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1.
Context  The decentralization of clinical teaching networks over the past decade calls for a systematic way to record the case-mix of patients, the severity of diseases, and the diagnostic procedures that medical students encounter in clinical clerkships. Objective  To demonstrate a system that documents medical students' clinical experiences across clerkships. Design and Settings  Evaluation of a method for recording student-patient clinical encounters using a pocket-sized computer-read patient encounter card at a US university hospital and its 16 teaching affiliates during academic years 1997-1998 through 1999-2000. Participants  A total of 647 third-year medical students who completed patient encounter cards in 3 clerkships: family medicine, pediatrics, and internal medicine. Main Outcome Measures  Number of patient encounters, principal and secondary diagnoses, severity of diseases, and diagnostic procedures as recorded on patient encounter cards; concordance of patient encounter card data with medical records. Results  Students completed 86 011 patient encounter cards: 48 367 cards by 582 students in family medicine, 22 604 cards by 469 students in pediatrics, and 15 040 cards by 531 students in internal medicine. Significant differences were found in students' case-mix of patients, the level of disease severity, and the number of diagnostic procedures performed across the 3 clerkships. Stability of the findings within each clerkship across 3 academic years and the 77% concordance of students' reports of principal diagnosis with faculty's confirmation of diagnosis support the reliability and validity of the findings. Conclusions  An instrument that facilitates students' documentation of clinical experiences can provide data on important differences among students' clerkship experiences. Data from this instrument can be used to assess the nature of students' clinical education.   相似文献   

2.
目的 探索与传统科室轮转实习相比,纵向整合临床实习(longitudinal integrated clerkship,LIC)模式是否更有利于提升临床医学专业学生的岗位胜任力及实习满意程度。方法 选取2018年6月至2019年6月在哈尔滨医科大学附属第一医院进行毕业实习的72名学生,分为试验组和对照组,每组36名学生。试验组采用LIC模式,对照组采用传统科室轮转临床实习。实习结束后,对两组学生进行岗位胜任力评价。学生通过客观测试进行医学理论知识及临床基本能力评价,学生本人及带教教师对学生岗位胜任力其他五项进行评分。此外,对两组学生进行实习安排满意度问卷调查。采用SPSS 23.0统计软件进行t检验和卡方检验。结果 客观测试及学生自评显示,试验组学生的医学理论知识、临床基本能力、医学职业精神、医患沟通能力、团队合作能力、文献检索能力、科研能力得分分别为(8.02±1.11)(7.63±0.90)(7.74±0.56)(8.10±1.06)(7.84±0.62)(6.25±0.60)(4.26±0.88),均明显高于对照组的(7.50±0.97)(6.93±0.73)(7.31±0.78)(7.22±0.60)(7.11±0.69)(4.78±0.84)(2.46±1.20),差异有统计学意义(P<0.05)。试验组带教教师评价其医学职业精神、医患沟通能力、团队合作能力、文献检索能力、科研能力得分分别为(8.03±0.74)(7.95±0.73)(7.96±0.75)(4.84±0.84)(4.53±1.03),高于对照组的(6.59±0.70)(6.87±0.67)(6.95±0.69)(3.30±0.69)(2.70±1.05),差异有统计学意义(P<0.01)。试验组对课程安排满意度、师生互动满意度、自身提升满意度、临床工作顺畅度四方面分数分别为(7.17±0.91)(7.08±0.69)(7.28±0.45)(7.72±0.82),高于对照组的(6.56±0.84)(6.28±0.82)(6.36±0.49),(6.81±0.71),差异有统计学意义(P<0.01)。结论 与传统科室轮转实习模式相比,LIC模式更有助于提高临床医学专业学生的岗位胜任力,有望成为取代传统科室轮转的新型临床实习模式。  相似文献   

