scholarly journals Effect of healthcare system reforms on job satisfaction among village clinic doctors in China

2021 ◽  
Vol 19 (1) ◽  
Author(s):  
Zhongming Chen ◽  
Lifang Zhou ◽  
Haiyuan Lv ◽  
Kui Sun ◽  
Hongwei Guo ◽  
...  
Keyword(s):  
Job Satisfaction ◽  
Health Service ◽  
Medical Practice ◽  
Negative Impact ◽  
Baseline Survey ◽  
Chinese Government ◽  
Practice Environment ◽  
Village Clinic ◽  
Significant Difference ◽  
The Mean

Abstract Background Village clinic doctors (VCDs) are part of the health service force in rural China. VCDs’ job satisfaction (JS) is important to the stability of the three-tiered health service system. Since 2009, the Chinese government launched a new health care system reform (NHCSR) which affected VCDs significantly. This study aimed to analysing the effect of NHCSR on JS among VCDs. Methods All the data came from three surveys in Shandong Province conducted in 2012, 2015 and 2018. In 2012, an originally designed questionnaire was used to conduct a baseline survey of 405 VCDs from 27 townships in nine counties. In 2015 and 2018, 519 and 223 VCDs in the same counties were surveyed with the same questionnaire. Descriptive analysis and ANOVA were used to analyse the level and changes in VCDs’ JS. Results The mean scores of VCDs’ total JS were 2.664 ± 1.069, 3.121 ± 0.931 and 2.676 ± 1.044 in 2012, 2015 and 2018, respectively, with a significant difference (F = 28.732, P < 0.001). The mean scores of the medical practice environment and the job itself showed a continuous downward trend. The trends of the mean scores for job reward, internal work environment and organizational management were consistent with the trend for total JS. Conclusion The NHCSR had a partly negative impact on VCDs’ JS. Policy-makers should pay more attention to VCDs’ job reward and medical practice environment. With the implementation of new reform policies, VCDs’ JS should be the subject of more systematic and detailed research.

scholarly journals Changes in the Job Satisfaction of Village Clinic Doctors Since the New Health Care System Reform: A Comparison Based on Three Surveys in Shandong, China

2021 ◽  
Author(s):  
Zhongming Chen ◽  
Lifang Zhou ◽  
Haiyuan Lv ◽  
Kui Sun ◽  
Hongwei Guo ◽  
...  
Keyword(s):  
Job Satisfaction ◽  
Health Care ◽  
Health Service ◽  
Health Care System ◽  
Chinese Government ◽  
System Reform ◽  
Village Clinic ◽  
The Mean ◽  
Health Service System ◽  
Care System

Abstract Background: In 2009, the Chinese government launched a new health care system reform. One of the important aims of the reform was to improve the capacity of primary health institutions. Village clinic doctors are part of the health service force rooted in rural China and the basis of the three-tiered health service system. The job satisfaction of village clinic doctors has an important impact on the stability and sustainable development of the three-tiered health service system. This study aimed to analyse the changes in village clinic doctors' job satisfaction after the implementation of the new health care system reform.Methods:All the data came from three surveys of village clinic doctors in Shandong Province conducted in 2012, 2015 and 2018. In 2012, an originally designed questionnaire was used to conduct a baseline survey of 405 village clinic doctors from 27 townships in 9 counties (the response rate was 92.9%). In 2015 and 2018, 519 and 223 village clinic doctors in the same counties were surveyed with the same questionnaire (the response rates were 94.3% and 92.9%, respectively). Descriptive analysis, χ2 test and ANOVA were used to analyse the level of and changes in village clinic doctors' job satisfaction.Results: The mean scores of village clinic doctors' total job satisfaction were 2.664 ± 1.069, 3.121 ± 0.931 and 2.676 ± 1.044 in 2012, 2015 and 2018, respectively, with a significant difference (F = 28.732, P < 0.001). The mean scores of the medical practice environment and the job itself showed a continuous downward trend. The change trends of the mean scores for job reward, internal work environment and organizational management were consistent with the trend for total job satisfaction.Conclusion: After the implementation of the NHCSR, the job satisfaction of village clinic doctors showed a trend of first rising and then falling. To improve primary health care service capacity, the Chinese government has implemented a series of new reform policies. With their ongoing implementation, village clinic doctors' job satisfaction should be the subject of more systematic and detailed research.

