ObjectiveTo explore the impact of the preoperative nutritional status on quality of life of colorectal cancer patients. MethodsIn this study, patients diagnosed definitely as colorectal cancer were enrolled from September 2012 to December 2012 in this hospital.NRS-2002 was used to assess the preoperative nutritional status, and QLQ-C30 was used to assess the quality of life. ResultsForty-four patients were enrolled in this study and divided into two groups based on NRS-2002 preoperative nutritional status evaluation scores:mild nutritional risk group had 27 patients who got 1 point, and moderate-severe nutritional risk group had 17 patients who got 2 point or over it.Patients in moderate-severe nutritional risk group were significantly older than the mild nutritional risk group (P=0.001), but there were no statistical differences between the two groups in gender (P=0.718), TNM stage (P=0.302), differentiation degree (P=0.564), preoperative medical complications (P=0.070), postoperative complications[NS (not significant)], and stoma (P=0.786).There were no statistical differences between the two groups in quality of life, too (P > 0.05). ConclusionsThis study don't get the conclusion that there is any relationship between nutritional status and quality of life of the colorectal cancer patients.And maybe it is effected by the too small sample size and single time of accessing.Therefore, the further research by expanding sample size, using more kinds of assessment tools, and selecting different time to explore the impact of the preoperative nutritional status on quality of life of colorectal cancer patients are necessary.
ObjectiveTo investigate the status of quality of life and influencing factors among newly diagnosed epilepsy patients with co-morbid anxiety and depression. MethodsA total of 180 newly diagnosed epilepsy patients from June 2022 to December 2022 in a district of Shanghai were selected as the study subjects. The Quality of Life in Epilepsy-31 (QOLIE-31), Hamilton Depression Rating Scale (HAMD-24), Hamilton Anxiety Rating Scale (HAMA), and Epilepsy Self-Management Scale (ESMS) were used to assess patients' quality of life, depression levels, anxiety levels, and self-management abilities, respectively. Patients were divided into the co-morbid depression group (HAMA≥14 and HAMD>17) and the control group (HAMA<14 and HAMD≤17), and their general characteristics and scale scores were compared. Spearman correlation, Pearson correlation, and multiple linear regression analysis were used to identify influencing factors of quality of life in epilepsy patients with co-morbid depression. ResultsCompared to the control group, the anxiety comorbid with depression group of older adults had a higher proportion, higher unemployment rate, lower personal and family annual income in the past year, higher frequency of epileptic seizures, and lower medication adherence (P<0.05). The correlational analysis revealed a negative correlation between the quality of life abilities of epilepsy patients with comorbid anxiety and depression and the severity of anxiety and depression. (r=−0.589, −0.620, P<0.05). The results of multiple linear regression analysis showed that the frequency of seizures in the past year (β=−1.379, P<0.05), severity of anxiety (β=−0.279, P<0.05), and severity of depression (β=−0.361, P<0.05) have an impact on the ability to quality of life in epilepsy patients with co-morbid anxiety and depression. These factors account for 44.1% of the total variability in quality of life (R2=0.4411, P<0.05). ConclusionThe frequency of seizures in the past year, as well as the severity of anxiety and depression, are important factors that influence the ability to quality of life in epilepsy patients with comorbid anxiety and depression. For these patients, it is crucial to take into account these factors and provide appropriate support and interventions.
ObjectiveTo explore the application of clinical pathway in patients undergoing orthopedic day surgery.MethodsPatients who were scheduled for orthopedic treatment at Day Surgery Department of the Second Hospital of Shanxi Medical University from May to October 2020 were selected as the clinical pathway group, and all of them were managed by clinical pathway. Patients who were scheduled for orthopedic treatment at Day Surgery Department of the Second Hospital of Shanxi Medical University from May to October 2019 were selected as the routine group, and all of them were managed by conventional clinical methods. The general conditions of patients, physicians’ work efficiency, medical costs and medical quality were compared between the two groups.ResultsThe clinical pathway group included 246 patients, and the routine group included 391 patients. There was no significant difference in gender, age or disease distribution between the two groups (P>0.05). Compared with the routine group, the clinical pathway group had obvious advantages in terms of average time spent by a physician in issuing a medical order each time [(5.64±3.29) vs. (2.12±1.05) min], average number of revisions per physician’s order (1.40±0.24 vs. 0.38±0.19), rate of filing medical records within 3 days (90.28% vs. 97.97%), hospital costs [(7462.10±1035.01) vs. (6252.52±1189.05) yuan], drug costs [(652.21±88.53) vs. (437.17±108.20) yuan], length of stay [(1.23±1.04) vs. (1.02±0.18) d] and delayed discharge rate (7.93% vs. 2.03%), with statistically significant differences (P<0.05). There was no significant difference between the two groups in terms of unplanned reoperation rate, unplanned rehospitalization rate, or patient satisfaction (P>0.05).ConclusionCompared with routine clinical management, clinical pathway management can improve work efficiency, reduce medical cost and improve medical quality more effectively in the implementation of orthopedic day surgery, which has very positive effects and is worthy of promotion and application.
