The aim of our study is to evaluate the knowledge regarding physical medicine and rehabilitation among physicians in training and medical students at the Mohammed VI University Hospital in Marrakech, to approach the k...The aim of our study is to evaluate the knowledge regarding physical medicine and rehabilitation among physicians in training and medical students at the Mohammed VI University Hospital in Marrakech, to approach the knowledge, attitudes, and practices of doctors regarding physical medicine and rehabilitation and evaluate the knowledge in theoretical training related to PRM among the students. We conducted a monocentric cross-sectional analytical study, using a web-based anonymous survey, carried out among 558 undergraduate student and training doctors, randomly selected in the form of a survey on the knowledge towards Physical Medicine and rehabilitation. We received 558 survey duly completed by students of the Faculty of Medicine and Pharmacy of Marrakech (62.4%) and training doctors (37.6%). The mean age of the participants was 24.53 ± 3.9 years, with extremes ranging from 17 to 39 years. 52.7% of the participants were from the former educational reform, The predominance of participation was remarkable among pediatricians 23%, The population who knew PRM was the majority (79.3%), 40.7% of the participants were unaware of the availability of a PRM department at Mohamed VI University Hospital, 0.5% of all training doctors and medical students questioned strongly agreed with the sufficiency of their training in disability management were belonging to the new reform, 84.1% of participants had never attended or referred a patient to the PRM department. 23.2% of training doctors affirmed the referral of patients to PRM for further management. Despite the essential role of PRM in the management of diseases, it remains little known by training doctors and medical students. This lack of knowledge of PRM reflects the lack of the undergraduate and postgraduate of the medical education in the field of rehabilitation.展开更多
Objective: To explore the application effect of flipped classroom combined with problem-based learning teaching method in clinical skills teaching of standardized training for resident doctors of traditional Chinese M...Objective: To explore the application effect of flipped classroom combined with problem-based learning teaching method in clinical skills teaching of standardized training for resident doctors of traditional Chinese Medicine. Methods: The study used the experimental control method. The study lasted from September to November 2022. The subjects of this study were 49 students of standardized training for resident doctors of traditional Chinese Medicine from grades 2020, 2021 and 2022 of Dazhou integrated TCM & Western Medicine Hospital. They were randomly divided into experiment group (25) and control group (24). The experiment group adopted flipped classroom combined with problem-based learning teaching method, and the control group adopted traditional teaching method. The teaching content was 4 basic clinical skill projects, including four diagnoses of traditional Chinese Medicine, cardiopulmonary resuscitation, dressing change procedure, acupuncture and massage. The evaluation method was carried out by comparing the students’ performance and a self-designed questionnaire was used to investigate the students’ evaluation of the teaching method. Results: The test scores of total scores in the experimental group (90.12 ± 5.89) were all higher than those in the control group (81.47 ± 7.96) (t = 4.53, P P Conclusions: The teaching process of the flipped classroom combined with problem-based learning teaching method is conducive to improving the efficiency of classroom teaching, cultivating students’ self-learning ability, and enhancing students’ willingness to learn.展开更多
Background Burn-out among doctors threatens their own health, and that of their patients. To identify risk factors of the doctor burn-out is vital to improving their health and increasing the quality of healthcare s...Background Burn-out among doctors threatens their own health, and that of their patients. To identify risk factors of the doctor burn-out is vital to improving their health and increasing the quality of healthcare services. This study aims to explore the relationship between work-family confict （WFC） and burn-out among Chinese doctors and the mediating role of coping styles in this relationship.Methods A cross-sectional survey was conducted in China, with a questionnaire packet which consisted of the Chinese Maslach Burnout Inventory （CMBI）, WFC Scale and the Simplifed Coping Style Questionnaire （SCSQ）. A total of 2530 doctors participated in the survey. Correlation analysis was performed to explore the relationship between CMBI, WFC and SCSQ scores. A linear regression model was set to determine the mediating role of coping styles on the relationship between WFC and burn-out.Results Doctors who had higher scores on work interfering with family confict, reported more emotional exhaustion （r=0.514, P〈0.001） and had a sense of accomplishment （r= 0.149, P〈0.001）. Simultaneously, family interfering with work （FIW） was positively associated with all dimensions of burn-out （r=0.213, 0.504, 0.088, respectively, P〈0.001）. Coping styles had partial, complete and even mediating effects on the relationship between WFC and burn-out among Chinese doctors.Conclusions WFC was correlated with burn-out, and coping style was a mediator in this relationship among Chinese doctors. Coping style was a positive resource against burn-out.展开更多
Medical graduates are not fully trained physicians when they leave medical school.Currently,standardized training for resident doctors in most hospitals in China is carried out according to the Ministry of Health guid...Medical graduates are not fully trained physicians when they leave medical school.Currently,standardized training for resident doctors in most hospitals in China is carried out according to the Ministry of Health guidelines.However,these guidelines provide only outline guidance,and specific resident training is managed independently by and varies with individual institutions.Therefore,it is important to study training demand to learn about the content and emphasis of training.展开更多
