Mediated smoking cessation programs in the Stanford five-city project

Two mediated smoking cessation programs were subjected to a field evaluation. The Quit Kit is a printed self-help package, and "Calling It Quits" consists of five segments which were aired on the local television news. A sample of 239 persons requested the Quit Kit and were followed. At the 2-month and 12-month follow-ups, respectively, 13.6% and 17.9% of those surveyed reported abstinence. Results indicate the potential of mediated interventions.     

Ejaculatory incompetence: a theoretical formulation and case illustration

Three theoretical formulations of ejaculatory incompetence have been proposed in the literature. They include: (1) aversive conditioned inhibition of the ejaculatory reflex, (2) an "autosexual" orientation associated with discrepant levels in the cognitive and physiological dimensions of sexual arousal, and (3) a discriminative learning model. These three models are discussed in relation to their theoretical and therapeutic implications. Clinical data supporting the discriminative view is presented.     

北京市13家中医综合医院住院医疗服务评价研究

目的建立中医综合医院住院医疗服务评价指标体系,对之进行评价,以明确优势与短板并针对性改进。方法通过文献分析法确定评价指标体系,运用层次分析法对指标权重进行赋值,利用改良TOPSIS法对北京市13家中医综合医院进行排名。结果综合排名前3的分别是E、B、D 三家中医综合医院。服务能力最强的为M医院,服务效率、医疗安全和数据质量最好的均为D医院,运营效益最优的为F医院,中医特色最强的为E医院。结论建立的指标体系能够对中医综合医院住院医疗服务进行客观评价,有利于医院持续改进,从而全面提高服务能力。     

两种DRGs指标体系的绩效评价效果比较研究

目的应用传统与新型DRGs指标体系进行绩效评价效果比较研究,探讨新型DRGs指标体系应用价值。方法基于某省大数据平台的31家三级综合公立医院DRGs资料,分别采用传统与新型DRGs指标体系对之进行综合绩效评价,采用Pearson检验对医院排名进行相关性分析,通过专家咨询法论证两种指标体系。结果31家医院排名均发生了变化,超过一半的医院排名变化幅度超过10名。两种DRGs指标体系的医院排名不存在显著相关性（相关系数为-0.348,P=0.057）,即在实际评价效果上存在较大差异。新型DRGs评价指标体系的应用价值优于传统型。结论相较于传统DRGs指标体系,新型DRGs指标体系严格把控区域医疗质量指标,通过强化学科评价与费用控制,重视患者医疗质量,使评价更为科学、全面。     

基于循证的预警性护理干预对儿童全身麻醉患者压疮的预防效果

目的探讨基于循证的预警性护理干预对儿童全身麻醉患者压疮的预防效果。方法选择2020年1月至2020年6月我院收治的全身麻醉患儿288例,随机分为两组各144例。对照组给予常规护理,观察组在对照组基础上给予基于循证的预警性护理干预。比较两组的压疮发生率以及护理满意度。结果观察组的压疮发生率为4.17%,显著低于对照组的11.11%(P<0.05)。观察组的护理满意度为98.61%,显著高于对照组的90.97%(P<0.05)。结论基于循证的预警性护理干预可以降低儿童全身麻醉患者的压疮发生率,提高护理满意度。     

Views of Dutch general practitioners about premenstrual symptoms: A qualitative interview study

BackgroundGeneral practitioners (GPs) encounter women suffering from premenstrual symptoms. Often women with premenstrual problems experience little understanding from GPs. Views of GPs will influence their approach to these women and their care. Insight into these views is lacking but could help in designing educational programmes for GPs.ObjectivesTo explore the views of Dutch GPs towards aetiology, diagnostic process, and preferred treatment of premenstrual symptoms.MethodsIn 2017, we conducted a qualitative, semi-structured, interview survey among 27 GPs, varying in age, gender, and practice setting.ResultsImportant themes emerged from the interviews: ‘no need for a symptom diary,’ ‘PMS defined as illness’ exclusively in case of disruption of normal functioning, and ‘symptomatic treatment’ as preferred approach. Most GPs considered PMS to be a physiological phenomenon, with taking history as an adequate diagnostic tool. Almost all GPs regarded a normal cyclical hormonal cycle as causal; many also mentioned the combination with personal sensitivity. Some pointed to a dividing line between physiological condition and illness if women could not function normally in daily life. Lastly, the approach GPs preferred was focussing on relieving symptoms of individual patients. In addition to explaining the hormonal cycle and lifestyle advice, all GPs advocated oral contraceptives, and if necessary psychological support. GPs expressed negative feelings about prescribing antidepressants.ConclusionGPs considered physiological changes and personal sensitivity as aetiological factors. We recommend more training to improve GPs knowledge and more insight into the burden of women with PMS. A symptom diary is an essential diagnostic tool for GPs.     

基于DRGs的医疗服务绩效差异分析:以二级综合医院为例

目的对成都市二级民营综合医院与公立综合医院住院医疗服务绩效进行DRGs分析和比较,找出差异,提出建议。方法收集2019年成都市二级民营综合医院和二级公立综合医院住院病案首页数据,利用四川省DRGs应用平台进行分组计算,使用SPSS 20.0软件进行指标分析。结果成都市二级民营综合医院与二级公立综合医院2019年住院医疗服务绩效在医疗服务（总权重、覆盖DRGs组数和CMI值）、医疗效率（时间消耗指数、费用消耗指数）上并无显著差异,但在医疗质量与安全（中低风险及以下组病死率、标化病死率）上差异明显。结论二级民营综合医院与二级公立综合医院整体医疗服务差距逐渐缩小;二级民营综合医院内部发展不均衡,医疗质量与安全水平低于二级公立综合医院。建议持续提升民营综合医院服务能力,加强民营综合医院医疗质量与安全管理,同时政府须对民营医院强化监管。     

综合行为干预对慢性阻塞性肺病患者生命质量的影响

目的观察综合行为干预对缓解期慢性阻塞性肺病(COPD)患者生命质量的影响.方法150例COPD患者分为治疗组和对照组,两组均给予常规药物治疗,治疗组增加综合行为干预措施,时间1年,分别在治疗前和1年后应用生命质量测评表评估患者生命质量变化.结果治疗组生命质量总分从2.3±0.4下降到1.59±0.3,日常生活能力评分由1.95±0.5降为1.43±0.3,社会活动评分由2.59±0.5降为1.63±0.5,抑郁心理评分由2.47±0.4降为1.59±0.3,焦虑心理评分由2.21±0.3降为1.78±0.2,对照组各项评分无明显改变.结论综合行为干预能改善COPD患者生命质量.     

推进整体护理提高护理质量

介绍了四川省以点带面开展整体护理的做法,取得的成效,存在的问题与对策,并提出了下一步的工作目标与计划设想.要求转变观念,加强培训;保证人力配备,提高综合素质.     

开展社区卫生服务 促进基层医院发展

论述了开展社区卫生服务的必要性,提出开展社区卫生服务是基层医院和乡镇卫生院摆脱困境,取得新的发展的一条重要途径。在此基础上指出,开展社区卫生服务需要政府的高度重视和有关部门的大力支持;需要合理的区域规划,防止卫生资源的浪费;需要花大气力培养全科医生,提高业务素质;需要提高认识,转变观念,增强服务功能;需要加强管理,拓展服务范围,规范服务方式。