The paper expounds the ethics problems caused by doctor's selling activities in consulting room,which means the conflicts between doctors and patients, purchase pressure implied in seeking medical ad vice, disgrace to the aim of medical service etc. Furthermore puts forward some suggestions about strengthening management, stopping doctors' selling activities:1. to curb doctors' selling activities in consulting room; 2. to formulate health law and regulations, standardize medical behavior; 3. to deepen health reformation, improve investment mechanism.

Objective To understand the status and influencing factors of job burnout in medical staff providing highly active antiretroviral therapy(HAART)for people living with human immunodeficiency virus(HIV)in Yunnan province.Methods Using cluster sampling method,the self-made general information questionnaire and Chinese version of Maslach burnout inventory(CMBI)were published in Yunnan province HAART information management system in January 2022 for investigation.Results A total of 442 valid questionnaires were received.The detection rate of job burnout was 53.39%,emotional exhaustion was 15.61%,depersonalization was 21.04%,and reduced personal accomplishment was 38.01%.Binary Logistic regression analysis showed that the medical staff with high frequency of working overtime(OR=2.793,95%CI:1.844-4.213)and low equity of pay(OR=0.676,95%CI:0.496-0.921)were more prone to emotional exhaustion.The medical staff with low equity of pay(OR=0.705,95%CI:0.547-0.908)were more prone to depersonalization.The medical staff with low frequency of working overtime(OR=0.749,95%CI:0.572-0.981)and work in primary HAART sites(tertiary OR=0.377,95%CI:0.161-0.883,secondary OR=0.438,95%CI:0.242-0.794)were more prone to low personal accomplishments.Conclusion The status of job burnout among medical staff providing HAART for people living with HIV in Yunnan province is at middle level and has a significant reduction of personal accomplishments.It is suggested to alleviate the burnout of medical staff through improving workflow of HAART,planning reasonable rewarding system,valuing the physical and mental health of primary medical staff.

Objective To investigate the applicability of beliefs about medicines questionnaire specific(BMQ-specific)in HIV/AIDS patients receiving highly active antiretroviral therapy(HAART).Methods From November to December in 2021,583 HIV/AIDS patients receiving HAART in 3 clinical treatment sites were selected according to the prevalence of HIV/AIDS in Yunnan Province by matched sampling.The applicability evaluation of the scale includes item analysis,validity and reliability test.Results BMQ-specific had good discrimination(P＜0.001),and the correlations between score of each item and the respective dimension total score ranged from 0.641-0.820(P＜0.001).The results of exploratory factor analysis and validation confirmatory factor analysis showed that the model fitting indicators were within the standard range.The item-content validity index of each item was beyond 0.78,and the scale-content validity index was 0.970.BMQ-specific scores were significantly correlated with the Morisky medication adherence scale 8-item version(P＜0.001).Reliability analysis showed that the Cronbach's α of necessity and concern were 0.854 and 0.790 respectively,and the corrected item-total correlation values of 10 items were larger than 0.5,if item deleted was all smaller than the Cronbach's α in the corresponding dimensions,the test-retest reliability of the two dimensions with for-week interval was 0.786 and 0.753.Conclusion The Chinese version of BMQ-specific had proved its good applicability in HIV/AIDS patients receiving HAART.

Objective:To investigate the situation of patients with human immunodeficiency virus (HIV) infection who re-engaging treatment after dropping-out during anti-retroviral therapy (ART), and the influencing factors of ART re-engagement in Yunnan Province.Methods:The total dropping-out cases of ART up to December 31, 2018, including cases of lost-of-follow-up and withdrawing medications in Yunnan Province were included. The status of drop-out and demographic data were collected from survey questionnaires and the extracted medical-visiting records from the China National Free Antiretroviral Treatment Program Database of Chinese Center for Disease Control and Prevention. Chi-square test was used in statistical analysis and logistic regression was applied in analyzing factors related with re-engagement.Results:Among the total 6 075 cases with HIV infection which were recorded with the status of drop-out during ART in Yunnan Province, 5 340(87.9%) cases were confirmed drop-out, 540(8.9%) cases were false dropping-out due to belated medical visiting records, 109(1.8%) cases provided invalid answers or had no response to survey questionnaire, and 86(1.4%) cases failed to report results. Among 5 340 confirmed drop-out cases, the findings showed that 923(17.3%) cases were tracked and successfully re-initiated ART, 2 327(43.6%) cases could not be contacted, 1 443(27.0%) cases refused ART, 100(1.9%) cases died, 39(0.7%) cases came back for treatment by self-willing, 91(1.7%) cases were detained, and 417(7.8%) cases were in other situations. Tracking the dropping-out cases were through the workers based on the health facilities including ART clinics, centers for disease control and prevention and the community-based organizations. They tracked the dropping-out cases by phone, through household visiting or face-to-face communication. Statistically significant differences were found in the proportion of patients re-engagement by gender, re-engagement age, route of infection, education level and time from entry to last loss ( χ2=6.14, 21.26, 8.24, 17.69, 12.75, respectively, all P<0.050). The logistic regression suggested that the protective factors related with the re-engagement included female (adjusted odds ratio (a OR)=1.34, 95% confidence interval ( CI) 1.12 to 1.61, P=0.002), re-engagement age≤30 year-old (a OR=1.78, 95% CI 1.25 to 2.55, P<0.001), age of 31 to 60 year-old (a OR=1.33, 95% CI 1.01 to 1.76, P=0.043), education level with primary school to high school or technical secondary school (a OR=1.56, 95% CI 1.21 to 2.01, P<0.001), the period>24 months between first initiating ART and dropping-out (a OR=1.37, 95% CI 1.11 to 1.70, P=0.004). Conclusions:The program of tracking and re-engagement for ART dropping-out patients in Yunnan Province needs multi-department participation and investing large resources, but the success rate of tracking and re-engagement is not high. The protective factors related with re-engagement are female, re-engagement age≤60 year-old, education level with primary school to high school or technical secondary school, the period>24 months between first initiating ART and dropping-out.

