预防医学专业学生对某起突发公共卫生事件知晓情况的分析

Objective To investigate preventive medical students' awareness for emergency public health event, to understand their attention extent to this event, their ability of linking theory with practice , analyzing and solving problems and to perform the teaching reform based on the findings of this study.Methods 423 undergraduates students of grade 1 to grade S and 104 postgraduates majoring in preventive medicine from an university were investigated by questionnaire anonymously. The total score of the questionnaire was 20. Results The average score of all the participants was 6.15 ±.95, and the postgraduates ' average score was 8. 53 ±3.26, significantly higher than that (5.56±.89) of the undergraduates'(P<0.001). The average score of the latter increased with grades, P<0.001. The corrective rates for most questions were low. Among all the participants, only 2. 1 percent considered three or more causes for having more death cases, only 1.9 percent obtained the information about the disease from the authoritative and professional medical websites and academic journals. Conclusions The preventive medical students were not aware of this emergency public health event completely and were not able to analyze it comprehensively. Moreover, the approaches to acquire the information were very limited. It is urgent to reform education system, renew educational thoughts and enhance the cultivation of contact between theory and practice capabilities.     

AIDS—related Knowledge,Condom Usage Among Medical Postgraduates

Objective To investigate the knowledge about safety/unsafty of sexual acts relating to HIV transmission, levels of embarrassment related to condom and condom usage among medical postgraduates. Methods From August to December, 1998, a self-administered anonymous questionnaire was given to 271 new medical postgraduates from two medical colleges of Beijing and Hebei Province. Results There was a hazy understanding of the protective function of condom from AIDS among medical postgraduates. Only 14.4% medical postgraduates persisted in using condom, and 27.94% had never or almost never used it. The levels of embarrassment about condom were high. The median score was 3.55+0.98. Whether to use condom was related with the attitudes to condom, but not to AIDS. Conclusion There was some misunderstanding about condom and inconsistent condom usage in medical postgraduates. So it is essential to strengthen the sexual health education among them.     

Analysis of High Alert Medication Knowledge of Medical Staff in Tianjin:A Convenient Sampling Survey in China

The current situation of medical staff’s awareness about high alert medication was investigated in order to promote safe medication and standardized management of the high alert medication in China. Twenty questions were designed concerning elementary knowledge of high alert medications, storage management, medication issues and risks. In order to understand the knowledge level and education status of high alert medication, a convenient survey was conducted among 300 medical staffs in Tianjin. Medical staff’s average score of high alert medication knowledge was 12.43±0.27, and the average scores of elementary knowledge of high alert medication, storage management, medication issues and risks were 3.38±0.11, 2.46±0.14, 3.17±0.11 and 3.41±0.12 respectively. Occupation(F=4.86, P=0.003), education background(F=5.57, P=0.019) and professional titles(F=13.44, P≤0.001) contributed to the high alert medications knowledge scores. Currently, the most important channel to obtain high alert medication knowledge was hospital files or administrative rules, and clinical pharmacist seminars were the most popular education form. It was suggested that the high alert medication knowledge level of the medical staff needs to increase, and it might benefit from targeted, systematic and diverse training to the medical staff working in the different circulation nodes of the medications. Further research to develop and validate the instrument is needed.     

Analysis on the Emergency Contraception Knowledge Level and Its Influencing Factors among Abortion Patients in Shanghai City

