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Diabetes self-care in primary health facilities in India - challenges and the way forward 预览
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作者 Saurav Basu Nandini Sharma 《世界糖尿病杂志:英文版(电子版)》 2019年第6期341-349,共9页
India has approximately 73 million people living with diabetes and another 37 million with prediabetes while nearly 47% of the diabetes cases are undiagnosed. The high burden of poor glycemic control and early onset o... India has approximately 73 million people living with diabetes and another 37 million with prediabetes while nearly 47% of the diabetes cases are undiagnosed. The high burden of poor glycemic control and early onset of complications with associated economic costs indicates a high prevalence of poor self-management practices. It is well-established that achieving patient-centered primary care consistent with a chronic care model ensures optimum diabetes self-management support and improves long-term clinical and health outcomes in diabetes patients. The public sector primary care system in India provides services free of cost to beneficiaries but lacks patient-centered care that undermines diabetes selfmanagement education and support. Furthermore, factors like poor patient knowledge of diabetes, suboptimal medication adherence, persistent clinical inertia, lack of data for monitoring and evaluation through clinical audit worsens the standards of diabetes care in primary care settings of India. There is a need for government initiatives to be directed towards the provision of comprehensive outpatient care that is inclusive of uninterrupted supply of drugs, provision of essential laboratory investigators, training and availability of qualified diabetes educators and availability of specialist support when required. Furthermore, the integration of depression screening and smoking cessation services at the primary care level is warranted. 展开更多
关键词 Primary care DIABETES SELF-CARE ADHERENCE INDIA
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全程康复护理在抑郁症患者护理中的应用 预览
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作者 许秀宾 《中国卫生标准管理》 2019年第9期157-159,共3页
目的评价全程康复护理对改善抑郁症患者心理状态的效果。方法选入2017年12月22日—2018年12月31日我院收治的抑郁症患者150例,采用抽签法的分组形式将其平均分成两组,即试验组与对照组,每组各75例,对照组实施基础护理,试验组实施全程康... 目的评价全程康复护理对改善抑郁症患者心理状态的效果。方法选入2017年12月22日—2018年12月31日我院收治的抑郁症患者150例,采用抽签法的分组形式将其平均分成两组,即试验组与对照组,每组各75例,对照组实施基础护理,试验组实施全程康复护理,分析抑郁症康复效果、护理之前与护理之后的焦虑、抑郁评分。结果试验组抑郁症康复效果、护理之后的焦虑、抑郁评分优于对照组,数据之间的对比存在统计学差异(P<0.05)。结论在抑郁症实际护理的过程中,采用全程康复护理法,有助于改善心理状态,具有较高的推广优势。 展开更多
关键词 全程康复 护理 抑郁症 心理状态 焦虑 基础护理
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Competences for self-care and self-control in diabetes mellitus type 2 in primary health care 预览
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作者 Maria Marta Amancio Amorim Alessandra Hugo de Souza Adriana Keller Coelho 《世界糖尿病杂志:英文版(电子版)》 2019年第8期454-462,共9页
The purpose of the guidelines of self-care and self-control of type 2 diabetes mellitus proposed by the Brazilian Ministry of Health is to strengthen and qualify users and health care professionals through the integra... The purpose of the guidelines of self-care and self-control of type 2 diabetes mellitus proposed by the Brazilian Ministry of Health is to strengthen and qualify users and health care professionals through the integrality and longitudinality of care with this disease.This article aims to present the self-care and self-control of people with type 2 diabetes mellitus in objective terms,taking into account the current recommen-dations based on scientific evidence and also from the subjective point of view,that is,emphasizing the aspects related to experience and subjectivity of these people.Next,we present the essential skills for self-care and self-control of users and professionals working in primary health care. 展开更多
