• <tr id="yyy80"></tr>
  • <sup id="yyy80"></sup>
  • <tfoot id="yyy80"><noscript id="yyy80"></noscript></tfoot>
  • 99热精品在线国产_美女午夜性视频免费_国产精品国产高清国产av_av欧美777_自拍偷自拍亚洲精品老妇_亚洲熟女精品中文字幕_www日本黄色视频网_国产精品野战在线观看 ?

    What factors influence patient experience in orthopedic oncology office visits?

    2020-06-19 06:35:58AlanBlankSaraShawConnorWakefieldYueZhangWeiLiuKevinJonesLorRandall
    World Journal of Clinical Oncology 2020年3期
    關(guān)鍵詞:樹丫用力風(fēng)箏

    Alan T Blank, Sara Shaw, Connor J Wakefield, Yue Zhang, Wei J Liu, Kevin B Jones, R Lor Randall

    Abstract

    Key words: Press Ganey? survey; Orthopedic oncology; Outpatient clinic; Patient experience; Patient satisfaction; Patient reported outcomes

    INTRODUCTION

    Patient satisfaction and patient reported outcomes are becoming increasingly important in determining the efficacy of clinical care. For decades in the orthopedic oncology literature, overall survival, metastasis and local recurrence statistics have been well published[1-4]. Using these metrics, patients were determined to be doing well if they were alive, free of local or metastatic disease at various time points.Assessment of patient functional outcomes has been evaluated using scoring systems such as the musculoskeletal tumor society score and Toronto extremity salvage score.However, not until more recently have physicians begun to evaluate various functional, pain related, and psychological outcomes[5-8]. Since this recent interest, the literature has shown that using these metrics can provide valuable information regarding how patients are functioning on a physical and psychological level while being treated as well as during surveillance.

    Overall patient satisfaction scores and patient reported outcomes are challenging measurements to understand[9-11]. Each patient has a unique personality as well as pathology and these can both affect patient satisfaction scores. There has been some conflicting data published studying the subject of how patient satisfaction correlates to efficacy of clinical care. Some studies have found positive correlations to efficacy of care and others have found the opposite[9,12]. Understanding the patient perspective certainly provides the care team insight regarding the patients' perceived strengths and weaknesses of care. Furthermore, patient satisfaction scores may in part determine the future of hospital and physician reimbursements[13]. Press Ganey?medical practice outpatient and ambulatory surgery patient experience of care survey(“Press Ganey survey”) is a questionnaire used to evaluate patient satisfaction in the outpatient clinic setting. The number of cancer patients and cancer related costs in the United States is significant and rises every year, hence we feel this is an important demographic to further investigate[14]. In this study, our group evaluated prospectively collected survey information to determine what factors contributed to patients’ likelihood to recommend our practice as well as our providers in our orthopedic oncology outpatient clinic. The study also aimed to identify areas of our clinical practice that were rated highly and those that needed improvement from the patient perspective.

    Patient satisfaction surveys have the capacity to provide the orthopedic care team with a window into the perspective of the patient. Although it is unclear whether patient satisfaction scores are directly or indirectly related to efficacy of care this information provides insight to the care team and can help to implement reasonable and necessary changes. The Press Ganey survey is a questionnaire used in the outpatient setting to gather this information from the patient perspective. No study to date has evaluated which factors within the Press Ganey survey are most valued by orthopedic oncology patients. Further, no study to date has reviewed Press Ganey survey results from an orthopedic oncology practice outpatient setting in order to determine practice strengths and weaknesses. We feel the results of this study can provide valuable information about the patient perspective in a clinic setting which can be useful for not just orthopedic oncology clinics but all orthopedic outpatient clinics.

    MATERIALS AND METHODS

    Patients and methods

    We performed an IRB approved retrospective review of prospectively collected Press Ganey survey data from our orthopedic oncology outpatient clinic. The Press Ganey survey was distributed electronically to all patients seen in the outpatient orthopedic oncology clinic. The Press Ganey survey consists of 37 questions involving the clinical check-in process, facility quality, ease of communication with clinic staff, surgical educational information, and overall patient experience. The full survey takes approximately 15 min to complete. Computer adaptive versions are available which shorten the survey to 5-10 questions and allow for completion in as little as 5 min.Patients have 30 d from their clinic encounter to complete the questionnaire. Data was collected during the 2015 and 2016 calendar year. One hundred sixty-two completed the Press Ganey surveys from the outpatient orthopedic oncology clinic and responses were prospectively collected in order to retrospectively review. Basic demographic data along with survey category responses were collected.

