ObjectiveTo investigate the community residents' awareness of knowledge on cardiovascular disease prevention and control and their access methods to relevant information. MethodsBetween June and August, 2013, the residents aged above 45 who came to community health center for diagnosis or treatment were investigated by questionnaires including the acknowledge of prevention for cardiovascular diseases and the access methods to relevant information. ResultsA total of 1 000 residents were involved in this study, including 394 (39.40%) males and 606 (60.60%) females aged from 45 to 98 with an average of 68.3±10.4. The highest rate of awareness of cardiovascular prevention knowledge was regular physical exercise (89.20%), followed by low salt diet (67.20%) and fried food (6.30%). The highest rate of access to the information was information provided verbally by doctors or nurses (77.50%), followed by television and radio (56.00%). ConclusionCommunity center should strengthen the health education of cardiovascular disease prevention and control. Health education should be practiced in an easy way for the residents.
ObjectiveTo get known of the knowing and utilization of essential public health services among community residents for clinical visits in Nanchang city, and to provide evidence for promoting the effective use of public health services. MethodsA total of 20 community health services (CHS) organizations were finally selected by stratified random sampling method from 5 administrative regions in Nanchang city. Questionnaire survey about the knowing and utilization of public health services was performed to the 500 residents. We used EpiData 3.0 software to establish the database and SPSS 17.0 software for statistical analysis. ResultsThe awareness rate about essential public health services among them was 77.6% in Nanchang, which was highest to 91.0% in Wanli district and lowest to 47.0% in Xihu district. The differences between the administrative regions were significant (χ2=75.893, P=0.000). The archiving rate in CHS organizations among visits was 59.2%, which was up to 84.0% in Wanli district and lowest to 40.0% in Qingshanhu district. It also showed statistical significance between the regions (χ2=110.493, P=0.000). The total utilization rate about essential public health services was 95.8% in the population, which was no significant difference between the regions (χ2=7.772, P=0.100). However, the utilization rate in different populations was statistically significant (P < 0.05). ConclusionThe awareness rate and archiving rate about essential public health services among the residents in CHS organizations in Nanchang was not high, but the utilization rate was much higher, which was different among the administrative regions. The CHS organizations should strengthen the publicizing of essential public health services knowledge for the people in different regions to improve the co-development of the regions. In addition, it is also necessary to improve the use of community health services among the populations to achieve the goal about the equalization of essential public health services.
Objective To investigate the safety of thoracic surgery for high-altitude patients in local medical center. MethodsWe retrospectively collected 258 high-altitude patients who received thoracic surgery in West China Hospital, Sichuan University (plain medical center, 54 patients) and People's Hospital of Ganzi Tibetan Autonomous Prefecture (high-altitude medical center, 204 patients) from January 2013 to July 2019. There were 175 males and 83 females with an average age of 43.0±16.8 years. Perioperative indicators, postoperative complications and related risk factors of patients were analyzed. ResultsThe rate of minimally invasive surgery in the high-altitude medical center was statistically lower than that in the plain medical center (11.8% vs. 55.6%, P<0.001). The surgical proportions of tuberculous empyema (41.2% vs. 1.9%, P<0.001) and pulmonary hydatid (15.2% vs. 0.0%, P=0.002) in the high-altitude medical center were statistically higher than those in the plain medical center. There was no statistical difference in perioperative mortality (0.5% vs. 1.9%, P=0.379) or complication rate within 30 days after operation (7.4% vs. 11.1%, P=0.402) between the high-altitude center and the plain medical center. Univariate and multivariate analyses showed that body mass index≥25 kg/m2 (OR=8.647, P<0.001) and esophageal rupture/perforation were independent risk factors for the occurrence of postoperative complications (OR=15.720, P<0.001). ConclusionThoracic surgery in the high-altitude medical center is safe and feasible.
