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61.
62.
APEC 医院认证工作会议(CHICAGO)综述 总被引:3,自引:1,他引:3
从建立国家医疗质量评估项目的优先发展战略;APEC成员国在医疗质量评估上的经验及合作状况;如何建立与完善质量评估标准;评估对执业机构与人员的价值与影响;建立评估体系的跨地域协作等方面介绍了亚太经济合作组织医院认证工作大会的概况。 相似文献
63.
目的:对早期自然流产与人绒毛膜促性腺激素HCG的关系进行探索研究,以加强HCG对孕妇妊娠预测作用的认识.方法:在我院选取2007年5月--2009年8月的早期自然流产孕妇50例作为实验组,另外选取正常早期妊娠孕妇50例作为对照组,对两组的血清HCG进行统计分析.结果:实验组与对照组在HCG水平上存在显著差异,早期自然流产孕妇的血清HCG明显低于正常早期妊娠的对照组的血清HCG水平.结论:测定母体中血液或尿液中的HCG水平极其变化有助于诊断和鉴别早期流产,具有一定的早期预测效果. 相似文献
64.
中药保留灌肠治疗溃疡性结肠炎疗效的系统评价 总被引:4,自引:0,他引:4
目的评价中药保留灌肠治疗溃疡性结肠炎的疗效。方法应用国际Cochrane协作网系统评价方法,对中药保留灌肠治疗溃疡性结肠炎的随机对照试验(RCT)进行系统评价。计算机检索(1995~2005年)EMBASE、中国生物医学文献数据库、中国期刊网等。手工检索发表与未发表的文献,纳入中药与传统西药治疗措施相比较的随机对照试验,统计学处理采用Cochrane协作网的Rev Man 4.2软件。结果共纳入23个RCT试验。短期结果显示中药灌肠组比对照组的疗效好,8个RCT结果显示中药灌肠组有效率(92.8%)高于口服柳氮磺吡啶组(89.9%),3个RCT结果显示中药灌肠组有效率(93.1%)高于庆大霉素加皮质激素灌肠组(71.6%),4个RCT结果显示中药灌肠组有效率(94.2%)高于柳氮磺吡啶加皮质激素组(74.9%)。中药灌肠治疗未发现明显不良反应。结论该研究所纳入试验的方法学质量均较低,虽显示中药灌肠疗法在改善溃疡性结肠炎近期临床疗效指标方面优于常规西药疗法,但因无评价远期疗效的试验,尚不能对其疗效得出可靠的结论。 相似文献
65.
Carolyn E. Schwartz Jie Zhang Bruce D. Rapkin Joel A. Finkelstein 《The spine journal》2019,19(4):726-734
Background Context
Underlying cognitive factors have been found to influence patients’ symptom experience. Current evidence suggests that concomitant changes in appraisal must be taken into account to accurately interpret change as measured by standard spine patient-reported outcomes (PROs).Purpose
To investigate changes in patients’ minimally important differences (MID) over recovery from spinal surgery; whether and how cognitive appraisal processes are implicated in the change trajectories.Study Design/Setting
Longitudinal cohort study with up to 12 months follow-up.Patient Sample
Surgical patients (n?=?167) with a diagnosis of disc herniation or spinal stenosis.Outcome Measures
Standard spine patient-reported PROs were used (Rand-36, Oswestry Disability Index, Numerical Rating Scale for pain, PROMIS Pain Impact).Methods
This study was funded by the Feldberg Chair in Spinal Research, Sunnybrook Health Sciences Centre and the authors have no conflicts of interest. MID used an anchor technique and was computed by global assessment of change (GAC) grouping. Participants were binned into groups based on their GAC response patterns at all time points: Consistently better post-surgery, consistently worse post-surgery, and bouncers, whose GAC ratings fluctuate (ie, better-then-worse-then-better; or vice versa). Individuals’ longitudinal quality of life (QOL) and appraisal slope scores were computed. QOL-appraisal slopes’ correlations were computed by GAC group. Fisher's Z transformation tested the hypothesis that GAC groups differed in the QOL-appraisal relationship over time.Results
Moderate to large changes are recognized as clinically important in the early stages of recovery (ie, 6 weeks post-surgery), and over time smaller and smaller changes become important. The three pattern groups emphasized and deemphasized different standards of comparison over time, with the Better group emphasizing personal goals and the Worse and Bouncers deemphasizing doctors’ input. These group differences translated to differential relationships between PRO change and appraisal changes over time.Conclusions
The MID reflects increasingly subtle change over time in PROs. Appraisal may influence how patients experience the same (MID) change over time, with better outcomes associated with emphasizing long-term goals. PRO change seems to be driven by different standards of comparison. Potential avenues for clinical intervention are discussed. 相似文献66.
