TH.E PLACE OF MISSION HOSPITALS AND MEDICAL SCHOOLS IN THE NATIONAL HEALTH PROGRAMME OF CHINA

In the Canton Hospital there hangs a unique painting of Doctor Peter Parker, the pioneer medical missionary to China. It shows him with Kwan Ato, the young assistant whom he chose to teach as an apprentice. The painting is far more than a portrait; it is a symbol of the way in which, through these years of the century ending in 1935, the medical missionary has conceived it to be his duty and his oppor- tunity, not merely to dispense medicines for the relief of the sick, but unceasingly to train workers who should be able to carry on the work commenced by him. In a very real sense, therefore, the hundredth anniversary of the beginning of hospital work in Canton is also the centenary of moclern medical education in China. No other spirit could possibly actuate the modern man who views his task on any permanent basis. He must reproduce himself if his life and activity are to last. It is natural, therefore, that, over and again through the yeais, as one hospital cornerstone after another has been laid, the chief address of the day has laid emphasis on the fact that this new building was to be a place for healing, a place for teaching and, so far as pos- sible, a place for inquiry into the causes of disease. The three go hand in hand     

Associations of sense of coherence with psychological distress and quality of life in inflammatory bowel disease

AIM: To investigate the relationship between sense of coherence, psychological distress and health related quality of life in inflammatory bowel disease (IBD).METHODS: This cross-sectional study enrolled a consecutive sample of 147 IBD (aged 45.1 ± 14.1 years; 57.1% female) patients recruited from a tertiary gastroenterology service. Sixty-four participants met diagnostic criteria for Crohn’s disease, while eighty-three patients had ulcerative colitis. Socio-demographic data (education, age, race, gender, gross monthly income and marital status), disease-related variables (illness activity, relapse rate in past 2 years, history of surgery and time since diagnosis), sense of coherence (Antonovsky’s SOC scale), psychological distress symptoms (Hospital Anxiety and Depression Scale) and health-related quality of life (HRQoL; WHOQOL-Bref) were assessed. Hierarchical multiple regression analyses were performed to identify factors that are independently associated with psychological distress and HRQoL in patients with IBD and to provide indications for possible moderating or mediating effects. In addition, formal moderation and mediation analyses (Sobel tests) were performed to confirm potential moderators/mediators of the relationship between SOC, psychological distress symptoms and HRQoL.RESULTS: Lower SOC scores (std beta= -0.504; P < 0.001), female gender (std beta = 0.176; P = 0.021) and White race (std beta = 0.164; P = 0.033) were independently associated with higher levels of depressive symptoms, while lower levels of SOC (std beta = -0.438; P < 0.001) and higher relapse rate (std beta = 0.161; P = 0.033) were independently associated with more severe anxiety symptoms. A significant interaction between time since diagnosis and SOC was found with regard to the severity of depressive or anxiety symptoms, as the interaction term (time since diagnosis X SOC) had beta coefficients of -0.191 (P = 0.009) and -0.172 (P = 0.026), respectively. Lower levels of anxiety symptoms (std beta = -0.369; P < 0.001), higher levels of SOC (std beta = 0.231; P = 0.016) and non-White race (std beta = -0.229; P = 0.006), i.e., mixed-race, which represented the reference category, were independently associated with higher levels of overall HRQoL. Anxiety symptoms were the most potent independent correlate of most aspects of HRQoL. In addition, anxiety mediated the association between SOC and satisfaction with health, as well as its relationship with physical, mental, and social relations HRQoL. Depressive symptoms also mediated the association between SOC and mental HRQoL.CONCLUSION: Our data indicated that SOC is an important construct, as it influences psychological distress and has significant albeit indirect effects on several HRQoL domains in IBD.