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October 2017, Volume 20, No.28 Abstracts

Equity of Health Resource Distribution in Primary Healthcare Institutions in China  WANG Yuan-yuan1,LIU Wei-wei1*,HAN Jian-jun2
1.The Second Clinic of Peking University Third Hospital,Beijing 100191,China
2.Publishing House of Journal of Chinese General Practive,Beijing 100053,China
*Corresponding author:LIU Wei-wei,Researcher,Associate chief physician,Master supervisor;E-mail:c_lww@126.com
    【Abstract】  Objective  To evaluate the trend and equity of health resource distribution in primary healthcare institutions in China during 2012 to 2015,so as to provide an evidence for further studies and the formulation and enaction of related policies.Methods  From China′s Health Statistics Yearbook 2013,China′s Health And Family Planning Statistical Yearbook 2014,China′s Health And Family Planning Statistical Yearbook 2015,China′s Health And Family Planning Statistical Yearbook 2016,we obtained the number of primary healthcare institutions,number of beds and number of primary healthcare providers in primary healthcare institutions in China from 2012 to 2015,and analyzed the status and trend of health resource distribution during the period,and explored its equity by using Gini coefficient and Theil index.Results  From 2012 to 2015,the number of primary healthcare institutions,number of beds and primary healthcare providers in these institutions increased by 8 150,89 572 and 205 950 respectively,with an annual growth rate of 0.30%,2.21% and 3.24%,respectively. From 2012 to 2015,the Gini coefficient for the distribution of primary healthcare institutions in China were 0.192,0.191,0.192,0.191,respectively;Theil index for the distribution of them respectively were 0.066 2,0.066 6,0.066 6,and 0.066 2;Intra-region contribution rate was found to be higher than inter-region contribution rate for Theil index in each year of this period(58.91% vs 41.09% in 2012,57.81% vs 42.19% in 2013,57.81% vs 42.19% in 2014,58.36% vs 41.64% in 2015). The Gini coefficient for the distribution of beds in primary healthcare institutions in China were 0.166,0.168,0.174,0.178,respectively during 2012 to 2015;Theil index for the distribution of them respectively were 0.054 8,0.057 1,0.061 1,and 0.063 1;Intra-region contribution rate was found to be higher than inter-region contribution rate for Theil index in each year of this period(53.55% vs 46.45% in 2012,52.79% vs 47.21% in 2013,51.32% vs 48.68% in 2014,52.12% vs 47.88% in 2015). The Gini coefficient for the distribution of the primary healthcare providers in primary healthcare institutions in China from 2012 to 2015 respectively were 0.089,0.096,0.091 and 0.090;Theil index for the distribution of them respectively were 0.013 2,0.014 9,0.013 1 and 0.013 0;Intra-region contribution rate was found to be higher than inter-region contribution rate for Theil index in each year of this period(86.20% vs 13.80% in 2012,78.73% vs 21.27% in 2013,77.60% vs 22.40% in 2014,73.99% vs 26.01% in 2015).Conclusion  The equity of health resource distribution in primary healthcare institution in China during 2012-2015 was reasonable on the whole.The distribution equity of the number of primary healthcare providers was better than that of primary healthcare institutions and beds in these institutions.However,intra-region differences were greater than inter-region differences in the distribution equity of these three items.Therefore,priority should be given to the improvement of intra-region equity of health resource distribution in primary healthcare institutions.
    【Key words】  Primary health care;Health care rationing;Gini coefficient;Theil index
 
The Current Situation of Family Doctor Team Services Mode   PAN Gong-yi,YANG Ye*
Jiangpu Community Health Service Center of Yangpu District,Shanghai 200092,China
*Corresponding author:YANG Ye,Associate chief physician;E-mail:29931461@qq.com
    【Abstract】  The construction of the family doctor system is an important measure of new medical reforms in China.Since reforms of the family doctor system in 2011,how to set up an effective family doctor team services mode has become a top priority.This study introduces the service modes of the family doctor team in Shanghai and other areas of China.Lack of general physicians and traditional Chinese medicine with a broad mass base can not be well integrated into family doctor services are still main difficulties in service modes of the family doctor team at the present time.It is believed that the operation mechanism,personnel responsibilities and social division of labor of the family doctor team services should be explored and innovated in the near future.
    【Key words】  Family doctor services;Team;Service mode;Review
 
Present Situation of Patient-centered Medical Home in the United States and Its Enlightenment to Family Doctor Services in China  CHANG Fei-fei,CHEN Xian-hui*,WANG Qiang
School of Nursing and Health,Henan University,Kaifeng 475000,China
*Corresponding author:CHEN Xian-hui,Associate chief physician,Master supervisor;E-mail:chenxianhui668@163.com
    【Abstract】  The experience of health reform in the world shows that a suitable mode of community health services will be the inevitable result of global health system reform.The patient-centered medical home(PCMH) has been hailed by the World Health Organization(WHO) as the most economical and most appropriate community health services mode which has developed maturely in the United States.This paper introduces the concept,characteristics,development process,implementation effect,authentication and quality management of PCMH in the United States.Based on the experience of PCMH,this paper puts forward that China should establish and improve the quality certification system and incentive mechanism of community health services to promote the quality of family doctor services and attract excellent general practitioners to join the primary health care service team.
    【Key words】  Patient-centered medical home;Family doctor services;United States
 
Visualization Studies of Research Subjects of China′s National Essential Drug System  KANG Ji-hong1,2,CHEN Ge-shuyi2,3,LIU Juan2,4,SU Xiao-jie2,4,TIAN Jin-hui2,5*
1.Department of Drug and Device,Dingxi People′s Hospital,Dingxi 743000,China
2.Evidence-based Medicine Center,School of Basic Medical Sciences,Lanzhou University,Lanzhou 730000,China
3.The First Clinical Medical College of Lanzhou University,Lanzhou 730000,China
4.The Second Clinical Medical College of Lanzhou University,Lanzhou 730000,China
5.Key Laboratory of Evidence-based Medicine and Knowledge Translation of Gansu Province,Lanzhou 730000,China
*Corresponding author:TIAN Jin-hui,Associate professor,Master supervisor;E-mail:tjh996@163.com
    【Abstract】  Objective  To analyze the research topics of China′s national essential drug system(NEDS),in order to provide a reference for its development in the future.Methods  On February 28th,2017,we searched the databases of CBMdisc,CNKI,WANFANG DATA for articles that studied China′s NEDS as of December 31st,2016.The subject headings of the included articles were standardized based on the Chinese version of Medical Subject Headings(MeSH) developed by the National Library of Medicine and Chinese Traditional Medicine and Materia Medica Subject Headings.Bibliographic Item Co-occurrence Mining System(BICOMS) was used to extract and summarize the data of subject headings and produced a co-occurrence matrix.NetDraw of Ucinet 6.0 was employed to draw the social network diagram of the subject headings.And cluster analysis of the subject headings was performed by gCLUTO 2.0.Results  A total of 2 096 studies involving 1 588 medical subject headings with substantial meanings were included.The three major subject headings were NEDS,national essential medicine,and grassroots medical institutions.The subject headings were divided into 7 research topics:1 Challenges for the implementation of China′s NEDS and corresponding countermeasures;2 Suggestions for/assessment/reform of the implementation of China′s NEDS,and implementation and development of China′s NEDS;3 Surveys about the awareness of China′s NEDS and satisfaction with the implementation of China′s NEDS in primary care providers;4 Analyses of reimbursement ways/mechanism/ standard/ policy and effect about the implementation of China′s NEDS,and the compensation/policy related to the zero-profit sale of drugs;5 Effect of the implementation of China′s NEDS on the reasonable use of antimicrobial agents in grassroots medical institutions;6 Influence of NEDS on use frequency and selection of essential drugs;7 Availability and implementation effect/implementation strategy/implementation model of China′s NEDS.Conclusion  The studies of China′s NEDS focus on the aspects of compensation and effectiveness analysis of implementation.Future research should focus on the relationship between China′s NEDS and medical insurance,and the development of markers for the assessment of  the implementation of China′s NEDS.
    【Key words】  National essential drug system;Subject headings;Visualized analysis
 
