RESUMO
OBJECTIVE: To investigate the incidence of falls and recurrent falls, and explore associated factors for single and recurrent falls among urban community-dwelling elderly in Beijing. METHODS: A cross-sectional study was conducted in 472 elderly in the Longtan community of Dongcheng district, Beijing in 2009. Data regarding the incidence of fall and recurrent falls in the previous year, as well as associated factors were collected from the elderly through face-to-face interviews. RESULTS: The incidence of falls and recurrent falls was 17.8% and 6.1%, respectively, and it increased with age (χ2for trend=21.06, 19.20, P=0.001, 0.002). Binary logistic stepwise regression analysis showed that age (OR=2.20), living alone (OR=4.67) and gait disturbance (OR=1.27) were risk factors, while housing with elevators (OR=0.35), appropriate width/height of stair steps (OR=0.78), sufficient lighting for stairway (OR=0.45) and regular exercise (OR=0.12) could lower the risk for single fall; factors such as low monthly family income (OR=1.39), poor vision (OR=1.83), low physical ability (OR=4.47), abnormal static balance (OR=2.48), and fear of falls(OR=2.23) were risk factors, while appropriate width/height of stair steps (OR=0.49) and easiness of access to daily supplies (OR=0.41) were protective factors for recurrent falls. CONCLUSION: The incidence of falls in community-dwelling elderly people in Beijing is common, and falls and their related injuries have been associated with both intrinsic and extrinsic factors.
Assuntos
Acidentes por Quedas/estatística & dados numéricos , Idoso , Idoso de 80 Anos ou mais , China/epidemiologia , Cidades/estatística & dados numéricos , Feminino , Humanos , Incidência , Masculino , Recidiva , Ferimentos e Lesões/epidemiologiaRESUMO
OBJECTIVE: To determine the prevalence of non-fatal injuries among children aged 5-14 years in China. METHODS: Data of 21 973 children aged 5-14 years were extracted from the Fourth National Health Service Survey of China carried out between June 15 and July 10, 2008. Injury-related indicators included: history of ever having had an injury, and injury frequency, cause, location and severity. RESULTS: The overall prevalence of non-fatal injuries among the children in the previous 12 months was 17.0 per 1000 subjects. The leading causes of non-fatal injuries were falls, animal bites, traffic accidents, falling objects and burns. The majority of children sustained only one injury. The main place of injury was at home in 40% and 54% of urban boys and girls, respectively, at school in 48% of rural boys, and at home and at school each in 33% of rural girls. Medical treatment for one day was the main option for 80% of urban boys and girls, 84% of rural boys, and 72% of rural girls. CONCLUSION: Nonfatal injuries among children aged 5-14 years are a serious public health concern in China.
Assuntos
Ferimentos e Lesões/epidemiologia , Acidentes/estatística & dados numéricos , Acidentes de Trânsito/estatística & dados numéricos , Adolescente , Criança , Pré-Escolar , China/epidemiologia , Coleta de Dados , Feminino , Humanos , Masculino , Prevalência , População RuralRESUMO
OBJECTIVE: To assess the diagnostic and therapeutic modality preferences of physician implementation of the Chinese Clinical Practice Guidelines for Benign Prostatic Hyperplasia (BPH) for geriatric BPH patients. METHODS: This cross-sectional survey was conducted at 33 medical centers located in 11 different cities in China (4 in north; 7 in south). A total of 190 physicians were requested to record their preferences in diagnostic tests and treatment options for elderly BPH cases. RESULTS: The physician response rate was 97.4%. Respondents generally selected those practices consistent with the guidelines, but their preferences for recommended tests varied. The use of medical history, ultrasonography and urinalysis was higher (> 90.0%) and that of uroflowmetry was lower (31.2%). In addition, the rate of use of recommended tests was higher among physicians in the north than those in the south. Drug therapy was the preferred treatment option. The proportion of drug treatment increased with the severity of symptoms in elder patients. In the south, the proportion of drug treatment in severe cases increased to 82.6% versus 61.9% in mild cases. In the north, the proportion of rug treatment in severe cases increased to 83.5% versus 54.6% in mild cases. CONCLUSION: This study provides insights into the physician preferences of diagnosis and treatment. The physicians generally comply with the BPH clinical practice guidelines. It may also serve as a practical reference for updating and improving the Chinese Clinical Practice Guidelines for BPH.