    Statistical analysis

    Data was recorded electronically and obtained in accordance with the medical center’s IRB protocol. The data was then submitted to the University Study Design and Biostatistics Center for statistical evaluation. Frequency and percent were presented for all categorical variables as well as for outcome variables "likelihood to recommend the physician" and "likelihood to recommend the practice". Analysis of variance was applied continuous variables andχ2-test/Fisher’s exact test was applied to assess between categorical variables. All bivariate analyses were two-tailed and the statistical significance was set asP< 0.05. Firth logistic regression analyses were performed using least absolute shrinkage and selection operator (LASSO) to identify predictive factors for each outcome of interest.

    Due to the low frequencies of some answers in the survey all original variables with results-0, 25, 50, 75, 100 and N/A were re-categorized as not completely satisfied(0/25/50/75), completely satisfied (100) and N/A.

    Descriptive and bivariate analyses were based on the analysis data set composed by every patient’s first record. Mean, standard deviation, median, minimum and maximum were presented for numeric variables. Frequency and percent were presented for categorical variables in overall, and by outcome variables "likelihood to recommend the physician" and "likelihood to recommend the practice". Analysis of variance was applied to assess the possible difference in mean of continuous variable with approximately normal distribution among groups specified by outcome variable.χ2-test or Fisher’s exact test was applied to assess the possible association between two categorical variables. All bivariate analyses were two-tailed and the statistical significance was set asP< 0.05.

    Based on results from previous steps and nature of the data (e.g., rare events and quasi-complete separation), Firth logistic regression analyses were performed using LASSO to identify predictive factors truly informative for each outcome of interest,and the final model for each outcome was determined based on the optimal tuning parameter adopting 10 fold cross-validation criteria. The final models were unpenalized; odds ratios and 95% confidence intervals were reported.

    Statistical software was SAS 9.4 (SAS Institute Inc., Cary, NC, United States) and R(www.r-project.org). All LASSO analyses were conducted using the “glmnet” package in R. All statistical methods were reviewed by Yue Zhang and Wei J Liu from the University of Utah.

    RESULTS

    Among the 162 participants, regarding patient’s characteristics, the average age was 54.4 years (standard deviation = 16.2 years, median = 56 years, range = 17 to 95 years);83 (51.2%) participants were female; 104 (64.2%) participants were from in-state; 89(54.9%) participants had malignant diagnosis.

    Regarding the outcomes “l(fā)ikelihood to recommend the physician/likelihood to recommend the practice” and patient’s characteristics, it was statistically significant on bivariate analysis that participants who lived out of state were more likely to have complete satisfaction of “l(fā)ikelihood to recommend the physician/likelihood to recommend the practice” compared to participants who lived in state (91.4%vs73.1%,P= 0.027; 86.2%vs69.2%,P= 0.029,χ2-test); among other patient characteristics, there were no statistically significant relationships observed (P> 0.02,P> 0.05 in all instances, ANOVA,χ2-test or Fisher’s exact test).

    Regarding outcomes “l(fā)ikelihood to recommend the physician/likelihood to recommend the practice” and individual question responses, it was statistically significant on bivariate analysis that, for each item participants reported “Completely satisfied” they were more likely to have complete satisfaction of “l(fā)ikelihood to recommend the physician” compared to participants who reported “Not completely satisfied” (P< 0.004,P< 0.001 in all instances,χ2-test or Fisher’s exact test). The outcome “l(fā)ikelihood to recommend the physician/likelihood to recommend the practice” was statistically associated with each individual survey question answered on bivariate analysis (P< 0.01,P< 0.001 in all instances, Fisher’s exact test).

    Regarding the model of “l(fā)ikelihood to recommend the physician”, Firth logistic regression analysis (with LASSO regulation) results suggested that complete satisfaction of “l(fā)ikelihood to recommend the physician” was positively associated with complete satisfaction of factors including MD friendliness/courtesy (OR = 14.4,95%CI: 2.5-84.3), MD confidence (OR = 48.2, 95%CI: 6.2-376.5), MD instructions follow up care (OR = 2.5, 95%CI: 0.4-7.4), sensitivity to needs (OR = 16.1 , 95%CI: 1-62.5)(Table 1).