Abstract TP148: The Hydration Influence on the Risk of Ischemic Stroke Outcomes (THIRST-EXPANSION STUDY)

Stroke ◽  
2013 ◽  
Vol 44 (suppl_1) ◽  
Author(s):  
Mohammad Moussavi ◽  
Gustavo Rodriguez ◽  
Joseph Alario ◽  
Ravjot Sodhi ◽  
Aaron Nizam ◽  
...  
Keyword(s):  
Ischemic Stroke ◽  
Negative Impact ◽  
Serum Osmolality ◽  
Hydration Status ◽  
Stroke Severity ◽  
Past Study ◽  
Stroke Patients ◽  
Stroke Outcomes ◽  
Significant Difference ◽  
The Mean

Introduction: Extensive studies have not been done in patients presenting with ischemic stroke regarding hydration status. It is unclear whether all of the elements of hydration status affect disability on discharge. Our past study suggests that high serum osmolality has a negative impact on ischemic stroke severity. This continuation of our prior study aims to test the effect of all laboratory elements of dehydration on severity and outcome of ischemic stroke patients. Methods: We conducted a retrospective analysis of ischemic stroke patients admitted between 2004 and 2009 at a community teaching hospital. Serum BUN/Creatinine and serum osmolality (sOsm) was calculated at initial presentation. sOSm, BUN/Cr, hematocrit and bicarbonate levels were analyzed for association with NIHSS and mRS. Patients were divided into two groups by sOsm as follows: (1) sOsm < 295, (2) sOsm ≥ 295; and two groups by BUN/Cr as follows: (3) BUN/Cr < 20, (4) BUN/Cr ≥ 20. Discharge mRS score was compared between (1) and (2); and (3) and (4) to determine the effect of sOsm and BUN/Cr on stroke outcomes. All data was analyzed using SPSS software version 20. Results: Of 1350 patients, 543 (mean age = 72.5 +/-14.2, 56% female) were included. There was a significant difference between the mean admission NIHSS in (1) 8.57, n = 222 and (2) 7.09, n = 319, p < .05 and between (3) 8.90, n = 219 and (4) 6.87, n = 322, p < .05. There was a significant difference in the mean mRS score between (1) 2.92, n = 222 and (2) 2.54, n = 317, p < .05, and (3) 2.92, n = 218 and (4) 2.56, n = 321, p < .05. The same results were found when comparing discharge sOsm values to predict patient outcome. Discharge sOsm correlated with mRS (r = .147, p < .05). Initial BUN/Cr correlated with NIHSS (r = .128, p < .05) and mRS (r = .107, p < .05) and final BUN/Cr with mRS (r = .161, p < .001). Bicarbonate levels at admission correlated with NIHSS at admission (r = -0.134), p < 0.05. Hematocrit levels at discharge correlated with mRS (r= -0.183), p <0.001. Conclusion: Our study suggests that patients with BUN/Cr and sOsm above normal levels at admission and dishcarge have worse outcome at discharge. We also found a correlation between other laboratory variables of dehydration status, namely hematocrit levels and outcome. A future prospective randomized study is warranted.

scholarly journals Antimullerian Hormone Changes after Laparoscopic Ovarian Cystectomy for Endometrioma Compared with the Nonovarian Conditions

2014 ◽  
Vol 2014 ◽  
pp. 1-5
Author(s):  
Chamnan Tanprasertkul ◽  
Sakol Manusook ◽  
Charintip Somprasit ◽  
Sophapun Ekarattanawong ◽  
Opas Sreshthaputra ◽  
...  
Keyword(s):  
Ovarian Reserve ◽  
Negative Impact ◽  
Pelvic Surgery ◽  
Ovarian Cystectomy ◽  
Antimullerian Hormone ◽  
Significant Difference ◽  
The Mean ◽  
Antimüllerian Hormone ◽  
A Prospective Study ◽  
The Impact

