Читать книгу Medical Communication: From Theoretical Model To Practical Exploration - Tao Wang - Страница 23

Medical communication is mainly aimed at the general public without medical knowledge, who are also known as the common people. Therefore, scientificity and accuracy are very important, otherwise it will mislead the common people. In the last section, we mentioned that the knowledge suitable for popularization to the public should have a gold standard in the stage of popularization of scientific knowledge. The scientific knowledge must have a conclusion. However, there are some medical staff who neglect to do medical science popularization and medical communication, and think that doing medical science popularization and medical communication is just making a fuss, out of business and a waste of time. In fact, this is a misunderstanding of the concept.

Medical communication, medical research, and academic fields complement each other and interact well. Science popularization mainly focuses on the needs of the public. The topics are from academic research. At the same time, science popularization also needs to learn from academic achievements, lift academic status, and produce topics of scientific research while conducting science popularization. Scientific research further improves science popularization at the same time. We analyze a specific case. For example, among the fracture patients over 50 years old in the orthopedic ward of a hospital, doctors found that many of them were brittle fracture, which is the fracture occurred without trauma or slight trauma, and most of them were diagnosed of osteoporosis through further examination. Osteoporosis is a group of bone diseases caused by many reasons. Bone tissue has normal calcification. Calcium salt is in normal proportion to matrix. The metabolic bone disease is characterized by the decrease of bone tissue in unit volume. In most osteoporosis, the decrease of bone tissue is mainly due to the increase of bone absorption. Osteoporosis is usually characterized by bone pain and easy fracture. With the above findings, doctors conducted a survey of osteoporosis knowledge among people over 50 years old, and found that many people are concerned about osteoporosis, but it is not clear what kind of people will get osteoporosis, what symptoms and hazards of osteoporosis, and how to prevent and treat osteoporosis. It is a good topic to carry out science popularization or medical communication about osteoporosis for people over 50 years old, which can be seen as a typical science popularization topic found in academic activities. How shall we do the science popularization of osteoporosis then? The audience of popular science is ordinary people, who have no medical knowledge, so the content popularized must be scientific and accurate, and the opinions must have exact basis. This means that communicators have to look up a lot of documents and materials, especially textbooks, in order to complete a scientific popularization with a sound basis and a correct viewpoint. This is what science popularization should learn from academic. The rigorous attitude required for learning science is extremely important. The preciseness of science popularization is also vital. It must not be cursory, otherwise it may bring confusion or even harm to the general public. In the process of popularizing osteoporosis among the above-mentioned people, besides orthopedic doctors, other relevant departments, such as osteoporosis doctors, nutrition doctors, clinical pharmacists, rehabilitation doctors, and nursing personnel, are invited to participate in the process. This not only facilitates the audience but also enables them to receive the required knowledge of osteoporosis at the same time. Medical knowledge, including nutrition, medicine, nursing, rehabilitation, and other links, also drives the common development of these other related departments and orthopedics, forming a multi-disciplinary cooperation of medical communication and science popularization. Then in order to reduce the incidence of brittle fracture and the rate of refracture in the high-risk group, we need to intervene the fracture group and the high-risk group. During the intervention, other relevant hospitals and community health service centers were invited to carry out the intervention of high-risk factors. In addition to the hospital, primary health care institutions such as lower level hospitals or community health service centers are also promoted, forming a mechanism of up-down linkage and joint participation, and may eventually build a bone health communication base that affects the whole region. The radiation and benefited population will continue to expand. Then, in the process of bone health transmission, we need to evaluate the effect of fracture patients and general high-risk groups, respectively. At this time, if a health evaluation system is established for these two groups, and the effect of the health system is evaluated respectively, and the incidence of brittle fracture and the incidence of refracture of patients with brittle fracture in high-risk groups are evaluated at the same time, which is the problem of scientific research found in the popular science. While evaluating the health system’s effect on these people, scientific research can further improve the effect of science popularization (Figure 2.4). Therefore, it can be seen that scientific research and popular science can complement each other and develop together.

For example, the incidence of liver cancer in a certain place is relatively high. Through epidemiological investigation, it is found that local residents like to eat salted food, and salted food contains nitrosamine, which has been widely recognized as a strong carcinogen, also as one of the most important chemical carcinogens. Long-term consumption may induce gastrointestinal cancer. According to the incidence of local diseases and the results of flow regulation, science popularization about eating less salted food and preventing liver cancer is a science popularization topic found by the academic, which can well meet the needs of local residents. After actively popularizing science among the local population, long-term follow-up survey was carried out to assess whether the incidence of liver cancer in the local area had declined, which is a good scientific research topic derived from popular science. Such an organic combination of complementary scientific research and popular science may improve the diet of local residents and then reduce the incidence of liver cancer. Ultimately disease prevention and control are achieved, in line with the current concept of prevention first and healthy China, and real benefits are brought to the people.