To investigate the role of sleep quality and psychosocial problems as predictors of functional gastrointestinal disorders (FGIDs) in doctors that work 24 hour-on-call shifts.METHODSIn this cross-sectional observation ...To investigate the role of sleep quality and psychosocial problems as predictors of functional gastrointestinal disorders (FGIDs) in doctors that work 24 hour-on-call shifts.METHODSIn this cross-sectional observation study, using the Rome III Questionnaire and Pittsburgh Sleep Quality Index (PSQI), we analyzed 170 doctors with 24 hour-on-call shifts.RESULTSAmong the participants that had experienced a 24 hour-on-call shift within the last 6 mo, 48 (28.2%) had FGIDs. Overall prevalence of irritable bowel syndrome (IBS) and functional dyspepsia (FD) were 16.5% and 17.1%, respectively, with 5.3% exhibiting both. Sleep scores (PSQI) (8.79 ± 2.71 vs 7.30 ± 3.43, P = 0.008), the presence of serious psychosocial alarm (83.3% vs 56.6%, P = 0.004), and the proportion of doctors who experienced over two months of recent on-call work (81.2% vs 68.9%, P = 0.044) were significantly different between individuals with or without FGIDs. Multivariate analysis revealed that presenting serious psychosocial alarm was an independent risk factor for prevalence of FD (OR = 5.47, 95%CI: 1.06-28.15, P = 0.042) and poor sleep quality (PSQI ≥ 6) was a predictor of IBS (OR = 4.17, 95%CI: 1.92-19.02, P = 0.016).CONCLUSIONPhysicians should recognize the role of sleep impairment and psychological stress in the development of FGIDs and a comprehensive approach should be considered to manage patients with FGIDs.展开更多
Many health professionals in Vietnam have limited knowledge and experience in coordinating care for victims of Domestic Violence (DV). This qualitative study aimed to elicit the beliefs of nurses and doctors that are ...Many health professionals in Vietnam have limited knowledge and experience in coordinating care for victims of Domestic Violence (DV). This qualitative study aimed to elicit the beliefs of nurses and doctors that are influencing the care of victims of DV. Data were collected by semi-structured interviews with nineteen nurses and doctors. Data were analyzed by content analysis and organized by three main themes;behavioral beliefs, normative beliefs and control beliefs. The outcomes of this study will inform the development of intervention strategies that will enable health professionals to better respond to and manage care for women who experience domestic violence in Vietnam.展开更多
Township and Village Health Services Integration Management（TVHSIM） is an essential form of China＇s two-tiered health service integration plan at the township and village level. Its main purpose, also one of the ta...Township and Village Health Services Integration Management（TVHSIM） is an essential form of China＇s two-tiered health service integration plan at the township and village level. Its main purpose, also one of the target goals in China＇s new healthcare reform, is to gradually integrate rural health services and appropriately allocate rural health resources. This study aims to assess the village doctors＇ satisfaction with the TVHSIM and provide scientific base to further improve TVHSIM. A cross-sectional study was carried out in which 162 village doctors from Qinghai, Inner Mongolia and Xinjiang in western China were interviewed. Descriptive analysis, independent t-test, one-way ANOVA, Spearman rank correlation and multiple linear regression were used to analyze the difference and relevance between village doctors＇ personal characteristics and their satisfaction with TVHSIM and six subscales. Village doctors with different years of practice, social insurance status and essential medical knowledge level showed statistically significant differences in their satisfaction levels（all P〈0.05）. Age（P〈0.05） and years of practice（P〈0.01） were negatively correlated with Drug and Medical Device Management and Financing Management. Essential medical knowledge level（P〈0.05） was negatively correlated with Operations Management as well. However, social insurance status（P〈0.05） was positively correlated with Human Resources Management and Drug and Medical Device management. Gender, age and years of practice respectively had significant influence on village doctors＇ satisfaction with TVHSIM（P〈0.01）. In conclusion, in order to further promote TVHSIM policy in rural China, a well-rounded social insurance model for village doctors is urgently needed. In addition, the development of TVHSIM is regionally imbalanced. Efficient and effective measures aiming at rationalizing gender and age structure and enhancing essential medical training should be carefully considered.展开更多
This paper provides an overview of research into mental health problem and occupational stress among Chinese doctors in recent 10 years. It indicates that doctors in general hospitals have worse mental status. Occupat...This paper provides an overview of research into mental health problem and occupational stress among Chinese doctors in recent 10 years. It indicates that doctors in general hospitals have worse mental status. Occupational stress comes from over workload, high demanding from patients, occupational risk, effort-reward imbalance and fierce competition for job promotion. For medical staffs battling against severe acute respiratory syndrome (SARS), or working in catastrophic Wenchuan earthquake-affected areas, they have elevated stress and worrying levels of psychological distress. Post-traumatic stress disorder (PTSD) is a common mental health problem among them. The most common diseases the Chinese doctors usually suffered were cervical spondylosis, hyperlipidemia, hypertension, fatty liver and hyperglycemia. It could be important for health administrators to note that mental health appears to be an?increasing problem in Chinese doctors and corresponding helping measure should be made.展开更多
Objectives: This paper examines the basic knowledge ofAIDS and HIV transmission through unsafe blood collec-tion and supply among rural Chinese doctors. It also ex-plores the accessibility of AIDS intervention methods...Objectives: This paper examines the basic knowledge ofAIDS and HIV transmission through unsafe blood collec-tion and supply among rural Chinese doctors. It also ex-plores the accessibility of AIDS intervention methods inrural area. Methods: We did Case studies, held focus group discus-sions and provided questionnaires to all rural doctors inone township where the epidemic of HIV was known to bespread through blood collection and supply. Data were col-lected and analyzed with software EPI 6.0.Results: The effective response rate to the questionnairewas 100%. The results showed that more than 95% of in-formants gave correct answers to the questions about thesexual and blood-bourne transmission of HIV as well as itscontagiousness. Half of the participants were ignorant aboutmother to child transmission of HIV and did not know thatHIV couldn’t be transmitted by saliva, sweat, mosquito bites,sharing of bathtubs or toilets. More than 80% of infor-mants were opposed to blood selling and reportedly under-stood the objective of the blood organizers in their villages,knew the peak time of blood selling by the villagers, and ,were aware of the risks of diseases being spread throughblood. . 27.3% used disposable syringes ‘once in a while’,and 15.2% discarded or sold used disposable syringes.Conclusions: The authors assert that there are severe lurk-ing perils of iatrogenic cross infection in rural areas. Ruraldoctors urgently need formal training on prevention andtreatment of HIV infection. We believe that rural doctorsshould become the key force in AIDS prevention and con-trol in rural area.展开更多
