住院患者用药行为风险知信行调查分析

目的 调查住院患者用药行为风险知识、态度和行为（knowledge，attitude and practice，KAP）现状及影响因素。方法 以纸质问卷/微信问卷2种方式对山东某医院749例住院患者展开调查。采用Excel建立数据库，应用SPSS 24.0软件进行统计分析。结果 KAP与知识教育活动必要性看法平均得分分别为（2.09±1.17）分、（1.89±1.81）分、（2.29±1.30）分、（3.45±1.30）分。患者知识和行为对各种形式合理用药知识教育活动必要性的看法处于较好水平，而接触过的用药知识讲座或用药教育活动的频率（态度）处于较差水平。态度与知识、行为皆为负相关（P<0.01）。结论 用药知识讲座和用药教育活动需要改进；年龄、职业、受教育程度、工作状况、月收入是受访者用药行为风险KAP的主要影响因素；应进一步加强对低学历、老年人的用药安全知识的宣教力度。     

某市师专新生口腔健康知识态度及行为影响因素分析

目的 调查阜阳幼儿师范高等专科学校2016级新生口腔健康知识、态度、行为现况,为进一步完善师专学生口腔健康教育工作、制定相关干预措施提供依据。方法 自行设计问卷,整群抽取阜阳幼儿师范高等专科学校2016级750名新生进行问卷调查,采用单因素方差分析对师专新生口腔健康知识、态度及行为的影响因素进行统计学分析。结果 该校新生的口腔健康知识平均得分（6.92 ±1.86）分,女生高于男生（P<0.05）;口腔健康态度平均得分（17.78 ±1.92）分,女生高于男生（P<0.05）,非独生子女高于独生子女（P<0.05）;口腔健康行为平均得分（16.72 ±2.77）分,男生高于女生（P<0.05）,城市学生高于农村学生（P<0.05）,母亲文化程度高的学生口腔健康行为得分优于母亲文化程度低者（P<0.05）。口腔健康知识、态度及行为得分存在相关性（P<0.05）。结论 师专新生口腔健康态度较好,口腔健康知识的掌握及行为习惯需要改善,不同特征的新生口腔健康知识、态度及行为得分存在差异,需有针对性地制订学校口腔健康教育计划,促进口腔健康行为习惯的养成。     

合肥市社区医务人员食源性疾病认知及临床诊断能力调查

目的 调查合肥市社区医务人员食源性疾病知信行及其临床诊断能力并分析相关因素,为疾病预防控制机构和街道社区卫生服务中心内部的培训工作提供理论依据。方法 采用整群随机抽样的方法抽取41家街道社区卫生服务中心,选取929名医务人员进行问卷调查,采用单因素分析和多因素logistic回归模型分析医务人员基本特征对食源性疾病认知及其临床诊断能力的影响。结果 社区医务人员知识、态度、行为和临床情景模拟诊断的得分分别是（8.38±2.92）、（7.18±1.64）、（9.51±3.41）、（5.49±2.54）分。多因素分析表明科室是食源性疾病知识及行为的影响因素（P< 0.05）,是否参加培训是态度及行为的影响因素（P< 0.05）。结论 合肥市社区医务人员对食源性疾病的认知和诊断水平有待加强,培训应区别不同科室有针对性开展。     

认知行为干预对阴道分娩产妇产后出血及分娩结局的影响

目的 探讨认知行为干预对阴道分娩产妇产后出血及分娩结局的影响。方法 选取2016年8月至2017年8月在安徽医科大学第一附属医院接受阴道分娩的82例产妇为研究对象,按照入院顺序,采用随机数字表法分为干预组和对照组,其中干预组43例,对照组39例。对照组采用常规护理,干预组在对照组基础上增加认知行为干预。分别在产妇入院时及干预后采用自制调查量表评价分娩知识、分娩态度及应对方式情况;孕妇分娩后测定其出血情况、并发症发生率及分娩结局。结果 干预组分娩知识评分（19.02±0.33）分,分娩态度（43.02±1.74）分,应对方式（27.93±1.41）分,分别较对照组的分娩知识（15.12±1.24）分、分娩态度（36.72±3.45）分、应对方式（19.08±2.74）分高,差异有统计学意义（P<0.05）;干预组产后2小时出血量（154.83±12.51）mL,产后24小时出血量（212.22±17.61）mL,均少于对照组,差异均有统计学意义（P<0.05）;干预组并发症发生率4.65%较对照组23.08%低,差异有统计学意义（P=0.021）;干预组新生儿不良结局发生率2.33%较对照组的15.38%低,差异有统计学意义（P=0.049）。结论 认知行为干预可减少阴道分娩产妇产后出血量、产后并发症和新生儿不良结局发生率。     