Objective To observe the changes and influencing factors on pulse oxygen saturation and hemoglobin in Tibetan residents of 4 200 meters above sea level. Methods The health examination data of the Tibetan village residents were collected in Rerong Country, Shannan Prefecture of Tibet autonomous region from January 4 to February 4, 2012. And the information of pulse oxygen saturation was recorded at the same time. The residents were categorized by sex, age and smoking history to observe the difference in each group. Results The clinical data of 234 healthy Tibetan residents were collected with average age of (37.9±13.9) years old, and 97 were male (41.5%). There were no difference in pulse oxygen saturation [(86.1±3.4)% and (86.0±4.7)%, P=0.784) between male and female residents, and heart rate of the male was less than that of the female [(77.9±9.8) bpm and (81.1±12.1) bpm, P=0.036], while the hemoglobin content was higher in male residents [(164.5±15.4) g/L and (139.1±19.2) g/L, P=0.000). With the increase of age, especially in the group older than 60 years, the pulse oxygen saturation significantly decreased (P=0.003), while hemoglobin content showed a gradual increase trend (P=0.000). And in the group which smoking history more than 20 pack-years, the pulse oxygen saturation was lesser than the other groups, and the hemoglobin content increased (P=0.000). Conclusions The pulse oxygen saturation level of Tibetan residents of 4 200 meters above sea level is negatively correlated with age and smoking history, and the level of hemoglobin is positively correlated with age and smoking history. In resting state, there is no significant difference in heart rate between the groups divided by ages.
Objective To survey the relations between the rural residents’ occupational satisfaction, the health policies and demographic factors in Henan province and then to confirm the health policy order and its key target populations. Methods The questionnaires were distributed to 1 117 rural residents in 156 villages among 44 townships in 19 counties (cities, districts). The frequency analysis, multivariate linear regression analysis and multiple comparisons were conducted. Results The average value of rural residents’ occupational satisfaction scored 68.23, among which the complete dissatisfaction scored 0 accounting for 1.9%, the complete satisfaction scored 100 accounting for 9.0%, the one scoring no more than 50 accounted for 20.9%, and the one scoreing equal 80 or more than 80 accounted for 37.5%. By regarding the occupational satisfaction as the dependent variable, the independent variables stayed in the model were as follows in order according to their influence from heavy to little on the dependent variable: new rural cooperative medical system (NRCMS), occupation, village general practitioner’s work, family formation, age, disease prevention and control efforts. The occupational satisfaction was much higher when there were the following conditions: the higher satisfaction with the NRCMS, the more financial burden relieved by the NRCMS, and the higher satisfaction with village general practitioners’ work. The occupational satisfaction was the highest when villagers lived with their spouses, while it was the lowest when villagers lived with their spouses and children, as well as they lived with their parents, spouses and children. The peasants’ occupational satisfaction was the lowest. The occupational satisfaction had significantly negative correlation with cultural level, and had positive correlation with age. Conclusion The occupational satisfaction is an important indicator for assessing the level of social harmony, and is the basis for policy decision-making, implementation, and evaluation. The overall occupational satisfaction of the rural residents in Henan is lower, so the social harmoniy and stability should be alerted. The priority order of the existing rural health policy should be the NRCMS policy, village general practitioner work policy, and village disease prevention and control policy. When we are formulating and implementing the rural health policy, the key target populations should be considered among the people whose families comprise two or three generations, whose occupations are farmers, whose cultural level is lower, and whose ages are younger.
Objective To investigate the construction and services of the community health service system in Shifang, as well as the satisfaction of community residents with the community health services and the post-disaster emergency response capability of the community hospital, so as to provide decision-making suggestions on better reconstruction of the community health service system and improvement of its post-disaster emergency response capability. Methods There were 4‰ of community residents in Fangting town were selected by convenience sampling for a face-to-face interview using a questionnaire. Logistic regression was used to identify the influencing factors of residents’ satisfaction with community health services. Results A total of 250 questionnaires were conducted for face-to-face interviews, and 246 ones were retrieved (response rate 98.4%). Residents’ understanding and satisfactory degree of the community health service were 41.1% and 36.6%, respectively. Health education, medical expenses and medical insurance were the main factors influencing the residents’ satisfactory degree of community health services (P=0.050, 0.001, and 0.001). The proportions of disaster / disaster prevention education, exercises of post-disaster contingency plans, and psychological intervention as well as rehabilitation for residents were 37.4%, 10.6%, and 12.6%, respectively. Conclusion Community health services have not been widely accepted by community residents, and the satisfactory degree is low. The residents’ understanding and adaptation can be improved by strengthening the community health service propaganda. Strengthening health education, improving the quality of services, controlling costs, and introducing medical insurance reimbursement mechanism can increase the residents’ satisfactory degree. Including disaster emergencies into basic tasks can strengthen the emergency response capability and then provide guarantee for the residents’ health.