Objective To evaluate the knowledge level of emergency contraception, explore the determinants of the knowledge level among women seeking abortion and give suggestions on how to improve the quality of emergency contraception service.Method A total of 606 women requiring abortion at three MCHs in Shanghai City were interviewed face to face with structured questionnaire.Results 63. 7% of unwanted pregnancy could use EC to prevent. Subjects got their knowledge on EC mainly from books~newspapers~magazines and relatives/friends/parents. The proportion of the awareness of EC was 28. 5%. Most subjects were aware of hormonal EC pill, but only 14. 9% of them knew that the pill should be taken within 72 hours after the intercourse. Among the subjects who were aware of EC, the average score of the knowledge was lower than half of the full marks. The lower the subject‘s educational level was, the less likely they were aware of EC and the lower score of the knowledge of EC they had. The score of the knowledge of EC was higher among subjects who learned of EC mainly from family planning publicity.Conclusion It is urgent to popularize EC in order to reduce unwanted pregnancy and induced abortion. The information, including EC can be used in which situations, it‘s advantages and disadvantages as well as indication, should be given to women in an appropriate way and using plain language. The departments of family planning should play a leading role in improving women‘s knowledge of EC.     

Current situation on the reporting quality of randomized controlled trials in 5 leading Chinese medical journals

Objective： The Consolidated Standards for Reporting of Trials （CONSORT） statement has already proved to be an efficient standard for reporting quality of randomized controlled trials （RCTs）. However, most of the Chinese medical journals have not endorsed the CONSORT statement. The current situation about the reporting quality of RCTs in Chinese medical journals is still unclear. The purpose of the study was to evaluate the reporting quality of RCTs on papers published in 5 leading Chinese medical journals. Methods： We evaluated 232 original RCT papers using a reporting quality scale based on CONSORT statement from 2001 to 2006 in 5 Chinese medical journals （Journal type 1） without adoption of CONSORT and Chinese Journal of Evidence-based Medicine （Journal type 2） which adopted CONSORT in 2004. We measured the inclusion of 26 items for the reporting quality scale and 6 core items of each RCT report, gave score to each item and calculated the total score obtained in each report and the proportion of reports including individual items. The reporting quality of RCT trials from 2001 to 2003 （pre-adoption period） was compared with that from 2004 to 2006 （post-adoption period）. Results： The average reporting quality of RCTs was moderate （mean score, 15.18）, and the mean score of the 6 core items was low （mean score, 1.09） in 5 leading journals. The difference in the total score and the score of the 6 core items between pre-adoption period （2001-2003） and post-adoption period （2004-2006） was statistically significant （P=0.003; P=0.000）. Interaction between journal type and period was not significant （F=0.76; P=0.383）. We concluded that the change tendency of reporting quality between Journal type 1 and 2 was not different. But as to the core items of sequence concealment and intention-to-treat analysis, the increases were greater for Journal type 2 when evaluated against Journal type 1 （P=0.038; P=0.016）. Conclusion： The reporting quality of RCT trials in 5 leading Chinese medical journals is improving. However, the lack of important items in RCT trials remains a serious problem. We recommend the endorsement of the Consolidated Standards for Reporting of Trials statement in Chinese medical journals and the continuing education on evidence-based medicine in China.     

维持性血液透析述情障碍患者医学应对方式和生活质量的研究

Objective To discuss alexithymia in patients with maintenance hemodialysis and its impact on medical coping style and the ability of daily living. Methods The patients with end-stage renal disease treated by the maintenance hemodialysis (MHD) were divided into 2 groups, namely, alexithymia group (total score>60) and non-alexithymia group (total score <50) ,according to the Toronto Alexithymia Scale (TAS-20). The Medical response to the questionnaire (MCMQ) and the activities of daily living scale (ADL) were used to evaluate the patients. Results The TAS-20 score was (72.31±12.28) in 67 cases of patients with MHD. Among these, 31 cases for TAS-20 total score>60 points ,with an average score (82.37±15.84) and 26 cases for TAS-20 total score <50 points, with an average score (50.17±10.24). There was significant difference (t=8.90, P<0.01). The face factor score of MCMQ was significantly lower in alexithymia groups than that in non-alexithymia group,while the avoidance and subordination factor score was significantly higher than that in non-alexithymia group(P<0.01 or 0.05). The ADL scores and factor scores of the alexithymia group were significantly higher than that of non-alexithymia group,and there was a significant difference (t=3.53, P<0.01). Correlation analysis showed that TAS-20 score and the face factor score of MCMQ was significantly negatively correlated with MCMQ e-vasive and subordination factor,and factor scores and ADL score was significantly positively correlated (P<0.01 or 0.05). Conclusion MHD patients in the alexithymia group tend to use and yield response to avoid negative cop-ing style and less use of active coping style. The quality of life and activities of daily living of MHD patients in alex-ithymia group are worse than that of the non-alexithymia group.     