Assuntos
Hiperplasia Prostática/diagnóstico , Hiperplasia Prostática/terapia , Idoso , China , Estudos Transversais , Humanos , Masculino , Guias de Prática Clínica como AssuntoRESUMO
Quantitative trait locus (QTL) mapping can be accomplished through the method of selective genotyping, which is based on the differences of frequencies between an upper sample and a lower sample in population. However, amplifying the differences in marker allele frequencies in extreme samples may increase the probability for QTL mapping. Shannon entropy, which is a nonlinear function of allele frequencies, can be used to amplify the differences in marker allele frequencies. In this paper, we present a novel measure for linkage disequilibrium (LD) between a marker and single QTL, that is based on the comparison of the entropy and conditional entropy in a marker in extreme samples of population. This measure of LD between the marker and the trait locus can be used when the marker allele frequencies are known in the extreme samples of a population. We investigate the mapping performance in both analytic and simulation scenarios of a single QTL linked to a single marker. Our results show that the measure has very reasonable performance. In addition, a simulation study is performed on the basis of the haplotype frequencies of 10 SNPs of angiotensin-I converting enzyme (ACE) genes.
Assuntos
Entropia , Locos de Características Quantitativas , Mapeamento Cromossômico , Simulação por Computador , Marcadores Genéticos , Haplótipos , Humanos , Modelos Lineares , Desequilíbrio de Ligação , Peptidil Dipeptidase A/genética , Polimorfismo de Nucleotídeo ÚnicoRESUMO
OBJECTIVE: To understand the prevalence, consequences and risk factors of falls among urban community-dwelling elderly in Beijing. METHODS: A cross-sectional study was conducted in Longtan Community, Beijing. A total of 1512 individuals aged 60 years or over were selected by stratified cluster sampling. Data regarding the frequency of falls in the previous year, as well as circumstances, consequence and related factors of falls were collected from the elderly through face-to-face interviews with questionnaires in their home. RESULTS: The prevalence of falls was 18.0% on the average among 1512 participants, higher in women (20.1%) than in men (14.9%) (P = 0.006), and increased with age (chi2(for trend) = 10.37, P = 0.001). The total rate of falls-induced injuries among the fallers was 37.7%. Falls usually resulted in soft-tissues bruises (58.7%), fear of repeated episodes of falls (58.8%), loss of independence and confidence in movement (35.7%) and even in hip fracture. In addition to the burden of medical care, falls also generated a big economic burden. Occurrence of falls was significantly associated with both intrinsic and extrinsic factors. The related factors of falls in the elderly included age > or = 60-70 years, femininity, less physical activities, fear of future falls, living alone, severely impaired vision, health problem-impacted activities of daily living, chronic diseases (diabetes, hypertension, postural hypotension, stroke sequela, cataract, arthritis, dementia and depression), medications (psychoactive, anti-diabetic), gait imbalance, high bed and faintly-lighted stairway. CONCLUSION: The prevalence of falls among urban community-dwelling elderly in Beijing is closely associated with significant associated with intrinsic and extrinsic factors. Efforts to prevent falls in the elderly should be made at community level.
Assuntos
Acidentes por Quedas/prevenção & controle , Idoso , Idoso de 80 Anos ou mais , China , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Prevalência , Fatores de RiscoRESUMO
BACKGROUND: Adiponectin, leptin, resistin, and visfatin, as the main circulating peptides secreted by adipose tissue, are potential contributors to bone metabolism. We investigated whether these serum adipocytokines levels are associated with BMD and bone turnover biochemical markers in 232 Chinese men (20-80 y). METHODS: Serum adiponectin, leptin, resistin, and visfatin levels were determined by ELISA. RESULTS: Leptin had a positively correlation with fat mass, and remained significant after adjustment for age and BMI. There was a significant negative weak correlation between adiponectin and fat mass, and disappear after adjustment for age and BMI. Resistin and visfatin were not significantly correlated with fat mass. In the multiple linear stepwise regression analysis, lean mass and adiponectin, but not leptin, resistin and visfatin, were independent predictors of BMD. The significant positive correlations between adiponectin and bone-specific alkaline phosphatase (BAP), bone cross-linked N-telopeptides of type collagen (NTX) were found, and remained significant after adjustment for age and fat mass. CONCLUSIONS: Adiponectin was an independent predictor of BMD in Chinese men, and positively correlated with bone turnover biochemical markers. It suggested that adiponectin exert a negative effect on bone mass in men.