Background: Work agencies that assign temporary jobs to doctors and nurses are becoming an increasing phenomenon. Aim: The purpose of this pilot study was to explore how consultant doctors (CDs) experience their compe...Background: Work agencies that assign temporary jobs to doctors and nurses are becoming an increasing phenomenon. Aim: The purpose of this pilot study was to explore how consultant doctors (CDs) experience their competence as utilized in practice and what impact this has on their perceived psychosocial work environment. Methods: The findings are based on 11 interviews with CDs working on consultancy assignments in Norway. The CDs were all specialists in fields such as general practice, psychiatry, anesthesia, gynecology, orthopedics, and otolaryngology. Results: The competence that the CDs contributed to their hosting work organization was interpreted differently based on whether the consultant played an active role in the psychosocial work environment and also depended on the doctor’s specialty. Not being integrated into the hosting work organization enhanced the feeling of exclusion and the idea that little or no room was available to contribute one’s competence. Most of the CDs experienced their competence as being utilized to a certain extent, which strengthened their work satisfaction and feeling of playing an active role in the psychosocial work environment.展开更多
We make some efforts to find some connections between religion and medical science. Medical science can be regarded as sacred and holy as a religion for doctors to believe. The common points between them are the basis...We make some efforts to find some connections between religion and medical science. Medical science can be regarded as sacred and holy as a religion for doctors to believe. The common points between them are the basis to successfully integrate them into doctors' faith. Furthermore, we explain that doctors need a faith to believe so as to meet the demand of humanitarian traits we should have and to do better in the scientific work and win in the battles with the diseases.展开更多
Malaria is a major health problem in Nigeria that has as high as 25% of all global cases, and 30% of deaths attributable to malaria. In 2010, World Health Organization (WHO) recommended universal confirmation of diagn...Malaria is a major health problem in Nigeria that has as high as 25% of all global cases, and 30% of deaths attributable to malaria. In 2010, World Health Organization (WHO) recommended universal confirmation of diagnosis of malaria through blood parasitological test, prior to initiation of treatment. In addition to Microscopy, Malaria Rapid diagnostic Tests (mRDTs) are blood tests for malaria. Early diagnosis of malaria ensures that the correct treatment is commenced in good time, and this subsequently improves the prognosis. The objective of this study is to assess the use of mRDTs among medical doctors working in a tertiary hospital, Southeast Nigeria. This study was conducted in Enugu State Teaching hospital, Southeast Nigeria. The study was of cross-sectional design, and conducted in October 2016 among medical doctors working in the General Outpatient, Internal Medicine, and Paediatrics departments of the Teaching hospital. Statistical Package for Social Sciences (SPSS) version 20.0 was used for data analysis. A total of 86 medical doctors, out of the eligible 91 in the three departments participated in the study, and were distributed as follows;24 (27.9%) in the General Outpatient, 30 (34.9%) in the Internal Medicine, and 32 (37.2%) in the Paediatrics departments. More medical doctors in the Paediatrics department (31.3%) used mRDTs in making diagnosis of malaria, followed by Internal medicine (13.3%), then General Outpatient Department (8.3%). Malaria rapid diagnostic tests are cost-effective, and useful tools in malaria control and elimination programmes. If tangible progress on the implementation of the WHO guidelines on confirming diagnosis of malaria before treatment;and the T3: Test, Treat, Track initiative is to be made;then the government and the Management of hospitals ought to take more determined efforts aimed at educating and informing health workers, especially medical doctors on the benefits of mRDTs.展开更多
Malaria commonly causes fever in tropical Africa. In 2010, World Health Organization recommended parasitological diagnosis of malaria before treatment. Rapid Diagnostic Test (RDT) aims at making malaria diagnosis more...Malaria commonly causes fever in tropical Africa. In 2010, World Health Organization recommended parasitological diagnosis of malaria before treatment. Rapid Diagnostic Test (RDT) aims at making malaria diagnosis more accessible. The objective of this study was to assess knowledge, and perception of malaria rapid diagnostic test (mRDT), among doctors in a tertiary health facility. A descriptive, cross sectional study, conducted in October 2016, in a state University Teaching hospital, Enugu state, Nigeria. 86 doctors in the General Outpatient, Internal Medicine, and Paediatrics departments participated. 90.7% of respondents knew parasitological examination of blood is the certain method of making malaria diagnosis, 89.5% knew microscopy and RDT are methods for parasitological diagnosis, 91.9% knew mRDT is quick blood test for malaria, 54.7% knew mRDT is usually specific for one or more species of malaria, 46.5% knew mRDT detects circulating malaria parasite antigen, 29.1% knew mRDT is read 15 to 20 minutes after the test, 70.9% knew mRDT is not superior to microscopy, 79.1% knew mRDT is not 100% specific, 80.2% knew mRDT ought not be done always by Laboratory Scientists, and 66.3% knew more than one type of mRDT kit is available. On perception, 64.0% thought it was important to confirm diagnosis before commencing treatment, 90.7% perceived mRDT as being very useful, 96.5% did not perceive mRDT as endangering patients, 70.9% opinioned that presumptive diagnosis of malaria is not a better way of making diagnosis, 76.7% did not believe malaria diagnosis is always clear on listening to the patient, 90.7% did not perceive mRDT as being hazardous, 83.7% believe using mRDT can reduce the quantity of anti-malaria drugs consumed, and 94.2% opinioned that mRDT should be encouraged and promoted. Training and re-training of health workers shall greatly enhance mRDT use in implementing the WHO T3 Initiative, and ultimately eliminating malaria.展开更多
