Objective To explore the factors which affect shared decision-making and develop strategies to get patients actively involved in clinical decision-making. Methods We conducted a survey on 566 patients of a Class A Hospital in Sichuan with group random sampling method. The data were collected by the use of anonymous selfadministered questionnaires. We used SPSS 10.0 to analyse the data. Results A total of 600 questionnaires were distributed at random, of which 565 were completed. There were 68% patients who had some knowledge of the disease, and 93% who were willing to participate in clinical decision-making. The patients’ biggest concerns were: treatment effect, cost and doctors’ skills. The biggest difficulties that patients worried about were: long-time waiting in out-patient departments and limited time to communicate with doctors. Conclusion As more and more patients would like to involve in shared decision-making, doctors need to provide patients with more choices and help them make a right decision in their treatment.
The relationship between doctors and patients becomes a public hot topic recently, which becomes more prominent during the reforming and transition of the health care system. The emergence of evidence-based medicine corresponds to the requirement of the clinical practice brought by the transition of the health care system. It will play an important role in improving the relationship between doctors and patients. The promotion of evidence-based practice will be helpful to alleviate the conflict between doctors and patients and to increase the quality of health care.
Medical behaviors involve multi level and multi subject legal relations. In the process of medical and nursing care, there are two categories of legal relations concerning medical behaviors. They are external and internal legal relations. External legal relations involve legal relations between hospitals, between physicians and patients and between major medical accidents and penalties; internal legal relations involve physicians, nurses and hospital authorities.
It is essential to improve the practice of community healthcare service for the resolution of the problem of inadequate and overly expensive medical services, to promote the harmonization of doctor-patient relationship. From the aspects of the introduction of community healthcare service and the necessity of its standard management, the civil legal relation of community healthcare and its major problems, as well as the rights and duties of community doctors, the authors discussed the importance and necessity of scientific management, right protection by law as well as sound and orderly development of community healthcare service.
Objective To investigate the effects of QUE on proliferation and DNA synthesis of cultured retinal pigment epithelium(RPE) cells with or without EGF. Methods With or without EGF, cultured RPE cells were treated with QUE by various concentrations(200,100,50,1mu;mol/L) and with QUE 200mu;mol/L at different times(24-168 hr), cells proliferation and DNA synthesis were evaluated by cell count method and the uptake of thymidine. The viability of cells was determined by trypanblue exclusion. Results The best concentration of QUE which inhibits proliferation and DNA synthesis of PRE cells was 200mu;mol/L. The significant inhibition effect of QUE occurred at 48hr, and the best inhibition of QUE occurred at 96hr. QUE had more powerful effect of antiproliferation on RPE cells, and the viability of RPE cells was over85%. Conclusion The results suggested that QUE could inhibit the proliferation of RPE cells in a dose-dependent and time-dependent manner, especially inhibit the proliferation induced by EGF stimulating. QUE had no cyto-toxic effect on RPE cells cultured in vitro. (Chin J Ocul Fundus Dis,1999,15:27-29)
We introduced the current doctor-patient relationship and analyzed its opposition and unification based on present medical practice. We suggested that evidence-based medicine should be an important in improving doctor-patient relationship in clinical practice. We urged health care professionals to learn and apply initiatively evidence-based medicine, so as to improve the patient-professional relationship.
Objective To explore the factors which influence the doctor-patient relationship and to provide evidence to help decision makers improve hospital management and construct a harmonious doctor-patient relationship. Methods Discharged patients of West China Hospital from 2003-2006 were randomly selected and asked to complete a specially designed questionnaire. Results In total, 8 000 questionnaires were distributed and 2 526 were returned. The retrieval rate was 31.57%. The responses showed that non-medical factors have became the main factors affecting the doctor-patient relationship (91.8%). Other important factors included medical cost (21.5%) and doctor-patient communication (11.51%). Conclusion We should boost hospital management level, train non-medical staff, save costs and improve doctor-patient communication.
To analyze the current doctor-patient relationship and explore its underlying reasons. Evidence-based medicine may provide scientific evidence for the deepening of healthcare reforms as well as the improvement of social security system; provide abundant information for both sides of the doctor-patient relationship; improve medical quality and reduce medical costs, so as to establish a harmonious patient-oriented doctor-patient relationship .
ObjectiveTo provide references in the forensic identification of injury and cerebrovascular malformation involved death cases, and to reduce the relevant medical dispute by exploring the forensic pathological features, identification of medical dispute as well as relationship between injury and disease. MethodsWe collected 33 cases of cerebrovascular malformation from January 2006 to December 2014 in West China Center of Forensic Medicine, including details of cases, clinical medical record and forensic pathology examination, and then the cases were retrospectively analyzed. ResultsIn the 33 cases, the average age of the individuals was 37.4 years old, and the male/female ratio was 23/10. Nineteen patients (57.6%) died within 1 hour. Seventeen patients with mixed pathological type of cerebrovascular malformation dominated (51.5%). Medical dispute happened in 7 cases (21.1%), 4 of which were identified to be led by medical fault and 3 with no medical fault. Relationship between injury and disease was analyzed in 11 cases (33.3%), in which injury was identified to take full responsibility in 1 case, inductive cause of death in 9 cases, and no relationship between injury and death in 1 case. ConclusionComprehensive and systematic investigation of forensic pathology plays an important role in the proper settlement of medical disputes as well as the identification of cause of death and relationship between injury and disease.