Cause and Solution Analysis of the Petitioning Associated with Community Health Services in Beijing Chaoyang District  NI Na-na1,LIU Bao-hua1*,BAI Jiang-liang1,ZHANG Sha1,HU Sheng-xing1,BAI Xu1,LYU Chun-hua2,ZHANG Wei2
1.School of Public Health,Peking University,Beijing 100191,China
2.Chaoyang District Health Petition Center,Beijing 100026,China
*Corresponding author:LIU Bao-hua,Associate professor,Master supervisor;E-mail:baohualiu@bjmu.edu.cn
    【Abstract】  Objective  To analyze the reasons of petitioning associated with community health services in Beijing Chaoyang District and put forward corresponding treatment measures,so as to prevent medical malpractices.Methods  We analyzed the letters and calls of complaints,tip-offs and suggestions verified to be true or partially true among the petition cases recorded in the Health Petition Information Management Platform of Chaoyang District Health Petition Center from September 1,2014 to August 31,2015,and collected the data about the quantity of medical services and medical expenses of the community health service organizations(CHSOs) recorded in Chaoyang District Health Petition Center during the same period.Spearman′s rank correlation coefficient was used to analyze the correlation of number of petition cases with total annual amount of medical services,per-capita quantity of medical services,and the cost of per patient medical care.And comparison was made in the status of health petitioning between the CHSOs with different financial compensation modes.Results  Four hundred and sixty of the 534 petition cases were verified to be true or partially true with a verification rate of 86.1%.Of them,26.1%(120/460) were about drugs,19.8%(91/460) were related to hospital management,12.4%(57/460) were associated with service attitude.Spearman′s rank correlation coefficient analysis found that,the number of petition cases had positive correlation with the total quantity of medical services annually,per capita quantity of medical services and the cost of per patient medical care(P<0.05).The percentage of CHSOs with the "separate management of revenue and expenditure" financing mode complained was 25.6%(30/117),with a complaint rate of 0.669/100 000;the percentage of CHSOs with pooled social health insurance financing mode complained was 30.0%(18/60),with a complaint rate of 0.753/100 000.Conclusion  Main problems reflected in the petition events were issues of drugs,hospital management and service attitude.In view of this,it is suggested that the drug directory should be unified between CHSOs and higher-level hospitals as soon as possible,relevant laws and regulations about injection of exogenous drugs should be formulated and improved,number of primary care providers should be increased and the management of them should be bettered,and a petition risk prevention mechanism should be established.
    【Key words】  Community health services;Health petition;Beijing
 
Status of Signing a Contract with a Family Doctor Team and Associated Factors of Needs for Family Doctor Services among Residents in Underdeveloped Areas of Guangdong Province  MO Hai-yun1,LUO Zhi-rong2,OU Wen-sen1,ZHANG Man1,YANG Zhi-peng1,OU Wei-lin1,SHEN Huan-yu1,WANG Jia-ji1*
1.School of Public Health,Guangzhou Medical Universiy,Guangzhou 510182,China
2.Ruibao Street Community Health Service Center,Guangzhou 510280,China
*Corresponding author:WANG Jia-ji,Professor,Master supervisor;E-mail:wjiaji@163.com
    【Abstract】  Objective  To investigate the status of signing a contract with a family doctor team and associated factors of needs for family doctor services among residents in underdeveloped areas of Guangdong Province.Methods  Using multi-stage random sampling,at first,we randomly sampled 6 cities from eastern Guangdong,western Guangdong,and northern Guangdong(2 from each of the three parts of Guangdong ),then,we randomly selected 2 community health service centers(CHSCs)/community health service stations(CHSSs) from the urban and rural areas of each city,respectively(24 in total),and finally,from these CHSCs/ CHSSs,we selected 3 000 residents receiving treatment and meeting the inclusion and exclusion criteria of this study as the participants by convenience sampling.In August 2016,we conducted a survey in the participants using a self-designed questionnaire consisting of demographic data,level of awareness of family doctor services,status of signing a contract with a family doctor team,causes for failing to sign a contract with a family doctor team,and the needs for family doctor services.The survey obtained a response rate of 96.2%(2 887/3 000).Results  A total of 42.7%(1 233/2 287) of the final participants had heard of family doctor services,but only 56.4% (628/1 114) of them had already signed a contract with a family doctor team.Among those who did not sign a contract with a family doctor team,86.6% were due to lack of needs (421/486).After knowing about family doctor services,89.6% (2 581/2 879) thought that they needed the services.The needs for family doctor services varied by age,educational attainment,marital status,employment status,household monthly income,self-perceived health status,status of medical insurance and prevalence of chronic diseases(P<0.05).Multivariate Logistic regression analysis found that,age,employment status and medical insurance status were associated factors of the needs for the services (P<0.05).Conclusion  Both the awareness level of family doctor services and rate of signing a contract with a family doctor team are unsatisfactory among residents in underdeveloped areas of Guangdong Province.However,the residents′ needs for family doctor services are increased after knowing about the services.Age,employment status and medical insurance status are the factors associated with the needs for family doctor services.Therefore,in order to promote the development of family doctor system,strong policy support and publicity and targeted services developed for priority groups are necessary.
    【Key words】  Family doctor services;Signing a contract;Root cause analysis;Guangdong
 
