单项筛选在病案终末质量控制中的作用

目的检查病历终末质量，探讨单项筛选的重要性，提高病历书写质量。方法参照国家、省、市有关病历书写规定，采用单项筛选法，对所有出院病案进行逐份检查。结果在71，319份病案中，发现9285份有不同程度的缺陷，其中乙级病历650份，丙级病历120份，病案完整率为86．98％。结论单项筛选法可以保证病案的完整性，减少由于病历资料的缺陷而造成的医疗纠纷。     

我国医院成本核算研究方法比较分析

医院经济管理带动了医院成本核算研究的发展，综合比较了不同时期不同研究者同类研究成果．试图以此揭示不同研究者在科室成本核算、项目成本核算和病种成本核算方面各自的特点与细微差别。     

军队中主要精神疾病筛查量表修订后在精神科门诊中的初步应用

目的 探讨台湾学者根据MMPI构建的29条目自评量表在精神科门诊中的应用价值。方法 翻译并对台湾学者构建的29条目自评量表进行适当修订，进而在精神科门诊中加以应用，将自评结果同最终诊断结果进行比较，应用尤登指数确定最佳截断点，进一步评价该自评量表在初步诊断中的应用价值。结果 136人按要求完成了量表填写，结果发现该自评量表灵敏度，特异度均较理想，可为精神疾病的诊断提供有用线索，有效的缩短就诊时间，记分方法简单，填表时间短，便于在门诊中应用，具有较大的实用价值。本研究应用尤登指数确定了新的最佳截断点，精神分裂症，抑郁症，噪狂症各自的最佳截断点分别是2分，2分，3分。结论 经过修订的29条目自评量表简便，快捷，实用，成本低，可用于在精神科门诊中初步诊断病人，有效的节约就诊时间，更充分的利用现有的医疗资源。     

Assessment of medication adherence and treatment satisfaction in Japanese patients with psoriasis of various severities

Psoriasis is a chronic, relapsing, inflammatory keratotic skin disease. To elucidate the medication adherence and treatment satisfaction, we performed a questionnaire survey using the eight‐item Morisky Medication Adherence Scale (MMAS‐8) and nine‐item Treatment Satisfaction Questionnaire for Medication (TSQM‐9) of 163 psoriatic patients who regularly visited hospitals or clinics. To assess the relationship between the MMAS‐8/TSQM‐9 outcomes and severity of psoriasis, two different clinical severity indices were used: the Psoriasis Area and the Severity Index (PASI) for disease severity and the Psoriasis Disability Index (PDI) for quality of life (QOL) impairment. The MMAS‐8 score for oral medication was significantly higher than that for topical medication. The oral and topical MMAS‐8 scores were significantly correlated with the PDI score, but not with the PASI score, indicating that QOL impairment lowered treatment motivation. All of the TSQM‐9 domain scores (effectiveness, convenience and global satisfaction) were significantly correlated with both the PASI and PDI scores, suggesting that patients whose skin and QOL conditions were under good control had high satisfaction with treatment. Patients treated with biologics had higher satisfaction than those treated with non‐biologics.     

Rasch Measurement Properties of the KIDSCREEN Quality of Life Instrument in Children with Cerebral Palsy and Differential Item Functioning between Children with and without Cerebral Palsy

Objective:  To assess if the Rasch-scaled KIDSCREEN-52 generic health-related quality of life measure was valid in children with cerebral palsy (CP).
Methods:  The Rasch measurement properties and differential item functioning (DIF) of the KIDSCREEN-52 were examined in children with CP. Data were available from the KIDSCREEN project from 3219 children aged 8 to 12 years and 2126 parents in the general population; and from the SPARCLE project from 501 children aged 8 to 12 years with CP and 823 parents. Analysis used Zumbo's logistic regression DIF approach. Partial credit model analyses were conducted.
Results:  All items of the KIDSCREEN self-report version fitted the partial credit model (smallest P -value: 0.256). Only one item of the parent version did not fit the data well (smallest P -value 0.001). Statistically significant DIF was observed in some items, but was of substantial magnitude (Δ R ² = 0.046, 0.049) for only two items in two dimensions of the parent version. The practical impact of DIF was small. DIF-adjusted standardized mean differences between children with and without CP being 1.07 and 0.34 for the physical and school dimensions, respectively (unadjusted: 1.09 and 0.16).
Conclusion:  The KIDSCREEN-52 functions in a similar way in children with CP and in the general population. Comparisons of quality of life between such children are therefore likely to be valid.     

58例残疾工人工业外伤分析

作者对比分析了某福利机械加工厂58例残疾工人和32例健全工人工伤发生情况,工伤检出率分别为41.7%、24.8%,工伤致残率分别为31.0%、9.4%,残疾工人显著高于对照组。工龄与工伤检出率呈密切负相关,机械操作工工伤检出率明显高于其他工种。工伤与残疾类型有密切关系,智力低下、视力残疾、侏儒、流脑后遗症等残疾工人工伤检出率显著高于聋哑和肢体残疾,原有残疾是残疾工人发生工伤的主要原因之一,约占致伤原因的1/4,并指出残疾工人工伤的特殊性及其劳动保护的重要性。     

缺陷型与非缺陷型精神分裂症的脑电图分析

目的 研究缺陷型、非缺陷型精神分裂症患者在脑电图(EEG)方面的差异。方法 采用国产ND-82B型八道EEG机对69例精神分裂症患者进行标准EEG描记,并对结果进行分析。结果 缺陷型精神分裂症的EEG异常率明显高于非缺陷型精神分裂症,二者有显著性差异(P<0.01)。结论 提示缺陷型与非缺陷型患者相比,有更明显的病理性生物学基础。     

Validation of the Spinal Cord Injury–Functional Index for Use in Community-Dwelling Individuals With SCI

ObjectiveTo evaluate the psychometric properties of the Spinal Cord Injury–Functional Index (SCI-FI) instruments in a community-dwelling sample.DesignCross-sectional study.SettingCommunity setting.ParticipantsIndividuals (N=269) recruited from 6 SCI Model Systems sites.InterventionsNot applicable.Main Outcome MeasuresParticipants completed computer adaptive test and short form versions of 4 SCI-FI/Capacity (C) banks (ie, Ambulation, Basic Mobility, Fine Motor, Self-Care) and 1 SCI-FI/Assistive Technology (AT) bank (Wheelchair Mobility) at baseline and after 2 weeks. The Self-Report Functional Measure (SRFM) and the clinician-rated motor FIM were used to evaluate evidence of convergent validity.ResultsPearson correlations, intraclass correlation coefficients, minimal detectable change, and Bland-Altman plots supported the test-retest reliability of the SCI-FI instruments. Correlations were large with the SRFM (.69-.89) and moderate-to-large for the FIM instrument (.44-.64), supporting convergent validity. Known-groups validity was demonstrated by a significant main effect of injury level on all instruments and a main effect of injury completeness on the SCI-FI/C instruments. A ceiling effect was detected for individuals with incomplete paraplegia on the Fine Motor/C and Self-Care/C Short Forms.ConclusionFindings support the test-retest reliability, convergent validity, and known-groups validity of the SCI-FI/C instruments and the SCI-FI/AT Wheelchair Mobility instruments for use by community-dwelling individuals.