OBJECTIVE:To formulate the first clinical practice guideline for the treatment of cough using Chinese medicine based on the grading of recommendations assessment,development,and evaluation(GRADE)systematic approach,in...OBJECTIVE:To formulate the first clinical practice guideline for the treatment of cough using Chinese medicine based on the grading of recommendations assessment,development,and evaluation(GRADE)systematic approach,including clinical evidence,evaluation of ancient literature,and expert consensus.METHODS:In the process of development,the regulation of"evidence-based,consensus-assisted,and empirical"was followed,and a comprehensive systematic approach of recommendation assessment,GRADE,evidence-based evaluation,expert consensus,and the Delphi method was used.In the process of guideline development,evidence-based evaluation of ancient literature was included for the first time,and clinical evidence was fully integrated with clinical expert consensus.RESULTS:The clinical practice guidelines for the treatment of cough with Chinese herbal medicine were developed after a comprehensive consideration of evidence-based evaluation and expert opinions.The guideline recommendations focused on recommending herbal compound decoctions and Chinese patent medicines for cough in different conditions.Based on the GRADE systematic approach,we conducted an evidence-based evaluation of the recommended Chinese patent medicines one by one;meanwhile,the expert consensus method was used to unify the recommendations of both.CONCLUSION:Based on clinical evidence,ancient literature evaluation,and expert consensus,a clinical practice guideline for Traditional Chinese Medicine(TCM)in the treatment of cough was developed,providing the first current clinical practice guideline for domestic and foreign TCM and Western medicine practitioners,especially respiratory professionals at home and abroad.展开更多
目的探讨将学生标准化病人应用于神经内科临床实践教学中的应用效果。方法将80名临床医学本科大四学生随机分成为传统临床带教对照组和学生标准化病人(student as standardized patients,SSP)组。对照组以传统临床带教的方式进行临床实...目的探讨将学生标准化病人应用于神经内科临床实践教学中的应用效果。方法将80名临床医学本科大四学生随机分成为传统临床带教对照组和学生标准化病人(student as standardized patients,SSP)组。对照组以传统临床带教的方式进行临床实践教学,SSP组采用学生标准化病人进行临床实践教学。临床实践结束后所有学生接受客观结构化临床考试(objective structured clinical examination,OSCE)及完成满意度问卷调查。结果SSP组在OSCE考试中病史采集、神经系统查体得分方面优于对照组,差异有统计学意义(P<0.05)。调查问卷结果显示,SSP组在临床思维提升、激发学习兴趣、沟通能力提升方面得分均高于对照组,差异有统计学意义(P<0.05)。结论学生标准化病人应用于神经内科的临床实践过程中有助于提高临床医学生的病史采集及神经系统体格检查技能,取得更好的教学效果。展开更多
目的近年来,临床规范化培训中住培医师职业倦怠度及其影响因素受到广泛关注,而其与心理弹性的关联仍缺乏正式研究;因此,该研究旨在调查骨科住培医师心理弹性和职业倦怠的关联性以及探究改善职业倦怠的方法。方法2021年6月—2022年1月,...目的近年来,临床规范化培训中住培医师职业倦怠度及其影响因素受到广泛关注,而其与心理弹性的关联仍缺乏正式研究;因此,该研究旨在调查骨科住培医师心理弹性和职业倦怠的关联性以及探究改善职业倦怠的方法。方法2021年6月—2022年1月,采用中国成年人心理弹性量表(resilient trait scale for Chinese adults,RTSCA)和马斯拉奇职业倦怠综合量表(Maslach burnout inventory general survey,MBI-GS)分别用于评估华东地区3所医院(浙江大学医学院附属第二医院、上海交通大学附属第六人民医院和苏州大学附属第一医院)总计400名骨科住培医师的心理弹性和职业倦怠水平。结果本次调查共完成322份在线和纸质调查,其中纸质调查回应率为42.0%(168/400)。心理内控性是情绪衰竭和人格障碍的重要预测因子(P<0.001);与男性相比,女性更容易体验情绪衰竭(P<0.001),可能与应对问题的方式不同有关(P<0.05);善于接受和运用社会支持以及良好的心理接纳性有助于防止人格障碍的发生(P<0.001);而注重问题解决的应对和乐观性能够提升个人成就感(P<0.001)。结论该研究揭示了骨科住培医师心理弹性和职业倦怠度现状以及二者之间的关系,以期为提高医生心理弹性、改善临床医生职业倦怠水平提供必要的建议和理论支持。展开更多
基金National Key R&D Plan:Development of International Standards for Traditional Chinese Medicine Technology(No.2019YFC1712003)。
文摘OBJECTIVE:To formulate the first clinical practice guideline for the treatment of cough using Chinese medicine based on the grading of recommendations assessment,development,and evaluation(GRADE)systematic approach,including clinical evidence,evaluation of ancient literature,and expert consensus.METHODS:In the process of development,the regulation of"evidence-based,consensus-assisted,and empirical"was followed,and a comprehensive systematic approach of recommendation assessment,GRADE,evidence-based evaluation,expert consensus,and the Delphi method was used.In the process of guideline development,evidence-based evaluation of ancient literature was included for the first time,and clinical evidence was fully integrated with clinical expert consensus.RESULTS:The clinical practice guidelines for the treatment of cough with Chinese herbal medicine were developed after a comprehensive consideration of evidence-based evaluation and expert opinions.The guideline recommendations focused on recommending herbal compound decoctions and Chinese patent medicines for cough in different conditions.Based on the GRADE systematic approach,we conducted an evidence-based evaluation of the recommended Chinese patent medicines one by one;meanwhile,the expert consensus method was used to unify the recommendations of both.CONCLUSION:Based on clinical evidence,ancient literature evaluation,and expert consensus,a clinical practice guideline for Traditional Chinese Medicine(TCM)in the treatment of cough was developed,providing the first current clinical practice guideline for domestic and foreign TCM and Western medicine practitioners,especially respiratory professionals at home and abroad.
文摘目的近年来,临床规范化培训中住培医师职业倦怠度及其影响因素受到广泛关注,而其与心理弹性的关联仍缺乏正式研究;因此,该研究旨在调查骨科住培医师心理弹性和职业倦怠的关联性以及探究改善职业倦怠的方法。方法2021年6月—2022年1月,采用中国成年人心理弹性量表(resilient trait scale for Chinese adults,RTSCA)和马斯拉奇职业倦怠综合量表(Maslach burnout inventory general survey,MBI-GS)分别用于评估华东地区3所医院(浙江大学医学院附属第二医院、上海交通大学附属第六人民医院和苏州大学附属第一医院)总计400名骨科住培医师的心理弹性和职业倦怠水平。结果本次调查共完成322份在线和纸质调查,其中纸质调查回应率为42.0%(168/400)。心理内控性是情绪衰竭和人格障碍的重要预测因子(P<0.001);与男性相比,女性更容易体验情绪衰竭(P<0.001),可能与应对问题的方式不同有关(P<0.05);善于接受和运用社会支持以及良好的心理接纳性有助于防止人格障碍的发生(P<0.001);而注重问题解决的应对和乐观性能够提升个人成就感(P<0.001)。结论该研究揭示了骨科住培医师心理弹性和职业倦怠度现状以及二者之间的关系,以期为提高医生心理弹性、改善临床医生职业倦怠水平提供必要的建议和理论支持。