    Regarding model of “l(fā)ikelihood to recommend the practice”, Firth logistic regression analysis (with LASSO regulation) results suggested that complete satisfaction of “l(fā)ikelihood to recommend the practice” was positively associated with complete satisfaction of factors including MD confidence (OR = 11.6, 95%CI: 2.1-63.4),sensitivity to needs (OR = 5.8, 95%CI: 1.3-26.7), staff work together (OR = 36.1, 95%CI:7.9-165.1) (Table 1).

    DISCUSSION

    Disease related outcomes have been the gold standard in outcomes measures when discussing oncology patients for many years. Indeed, knowing local recurrence,metastasis and overall survival rates are crucial in understanding the efficacy of treatments. However, functional outcomes and patient reported outcomes also have critical roles in better describing how patients are living after their diagnosis is made and treatment undertaken.

    In the orthopedic oncology literature functional outcomes have adapted over time starting with general evaluations such as the SF-36. Functional outcomes then became somewhat more orthopedic based and included tests such as the Harris hip, Oxford knee and DASH scores. From that point, functional evaluations have been developed specifically for orthopedic oncology and include the musculoskeletal tumor society score and Toronto extremity salvage scoring system[1-3]. A relatively new development in patient reported outcomes is the utilization of Patient Reported Outcomes Measurement Information System, which is a simple, computer adaptive test that has been utilized in the oncology literature recently[15-17].

    The next progression in evaluating care from the patient perspective comes in the form of patient satisfaction surveys. These surveys, such as Press Ganey, focus on the purely subjective aspect of which aspects of their care they found to be acceptable,and which needed improvement[8,18-20]. There is some debate in the literature as to whether patient satisfaction is positively or negatively correlated with efficacy of care[21,22]. Fentonet al[9]in 2012 published results of a large prospective series and found that higher patient satisfaction was associated with more admissions, more prescription drugs, more overall expenditures and a higher mortality rate. Changet al[7]in 2006 published their results that among a geriatric cohort of 236 patients,assessments of quality of care was not related to global ratings of care. The group recommended against using global ratings of care to be used as a marker of technical quality of care[7]. In the orthopedic literature, Chughtaiet al[18]published their results of a retrospective study involving 736 knee replacement patients and found there was no statistically significant relationship between Press Ganey survey scores and standard arthroplasty outcomes measures.

    Table 1 Factors for likelihood to recommend physician and practice

    Conversely Tsaiet al[12]published in 2015 that among a large cohort of surgical patients, hospitals with higher patient satisfaction provided more efficient care with fewer readmissions and lower mortality rates. Similarly, Sackset al[23]in 2015 published results of a retrospective study of over 100,000 patients and found that patients treated in hospitals which ranked in the highest satisfaction quartile had significantly lower risk of death and minor complications compared to those in the lowest satisfaction quartile.

    Regardless of the correlation, important information can be gathered from the survey data collected in this study. In the oncology patient population, we believe that elucidating which factors of the clinic experience are perceived positively and which negatively can help the care team to improve the overall patient experience while not compromising clinical care.

    Our study certainly has several limitations including the response rate of 17%overall. Other limitations include the ability of patients to complete surveys up to 30 d after the clinical encounter which may affect patient recall ability. Our clinical practice is quite diverse, with some patients presenting for general orthopedic complaints and a distant history of cancer, and some currently undergoing treatment for sarcoma. We believe that this is in fact the typical patient population for an orthopedic oncology clinic and the heterogeneity increases our external validity. Finally, there is no consensus as to whether patient satisfaction scores are positively or negatively correlated with clinical outcomes. Because of this it is quite difficult to determine if implementing changes based on the outcomes of the satisfaction scores is appropriate in all settings.

    The results of this study demonstrate that out-of-state patients may be more likely to be satisfied with their care than inpatients. The group had a difficult time explaining this finding but believes may be related to the fact that our clinical practice has a very wide catchment area and often patients will travel more than 500 miles for care. Those traveling very far are from more rural areas and often have a difficult time finding appropriate physicians for treatment in their hometown, which contributes to their unique perspective.

