meta analysis paper format
1, the title: it should be concise, clear, generalized, and the word count should not exceed 20 words.
2, Abstract: to have a high degree of generalization, the language is concise, clear, Chinese abstract about 100?200 words;
3, Keywords: from the title of the paper or the main body of the paper to select the 3 to 5 words that best express the main content of the words as keywords.
4, Table of Contents: write a table of contents with page numbers.
5. Body:
The body of the paper should generally be more than 3,000 words.
The body of the paper: including the preface, the thesis, the conclusion of the three parts.
The preface (introduction) is the beginning of the paper, mainly explaining the purpose of the paper, the significance of reality, the understanding of the research problem, and put forward the central thesis of the paper. The introduction should be written concisely, not too long.
This thesis is the main body of the dissertation, including the content and methods of research, experimental materials, experimental results and analysis (discussion). In this part to use all aspects of research methods and experimental results, analyze the problem, argue the point of view, try to reflect their scientific research ability and academic level.
The conclusion is the final part of the paper, is the closing statement around the thesis. The basic point is to summarize the whole text, deepen the meaning of the topic.
6, thank you: briefly describe their experience by doing the paper, and should be guided by teachers and assist in the completion of the paper to express gratitude to the relevant personnel.
7, references: at the end of the paper should be listed in the paper referenced monographs, theses and other materials, listed references should be referenced in the text or cited in the order of sequence.
8, notes: in the process of writing the paper, some issues need to be elaborated and explained outside the text.
9. Appendix: For some of the content that should not be placed in the text, but has a reference value, can be compiled into the appendix.
Sample papers on meta-analysis
Meta-analysis of the causes of medical disputes in China
[Abstract] Purpose To analyze the reasons for the occurrence of medical disputes and the departments in which the disputes are more frequent, with a view to providing guiding bases for the medical institutions to better deepen the implementation of specific measures for reform of the medical system. Methods The method of meta-analysis in statistics was used to process the collected literature that met the inclusion criteria, and to compare the composition ratio of the causes of medical disputes and the proportion of medical disputes occurring in each department. Results The top 3 causes of disputes were poor professional diagnosis, treatment and nursing skills (22.95%), poor service attitude (21.24%), and communication barriers between doctors and patients (12.61%); in the distribution of medical disputes by department, surgery accounted for the highest proportion (34.80%), and surgery was the first department in which medical disputes occurred. Conclusion Medical institutions should further deepen the reform of the medical system; medical staff should enhance their professionalism, improve their service consciousness, and emphasize and improve the communication between doctors and patients; and strengthen the management of departments with more medical disputes to ensure the quality of medical care and to reduce and avoid medical disputes.
[Keywords] Medical disputes; Causes analysis; Meta-analysis
[CCS] R197.32 [LID] B [Article ID] 1673-7210(2012)02(c)-0160-03
Meta-analysis of medical dispute causes in China
GAO Xiaofei1,2 ZHOU Weiyan1,2 SUN Zhonghe1▲
1.The Affiliated Nanjing First Hospital of Nanjing Medical University, Jiangsu Province, Nanjing 210006, China. The Affiliated Nanjing First Hospital of Nanjing Medical University, Jiangsu Province, Nanjing 210006, China; 2.School of Clinical Medicine, Nanjing Medical University, Jiangsu Province, Nanjing 210029, China
[ Abstract] Objective To provide better guidance for those medical institutions in implementing specific measures associated with the reform of medical system by analyzing the reasons and departmental requirements. system by analyzing the reasons and department distribution for the medical disputes was conducted. Methods The statistical method of Meta-analysis to The statistical method of Meta-analysis to collect was used and analyzed all the literature which met the inclusion criteria, thus to get results about the composition of the causes, as well as some The statistical method of Meta-analysis to collect was used and analyzed all the literature which met the inclusion criteria, thus to get results about the composition of the causes, as well as some department happening proportion of medical disputes. Dispute reasons ranking first three were unsatisfactory professional medical technical level (22.95%), bad service attitude (21.24%), the doctor-patient communication obstacles (12.61%), respectively; surgical constituted 34.80% which was the primary department where medical disputes occurred. Conclusion Medical institutions to deepen the reform of medical system, the staff need further strengthen professional business level, and to improve the quality of medical services. Medical institutions to deepen the reform of medical system, the staff need further strengthen professional business level, and promote the service consciousness, emphasize and improve doctor-patient communication, reinforce the management of departments with more medical disputes, ultimately to ensure the medical quality, reduce and avoid medical disputes.