3.
目的 调查医学硕士研究生撰写的综述质量问题,为提升该群体撰写的医学综述的质量提供参考。方法 收集2018年至2022年上海交通大学医学院各附属医院在读医学硕士研究生撰写的141篇医学综述,从综述选题、写作表达维度评估撰写质量。综述选题采用自行设计的选题创新性调查问卷(以下简称“选题问卷”)收集外审专家的评价;写作表达依据相关文献提示的综述评价标准,考查综述的提纲、参考文献时效性、分析评价及文本质量问题。采用EPIDATA 3.2录入数据,采用SPSS 20.0进行卡方检验。结果 本研究共回收有效选题问卷135份(96%,135/141),结果提示70%(94/135)的综述选题缺乏新意。写作表达调查结果提示,95%(128/135)的综述参考文献陈旧,68%(92/135)的综述提纲缺乏重点、层次或逻辑,占比均分别高于分析及评价(59%,80/135)和文本质量问题(61%,83/135),差异有统计学意义(P<0.05)。结论 医学硕士研究生撰写的医学综述存在选题创新性不足、提纲总体质量偏低等问题,学校及导师首先应加强与综述选题相关的创新思维指导方面的教学,同时也应重视科研分析、科研逻辑等科研写作表达的相关培训,从而提高医学硕士研究生相应的科研能力。  相似文献   

4.
Objectives:To quantify the prevalence of primary dysmenorrhea, study its associated factors, and to assess its effect on the quality of life of female medical students.Methods:A cross-sectional study was conducted among 376 female medical students at King Saud University student campus and King Khalid University Hospital (KKUH), Riyadh, Saudi Arabia, between September 2017 and May 2018. The study was conducted using a consecutive, non-random sampling technique.Results:The prevalence of primary dysmenorrhea among female medical students was 80.1%; most of the participants (n=134) reported moderate pain (49.8%). Primary dysmenorrhea was significantly associated with caffeine consumption (p<0.05) and did not show an association with factors, body mass index, diet, lack of physical activity, and smoking. Among the SF-36 domains, the 4 domains physical health (p<0.001) and emotional health (p=0.01) including health changes (p=0.033) and pain (p<0.001) were statistically significantly affected by dysmenorrhea. Primary dysmenorrhea also had a significant impact on the students’ academic performance where a higher proportion of students suffering from primary dysmenorrhea showed negative effects on their attendance, concentration, study time, and participation in class.Conclusion:Most female medical students suffer from primary dysmenorrhea, which adversely affects their quality of life and academic performance. Caffeine consumption demonstrated a significant association with primary dysmenorrhea. Periodical awareness programs to minimize the consequences of primary dysmenorrhea should be introduced.  相似文献   

5.
Abstract

Background: Experiences of sexual violence among women can lead to ill health and increase the risk of lifetime co-occurrence of violence. Identifying risk factors and victims facilitates development of effective programmes for treatment and prevention of additional violence. The primary aim of this study was to assess the prevalence and correlates of sexual violence experiences among women seeking care at a family planning unit in Sweden. A secondary aim was to examine associations between sexual violence and other types of violence.

Methods: Women (n?=?1226) seeking services at a family planning unit, Uppsala University Hospital, Sweden, answered a questionnaire and were interviewed about experiences of sexual violence. Bivariate associations were examined using the chi-square test.

Results: Experiences of sexual violence were reported by 27% of the participants, of which 57% were exposed when they were younger than 18 years old. Women with experiences of sexual violence were more likely to have lower education (P?=?0.024), were students or without occupation (P?=?0.037), and were not in a current relationship (P?<?0.001). Women with experiences of non-partner sexual violence were more likely to have experiences of intimate partner violence (P?<?0.001).

Conclusion: Prevalence of sexual violence was high among the respondents. Many women were young when they were exposed to violence, and lifetime co-occurrence of violence was common among women with experiences of non-partner sexual violence.  相似文献   

6.
Objectives:To estimate the prevalence of internet gaming disorder (IGD) among King Saud University (KSU), Riyadh, Saudi Arabia medical students and to determine the association of IGD with gender, age, academic achievement, amount of sleep, and accommodation.Methods:We conducted a cross-sectional study between October 2019 and April 2020 on KSU medical students with a sample size of 281 medical students currently studying at KSU chosen by a stratified proportionate random sampling. The questionnaire contained the IGD short scale and questions eliciting demographic data.Results:The sample comprised of 228 responses. The prevalence of IGD was 8.8% (n=20), while 19.3% (n=44) of the participants were risky gamers. There was a significant association (p=0.0040) between IGD and gender, with 10.1% (n = 15) of males having IGD compared to 6.3% (n=5) of females. Additionally, 25% (n = 37) of males were risky gamers, as compared to 8.8% (n=7) of females.Conclusion:There is a high prevalence of internet gaming disorder among KSU medical students, with higher frequency among males. However, there was no significant association between this disorder and age, sleep, academic achievement, or accommodation.  相似文献   