Assuntos
Adiponectina/sangue , Biomarcadores/sangue , Densidade Óssea , Osso e Ossos/metabolismo , Leptina/sangue , Nicotinamida Fosforribosiltransferase/sangue , Resistina/sangue , Adulto , Idoso , Idoso de 80 Anos ou mais , Índice de Massa Corporal , Ensaio de Imunoadsorção Enzimática , Humanos , Masculino , Pessoa de Meia-IdadeRESUMO
BACKGROUND: Recently, membrane type matrix metalloproteinase-1 (MT1-MMP) was found to participate in bone metabolism. We investigated the relationship between serum MT1-MMP and bone mineral density (BMD) as well as bone metabolic markers in 206 Chinese postmenopausal women aged 43-80 years. METHODS: Western analysis and ELISA were performed to detect serum soluble MT1-MMP levels. BMD was measured by dual energy X-ray absorptiometry (DXA). Serum alkaline phosphatase (BAP) and N-telopeptides of type I collagen (NTX) were assayed using ELISA. RESULTS: We found that soluble MT1-MMP abundantly existed in human serum as protein lack of transmembrane domain. Serum MT1-MMP levels were detectable in all participants and the range of value was 221.2-863.0 ng/ml (435.6+/-98.2 ng/ml). We found a significant negative weaker correlation between MT1-MMP and BMD at lumbar spine, total hip (Thip), and femoral neck (FN) (all P<0.05). After adjustment for age and BMI, the correlation with BMD at FN and Thip disappeared (all P>0.05). Multiple linear stepwise regression analysis showed that MT1-MMP was not a determinant factor for BMD. The significant positive correlations between MT1-MMP and BAP, NTX were found, and remained significant after adjustment for age and BMI (all P<0.05). Moreover, serum MT1-MMP, BAP, and NTX decreased in response to alendronate therapy. CONCLUSION: Circulating MT1-MMP and bone turnover markers are correlated, and serum MT1-MMP levels may rise with increase in bone turnover.
Assuntos
Biomarcadores/sangue , Densidade Óssea , Metaloproteinase 14 da Matriz/sangue , Pós-Menopausa , Absorciometria de Fóton , Adulto , Idoso , Idoso de 80 Anos ou mais , Western Blotting , Ensaio de Imunoadsorção Enzimática , Feminino , Humanos , Pessoa de Meia-Idade , SolubilidadeRESUMO
OBJECTIVE: To develop a capacity questionnaire in public health emergency for Chinese local governments. METHODS: Literature reviews, conceptual modelling, stake-holder analysis, focus group, interview, and Delphi technique were employed together to develop the questionnaire. Classical test theory and case study were used to assess the reliability and validity. RESULTS: (1) A 2-dimension conceptual model was built. A preparedness and response capacity questionnaire in public health emergency with 10 dimensions and 204 items, was developed. (2) Reliability and validity results. Internal consistency: except for dimension 3 and 8, the Cronbach's alpha coefficient of other dimensions was higher than 0.60. The alpha coefficients of dimension 3 and dimension 8 were 0.59 and 0.39 respectively; Content validity: the questionnaire was recognized by the investigatees; Construct validity: the Spearman correlation coefficients among the 10 dimensions fluctuated around 0.50, ranging from 0.26 to 0.75 (P<0.05); Discrimination validity: comparisons of 10 dimensions among 4 provinces did not show statistical significance using One-way analysis of variance (P>0.05). Criterion-related validity: case study showed significant difference among the 10 dimensions in Beijing between February 2003 (before SARS event) and November 2005 (after SARS event). CONCLUSION: The preparedness and response capacity questionnaire in public health emergency is a reliable and valid tool, which can be used in all provinces and municipalities in China.
Assuntos
Serviços de Saúde Comunitária , Planejamento em Desastres , Serviços Médicos de Emergência/organização & administração , Saúde Pública , Inquéritos e Questionários , China , Planejamento em Desastres/organização & administração , Humanos , Saúde Pública/educação , Medição de RiscoRESUMO
OBJECTIVE: To explore the change and influence factors of quality of life QOL for drug abusers who accepted methadone maintenance treatment (MMT). METHODS: The questionnaire of QOL-BRIEF was used to measure the level of QQL when patients just entered the study and 6 months after the treatment respectively. The effect of therapy and characteristic of patients on change of QOL was analyzed. RESULTS: The scores in physiological domain, psychological domain, and the total score obviously increased after the treatment. There was no significant difference in the change of QOL between the patients of different dose groups. The QOLs of males and patients with long-time drug use improved significantly after the treatment. CONCLUSION: MMT can raise the QOL of drug abusers. Gender and time of drug use may be the risk factors of QOL improvement.