[Key words] Medical disputes; Cause analysis; Meta-analysis
Individual variability, disease complexity, and limitations of diagnostic and therapeutic means and many other factors are mixed together, which determines the high degree of difficulty and high risk of the medical industry. In the process of transforming the medical model from a purely biomedical model to a biopsychosocial model, the doctor-patient relationship has become more complex and tends to be tense, and even Chinese doctors have often become the victims of violence in medical disputes [1]. It is urgent to understand and analyze the reasons for the occurrence of doctor-patient disputes in China, as well as the distribution ratio of departments where the disputes occur, and put forward targeted countermeasures to reduce and avoid the disputes. This paper uses Meta-analysis to comprehensively analyze and discuss the causes of medical disputes and the proportion of departmental distribution, in order to provide guidance for medical institutions to better deepen the implementation of specific measures to reform the medical system.
1 Materials and Methods
1.1 Search strategy
Through the method of direct computerized literature search and literature tracing, the databases of PubMed, China Knowledge Network (CNKI), Wanfang and other databases were searched for literature on the analysis of the causes of medical disputes before May 2011. The search keywords were ? doctor-patient conflict? , ? doctor-patient disputes? , medical disputes? medical disputes? and? Causes? The causes and consequences of medical disputes. causes?
1.2 Inclusion and exclusion criteria
Inclusion criteria: ① Chinese and English literature on the analysis of the causes of medical disputes that can be retrieved by PubMed, CNKI and other databases; ② literature that can be viewed in full text.
Inclusion criteria: ① articles that do not contain original data; ② literature on the causes of medical disputes that are not clearly categorized or generalized (e.g., the cause of the dispute is poor quality of care); ③ literature on the causes of disputes according to the number of cases; ④ literature with a sample size of less than 50; ⑤ literature on the causes of fatal disputes alone; ⑥ literature on the causes of disputes that overlap in time and have the same source of disputes; ⑦ literature published in a repetitive manner. The results of this study are summarized in the following table.
1.3 Causes of medical disputes and departmental classification
In the process of medical activities, disputes caused by imperfections or faults in technology, service, and doctor-patient communication are important causes of medical disputes in hospitals. In this paper, the causes of medical disputes are divided into: ① poor service attitude: lack of responsibility and medical ethics; ② poor professional diagnostic nursing skills: a variety of missed diagnosis and misdiagnosis, dependence on medical equipment, improper choice of treatment options, incomplete grasp of the surgical indications, incorrect use of medication, operational errors, the operation of a variety of medical complications; ③ medical costs: some hospitals do not have fee transparency, prescribe expensive medicines, prescribe a big Medical costs: some hospitals do have non-transparent charges, prescribe expensive drugs, prescribe large tests, indiscriminate charges, or patients have doubts about the cost; ④ hospital management system is not in place (mainly core medical systems and technical procedures), including the section and the section of poor cooperation between each other, shirking and other bad phenomena; ⑤ doctor-patient communication barriers: the doctor as the leading side, failed to characterize a full range of information through a variety of multi-channel exchanges, so that both sides to reach a **** knowledge of the failure to establish The patient's reasons: the patient's lack of medical knowledge, unilateral lack of understanding, high expectations, unreasonable, and seeking financial compensation; (7) other: including such as patients walking, slipping and falling, money and property theft, suicide and other accidents, the quality of instruments, medical materials and drugs, adverse drug reactions, interns operate without teacher care, waiting time is too long, the environment of the clinic is poor, and other medical disputes such as dissatisfaction with the hardware and equipment of the hospital, and so on. Other medical dispute cases such as dissatisfaction with hardware and equipment. In this paper, the dispute departments are divided into: internal medicine (including dermatology), surgery, obstetrics and gynecology, pediatrics, ophthalmology (including ophthalmology, stomatology, otorhinolaryngology), emergency department (including ICU), medical technology (including a variety of auxiliary examination departments), other departments (including neurology, etc.).