7.
目的探讨多种形式病历书写教学在医学生岗前培训中的应用效果。方法制作多种形式的电脑文字讲解、图文并茂画面和多媒体故事化的病历书写规范课件,以讲解协和“三宝”、名人病历、名家病历、首例病例、疑难病例、病案历史和病案管理故事为主题,对2011年、2012年、2013年医院新上岗的大专生、大学生和研究生,以及甘肃省中医学院的实习学生和见习学生共300名进行岗前培训,让医学生在岗前培训中就懂得“病历书写是每一位医生的基本功”的道理。结果2011年卷面成绩以60分,80分居多,2012年卷面成绩以70分-90分居多,2013年卷面成绩以80分~1013分居多。经X^2检验:分数3年相比,P〈0.01,说明学生成绩有明显提高。多媒体故事化病历书写规范课件成为医学生岗前培训课程中最受欢迎的课件。结论多媒体故事化病历书写规范课件应用于医学生岗前培训,弥补了单纯文字讲解和规章制度解析的枯燥,能够使医学生通过每一个病案故事的情景画面,充分认识到“一份好的病案就是一本好的教科书”。  相似文献   

8.
目的 探讨大学生自杀意念与社会支持和生命质量之间的相关性。 方法 采用分层整群随机抽样方法对重庆市9 808名在校大学生进行问卷调查,了解重庆市在校大学生自杀意念的发生情况,并通过多元相关分析探讨大学生自杀意念与社会支持和生命质量之间的关系。 结果 重庆市大学生自杀意念的报告率为13.04%,女生、文科学生、有宗教信仰和有自杀未遂史的大学生自杀意念的发生率较高(分别为16.39%、15.09%、15.05%和68.64%);有自杀意念的大学生在社会支持总分、客观支持、主观支持、对支持的利用度以及生命质量总分、躯体健康状况、心理健康状况、经济状况、工作状况、与家人关系、与他人关系方面均低于无自杀意念大学生(P<0.01);大学生自杀意念与社会支持因子的主观支持(r=-0.100,P<0.01)、对支持的利用度呈负相关(r=-0.094,P<0.01),与生命质量因子的躯体健康状况(r=-0.127,P<0.01)、心理健康状况(r=-0.067,P<0.01)和经济状况(r=-0.081,P<0.01)呈负相关。 结论 重庆市大学生自杀意念的发生率较高。社会、家庭、学校应重视大学生心理健康,完善大学生的社会支持系统,并采取综合干预措施,预防大学生自杀意念和自杀行为的发生。  相似文献   

9.
国外医学信息学领域研究前沿   总被引:1,自引:2,他引:1       下载免费PDF全文
利用BICOMB、VOSviewer、SPSS等分析软件,以PubMed数据库中医学信息学领域核心期刊2010-2014年的科技文献为数据来源,绘制共现网络图、热点密度图和聚类树图,探测国外医学信息学领域研究前沿,研究显示国外医学信息学领域的研究前沿主要包括电子健康档案的自然语言处理和数据挖掘,医疗决策帮助系统,计算机辅助的药物治疗,临床决策支持,医疗保健的态度、质量和模式,病案系统及其联动,信息系统及其整合等。  相似文献   

10.
使用中国知网的知识图谱可视化分析系统,通过关键词共现网络和文献共被引分析的方法,从情报分析的角度探讨近年来国内医学期刊微信公众平台的应用现状和热点,分析存在的问题,提出改进的对策和建议,为加强医学期刊微信平台建设提供参考。  相似文献   