Background and objectives: The medical care that doctors receive is different than that of individuals who are not in the medical profession. The objective was to assess how family doctors in the Negev region chose th...Background and objectives: The medical care that doctors receive is different than that of individuals who are not in the medical profession. The objective was to assess how family doctors in the Negev region chose their own doctors. Methods: 103 family doctors in the southern region of Israel completed a self-administered, anonymous questionnaire that included sociodemographic data and how doctors choose their own doctors. Results: The study population included 103 family doctors with a mean age of 44.7±9.8, of them 65 women (63.1%). Most of the participants (69.9%) were born in the former Soviet Union and completed their medical studies there (71.8%). Thirty two (31.4%) were specialists in family medicine and 42 (41.2%) were residents in family medicine. For most of the participants the gender and age of their treating physician were not important (74.8% and 63.1%, respectively). The treating physician’s level of expertise was very important to 87.4%. Only half consulted a colleague before choosing a physician. Their personal connection to the treating physician was very important to 46 (44.7%). Female doctors were more likely to choose a female physician com-pared to males (P=0.025). Residents were more likely to consult a colleague than specialists before choosing a treating physician (P=0.023). Female doctors are more likely than male to care for themselves both for chronic and acute conditions. Conclusions: Choosing a treating physician is a subjective process with each doctor having individual requirements and ex-pectations. The factors that most influenced the choice of treating physician were professional skills and specialization.展开更多
Doctors＇ clothes have bidden farewell to the historical limitation of only being used as the working clothes, which have become an important part of hospital image. In the eyes of patients, the appearance image of do...Doctors＇ clothes have bidden farewell to the historical limitation of only being used as the working clothes, which have become an important part of hospital image. In the eyes of patients, the appearance image of doctors is the image which is most concerned by patients. Doctors＇ clothes beauty reflects the inner beauty of doctors in working, giving the patients the warmth and comfort, which is of great importance to both the physical and mental therapy.展开更多
<strong>Introduction:</strong> Burnout syndrome is prevalent to a great extent among medical residents, and this can interfere with their training and patient management. However, the extent of the problem...<strong>Introduction:</strong> Burnout syndrome is prevalent to a great extent among medical residents, and this can interfere with their training and patient management. However, the extent of the problem is still unknown in our setting. This study therefore aimed at determining prevalence and factors associated with burnout syndrome among resident doctors at tertiary teaching hospitals in Dar es Salaam, Tanzania. <strong>Method: </strong>A cross-sectional study of resident doctors was carried out in four teaching hospitals of Muhimbili University of Health and Allied Sciences between January 2021 and March 2021. Participants were interviewed using a structured questionnaire and Maslach Burnout Inventory. <strong>Results:</strong> The study had 398 participants with a mean age of 35 <span style="white-space:nowrap;">±</span> 3.5 years. Overall burnout prevalence was 33.7%, as for the burnout dimensions, 205 (51.5%) respondents reported burnout in the dimension of emotional exhaustion (EE), 177 (44.5%) in the dimension of depersonalization (D), and 144 (36.2%) in the dimension of reduced personal accomplishment (RPA). Independent factors associated with burnout syndrome were: inadequate support from residency program supervisors (Odds Ratio (OR) 1.97, 95% CI: 1.23 - 3.14, p = 0.005), work-related family conflicts (Odds Ratio (OR) 3.2, 95% CI: 1.35 - 7.71, p = 0.008), stressful call perception (Odds Ratio (OR) 3.31, 95% CI: 1.90 - 5.76, p = 0.001) and each added year of study (Odds Ratio (OR) 3.46, 95% CI: 1.08 - 6.73, p = 0.009). <strong>Conclusion: </strong>Burnout is a problem among resident doctors in Tanzania. This could be addressed by directing preventive and intervention measures in the residency training program. Periodic assessment is also needed to mitigate factors associated with burnout among resident doctors.展开更多
To analyze the herbal medicine prescribing patterns of contemporary famous old traditional Chinese medicine doctors in treating coronary heart disease,based on data mining technology,so as to provide useful insights i...To analyze the herbal medicine prescribing patterns of contemporary famous old traditional Chinese medicine doctors in treating coronary heart disease,based on data mining technology,so as to provide useful insights into the clinical practice.Methods:Databases,including Medline(January 1966 to December 2019),Wanfang(January 1982 to December 2019),VIP Database(January 1989 to December 2019),CNKI(January 1979 to December 2019),CBMdisc(January 1978 to December 2019),and Classic Case Collection from Contemporary Famous Old Traditional Chinese Medicine Doctors were searched,and 224 eligible studies involving 416 patients were entered into the case study database after data processing.Frequency analysis and association rule analysis were used to investigate the prescribing patterns of contemporary famous old traditional Chinese medicine doctors in treating coronary heart disease.Results:In total 290 kinds of Chinese herbal drugs and 19 core drugs were used in the cases studied.The most commonly used categories were“Qi-Tonifying Drugs”,“Blood-Activating Drugs”,and“Phlegm-Eliminating Drugs”.The association rule analysis identified 14 commonly used herbal pairs,19 three-drug combinations,and 1 four-drug combination.Conclusion:Contemporary famous old traditional Chinese medicine doctors considered warming heart yang as an extremely important approach to treat coronary heart disease based on Zhang Zhongjing’s treatment for chest painful obstruction caused by“Inactivity of Chest Yang”(blockade of phlegm turbidity).Both symptoms and root causes were addressed in the formulas prescribed by these doctors.“Tonifying Qi,Nourishing Yin,Activating Blood,and Eliminating Phlegm”were the most commonly used therapeutic methods for patients with coronary heart disease.展开更多