Laparoscopic ovarian cystectomy is recommended for surgical procedure of endometrioma. The negative impact on ovarian reserve following removal had been documented. Little evidence had been reported for nonovarian originated effects.Objective.To evaluate the impact of laparoscopic ovarian cystectomy for endometrioma on ovarian reserve, measured by serum antimullerian hormone (AMH), compared to nonovarian pelvic surgery.Materials and Methods.A prospective study was conducted. Women who underwent laparoscopic ovarian cystectomy (LOC) and laparoscopic nonovarian pelvic surgery (NOS) were recruited and followed up through 6 months. Clinical baseline data and AMH were evaluated.Results.39 and 38 participants were enrolled in LOC and NOS groups, respectively. Baseline characteristics (age, weight, BMI, and height) and preoperative AMH level between 2 groups were not statistically different. After surgery, AMH of both groups decreased since the first week, at 1 month and at 3 months. However, as compared to the LOC group at 6 months after operation, the mean AMH of the NOS group had regained its value with a highly significant difference.Conclusion.This study demonstrated the negative impact of nonovarian or indirect effects of laparoscopic surgery to ovarian reserve. The possible mechanisms are necessary for more investigations.

scholarly journals Factors Affecting Hospital Nurses Intention to Remain: Focusing on Role Conflict

2017 ◽  
Vol 23 (3) ◽  
pp. 290-299 ◽  
Author(s):  
Kyung Sook Cho ◽  
Eun Hee Lee ◽  
Haeng Mi Son
Keyword(s):  
Job Satisfaction ◽  
Role Conflict ◽  
Nursing Practice ◽  
Stepwise Multiple Regression ◽  
Factors Affecting ◽  
Positive Attitudes ◽  
Significant Difference ◽  
Nurses Role ◽  
The Mean ◽  
Influential Variable

Purpose: The purpose of this study is to investigate nurses' role conflict and intention to remain and to identify factors that may influence this intention. Methods: Data were collected from 172 nurses in a 600-plus bed hospital on nurses' intention to remain, which included 47 items and nurses' role conflict, which included 82 items from a self-reported questionnaire. Data were analyzed by descriptive statistics and stepwise multiple regression using SPSS 22.0 Results: The mean of the role conflict frequency was 2.71(${pm}.39$) and the mean severity was 2.86 (${pm}.47$). The most significant item among the items of intention to remain was "a nurse's job is to help people." The intention to remain employed showed a significant difference in the duration of desired working period and subjective job satisfaction. The subjective job satisfaction of nurses was the most influential variable as a factor affecting the intention to remain, followed by frequency of role conflict in nursing practice. Conclusion: These results suggest that inadequate nursing environments in nursing practice require improvement and support the idea that nurses with positive attitudes of the nursing organization and theirs leaders reduce nurses' related fatigue.

Efficacy of Preoperative Usage of Dexamethasone in Diabetic Patients Undergoing Total Hip or Knee Arthroplasty for Control of Nausea and Vomiting

2020 ◽  
pp. 000313482094739
Author(s):  
Tarik J. Wasfie ◽  
Jessica Groton ◽  
Natalia Cwalina ◽  
Jennifer R. Hella ◽  
Kimberly Barber
Keyword(s):  
Knee Arthroplasty ◽  
Postoperative Nausea ◽  
Negative Impact ◽  
Nausea And Vomiting ◽  
Diabetic Patients ◽  
Total Hip ◽  
Significant Difference ◽  
Total Knee ◽  
The Mean ◽  
Replacement Operation

Background Dexamethasone has been used in surgical patients to decrease nausea, vomiting, and postoperative pain. However, it is not well studied how much dexamethasone complicates glucose control in diabetic patients and whether this leads to poor surgical outcomes. Methods We analyzed 256 diabetic patients who underwent elective hip and knee arthroplasty and evaluated the groups that received dexamethasone intraoperatively (201 patients), those who received dexamethasone postoperatively (237 patients), and those who did not receive the steroid intraoperatively (55 patients) and postoperatively (19 patients). Results 256 diabetic patients were included in the study. The mean age of the group was 68.7 (SD ± 9-10) years. Patients were divided into 123 males (48%) and 133 females (52%). 174 (78%) patients had a total knee replacement operation, and 82 (32%) patients had total hip replacement operation. The mean hemoglobin A1c was 6.728 (SD ± 0.99). The mean ASA score was 2.86 (SD ± 0.38). 201 (78.5%) patients received preoperative or intraoperative dexamethasone, and 237 (92.6%) patients received it postoperatively. The mean blood glucose for all patients raised from 131.9 to 172.2 mg/dL ( P = .012) postoperatively, 206.1 mg/dL in the first 24 hours, and 146.2 mg/dL ( P = .39) in the second postoperative day. The change was significant in patients who had poorly controlled diabetes ( P < .01) preoperatively. There was no significant difference in our study regarding dexamethasone use and effect on postoperative nausea ( P = 1.0) and vomiting ( P = .52). There was an improvement in pain scores in the patients who received dexamethasone postoperatively which was statistically significant ( P = .054). Conclusion Dexamethasone use in diabetic patients for control of postoperative nausea and vomiting in those undergoing elective total knee and hip arthroplasty had a negative impact on glycemic control specifically in those with poorly controlled diabetes and should be avoided.