Intention and Associated Factors of Signing a Contract with a Family Doctor Team in Residents in Henan Province   LIANG Shi-min1,YU Xiao-fei1,LI Chen1,ZOU Hao-ran1,HU Yong-jian1,ZHANG Hui-ying2*
1.Scientific Research Association,Sanquan College of Xinxiang Medical University,Xinxiang 453000,China
2.School of Basic Medical Sciences,Sanquan College of Xinxiang Medical University,Xinxiang 453000,China
*Corresponding author:ZHANG Hui-ying,Professor,Master supervisor;E-mail:zhanghy2001@163.com
    【Abstract】  Objective  To investigate the intention and associated factors of signing a contract with a family doctor team among residents in Henan Province,China.Methods  By convenience sampling,1 500 adults with literacy and effective communication skills were selected from the urban and rural areas in 14 cities(household location of the investigators of this study) in Henan Province.From December 2016 to February 2017,a survey was conducted in these participants with a self-developed questionnaire consisting of demographic data,intention of signing a contract with a family doctor team,misgivings for signing a contract with a family doctor team,and expected propagandistic ways for benefits of family doctor services.The survey obtained a response rate of 87.8%(1 317/1 500).Results  Of the 1 317 final participants,11.4%(150/1 317) were willing to sign a contract with a family doctor team without misgivings,63.1%(831/1 317) were willing to sign a contract with a family doctor team but with misgivings,12.1%(159/1 317) had too many misgivings to sign a contract with a family doctor team and 13.4%(177/1 317) were not willing to sign a contract with a family doctor team and thought it was unnecessary.In general,74.5%(981/1 317) of them wanted to sign a contract with a family doctor team.The status of intention of signing a contract with a family doctor team significantly varied by age,educational attainment,occupation,type of medical insurance,type of household registration and prevalence of chronic conditions in relatives(P<0.05).Multivariate Logistic regression analysis identified that educational attainment,occupation,type of medical insurance were significantly associated with the intention of signing a contract with a family doctor team(P<0.05).The main factor why residents are worried about family doctor services is "medical level"(80.5%,1 060/1 317)and the most expected publicity method is "radio and television"(77.5%,1 020/1 317).Conclusion  Most residents in Henan Province want to sign a contract with a family doctor team,but many of them have misgivings about doing so.The associated factors for signing a contract with a family doctor team are educational attainment,occupation and type of medical insurance.In view of this,it is suggested that family doctor services should be extended gradually,the priority groups and contents of services should be determined,the professional capacities of family doctors should be improved and the publicity of the contents and benefits of family doctor services should be promoted.
    【Key words】  Family doctor services;Intention of signing a contract;Root cause analysis;Henan
 
Residents′ Awareness and Satisfaction of Family Doctor Services and Two-way Referral in Two Pilot Towns of Shaanxi Province  GE Gao-qi1,TANG Nan1,CHEN Zhao-jie2*,WANG Jing-jing1
1.School of Nursing,Jilin University,Changchun 130021,China
2.Department of Endocrinology,China-Japan Union Hospital of Jilin University,Changchun 130021,China
*Corresponding author:CHEN Zhao-jie,Chief superintendent nurse,Master supervisor;E-mail:1097147280@qq.com
    【Abstract】  Objective  To understand residents′ awareness and satisfaction of family doctor service and two-way referral through investigating their situation of visiting family doctors and demand for family doctor services in two pilot towns in Shaanxi Province.Methods  Using the convenience sampling,local residents from Shengshui Town and Huangguan Town in Hanzhong City of Shaanxi Province were recruited according to the locations of investigators.Residents were interviewed face to face with a self-designed questionnaire from July to August of the year 2016.The main contents of the questionnaire were the baseline characteristics of residents,residents′ awareness of family doctor service and two-way referral,residents′ demand for family doctor services,ways they get information about family doctor services,residents′ situation of visiting family doctors and asking for the two-way referral,residents′ satisfaction of family doctor services,and residents′ evaluation of the two-way referral.A total of 300 questionnaires were distributed and 225 effective questionnaires were collected.The effective recovery rate was 75.0%.Results  There were 91.1%(205/225) of the residents who knew the family doctor services and two-way referral.Top three service projects with the highest awareness rate were annual free medical examination〔83.6%(188/225)〕,the establishment and management of health records〔56.0%(126/225)〕 and reimbursement ratio of two-way referral〔53.8%(121/225)〕.There were significant differences among residents with different age,occupation and self-health status in residents′ awareness rate of the family doctor services and two-way referral(P<0.05).And 72.9%(164/225) of residents believed that the current service projects of family doctors could meet their basic needs.The service project with the highest demand rate〔81.3% (183/225)〕 was regular medical examination,and the main way the residents got information about family doctor services〔36.0% (81/225)〕 was the introduction of medical staff.In addition,89.3%(201/225)of the residents were in favor of initial diagnosis in primary health care institutions,and 86.2%(194/225) of the residents preferred to visit doctors in primary health care institutions.The most satisfying service project was service attitude.Moreover,18.2%(41/225) of the residents were satisfied with the service attitude very much,and 66.2%(149/225) of the residents were satisfied with the service attitude.The residents who thought the referral to superior hospitals from the primary health care institutions was carried out in a more timely manner accounted for 21.3%(48/225),and 70.7%(159/225)of the residents thought the referral to superior hospitals was carried out in time.The residents who thought the superior hospitals took more timely action on the referral accounted for 22.7%(51/225),and 62.6%(141/225)of the residents thought the superior hospitals took action on the referral timely.Conclusion  The residents′ awareness and satisfaction of the family doctor services and two-way referral are both in a high level.Family doctor services and two-way referral plays an important role in increasing the initial diagnosis rate in primary health care institutions and relieving the treatment pressure of large hospitals,which makes it deserve to be promoted in the future.
    【Key words】  Family doctor services;Signing a contract;Two-way referral;Awareness;Satisfaction;Shaanxi
 