关键词 DIABETES MELLITUS TYPE 2 SELF-CARE Primary health care
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Model of Healthcare-Associated Infection Control in Primary Health Care Institutions:A Structural Equation Modeling 预览
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作者 Zi-nan ZHANG Xin-ping ZHANG Xiao-quan LAI 《当代医学科学(英文)》 SCIE CAS 2019年第1期153-158,共6页
The purpose of this study was to construct the model of organization system,managemcnt,training and surveillance in healthcare-associated infection prevention and control(IC)of primary health care institutions and ide... The purpose of this study was to construct the model of organization system,managemcnt,training and surveillance in healthcare-associated infection prevention and control(IC)of primary health care institutions and identify its efleet on patient safety and decreasing economic burden by standardizing IC.A cross-sectional survey was conducted with questionnaires.Data were collected from 268 primary health care institutions in Hubei province,China.Hypotheses on the model of IC were analyzed by means of confirmatory factor analysis and structural equation modeling.The results showed that the fit indices of the hypothesized model of IC satisfied recommended levels:root mean square error of approximation(RMSEA)=0.071;comparative fit index(CFI)=0.965;tucker lewis index(TLI)=0.956:weighted root mean square residual(WRMR)=1.014.The model showed that organization system had a direct effect on management(β=0.311.P<0.01),and training(β=0.365,P<0.01).Management and training played an intermediary role that partially promoted organization system impact on surveillance.Results also showed that institutional factors such as the number of physicians、the ninnber of nurses,the designated capacity of beds,the actual number of open beds and surgery trips had positive impacts on management(β=0.050,P<0.01;β=0.181,P<0.01;β-0.111.P<0.01;β=0.064,P<0.01;β=0.084,P=0.04);nd training(β=0.21,P=0.03;β=0.050,P=0.02;β=0.586.P=0.01;0=0.995,P=0.02;β=0.223.P=0.03).In conclusion.the model of organization system,managemcnt,training and surveillancc in IC of primary health care institutions is valuable tor guiding IC practice. 展开更多
关键词 model ORGANIZATION system:management TRAINING SURVEILLANCE INFECTION control primary HEALTH CARE institutions
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Systemic analysis of pre-hospital trauma emergency treatment in Zhengzhou
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作者 Xiao-Peng Shi Li-Jie Qin +2 位作者 Yu-Xia Chang Fa-Liang Li Peng Wang 《急性病杂志(英文版)》 2019年第1期34-37,共4页