1.4 Quality control
The data were collected according to the literature inclusion criteria and excluded from the literature with small sample size (<50 cases), poor quality, repetitively published, no original data, or the original text could not be found; in addition, all the data established by the literature were double-checked for accuracy.
1.5 Statistical methods
For the selected literature to organize and establish a database, the data were tested for consistency before analysis. Because of the large heterogeneity in this study (I2>50%), the random effects model was selected. Data processing was completed using Stata 11 statistical software, using the heterogeneity test, with P < 0.05 as the difference was statistically significant.
2 Results
2.1 Literature search
Relevant literature on the analysis of the causes of medical disputes was obtained through PubMed and CNKI and other databases, totaling 458 articles, and 30 articles were finally retained according to the inclusion and exclusion criteria, with a combined total of 6,970 cases of medical disputes. The main sources of medical dispute cases are medical departments of medical institutions at all levels, medical malpractice appraisal medical associations, and hospital departments. Literature clear disputes originating from tertiary hospitals *** 19 articles (17 articles of three A, two articles of three B), two articles of the second level of hospitals, the remaining nine articles of medical institutions level is not clearly stated.
2.2 Causes of medical disputes
The results showed that among all the causes of medical disputes, the service attitude and the level of diagnosis and treatment and care accounted for the highest proportion, 21.24% (95% CI: 14.70% to 28.62%) and 22.95% (95% CI: 16.66% to 29.94%), respectively. Doctor-patient communication accounted for the next highest proportion, 12.61% (95% CI: 8.07% to 17.99%). The smaller proportions of each reason were poor implementation of the hospital system (9.98%), medical costs (3.19%), patient reasons (6.71%), and other reasons (5.72%). There was a statistically significant difference between the reasons (Z = 20.82, P < 0.01). See Table 1.
Table 1 Analysis of the causes of medical disputes (%)
Note: REM is a random effect model (random effect model)
2.3 Proportion of the distribution of medical disputes departments
In the collected literature *** there are 10 pieces of literature related to the analysis of the proportion of distribution of the departments of the doctor-patient disputes, and statistically derived: surgery had the highest proportion (34.80%), followed by internal medicine (18.92%) and obstetrics and gynecology (11.53%), pediatrics (5.24%), pentacameral medicine (3.85%), emergency medicine (3.24%), and medical technology (7.32%), and other departments (2.95%) had the least. The difference between departments was highly statistically significant (Z = 14.32, P < 0.01). See Table 2.
Table 2 Distribution analysis of medical dispute departments (%)
Note: REM is random effect model (random effect model)
3 Discussion
This Meta-analysis of the causes of medical disputes showed that the top 3 causes of disputes were poor professional diagnosis and treatment and nursing care technology level ( 22.95%), poor service attitude (21.24%), and doctor-patient communication barriers (12.61%), which is significantly higher than that of doctor-patient disputes due to unilateral factors of the patient (6.71%), indicating that there is more room for improvement in improving the tension between doctors and patients.
3.1 The three major causes of disputes all reflect the hospital? soft competitiveness?
3.1.1 China's medical status quo is worrying Due to the defects of the health care system, all levels of government investment in hospitals is only about 7% of the average hospital expenditure [2]. Survival? has become the top priority of public hospitals, and some hospitals can only rely on medical services to generate income. The ratio of medical staff in each medical institution is too small, more patients, fewer doctors and nurses, and the pressure of medical and nursing work is great. Even so, the treatment of medical personnel in China is generally inferior to that in foreign countries. In addition, the training of medical personnel than other professions need to pay more time, money and effort, employment, high pressure, high risk and treatment of unsatisfactory contrast, medical personnel have heart gap, physical and mental fatigue, work enthusiasm is not high, motivation hit, which may result in a poor service attitude, lack of responsibility. The economic interests of the drive, medical ethics problems are not easy to correct.
3.1.2 More emphasis should be placed on the patient's psychological and social environment on the health, the impact of the disease Physicians and patients should pay attention to the exchange and communication. Doctors should not only focus on the disease itself and ignore the patient is a complete social person. The process of providing medical services should not be mechanized, and doctors and patients are not in a command-and-obey relationship. Seeing a doctor is not the same as analyzing all kinds of laboratory tests and checklists. Doctors should learn to listen to their patients and communicate effectively with them. Medical treatment is the interaction between doctors and patients, both sides to take the initiative in the process, with the increasing awareness of patients' rights, the determination of medical programs need to consult the patient's opinion, the use of drugs need to explain to the patient, explain. The medical side needs to take certain interventions for patients, such as written guidelines, video courses, face-to-face teaching and other measures to train patients to learn to communicate with health care personnel, improve patient participation, and form a consultative doctor-patient relationship [3].