Value of Chinese Evaluation Method Versus Pooled Cohort Equations for Assessing the 10-year Risk of Ischemic Cardiovascular Disease in Population Undergoing Health Examination  WANG Fang1,LIANG Li-rong2,YU Li-ping1*,ZHONG Guang-zhen1*
1.Cardiology Center, Beijing Chao-Yang Hospital Affiliated to Capital Medical University,Beijing 100020,China
2.Department of Clinical Epidemiology Research,Beijing Chao-Yang Hospital Affiliated to Capital Medical University,Beijing 100020,China
*Corresponding author:YU Li-ping,Associate professor,Master supervisor;E-mail:yhp@medmail.com.cn
ZHONG Guang-zhen,Associate professor,Master supervisor;E-mail:zhongguangzhen@hotmail.com 
    【Abstract】  Objective  To determine which one of the two methods,Chinese evaluation method for 10-year risk of ischemic cardiovascular disease(hereinafter referred to as "Chinese evaluation method") proposed in 2011 Chinese Guidelines for Prevention of Cardiovascular Diseases and pooled cohort equations for atherosclerotic cardiovascular diseases(ASCVD) recommended by American College of Cardiology/American Heart Association(ACC/AHA) in 2013(hereinafter referred to as "pooled cohort equations"),can evaluate cardiovascular disease(CVD) risk more accurately for population having health examination.Methods  Totally 733 individuals(40-79 years old,no history of CVD) having health examination in Physical Examination Center,Beijing Chao-Yang Hospital Affiliated to Capital Medical University from April to September 2016 were enrolled.Chinese evaluation method and pooled cohort equations were used to assess their 10-year absolute risk of CVD,respectively.We chose the carotid atherosclerotic plaque as an alternative indicator of CVD.Predicting the 10-year risk of carotid atherosclerotic plaques was supposed to indirectly reflect the values of the two assessment methods for CVD risk.Results  Pooled cohort equations had higher accuracy than Chinese evaluation method in predicting the absolute risk of CVD 〔3.6%(6.6%)vs 1.5%(3.4%),Z=-19.122,P<0.05〕.Taking 7.5% as the value for low-risk threshold of 10-year absolute risk of CVD,participants with 10-year absolute risk value of CVD <7.5% and ≥7.5% could be assigned to low-risk group and non-low-risk group,respectively.The detection rate of low-risk participants of pooled cohort equations and Chinese evaluation method was respectively 73.1%(536/733) and 94.1%(690/733).The detection rate of non-low-risk participants of pooled cohort equations was higher than that of Chinese evaluation method 〔26.9%(197/733) vs 5.9%(43/733),χ2=146.306,P<0.05 〕.As for the prediction of the absolute risk of carotid atherosclerotic plaques,pooled cohort equations had higher area under the receiver operating characteristic(ROC) curve(AUC) value than Chinese evaluation method did {0.770〔95%CI(0.738,0.800)〕 vs 0.717〔95%CI(0.683,0.749)〕,Z=3.935,P<0.05}.Conclusion  Pooled cohort equations assesses the 10-year risk of carotid plaques more accurately in population having physical examination than Chinese evaluation method,which suggests that it may be more accurate to evaluate the 10-year risk of CVD.Therefore,it is advisable to use pooled cohort equations clinically to identify high-risk groups timely,by which the primary prevention of CVD can be promoted.
    【Key words】  Cardiovascular diseases;Risk assessment;Chinese evaluation method;Pooled cohort equations
 
Changes in Body Composition and Associated Factors for Sarcopenia in Patients with Chronic Obstructive Pulmonary Disease  LIAN-Jie1,PAN Dian-zhu2*,AN Xiao-qin2,LI Yang3
1.Graduate School,Jinzhou Medical University,Jinzhou 121000,China
2.Department of Respiratory Medicine,The First Affiliated Hospital of Jinzhou Medical University,Jinzhou 121000,China
3.The First Clinical College,Jinzhou Medical University,Jinzhou 121000,China
*Corresponding author:PAN Dian-zhu,Professor,Master supervisor;E-mail:pandianzhu@163.com
    【Abstract】  Objective  To investigate the changes in body composition and associated factors for sarcopenia in patients with chronic obstructive pulmonary disease(COPD).Methods  Ninety-six patients with COPD who were treated in The First Affiliated Hospital of Jinzhou Medical University from September to December 2016 were selected as the case group,and other 52 sex-and age-matched healthy adults underwent physical examination in the hospital during the same period were selected as the control group.All of them measured height,weight,BMI and body composition.In accordance with the definition and consensus diagnostic criteria developed by the European Working Group on Sarcopenia in Older People(EWGSOP),sarcopenia was identified by skeletal muscle mass index and gait speed.Univariate Logistic regression analysis and multiple stepwise Logistic regression analysis were performed to investigate the associated factors for COPD with sarcopenia.Results  The measured values of weight,BMI,total-body skeletal muscle mass,trunk muscle mass,upper extremity skeletal muscle mass,lower extremity skeletal muscle mass,limb skeletal muscle mass,lean body mass,skeletal muscle index and lean body mass index were lower in male COPD patients than in male controls(P<0.05).Female COPD patients were found with higher values of weight,BMI,total-body skeletal muscle mass,trunk muscle mass,upper extremity skeletal muscle mass,lower extremity skeletal muscle mass,limb skeletal muscle mass,lean body mass and skeletal muscle index compared with the female controls(P<0.05).The incidence of sarcopenia in case group was higher than that in the control group(P<0.05).The results of the univariate Logistic regression analysis showed that age,course of COPD and BMI are the associated factors of COPD with sarcopenia(P<0.05).Multivariate Logistic regression analysis showed that age,long-term smoking history,course of COPD,BMI are the associated factors of COPD with sarcopenia(P<0.05).Conclusion  COPD patients are identified with significantly decreased muscle mass(total-body skeletal muscle mass,trunk muscle mass,upper extremity skeletal muscle mass,lower extremity skeletal muscle mass,limb skeletal muscle mass) and declined lean body mass.Moreover,they are prone to suffer from sarcopenia.Advanced age,long-term smoking,long course of COPD and decreased BMI are the risk factors.
    【Key words】  Pulmonary disease,chronic obstructive;Sarcopenia;Body composition;Root cause analysis
 
Effects of Atorvastatin Withdrawal on the Vulnerable Carotid Plaque and Prognosis in Elderly Patients with Acute Cerebral Infarction  ZHANG Yan-ying1,SHI Zhen-dong2*
1.Department of Neurology,Tiefa Coal Industry Group General Hospital Affiliated to Shenyang Medical College,Tieling 112700,China
2.VIP Ward,Tiefa Coal Industry Group General Hospital Affiliated to Shenyang Medical College,Tieling 112700,China
*Corresponding author:SHI Zhen-dong,Associate chief physician;E-mail:shiminghan666@163.com
    【Abstract】  Objective  To investigate the effect of atorvastatin withdrawal on vulnerable carotid plaque and prognosis in elderly patients with acute cerebral infarction(ACI).Methods  The enrolled participants were 235 elderly patients with ACI who received inpatient treatment in Department of Neurology,Tiefa Coal Industry Group General Hospital Affiliated to Shenyang Medical College from February 2012 to September 2015.All received the conventional treatment during the hospitalization and were prescribed long-term oral administration of atorvastatin and aspirin after discharge.Of them,those who long-termly orally took atorvastatin and aspirin after discharge were assigned to the observation group(n=102),and those who voluntarily stopped taking atorvastatin at one week after discharge and only took aspirin and other drugs for basic disease were assigned to the control group(n=133).Levels of blood lipid-related markers,carotid intima-media thickness(CIMT),carotid plaque area,plaque index measured at the onset of ACI,6 months and 12 months after the onset of ACI,recurrence rate of cerebral infarction and incidence of adverse reactions within 12 months after onset in both groups were analyzed and compared.Results  The levels of TC,TG,LDL-C and HDL-C differed significantly between the two groups before and after treatment(P<0.05),and they varied by the time point of measurement(P<0.05).Treatment regimen and duration exerted interaction effects on the levels of TC,TG,LDL-C and HDL-C(P<0.05).The severity of CIMT,size of carotid plaque area and plaque index in the observation group were significantly different from those in the control group before and after treatment(P<0.05),and they were varied by the time point of measurement(P<0.05).Treatment regimen and duration produced interaction effects on the severity of CIMT,size of carotid plaque area and plaque index(P<0.05).The levels of TC,TG and LDL-C were lower in the observation group than in the control group at 6,12 months after the onset of ACI,but levels of HDL-C were higher in the observation group than in the control group at 12 months after the onset of ACI(P<0.05).The observation group had milder CIMT,smaller carotid plaque area,lower plaque index compared with the control group at 6,12 months after the onset of ACI(P<0.05).The recurrence rate of cerebral infarction in the observation group was lower than that in the control group(P<0.05).There was no significant difference in the incidence of adverse reactions between the two groups(P>0.05).Conclusion  Atorvastatin can decrease the blood-lipid levels,control atherosclerosis,and stabilize the vulnerable carotid plaque in elderly ACI patients.Blindly and voluntarily stop taking atorvastatin can increase the recurrence rate of cerebral infarction.
    【Key words】  Brain infarction;Atorvastatin;Drug withdrawal;Vulnerable carotid plaque;Prognosis
 