Medical records play an important role in medical treatment, prevention, teaching, scientific research and hospital management. The epidemic situation of coronavirus disease 2019 is very serious. How to complete the writing of medical records with high quality and high efficiency under the high-intensity, high-pressure environment of the prevention, diagnosis, and treatment of coronavirus disease 2019 is an important issue for medical quality control management departments. West China Hospital of Sichuan University has adopted various measures to continuously improve the quality management of medical records, including optimizing the medical records of fever clinics and isolation wards, and using various methods of medical record quality management under the support of electronic medical record information systems, so as to improve the writing quality and efficiency of medical records during the diagnosis and treatment of coronavirus disease 2019.
ObjectiveTo investigate the current situation of orthopedic quality control and management in county-level regional general hospitals in Guangdong, and to provide a scientific basis for further standardizing the procedures of orthopedic quality control and management in county-level regional general hospitals and continuously improving the work of provincial orthopedic quality control center.MethodsFrom June 2019 to July 2020, online and offline questionnaire survey and field survey were used to investigate the quality control and management of orthopedic departments in 22 county-level regional general hospitals in Guangdong.ResultsAmong the overall scores of the surveyed hospitals, the highest score was 96.5, the lowest score was 72.0. There were 6 hospitals with a total score of “excellent” (accounting for 27.3%). The “facilities and equipment” and “medical quality” of the surveyed hospitals were relatively valued. Taking Guangzhou, the capital of Guangdong as the center, the districts and counties were divided into the east, the south, the west and the north regions, and the difference in overall scores of orthopedics among the four regions was statistically significant (F=6.299, P=0.004). The unqualified rates of department setting, key technology development, average hospitalization days of representative diseases, equipment allocation, personnel allocation, department management and building layout were relatively high, which were 77.3%, 63.6%, 45.5%, 40.9%, 40.9%, 36.4% and 36.4%, respectively. Most hospitals had set up special debridement rooms in orthopedic department (95.5%), and the management and monitoring of the use of antibacterial drugs was mostly reasonable (90.9%). In terms of the level of orthopedic medical treatment, only 3 hospitals with sufficient key technologies reached the standard, accounting for 13.6%, and only 7 hospitals reached the standard of scientific research capacity, accounting for 31.8%. In terms of quality control, the numbers of hospitals with qualified medical record sampling (72.7%), perfect management and supervision mechanism (86.4%) and quality management team in departments (77.3%) were the least. In addition, among the investigated hospitals, beds were in short supply in orthopedic departments, with 12 hospitals accounting for 54.5% being deducted; 16 hospitals (72.7%) were deducted for unqualified doctor-patient ratio and 11 hospitals (50.0%) were deducted for unqualified nurse-patient ratio.ConclusionsThe overall level of orthopedics construction and management in the surveyed hospitals is uneven. The medical professional and technical level is insufficient. It is difficult to meet the practical needs, and there is an imbalance in the ratio of medical personnel. In the future, it is necessary to strengthen the quality control of orthopedic medical care, strengthen the medical technology training of county-level regional general hospitals and increase the medical and health resources and capital investment, so as to improve the quality control of county-level regional general hospitals.