Assuntos
Metadona/administração & dosagem , Transtornos Relacionados ao Uso de Opioides/tratamento farmacológico , Qualidade de Vida , Síndrome de Abstinência a Substâncias/tratamento farmacológico , Feminino , Humanos , Masculino , Inquéritos e QuestionáriosRESUMO
OBJECTIVE: To assess the capacity for logistics, public education, and training in managing public health emergency in China at present. METHODS: Four provinces were selected using stratified sampling. All the municipalities of these 4 provinces were assessed using the 9th and 10th subscales (logistics, public education and training) of Preparedness and response capacity questionnaire for public health emergencies for provincial or municipal governments developed by the Center for Health Statistics and Information, Ministry of Health of China. RESULTS: Sixty of the 66 questionnaires (90.91%) were collected. Among the 60 investigated municipalities, 80% established a specific agency to take charge of emergency material storage, management and allocation, 65% developed standard for material storage, 35% developed standard of places for material storage, 25% built regulation for testing, maintaining, and updating the emergency materials regularly, 45% arranged budget for routine payment, 27% established standard of emergency fund, and 28% set up the procedure to initiate emergency fund. The average of standard score of subscale 9 was 43.33 (95% confidence interval, 35.65~51.01). 25% of the 60 municipalities conducted assessment for training in the past 2 years, 53% developed plan for emergency personnel training, 20% developed effectiveness assessment regulation of emergency personnel training, 80% assigned a specific agency to be responsible for public education, and 23% established regulation for public education. The average of standard score of subscale 10 was 47.43 (95% confidence interval, 40.69~54.17). CONCLUSION: Serious problems are found in logistics, public education, and training for public health emergency management in China. Measures should be taken immediately by the central and local government to improve these capacities.
Assuntos
Serviços Médicos de Emergência/normas , Administração em Saúde Pública , Saúde Pública/educação , Inquéritos e Questionários , China , Planejamento em Desastres/organização & administração , Serviços Médicos de Emergência/estatística & dados numéricos , Equipamentos e Provisões Hospitalares/estatística & dados numéricos , Feminino , Humanos , MasculinoRESUMO
OBJECTIVE: To develop a self-administered risk questionnaire for common nutrition-related diseases in middle school students. METHODS: Two phases were conducted to develop the questionnaire: scale development and validation. Phase 1 included 7 steps: (1) determining the objective, theoretical framework, principles and format for indicator generation; (2) setting up the preliminary indicator pool; (3) selecting indicators and forming pilot questionnaire through focus groups; (4) testing the pilot questionnaire; (5) further correcting the questionnaire using expert consultation; (6) choosing indicators again using good-poor analysis; and (7) shaping the final questionnaire. Phase 2 consisted of: (1) using the Pearson correlation coefficient to assess test-retest reliability; (2) using the Cronbach's alpha coefficient to assess the internal consistency reliability; (3) using the feedback from field investigation to assess face validity; and (4) using explanatory factor analysis to assess construct validity. Students from 96 classes were selected at random in Hunan Province as the field test samples using stratified sampling and cluster sampling. And the students from 4 out of the 96 classes were chosen again to serve as the test-retest samples. We used Epidata 3.0 to build the database and SPSS 11.0 to analyze the data. RESULTS: A brief self-administered risk questionnaire for common nutrition-related diseases in middle school students with 12 items being formed after Phase 1. Good-poor analysis showed results from t tests for each item were statistically significant (P<0.05). The Pearson correlation coefficient was 0.76 (P<0.05) and the Cronbach's alpha coefficient was 0.56. The questionnaire was accepted by the students participating in the field test. Four common factors were extracted using explanatory factor analysis, accounting for 50.18% of the total variation. CONCLUSION: The brief self-administered risk questionnaire for common nutrition-related diseases in middle school students is reliable and valid.
