目的:分析新疆眼科资源配置现状,为优化地区资源配置提供依据。方法:采用问卷调查收集新疆眼科医疗机构数、床位数、医师数及护士数资料,运用洛伦兹曲线和基尼系数评估其在人口和地域面积的配置公平性。结果:2024年新疆每10万人口有眼科医疗机构0.68个、眼科床位13.90张、眼科医师7.68人、眼科护士5.88人。按人口配置:眼科医疗机构数、眼科床位数、眼科医师数、眼科护士数的基尼系数分别为0.22、0.23、0.26、0.29(相对公平);按地域面积配置:眼科医疗机构数、眼科床位数、眼科医师数、眼科护士数的基尼系数分别为0.40、0.60、0.59、0.60(高度不公平)。结论:新疆眼科资源总量显著提升,但地域配置公平性极差(基尼系数普遍大于0.4),护士配置明显不足。亟须优化资源配置策略,重点提升地域(尤其是偏远广阔地区)可及性并加强护士队伍建设。
Objective: To analyze the equity of ophthalmic resource allocation in Xinjiang and provide evidence for optimizing distribution. Methods: Data on the number of ophthalmic medical institutions,beds, physicians, and nurses in Xinjiang were collected through questionnaires. The Lorenz curve and Gini coefficient were used to evaluate allocation equity in terms of population and geographic area. Results: In 2024,Xinjiang had 0.68 ophthalmic medical institutions,13.90 ophthalmic beds, 7.68 ophthalmic physicians,and 5.88 ophthalmic nurses per 100,000 population. Population-based allocation showed Gini coefficients of 0.22, 0.23, 0.26,and 0.29 for ophthalmic institutions,beds, physicians,and nurses respectively (relatively equitable). Geographic area-based allocation yielded Gini coefficients of 0.40, 0.60, 0.59, and 0.60 for the same categories (highly inequitable). Conclusions: While the total ophthalmic resources in Xinjiang have significantly increased, geographic allocation remains extremely inequitable (Gini coefficients generally >0.4), with particularly insufficient nurse staffing. Urgent optimization of resource allocation strategies is needed, focusing on improving accessibility in remote areas and strengthening the nursing workforce.
目的:了解玻璃体切除硅油填充术后患者(face-down positioning,FDP)依从性的相关影响因素。方法:采用随机抽样研究的方法,选取2018年1月至2019年12月于无锡市人民医院眼科行玻璃体切除硅油填充术后的患者100例,采用问卷调查对一般资料、FDP可能发生的反应和依从性进行调查。采用SPSS 19.0进行统计分析。结果:患者性别、对疾病的重视程度与FDP的依从性有显著差异(P<0.05),但家庭支持系统与FDP的依从性差异无统计学意义(P>0.05)。患者术后第1天对FDP依从性的主要影响因素依次为呼吸不畅(84%)、睡眠不佳(78%)、肩颈部不适(10%);术后第3天的主要影响因素依次为呼吸不畅(66%)、腰酸背痛(50%)、睡眠不佳(39%);术后第5天的主要影响因素依次为肢体麻木(70%)、腰酸背痛(87%)、睡眠不佳(30%)、肩颈部不适(18%)以及肘关节疼痛(10%)。结论:影响患者依从性的主要因素主要有性别、对疾病的自我重视程度以及FDP引起的不适症状。需加强对高危因素的识别,不同病情时段给予征对性的宣教和指导,以提高患者对FDP的依从性。
Objective: To investigate the influencing factors of compliance of patients with silicone oil tamponade after vitrectomy. Methods: A total of 100 patients with silicone oil tamponade after vitrectomy in Wuxi People’s Hospital of Jiangsu Province from January 2018 to December 2019 were selected by random sampling method.The general information, possible reaction, and compliance of face-down positioning (FDP) were investigated by questionnaire. SPSS 19.0 was used for statistical analysis. Results: There were significant differences in patients’gender, attention to disease and FDP compliance (P<0.05), but there was no significant difference between family support system and FDP (P>0.05). The main influencing factors of FDP compliance were dyspnea (84%), poor sleep (78%), the discomfort of shoulder and neck (10%); on the third day after operation, the main influencing factors were dyspnea (66%), low back pain (50%) and poor sleep (39%); on the fifth day, the main influencing factors were numbness of the limbs (70%), low back pain (87%) and poor sleep (30%), the discomfort of shoulder and neck (18%) and elbow pain (10%). Conclusion: The main factors that affect the compliance of patients are gender, self-awareness of the disease and discomfort caused by FDP. It is necessary to strengthen the identification of high-risk factors, and give symptomatic education and guidance at different stages of illness, to improve the compliance of patients to FDP.