Wilson病患者生活质量与社会支持的相关性分析

目的 探讨Wilson病(WD)患者获得的社会支持对其生活质量的影响。方法 采用世界卫生组织生存质量评定量表简表(WHOQOL-BREF)、社会支持评定量表(SSRS)对51例健康者(对照组)和287例WD患者(WD组)进行生活质量问卷调查并对比分析,运用Spearman相关分析统计方法分析相关影响因素。结果 ①SSRS测量结果显示,WD患者的客观支持得分为(8.01±2.87)分、社会利用度得分为(7.79±2.49)分,对照组得分分别为(7.10±1.87)分和(9.16±1.64)分,两组比较,差异有统计学意义(P<0.05);WD患者的社会支持总分(33.30±7.42)分、主观支持得分(17.73±4.99)分,与对照组的(32.47±5.38)分、(17.22±3.98)分相比,差异无统计学意义(P>0.05)。②社会支持总分对患者的生活质量有显著影响(P<0.01)。结论 ①WD患者对社会支持的利用度低于一般人群。②文化程度,社会支持等对WD患者生活质量有影响。要提高其生活质量,须多方位采取干预措施。     

慢病患者安全用药行为的评估和干预研究

目的 建立患者用药行为的评估指标体系,分析患者用药行为模式和潜在风险,对患者的不良用药行为进行干预。方法 采用德尔菲法自制问卷,把患者用药行为因素分为4个方面,包括基础信息、知识、态度和能力。检查问卷信度效度后,用于患者用药行为的评估和干预,对高风险患者进行二次评估和干预。结果 535例慢病患者中,高风险患者150例。高风险患者的用药行为干预前后,用药行为得分均值由9.9下降到5.8,知识得分均值由2.9降到0.8、态度得分均值由1.8降到1.4、能力得分均值由2.3降到0.7,干预前后患者用药行为风险存在显著性差异（P<0.05）。结论 药师通过对慢性病长期用药患者进行用药行为的风险评估,针对风险因素,进行个体化用药教育,效果显著。     

2型糖尿病患者自我感受负担自我管理水平及应对方式的调查分析

目的 了解2型糖尿病患者自我感受负担、自我管理水平及应对方式的现状,探讨自我感受负担与自我管理水平、应对方式的相关性。方法 采用横断面调查法,选取2016年5月至2017年5月在安徽医科大学第四附属医院住院的169例确诊为2型糖尿病的患者为研究对象,发放一般资料调查表、患者自我感受负担量表、糖尿病自我管理行为量表、医学应对方式问卷对患者自我感受负担、自我管理水平等进行调查,采用Pearson相关分析法分析2型糖尿病患者自我感受负担与自我管理水平、应对方式的相关性。结果 94.67%的患者存在不同程度的自我感受负担,自我感受负担得分为（30.54±5.84）分;2型糖尿病患者自我管理的6个维度得分最高的为普通饮食（8.83±1.25）分,最低的为药物（4.05±0.95）分;在疾病治疗期间,患者采取的3种应对方式中得分最高的为面对（17.40±2.66）分,得分最低的为屈服（11.51±1.54）分;2型糖尿病患者自我感受负担得分与回避、屈服方式得分呈正相关关系（r=0.313,0.493,P<0.05）,与面对方式、自我管理水平得分呈负相关关系（r=-0.231、-0.161,P<0.05）。结论 2型糖尿病患者的自我感受负担处于中度水平,面对是患者在疾病治疗期间采取较多的应对方式,2型糖尿病患者的自我感受负担水平与回避、屈服应对方式正相关,与面对方式、自我管理水平负相关。     