Objective: To analyze the data of pre-hospital emergency treatment in zhengzhou from 2007 to 2016, and evaluate the current situation of pre-hospital trauma emergency treatment, in order to provide a scientific basis ... Objective: To analyze the data of pre-hospital emergency treatment in zhengzhou from 2007 to 2016, and evaluate the current situation of pre-hospital trauma emergency treatment, in order to provide a scientific basis for effective use of first aid resources and enhance success rate of trauma emergency treatment. Methods: Retrospective analysis was conducted based on pre-hospital emergency resources of Zhengzhou Emergency Medical Rescue Center from 2007 to 2016. Results: The total number of pre-hospital emergency treatment cases was 9305687 from 2007 to 2016 in Zhengzhou, of which 418882 were trauma cases. The top five causes of injury were traffic accident injury, cutting injury, beating injury, crushing injury and falling injury. The top five emergency treatments used were oxygen, hemostasis, dressing and fixation, fluid supplementation, analgesics and sputum aspiration. According to different directions of diagnosis, the pre-hospital emergency patients were divided into four groups:emergency treatment group, emergency observation group, admission to general ward group and admission to ICU group. There was no statistical difference in the ages among the four groups (P>0.05). There were significantly statistical differences in gender composition among the four groups, with more males than females (P<0.01). Significant statistical differences also showed in CRAMS scores among the four groups (P<0.01). Before and after the training of primary trauma care, there was no significant difference in the constituent ratio of the trauma (P>0.05), but the mortality of the trauma, the average arrival time, and the mean treatment time were significantly different (P<0.01). Conclusions: The number of pre-hospital emergency trauma patients increased year by year, but the constituent ratio changed little. CRAMS score is important for the patients triage. Through the training of primary trauma care, the constituent ratio of death was reduced, and the average treatment time was shortened. 展开更多
关键词 PRE-HOSPITAL FIRST AID TRAUMA CRAMS PRIMARY TRAUMA CARE
PDCA循环在高浓度电解质管理中的应用 预览
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作者 萧灿荣 王功顺 梁达成 《中国当代医药》 2019年第15期154-157,共4页
对基层医疗机构的高浓度电解质进行完善管理,促进安全用药,降低高危药品用药差错的发生.运用PDCA管理工具,通过多部门协调机制,以规范高浓度电解质管理制度、制定高浓度电解质目录、对高浓度电解质各环节进行规范化及同质化管理.建立了... 对基层医疗机构的高浓度电解质进行完善管理,促进安全用药,降低高危药品用药差错的发生.运用PDCA管理工具,通过多部门协调机制,以规范高浓度电解质管理制度、制定高浓度电解质目录、对高浓度电解质各环节进行规范化及同质化管理.建立了以患者安全为核心的高浓度电解质管理规范,保证患者的安全合理用药,减少用药差错.结合医院自身医疗条件,开展高浓度电解质的规范管理,保证患者用药安全. 展开更多
关键词 高浓度电解质 PDCA循环 安全用药 药品管理 基层医疗 组织与管理
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Diabetes empowerment scores among type 2 diabetes mellitus patients and its correlated factors:A cross-sectional study in a primary care setting in Malaysia 预览
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作者 Thew Hui Zhu Ching Siew Mooi Nurainul Hana Shamsuddin 《世界糖尿病杂志:英文版(电子版)》 2019年第7期403-413,共11页
BACKGROUND There are limited studies on diabetes empowerment among type 2 diabetes patients,particularly in the primary care setting.AIM To assess the diabetes empowerment scores and its correlated factors among type ... BACKGROUND There are limited studies on diabetes empowerment among type 2 diabetes patients,particularly in the primary care setting.AIM To assess the diabetes empowerment scores and its correlated factors among type 2 diabetes patients in a primary care clinic in Malaysia.METHODS This is a cross sectional study involving 322 patients with type 2 diabetes mellitus(DM)followed up in a primary care clinic.Systematic sampling method was used for patient recruitment.The Diabetes Empowerment