scholarly journals Physiological impact of wearing a surgical face mask during walking in the COVID-19 pandemic

2021 ◽  
Vol 25 (4) ◽  
pp. 202-207
Author(s):  
Mustafa Ş. Akgül ◽  
Neslihan Ozcan ◽  
Mahmut E. Uzun ◽  
Veli V. Gurses ◽  
Bilgehan Baydil
Keyword(s):  
Blood Pressure ◽  
Healthy Volunteers ◽  
Negative Impact ◽  
Face Mask ◽  
Arterial Oxygen ◽  
Brisk Walking ◽  
Arterial Oxygen Content ◽  
Significant Difference ◽  
The Mean ◽  
Physiological Impact

Background and Study Aim. Common use of surgical face masks is recommended for social and individual health due to the COVID-19 pandemic. However, there is no systematic report for responses of organism to wearing a surgical face mask during different exercises. In this context the purpose of this study was to examine the impacts of wearing a surgical face mask during a one-hour brisk walking. Material and Methods. A total of thirty male (n=16) and female (n=14) volunteers (mean age and BMI of 32±1.07 years and 25.1±0.68 kg/m2, respectively) completed the protocol. This was a multiple cross-over trial for healthy volunteers. All participants took a one-hour brisk walking with and without a surgical face mask. Specific physiological measurements (HR - heart rate; BP - blood pressure, SaO2 - arterial oxygen content) were compared before and immediately after two brisk walking. Each subject served their own control. Results. The evaluation found that there was no statistically significant difference between the mean HR and blood pressure values during the brisk walking with and without a surgical face mask, while there was a statistically significant difference in the SaO2 values on behalf of no-mask-walking (p<0.05). Conclusions. The use of surgical face masks in healthy volunteers causes a decrease in SaO2 during brisk walking. However, it does not affect the mean pulse rate and blood pressure. Although there was a statistically significant decrease in the SaO2 parameter during mask-walking, it is possible to state that brisk walking with a surgical face mask does not have a physiologically negative impact, because this decrease is in ranges that are accepted to be normal. 

scholarly journals Methotrexate plus narrow band ultraviolet B (NBUVB) versus methotrexate alone in the treatment of moderate to severe plaque psoriasis: A randomized clinical trial

2016 ◽  
Vol 13 (1) ◽  
pp. 12-23 ◽  
Author(s):  
Dhan Keshar Khadka ◽  
S Agrawal ◽  
T K Dhali
Keyword(s):  
Plaque Psoriasis ◽  
Negative Impact ◽  
Ultraviolet B ◽  
Plaque Type ◽  
Number Of Patients ◽  
Significant Difference ◽  
Group A ◽  
The Mean ◽  
Group B

Introduction: Psoriasis is a chronic, recurring inflammatory disease affecting the skin, joints and nails that has a significant negative impact on the quality of life. Efficacy of combination of methotrexate/narrowband ultraviolet B (NBUVB) phototherapy in the treatment of psoriasis has been rarely assessed. Objectives: To compare the therapeutic efficacy of methotrexate plus NBUVB phototherapy combination vs.  methotrexate  in  the  treatment  of  moderate  to  severe  chronic  plaque  psoriasis. Material and methods: Seventy-nine patients with chronic plaque-type psoriasis (body surface area involvement >2%) were randomized to receive either methotrexate/NBUVB phototherapy (group A) or methotrexate (group B). End point of treatment was 75% reduction in Psoriasis Area and Severity Index (PASI75) Score or up to 12weeks, whichever was earlier. Patients were then followed up for a period of 12 weeks for assessment of adverse effect, DLQI and relapse.Results: Of 79 patients, 69 completed the treatment period and follow-up. PASI 75 was achieved in 35/39(89%) patients in group A and 34/40(85%) patients in group B (P=0.052). The mean number of weeks (P = 0.031), the mean cumulative dose of NBUVB (8.2±3.5J/cm2)) and the mean number of phototherapy sessions (12±3)) required to achieve PASI 75 were less in group A compared with group B. There was no significant difference in the number of patients who relapsed during the follow- up period (P = 0.68). Conclusion: Combination of methotrexate and NBUVB phototherapy provides more rapid clinical improvement compared with methotrexate monotherapy in the treatment for chronic plaque-type psoriasis.NJDVL Vol. 13, No. 1, 2015 Page: 12-23