Correlation of Hypertension and Cognitive Dysfunction with Serum 25-hydroxyvitamin D3 Level in Aged Patients  GUAN Chun-lan1,MIAO Yi-de2*
1.Zichengjiayuan Community Health Service Station,Beijing 100193,China
2.Department of Geriatrics,Peking University People′s Hospital,Beijing 100044,China
*Corresponding author:MIAO Yi-de,Chief physician,Master supervisor;E-mail:13911190052@163.com
    【Abstract】  Objective  To investigate the correlation of hypertension and cognitive dysfunction with serum 25-hydroxyvitamin D3〔25-(OH)D3〕 level in aged patients.Methods  The enrolled participants were 117 inpatients who received treatment in Department of Geriatrics,Peking University People′s Hospital from October 2013 to July 2015.Based on the status of cognitive function evaluated with the Mini-mental State Examination(MMSE) and the measured blood pressure level,we assigned 30 of them with both hypertension and cognitive dysfunction to the observation group,and other 87 cases,including the cases with hypertension but without cognitive dysfunction,those with cognitive dysfunction but without hypertension and those without hypertension and cognitive dysfunction,were assigned to the control group.We obtained the clinical data of the participants.Multivariate Logistic regression analysis and ROC curve of serum 25-(OH)D3 level were used to investigate the correlation of 25-(OH)D3 level with hypertension and cognitive dysfunction in aged patients.Results  Two groups had no significant differences in terms of sex distribution,years of education,ratios in smoking prevalence,alcohol consumption prevalence,diabetes prevalence,coronary heart disease prevalence and treatment with vitamin D supplementation,BMI,levels of hemoglobin(Hb),glycosylated hemoglobin(HbA1c),and serum levels of total cholesterol(TC),triacylglycerol(TG),low-density lipoprotein cholesterol(LDL-C),high-density lipoprotein cholesterol(HDL-C),free triiodothyronine(fT3),free thyroxine(fT4),total triiodothyronine(TT3),total thyroxine(TT4),thyroid-stimulating hormone(TSH),concentrations of calcium,urea nitrogen(BUN),uric acid(UA) and creatinine(Cr)(P>0.05).Compared with the control group,patients in the observation group were much older,and they had obviously longer duration of hypertension and lower serum 25-(OH)D3 level(P<0.05).Multivariate Logistic regression analysis found that,age,duration of hypertension,levels of serum Hb,fT3 and 25-(OH)D3 were the factors associated with hypertension and cognitive dysfunction in aged patients(P<0.05).The area under the ROC curve(AUC) of serum 25-(OH)D3 level showed that it had moderate value in predicting the occurrence of both hypertension and cognitive dysfunction in aged patients( AUC=0.675,P<0.05).Conclusion  The decreased serum 25-(OH)D3 level may play an important role in the development of hypertension and cognitive dysfunction in aged patients.
    【Key words】  Hypertension;Cognition disorders;Calcifediol;Aged
 
Adverse Reactions to Zoledronic Acid Injection in Chinese Elders Aged 75 or Over with Osteoporosis  GUAN Yuan*,GAO Yan-ling,LI Gui-qing
Department of Endocrinology,Yangzhou First People′s Hospital,Yangzhou 225000,China
*Corresponding author:GUAN Yuan,Attending physician;E-mail:lgq333gy@163.com
    【Abstract】  Objective  To investigate the adverse reactions to zoledronic acid injection in Chinese elders with osteoporosis,and based on this,to evaluate the correlation between advanced age(≥75 years) and the occurrence of adverse drug reactions.Methods  Forty-five consecutive elderly patients with osteoporosis who were treated with zoledronic acid injection in Yangzhou First People′s Hospital from March 2011 to July 2016 were enrolled and divided into elderly group(aged 60-74 years,n=26) and very elderly group(aged 75-88 years,n=19).The baseline data and information about adverse reactions to zoledronic acid injection of both groups were collected.Partial correlation analysis was performed to find the correlation between advanced age and the incidence of adverse drug reactions.Results  Sex distribution,values of BMI,osteocalcin,calcium ion,phosphorus ion,alkaline phosphatase(ALP),parathyroid hormone(PTH),25-hydroxyvitamin D〔25-(OH)D〕 and bone mineral density of lumbar L1-4 and femoral neck,utilization rate of bone resorption inhibitors,incidence of hypertension,diabetes mellitus and heart disease did not differ significantly between the two groups(P>0.05).Adverse reactions to zoledronic acid injection occurred significantly less in very elderly group than in the elderly group(P<0.05).The age and utilization rate of bone resorption inhibitors differed significantly between patients with adverse reactions to zoledronic acid injection and those without(P<0.05).After adjusting for the use of bone resorption inhibitors,advanced age presented a negative correlation with the incidence of adverse drug reactions(P<0.05).Conclusion  Patients aged 75 or over with acute exacerbation of osteoporosis are less likely to have adverse reactions to zoledronic acid injection compared with those less than 75 years old.Advanced age is negatively correlated with the incidence of adverse drug reactions.
    【Key words】  Osteoporosis;Zoledronic acid;Drug toxicity;Advanced age
 