BEFORE Chinese medical teams were sent to Africa, to most Africans. China was a remote country that they had barely heard of. But through seeing and being treated by Chinese doctors Africans began to learn about China...BEFORE Chinese medical teams were sent to Africa, to most Africans. China was a remote country that they had barely heard of. But through seeing and being treated by Chinese doctors Africans began to learn about China and its people.展开更多
文摘The aim of our study is to evaluate the knowledge regarding physical medicine and rehabilitation among physicians in training and medical students at the Mohammed VI University Hospital in Marrakech, to approach the knowledge, attitudes, and practices of doctors regarding physical medicine and rehabilitation and evaluate the knowledge in theoretical training related to PRM among the students. We conducted a monocentric cross-sectional analytical study, using a web-based anonymous survey, carried out among 558 undergraduate student and training doctors, randomly selected in the form of a survey on the knowledge towards Physical Medicine and rehabilitation. We received 558 survey duly completed by students of the Faculty of Medicine and Pharmacy of Marrakech (62.4%) and training doctors (37.6%). The mean age of the participants was 24.53 ± 3.9 years, with extremes ranging from 17 to 39 years. 52.7% of the participants were from the former educational reform, The predominance of participation was remarkable among pediatricians 23%, The population who knew PRM was the majority (79.3%), 40.7% of the participants were unaware of the availability of a PRM department at Mohamed VI University Hospital, 0.5% of all training doctors and medical students questioned strongly agreed with the sufficiency of their training in disability management were belonging to the new reform, 84.1% of participants had never attended or referred a patient to the PRM department. 23.2% of training doctors affirmed the referral of patients to PRM for further management. Despite the essential role of PRM in the management of diseases, it remains little known by training doctors and medical students. This lack of knowledge of PRM reflects the lack of the undergraduate and postgraduate of the medical education in the field of rehabilitation.
文摘Objective: To explore the application effect of flipped classroom combined with problem-based learning teaching method in clinical skills teaching of standardized training for resident doctors of traditional Chinese Medicine. Methods: The study used the experimental control method. The study lasted from September to November 2022. The subjects of this study were 49 students of standardized training for resident doctors of traditional Chinese Medicine from grades 2020, 2021 and 2022 of Dazhou integrated TCM & Western Medicine Hospital. They were randomly divided into experiment group (25) and control group (24). The experiment group adopted flipped classroom combined with problem-based learning teaching method, and the control group adopted traditional teaching method. The teaching content was 4 basic clinical skill projects, including four diagnoses of traditional Chinese Medicine, cardiopulmonary resuscitation, dressing change procedure, acupuncture and massage. The evaluation method was carried out by comparing the students’ performance and a self-designed questionnaire was used to investigate the students’ evaluation of the teaching method. Results: The test scores of total scores in the experimental group (90.12 ± 5.89) were all higher than those in the control group (81.47 ± 7.96) (t = 4.53, P P Conclusions: The teaching process of the flipped classroom combined with problem-based learning teaching method is conducive to improving the efficiency of classroom teaching, cultivating students’ self-learning ability, and enhancing students’ willingness to learn.
基金special fund for public welfare industry of health grant(200802150)(JSYRKJ2010-C1-001Jiangsu Provincial Medical Humanities and Social Science committee(No:JSYRKJ2010-C1-001)+1 种基金Philosophy and Social Science Special Project in Nanjing Medical University(No:2013NJZS40)Key Project supported by Medical Science and Technology Development Foundation Nanjing Department of Healt(No.YKK17246,YKK16241)
文摘Background Burn-out among doctors threatens their own health, and that of their patients. To identify risk factors of the doctor burn-out is vital to improving their health and increasing the quality of healthcare services. This study aims to explore the relationship between work-family confict （WFC） and burn-out among Chinese doctors and the mediating role of coping styles in this relationship.Methods A cross-sectional survey was conducted in China, with a questionnaire packet which consisted of the Chinese Maslach Burnout Inventory （CMBI）, WFC Scale and the Simplifed Coping Style Questionnaire （SCSQ）. A total of 2530 doctors participated in the survey. Correlation analysis was performed to explore the relationship between CMBI, WFC and SCSQ scores. A linear regression model was set to determine the mediating role of coping styles on the relationship between WFC and burn-out.Results Doctors who had higher scores on work interfering with family confict, reported more emotional exhaustion （r=0.514, P〈0.001） and had a sense of accomplishment （r= 0.149, P〈0.001）. Simultaneously, family interfering with work （FIW） was positively associated with all dimensions of burn-out （r=0.213, 0.504, 0.088, respectively, P〈0.001）. Coping styles had partial, complete and even mediating effects on the relationship between WFC and burn-out among Chinese doctors.Conclusions WFC was correlated with burn-out, and coping style was a mediator in this relationship among Chinese doctors. Coping style was a positive resource against burn-out.