    The data demonstrated that patients perceived our clinic to perform well in the categories of confidence in MD (81%), MD concern about worries/questions (75%),courtesy of staff (76%), MD friendliness/courtesy (79%), cleanliness (75%), MD including you in decision making (72%) and MD explained condition (75%). The clinic showed room for improvement in the categories of ease of getting on the phone (49%),information about delays (36%), wait time (37%) and MD speaking about medications(45%). Our outpatient clinic found this information useful in regards to areas which were satisfactory and which needed improvement and simple measures will be taken to address those insufficiencies while not compromising clinical care.

    The data demonstrated that the patients' likelihood to recommend the practice was positively associated with confidence in the physician, sensitivity to their needs and the staff working together. The data also demonstrated that the patients' likelihood to recommend the physician was positively associated with the courtesy of the physician, confidence in the physician, physician instructions on follow up care, and sensitivity to the patients’ needs. These findings are also reasonable categories which patients would find most important and should be considered during every patient interaction.

    We believe that by understanding which aspects of patient care are important to the patient, we can continue to improve the patient experience without compromising clinical care. The literature has shown that in some circumstance’s patient reported outcomes may be negatively correlated to clinical outcomes while at other times they are positively associated[9,12]. In both situations, useful information can be obtained from better understanding the patient perspective. The outpatient clinic of study was able to determine which areas of their care were perceived as sufficient and which were insufficient and thus was able to make reasonable and appropriate changes without changing the overall care algorithm. This information may be very useful to orthopedic oncology clinics in addition to the various surgical oncology clinics in the quest to improve on patient experiences in a clinic setting.

    ARTICLE HIGHLIGHTS

    Research background

    Patient satisfaction and reported outcomes play an important role in determining efficacy of clinical care. Little is known about the patient experience in an orthopedic oncology outpatient clinic.

    風(fēng)箏被樹丫只是輕輕地纏住,樹很高,爬上去弄是不現(xiàn)實的,而如果手用力,只會讓風(fēng)箏扯破。我建議,要不把線剪斷吧。

    Research motivation

    This study aims to evaluate the potential factors that impact the patient experience within an outpatient orthopedic oncology clinic. Identification of these factors will allow us and others to improve the patient experience.

    Research objectives

    The primary objective of this study was to identify potentially modifiable factors that impact the patient reported experience. With this knowledge one can implement strategies to improve the outpatient experience.

    Research methods

    This study was a retrospective review of prospectively collected data obtained through routine medical care at a single orthopedic oncology outpatient clinic.

    Research results

    This study identified that most patients within the practice were from out of state. Likelihood to recommend the attending physician was associated with MD friendliness/courtesy, MD confidence, MD instructions follow-up care, and sensitivity to needs. Although the clinic operation performed well in the categories of courtesy of staff and cleanliness there is room for improvement in ease of getting on the phone, information about delays, and wait time.

    Research conclusions

    Orthopedic specialties can greatly benefit with the knowledge obtained from this study by understanding which factors are associated the patient experience in an outpatient clinic. Future studies can be aimed at improving areas of care identified from this study.

    Research perspectives

    The patient experience and reported satisfaction is becoming an important measure of clinical efficacy through various surgical and medical specialties. Little is known on the patient experience within an orthopedic oncology outpatient clinic. Future research is required to investigate strategies at improving areas within the outpatient clinic identified from this study.