基于微信平台的延续护理对肿瘤患者居家口服化疗药物依从性的影响

目的 探讨基于微信平台的延续护理对肿瘤患者居家口服化疗药物依从性的影响。方法 以安徽医科大学第一附属医院肿瘤内科100例居家口服化疗药物的患者为研究对象,按照患者出院时间顺序分为对照组和观察组,各50例,其中2018年1~4月出院患者为对照组,6~7月出院患者为观察组。对照组实施肿瘤患者居家口服化疗药物常规延续护理,观察组实施基于微信平台的肿瘤患者居家口服化疗药物延续护理,包括建立微信公众号、微信群,微信公众号定时更新推送肿瘤及口服化疗相关知识,微信群答疑解惑、发送每日温馨提醒等。使用合理用药自我效能量表和修订版Morisky药物依从性量表进行评价,比较两组患者服药2个月后的合理用药自我效能和服药依从性。结果 服药2个月后,观察组患者合理用药自我效能及其两个维度得分[（32.34±2.81）分、（20.16±2.31）分、（12.18±1.75）分]均高于对照组[（26.50±2.96）分、（16.56±2.38）分、（9.94±1.54）分],差异有统计学意义（P<0.05）。观察组患者合理用药自我效能、困难情况下自我效能、不确定情况下自我效能均处于高水平,对照组均处于中等水平。观察组患者服药依从性得分[（7.36±1.12）分]高于对照组[（5.88±1.59）分],差异有统计学意义（P<0.05）。结论 基于微信平台的延续护理能够提升患者合理用药自我效能和口服化疗药物的依从性。     

齐拉西酮对精神分裂症患者血清胆碱酯酶浓度的影响

目的 探讨齐拉西酮对精神分裂症患者血清胆碱酯酶浓度（CHE）浓度的影响。方法 将126例精神分裂症患者随机分为观察组和对照组,观察组给予齐拉西酮治疗,对照组给予氯氮平治疗,进行阳性和阴性症状量表（PANSS）评定,并检测治疗后7、14、28 d的CHE浓度。结果 ①治疗后观察组和对照组PANSS得分均有不同程度的降低,但对照组PANSS得分显著低于观察组[阳性症状：（15.3±4.7）vs（22.4±4.8）,P<0.01;阴性症状：（14.6±4.5）vs（21.8±5.2）,P<0.01;一般精神症状：（13.3±3.4）vs（19.2±3.9）,P<0.01）]。②齐拉西酮或氯氮平治疗均能明显降低CHE的浓度;两种药物分别治疗28 d后,对照组CHE浓度较观察组明显降低[（8 339±2 106）vs（7 366±2 024）,P<0.01]。③治疗中两组均有不良反应,观察组不良反应率为34.9%,对照组不良反应率为71.4%,组间比较有显著性差异（χ²=16 862,P<0.001）。结论 齐拉西酮能对CHE活性有抑制作用,其抑制强度较氯氮平弱,从而可能使齐拉西酮对精神分裂症患者疗效低于氯氮平,但其安全性明显高于氯氮平。     

Wilson病患者自我效能与生存质量状况及其相关性分析

目的 探讨Wilson病（WD）患者自我效能与生存质量状况及其相关性。方法 采用一般自我效能感量表（GSES）和世界卫生组织生存质量测定量表简表（WHOQOL-BREF）对2013年1月至2014年1月安徽中医药大学神经病研究所附属医院215例WD患者和相匹配的190例健康人群（对照组）进行问卷调查,了解WD患者自我效能与生存质量状况及其相关性。结果 WD组患者自我效能得分低于对照组[（2.344±0.4978）分vs（2.611±0.4912）分],差异有统计学意义（t=5.407,P<0.05）;WD组患者生存质量总分低于对照组[（76.46±13.20）分vs（91.26±16.95）分],差异有统计学意义（t=9.835,P<0.05）,各维度得分均低于对照组（P<0.05）;WD患者自我效能得分与生存质量总分及各维度得分呈正相关（P均<0.05）。结论 WD患者一般自我效能及生存质量低于健康人群,其自我效能与生存质量呈正相关,即一般自我效能感越好其生存质量越好。     

How does the general public view antibiotic use in China? Result from a cross-sectional survey