基金supported by the Qingdao City Public Science and Technology Support Program of Soft Science Research Project(11-2-3-75-(50)-zhc)
文摘Medical graduates are not fully trained physicians when they leave medical school.Currently,standardized training for resident doctors in most hospitals in China is carried out according to the Ministry of Health guidelines.However,these guidelines provide only outline guidance,and specific resident training is managed independently by and varies with individual institutions.Therefore,it is important to study training demand to learn about the content and emphasis of training.
文摘To investigate the role of sleep quality and psychosocial problems as predictors of functional gastrointestinal disorders (FGIDs) in doctors that work 24 hour-on-call shifts.METHODSIn this cross-sectional observation study, using the Rome III Questionnaire and Pittsburgh Sleep Quality Index (PSQI), we analyzed 170 doctors with 24 hour-on-call shifts.RESULTSAmong the participants that had experienced a 24 hour-on-call shift within the last 6 mo, 48 (28.2%) had FGIDs. Overall prevalence of irritable bowel syndrome (IBS) and functional dyspepsia (FD) were 16.5% and 17.1%, respectively, with 5.3% exhibiting both. Sleep scores (PSQI) (8.79 ± 2.71 vs 7.30 ± 3.43, P = 0.008), the presence of serious psychosocial alarm (83.3% vs 56.6%, P = 0.004), and the proportion of doctors who experienced over two months of recent on-call work (81.2% vs 68.9%, P = 0.044) were significantly different between individuals with or without FGIDs. Multivariate analysis revealed that presenting serious psychosocial alarm was an independent risk factor for prevalence of FD (OR = 5.47, 95%CI: 1.06-28.15, P = 0.042) and poor sleep quality (PSQI ≥ 6) was a predictor of IBS (OR = 4.17, 95%CI: 1.92-19.02, P = 0.016).CONCLUSIONPhysicians should recognize the role of sleep impairment and psychological stress in the development of FGIDs and a comprehensive approach should be considered to manage patients with FGIDs.
文摘Many health professionals in Vietnam have limited knowledge and experience in coordinating care for victims of Domestic Violence (DV). This qualitative study aimed to elicit the beliefs of nurses and doctors that are influencing the care of victims of DV. Data were collected by semi-structured interviews with nineteen nurses and doctors. Data were analyzed by content analysis and organized by three main themes;behavioral beliefs, normative beliefs and control beliefs. The outcomes of this study will inform the development of intervention strategies that will enable health professionals to better respond to and manage care for women who experience domestic violence in Vietnam.
基金supported by the National Natural Science Foundation of China(No.71273097)
文摘Township and Village Health Services Integration Management（TVHSIM） is an essential form of China＇s two-tiered health service integration plan at the township and village level. Its main purpose, also one of the target goals in China＇s new healthcare reform, is to gradually integrate rural health services and appropriately allocate rural health resources. This study aims to assess the village doctors＇ satisfaction with the TVHSIM and provide scientific base to further improve TVHSIM. A cross-sectional study was carried out in which 162 village doctors from Qinghai, Inner Mongolia and Xinjiang in western China were interviewed. Descriptive analysis, independent t-test, one-way ANOVA, Spearman rank correlation and multiple linear regression were used to analyze the difference and relevance between village doctors＇ personal characteristics and their satisfaction with TVHSIM and six subscales. Village doctors with different years of practice, social insurance status and essential medical knowledge level showed statistically significant differences in their satisfaction levels（all P〈0.05）. Age（P〈0.05） and years of practice（P〈0.01） were negatively correlated with Drug and Medical Device Management and Financing Management. Essential medical knowledge level（P〈0.05） was negatively correlated with Operations Management as well. However, social insurance status（P〈0.05） was positively correlated with Human Resources Management and Drug and Medical Device management. Gender, age and years of practice respectively had significant influence on village doctors＇ satisfaction with TVHSIM（P〈0.01）. In conclusion, in order to further promote TVHSIM policy in rural China, a well-rounded social insurance model for village doctors is urgently needed. In addition, the development of TVHSIM is regionally imbalanced. Efficient and effective measures aiming at rationalizing gender and age structure and enhancing essential medical training should be carefully considered.
文摘This paper provides an overview of research into mental health problem and occupational stress among Chinese doctors in recent 10 years. It indicates that doctors in general hospitals have worse mental status. Occupational stress comes from over workload, high demanding from patients, occupational risk, effort-reward imbalance and fierce competition for job promotion. For medical staffs battling against severe acute respiratory syndrome (SARS), or working in catastrophic Wenchuan earthquake-affected areas, they have elevated stress and worrying levels of psychological distress. Post-traumatic stress disorder (PTSD) is a common mental health problem among them. The most common diseases the Chinese doctors usually suffered were cervical spondylosis, hyperlipidemia, hypertension, fatty liver and hyperglycemia. It could be important for health administrators to note that mental health appears to be an?increasing problem in Chinese doctors and corresponding helping measure should be made.
文摘Objectives: This paper examines the basic knowledge ofAIDS and HIV transmission through unsafe blood collec-tion and supply among rural Chinese doctors. It also ex-plores the accessibility of AIDS intervention methods inrural area. Methods: We did Case studies, held focus group discus-sions and provided questionnaires to all rural doctors inone township where the epidemic of HIV was known to bespread through blood collection and supply. Data were col-lected and analyzed with software EPI 6.0.Results: The effective response rate to the questionnairewas 100%. The results showed that more than 95% of in-formants gave correct answers to the questions about thesexual and blood-bourne transmission of HIV as well as itscontagiousness. Half of the participants were ignorant aboutmother to child transmission of HIV and did not know thatHIV couldn’t be transmitted by saliva, sweat, mosquito bites,sharing of bathtubs or toilets. More than 80% of infor-mants were opposed to blood selling and reportedly under-stood the objective of the blood organizers in their villages,knew the peak time of blood selling by the villagers, and ,were aware of the risks of diseases being spread throughblood. . 27.3% used disposable syringes ‘once in a while’,and 15.2% discarded or sold used disposable syringes.Conclusions: The authors assert that there are severe lurk-ing perils of iatrogenic cross infection in rural areas. Ruraldoctors urgently need formal training on prevention andtreatment of HIV infection. We believe that rural doctorsshould become the key force in AIDS prevention and con-trol in rural area.