    猜你喜歡
    樹丫用力風(fēng)箏
    《樹丫上的鳥巢》
    散文詩(2019年12期)2019-01-28 06:24:38
    風(fēng)箏
    在手賬中為風(fēng)箏比心
    小樹丫的翅膀
    暮鴉
    民主(2017年4期)2017-05-10 19:30:00
    學(xué)做風(fēng)箏
    雪花(2015年5期)2015-10-28 18:06:45
    “小狗”上樹
    用力!用力!再用力!
    小主人報(2015年23期)2015-02-28 20:45:10
    暴力行為
    海外英語(2013年6期)2013-08-27 09:23:45
    欧美成人精品欧美一级黄| 亚洲国产精品sss在线观看| 黄色配什么色好看| 又黄又爽又刺激的免费视频.| 中文乱码字字幕精品一区二区三区 | 国产精品久久久久久av不卡| 七月丁香在线播放| 国产精品一区二区性色av| 美女被艹到高潮喷水动态| av女优亚洲男人天堂| 国产精品日韩av在线免费观看| 中文字幕av成人在线电影| 不卡视频在线观看欧美| 国产在线一区二区三区精 | 精品99又大又爽又粗少妇毛片| 国产精品国产三级国产专区5o | 亚洲自拍偷在线| 内射极品少妇av片p| 高清在线视频一区二区三区 | 又爽又黄a免费视频| 久久久国产成人免费| 欧美成人a在线观看| 97在线视频观看| 久久亚洲精品不卡| 亚洲自拍偷在线| 国产高潮美女av| 欧美一级a爱片免费观看看| 99热6这里只有精品| 六月丁香七月| 国产精品爽爽va在线观看网站| 婷婷六月久久综合丁香| 在线观看av片永久免费下载| 亚洲精华国产精华液的使用体验| 亚洲一区高清亚洲精品| 在线免费观看不下载黄p国产| 亚洲欧美日韩高清专用| 亚洲最大成人手机在线| 亚洲内射少妇av| 免费不卡的大黄色大毛片视频在线观看 | 精品无人区乱码1区二区| 秋霞在线观看毛片| 午夜激情福利司机影院| 精品人妻熟女av久视频| 丰满乱子伦码专区| 久久精品夜夜夜夜夜久久蜜豆| 精品一区二区三区人妻视频| 日韩在线高清观看一区二区三区| 在线播放国产精品三级| 午夜激情欧美在线| 亚洲精品影视一区二区三区av| 国产成人精品婷婷| 91久久精品电影网| 国产又色又爽无遮挡免| 中文在线观看免费www的网站| 日本三级黄在线观看| 免费看日本二区| 91精品国产九色| 1024手机看黄色片| 久久99热这里只频精品6学生 | 搡老妇女老女人老熟妇| 国产精品一及| 中文欧美无线码| 欧美三级亚洲精品| 三级经典国产精品| 久久久久久久久久成人| 可以在线观看毛片的网站| 色尼玛亚洲综合影院| 欧美成人精品欧美一级黄| 国产精品伦人一区二区| 热99re8久久精品国产| 能在线免费看毛片的网站| 国产视频首页在线观看| av免费在线看不卡| 亚洲自拍偷在线| 欧美精品一区二区大全| 国产白丝娇喘喷水9色精品| 少妇的逼水好多| 内地一区二区视频在线| a级毛色黄片| 午夜精品在线福利| 69av精品久久久久久| 听说在线观看完整版免费高清| 亚洲精品乱久久久久久| eeuss影院久久| 日韩av在线免费看完整版不卡| 美女脱内裤让男人舔精品视频| 国内精品一区二区在线观看| 91精品一卡2卡3卡4卡| 波多野结衣巨乳人妻| 天堂av国产一区二区熟女人妻| 国产欧美日韩精品一区二区| 又爽又黄a免费视频| 建设人人有责人人尽责人人享有的 | 国产精品不卡视频一区二区| 日韩av在线大香蕉| 欧美一区二区精品小视频在线| 午夜福利成人在线免费观看| 国国产精品蜜臀av免费| h日本视频在线播放| 免费在线观看成人毛片| 最近最新中文字幕免费大全7| 日韩国内少妇激情av| 桃色一区二区三区在线观看| 国产精品人妻久久久影院| 小说图片视频综合网站| 高清视频免费观看一区二区 | 国产久久久一区二区三区| 国产大屁股一区二区在线视频| 中文在线观看免费www的网站| 美女黄网站色视频| 精品久久久久久电影网 | 韩国高清视频一区二区三区| 男人狂女人下面高潮的视频| 久久精品夜色国产| 三级国产精品片| 亚洲欧美日韩卡通动漫| 国产精品精品国产色婷婷| 久久久精品欧美日韩精品| 日韩成人av中文字幕在线观看| 日本爱情动作片www.