Background Resistance to antibiotics is a major threat to global health and general public play a significant role in the fight against antimicrobial resistance. Objective The present study aimed to identify the knowledge, attitudes, and practice of the general public towards antibiotic use in China. Setting Randomly selected parks in three cities of western, central and eastern China: Xi’an, Changsha, and Nanjing. Method A cross-sectional survey was conducted on a sample of 1400 residents, from January to June 2015. Main outcome measures Knowledge, attitudes and practices scores toward self-medication with antibiotics and compliance with antibiotic regimens. Results The response rate was 86.0% (n = 1204). Only 192 (19.5%) respondents gained a score of 3 or above, and the maximum score of 4, reflecting poor knowledge towards antibiotics. Just over half (54.8%) of respondents incorrectly believed antibiotics were effective against viral infections and only one-third (34.3%) knew that antibiotics were not anti-inflammatories. Nearly half of the respondents (49.0%) had changed the dosage when taking antibiotics, 35.6% switched to another class, 33.4% had not finished the full treatment course and over 60.0% kept leftover antibiotics for future use. Almost half of the respondents (45.7%) stated they had used antimicrobials during the last 6 months and 64.4% of them had self-medicated. Conclusion This study identified serious misconceptions regarding antibiotics use in the Chinese general public. Effective interventions should be developed to provide practical and appropriate advice to effect behaviour change within this population.

     

Knowledge and attitude towards antibiotic use within consumers in Alkharj,Saudi Arabia

Background

The World Health Organization (WHO) has made the problem of solving antibiotic resistance one of its priorities. The present study was designed to determine knowledge and attitude towards antibiotic use in Alkharj, Saudi Arabia.

Can Doctors Be Divided Into Groups Based on Their Attitudes to Addressing Alcohol Issues in Their Patients? Analyses From a Survey of Portuguese General Practitioners

Background: The effectiveness of interventions to increase general practitioners' management of alcohol problems is affected by their attitudes toward at-risk drinkers. Tailoring training programs to general practitioners' attitudes may be useful in increasing alcohol screening and brief advice. Objectives: to determine whether general practitioners could be divided into distinct groups based on their attitudes toward at-risk drinkers. Another aim of this study was to develop and validate a model for classifying general practitioners into distinct groups. Methods: A total of 234 general practitioners answered the questionnaire. Physicians' attitudes toward patients with hazardous or harmful alcohol use were measured with the Short Alcohol and Alcohol Problems Perception Questionnaire. Cluster analysis was performed to identify distinct general practitioner groups based on their attitudes toward at-risk drinkers. Logistic regression analysis was used to develop a model for predicting group membership. Results: Cluster analysis identified two distinct groups of general practitioners, one with more positive attitudes (adequacy = 10.8 ± 1.6, legitimacy = 11.8 ± 1.7, motivation = 9.8 ± 1.7, satisfaction = 8.1 ± 1.9, and self-esteem = 9.7 ± 2.1), the other with more negative attitudes (adequacy = 8.9 ± 1.8, legitimacy = 11.0 ± 1.8, motivation = 7.8 ± 1.6, satisfaction = 5.7 ± 2.0, and self-esteem = 6.8 ± 1.7). The predictors in the final model were self-esteem, motivation, and adequacy. The model predicted general practitioner groups on the training set with 90.4% accuracy (area under receiver operating characteristic [ROC] curve = 0.96), and maintained its predictive performance when applied to the test set (accuracy 93.6%, area under ROC curve = 0.97). Conclusions: General practitioners could be divided into distinct groups based on their attitudes toward at-risk drinkers. These findings may prove useful in designing alcohol-specific training programs for general practitioners.     

对四川大学学生抗菌药物知识及应用观念的调查

目的：了解大学生关于抗生素知识掌握、观念与具体应用等方面的情况。方法：采用分层抽样的方法进行线上、线下问卷调研。结果：共收到有效问卷363份,其中医药学专业学生占50.41%。调查对象整体上对于抗菌药物知识的了解较少。医药类专业学生对相关知识的掌握显著优于其他专业;在医药类专业中,临床药学专业的学生对抗菌药物的了解优于其他专业。结论：四川大学学生对抗菌药物知识的掌握仍有待加强,可以通过学校教育提高学生对正确使用抗菌药物的认识,提高合理用药水平。     

Knowledge,attitudes, and practices of pharmacists toward biosimilar medicines in Nigeria