This study evaluates the influence of different factors in the adaptation process activated by uncertainty in illness on health-related quality of life. The sample included 100 women (mean age = 52.1 years) receiving treatment for newly diagnosed (M=52.1 months) gynaecological cancer (38 cervical, 26 ovarian, 24 endometrial, 7 uterine, 4 vulvar, and 1 vaginal). Stepwise regression analyses identified mood states, ambiguity about illness-wellness state, dangerfocused appraisal and mastery as key predictors of four health-related quality of life scores. The variance accounted for by those variables is reflected in cumulative multipleR
2 of 0.56 for total quality of life score, 0.57 for psychosocial well-being, 0.235 for physical well-being and 0.25 for disease/symptom distress. These variances do not reflect the contribution of age, time since diagnosis, metastasis and stage of cancer which were forced to enter the regression equation first. The latter set of variables accounted for a smaller portion of the variance in health-related quality of life (R
2=0.03–0.195). Coping strategy did not predict health-related quality of life. These findings provide beginning support for conceptualizing health-related quality of life as the outcome of an adaptation process explained by the uncertainty in illness theory. However, uncertainty in illness theory may not be sufficient to predict quality of life outcomes. Future research should consider the addition of discrepancy theory to guide the selection or development of a health-related quality of life measure, to account for the perceived discrepancy between actual experience and expected well-being.This study was supported by NCNR Grant No. 3NR011030451, Coping with Uncertainty in Gynaecological Cancer; by DRR Grant No. RR06014, Biomedical Research Support Grant. 相似文献
67.
姜立耿庆山 《中国卫生质量管理》2021,(10):042-45
国家三级公立医院绩效考核是对医院综合质量的检阅,对公立医院发展具有指挥棒作用。广东省人民医院通过建立绩效考核三级管理机制,对标公立医院绩效考核评分细则,实施精细化管控,促进医院绩效考核相关指标改进。在医疗质量、运行效率、可持续发展和满意度评价4个维度中均实现了提升。为促进医院高质量发展,建议强化绩效考核意识,完善绩效考核管理机制;制定“大规划、大战略”,持续优化考核效果。 相似文献
68.
董旻晔宋可玉施贞夙李国红 《中国卫生质量管理》2022,(8):015-19
目的从医务人员视角评价国家公立医院绩效考核政策执行效果。方法采用多阶段随机抽样法,从我国东部、中部、西部3个地区各随机抽取一个省级行政区,再从每个省级行政区选取2019年度国家三级公立医院绩效考核结果为一般、良好、优秀的各一家三级公立医院,进行医务人员政策执行效果评价调查。采用主成分分析法拟合综合评分进行多指标评价,多元线性回归分析影响政策执行效果评价的因素。结果共调查了13 211名医务人员。医务人员认为国考政策在规范个人诊疗行为(94.28%),提升信息化程度(93.13%),改善医患关系(92.39%),保障医疗安全(92.02%),提高诊疗效率(91.73%)等方面具有良好效果。年龄、最高学历、专业技术职称、行政管理职务、从事专业类别、地区、绩效考核等级以及建立奖惩机制显著影响国考政策执行效果评价(P<0.05)。结论国考政策执行效果良好,绩效考核等级和医院建立奖惩机制对政策执行效果评价产生积极影响。但存在医务人员个体及地区差异,医疗机构应结合地区特点和绩效考核结果反馈,从利益相关者角度出发建立政策共同体,推动绩效考核走向绩效管理。 相似文献
69.
医学人才素质评估方法研究 总被引:3,自引:0,他引:3
文章以医学人才基本素质为切入点,研究医学人才基本素质群体与群体、群体与个体、个体与个体之间的差异,且从差异中寻找与其成才的关系,以期建立一种医学人才基本素质较为客观的评估方法。同时,通过此项研究揭示医学人才成长的一般规律和相关影响因素,为有的放矢地设计育才方案提供依据。 相似文献
70.