1.Research of concentration in clinical service:a patient-disease-medical humanities perspective
Chinese Journal of Hospital Administration 2017;33(6):423-425
Objective To investigate the concentration on clinical service of both medical workers and patients,for the purposes of better quality of care and concentration of medical workers,and better mental feelings of the patients′ and doctor-patient relationship.Methods 1 000 medical workers and patients were sampled from 8 hospitals of four regions in Jiangsu province by stratified randomization for questionnaire survey.The purpose is to study the clinical concentration of medical workers in terms of interpretation,listening,emotion and empathy,and compare the differences between doctors and patients regarding clinical concentration.Results 48.5% of the medical workers and 44.8% of the patients said that medical workers would interrupt the patients within 2 minutes.Time constraints of clinical consultation contribute to poor disease information collection,medical explanation and informing.The investigation found the difference between doctors and patients in clinical concentration is significant statistically(χ2=104.329,P=0.000),while medical workers were unaware of their lack of concentration to patients.18.2% of the patients complained that medical workers could hardly or refuse to understand their feelings.Conclusions Medical workers are advised to respect their patients by offering total concentration on diagnosis and treatment;to respect their career with sufficient concentration on diagnosis and treatment;and to respect medical science to offer medical humanistic care.
2.Prognosis of middle-aged and elderly patients with aspiration pneumonia in integrated medical and elderly care institutions and logistic regression analysis of related influencing factors
Lineng XIE ; Hua YE ; Guangzhao GONG ; Lanjiao ZHOU ; Jun ZHAO ; Wei MA
Journal of Public Health and Preventive Medicine 2023;34(4):67-71
Objective To investigate the prognosis of middle-aged and elderly patients with aspiration pneumonia and related influencing factors in integrated medical and elderly care institutions. Methods A total of 604 elderly patients with aspiration pneumonia were selected from integrated medical and elderly care institutions from January 2016 to December 2020. The prognosis of the patients was counted, and the prognostic factors were analyzed by univariate and multivariate logistic regression equations. The receiver operating characteristic (ROC) curve and area under the curve (AUC) were used to analyze the predictive value of logistic regression model for the prognosis of elderly patients with aspiration pneumonia. Results Univariate analysis showed that Alzheimer's disease, severe pneumonia, ability of daily living (ADL), and the number of rescues were related to the prognosis of elderly patients with aspiration pneumonia (P<0.05). Logistic regression model showed that the death risk of patients with Alzheimer's disease was 2.883 times higher than that of patients without Alzheimer's disease, the death risk of patients with severe pneumonia was 3.292 times higher than that of patients without severe pneumonia, the death risk of patients with severe dependence in ADL was 3.719 times higher than that of patients with mild dependence, the death risk of patients with moderate dependence in ADL was 2.558 times higher than that of patients with mild dependence, and the death risk of patients with rescue times ≥ 2 times was 2,922 times higher than that of patients without rescue times (P < 0.05). Logistic regression equation: logistic (P=-8.264+2.883)×Alzheimer disease ≥60 years old + 3.292×severe pneumonia + 3.719×severe dependence in ADL+2.558×moderate dependence in ADL +2.922× number of rescues. The predicted prognosis AUC of elderly aspiration pneumonia was 0.907 (95%CI: 0.848-0.966). When logistic(P>12.97), the predictive value was the best, with the predictive sensitivity being 83.87%, and the specificity being 84.15%. Conclusion Alzheimer's disease, severe pneumonia, moderate and severe dependence in the ability of daily living and rescue times ≥ 2 are related to the prognosis of middle-aged and elderly patients with aspiration pneumonia in the integrated medical and elderly care institutions, which can be used as a prognostic plan for clinical treatment and nursing management. At the same time strengthening the intervention of patients with the above characteristics will help to promote the improvement of prognosis.