Objective To investigate patients in gynecological endocrinology clinic with the following three pieces of information: how did they provide their symptom information, how did they understand diagnostic and therapeutic information, and what was their attitude towards the visit, and to get to know about the situation and problems in doctor-patient communication, so as to aim directly at improving the efficiency of diagnosis and treatment. Methods A total of 403 patients, who visited Prof. HAN Zi-yan’s clinic in the hospital from April to August 2010, were evaluated using self-edited Assessment on Doctor-patient Communication in Gynecological Endocrinology Outpatient Clinic. Results a) As to the situation of patients providing symptom information as well as understanding diagnostic and therapeutic information, when doctor asked, only 29% (118/403) of patients could narrate their treatment history clearly, and 38% (152/403) could tell their examination history exactly. After doctors’ explanation, only 21% (86/403) understood their examination results correctly, and 27% (108/403) understood management and therapeutic advice. The result of correlation analysis showed the accuracy of patients in providing disease information and accepting diagnostic and therapeutic information was higher in patients aged from 21 to 40 rather than those younger than 20, in patients well- educated rather than those with little education at the primary school, and in patients who were also engaged in medical work, All differences were significant (all Plt;0.05); and b) As to patients’ attitude towards visit, 55% (222/403) of patients hoped to get more attention from doctor, and 37.5% (151/403) overly expected the visit. Conclusion In the professor’s gynecological endocrinology outpatient clinic, many patients can’t clearly provide their treatment and examination history, neither understand exam situation and therapeutic advice at that visit, which are influenced by their age, education and occupation. In addition, psychological needs of patients should be concerned, too
ObjectiveTo evaluate the infiuence of doctor-nurse double check table applied before operation on the completion of preoperative preparation in gastrointestinal surgery department of class-three grade-one hospitals. MethodsA total of 647 selective operation patients from April to September 2013 in the Department of Gastrointestinal Surgery were divided into observation group (n=315) and control group (n=332) based on admission time. After training for medical staff, the check tables were filled, and relatively high frequency issues were followed up for quality tracking. The completion of preoperative preparation was compared between the two groups after operation. ResultsCompared with the control group, the completion of preoperative preparation and satisfaction of patients of the observation group were significantly higher and the operation delay was significantly lower (P<0.05). ConclusionPreoperative application of doctor-nurse double check table can significantly improve the completion rate of preoperative preparation, the operation delay phenomenon and satisfaction of patients, promote the communication between doctors and nurses, reduce the risk of operation, and ensure the safety of surgical patients.
We introduced the current doctor-patient relationship and analyzed its opposition and unification based on present medical practice. We suggested that evidence-based medicine should be an important in improving doctor-patient relationship in clinical practice. We urged health care professionals to learn and apply initiatively evidence-based medicine, so as to improve the patient-professional relationship.
Abstract: Objective To study the expression of E-selectin on vascular endothelial cells of nude mice liver induced by esophageal carcinoma cells, in order to find out the function of E-selectin in the metastasis of esophageal carcinoma into the liver. Methods Twelve Balb/c nude mice aged from 6 to 8 weeks with their weight ranged between 20 and 25 grams were selected in our research. The mice were equally distributed into the experimental group and the control group(n=6). EC9706 cell solution (5×10.6/0.02 ml) were injected beneath the splenic capsule of the mice in the experimental group. One hour later, spleen was removed. For the mice in the control group, after laparotomy, phosphate buffer without EC 9706 was injected beneath the splenic capsule and spleen was also removed one hour after the injection. Eight hour later, we resected the liver of the nude mice, and expression of E-selectin on vascular endothelial cells of the liver was detected with reverse transcription polymerase chain reaction (RT-PCR) and immunohistochemistry (IHC). Results In the experimental group, 8 hours after injection of EC9706 cells (5×10.6), the results of RT-PCR showed expression of E-selectin mRNA in the liver, and IHC showed a positive protein expression of E-selectin in the cytosol and membrane of hepatic sinus vessels.However, no E-selectin mRNA expression was found in the control group and IHC showed a negative protein expression of E-selectin. Conclusion Human esophageal carcinoma cell line EC9706 can induce balb/c mice liver vascular endothelial cell E-selectin expression, which shows that EC9706 may stay in the liver and form etastatic focus.
This article briefly introduces the status and problems of research and application on medical professionalism in China; proposes the concept of translational medicine and the challenges of introduction of translational medicine to physician professionalism research and translation. Some measurements or approaches to promote research translation on medical professionalisms are proposed to shorten the distance from research outcomes to practical application, in order to carry out evidence-based construction of modern medical professionalism of Chinese characteristics and build a harmonious doctor-patient relationship.
Objective To explore the factors which affect shared decision-making and develop strategies to get patients actively involved in clinical decision-making. Methods We conducted a survey on 566 patients of a Class A Hospital in Sichuan with group random sampling method. The data were collected by the use of anonymous selfadministered questionnaires. We used SPSS 10.0 to analyse the data. Results A total of 600 questionnaires were distributed at random, of which 565 were completed. There were 68% patients who had some knowledge of the disease, and 93% who were willing to participate in clinical decision-making. The patients’ biggest concerns were: treatment effect, cost and doctors’ skills. The biggest difficulties that patients worried about were: long-time waiting in out-patient departments and limited time to communicate with doctors. Conclusion As more and more patients would like to involve in shared decision-making, doctors need to provide patients with more choices and help them make a right decision in their treatment.
Objective To investigate and assess the current status of communication between medical students and old patients so as to improve the communication skills of medical students. Methods A total of 90 medical students were surveyed by a questionnaire. Data analysis was performed with SPSS 13.0 software. Results Medical students have recognized the importance of communication with patients, but they rarely had active communication behaviors. In addition, their knowledge of communication skills was utterly inadequate. Conclusion It is necessary to strengthen the training of communication skills among medical students.
ObjectiveTo study the status-quo of doctors' workload in China, analyze its influential factors, and to provide references for relevant policy-making. MethodsA multi-centre cross-sectional study was conducted. Clinical doctors who had worked for more than 6 months from 46 hospitals in 10 provinces were enrolled. The included doctors' workload was measured with working time per week and number of daily service patients. SPSS 20.0 software was used to analyze the data. ResultsA total of 1 537 doctors were included. The number of daily service outpatients and that of daily service inpatients per doctor were 22.17±20.95 person and 13.24±11.13 h, respectively. Working time per week were 54.06±10.76 h. The significant influential factors of the number of daily service outpatients were gender, employment relationship, hospital grade, age, professional title, and location; while those of the number of daily service inpatients were hospital grade, professional title, and location. Besides, type of department, hospital grade, doctor's age, education background and location were closely related to working time per week. ConclusionChinese doctors' workload is very heavy especially for long-time work. Hospitals and health departments should develop some target measures to reduce doctor's workload, so as to ensure medical safety.