Objective:To investigate the effectiveness of a tiered progressive training model in the standardized residency training of general practice in primary care institutions.Methods:A tiered progression teaching plan was applied for 26 general practice residents who attended the rotation of general practice residency training in Beijing Fangzhuang Community Hearlth Service Center from June 2022 to May 2023. The plan defined the teaching objectives and requirements for different stages, and the Leicester Assessment Package (LAP) and narrative medicine were included in the teaching methods. The effectiveness of the tiered progression training was evaluated through a questionnaire survey on the post competency of general practice residents.Results:There were 12 primary stage residents, 9 intermediate stage residents and 5 advanced stage residents. The post-training scores of general practice residents in all three stages of residents were significantly higher than the pre-training scores ( t=-3.627,-2.073,-5.277,all P<0.05). The scores of basic medical and health services, basic public health services, information utilization ability and management ability, medical knowledge and lifelong learning, interpersonal communication and teamwork, professional quality after six post competency training were significantly higher than those before training in all three stages of residents. The scores of basic medical and health services, basic public health services, medical knowledge and lifelong learning, in primary residents were significantly improved compared with those before training ( t=-3.457,-3.428,-3.063, all P<0.05);the scores of basic public health services, interpersonal communication and teamwork, and professional quality in intermediate residents were significantly higher than those before training ( t=-2.328,-2.100,-1.997, all P<0.05); the scores of basic medical and health services, basic public health services, information utilization ability and management ability, medical knowledge and lifelong learning, interpersonal communication and teamwork, and professional quality in senior residents were significantly higher than those before training ( t=-5.707,-4.542,-2.952,-1.753,-2.705,-2.805, all P<0.05). Conclusion:The application of tiered and progressive training model in the standardized residency training is helpful to improve the post competency of general practice residents.

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.

Objective:To evaluate the effectiveness of mentorship-Leichester assessment package (LAP) model in general practice teaching.Methods:Sixty five-year Traditional Chinese Medicine (TCM) students undergoing general medicine internship from July 2020 to December 2020 were divided into study group and control group with 30 students in each group. Students in study group undertook general practice internship in Fangzhuang Community Health Service Center with the mentorship-LAP model, including group-based teaching, weekly LAP case discussion and mentor-intern individualized LAP clinical practice teaching; students in control group undertook general practice internship in other community teaching bases with the traditional clinical practice training methods. After one month, students were evaluated with LAP score sheet and the evaluation results were compared between two groups.Results:After one month of training, the scores of medical history collection, physical examination, problem solving, patient management, doctor-patient relationship, expected care and medical records in both groups increased compared with pre-training (the control group: t=4.23, 5.06, 8.94, 4.85, 3.99, 1.04, 5.13, study group: t=1.86, 2.85, 12.42, 13.61, 6.29, 4.83, 5.63, all P<0.05). The scores of medical history collection, physical examination, problem solving, patient management, doctor-patient relationship, and expected care after training in the study group were higher than those in the control group ( t=5.66, 2.83, 5.67, 8.13, 2.76, 2.52, all P<0.05). After the training, in the medical history collection items, the scores of patient-centered communication, RICE recognition, and physical-psychological-social factors in study group were higher than those in the control group ( t=5.66, 7.35 and 2.66, all P<0.05); in the problem-solving items, the scores of clinical data application, comprehensive analysis ability and personal ability limitation in study group were higher than those in the control group ( t=4.32, 3.38 and 2.26, all P<0.05); in the patient management items, the scores of overall management plans, doctor-patient collaboration, dispelling doubts, subsequent visits/follow-up, and the degree of patient understanding the management plan in the study group were higher than those in the control group ( t=3.03, 2.07, 2.43, 3.15 and 2.17, all P<0.05). Conclusion:The mentorship-LAP teaching model is helpful to improve the effectiveness of general practice internship for medicine students.

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 evaluate an intelligent voice call system in popularizing knowledge of prevention and control of Coronavirus Disease 2019 (COVID-19) for chronic disease patients in the community.Methods:An intelligent voice call system for popularization of scientific knowledge of COVID-19 and protective measures was developed in Fangzhuang Community Health Service Center of Beijing Fengtai district, in which 12 popular education modules ware designed and 3-6 core points were extracted from each module. During January 23 to January 29, 2020, the system was applied to send voice calls and text messages to all contracted chronic disease patients in Fangzhuang community with popular science education in different time points. Using equidistant sampling method, 400 participants were selected from the patients of successful voice outbound calls. The intelligent voice outbound system was used to investigate the participants′ COVID-19 knowledge levels, the main sources of knowledge and satisfaction with education. The outbound results of the above indicators were queried from the database of the intelligent voice outbound system.Results:A total of 98 487 voice outbound calls were effectively connected, the average call duration per person was 2.24 minutes, and the total call duration was equivalent to 488.5 workdays. A total of 141 201 messages were sent, with a read rate of 97.8% (141 201/144 405) . After the voice outbound education, the participants′ scores in answering the questionnaire on 12 popular science knowledge modules ware all significantly increased compared to those before the education ( t=22.4, 27.5, 24.3, 31.2, 25.6, 18.9, 22.5, 27.3, 28.1, 26.4, 15.2, 22.6, all P<0.01) ; 94.8% (235/248) of participants′ knowledge of COVID-19 mainly came from voice call. In addition, the patient′s overall satisfaction with the application of the intelligent voice call system for popularizing science education was 90.8% (225/248). Conclusions:The knowledge levels of COVID-19 and its prevention and control measures effectively have been improved among the community chronic disease patients with the application of an intelligent voice outbound system. Moreover, this mode is highly acceptable to patients, which would be introduced to other urban communities in China.