高仿真模拟人在心肺复苏教学中的应用研究

Objective To evaluate the application effect of high-fidelity human patient simulation in cardiopulmonary resuscitation (CPR) training in emergency medicine course. Method All of the 84medical freshmen in the academic year of 2008, who studied emergency medicine course, were chosen as the study object. The students were randomly divided into high-fidelity simulator (SimMan) training group(EG) and ordinary training group (CG), when they finished the course. Two groups accepted training for the same time, and then examined the CPR performing by the system of advanced cardiovascular life support (ACLS) simulator, and make data-analysis with the software of SPSS 11.5. Result The students in EG group have higher total mean score than CG ( P ＜ 0.05). However, in the aspects of survival ratio,performing time and chest compression quality, EG has higher score than CG, but there is no significant statistical difference ( P ＞ 0.05 ). Conclusion This study demonstrates that high-fidelity human patient simulation can simulate many common symptoms of emergency patients, it has great effect on helping medical students to improve the quality of doing CPR, but the training results is not as good as the author expected compared with the ordinary training. So the training method in the application of high-fidelity human patient simulation should be improved.     

高仿真模拟人在心肺复苏教学中的应用研究

Objective To evaluate the application effect of high-fidelity human patient simulation in cardiopulmonary resuscitation (CPR) training in emergency medicine course. Method All of the 84medical freshmen in the academic year of 2008, who studied emergency medicine course, were chosen as the study object. The students were randomly divided into high-fidelity simulator (SimMan) training group(EG) and ordinary training group (CG), when they finished the course. Two groups accepted training for the same time, and then examined the CPR performing by the system of advanced cardiovascular life support (ACLS) simulator, and make data-analysis with the software of SPSS 11.5. Result The students in EG group have higher total mean score than CG ( P ＜ 0.05). However, in the aspects of survival ratio,performing time and chest compression quality, EG has higher score than CG, but there is no significant statistical difference ( P ＞ 0.05 ). Conclusion This study demonstrates that high-fidelity human patient simulation can simulate many common symptoms of emergency patients, it has great effect on helping medical students to improve the quality of doing CPR, but the training results is not as good as the author expected compared with the ordinary training. So the training method in the application of high-fidelity human patient simulation should be improved.     

An approach to timing selection of emergency operation for acute cholangitis of severe type

This article reports on a retrospective analysis on 121 patients and a prospectivestudy on 21 patients with acute cholangitis of severe type(ACST)for a study on the timing se-lection of emergency operation for ACST.Twenty two clinical,biological,etiologic,pathologicand operative variables were analyzed.Simple regression revealed 11 factors with prognosticsignificance,but multivariate analysis detected only 6 factors with independent significance inpredicting mortality(age,mean blood pressure,generalized peritonitis,serum albumin-globin ra-tio,blood culture,and the number of failed organs and systems).The results indicate that theclinical principles of treatment for ACST should be the combination of medical and surgicaltreatment.Active conservative treatment is practically applicable to the majority of ACST,espe-cially,those with short history and few complication.Prognostic mathematical model of ACSTdoes good for its timing selection of emergency operation.A critical level of 0.40 is determinedto be the discriminant score for emergency bile duct drainage.The model seems to have advan-tages over the traditional method.     

临床医学专业研究生预防医学教育现状与对策研究

医学模式和健康观念的转变迫切需要大量具备预防医学知识和技能的高层次临床医学专业人才.本文分析了临床医学专业研究生预防医学教育的现状及其存在的问题,并提出了相应的对策以强化临床医学专业研究生的预防医学素质,进而不断适应"预防为主"的战略需求.