文摘Background: Work agencies that assign temporary jobs to doctors and nurses are becoming an increasing phenomenon. Aim: The purpose of this pilot study was to explore how consultant doctors (CDs) experience their competence as utilized in practice and what impact this has on their perceived psychosocial work environment. Methods: The findings are based on 11 interviews with CDs working on consultancy assignments in Norway. The CDs were all specialists in fields such as general practice, psychiatry, anesthesia, gynecology, orthopedics, and otolaryngology. Results: The competence that the CDs contributed to their hosting work organization was interpreted differently based on whether the consultant played an active role in the psychosocial work environment and also depended on the doctor’s specialty. Not being integrated into the hosting work organization enhanced the feeling of exclusion and the idea that little or no room was available to contribute one’s competence. Most of the CDs experienced their competence as being utilized to a certain extent, which strengthened their work satisfaction and feeling of playing an active role in the psychosocial work environment.
文摘We make some efforts to find some connections between religion and medical science. Medical science can be regarded as sacred and holy as a religion for doctors to believe. The common points between them are the basis to successfully integrate them into doctors' faith. Furthermore, we explain that doctors need a faith to believe so as to meet the demand of humanitarian traits we should have and to do better in the scientific work and win in the battles with the diseases.
文摘Malaria is a major health problem in Nigeria that has as high as 25% of all global cases, and 30% of deaths attributable to malaria. In 2010, World Health Organization (WHO) recommended universal confirmation of diagnosis of malaria through blood parasitological test, prior to initiation of treatment. In addition to Microscopy, Malaria Rapid diagnostic Tests (mRDTs) are blood tests for malaria. Early diagnosis of malaria ensures that the correct treatment is commenced in good time, and this subsequently improves the prognosis. The objective of this study is to assess the use of mRDTs among medical doctors working in a tertiary hospital, Southeast Nigeria. This study was conducted in Enugu State Teaching hospital, Southeast Nigeria. The study was of cross-sectional design, and conducted in October 2016 among medical doctors working in the General Outpatient, Internal Medicine, and Paediatrics departments of the Teaching hospital. Statistical Package for Social Sciences (SPSS) version 20.0 was used for data analysis. A total of 86 medical doctors, out of the eligible 91 in the three departments participated in the study, and were distributed as follows;24 (27.9%) in the General Outpatient, 30 (34.9%) in the Internal Medicine, and 32 (37.2%) in the Paediatrics departments. More medical doctors in the Paediatrics department (31.3%) used mRDTs in making diagnosis of malaria, followed by Internal medicine (13.3%), then General Outpatient Department (8.3%). Malaria rapid diagnostic tests are cost-effective, and useful tools in malaria control and elimination programmes. If tangible progress on the implementation of the WHO guidelines on confirming diagnosis of malaria before treatment;and the T3: Test, Treat, Track initiative is to be made;then the government and the Management of hospitals ought to take more determined efforts aimed at educating and informing health workers, especially medical doctors on the benefits of mRDTs.
文摘Malaria commonly causes fever in tropical Africa. In 2010, World Health Organization recommended parasitological diagnosis of malaria before treatment. Rapid Diagnostic Test (RDT) aims at making malaria diagnosis more accessible. The objective of this study was to assess knowledge, and perception of malaria rapid diagnostic test (mRDT), among doctors in a tertiary health facility. A descriptive, cross sectional study, conducted in October 2016, in a state University Teaching hospital, Enugu state, Nigeria. 86 doctors in the General Outpatient, Internal Medicine, and Paediatrics departments participated. 90.7% of respondents knew parasitological examination of blood is the certain method of making malaria diagnosis, 89.5% knew microscopy and RDT are methods for parasitological diagnosis, 91.9% knew mRDT is quick blood test for malaria, 54.7% knew mRDT is usually specific for one or more species of malaria, 46.5% knew mRDT detects circulating malaria parasite antigen, 29.1% knew mRDT is read 15 to 20 minutes after the test, 70.9% knew mRDT is not superior to microscopy, 79.1% knew mRDT is not 100% specific, 80.2% knew mRDT ought not be done always by Laboratory Scientists, and 66.3% knew more than one type of mRDT kit is available. On perception, 64.0% thought it was important to confirm diagnosis before commencing treatment, 90.7% perceived mRDT as being very useful, 96.5% did not perceive mRDT as endangering patients, 70.9% opinioned that presumptive diagnosis of malaria is not a better way of making diagnosis, 76.7% did not believe malaria diagnosis is always clear on listening to the patient, 90.7% did not perceive mRDT as being hazardous, 83.7% believe using mRDT can reduce the quantity of anti-malaria drugs consumed, and 94.2% opinioned that mRDT should be encouraged and promoted. Training and re-training of health workers shall greatly enhance mRDT use in implementing the WHO T3 Initiative, and ultimately eliminating malaria.