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.

bjective? To explore the effects of Daiwenjiu Gao combined with ear acupoint bean-pressing on migraine of deficiency of both qi and blood. Methods? From June 2015 to July 2017, we selected 111 outpatients with migraine of deficiency of both qi and blood in Hangzhou Red Cross Hospital. All of the patients were divided into three groups including group of Daiwenjiu Gao, group of ear acupoint bean-pressing and group of Daiwenjiu Gao combined with ear acupoint bean-pressing with the method of random number table, 37 cases in each group. There was a loss to follow-up in group of Daiwenjiu Gao and group of Daiwenjiu Gao combined with ear acupoint bean-pressing respectively, and there was a case refusing treatment in group of ear acupoint bean-pressing; there were 36 cases with valid data in each group finally. Group of ear acupoint bean-pressing received ear acupoint bean-pressing for migraine; group of Daiwenjiu Gao carried out ear acupoint application by Daiwenjiu Gao for migraine; group of Daiwenjiu Gao combined with ear acupoint bean-pressing combined two treatments for migraine; the intervention continued for four weeks in three groups. The Sun's criteria was used to evaluate the severity, duration, frequency of outbreak, accompanying symptoms of headache of patients one and six months after intervention. SPSS 17.0 was used to statistical analysis. Results? Among patients with migraine of deficiency of both qi and blood in three groups, there were statistical differences between group of Daiwenjiu Gao and group of Daiwenjiu Gao combined with ear acupoint bean-pressing (P＜0.01), and there were also statistical differences between group of ear acupoint bean-pressing and group of Daiwenjiu Gao combined with ear acupoint bean-pressing (P＜0.01) one and six months after intervention. Conclusions? Daiwenjiu Gao combined with ear acupoint bean-pressing is with a simple operation, few adverse reactions, and it has better effects for migraine of deficiency of both qi and blood than general treatments which is worth to be used widely in clinical application.

Objective To investigate the health-seeking behavior and related factors among hypertensive and diabetic patients contracting medical service in Beijing Fangzhuang Community Health Service Center.Methods By using stratified random sampling method, 830 contracted hypertensive and diabetic patients were selected in the study.A face to face questionnaire survey was conducted in Fangzhuang Community Health Service Center from November 2016 to January 2017.Total 800 questionnaires were completed, and the medical behavior and influencing factors of patients were analyzed.Results The first-contact rate of community for hypertensive and diabetic patients was 73.0%(584/800).The reasons for choosing community service were: near home(86.3%,690/800), shorter waiting time(71.4%, 571/800)and trust in doctors(50.3%, 402/800); while the reasons for not choosing community service were less drug varieties(76.1%, 609/800), poor facilities(32.1%,257/800)and lower technical level(11.4%, 91/800).Its influencing factors were: frequent need of accompanying for visit(χ2=5.719, P=0.012),family income(χ2=4.540,P=0.021),awareness of service scopes(χ2=64.668,P=0.000),purpose of service(χ2=19.234,P=0.000),frequency of doctor contact(χ2=9.367, P=0.001), the awareness of referral(χ2=5.736,P =0.011).Conclusion The community health service centers should take the advantage of easy access, short waiting time and patients′trust,at the same time should improve the service conditions and quality,so as to increase the first-contact rate for patients contracting medical service.

Objective To observe the clinical effects of traditional Chinese medicine and foam dressing in the treatment of stageⅢ pressure sores. Methods A total of 94 patients with stageⅢ pressure sores in neurology department of Hangzhou Red Cross Hospital from January 2015 to December 2016 were recruited and randomly divided into control group (n=44) and observation group (n=50) by random number table method. Besides routine treatment and care of pressure sores, control group was given traditional Chinese medicine, while patients of observation group received traditional Chinese medicine combined with foam dressing treatment. The treatment effects of the two groups were observed and compared. Results The total effective rate of pressure sore in was 90.00% in the observation group and 86.36% in the control group, and there was no statistical difference (P>0.05). The average healing time of the observation group was (13.56±4.35) days, which was significantly shorter than that of the control group (21.45±3.47) days, and the difference was statistically significant (P< 0.01). Conclusions The effects of traditional Chinese medicine combined with foam dressing in the treatment of stageⅢ pressure ulcer is better than that of traditional Chinese medicine, which can improve the cure rate of pressure ulcer, shorten the healing time of pressure ulcer, and is worthy of clinical promotion.

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.