Abstract：

With the transformation of medical model and health concept, a large number of high level clinical medical professionals with prevention medicine knowledge are needed. The paper analyzed the situation and existing problems of preventive medicine education for clinical medical postgraduates, and put forward countermeasures accordingly to strengthen the prevention medicine quality of clinical medical postgraduate to adapt the "prevention first" strategy requirement.     

医学生传染病防治知识技能现状及影响因素调查分析

为了解医学生传染病防治知识技能现状及其影响因素,本研究随机抽取预防医学和临床医学专业毕业生114人,调查分析医学生主干课程平均成绩、医学微生物成绩、传染病学成绩、流行病学成绩、传染病实习时间及传染病知识技能掌握情况。结果显示预防医学专业学生知识技能得分(26.490±1.030)高于临床医学专业学生得分(21.730±1.400)(P<0.05),影响医学生知识技能得分的因素有主干课程平均成绩和传染病实习时间(P<0.05)。说明医学生传染病防治知识技能掌握情况不容乐观,医学生的主干课程平均成绩和传染病实习时间为传染病知识技能掌握的促进因素。     

预防医学专业学生现场实践技能培养中存在问题及对策分析

当前高等医学院对预防医学专业学生实践技能培养存在诸多不足之处：混淆实践技能与应急技能,教学内容与形式及师资力量不能满足实践技能培养需要。应提升专业教师自身实践技能水平、利用各种科研活动提供学生接触实践的机会、及时跟踪公共卫生领域发展动态、充分利用毕业实习机会、重视社区卫生服务相关技能培养。     

医学类专业学生统计学态度现状调查及相关影响因素分析

目的 调查高校医学类专业学生的统计学态度现状,探讨其影响因素,并分析统计学态度与统计学课程成绩的相关性,为探索教学改革方向和提升教学效果提供科学依据。 方法 以教育部直属某综合性大学医学院2018~2019学年开设医学统计学的学生为研究对象,使用汉化版的统计学态度调查量表(SATS-36)作为测量工具,量表各条目均以Likert 7分法计分,得分越高代表态度越积极。通过问卷星平台进行在线调查,调查结果采用SPSS软件进行统计分析。 结果 共有776名学生完成调查,总量表条目均分为4.84±0.64;分维度统计,努力程度得分最高(6.41±0.85),其次是价值判断(5.93±0.88),得分最低的维度为难度评价(2.73±0.77);性别、学历层次、专业和数学背景是影响统计学态度的主要因素,量表得分男生高于女生,研究生高于本科生,临床专业和公共卫生/卫生管理专业高于其他专业;数学成绩自评等级越高者统计学态度越积极;课程成绩与统计学态度呈正相关,但相关程度属弱相关(Spearman相关系数为0.227,P<0.001)。 结论 医学生的统计学态度属中等偏上积极性,尤其在努力程度和价值判断方面,积极性最高,但存在明显的畏难情绪;态度积极性与统计学课程成绩呈正相关。进行医学统计学教学时,应针对不同性别、不同专业和不同层次医学生的学习障碍,采取不同的应对措施,改革教学方法,以达到帮助学生提高积极性进而提高学业成绩的目的。     