摘要:目的: 了解绵竹市社区卫生服务系统震后现状,同时分析社区医疗震后居民满意度和社区卫生服务机构震后灾害干预能力,以期为社区卫生服务体系地震应急恢复和重建提供参考意见。 方法 :采用随机抽样的方法,抽取绵竹市剑南社区卫生服务中心和天河社区卫生服务中心进行访谈,采取方便抽样的方法,抽取24‰的绵竹城区居民采用面对面访谈的方式用自制问卷进行调查,并用Epidata30 进行数据录入、SPSS130进行统计分析。 结果 :共发放问卷240份,收回有效问卷229份(有效回收率954%)。当地社区卫生服务系统在地震中受损严重。社区卫生服务系统灾后工作居民满意度为454%,社区卫生服务机构对居民进行抗灾/防灾知识教育的比例为336%,灾后是否有持续而足够的常见病药品供应及是否有持续而足够的慢性病药品供应是影响当地居民对当地社区卫生服务体系灾害应急工作的满意度的影响因素(P 值分别是0033,0001)。 结论 :震后社区卫生服务居民满意度较低,服务体系地震灾害干预能力不足。居民在在灾前接受抗灾教育的比例较低,加强药品储备能提高社区卫生机构灾害应急工作的效果。在社区卫生服务体系重建的过程中,应注重社区医疗基础工作的恢复,基础设施的重建和健全社区急救体系。Abstract: Objective: To investigate the reality of community health service system after earthquake in Mianzhu, the satisfaction of community residents to the community health service as well as the postdisaster emergency response capability of community hospital in order to provide decisionmaking suggestions on better reconstruction of community health service system. Methods : Jiannan and Tianhe community hospital were randomly selected for visiting and 24‰ of community residents in the city zone of Mianzhu were selected by convenience sampling for a facetoface interview using a questionnaire. Data entry and statistically analysis were completed by Epidata30 and SPSS130 respectively. Results :A total of 240 questionnaires were conducted to facetoface interviews, and 229 questionnaires were returned (response rate 954%).The community health service system was badly injured. Residents’ satisfactory degree of the community health service after earthquake was 454%. The proportions of disaster / disaster prevention education was 336%,medicine supply for familiar diseases and the chronic were the main factors which influenced judgements of residents to the emergency response capabilities of community hospitals(〖WTBX〗P =0033,P=0001,respectively). Conclusion :The community health services after earthquake had not been widely satisfied and the emergency response capability of community hospital was far from enough. The proportions of disaster / disaster prevention education were far from enough. The effectiveness of emergency response work of community hospitals can be enhanced by reinforcing medicine preparation.In the course of the reconstruction, community health service system should pay attention to the resumance of basic community health service,reconstruction of basic establishment and construction of firstaid system.