Scale(DES)questionnaire was used to measure patient empowerment.It consists of three domains:(1)Managing the psychosocial aspect of diabetes(9 items);(2)Assessing dissatisfaction and readiness to change(9 items);and(3)Setting and achieving diabetes goal(10 items).A score was considered high if it ranged from 100 to 140.Data analysis was performed using SPSS version 25 and multiple linear regressions was used to identify the predictors of total diabetes empowerment scores.RESULTS The median age of the study population was 55 years old.56%were male and the mean duration of diabetes was 4 years.The total median score of the DES was 110[interquartile range(IQR)=10].The median scores of the three subscales were 40 with(IQR=4)for"Managing the psychosocial aspect of diabetes";36 with(IQR=3)for"Assessing dissatisfaction and readiness to change";and 34 with(IQR=5)for"Setting and achieving diabetes goal".According to multiple linear regressions,factors that had significant correlation with higher empowerment scores among type 2 diabetes patients included an above secondary education level(P<0.001),diabetes education exposure(P=0.003),lack of ischemic heart disease(P=0.017),and lower glycated hemoglobin(HbA1c)levels(P<0.001).CONCLUSION Diabetes empowerment scores were high among type 2 diabetes patients in this study population.Predictors for high empowerment scores included above secondary education level,diabetes education exposure,lack of ischemic heart disease status and lower HbA1c. 展开更多
关键词 DIABETES EMPOWERMENT SCORES DIABETES EMPOWERMENT Scale Type 2 DIABETES Primary care MALAYSIA
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Treatment patterns of primary care physicians vs specialists prior to subspecialty urogynaecology referral for women suffering from pelvic floor disorders 预览
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作者 Abigail Prentice Ali Ahmad Bazzi Muhammad Faisal Aslam 《世界方法学杂志》 2019年第2期26-31,共6页
BACKGROUND There are approximately 25% of women in the United States suffering from pelvic floor disorders (PFDs) and this number is predicted to rise. The potential complications and increasing healthcare costs that ... BACKGROUND There are approximately 25% of women in the United States suffering from pelvic floor disorders (PFDs) and this number is predicted to rise. The potential complications and increasing healthcare costs that exist with an operation indicate the importance of conservative treatment options prior to attempting surgery. Considering the prevalence of PFDs, it is important for primary care physician and specialists (obstetricians and gynecologists) to be familiar with the initial work-up and the available conservative treatment options prior to subspecialist (urogynecologist) referral. AIM To assess the types of treatments that specialists attempted prior to subspecialty referral and determine the differences in referral patterns. METHODS This is a retrospective cohort study of 234 patients from a community teaching hospital referred to a single female pelvic medicine and reconstructive surgery (FPMRS) provider for PFD. Specialist vs primary care provider (PCP) referrals were compared. Number, length and treatment types were studied using descriptive statistics. RESULTS There were 184 referrals (78.6%) by specialists and 50 (21.4%) by PCP. Treatment (with Kegel exercises, pessary placements, and anticholinergic medications) was attempted on 51%(n = 26) of the PCP compared to 48%(n = 88) of the specialist referrals prior to FPMRS referral (P = 0.6). There was no significant difference in length of treatment prior to referral for PCPs vs specialists (14 mo vs 16 mo, respectively, P = 0.88). However, there was a significant difference in the patient’s average time with the condition prior to referral (35 mo vs 58 mo for PCP compared to specialist referrals)(P = 0.02). CONCLUSION One half of the patients referred to FPMRS clinic received treatment prior to referral. Thus, specialists and generalists can benefit from education regarding therapies for PFD before subspecialty referral. 展开更多
关键词 PELVIC floor disorders REFERRAL patterns Female PELVIC medicine and RECONSTRUCTIVE surgery Primary care PROVIDER
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糖尿病主要照顾者健康行为与照护行为的相关性研究 预览
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作者 任海霞 李新辉 +2 位作者 欧闪 范玲 谭敏 《全科护理》 2019年第17期2051-2054,共4页
[目的]调查糖尿病主要照顾者健康行为与照护行为的现状,分析两者间的关系。[方法]采用一般资料、健康促进生活方式-ⅡR和自制的糖尿病主要照顾者照护行为问卷对新疆2所三级甲等医院的300例2型糖尿病主要照顾者进行调查。[结果]糖尿病主... [目的]调查糖尿病主要照顾者健康行为与照护行为的现状,分析两者间的关系。[方法]采用一般资料、健康促进生活方式-ⅡR和自制的糖尿病主要照顾者照护行为问卷对新疆2所三级甲等医院的300例2型糖尿病主要照顾者进行调查。[结果]糖尿病主要照顾者健康行为总分为(107.49±17.59)分,照护行为总分为(100.81±19.96)分,两者之间呈正相关(r=0.650,P<0.05)。[结论]糖尿病主要照顾者健康行为与照护行为均处于中等水平,且两者具有相关性,护理人员应关注其健康行为,且给予针对性的指导,旨在为提高照护行为提供依据。 展开更多
关键词 主要照顾者 健康行为 照护行为
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Consultation-Liaison Psychiatry for Outpatients in a Great Metropolitan Hospital 预览
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作者 Matteo Porcellana Roberta Bassetti +1 位作者 Adelaide Panariello Mauro Percudani 《心理学研究:英文版》 2019年第1期1-5,共5页
Consultation-liaison psychiatry remains the guardian of holistic approach to the patient and consultation services in general hospital could therefore be referred to as“filters”for mental health care,in particular f... Consultation-liaison psychiatry remains the guardian of holistic approach to the patient and consultation services in general hospital could therefore be referred to as“filters”for mental health care,in particular for patients with minor depressive or anxiety disorders.It is worth noting that psychiatric disorders,even when sub-clinical,worsen outcome whereas their early detection and treatment reduce health care costs significantly.The present study was transversal,exploratory,and descriptive in order to investigate the sample of outpatients referred from general practitioners(GP)to service of consultation-liaison psychiatry of the ASST Great Metropolitan Hospital Niguarda of Milan over a 7-months period.Data from all psychiatric consultations for outpatients were collected by a structured clinical report including socio-demographic features,features of referrals,and features of back-referrals.Five hundred and eleven consultations were performed.Participants were mainly female(58.7%)with an average age between 45 and 55 years(27.6%);31.1%of these patients was at the first contact with a mental health specialist.The diagnoses formulated were distributed as follows:The most common diagnoses were affective disorders(44.6%),followed by neurotic disorders(34.1%),personality disorders(6.8%),and finally,psychosis(6.2%).The study showed an example of a consultation-liaison service situated in a Great Metropolitan Hospital offering to GP the opportunity of a diagnostic assessment and shared management of minor psychiatric disorders.This approach could lead to several vantages,such as the management in a non-psychiatric setting of patients with reduction of stigma and reduced costs for specific psychiatric services where are referred more severe patients. 展开更多