Job Stress, Ill Health and Job Satisfaction among Health Service Employees

1994 ◽  
Vol 7 (4) ◽  
pp. 250-264 ◽  
Author(s):  
David W. Rees ◽  
Cary L. Cooper
Keyword(s):  
Job Satisfaction ◽  
Health Service ◽  
Negative Impact ◽  
Well Being ◽  
Behaviour Pattern ◽  
Occupational Groups ◽  
Service Employees ◽  
Stress Indicator ◽  
Perceived Locus Of Control ◽  
Occupational Stress Indicator

The study examined the effects of occupational stressors, perceived locus of control, Type A behaviour pattern and use of coping strategies on well-being and job satisfaction of 1, 176 health service employees. Several stressors were identified as having a negative impact on health and job satisfaction although these differed between the various occupational groups included in the study. The interactionist model of stress used in the study, and the diagnostic tool used (the Occupational Stress Indicator) proved to be useful in suggesting means of intervening to reduce ill health and increase job satisfaction among health service employees.

A standardised patient education programme for peptic ulcer patients: impact on quality of life and medication adherence

2021 ◽  
Vol 19 (Sup2) ◽  
pp. S24-S31
Author(s):  
Sara Fahimi ◽  
Maryam Allahbakhshian ◽  
Amir Sadeghi ◽  
Atefeh Allahbakhshian ◽  
Malihe Nasiri
Keyword(s):  
Quality Of Life ◽  
Peptic Ulcer ◽  
Medication Adherence ◽  
Negative Impact ◽  
Control Group ◽  
Face To Face ◽  
Significant Difference ◽  
The Mean ◽  
The Impact

Background: Peptic ulcers can have a major negative impact on patients' quality of life (QoL), especially if patients do not adhere to prescribed medication. Aim: This study was carried out to investigate the impact on QoL and adherence of an educational programme for peptic ulcer patients, delivered by a variety of methods. Methods: The population in this single-blind randomised control experimental study included 120 peptic ulcer patients randomly assigned to four groups. Data were collected using the Gastrointestinal Patients' Quality of Life Index and the Morisky Medication Adherence Scale. Findings: A significant increase was observed in the mean scores related to QoL (p=0.001) and medication adherence (p=0.003) compared with the control group after the educational intervention in the intervention groups. One-way ANOVA test for four independent groups indicated a significant difference between the mean scores related to QoL and medication adherence in the four groups after the intervention (p<0.05). In addition, a significant difference was reported in the mean score changes before and after the intervention in QoL and medication adherence between messenger group and face-to-face, web and control groups. Conclusions: Although all three methods of face-to-face, web-based and messenger-based education improved the QoL and medication adherence in peptic ulcer patients, the last method enhanced these patient-related outcomes more effectively than the other two.

Vowel Recognition Threshold as a Function of Temporal Segmentations

1970 ◽  
Vol 13 (4) ◽  
pp. 715-724 ◽  
Author(s):  
Richard L. Powell ◽  
Oscar Tosi
Keyword(s):  
Normal Hearing ◽  
Recognition Threshold ◽  
Vowel Sound ◽  
Significant Difference ◽  
The Mean ◽  
Vowel Recognition ◽  
Temporal Segment

Vowels were segmented into 15 different temporal segments taken from the middle of the vowel and ranging from 4 to 60 msecs, then presented to 6 subjects with normal hearing. The mean temporal-segment recognition threshold of 15 msecs with a range from 9.3 msecs for the /u/ to 27.2 milliseconds for the /a/. Misidenti-fication of vowels was most often confused with the vowel sound adjacent to it on the vowel-hump diagram. There was no significant difference between the cardinal and noncardinal vowels.

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