ObjectiveTo investigate the prevalence status and characteristics of dyslipidemia and cardiovascular risk factors in urban communities of Chengdu city. MethodsBy cluster sampling, a population of 994 inhabitants were selected from 14 urban communities in Chengdu city between February and October 2010. We investigated patients between 35-70 years old who lived in the area over 2 years, by using questionnaires survey, physical examination, and laboratory tests. According to the age, the respondents were divided into three groups: young group ( ≤ 44 years old), middle-aged group (45-59 years old) and elderly group ( ≥ 60 years old). We further investigated the major cardiovascular risk factors for hyperlipidemic patients. ResultsThe prevalence of dyslipidemia in Chengdu urban area was 28.47% (283/994), and standardized prevalence rate was 24.65% (male, 24.68%; female, 30.91%). The prevalence rate between male and female had significant diTherence (χ2=4.513, P=0.034). Female elderly group and middle-aged group had a significantly higher prevalence than the young group (P<0.05), while the male prevalence had no statistical diTherences among all age groups (P>0.05). Hypertension was most common in patients with dyslipidemia (male, 50.04%; female, 52.41%) followed by diabetes and coronary heart disease. There was no difference between male and female in the prevalence of dyslipidemia accompanied hypertension, history of stoke and coronary heart disease, abdominal obesity,or obesity (P>0.05). Higher prevalence with smoking and drinking was in male patients (P<0.05). ConclusionThe prevalence of dyslipidemia is relatively high in urban communities of Chengdu city. According to the region of hyperlipemia epidemiological characteristics and risk factors, by using comprehensive intervention measures, we can reduce the prevalence of dyslipidemia.
ObjectiveTo evaluate the reasonableness of anticoagulation management strategy in patients after mechanical heart valve replacement. MethodsAll patients were followed and registered continually at outpatient clinic from July 2011 to February 2013, with a minimum of 6 months after surgery. Targeted international normalized rate (INR) 1.60 to 2.20 and warfarin weekly dosage adjustment were used as the strategy of anticoagulation management. Except bleeding, thrombogenesis and thromboembolism, time in therapeutic range (TTR) and fraction of TTR (FTTR) were adopted to evaluate the quality of anticoagulation management. ResultsA total 1 442 patients and 6 461 INR values were included for data analysis. The patients had a mean age of 48.2±10.6 years (14-80 years) and the following up time were 6 to 180 months (39.2±37.4 months) after surgery. Of these patients, 1 043 (72.3%) was female and 399 (27.7%) was male. INR values varied from 0.90-8.39 (1.85±0.49) and required weekly doses of warfarin were 2.50-61.25 (20.89±6.93 mg). TTR of target INR and acceptable INR were 51.1% (156 640.5 days/306 415.0 days), 64.9% (198 856.0 days/306 415.0 days), respectively. FTTR of target INR and acceptable INR were 49.4% (3 193 times/6 461 times), 62.6% (4 047 times/6 461 times). There were 8 major bleeding events, 7 mild bleeding events, 2 thromboembolism events, and 2 thrombogenesis in the left atrium. ConclusionIt is reasonable to use target INR 1.60-2.20 and warfarin weekly dosage adjustment for patients after mechanical heart valve replacement.
Objective To understand the demands on portable medicine kit of rural residents in well-off township hospitals, and to provide the basis for scientifically designing portable medicine kit for rural residents. Methods The methods of combining simple random sampling and cluster sampling were used to investigate and analyze the demands on portable medicine kit for 162 households from three well-off township hospitals in Shanghai, Zhejiang, and Sichuan province, respectively. Results The demand rate of 162 rural households on portable medicine kit was 75.3% (122/162). The main drugs that demanders expected in the portable medicine kit were cold medicine (86.1%), wound paste (82.0%), cooling oil (61.5%), essential balm (54.9%) and antihypertensive (34.4%); and the main medical devices that demanders expected were thermometer (82%), cotton swab (73%) and sphygmomanometer (32.8%). The sizes of portable medicine kit that demanders expected were 23.7±8.5 cm in length, 17.1±6.4 cm in width, and 14.1±6.5 cm in height. The main function characteristics of portable medicine kit that demanders expected were applicability (74.6%), safety (60.7%), light weight (68.0%), economics (60.7%), and waterproof (46.7%). A total of 72.1% of demanders expected the price of less than 15 yuan, and 91.8% expected kit made of hard materials as plastic as the first choice. Conclusion The demand rate of rural residents on portable medicine kit is higher in well-off township hospital. The design and production of portable medicine kit should fully meet the demands of rural residents. Only when sufficiant respect for the market demand is paid, can the promotion and application of portable kits will be ensured.