文摘Background and objectives: The medical care that doctors receive is different than that of individuals who are not in the medical profession. The objective was to assess how family doctors in the Negev region chose their own doctors. Methods: 103 family doctors in the southern region of Israel completed a self-administered, anonymous questionnaire that included sociodemographic data and how doctors choose their own doctors. Results: The study population included 103 family doctors with a mean age of 44.7±9.8, of them 65 women (63.1%). Most of the participants (69.9%) were born in the former Soviet Union and completed their medical studies there (71.8%). Thirty two (31.4%) were specialists in family medicine and 42 (41.2%) were residents in family medicine. For most of the participants the gender and age of their treating physician were not important (74.8% and 63.1%, respectively). The treating physician’s level of expertise was very important to 87.4%. Only half consulted a colleague before choosing a physician. Their personal connection to the treating physician was very important to 46 (44.7%). Female doctors were more likely to choose a female physician com-pared to males (P=0.025). Residents were more likely to consult a colleague than specialists before choosing a treating physician (P=0.023). Female doctors are more likely than male to care for themselves both for chronic and acute conditions. Conclusions: Choosing a treating physician is a subjective process with each doctor having individual requirements and ex-pectations. The factors that most influenced the choice of treating physician were professional skills and specialization.
文摘Doctors＇ clothes have bidden farewell to the historical limitation of only being used as the working clothes, which have become an important part of hospital image. In the eyes of patients, the appearance image of doctors is the image which is most concerned by patients. Doctors＇ clothes beauty reflects the inner beauty of doctors in working, giving the patients the warmth and comfort, which is of great importance to both the physical and mental therapy.
文摘<strong>Introduction:</strong> Burnout syndrome is prevalent to a great extent among medical residents, and this can interfere with their training and patient management. However, the extent of the problem is still unknown in our setting. This study therefore aimed at determining prevalence and factors associated with burnout syndrome among resident doctors at tertiary teaching hospitals in Dar es Salaam, Tanzania. <strong>Method: </strong>A cross-sectional study of resident doctors was carried out in four teaching hospitals of Muhimbili University of Health and Allied Sciences between January 2021 and March 2021. Participants were interviewed using a structured questionnaire and Maslach Burnout Inventory. <strong>Results:</strong> The study had 398 participants with a mean age of 35 <span style="white-space:nowrap;">±</span> 3.5 years. Overall burnout prevalence was 33.7%, as for the burnout dimensions, 205 (51.5%) respondents reported burnout in the dimension of emotional exhaustion (EE), 177 (44.5%) in the dimension of depersonalization (D), and 144 (36.2%) in the dimension of reduced personal accomplishment (RPA). Independent factors associated with burnout syndrome were: inadequate support from residency program supervisors (Odds Ratio (OR) 1.97, 95% CI: 1.23 - 3.14, p = 0.005), work-related family conflicts (Odds Ratio (OR) 3.2, 95% CI: 1.35 - 7.71, p = 0.008), stressful call perception (Odds Ratio (OR) 3.31, 95% CI: 1.90 - 5.76, p = 0.001) and each added year of study (Odds Ratio (OR) 3.46, 95% CI: 1.08 - 6.73, p = 0.009). <strong>Conclusion: </strong>Burnout is a problem among resident doctors in Tanzania. This could be addressed by directing preventive and intervention measures in the residency training program. Periodic assessment is also needed to mitigate factors associated with burnout among resident doctors.
基金This study was supported by Chongqing Young and Middle-aged Medical Senior Personnel Training Program[Grant no.1055]Inheritance Studio Construction Project of Famous Old Traditional Chinese Medicine Expert He Deying in Chongqing(YAY2020-20)+1 种基金Technology Innovation and Application Development Project of Chongqing Kewei Joint Traditional Chinese Medicine(No.:2020ZY023938)Special Project CSTC2020JXJL0052 of Chongqing Science and Technology Bureau for Performance Incentive and Guidance of Research Institutions.
文摘To analyze the herbal medicine prescribing patterns of contemporary famous old traditional Chinese medicine doctors in treating coronary heart disease,based on data mining technology,so as to provide useful insights into the clinical practice.Methods:Databases,including Medline(January 1966 to December 2019),Wanfang(January 1982 to December 2019),VIP Database(January 1989 to December 2019),CNKI(January 1979 to December 2019),CBMdisc(January 1978 to December 2019),and Classic Case Collection from Contemporary Famous Old Traditional Chinese Medicine Doctors were searched,and 224 eligible studies involving 416 patients were entered into the case study database after data processing.Frequency analysis and association rule analysis were used to investigate the prescribing patterns of contemporary famous old traditional Chinese medicine doctors in treating coronary heart disease.Results:In total 290 kinds of Chinese herbal drugs and 19 core drugs were used in the cases studied.The most commonly used categories were“Qi-Tonifying Drugs”,“Blood-Activating Drugs”,and“Phlegm-Eliminating Drugs”.The association rule analysis identified 14 commonly used herbal pairs,19 three-drug combinations,and 1 four-drug combination.Conclusion:Contemporary famous old traditional Chinese medicine doctors considered warming heart yang as an extremely important approach to treat coronary heart disease based on Zhang Zhongjing’s treatment for chest painful obstruction caused by“Inactivity of Chest Yang”(blockade of phlegm turbidity).Both symptoms and root causes were addressed in the formulas prescribed by these doctors.“Tonifying Qi,Nourishing Yin,Activating Blood,and Eliminating Phlegm”were the most commonly used therapeutic methods for patients with coronary heart disease.
文摘BEFORE Chinese medical teams were sent to Africa, to most Africans. China was a remote country that they had barely heard of. But through seeing and being treated by Chinese doctors Africans began to learn about China and its people.