11.
目的 以“新医科”为背景构建以“育人为驱动力—立德树人为核心”的全过程育人路径,为医学院校人文素质教育改革与创新发展,提供决策依据。方法 以齐齐哈尔医学院五年制临床医学(大一至大五)学生为研究对象,利用文献分析等方法构建临床医学生人文素质评价模型和调查问卷。通过问卷星平台对临床医学本科生采取随机抽样进行调研和数据收集工作。采用SPSS 26.0软件进行卡方检验,探讨构建全过程育人的路径。结果 实证调研对医学生人文素养培育情况的医学生人文态度评分均值为(3.47±0.75)分。从性别上来看,男生人文认知、态度、行为评分为2.81分、3.68分和3.22分,全部高于女生的2.52分、3.22分和2.95分,且差异有统计学意义(P<0.05)。从大一到大五年级数据显示:人文认知、态度、行为评分均呈现出年级升高而递增的趋势,运用“知信行 (Knowledge,Attitude/Belief,Practice,KAP)”模型发现医学生对人文素养认知率较为理想,不同年级医学生知晓率不同,并利用交叉分析去研究学校对医学生开展的思想品德和政治素养教育效果与多选题的交叉关系,呈现出显著性。结论 临床医学生人文素质有待提高,培育医学人文素养需贯穿大一至大五的全过程,从而提高职业能力的综合培养,促进医学生的全面发展。  相似文献   

12.
BackgroundFor the past 30 years, there has been a steady increase in the number of female physicians, but the relationship between their romantic lives and their pattern of training has been inadequately reported. This study was designed to investigate the interrelationships between medical training, quality of life, and the attitudes that female residents have toward romance.MethodsOf the 106 female medical residents at our medical center in 2009, a total of 78 residents (73.6%) were enrolled for the study. Structured questionnaires (Cronbach α = 0.878), which included questions about female resident quality of life, attitude toward spousal choice, and the impact of programmed professional medical training, were self-administered through an anonymous process.ResultsFemale residents, especially ward-care specialists, were determined to have excessively long working hours (84.6% > 88 work hours/week), insufficient and irregular sleep (44.9%), and inadequate personal time (73.1% < 24 hours/week) on average. Of the 48 residents with ongoing romances, 87.5% (n = 40) of romantic partners were physicians and 58.3% (n = 28) initiated their relationships when they were medical students, but exhibited no preferential dating of senior medical students or physicians. Factors affecting the choice of spouses included time limitations, a limited circle of friends, differences in values, and work-related stress. Those presumptive factors influencing romance between the assumed partner being a doctor or a “nondoctor” were significantly different with regard to lack of time (p = 0.002), values (p < 0.001), work-related stress (p < 0.001), and family background (p = 0.004).ConclusionRomance and quality of life were significantly influenced by the pattern of medical training in female residents. Setting duty-hour limits and initiating a new hobby were determined to be potentially beneficial to their quality of life and attitudes toward romance.  相似文献   

13.
目的 探讨改进版Mini-CEX在八年制《皮肤性病学》见习教学中的应用。方法 2019至2020年在中山大学附属第三医院八年制《皮肤性病学》见习教学中,58名学生在见习前、中、后期,分别接受改进版Mini-CEX评估各1次。具体改进内容体现在细化各项评估指标,其中病史采集方面包括皮疹的动态变化、有鉴别诊断意义的阴性症状和既往史/个人史/家族史等重要病史;体格检查方面包括皮疹专科情况、系统体格检查和有鉴别诊断意义的阴性体征;人文关怀方面包括关爱患者、健康教育和隐私保护;临床判断方面包括诊断、鉴别诊断和治疗原则;沟通技巧方面包括熟练程度、主次分明和肢体语言;组织效能方面包括时间分配、患者依从性和准备工作;整体表现方面包括镇定流畅、书写整洁和初步的临床思维。采用SPSS 20.0进行t检验。结果 58名八年制学生见习中、后期时的临床综合能力测评成绩均有提高,各个子项评估,后期与前期比较,评分均有提高(P<0.001);其中皮疹的动态变化、皮疹专科情况(皮疹的辨别与描述)等具有专科特色。结论 改进版Mini-CEX是一种客观、全面、简洁、高效的评估工具,符合《皮肤性病学》教学改革和实践的需求。  相似文献   