BackgroundBiopharmaceutical medicines have transformed the treatment of various long-term diseases, despite their high cost and limited availability. Due to their cost saving potentials, biosimilar medicines represent a new wave of therapy for several diseases in the next few years. Thus, pharmacists are uniquely placed to promote and enhance their uptake.ObjectivesThe objectives of this study were to assess Nigerian pharmacists’ biosimilar medicine knowledge, attitudes, and practices.MethodsThis was a cross-sectional, national online survey of conveniently sampled pharmacists in Nigeria. Data were collected with a validated 31-item biosimilar medicine knowledge, attitude, and practice questionnaire. The Pearson correlation (r) analysis was conducted to investigate the association among knowledge, attitude, and practice. A P value of < 0.05 was considered statistically significant.ResultsOf the 600 pharmacists who were invited to participate in the survey, 411 completed the questionnaire giving a response rate of 68.5%. The mean knowledge score was 6.2 ± 3.0 out of a maximum score of 14. Most of the participants (n = 268, 65.2%) had overall knowledge scores of 1 to 7. The mean attitude score was 35.0 ± 8.8 out of a maximum score of 55, whereas that of practice was 18.7 ± 5.3 out of a maximum score of 30. Knowledge was significantly positively correlated with practice (r = 0.360).ConclusionMost of the surveyed pharmacists had poor knowledge of biosimilar medicines, while their reported fair attitude did not translate to good practice.     

New Zealand community pharmacist attitudes toward opioid-dependent clients

Aim: To survey New Zealand community pharmacists to explore levels of training, attitudes towards providing services for drug users, and associations with current and past practice.

Methods: Postal survey of 898 randomly selected community pharmacists. Questions included demography, training and a 20-question attitude scale. Principle component analysis was conducted to identify the main attitude factors. Multiple linear regressions were used to model the effect of different independent variables on the factors.

Findings: Twenty-six percent of respondents had previously undertaken training about the management of opioid misuse. Four principal factors explained 57% of the variance within the attitude questions. These were attitudes towards: ‘the general results of dispensing methadone to opioid misusers’; ‘the effect of opioid-dependent clients on a pharmacy’; ‘reducing harm associated with drug use’; and ‘engaging with drug users’. Training (having it or wanting to have it) was positively associated with the four attitude factors.

Conclusions: The results of this study indicate that attitudes towards various aspects of service provision to drug misusers may not be as simple as previously perceived.     

对住院医师进行抗菌药物临床应用培训效果评价

目的：评价理论与互动相结合式抗菌药物培训效果,探索住院医师更易接受的培训方式,为更好执行《抗菌药物临床应用管理办法》提供参考。方法：对沧州市人民医院新入职住院医师进行理论与互动相结合式培训,比较培训前后抗菌药物考试成绩,在培训前后分别进行问卷调查,内容包括住院医师是否接受过抗菌药物培训、抗菌药物培训的必要性、对抗菌药物基础知识和法律法规的了解程度、培训满意度、哪种培训方式更容易接受等。结果：共83名新入职医师参加培训,回收有效试卷及调查问卷各76份。培训前平均成绩为（67.70±14.13）分,培训后为（94.54±4.84）分,较培训前平均提高39.65%（P < 0.01）。与单纯理论授课式、互动式培训相比,93.42%医师表示更容易接受二者相结合的培训模式,满意度为100%。结论：通过理论与互动相结合式抗菌药物培训,住院医师对抗菌药物认知水平明显提高,理论与互动相结合式抗菌药物培训更容易被住院医师接受。     

Working with substance use: Levels and predictors of positive therapeutic attitudes across social care practitioners in England

Aims: To measure the attitudes of social care practitioners towards working with alcohol and other drug (AOD) use and to identify the factors which can be used to predict positive engagement.

Methods: A cross-sectional online survey was completed by 646 front-line social care practitioners in 11 English Local Authorities. The survey included an adapted version of the Alcohol and Alcohol Problems Perceptions Questionnaire to measure overall therapeutic attitudes (OTAs). Using a principle component analysis, four attitudinal components were identified within the tool; role adequacy, role support, role legitimacy and role engagement.

Findings: Analysis of 597 responses (sub-sample excluding specialists substance misuse workers) revealed an average OTA score of 4.68 (SD?=?0.662; range: 1–7). The majority of scores (69%) fell in the middle range indicating that practitioners were neither positively nor negatively engaged with AOD-related work. Respondents reported more positive perceptions of role support and legitimacy (56% and 54%, respectively) than for role adequacy and role engagement (25% and 20%, respectively). A multiple regression model revealed that perceived preparedness by qualifying training, employing directorate, AOD-related practice experience and gender, were all predictors of OTAs.

Conclusion: For these social care professionals, neither positive nor negative attitudes towards working with AOD dominated. However, this research identifies several factors important for converting the largely ambivalent attitudes of social care practitioners into positive engagement with AOD use.