Assuntos
Inquéritos Nutricionais , Autoadministração/métodos , Inquéritos e Questionários , Adolescente , Adulto , Criança , China/epidemiologia , Feminino , Humanos , Masculino , Desnutrição/epidemiologia , Obesidade/epidemiologia , Medição de Risco , EstudantesRESUMO
BACKGROUND: At present, many administrators lack a theoretical guide to build management systems to cope with public health emergencies. This study developed a detailed function list for public health emergency management to help building the management systems scientifically. METHODS: The five steps in this study including literature review, semistructured interviews with experts, focus group, Delphi study and focus group were conducted to develop the detailed list of functions. RESULTS: An initial list of 25 functions with 188 items was formed through literature review. The list was reduced to 10 functions with 57 items by semistructured interviews with experts and focus group. Next, all these 57 items reached the consensus through one-round Delphi study. Some revisions of the consensus were done by the same focus group. CONCLUSION: The final 10 functions with 57 items could be used as a guide for most countries during their building of a public health emergency management system.
Assuntos
Serviços Médicos de Emergência/métodos , Modelos Teóricos , Saúde Pública/métodos , Técnica Delphi , Grupos Focais , Entrevistas como Assunto , Literatura de Revisão como AssuntoRESUMO
OBJECTIVE: To investigate the capacity for risk identification, assessment, and mitigation in public health emergency management in China. METHODS: Four provinces were randomly selected using stratified sampling. All the municipalities under these four provinces were assessed using the 3rd subscale (Risk Identification, Risk Assessment, and Risk Mitigation) of Preparedness and Response Capacity Questionnaire for Public Health Emergencies Used in Provincial or Municipal Governments, which was developed by the Center for Health Statistics and Information, Ministry of Health of the People's Republic of China. RESULTS: Sixty of 66 questionnaires (90.91%) were collected. Among 60 investigated municipalities, 35 (58%) identified the potential public health emergencies, 17 (28%) assessed the risks for the identified emergencies, and 5 (8%) conducted risk assessments for the locally accident-prone factories, mines, corporations, and big establishments, 6 (10%) identified the priorities in public health emergency management based on risk assessment, 6 (10%) developed special prevention strategies for main public health emergencies, 3 (5%) assessed the vulnerability of local residents to public health emergencies, and 34 (57%) assessed or were assessing the preparedness and response capacity for public health emergencies in the past 2 years. The mean of standard total score for risk identification, assessment, and mitigation was 24.05 (95% CI: 18.32, 29.77). CONCLUSION: Risk identification, assessment, and mitigation still require further improvement in China, and both the central and local authorities should implement more effective and efficient measures.
Assuntos
Planejamento em Desastres , Serviços Médicos de Emergência/organização & administração , Saúde Pública , China , Humanos , Medição de RiscoRESUMO
BACKGROUND: Previous studies showed that the prognostic factors for superficial transitional cell carcinoma of the bladder varied with the findings of different cohorts. Few multivariate analyses of prognostic factors for superficial bladder tumors have been reported in China and bladder preservation as a prognostic index of superficial bladder tumors is limited and scarce in Chinese patients. This study was conducted to analyze a group of risk factors for prognostic outcomes for patients with primary superficial transitional cell carcinoma of the bladder. METHODS: Between January 1980 to December 2000, 198 patients [172 men and 26 women; mean age (52.98 +/- 11.28) years] with primary superficial transitional cell carcinoma who were pathologically classified as Ta or T1 in Hunan Provincial Tumor Hospital (Changsha, China) were enrolled in this study. Surgical methods included local resection and electric coagulation of bladder tumors, transurethral resection of bladder tumors and partial cystectomy. After initial surgical treatment, patients were followed through a cystoscopy every three months during the first two years and every six months thereafter in the design of retrospective cohort. Survival analysis was performed to analyze risk factors of the prognostic outcomes for transitional cell carcinoma of the bladder. Canonical correlation analysis was conducted to present and interpret synthetically the multi-correlation between all kinds of prognostic outcomes and risk factor in multiply dimensions. RESULTS: The average follow-up period was (6.65 +/- 4.74) years. Assessments at three, five, and 10 years showed recurrence rates, respectively, of (28.32 +/- 3.45)%, (35.31 +/- 3.83)%, and (42.48 +/- 4.40)%; progression rates of (8.89 +/- 2.14)%, (15.16 +/- 2.94)%, and (23.88 +/- 4.19)%; bladder-preservation rates of (94.68 +/- 1.74)%, (93.87 +/- 1.91)%, and (91.51 +/- 2.49)%; metastasis rates of (8.25 +/- 2.05)%, (11.24 +/- 2.47)%, and (28.94 +/- 4.93)%; and cancer-related survival rates of (95.02 +/- 1.62)%, (90.70 +/- 2.45)%, and (77.14 +/- 4.88)%. The main risk factors for recurrence were histological grade, blood transfusion during surgery and the duration of symptoms. Progression was affected by blood transfusion during surgery, histological grade, the number of re-examinations, and the length of the recurrence-free period. Metastasis was associated with tumor multifocality, hydronephrosis, microscopic growth pattern, and the recurrence-free period. Cancer-related survival was influenced by microscopic growth pattern and the recurrence-free period. Bladder preservation involved only the recurrence-free period. The comprehensive results from canonical correlation analysis showed that the main prognostic outcomes were cancer-related survival, metastasis and progression respectively, while the dominate risk factors were histological grade, tumor multifocality and blood transfusion. CONCLUSIONS: The risk factors were different for each prognostic outcome of transitional cell carcinoma of the bladder. This is helpful for predicting the prognosis of transitional cell carcinoma of the bladder and designing therapeutic and follow-up strategies for this cancer.