sFlt-1 and Preeclampsia in Chinese Kazak and Han Pregnant Women During the Third Trimester of Pregnancy  ZHANG Li-hong,WANG Zhi-mei,XIE Wen-juan,ZHU Qi-ying*
Obstetrics Department,The First Affiliated Hospital of Xinjiang Medical University,Urumqi 830054,China 
*Corresponding author:ZHU Qi-ying,Chief physician,Doctoral supervisor;E-mail:zhuqiyingxq@sina.com
    【Abstract】  Objective  To explore the relationship between the soluble vascular endothelial growth factor receptor 1(sFlt-1) and preeclampsia(PE) in Chinese Kazakh and Han pregnant women in the third trimester of pregnancy.Methods  We enrolled 110 pregnant women who delivered in Obstetrics Department,The First Affiliated Hospital of Xinjiang Medical University between December 2015 and April 2016 and divided them into Chinese Kazakh pregnant women with PE(Kazakh PE group,n=25),Chinese Han pregnant women with PE(Han PE group,n=25),normal Chinese Kazakh pregnant women(normal Kazakh group,n=30) and normal Chinese Han pregnant women(normal Han group,n=30).We obtained the clinical data of all the participants.The level of sFlt-1 in the placental tissues was measured by qRT-PCR.Results  The average weight of the Kazakh PE group was higher than that of normal Han group(P<0.05).The average levels of systolic and diastolic blood pressure were higher in the PE groups than in the normal groups(P<0.05).Both PE groups had shorter gestational weeks than the normal groups(P<0.05).The average neonates delivered by PE groups demonstrated lower birth weight compared with those delivered by the normal groups(P<0.05).The average hemoglobin levels were found to be higher in Han groups than in the Kazakh groups(P<0.05).PE groups presented higher average creatinine levels than the normal groups(P<0.05).The expression level of sFlt-1 in the Han PE group was identified to be the highest(P<0.05).Kazak PE group showed higher expression level of sFlt-1than the normal groups(P<0.05).The expression level of sFlt-1 did not differ significantly between normal Kazak group and normal Han group(P>0.05).The Kazak severe PE subgroup,Kazak mild PE subgroup,Han severe PE subgroup,and Han mild PE subgroup showed similar expressional levels of sFlt-1(P>0.05).Conclusion  sFlt-1,a haematological marker,may be involved in the development of preeclampsia during the third trimester of pregnancy.PE can be identified by the expression level of sFlt-1,while the severity of PE can not.
    【Key words】  Eclampsia;Vascular endothelial growth factor receptor-1;Pregnancy trimester,third;Kazak nationality;Han nationality
 
Implementing Situation and Training Needs of Health Education among Community Doctors in Shanghai  ZHU Jing-fen1,YANG Ying-hua2,LU Yu2,CHENG Hai-ming2,YANG Hui1,ZHU Li-ye2,SHI Rong3*
1.School of Public Health,Shanghai Jiaotong University,Shanghai 200025,China
2.Shanghai International Center for Audiovisual Communication of Population,Shanghai 200040,China
3.School of Public Health,Shanghai University of Traditional Chinese Medicine,Shanghai 201203,China
*Corresponding author:SHI Rong,Professor,Master supervisor;E-mail:shirong61@163.com
    【Abstract】  Objective  To investigate the implementing situation and training needs of health education in community in order to improve the quality of health education and the ability of carrying out health education training among community doctors.Methods  Using stratified random sampling,The municipal districts in Shanghai were stratified by geographical location(urban districts,inner suburban districts,outer suburban districts).Xuhui District,Hongkou District,Yangpu District,Zhabei District and Putuo District from urban districts,Minhang District,Baoshan District and Pudong New Area from inner suburban districts,and Songjiang District and Jinshan District from outer suburban districts,a total of ten districts were selected.Four or five community health service centers were randomly selected from each district,and a total of 42 community health service centers were selected.Two or three community doctors were randomly selected from each community health service center,and therefore a total of 123 community doctors were selected.Based on the relevant documents,the questionnaire was compiled by Delphi expert consultation method and the main contents of the questionnaire were the basic information of community doctors,the implementing situation and training needs of health education.Questionnaires were sent from May to August in 2015.A total of 123 questionnaires were collected and the effective recovery rate was 100.0%.Results  The average proportion of health education workload was(28.0±16.4)% in the total workload of community doctors.There was no significant difference in the proportion of health education workload among community doctors with different gender,age,education level,professional title,work seniority,and doctor category(P>0.05).The main forms of health education in communities were dissemination of health education materials(91.1%,112/123),face-to-face consultation(90.2%,111/123),and group lectures(89.4%,110/123).At present,the main problems of health education in communities were lack of time and energy(medical staff)(79.7%,98/123),lack of coordination(residents)(66.7%,82/123),and single form of health education(59.3%,73/123).Of the 123 community doctors,79(64.2%) had received curricula or skills training of health education and 105(85.4%) considered it necessary to conduct health education training.There was no significant difference in training needs of health education among community doctors with different gender,age,education level,professional title,work seniority,and doctor category(P>0.05).The content needs of health education training were behavioral interventions for chronic diseases patients(84.6%,104/123),health management and care(74.8%,92/123),prevention of risk factors(70.7%,87/123).The method needs of health education training were combining teaching with classroom practice(51.2%,63/123),combining teaching with panel discussion(45.5%,56/123),and academic exchange and investigation(43.9%,54/123).Conclusion  Health education has become part of the important work of community doctors in Shanghai and the forms of community health education are diversified.But community doctors still have a greater demand for health education training and targeted training should be carried out in order to improve community doctors′capacity of carrying out health education training.
    【Key words】  Physicians,primary care;Health education;Training
 
Current Work Ability and Training Needs of General Practitioner Assistants in Shanghai  ZHAO Fang1*,YANG Ying-hua2,ZHANG Tian-ye3,LIU Yu-chang4,GU Hao5,DU Zhao-hui6,DU Xiao-lei1
1.Shanghai University of Medicine & Health Sciences,Shanghai 201318,China
2.Shanghai Municipal Center for Disease Control & Prevention,Shanghai 200336,China
3.Shanghai Municipal Commission of Health and Family Planning,Shanghai 200125,China
4.Longbai Community Health Center of Minhang District,Shanghai 201105,China
5.Xinzhuang Community Health Center of Minhang District,Shanghai 201199,China
6.Weifang Community Health Center of Pudong New District,Shanghai 200122,China
*Corresponding author:ZHAO Fang,Associate professor;E-mail:zhaof@sumhs.edu.cn
    【Abstract】  Objective  To investigate the current work ability and training needs in general practitioner(GP) assistants in Shanghai,with a view to providing a reference for the training of GP assistants in Shanghai.Methods  Using purposive sampling,we selected 6 out of the 13 community health service centers(CHSCs) in Minhang District,Shanghai in which services delivered by GP assistants were first carried out on a trial basis in Shanghai.Then,from these 6 CHSCs,we enrolled 170 GP assistants by random sampling.From July to August 2016,we conducted a survey in the GP assistants with a self-developed questionnaire covering the demographic data,positive value of GP assistants′ work for the work of the GP,work ability,main challenges encountered at work,and professional knowledge and skills needing to be trained.The survey achieved a response rate of 97.6%(166/170).Results  Of the 166 final participants,66.3%(110/166) majored in nursing,18.7%(31/166) majored in public health,and 15.0%(25/166) majored in other specialties.The value of GP assistants′ work in reducing the workload of the GP,helping the GP concentrate on diagnosis and treatment,increasing the time of the GP for learning,attending meetings and further study,and improving the doctor-patient relationship varied significantly by the major(P<0.05).The self-assessment scores of the work ability were(7.8±1.9)(7.1±2.2)(7.7±1.7)for GP assistants majoring in nursing,those majoring in public health and those majoring in other specialties,which were similar in the three groups(P>0.05).In view of the main challenges encountered in the work,challenges in self-perceived too heavy workload and self-perceived insufficiency in medical knowledge and skills differed significantly in these three groups(P<0.05).The knowledge needing to be trained for GP assistants majoring in nursing mainly included health psychology(72 cases,65.5%),common disease management standards(63 cases,57.3%),basic medical knowledge(62 cases,56.4%),that for GP assistants majoring in public health mainly covered health psychology(19 cases,61.3%),common disease management standards(17 cases,54.8%) and basic knowledge of nutrition(16 cases,51.6%),and that for GP assistants majoring in other specialties composed of basic medical knowledge(19 cases,76.0%),health psychology(18 cases,72.0%) and basic knowledge of nutrition(14 cases,56.3%).In general,the knowledge needing to be trained did not differ substantially between these groups(P>0.05).The skills needing to be trained for GP assistants majoring in nursing mainly consisted of communication(48 cases,43.6%),using basic office software(40 cases,36.4%) and health education(40 cases,36.4%);for those majoring in public health,the skills needing to be trained comprised preparation for small activities and meetings(13 cases,41.9%),communication(11 cases,35.5%),health assessment(11 cases,35.5%),preliminary analysis of data and from production(11 cases,35.5%);for GP assistants majoring in other specialties,the skills that they needed to be trained involved communication(10 cases,40.0%),health assessment(9 cases,36.0%),writing summary report(9 cases,36.0%).These groups showed no significant differences in the skills needing to be trained except health education(P>0.05).Conclusion  The levels of work ability are similar and need to be improved in the three groups of GP assistants in Shanghai.However,the priorities of the training that they need are different,so the training given to them should be targeted.
    【Key words】   General practitioner assistant;Professional competency;Training
 
