Measuring health-related quality of life in patients with venous leg ulcers

Introduction: The effect on quality of life by healing leg ulcers is not known and no validated disease-specific tool is available for measuring health-related quality of life (HRQoL) for people with venous leg ulcers. The objective of this paper was to compare four generic instruments [MOS 36-Item Short-Form Health Survey (SF-36); EuroQol (EQ); McGill Short Form Pain Questionnaire (SF-MPQ) and the Frenchay Activities Index (FAI)] used for measuring HRQoL in people with venous leg ulcers, and to offer guidance on the most appropriate tool for researchers. Methods: Two hundred and thirty-three patients with venous leg ulcers were recruited as part of a randomised controlled trial of the cost-effectiveness of community leg ulcer clinics. Subjects completed questionnaires containing the four instruments on three occasions (initial assessment, 3 and 12 months). The discriminative and evaluative properties of the four instruments were compared. Results: All four instruments were acceptable to patients, taking a mean of 19.3 (SD 6.3) min to complete. At initial assessment, the SF-MPQ had poorer discriminative properties than the other three instruments and was not able to distinguish between the different patient groups in relation to age and ulcer duration. The FAI was good at discriminating between the different patient groups (at initial assessment) in relation to age, mobility and ulcer size. At the three-month follow-up, the SF-MPQ was more responsive than the other measures and detected changes in HRQoL, whereas the EQ and SF-36 did not. At 12 months, the SF-MPQ still identified differences and the SF-36 and EQ also did at this stage. Conclusion: In the absence of a validated condition-specific tool for measuring changes in general health status for patients with venous leg ulcers, we make the following recommendations. For evaluating the outcome of interventions with a short-term follow-up (three months) in a clinical study we recommend the SF-MPQ and for 12-month follow-up in a clinical study the SF-36, with or without the SF-MPQ.     

氟苷双层单向缓释膜的研制及质量考察

研制一种子宫颈给药的双层单向缓释膜剂并建立其质量控制方法,拟为临床治子宫颈癌提供一种新型给药方式。以氟苷为模型药物,ＰＶＡ：ＳＣＭ（１：１）为含药膜基质,卡波姆－９４０为缓释材料,ＰＶＣ为覆盖材料制膜。紫外分光光度法测定主药含量,并进行均匀度实验、稳定性试验、用静态小室进行单向释药试验,并考察本品体内外释药特性,判断体内外释药相关性。结果表明：氟苷在ＰＨ５．０乙酸钠缓冲液中,在２６８．６ｎｍ处有吸     

住院医师与临床医学研究生临床能力培养中存在问题及对策

住院医师与临床研究生临床能力的培养是一项重要工作,但存在着一些问题：由于培养模式与要求不同, 临床医学研究生临床实践相对较少,实际工作能力较低;临床医师虽部分建立了导师制,但对知师其要求不其严格;     

强化动态管理 确保医疗质量稳步提高

医疗质量是医院管理永恒的主题。医疗质量直接关系到病人的生命安危,关系到医院的生存与发展。我院实行动态医疗质量管理,提出突出“三抓”,从增强全体医务人员的医疗质量意识入手,逐步完善制度,建立以“四级检查法”为主要手段的质量考核体系,确保医疗质量称稳步提高。     

儿童疾病单病种质量管理体系的研究

在总结分析武汉地区儿童疾病结构用度春诊疗规律的基础上,运用现代医院全面质量管理的理论,建立了以儿科常见病、多发 为主,兼纳部分专科疾病的２４个儿童疾病单病种质量控制标准及规范的组织管理和考核评价第统。形成以增强病种质量控制能力为核心的儿童疾病单病种质量管理体系。该管理体系运用后,医院医疗质量管理水平和社会、经济效益得到了同步提高,并了医务人员的医疗行为,使医院步入优质、低砂和高效的运营轨道。     

护理质量评价体系的改进及其软件开发

通过对《军队医院护理质量主要评价指标》在运用过程中存在不足之处的分析,结合实际对原评价体系的评价方法,评价内容进行了补充和完善,形成了一套既能从宏观上全面反映医院护理质量达标情况。又能从微观上具体反映各临床科室护理质量达标程度及名次排列的评价体系,使护理质量管理更具针对性。在此基础上又介绍了研制出的适合医院护理工作特点的《护理质量综合评价》软件。     

我国农村地区实施大病统筹合作医疗或医疗保险方案的技术缺陷

在我国中等发达及上农村地区,大病统筹合作医疗或医疗保险以其可缓解农村居民的就医经济风险而受到欢迎,但是在方案的拟订过程中尚存在一些明显的技术缺陷,比如,“大病”的技术定义、农村居民就医经济风险分析、风险临界线界定、保险经付比测算和保险费率厘定等,这些技术的缺乏,已严重影响农村合作医疗或医疗保险的推广和实施效果。