新乡医学院1998年级至2000年级医学生临床技能水平分析

目的探讨实习生考研与临床技能学习的关系,以提高医学生临床技能水平。方法采用包括病史采集、体格检查、基本技能操作、辅助检查和病例分析等同一方法对新乡医学院1998年级、1999年级、2000年级实习生进行临床技能考核,并对3个年级实习生考取研究生者临床技能考核情况进行统计分析。结果1998年级、1999年级、2000年级实习生临床技能考试的平均分分别为84.0分、73.2分、80.4分,1998年级、2000年级平均分无明显差异(P>0.05),均高于1999年级的平均分(P<0.05);3个年级中临床技能考试85.0分以上的比例,1998年级明显高于1999年级(P<0.01),1998年级与2000年级比较无明显差异(P>0.05)。1998年级、1999年级、2000年级实习生考取研究生者临床技能考试的平均分分别为85.54分、73.09分、83.56分,1998年级、2000年级平均分无明显差异(P>0.05),均高于1999年级的平均分(P<0.05);3个年级中临床技能考试85分以上的比例,1998年级明显高于1999年级(P<0.01),1998年级与2000年级比较无明显差异(P>0.05)。考取研究生者与其他实习生比较考试成绩无明显变化。结论1999年级实习生临床技能考试成绩明显低于1998年级和2000年级;3个年级实习生考取研究生者未影响临床技能学习。通过采取行之有效的措施,可以很好地解决考研与临床技能培训的问题。     

贵州某医学院校农村订单定向医学生学习适应状况调查

目的 探讨贵州某医学院校农村订单定向医学生学习适应状况及特点,为有效提高其学习适应水平提供理论依据。 方法 采用大学生学习适应量表,从学习动机、学习态度、学习能力、教学模式、环境因素5个维度对602名农村订单定向医学生进行问卷调查、数据统计、聚类分析。 结果 农村订单定向医学生学习适应总分值为3.26±0.46,高于中等临界值。学习适应总分值及学习态度、教学模式、环境因素维度上女生分值高于男生(P＜0.05);环境因素维度上城市生源学生分值高于农村生源学生,独生子女学生高于非独生子女学生(P＜0.05);学习态度维度上非独生子女学生分值高于独生子女学生(P＜0.05);学习适应总分值及学习动机、学习态度、学习能力和教学模式维度上分值无不及格记录学生高于有不及格记录学生(P＜0.05)。按年级分组,学习适应总分值及学习动机、学习态度、学习能力维度上1、2、3年级学生分值高于4年级学生(P＜0.05),其中3年级学生最高。 结论 农村订单定向医学生学习适应总体上表现良好,不同年级、性别、家庭环境及有无不及格记录的学生在学习适应上存在差异,医学院校应针对不同年级学生制定相应的辅导计划,针对不同性别、不同家庭环境及有无不及格记录的学生给予相应的学习指导和生活帮助,有效提高学生学习适应水平。      

湖南某三级甲等综合医院护士人文执业能力现状及影响因素：基于1196例问卷调查

目的 了解湖南省某三级甲等综合医院护士人文执业能力现状,分析其影响因素,为进一步进行人文执业能力干预提供依据。方法 应用自制一般资料问卷及护士人文执业能力测评量表问卷调查1196名护士人文关怀实践能力、心理调适能力、人际沟通能力、自我管理能力、伦理与法律实践能力5个维度的人文执业能力现状,并采用描述性分析、单因素及多因素分析方法分别探讨影响人文职业能力可能的影响因素。结果 1196名护士人文执业能力总分均分为105.69±16.45（量表满分为130分）,人文关怀实践能力、心理调适能力、人际沟通能力、自我管理能力、伦理与法律实践能力各维度均分分别为40.95±6.46、16.41±2.66、16.41±2.66、11.32±2.05、12.43±2.00分。单因素分析及多元线性回归分析结果显示,性别（P=0.033）、年龄（P<0.001）、科室（P=0.015）、工作年限（P<0.001）、职称（P<0.001）、第一学历（P<0.001）、最高学历（P<0.001）、家庭所在地（P=0.010）、婚姻状况（P=0.023）、照顾患者数量（P=0.022...     