14.
Background:Hyperbaric oxygen treatment (HBOT) has been demonstrated to influence the keloid recurrence rate after surgery and to relieve keloid symptoms and other pathological processes in keloids. To explore the mechanism of the effect of HBOT on keloids, tumor immune gene expression and immune cell infiltration were studied in this work.Methods:From February 2021 to April 2021, HBOT was carried out on keloid patients four times before surgery. Keloid tissue samples were collected and divided into an HBOT group (keloid with HBOT before surgery [HK] group, n = 6) and a non-HBOT group (K group, n = 6). Tumor gene expression was analyzed with an Oncomine Immune Response Research Assay kit. Data were mined with R package. The differentially expressed genes between the groups were compared. Hub genes between the groups were determined and verified with Quantitative Real-time PCR. Immune cell infiltration was analyzed based on CIBERSORT deconvolution algorithm analysis of gene expression and verified with immunohistochemistry (IHC).Results:Inflammatory cell infiltration was reduced in the HK group. There were 178 upregulated genes and 217 downregulated genes. Ten hub genes were identified, including Integrin Subunit Alpha M (ITGAM), interleukin (IL)-4, IL-6, IL-2, Protein Tyrosine Phosphatase Receptor Type C (PTPRC), CD86, transforming growth factor (TGF), CD80, CTLA4, and IL-10. CD80, ITGAM, IL-4, and PTPRC with significantly downregulated expression were identified. IL-10 and IL-2 were upregulated in the HK group but without a significant difference. Infiltration differences of CD8 lymphocyte T cells, CD4 lymphocyte T-activated memory cells, and dendritic resting cells were identified with gene CIBERSORT deconvolution algorithm analysis. Infiltration levels of CD4 lymphocyte T cell in the HK group were significantly higher than those of the K group in IHC verification.Conclusion:HBOT affected tumor gene expression and immune cell infiltration in keloids. CD4 lymphocyte T cell, especially activated memory CD4+T, might be the key regulatory immune cell, and its related gene expression needs further study.  相似文献   

15.
BackgroundMutations in the TREX1 and NOTCH3 genes cause retinal vasculopathy with cerebral leukodystrophy (RVCL) and cerebral autosomal dominant arteriopathy with subcortical infarcts and leukoencephalopathy (CADASIL), respectively. Both are hereditary small vessel diseases of the brain (HSVDB).MethodsWe performed mutational analyses of TREX1 in genomic DNA from 39 unrelated patients who were NOTCH3-negative in genetic testing, selected out of 72 unrelated consecutive patients with HSVDB.ResultsOnly one patient had a TREX1 sequence variation, a heterozygous TREX1 c.294dupA, putatively resulting in a truncated protein, p.C99MfsX3. The medical history of the patient's family was scrutinized, which revealed that heterozygous TREX1 p.C99MfsX3 was not segregating with the HSVDB. Re-examination of the NOTCH3 sequence data of the proband led to the identification of a homozygous NOTCH3 c.1630C>T (p.R544C) mutation, which segregated with the HSVDB in the family. The proband had a slightly more severe phenotype in comparison with her heterozygous p.R544C sister.ConclusionTREX1 mutation is not a common cause of HSVDB. TREX1 p.C99MfsX3 is not a dominant mutation. Homozygosity of the NOTCH3 p.R544C has a modestly deleterious effect on the CADASIL phenotype. The NOTCH3 mutation may cause CADASIL through a gain-of-toxic function effect, which can be modified by other genetic or environmental factors and results in the phenotypic variation of CADASIL.  相似文献   

16.
Objective: Medical science students, especially nursing students, are more likely to experience academic stress; therefore, resilience helps them focus on their lessons attentively. However, the results of a few existing studies regarding how resilience impacts the academic performance of medical science students are incongruent. This study aimed to investigate whether resilience impacts the academic performance of Japanese nursing students.Methods: We conducted a cross-sectional, self-administered questionnaire survey from September to November 2020. A total of 229 undergraduate nursing students participated in this study; here, resilience was measured using the Bidimensional Resilience Scale, which includes innate factors (optimism, control, sociability, and vitality) and acquired factors (problem-solving, self-understanding, and understanding others). Academic performance was measured using the functional grade point average (f-GPA). Covariates were demographics, pre-entry academic performance levels, medical history, time spent walking, psychological distress, subjective economic status, and part-time jobs. Multivariate regression analyses were performed.Results: Among the 229 participants, the f-GPA mean (standard deviation) was 2.93 (0.46). Only vitality was significantly associated with a higher f-GPA after multiple imputations (β = 0.06; 95% confidence interval = 0.03–0.09; P<0.01). The Poisson regression analysis of 212 participants with all data indicated that vitality was associated with the fourth quartile f-GPA (prevalence ratio, 1.05; 95% confidence interval, 1.03–1.08; P<0.01).Conclusion: There was a significant association between the vitality of resilience components and academic performance among Japanese nursing students. This study suggests that an approach that develops resilience is necessary for the academic success of nursing students.  相似文献   