High quality clinical trial depends on the preliminary research design and optimizing, the quality control in the medium term, the source data verification and statistics in later stages. Steering committee (SC) can meet above requirements. According to the characteristics of the research project, we invited international experts whose professional background are obstetrics and gynecology, statistics and methodology to set up SC. SC will hold regular conference, the content of the conference included project progress and quality control, research assistant training and assessment, conducting knowledge lectures and so on. The establishment of SC ensured the protocol maneuverability, answered PCOS related problems from different professional perspectives, and solved the problems such as how to improve the scientific research output. At the same time, it provides a platform of scientific research practice and self-improvement. It has profound influence on standardizing the management of the clinical trial, strengthening the consciousness of team work, promoting multi-disciplinary team cooperation, expanding scientific research thinking and cultivating clinical research talent.
Obtaining the best evidence is an important part of practicing evidence-based medicine. Evidence grading is an indispensable tool and process in helping decision makers obtain the best evidence. However, the current research evidence is numerous, the quality of evidence is uneven, the evidence classification system is diverse and the standards are different. By reviewing the development history and process of evidence grading and recommendation system, this paper analyzed representative grading recommendation systems with representative and international influence, and expounded the status quo, characteristics and development trend of evidence grading development, so as to provide a reference for the grading recommendation system exploration in contemporary medical field.
ObjectiveTo investigate the effect of quality control circle (QCC) activity in reducing the temporarily stopping rate of day surgery.MethodsThe QCC activity was carried out from December 2018 to October 2019. By determining the theme of the activity and drawing up the plan, a retrospective analysis of pre-hospital day surgery stoppage status and reasons was performed based on 2 696 patients who had reserved surgery in the day surgery center from December 2018 to February 2019. Based on the data, the goal was determined, and measures were developed and confirmed from May to August 2019. Then the measures were standardized and implemented continuously from September to October 2019. The rate of surgical cessation before the implementation of the measures (from December 2018 to February 2019) was compared with that after the implementation of the measures (from September to October 2019).ResultsAfter the QCC activity, the temporarily stopping rate decreased from 2.89% to 1.34%, and the difference was statistically significant (P<0.001).ConclusionThe QCC activity can effectively reduce the temporarily stopping rate of day surgery, and lay the foundation for continuously promoting the optimization of day surgery resources and quality improvement.
ObjectivesTo explore the status quo of the readiness for hospital discharge and the quality of discharge guidance in patients after total hip/knee arthroplasty, and analyze their correlations.MethodsA cross-sectional survey was conducted to investigate patients who underwent total hip/knee arthroplasty in a tertiary hospital in Chengdu between January and November 2017. The survey included basic patient information questionnaire, Readiness for Hospital Discharge Scale, and the Quality of Discharge Teaching Scale.ResultsThe average age of 352 patients undergoing total hip/knee arthroplasty was (59.56±12.69) years. The total score of readiness for hospital discharge was 177.08±19.41, the average score was 7.82±0.88, and the average quality of discharge teaching was 145.87±14.87. There was a statistically significant difference between the patients’ access and the required discharge teaching (t=28.742, P<0.001). The score of readiness for hospital discharge was positively correlated with the score of the quality of discharge guidance (r=0.645, P<0.001), the obtained content dimension (r=0.542, P<0.001), and the teaching skill dimension (r=0.522, P<0.001).ConclusionsThe readiness for hospital discharge in patients after total hip/knee arthroplasty is in a medium level, and the quality of discharge teaching is higher overall and it is positively correlated with the readiness for hospital discharge. Medical staff should pay attention to the discharge guidance for patients. In the course of health education, not only the content and quantity of guidance should be emphasized, but also the guiding skills should be paid attention to, so as to improve the quality of discharge teaching, thereby improving the patient’s discharge readiness and promoting the patient’s later rehabilitation.
ObjectivesTo assess the methodological quality of clinical practice guidelines of cervical cancer in China published from 2014 to 2018.MethodsCNKI, WanFang Data, CBM, VIP, Medlive.cn, the National Guideline Clearinghouse, PubMed, The Cochrane Library and EMbase were searched for cervical cancer clinical practice guidelines published in China from January 1st, 2014 to December 31st, 2018. Four reviewers searched and selected the literature independently according to the inclusion and exclusion criteria and assessed the methodological quality of the included guidelines by using AGREE Ⅱ.ResultsA total of 9 guidelines were included. The average score for each area was: scope and purpose 75.47%, stakeholders’ involvement 35.09%, the rigor of development 43.70%, clarity of presentation 87.74%, applicability 80.76%, and editorial independence 0%.ConclusionsThe quality of cervical cancer clinical practice guidelines in China requires further improvement.