Assuntos
Carcinoma de Células de Transição/mortalidade , Neoplasias da Bexiga Urinária/mortalidade , Adulto , Idoso , Carcinoma de Células de Transição/patologia , Estudos de Coortes , Progressão da Doença , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Recidiva Local de Neoplasia/mortalidade , Prognóstico , Estudos Retrospectivos , Fatores de Risco , Reação Transfusional , Neoplasias da Bexiga Urinária/patologiaRESUMO
OBJECTIVE: To obtain scores in a community-dwelling population over 60 using the SF-36, to assess the reliability and validity of this general health questionnaire, and to analyze the difference in dimension scores among the elderly Chinese in Changsha. METHODS: We randomly selected 602 elders, aged 60 to 91 years, in multi-phases. All the subjects had resided in Changsha for at least one year. The reliability of the SF-36 was assessed by split-half reliability and Cronbach's alpha coefficient and the validity through factor analysis and correlation analysis, etc. The dimension scores of different people were obtained by analysis of variance and independent-samples t-test. RESULTS: The split-half reliability was 0.72 and the Cronbach's alpha coefficients of all the 8 dimensions were more than 0.8; the Pearson correlate coefficients of all the items to their dimensions were more than 0. 59. SF-36 contained 8 domains and 2 summary scales in the factor analysis. Health-related quality was different in different elders. CONCLUSION: The SF-36 is practical in studying the quality of life among community-dwelling elders.
Assuntos
Serviços de Saúde Comunitária , Avaliação Geriátrica , Qualidade de Vida , Inquéritos e Questionários/normas , Idoso , Idoso de 80 Anos ou mais , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Reprodutibilidade dos Testes , Estudos de AmostragemRESUMO
OBJECTIVE: To establish a model based on artificial neural network in the prediction of nosocomial infection risk. METHODS: Clinical data of 27,352 inpatients extracted from hospital information system were cleaned and coded, and the model of prediction in nosocomial infection risk was developed based on artificial neural network. RESULTS: The structure of artificial neural network is {16-6-1}-BP, and the fit rate of prediction was 0.9891. The area under ROC curve was 0.986. CONCLUSION: Artificial neural network model can be used as a tool for nosocomial infection forecasting, which can provide supplementary information for the diagnosis and control of nosocomial infection.
Assuntos
Infecção Hospitalar , Redes Neurais de Computação , Medição de Risco/métodos , Feminino , Humanos , Masculino , Fatores de RiscoRESUMO
Based on the results of three national health surveys and relevant statistical data, this article reviews the main problems existed in the providers and demanders of rural health service in China and tries to provide evidences for health decision-makers.