When choosing the topic of medical communication, we also need to pay attention to the needs of people and do some academic research, to understand what people’s most missing knowledge or basic needs are. People with the same disease may have different missing parts or needs. If we can carry out targeted science popularization for different needs, we can get twice the result with half the effort. For example, hypertension is a very common chronic disease, which is characterized by high blood pressure of systemic circulation artery. It can damage many target organs, such as heart, brain, kidney, etc., and even cause death or disability. In 2017, the “12th Five-Year Plan” sampling survey was announced at the China heart conference; it was to study 500,000 residents over 15 years old in 31 provinces and cities in China. It shows that the prevalence of hypertension is 23%, which means that about one out of every four people is a patient with hypertension. The prevalence of hypertension reaches 243.5 million, while the prevalence of normal high blood pressure is 436.3 million. However, the awareness rate of hypertension is only 42.7%, and the control rate is only 14.5%, which means that less than half of the people know about hypertension. On average, only 1.5 of the 10 hypertensive patients have reached the standard of blood pressure control. The survey also shows that the difference between urban and rural areas in the prevalence of hypertension is narrowing, and there is no significant difference between urban and rural people in the prevalence of hypertension, but the awareness rate and treatment of hypertension are lower and less in rural areas. At this time, if carrying out academic research on hypertension in urban and rural areas respectively, we will find that the reasons for the high incidence and low control rate of hypertension in urban and rural populations are not the same. The high incidence and low control rate of hypertension in urban population may be due to high work pressure, long-term high tension in the mental state, unhealthy living and eating habits, lack of necessary sports, misleading by incorrect information through frequent internet search, lack of time for medical treatment, failure to see a doctor correctly, failure to regular treatment, poor treatment compliance, etc. However, the high incidence and low control rate of rural population are more likely due to the factors of low educational level, lack of awareness of the importance of hypertension, low economic income, heavy medical burden, difficult access to medical resources, relatively difficult access to medical services, relatively lack of medical care, lack of family company, etc. Then, according to the results of the survey, to urban and rural populations of two different kinds, carrying out more targeted medical communication and popular science for their own reasons will have good results.

Figure 2.4 Relationship between osteoporosis research and science popularization.

In the regional survey of hypertension, it was found that Beijing (35.9%), Tianjin (34.5%), and Shanghai (29.1%) ranked in the top three cities in China, followed by Liaoning, Yunnan, Guangdong, and Heilongjiang, which belonged to the first echelon; Jilin, Shanxi, Jiangsu, Tibet, Hanan, Fujian, Sichuan, Guizhou, Hebei, Zhejiang, and other provinces had relatively low prevalence, belonging to the second. The prevalence of hypertension was 15.6% in Hunan Province. According to the results of the regional survey, the prevalence of hypertension in the first echelon areas is in urgent need of the related knowledge, and the second and third echelons also need to be paid enough attention. In the past survey of hypertension, the prevalence of hypertension in China has always shown a feature of “high in the north and low in the south”. The academic circles think that it may be related to people in the north eating more salt. However, in this survey, it is found that the feature of “high in the north and low in the south” has been weakened. Maybe because of the wide-range communication and interaction among regions, the northern restaurants have opened in the south, and southern dishes are also distributed in the north, and the difference in diet between the north and the south is gradually narrowing. People in the south are eating more and more salty food now, which increases the prevalence of hypertension, and the phenomenon of high in the north and low in the south is gradually decreasing. Even in regions with similar prevalence, further research can also find that their high prevalence may have different characteristics and factors. For example, in some places, the high prevalence of hypertension is due to the local diet structure dominated by high salt diet, while in some places, the high prevalence is due to high oil and high fat diet. Then, for people in these two different regions, science popularization with different emphasis on improving the diet structure has achieved the goal of focusing on the needs of the people. In the meantime, the selection of topics comes from academic research; thus the effect will be better than science popularization without emphasis. The ultimate goal of science popularization and medical communication is to reduce the morbidity and mortality of diseases, to improve people’s health level, and to realize the ideal of healthy urban area and healthy China. Only when people’s health is guaranteed can the country develop better.

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