ObjectiveTo analyze the quality of the randomized controlled trials (RCTs) included in the systematic review in the anti-infection field in the elderly.MethodsA comprehensive and systematic literature search in PubMed, EMbase, CNKI, The Cochrane Library, WanFang Data, VIP and CBM was conducted to collect systematic review or meta-analysis which involoved anti-infection RCTs in the elderly from inception to February 17th, 2020. The results of Cochrane risk of bias assessment of the included RCTs were analyzed.ResultsA total of 8 systematic reviews were included, involving 19 RCTs and 6 735 participants. The sample size of the RCTs ranged from 23 to 2538, and the published date were from 1980 to 2020. The included RCTs focused on postoperative infection, urinary tract infection, Clostridium Difficile infection and so on. The included RCTs had methodological quality issues. Among the assessment results of low risk of bias, the domains of selection bias (random sequence generation) and selection bias (allocation hiding) had the lowest proportion (47.3%, 36.8%). Among the assessment results of unclear risk of bias, the domains of selection bias (random sequence generation) and selection bias (allocation hiding) had the highest proportion (42.1%, 52.6%). Among the assessment results of high risk of bias, the domains of measurement bias and performance bias had the highest proportion (21.1%, 21.1%).ConclusionsThe quality of RCTs in the field of anti-infection in the elderly requires further improvement. High-quality anti-infection RCTs for the elderly should be developed in future to better guide clinical practice.
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.
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.
Objective To evaluate the level of nursing competence of clinical nurses and determine its influencing factors so as to provide scientific information for nursing human resource management. Methods A cross-sectional survey was conducted on 1 042 nurses from 8 hospitals by using the Nursing Competence Scale. Results The mean score of nursing competence was 73.99±9.81. Factors influencing the nursing competence included personal interest in nursing, working experience, working position, educational background, hospital level, teaching activities and marital status. Conclusion The surveyed clinical nurses have been equipped with basic nursing competence, however, still needs to be improved. The nursing human resource management should be based on nurses’ competence.
Objective To investigate the quality of life (QOL) of Beichuan cadres 1 year after Wenchuan earthquake, so as to provide references for promoting psychological intervention and improving QOL. Methods With the adoption of WHOQOL-BREF, questionnaire survey on basic conditions of cadre victims, and PCL-C scale, cross-section survey was conducted for 2 055 cadres of Beichuan public institutions in aspects of their QOL, social demographic characteristics and psychological trauma. Results a) Compared with domestic norm, although the Beichuan cadres had higher score in social relation domain (14.31 ± 2.59, Plt;0.01), their QOL scores in each dimensions (physical domain score: 14.16 ± 2.43; psychological domain score: 13.79 ± 2.59, environmental domain score: 11.20 ± 2.74) were lower with significant difference (Plt;0.01); b) The group with population under the age of 30 scored higher than other age groups in the psychological and environmental domains; men scored higher than women in the psychological domain; the widowed group scored lower than other groups in all domains; the Han nationality group scored higher than the Qiang nationality group in all domains; the primary education group scored lower than other groups in the social relation domain; the group with relatives, houses and physical loss or damage scored lower than the non-loss group in all domains; and the higher the score in PCL-C, the lower the scores in all domains (all Plt;0.05). Conclusion Beichuan cadres are severely affected in their physical, psychological and environmental domains even one year after Wenchuan earthquake, especially the female, the Qiang nationality, the old, the lost, and the psychological injured cadres are more badly affected with worse QOL, so those population should be concerned in particular with sustainable psychological service and other measures. The finding of social relation domain score being higher than general population suggests that it is important to promote the satisfaction with social relation through the timely effective support from both government and civil society, and the resettlement of sample housing area as well.
Objective To investigate the ways of scientific research knowledge acquirement, and the situation of research capacity and demand of neurological nurses in Sichuan Province. Methods From May to June 2015, 153 neurological nurses from 7 hospitals of Sichuan Province were enrolled by convenient stratified sampling method. The ways of acquiring scientific research knowledge, research capacity, and research demand of the nurses were investigated by questionnaire. Results Among the 153 nurses, there were 50.3% with low level, 47.7% with moderate level, and 2.0% with high level of scientific research capacity, respectively. The total scores of nursing research capacity ranged from 4 to 101. The dimension of " capacity of generating the research ideas” was the highest, and the dimensions of " capacity of designing research protocol” and " capacity of analyzing research data and material” were the lowest. Of the respondents, 66.2% had never attended any research training program, 51.3% acquired scientific research knowledge by themselves, and 65.6% were willing to participate research training courses. The respondents tended to study on their own by internet. There were significant differences in scientific research capacity among neurological nurses with different initial education, attending the college entrance examination or not, having attended research training and self-study or not (P<0.05). Conclusions Most nurses acquire scientific research knowledge by themselves, and insufficient research training couldn’t satisfy the research demand of neurological nurses. The initial education degree and research study intention are related to research capacity. However, due to the limited amount of samples, the positive influence of self-study and research training on the research capacity still need to be further explored.