关键词 consultation-liaison PSYCHIATRY primary care MINOR DEPRESSIVE and ANXIETY disorders
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Auriculotherapy in primary health care: A large-scale educational experience in Brazil
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作者 Charles Dalcanale Tesser Ari Ojeda Ocampo More +3 位作者 Melissa Costa Santos Emiliana Domingues Cunha da Silva Fatima Terezinha Pelachini Farias Lucio Jose Botelho 《结合医学学报:英文版》 CAS CSCD 2019年第4期302-309,共8页
Auriculotherapy consists of physical stimuli applied to the outer ear and is commonly associated with traditional Chinese medicine (TCM). The authors present and discuss the development of a course that offers a semi-... Auriculotherapy consists of physical stimuli applied to the outer ear and is commonly associated with traditional Chinese medicine (TCM). The authors present and discuss the development of a course that offers a semi-on-site auriculotherapy course for Brazilian primary health care (PHC) professionals. The course was funded by the Brazilian Ministry of Health and developed at the Federal University of Santa Catarina in 2015 by a team of experts in auriculotherapy. It consisted of 75 h of distance learning (five sequential modules) and 5 h of on-site learning. The modules included the following items:(1) introduction to integrative practices;(2) ear reflexology;(3) introduction to TCM;(4) biomedical view of auriculotherapy;and (5) auriculotherapy in PHC. The teaching material in eluded a workbook for each module, 14 video lectures and an interactive ear(on line resource) to study location and application to the main auricular points. The on-site lectures follow a structured script of ear palpation techniques, auricular seed insertion practice and clinical case discussions, under the supervision of trained instructors. The course was offered in 2016 and 2017 and on-site lectures took place in 25 cities, covering all Brazilian regions, in coordination with municipal or state boards of health. A total of 4273 health professionals concluded the training and their evaluation of the course was highly positive. The Brazilian experience of large-scale training shows the potential to disseminate auriculotherapy in the context of PHC, given that its practice is fast, easy to learn, safe, effective for different health problems and well accepted by the patients. 展开更多
关键词 AURICULOTHERAPY TRADITIONAL Chinese MEDICINE Primary HEALTH care HEALTH education DISTANCE learning
门诊老年压力性损伤患者主要照顾者营养照护体验的质性研究
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作者 夏敏 吴金球 +1 位作者 芮菁 张小蔚 《中国实用护理杂志》 2019年第15期1176-1181,共6页
目的探讨门诊老年压力性损伤患者的主要照顾者为患者提供营养照护时的真实体验。方法采用目的抽样方法抽取复旦大学附属华东医院压力性损伤护理门诊就诊的15名老年压力性损伤患者的主要照顾者,运用半结构式访谈方法进行质性访谈,并用Col... 目的探讨门诊老年压力性损伤患者的主要照顾者为患者提供营养照护时的真实体验。方法采用目的抽样方法抽取复旦大学附属华东医院压力性损伤护理门诊就诊的15名老年压力性损伤患者的主要照顾者,运用半结构式访谈方法进行质性访谈,并用Colaizzi内容分析法进行资料分析。结果经分析得出7个主题:主要照顾者营养照护困扰较多,营养与压力性损伤之间关系的认知欠缺,营养照护知识缺乏,知识获取途径缺乏可靠性,应对态度缺乏积极性,应对方式欠妥,营养照护需求存在较大差异。结论医护人员要重视患者进食能力及行为的评估,提高主要照顾者压力性损伤营养照护知识水平,提供更多学习形式及途径,转变主要照顾者营养照护态度,建立正确的营养照护行为,必要时联合营养师进行多学科合作,建立有效的家庭和社会支持系统。 展开更多
关键词 压力性损伤 主要照顾者 营养照护 老年人 质性研究
离散选择实验在居民基层医疗服务利用中的应用及偏好异质性分析