17.
[目的]通过古今医案云平台进行数据挖掘,分析中医药治疗儿童咳嗽变异性哮喘(CVA)的用药规律。[方法]全面检索自建库至2021年12月31日在中国生物医学文献服务系统(SinoMed)、中国知网(CNKI)、维普数据库(VIP)、万方数据知识服务平台(WanFang)中收录的中医药治疗儿童CVA的相关文献,将相关中药处方导入Excel2018并建立标准化数据库,最后通过古今医案云平台软件进行频数分析、中药属性分析、关联规则分析、聚类分析等数据挖掘处理,分析中医药治疗儿童CVA的用药规律。[结果]研究共纳入文献190篇,录入方剂214首,合计中药203味。频数分析显示排名前10位的中药分别为苦杏仁、甘草、炙麻黄、半夏、地龙、蝉蜕、紫苏子、黄芩、桔梗、五味子,药性以温居多,药味以辛为首,归经以肺、脾、胃、肝为主。关联规则分析得出药物配伍规律26条,演化得到核心组合4组。[结论]现代中医药治疗儿童CVA多选用辛温之品,从肺、脾、胃出发,采用宣肺、祛痰、降气、平喘之法。  相似文献   

18.
目的 探讨转谷氨酰胺酶4(transglutaminase 4, TGM4)在前列腺癌诊断及预后评价中的可能价值。 方法 对159例前列腺癌患者的存档石蜡标本行TGM4免疫组织化学染色;根据染色情况将TGM4表达水平分为4级:不表达,弱表达,中表达和高表达。通过查阅病历、调用我院前列腺癌随访数据库和电话随访等方式获得患者临床病理资料及随访信息;进而对TGM4表达水平与前列腺癌临床病理特征及预后信息的关系进行统计学分析。 结果 与癌旁组织相比,TGM4在前列腺癌组织中高表达(P<0.001),且表达水平在不同Gleason分级(P<0.001)和前列腺特异抗原(PSA)水平(P=0.005)间差异有统计学意义。单因素Cox回归分析提示TGM4高表达是前列腺癌生化复发的高危因素(P=0.020),但多因素Cox回归分析并不支持TGM4高表达是前列腺癌生化复发的高危因素(P=0.139)。 结论 TGM4在前列腺癌中高表达,且在高Gleason分级和高PSA水平的前列腺癌中表达更高,值得进一步研究。  相似文献   

19.
目的:观察酸敏感离子通道亚基3(ASIC3,又名ACCN3)基因敲除ASIC3-/-小鼠、香草酸瞬时受体亚型I(TRPV1)基因敲除TRPV1-/-小鼠的生存曲线,为进一步繁殖使用该品系小鼠提供参考。方法选用105只基因敲除小鼠,其中ASIC3-/-鼠44只,TRPV1-/-鼠61只。观察正常喂养两种小鼠500d以内的生存情况,并绘制生存曲线,进行生存分析。结果ASIC3-/-小鼠与TRPV1-/-小鼠随着时间的延长,生存概率降低,经比较TRPV1-/-小鼠的生存概率优于ASIC3-/-小鼠的生存概率,两种小鼠的生存时间存在统计学差异,(P=0.004,P<0.01),两种小鼠中不同性别之间的生存曲线无显著学差异。结论TRPV1-/-小鼠的生存概率优于ASIC3-/-小鼠的生存概率。而两种鼠不同性别之间的生存概率则基本相当。  相似文献   

20.
张阳  辛利红  潘发明 《安徽医学》2016,37(1):100-103
目的 了解某市职业学校医学生生存质量的现状及影响因素,为采取相应的干预措施提供依据。方法 采用按专业、年级进行分层整群抽样,抽取阜阳市3所职业学校在校医学生729名进行调查,问卷使用世界卫生组织生存质量简表。结果 职业学校医学生在生理、心理、环境领域与大学生存在差异(P<0.05);在生理、心理领域与常模存在差异(P<0.05)。性别、年级、学历、体育锻炼、居住环境等因素对生存质量某些维度的影响有显著性。结论 职业学校的医学生生存质量偏低,不同专业、年级、家庭人均收入、是否住校及体育锻炼情况可能影响生存质量总体评分,应根据相关因素采取有效措施改善职业学校医学生的生存质量。  相似文献   

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