医学生内科临床见习专科带教模式的探索

目的：为了探索医学生内科学临床见习带教模式。方法：2000年级和2001年级医学生临床专业294名和预防专业的130名,临床和预防专业各分为2组,（1）专科带教模式组：临床148名,预防68名;（2）大内科带教模式组：临床146名,预防62名。结果：专科带教模式组的临床医学专业学生的轮科成绩为84．7±3．5分,明显高于大内科带教模式组（82．8±6．8分,P〈0．05）;预防医学专业学生的轮科成绩为82．6±4．9分,明显高于大内科带教模式组（80．9±2．7分,P〈0．05）。结论：专科带教模式优于大内科带教模式。     

护理专业毕业生临床沟通能力现状及影响因素研究

目的:为了解护理专业毕业生临床沟通能力现状,探索有效的临床沟通能力培养模式。方法:采用匿名调查方式,以黄山职业技术学院2016届全部护理专业毕业生为调查对象,调查问卷主要包括调查对象的基本情况、护士沟通能力量表和对临床沟通能力培养相关问题的比较。结果:毕业生临床沟通能力最低评分105分,最高评分167分,平均评分为（140.58±8.85）分,每个条目平均评分（2.34±0.26）分。对本专业不同兴趣者、在校不同课程加权平均分者和参加护患沟通讲座不同频次者临床沟通能力总评分及各维度评分比较,差异均有统计学意义（P<0.01）。有兴趣评分显著高于一般和没兴趣（P<0.01）,一般显著高于没兴趣（P<0.01）;≥80分者显著高于>70~<80分和≤70分者（P<0.01）,>70~<80分显著高于≤70分者（P<0.01）;参加护患沟通讲座频次≥4次/年和2~3次/年显著高于≤1次/年（P<0.01）。护士人格特质E-外向型和L-说谎与护生的沟通能力成正相关（P<0.05）,N-神经质和P-精神质与护生的沟通能力成负相关（P<0.05）。多元回归分析显示,对本专业兴趣越高、参加护患沟通讲座次数越多,外向型性格者,是护生沟通能力的保护因素,而神经质和精神质性格是护生沟通能力的危险因素。结论:应尽早培养学生的专业兴趣,加强其临床沟通能力学习意识;注重临床实践教学,采用多种教学方式相结合培养学生的沟通能力;同时加强医学教育改革,增加人文课程,培养积极乐观的性格,逐渐增加护生的临床沟通能力。     

反恐演习对预防医学专业学生应急能力培养的启发

目的探讨如何培养预防医学专业学生的应急能力。方法通过开展反恐演习,使预防医学专业学生亲身经历突发公共卫生事件。结果学生了解了常见的生物和化学毒剂的种类、毒性特点、防治措施,学会了如何在事故现场抢救伤员、运送伤员、处理现场,还懂得了突发公共卫生事件的处理原则和程序。结论反恐演习对应急型公共卫生人才的培养具有很大的作用。     

医学研究生拖延行为与焦虑抑郁情绪的相关分析

目的 探讨医学研究生拖延行为与焦虑、抑郁情绪的相关性,以便有效开展心理卫生工作.方法 随机抽取中南大学医学研究生423名,以拖延行为问卷(GPS)、焦虑自评量表(SAS)、抑郁自评量表(SDS)进行测评.结果 医学研究生拖延得分为(54.92±8.40)分,拖延率为60.99%,年级间拖延得分[(53.31±8.21)分,(55.90±8.30)分,(55.75±8.49)分,P=0.013]及拖延率(52.60%,66.09%,65.58%,P=0.028)均差异有统计学意义;焦虑、抑郁总粗分得分均高于国内常模[(31.24±7.40)分,(29.78±10.07)分.P=0.000;(34.89±8.11)分,(33.46±8.55)分,P=0.000),差异均有统计学意义;拖延行为与焦虑、抑郁情绪均呈显著正相关(r=0.304,P=0.000;r=0.369,P:0.000),相关性随年级增长而减弱,高拖延组、低拖延组和行为正常组焦虑情绪[(46.6±10.55)分,(44.01±10.12)分,(38.32±7.57)分,P=0.000]、抑郁情绪[(51.45±10.12)分,(47.81±10.78)分,(40.69±8.23)分,P=0.000]均差异有统计学意义.结论 医学研究生焦虑、抑郁情绪较突出,与拖延行为密切相关,应予高度重视并加强心理健康教育.