Objective To investigate adherence and the influence factors among patients who are on antiretrovirus therapy (ART) of 3 provinces in China. Methods This study selected 18?year?old and older AIDS patients as the survey objects who initiated anti?retrovirus therapy between April and September of 2014 and kept on the treatment for one year in Yunnan,Sichuan,and Hu'nan province. Information of demography, treatment and social support was collected by questionnaires. Adopt SSRS questionnaire to calculate the information of objective support, subjective support and utilization of social support.χ2 test and logistic regression were performed to examine relationships between factors and adherence. Results A total of 386 patients with medication were investigated. Among them, there were 365 (94.6%) cases who were compliant to the ART, and 357 (92.5%) cases can take their pills on time, and 29 (7.5%) cases take their medication in excess of the prescribed time more than two hours. Social support score was 27.2 ± 7.3, including objective support score (5.6 ± 2.7), subjective support score (16.1 ± 4.8), and utilization of social support (5.5 ± 1.9). Multivariate logistic regression analysis revealed that adherence was significantly associated with the correct cognition of medication (OR (95%CI):3.24 (1.17-9.00)), the self?awareness of the drug regimen was not complexity (OR (95%CI): 9.34 (3.27-26.68)), taking medication 1 time a day (OR (95%CI): 4.00 (1.35-11.84)), and the batter utilization of social support (OR (95%CI): 1.49 (1.06-2.01)). Married/cohabiting or farmers tend to be nonadherenced, while the OR (95%CI) was 0.24 (0.08-0.67) and 0.23 (0.08-0.69), respectively. Conclusion The patients among these provinces were compliant to the ART, and most of them can take their pills on time. The social support score of these patients was lower than normal person. Participants who have correct cognition of medication, thinking their drug regimen was not complexity; Taking medication 1 time a day or have high level of utilization of social support showed a significantly higher level of self?reported adherence.

Objective To investigate adherence and the influence factors among patients who are on antiretrovirus therapy (ART) of 3 provinces in China. Methods This study selected 18?year?old and older AIDS patients as the survey objects who initiated anti?retrovirus therapy between April and September of 2014 and kept on the treatment for one year in Yunnan,Sichuan,and Hu'nan province. Information of demography, treatment and social support was collected by questionnaires. Adopt SSRS questionnaire to calculate the information of objective support, subjective support and utilization of social support.χ2 test and logistic regression were performed to examine relationships between factors and adherence. Results A total of 386 patients with medication were investigated. Among them, there were 365 (94.6%) cases who were compliant to the ART, and 357 (92.5%) cases can take their pills on time, and 29 (7.5%) cases take their medication in excess of the prescribed time more than two hours. Social support score was 27.2 ± 7.3, including objective support score (5.6 ± 2.7), subjective support score (16.1 ± 4.8), and utilization of social support (5.5 ± 1.9). Multivariate logistic regression analysis revealed that adherence was significantly associated with the correct cognition of medication (OR (95%CI):3.24 (1.17-9.00)), the self?awareness of the drug regimen was not complexity (OR (95%CI): 9.34 (3.27-26.68)), taking medication 1 time a day (OR (95%CI): 4.00 (1.35-11.84)), and the batter utilization of social support (OR (95%CI): 1.49 (1.06-2.01)). Married/cohabiting or farmers tend to be nonadherenced, while the OR (95%CI) was 0.24 (0.08-0.67) and 0.23 (0.08-0.69), respectively. Conclusion The patients among these provinces were compliant to the ART, and most of them can take their pills on time. The social support score of these patients was lower than normal person. Participants who have correct cognition of medication, thinking their drug regimen was not complexity; Taking medication 1 time a day or have high level of utilization of social support showed a significantly higher level of self?reported adherence.