ObjectiveTo develop reporting guideline for dose-response meta-analysis (DMA), so as to help Chinese authors to understand DMA better and to promote the reporting quality of DMA conducted by them. MethodPubMed, EMbase, The Cochrane Library, CNKI, and WanFang Data were searched from Jan 1st 2011 to Dec 30th 2015 to collect DMA papers published by Chinese authors. The number of these publications by years, whether and what kind of reporting guideline was used, and whether the DMA method claimed in these publications was correct were analysed. Then we drafted a checklist of items for reporting DMA, and organized a discussion meeting with experts from the fields of DMA, evidence-based medicine, clinical epidemiology, and clinicians to collect suggestions for revising the draft reporting guideline for DMA. ResultsOnly 33.73% of the publications clarified it is a DMA on the title and 48.02% of them reported risk of bias. Almost 38.49% of the publications didn't use any reporting guidelines. Fourteen of them claimed an incorrect use of methodology. We primarily took account for 47 potential items related to DMA based on our literature analysis results and existing reporting guidelines for other types of meta-analyses. After the discussion meeting with 6 experts, we revised the items, and finally the G-Dose checklist with 43 items for reporting DMA was developed. ConclusionThere is a lack of attention on reporting guidelines in Chinese authors and evidence suggests these authors may be at risk of incomplete understanding on reporting guidelines. It is strongly recommended to use reporting guidelines for DMA and other types of meta-analyses in Chinese authors.
ObjectiveTo evaluate the level of arteriosclerosis in patients with hypertension defined by the American Heart Association (AHA) and classical diagnostic criteria. MethodsA total of 3 815 residents were enrolled in 10 communities in north Shanghai. According to the classic diagnostic criteria of hypertension (systolic blood pressure≥140 mmHg and/or diastolic blood pressure≥90 mmHg) and AHA diagnostic criteria (systolic blood pressure≥130 mmHg and/or diastolic blood pressure≥80 mmHg), the population was divided into normal blood pressure group, AHA diagnosis standard hypertension group, and classic methods of diagnosis of hypertension group. The differences in cervical-femoral pulse wave velocity (cf-PWV) and brachial-ankle pulse wave velocity (ba-PWV) among the three groups were compared. SPSS 13.0 software was then used for data analysis.ResultsCompared with the patients who met the standard criteria, patients who met AHA criteria had lower mean ages (70.2±7.4 vs. 71.4±7.9 year, P<0.001), more history of hypertension (48.8% vs. 72.7%, P<0.001) and lower body mass index (24.1±3.5 vs. 24.7±3.9 kg/m2, P<0.001), low-density lipoprotein (3.07±0.92 vs. 3.15±0.97 mmol/L, P=0.033), cf-PWV (8.7±2.7 vs. 9.8±3.0 m/s, P<0.001) and ba-PWV (1 647.7±610.1 vs. 1 797.2±729.7 cm/s, P<0.001). ConclusionsThe degree of arteriosclerosis of patients who meet AHA standards is between that who meet the standard criteria and the normal population. For these patients, blood pressure should be actively controlled to delay the progression of arteriosclerosis.
ObjectivesTo explore the poor population’s cognition and satisfaction on medical assistance policies in Sichuan province, so as to provide evidence for improving health poverty alleviation policies.Methods A telephone survey was conducted between October and December 2017 among 1 280 poor individuals in Sichuan Province, with multi-stage stratified random sampling. The contents of the survey included general demographics of the poor population, and knowledge and satisfaction of health poverty alleviation policies.ResultsThe awareness rate of medical assistance policy was 91.80%, and the satisfaction rate was 91.88%. Poor individuals from non-poor counties, who had been out of poverty, and who reported that they had not signed up for family doctors, had low awareness of poverty alleviation policies. Poor individuals from non-poor counties, who usually went to the municipal hospital, who reported that they have not signed up for family doctors, and who do not know about health policies for poverty alleviation had a lower satisfaction rate.ConclusionsThe overall awareness rate and satisfaction rate of medical assistance policies in Sichuan province are relatively high, however, there are still some shortage. In the future, more attention should be paid to strengthen the promotion of health poverty alleviation policies for non-poor areas and those who had been lifted out of poverty, speeding up the contract service of family doctors and exploring ways to further alleviate the burden of medical expense of patients with serious diseases.
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.