Development and Application of a Self-management Tool for Childhood Asthma Based on Mobile Internet Technology  XI Lei1,2,HUANG Hui-Jie1,NI Xin3,XIANG Li1*
1.Allergy Department,Beijing Children′s Hospital,Capital Medical University,Beijing 100045,China
2.Department of Paediatrics,Tongzhou Maternal & Child Health Hospital of Beijing,Beijing 101101,China
3.Department of Otorhinolaryngology,Beijing Children′s Hospital,Capital Medical University,Beijing 100045,China
*Corresponding author:XIANG Li,Chief physician,Associate professor,Master supervisor;E-mail:drxiangli@163.com
    【Abstract】  Objective  To develop a self-management application(APP) for childhood asthma based on mobile Internet technology and apply it to clinical practice,which explores the clinical value of mobile Internet technology preliminarily in the self-management of childhood asthma.Methods  According to the basic elements of childhood asthma management,a self-management APP for childhood asthma was developed,tested and optimized based on the Android mobile phone operating system.A total of 64 children with bronchial asthma who were visited the Allergy Department of Beijing Children′s Hospital,Capital Medical University,were selected from February to June of the year 2016.According to the wishes of guardians,these patients were divided into APP management group(n=28) and traditional diary card management group(n=36).Using the self-management APP for childhood asthma downloaded on smart phones,patients in APP management group were managed remotely,while patients in traditional diary card management group were managed with traditional diary cards in paper version to record their symptoms,medication and so on.The asthma control rate and the childhood asthma control test(C-ACT) scores were compared between two groups before and after the management.The medication compliance and self-management situation of childhood asthma〔the number of days of symptom recording and the number of days of(peak expiratory flow rate)〕 during the one-month management were compared between two groups.And guardians′ satisfaction and acceptance of the self-management APP were evaluated with questionnaire.Results  Eighteen patients from APP management group and 33 patients from traditional diary card management group completed the one-month management.There was no significant difference in asthma control rate and C-ACT scores between two groups before and after one-month management(P>0.05),while the asthma control rate and C-ACT scores after one-month management were both higher than that before the management in each group(P<0.05).After one-month management,there was no significant difference in medication compliance and the number of days of PEFR between two groups(P>0.05),while there was significant difference in the number of days of symptom recording(P<0.05).The satisfaction rate of the APP management group was 93.7%(15/16) and the acceptance rate was 81.3%(13/16).Conclusion  The self-management APP for childhood asthma is highly accepted and satisfied among users,but it has no significant advantage in improving asthma control rate,C-ACT scores and medication compliance,which needs further optimization of APP function and a large sample of randomized controlled study to support it.
    【Key words】  Athma;Disease management;Internet;Software;Child
 
Development and Evaluation of a Comprehensive Reminder System for the Promotion of Healthy Behaviors among Discharged Ischemic Stroke Patients  WAN Li-hong1,MO Miao-miao2,ZHANG Xiao-pei2,OU Cui-ling3,LI Ling4,RUAN Heng-fang3,LU Yu-wei5,CHEN Shao-xian6*
1.School of Nursing,Sun Yat-Sen University,Guangzhou 510089,China
2.Department of Neurology,Guangdong Provincial Hospital of Chinese Medicine,Guangzhou 510120,China
3.Department of Neurology,The Third Affiliated Hospital,Sun Yat-Sen University,Guangzhou 510630,China
4.Department of Neurology,The First Affiliated Hospital,Sun Yat-Sen University,Guangzhou 510080,China
5.Department of Neurology,Second Affiliated Hospital of Sun Yat-Sen University,Guangzhou 510120,China
6.School of Public Health,Sun Yat-Sen University,Guangzhou 510089,China 
*Corresponding author:CHEN Shao-xian,Professor,Doctoral supervisor;E-mail:chshaox@mail.sysu.edu.cn
    【Abstract】  Objective  To develop a comprehensive reminder system based on health belief model(CRS-HBM) and evaluate its effect on healthy behaviors among discharged ischemic stroke patients.Methods  We enrolled a convenience sample of 87 hypertensive ischemic stroke inpatients who received treatment in Guangdong Provincial Hospital of Chinese Medicine,The Third Affiliated Hospital,Sun Yat-Sen University and Second Affiliated Hospital of Sun Yat-Sen University from February 2015 to March 2016.The CRS-HBM was developed and applied to a program conducted in these patients consisting of face-to-face health belief-related education before discharge and a 6-month intervention after discharge including telephone-based education,weekly automated text message-based education,health education through written materials 〔Handbook of Health Beliefs for Stroke Patients & Monthly Calendar and Journal(hereinafter referred to as the Handbook) and guidance for self-management of the monthly calendar and journal covered in the Handbook〕.Seventy-six(87.4%)patients completed the whole 6-month intervention and they were surveyed by a self-designed questionnaire covering the implementation status of CRS-HBM and patient satisfaction with the CRS-HBM-based intervention program.The survey achieved a response rate of 100.0%.Ten out of 76 patients were purposively selected for semi-structured interview.The qualitative research method of phenomenology was used to collect,sort,analyze the results of interview and summarize themes.Results  The mean time of face-to-face interview before discharge for 76 patients was (29.0±5.9)min.The mean time were (6.8±3.0),(10.8±5.3),(8.9±4.3)min for telephone-based education conducted at 1 week,1 month,and 3 months after discharge respectively.All the patients or their relatives received text messages every week during the intervention period,and 22(28.9%) of them indicated that the text messages were received by their relatives(spouse or children).As for using the self-management sheet included in the Handbook,5(6.6%) never used,20(26.3%) used it for less than 1 month,32(42.1%) used it for 1-3 months,11(14.5%) used it for over 3 months,only 8(10.5%) used it for the whole 6-month intervention after discharge.As for using the blood pressure record sheet,5(6.6%) never used it;10(13.2%) used it for less than 1 month,26(34.2%) used it for 1-3 months.20(26.3%) used it for over 3 months,only 15(19.7%) used it for the whole 6 month after discharge.The scores of patient satisfaction with health belief-related education before discharge,telephone-based education and text message-based education following discharge and the Handbook were(9.88±0.43)(9.59±0.75)(9.81±0.39)(9.45±0.71) respectively.The 6 themes concluded based on the results of semi-structured interviews are as follows:Health belief-related education could enhance the level of risk awareness of stroke,improve knowledge related to stroke,reinforce the health beliefs and promote healthy behaviors;The Handbook was comprehensive,practical,illustrated,and convenient for reading;The self-management of the monthly calendar and journal covered in the Handbook could help to modify unhealthy lifestyles;The blood pressure record sheet was concise and convenient to record;Telephone-based education and text message-based education enhanced the intervention effect;The lifestyles were becoming more healthy,but it takes time to correct bad habits.Conclusion  Patient satisfaction with the CRS-HBM program is pretty good.The program is scientific,operating,effective and worth popularizing.
    【Key words】  Stroke;Health behavior;Patient discharge management;Comprehensive reminder system
 
