution does not conform to the normal distribution, the space between the median and interquartile was used to describe the score, and multiple measurement data was compared by the rank sum test. ResultsA total of 287 rescue drill personnel were included. The overall score M (P25, P75) of information contact ability was 19.57 (13.04, 28.26). The scores of each dimension were as follows: the safety zone was set as 0 (0, 10), the on-site hazard identification was 0 (0, 16.67), external contact and coordination was 50 (0, 50), internal coordination and command was 50 (16.67, 50), the on-site disaster statistics was 40 (10, 70), the on-site resource status was 0 (0, 0), and the on-site reinforcement demand was 0 (0, 0). Hierarchy by occupation: 19.57 (12.50, 28.26) for clinicians, 19.57 (14.13, 34.78) for nurses, 25 (14.67, 32.61) for medical skills, 21.74 (14.13, 30.44) for public health doctors, and 17.39 (9.78, 21.74) for health management. Hierarchy by titles: 21.74 (13.04, 28.26) for intermediate level, and 17.39 (10.33, 23.91) for advanced level. Scores of different dimensions, occupations and titles were compared respectively, and the differences were statistically significant (P<0.05). ConclusionsThe results of this survey show that the emergency medical rescue personnel at the city (prefecture) and county level of Sichuan province have insufficient overall ability to contact information on site, so those with insufficient ability need to be trained. The training focuses on the on-site resource status, on-site reinforcement demands, safety zone setting and the ability to identify on-site hazards.