Assuntos
Avaliação das Necessidades , Serviços de Saúde Rural , China , Humanos , Avaliação das Necessidades/economia , Avaliação das Necessidades/organização & administração , Serviços de Saúde Rural/economia , Serviços de Saúde Rural/organização & administraçãoRESUMO
OBJECTIVE: To evaluate quality of life (QOL) in the treatment assessment of postmenopausal osteoporosis (PMOP) by comparing the QOL of three treatments: hormone replacement treatment, supplement of calcium and vitamin D and risedronate. METHODS: All patients with postmenopausal osteoporosis (PMOP) in this clinical trial had been allocated into 4 groups: placebo therapy group, vitamin D addition calcium therapy group, hormone replacement treatment (HRT) therapy group, and risedronate therapy group. We measured the bone mineral density (BMD) and quality of life sale (QOLS) of patients in three times, before the treatment, 3 months after the treatment,and 12 months after the treatment. The differences of the QOL and BMD at the 4 groups and at different time, the linear correlation of the change of QOL and the change of BMD, were both compared after the measurement. RESULTS: The total score of QOL and the score of disease domain and physical domain of HRT therapy group and risedronate therapy group were higher than the placebo therapy group (F = 17. 335, P <0.001), but vitamin D addition calcium therapy group was not different from that of the placebo therapy group. The score of other three domains had no statistically significant difference among the 4 groups. The score of disease domain of the patients of risedronate therapy group started to increase after 3 months of treatment, and continued to increase after 12 months of treatment. The score of disease domain of the patients of HRT therapy group started to increase only after 12 months of treatment. But the score of disease domain of the patients of vitamin D addition calcium therapy group did not increase after 12 months of treatment. The changes of the score of disease domain had the linar correlation with the changes of BMD, and the correlation coefficient was from 0.608 to 0.827. CONCLUSION: QOL may become one of the indexes of medical treatment outcome assessment system for PMOP.
Assuntos
Alendronato/uso terapêutico , Terapia de Reposição de Estrogênios , Osteoporose Pós-Menopausa/tratamento farmacológico , Qualidade de Vida , Vitamina D/uso terapêutico , Absorciometria de Fóton , Feminino , Seguimentos , Humanos , Pessoa de Meia-Idade , Osteoporose Pós-Menopausa/psicologiaRESUMO
OBJECTIVE: To develop a specific quality of life scale for Chinese Type 2 diabetes mellitus (DM) patients. METHODS: According to the quality of life definition of WHO, we used methods adhered to the rigorous guidelines of instrument development in item pool formation, item selection and scale validation with the data of 236 Type 2 diabetic patients recruited. RESULTS: An 87-item Quality of Life Scale for patients with Type 2 DM-prior test version ( DMQLS), including 5 domains ( disease, physical, social, psychological, and satisfaction ) was developed and showed good reliability and validity. The disease domain made up of Type 2 diabetes mellitus-specific sub-scale and the other 4 domains formed the generic sub-scale for adults. The test-retest correlation coefficient, Cronbach's Alpha coefficient and split-half reliability coefficient of DMQLS were 0.996, 0.969 and 0.879, respectively. Twenty-one common factors were extracted according to the conceptual model. The scale's correlations with SF-36 and Diabetes Quality of Life Measure ( DQOL ) were 0.763 and 0.658. DMQLS could discriminate among those with different quality of lives. CONCLUSION: DMQLS is reliable, valid and sensitive, and can be used to evaluate the curative effect of Type 2 diabetic patients.
Assuntos
Diabetes Mellitus Tipo 2/psicologia , Qualidade de Vida , Inquéritos e Questionários/normas , Adulto , Estudos de Avaliação como Assunto , Feminino , Humanos , Masculino , Psicometria , Reprodutibilidade dos TestesRESUMO
OBJECTIVE: To develop a specific quality of life (QOL) scale for Chinese patients with benign prostatic hyperplasia (BPH). METHODS: The scale was developed with the programmed decision methods. The item pool was certified by experts. Five methods were used in item selection after a pilot study for which 256 BPH patients had been recruited. The scale was evaluated by its reliability and validity. RESULTS: We formed a 27-item quality of life scale specific for patients with benign prostatic hyperplasia prior test version (BPHSQL). The test-retest correlation coefficient and Cronbach's alpha coefficient of BPHSQL were 0. 774 and 0. 945. The structure of the scale was similar to the theory construction. The scale's correlation coefficients with criteria ranged from 0.531 to 0.700. BPHSQL could well discriminate the quality of life between BPH and non-BPH patients as well as patients with different degrees of symptoms, different sources and patients with or without urethral catheters. CONCLUSION: BPHSQL is reliable, valid and sensitive, and will be a convenient tool in clinical research to provide advice on different treatments for different patients.