Objective To explore the characteristics of illness attribution of outpatients with multiple somatic symptoms in Peking Union Medical College Hospital. Methods It was a cross-sectional study conducted from March to October,2012. A total of 150 outpatients were recruited from the departments of Gastroenterology,Traditional Chinese Medicine and Psychological Medicine by convenience sampling. Somatic symptom scale of the Patient Health Questionnaire (PHQ-15) was used to screening each patient in the waiting list. With the cut-off value of 10,patients were divided into the somatic symptom positive (SOM+) group and somatic symptom negative (SOM-) group. Sociodemographic characteristics were compared between these two groups. All the subjects completed interviews including questions about illness attribution. All the answers of illness attribution were concluded into three major groups as physical factors,situational factors and psychological factors. Results The proportion of female was significantly higher in SOM+ group than in SOM-group (69.3% vs. 53.3%;χ=4.048,P=0.044). In SOM+ group,significantly more patients contributed their illness to psychological factors (64.0% vs. 45.0%;χ=5.273,P=0.022). There was no significantly difference between SOM+ group and SOM-group on the phenomenon of multiple illness attribution (41.0% vs. 32.0%;χ=1.407,P=0.236). However,in the Department of Gastroenterology,there were significantly more outpatients in SOM+ group with multiple illness attribution (60.0% vs. 32.0%;χ=3.945,P=0.047).Conclusions The outpatients in general hospital with multiple somatic symptoms are more likely to contribute their illness to psychological factors. The phenomenon of multiple illness attribution is common among patients. Clinicians should increase their awareness and knowledge of illness attribution,so as to provide better holistic health services.

An iceberg model for better understanding the patients was developed.In this model the seeking for consultation is visible part of illness behavior,but the thoughts,concerns and expectations toward his or her illness are the hidden parts.Through detailed history taking,using appropriate language skill (Leichester Assessment Package) and nonverbal communication skill (space distance,eye contact,listening,pronunciation,appropriate silence),physicians can acquaint comprehensive knowledge about the hidden thoughts,concern and expectation of patients about their illness.This model would help general practitioners to raise communication and consultation ability and skills in their practice.

During the prevention and control of new coronavirus pneumonia, Fangzhuang community health service center gave full play the advantages of internet technology, developed and implemented the Intelligent Family Doctors Optimized Coordination Model for epidemic prevention in the community. An epidemic prevention and control team was established in the center, the team carried out the epidemic prevention and control with the opening of health records and by using "doctors around" APP. The center also opened the intelligent voice return visits, the 24-hour service hotline, and WeChat public column to provide consultation for the community residents; it also strentherned pre-check triage, realized the medical insurance sharing and the other measures. All these measures enabled the residents to have a correct understanding of the epidemic situation, eased their psychological panic, enhanced their sense of gain, and made residents more convenient to seek medical treatment nearby reducing interpersonal contact and aggregation, reduced the risk of cross-infection, and achieved accurate health management among community residents during COVID-19 epidemic.

Objective:To investigate the mental health status and its influencing factors in people under COVID-19 quarantine.Methods:A total of 130 people under quarantine in a centralized isolation site in Beijing from October 21 2021 to November 12 2021 were included in the study. The demographic data were collected, and the self-rating anxiety scale (SAS) and self-rating depression scale (SDS) were used for evaluation of mental health status.Results:One hundred and eleven people completed the survey; there were 10 people with anxiety (9.0%) and 34 people with depression (30.6%) among the study subjects. Multivariate logistic regression analysis showed that the number of physical diseases ≥2 was the independent risk factor for anxiety ( OR=119.76,95% CI: 5.31-2 702.08, P=0.003) and depression ( OR=41.41,95% CI:6.06- 282.75, P<0.001). Conclusions:The incidence of psychological problems among people under COVID-19 quarantine is relatively high, particularly for people with multiple physical diseases, it is necessary to carry out early intervention for vulnerable people in centralized isolation sites.

The community is the first line of endemic prevention and control. Facing the challenge of epidemic outbreak, Fangzhuang Community Health Service Center applied the intelligent family doctor model to carry out joint community prevention and control of coronavirus disease 2019 (COVID-19) epidemic. The intelligent family doctor model is a people-centered, information-based approach, which integrates community resources to carry out health education, counseling and public opinion guidance. With this model the community health service center can effectively screen and follow up the key groups to strengthen the joint prevention and control of COVID-19; at the same time it also can manage the chronic disease and the elderly care. This article introduces the intelligent family doctor model, and analyzes its advantages and existing problems, to provide references for community epidemic prevention and control.