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作者 蒋明珠 熊巨洋 +4 位作者 张晗 沈晓 贾二萍 黎相麟 彭莹莹 《中国卫生经济》 北大核心 2019年第4期55-59,共5页
目的:分析居民对基层医疗服务利用的偏好,掌握不同人群的偏好异质性及特征,为基层医疗服务提升提供依据与建议。方法:釆用分层抽样法,确定服务方式、服务类型、医疗费用、居民距最近医疗机构的时间、医生类别5个属性,运用离散选择实验... 目的:分析居民对基层医疗服务利用的偏好,掌握不同人群的偏好异质性及特征,为基层医疗服务提升提供依据与建议。方法:釆用分层抽样法,确定服务方式、服务类型、医疗费用、居民距最近医疗机构的时间、医生类别5个属性,运用离散选择实验引出偏好,运用潜在分类模型分析偏好。结果:在全国东、中、西部6个城市36个社区使用自制问卷调查2019名居民。受访者被分为经济型(37.79%)、专家型(34.17%)、综合型(27.29%)、随机型(0.75%)4个类别。为了获得专家服务和全科服务,受访者分别愿意多自付604.31元、237.25元,需要补贴202.12元才能更多提高中医服务的接受度。结论:居民对高质价优的医疗服务需求是医改的落脚点,需注重全人群的健康预防教育,增加低收入者的健康福利,引导全科医疗和中医服务在基层服务体系中进一步发挥作用。 展开更多
关键词 居民 基层医疗 卫生服务利用 离散选择实验
How to improve Iranians’ vision health: on the national policy of preventing Iranians’ blindness
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作者 Behzad Damari Alireza Mahdavi Maryam Hajian 《国际眼科杂志:英文版》 SCIE CAS 2019年第1期114-122,共9页
AIM: To review vision health situation of Iranian community, analyze its determinants, and discuss the adopted improvement strategies by the Iran Ministry of Health and Medical Education(MOHME). METHODS: This was a ra... AIM: To review vision health situation of Iranian community, analyze its determinants, and discuss the adopted improvement strategies by the Iran Ministry of Health and Medical Education(MOHME). METHODS: This was a rapid situation analysis with a qualitative approach in three parts of recognition, orientation and implementation. The data were gathered via review of upstream documents, national and international experiences, and experts and stakeholders’ opinions. RESULTS: Eradicating trachoma, increasing human resources, increasing educational and research centers and promotion of ophthalmic technologies were important achievements in the field of vision health in Iran. Through these achievements, it seemed that the pattern of causes of blindness and low vision was similar to that of the developed countries. However, the review of Iranians’ vision health indicators showed that a considerable percent of the blindness and low vision was avoidable through a national program demanding 3 types of interventions in social determinants of health(SDH), community education, and increasing the access to health care services by integrating the necessary services in primary health care system. CONCLUSION: Managing the issue requires attentions from a national committee for preventing blindness with participation of all stakeholders, implementing a national survey on vision health, preparation of the primary level health centers including employment and education of community health workers(Behvarzes), optometristsand general practitioners, fair distribution of specialized human resources and establishing at least one specialized center in each province for referring patients from the primary levels. 展开更多
关键词 VISION HEALTH POLICY document primary HEALTH CARE
青春期原发性痛经的自我护理研究进展 预览
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作者 刘婷婷 雷梦杰 +2 位作者 刘雅倩 孟丽娜 金昌德 《护理研究》 北大核心 2019年第1期83-86,共4页
对青春期女性原发性痛经的自我护理评价工具、应用现状、影响因素及提高原发性痛经女性自我护理行为的干预措施进行综述,以期为我国原发性痛经病人选择和提高痛经的自我护理能力提供依据,改善其经期的工作学习状态及生活质量。
关键词 青少年 原发性痛经 自我护理 评价工具 应用现状 影响因素 综述
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全科医生儿科专业培训的探索与建议 预览
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作者 周雪迎 齐建光 +2 位作者 韩彤妍 陈智 迟春花 《中国医刊》 CAS 2019年第1期112-115,共4页