3.2 Strengthening surgical medical technology
Medical disputes departmental distribution ratio of surgery accounted for 34.8%, similar to the results of the statistical analysis done by Wang Xi et al [4] (36.7%), the difference is highly statistically significant (P < 0.01). Surgical trauma patients are more, the condition is urgent and serious, the patient's family members have complex feelings, a little attitude is not good will feel left out. If intraoperative complications occur due to surgical operation errors, even if they are unavoidable complications of non-medical origin, they are very likely to lead to disputes. Surgery emphasizes the mutual cooperation between the surgical staff, strictly grasp the indications for surgery, do not disregard the existing medical level of the hospital, the patient promises too much. Surgery should also strive to improve the professional and technical level of doctors on the basis of efforts to manage the preoperative, intraoperative, postoperative these three important links, and strengthen the quality control of surgical medical materials such as plates, stents, etc., in order to make patients satisfied with the quality of care.
3.3 Establishment of an effective management system for the prevention of medical disputes
The establishment of an effective management system for the prevention of medical disputes mainly consists of the following measures: ① Improvement of the service model, enhancement of service awareness, reflecting humanistic care; ② standardization of medical behavior, strict implementation of medical rules and regulations; ③ emphasis on the study of medical theories to improve the level of medical technology [5]; ④ reasonable fees, increase the transparency of fees; ⑤ enhancement of the transparency of medical fees, increase the transparency of medical fees, increase the transparency of medical fees; ⑤ enhancement of the transparency of medical fees. Reasonable fees, increase the transparency of fees; ⑤ enhance the communication between doctors and patients, medical staff should strengthen psychology, sociology, interpersonal communication and other social disciplines of theoretical learning and practice; ⑥ carry out medical social work, follow the value of helping people to help themselves, the use of professional knowledge and methods of social work, to provide all kinds of help to patients; ⑦ strengthen the management of medical writing; ⑧ the introduction of third-party mediation mechanism [6-8], the correct treatment of doctor-patient disputes, improve the autopsy rate of death disputes Disputes, improve the autopsy rate of death disputes.
[References]
[1] The Lancet. Chinese doctors are under threat[J]. Lancet, 2010, 376:657.
[2] Li B, Sun XY, Wang JF. A review of research on the factors of doctor-patient communication barriers[J]. China Health Care Management, 2009, 26(5):303-304.
[3] Harrington J, Noble LM, Newman SP, et al. Improving patients' communication with doctors: a systematic review of intervention studies [J]. Patient Educ Couns, 2004,(52):7-16.
[4] Wang X, Lin CY, Wang Y. Analysis of the causes of medical disputes and countermeasures [J]. Journal of Naval Medicine, 2004, 25(3):269-272.
[5] Xiong Baili, He Xiaoxia, Chai Zhongping. Conducting outpatient drug counseling to improve the quality of medical care[J]. Journal of Pediatric Pharmacy, 2007, 13(3):37-38.
[6] Sun Zhonghe, Pan Huaining, Qi Jianwei, et al. Main Models of Alternative Dispute Resolution Mechanism for Doctor-Patient Disputes[J]. China Hospital Management, 2010, 30(12):37-38.
[7] Sun Zhonghe, Ma Jun. The main countermeasures to improve the people's mediation mechanism of doctor-patient disputes[J]. China Medicine Herald, 2011, 8(20):181-182.
[8] Sun Zhonghe, Pan Huaining. An analysis of the current situation of people's mediation mechanism for doctor-patient disputes[J]. Western Medicine, 2011, 23(7):1407-1409.
[9] Sun Zhonghe, Pan Huaining, Ma Zhenhua, et al. The Practice of Introducing People's Mediation Mechanism to Resolve Doctor-Patient Disputes in Tertiary Hospitals[J]. China Hospital Management, 2009, 29(11):56.
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