Research Progress of the Effect of Psychological Consultant and Visitors of the Same Race on Psychotherapy  ZHAO Jia-ying,LIU Huan-huan,ZHANG Xiao-yuan*
Department of Psychology,Southern Medical University,Guangzhou 510000,China
*Corresponding author:ZHANG Xiao-yuan,Professor,Doctoral supervisor;E-mail:zhxy@fimmu.com
    【Abstract】  Racial/ethnic matching means that psychological consultant and visitors are of the same race.Foreign researchers mainly studied the effect of psychological consultant and visitors of the same race on psychotherapy through empirical researches(analog study,archival study,quasi-experimental study),meta-analysis and qualitative researches,and have not got consistent conclusion.The author reviews these methods and results and hopes to explore the research prospect of racial/ethnic matching and other consult-visit matching characteristics in psychological consulting and treatment in China.
    【Key words】  Racial matching;Ethnic matching;Psychotherapeutic processes
 
Mediating Effect of Social Support Between Introvertion/Extraversion and Loneliness in College Students  XU Dan-yang,YANG Zhi-hui* 
Department of Psychology,School of Humanities and Social Sciences,Beijing Forestry University,Beijing 100083,China
*Corresponding author:YANG Zhi-hui,Associate professor,Master supervisor;E-mail:zhihuiyang2008@126.com
    【Abstract】  Objective  To explore the mediating effect of social support between introversion/extraversion and loneliness among college students.Methods  This study was conducted in May,2015.Two hundred and fifty college students were selected by convenience sampling from a college in Beijing and surveyed by the UCLA Loneliness Scale(Chinese version),extraversion and introversion dimensions of Eysenck Personality Questionnaire-Revised Short Scale for Chinese(EPQ-RSC) and objective support,subjective support and utilization of support dimensions of Social Support Rating Scale for assessing the degree of loneliness,extravert or introvert character and level of social support.The survey obtained a response rate of 95.2%(238/250).Results  The scores for loneliness,introvertion/extraversion and social support were (43.7±8.2)(7.4±2.6)(38.3±6.4)respectively.The Pearson′s analysis showed that,introversion/extraversion was negatively and linearly related to loneliness(P<0.01),while introversion/extraversion was positively and linearly related to social support,objective support,subjective support and utilization of support(P<0.01).Loneliness was negatively and linearly correlated with social support,objective support,subjective support and utilization of support(P<0.01).The analysis with structure equation modeling showed that,social support played a mediating role between introversion/extraversion and loneliness completely(P<0.01).According to the findings of hierarchical cluster analysis,there were 4 groups,namely,slightly introverted and high social support group(n=80),extroverted and high social support group(n=78),introverted and low social support group(n=33) and slightly extroverted and low social support group(n=47).The scores of loneliness of introverted and low social support group and slightly extroverted and low social support group were higher than those of the other two groups(P<0.05).The scores of loneliness of slightly introverted and high social support group were higher than those of extroverted and high social support group(P<0.05).Conclusion  Among college students,social support completely mediates the effect of introversion /extraversion on loneliness.
    【Key words】  Introversion(psychology);Extraversion(psychology);Loneliness;Social support;Mediation
 
Relationship Between Lifestyle Regularity and Ego-depletion among College Students and the Mediating Effect of Habitual Behavior  WANG Yun-hui1,2,3,WANG Li-gang1,ZHANG Jing-yi1,2,TAO Ting1,GAO Wen-bin1*
1.Key Laboratory of Mental Health,Institute of Psychology,Chinese Academy of Sciences,Beijing 100081,China
2.University of Chinese Academy of Sciences,Beijing 100049,China
3.Central University of Finance and Economics Hospital,Beijing 100081,China
*Corresponding author:GAO Wen-bin,Researcher,Master supervisor;E-mail:gaowb@psych.ac.cn
    【Abstract】  Objective  The study aims to examine the relationship between lifestyle regularity and ego-depletion among college students,and to verify the mediating role of habitual behavior between them.Methods  Four hundred and thirty-five college students were selected from Renmin University of China and Central University of Finance and Economics by convenience sampling in November 2015.They were surveyed by the Chinese version of the Self-Regulatory Fatigue Scale,College Students′ Weekend Life Behavior Questionnaire and Self-rating Lifestyle Regularity Scale for investigating the degree of ego-depletion,degree of habitual behavior and level of lifestyle regularity.The survey achieved a response rate of 98.9%(430/435).Results  The scores for the degree of ego-depletion,level of lifestyle regularity and degree of habitual behavior were(45.8±5.3)(7.0±1.8)(30.9±4.2) respectively in the participants.Female students had higher scores for level of lifestyle regularity than male students(P<0.05).The scores for the degree of habitual behavior were higher in juniors than in sophomores(P<0.05).Pearson′s correlation analysis found that,there was a significant negative linear correlation between lifestyle regularity and ego-depletion (P<0.05),a significant positive linear correlation between habitual behavior and lifestyle regularity(P<0.05),and a significant negative linear correlation between habitual behavior and ego-depletion(P<0.05).The analysis about the mediator effect showed that lifestyle regularity was the predictive variable of ego-depletion(β=-0.323,P<0.01) and it influenced the habitual behavior positively(β=0

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