儿童基本医疗是全科医生工作中的重要部分。提高基层卫生机构全科医生的儿童疾病诊治能力和信心,是实现儿童分级诊疗的重要前提条件。2016年底原国家卫生和计划生育委员会国际交流与合作中心与英国驻华使馆中国繁荣基金合作,通过借鉴英... 儿童基本医疗是全科医生工作中的重要部分。提高基层卫生机构全科医生的儿童疾病诊治能力和信心,是实现儿童分级诊疗的重要前提条件。2016年底原国家卫生和计划生育委员会国际交流与合作中心与英国驻华使馆中国繁荣基金合作,通过借鉴英国儿童健康照顾的专业知识,开展了全科医生儿科专业培训的试点项目,旨在探索开展全科医生儿科专业培训的相关内容、课程设置、培训效果、存在的问题等,并针对未来全科医生儿科专业培训提出可行的建议。 展开更多
关键词 全科医生 儿科培训 基层
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河北省乡村医生工作现状及培训需求调查
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作者 张金佳 张敏 +4 位作者 赵会芳 张雅丽 孙彦杰 邢晓英 王荣英 《中华全科医师杂志》 2019年第1期42-46,共5页
目的:了解河北省乡村医生工作现状及培训需求,为乡村卫生事业建设及乡村医生培训提供政策建议。方法2017年10-12月,按照分层抽样的原则,抽取河北省11个地级市现任乡村医生1 200名,采用自行设计的问卷进行调查,内容包括乡村医生的一般情... 目的:了解河北省乡村医生工作现状及培训需求,为乡村卫生事业建设及乡村医生培训提供政策建议。方法2017年10-12月,按照分层抽样的原则,抽取河北省11个地级市现任乡村医生1 200名,采用自行设计的问卷进行调查,内容包括乡村医生的一般情况、工作满意度、医改政策的影响、培训需求等。结果共发放问卷1 200份,收回有效问卷1 170份,有效回收率为97.5%。1 170名接受调查问卷的乡村医生中,男性占62.1%(726/1 170),40岁以上者占63.9%(748/1 170),中专学历者占52.3%(612/1 170),从事乡村医生年限≥10年的占70.6%(826/1 170),对工作总体满意度为30.8%(360/1 170);被调查者回答所在卫生室为标准化村卫生室的占73.8%(864/1 170),已施行家庭签约的占72.0%(842/1 170),认为新医改政策改善村民看病难、看病贵的占52.8%(618/1 170);98%(1 147/1 170)乡村医生认为需要接受培训,93.6%(1 095/1 170)表示曾经接受过培训;对于上级部门组织的专业技能培训应为哪些方面内容的问题,根据被调查者的选择,依次排序为常见病、多发病(904人,占77.3%)、人文医学(650人,占55.6%)、急救知识(492人,占42.1%)等;关于乡村医生进行培训的影响因素,根据被调查者的选择,依次排序为时间、精力不足(656人,占54.3%)、缺乏适宜的培训形式(510人,占43.6%)、经济原因(476人,占40.3%)等。结论各级政府部门应重视提高乡村医生的工作满意度,完善乡村医生培训体系,提高乡村医生业务水平,深入落实家庭医生签约服务,使乡村医生真正成为农村居民健康的"守门人"。 展开更多
关键词 医师 初级保健 乡村卫生服务 问卷调查
美国家庭医生/全科医生规范化培训的门诊培训新趋向 预览
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作者 李新农 徐宇红 杨乔欣 《中国毕业后医学教育》 2019年第1期13-15,23共4页
为适应以预防、慢病管理为主,以患者为中心的医疗模式的改变,美国近十多年强调对内科/家庭医学住院医师的门诊培训改革。本文介绍了以下六方面的改革尝试:(1)设计合理的轮转计划:保证教学和患者管理的连续性,减少住院医师同时要监管门... 为适应以预防、慢病管理为主,以患者为中心的医疗模式的改变,美国近十多年强调对内科/家庭医学住院医师的门诊培训改革。本文介绍了以下六方面的改革尝试:(1)设计合理的轮转计划:保证教学和患者管理的连续性,减少住院医师同时要监管门诊和住院患者的压力;(2)建立门诊教学的核心队伍:带教老师需要经过系列培训,提高教学能力,并保证老师有规定的教学时间、管理的权利、适当的报酬和晋升的待遇。(3)建立功能完备的门诊机构:可方便患者就诊并保证有效随访的连续性、合理的人群管理,与其他专科和医疗部门有很好的相关医疗合作。(4)建立有归属感的医疗团队:关系融洽的团队能有效提高医疗质量,改善患者的治疗满意度和住院医师受训的满意程度。(5)增加门诊轮转培训时间:保证相对长的时间段用于门诊培训。(6)培养住院医师成为门诊的协助领导者,借此培训住院医师的管理能力。以上改革的目的是将门诊能力训练放到最优先的地位来培养未来的主诊医生(primary care physician)。 展开更多
关键词 全科 规范化培训 门诊培训
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社区医师对脑卒中二级预防可控危险因素的认知情况及培训效果研究 预览
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作者 高彩红 裴建基 +3 位作者 马丽芳 穆利春 朱倩倩 安强 《中国全科医学》 CAS 北大核心 2019年第1期75-78,共4页
背景 脑卒中后二级预防对于患者预防血管并发症、再发脑卒中具有重要意义,社区医师是开展脑卒中防治工作的重要力量。目的 了解社区医师对脑卒中二级预防可控危险因素的认知情况,评价对社区医师进行相关培训的效果。方法 于2017年5月—2... 背景 脑卒中后二级预防对于患者预防血管并发症、再发脑卒中具有重要意义,社区医师是开展脑卒中防治工作的重要力量。目的 了解社区医师对脑卒中二级预防可控危险因素的认知情况,评价对社区医师进行相关培训的效果。方法 于2017年5月—2018年5月采用单纯随机抽样法在北京市门头沟区12家社区卫生服务中心中选取执业范围为内科或全科的社区医师50例,进行脑卒中二级预防可控危险因素相关知识培训。培训内容包括对脑卒中患者血压、血糖、血脂、心房颤动、抗血小板治疗的规范化二级预防治疗与管理。分别于培训前和培训后对纳入社区医师进行相关知识考核,比较培训前后的合格率,采用柏拉图分析法探讨培训未达标项(合格率<90.0%)的影响因素。结果 培训前,社区医师血压相关知识的合格率达80.0%,其他因素相关知识的合格率均<80.0%。培训后,社区医师对血压、血糖、血脂、心房颤动、抗血小板治疗相关知识的合格率均高于培训前(P<0.05);对血压、血糖、血脂、抗血小板治疗相关知识的培训达标〔合格率分别为100.0%(50/50)、92.0%(46/50)、90.0%(45/50)、96.0%(48/50)〕,对心房颤动相关知识的培训未达标〔合格率为70.0%(35/50)〕。柏拉图分析结果表明,导致社区医师对心房颤动相关知识培训未达标的主要影响因素为:对抗凝药物的了解(40.0%,20/50)、心房颤动抗凝适应证的掌握(28.0%,14/50)、心房颤动抗凝出血风险的评估(18.0%,9/50)。结论 目前社区医师对脑卒中二级预防主要可控危险因素的认知不足,对血压相关知识的认知较好,对心房颤动相关知识的认知较差,规范性培训可以提高其认知水平。 展开更多
关键词 社区卫生服务 医生 初级保健 卒中 二级预防 教育 医学
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国外初级保健机构患者安全文化量表比较及启示 预览
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作者 鲁春桃 胡银环 +1 位作者 邓璐 谢金柱 《中国医院》 2018年第7期34-36,共3页
通过检索国外初级保健机构的患者安全文化测评工具,分析与比较各测量工具的内容、理论基础、使用对象以及信效度检验方法,总结其异同,为开发国内基层医疗卫生机构的患者安全文化测评工具提供一定的理论依据和信息支持。
关键词 基层医疗卫生机构 初级保健 患者安全文化
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