在线观看| 亚洲国产精品成人综合色| 欧美xxxx黑人xx丫x性爽| 国内精品宾馆在线| 在现免费观看毛片| av女优亚洲男人天堂| 亚洲一区高清亚洲精品| 麻豆成人午夜福利视频| 国产成人aa在线观看| 建设人人有责人人尽责人人享有的 | 少妇的逼水好多| 联通29元200g的流量卡| 国产精品麻豆人妻色哟哟久久 | a级毛色黄片| 免费黄色在线免费观看| 老司机影院成人| 禁无遮挡网站| 男人的好看免费观看在线视频| 男女视频在线观看网站免费| 最近中文字幕高清免费大全6| 最近视频中文字幕2019在线8| 长腿黑丝高跟| 久久久久久大精品| 国产精品爽爽va在线观看网站| 国产在线男女| 精品久久久噜噜| 又黄又爽又刺激的免费视频.| 国产高清三级在线| 国产高清三级在线| 日韩视频在线欧美| 啦啦啦韩国在线观看视频| 一级毛片aaaaaa免费看小| 美女被艹到高潮喷水动态| 尾随美女入室| 国产免费男女视频| 晚上一个人看的免费电影| a级毛色黄片| 听说在线观看完整版免费高清| 国产三级中文精品| 非洲黑人性xxxx精品又粗又长| 国产亚洲午夜精品一区二区久久 | 黄片wwwwww| 欧美精品一区二区大全| 国产爱豆传媒在线观看| 22中文网久久字幕| 69av精品久久久久久| 国产免费视频播放在线视频 | 淫秽高清视频在线观看| 亚洲熟妇中文字幕五十中出| 亚洲最大成人av| 美女内射精品一级片tv| 99在线视频只有这里精品首页| 欧美丝袜亚洲另类| 尤物成人国产欧美一区二区三区| videos熟女内射| 美女被艹到高潮喷水动态| 国产成人freesex在线| 欧美不卡视频在线免费观看| 欧美不卡视频在线免费观看| 国产精品一区二区在线观看99 | 亚洲国产成人一精品久久久| 乱码一卡2卡4卡精品| kizo精华| 久久久久久久久久久免费av| 在线观看av片永久免费下载| 亚洲av.av天堂| 97超视频在线观看视频| 高清av免费在线| 国内精品宾馆在线| 99久国产av精品国产电影| 99在线视频只有这里精品首页| 能在线免费观看的黄片| 韩国av在线不卡| 久久草成人影院| av黄色大香蕉| 成人一区二区视频在线观看| 国产又色又爽无遮挡免| 国产伦理片在线播放av一区| 精品不卡国产一区二区三区| 久久99蜜桃精品久久| 精品久久久久久久久亚洲| 久久久久久伊人网av| 成人漫画全彩无遮挡| 噜噜噜噜噜久久久久久91| 嫩草影院新地址| 美女cb高潮喷水在线观看| 国产精品久久久久久精品电影小说 | 少妇丰满av| 国产精品,欧美在线| 99在线人妻在线中文字幕| 中国国产av一级| 免费搜索国产男女视频| 久久久久九九精品影院| 精品无人区乱码1区二区| 久久精品国产99精品国产亚洲性色| 亚洲av电影不卡..在线观看| 啦啦啦观看免费观看视频高清| 亚洲最大成人中文| 91午夜精品亚洲一区二区三区| 汤姆久久久久久久影院中文字幕 | 丝袜喷水一区| 我的女老师完整版在线观看| 日韩大片免费观看网站 | 六月丁香七月| 精品一区二区三区视频在线| 欧美3d第一页| 亚洲国产精品久久男人天堂| 十八禁国产超污无遮挡网站| 看黄色毛片网站| 黄色配什么色好看| 亚洲精品乱码久久久久久按摩| 国产不卡一卡二| 国产精品日韩av在线免费观看| 国模一区二区三区四区视频| 青春草国产在线视频| 啦啦啦韩国在线观看视频| 熟妇人妻久久中文字幕3abv| 身体一侧抽搐| www日本黄色视频网| 又粗又硬又长又爽又黄的视频| 99九九线精品视频在线观看视频| 免费搜索国产男女视频| 国产精华一区二区三区| 三级国产精品片| 精品99又大又爽又粗少妇毛片| 免费观看精品视频网站| 搞女人的毛片| 人体艺术视频欧美日本| 久久欧美精品欧美久久欧美| 亚洲美女视频黄频| 色综合站精品国产| 亚洲aⅴ乱码一区二区在线播放| 国产精华一区二区三区| 人妻系列 视频| 免费观看性生交大片5| 久久99热这里只频精品6学生 | 成人鲁丝片一二三区免费| 亚洲av成人精品一区久久| 91午夜精品亚洲一区二区三区| 色综合亚洲欧美另类图片| 久久99热这里只频精品6学生 | 女人被狂操c到高潮| 男女那种视频在线观看| 成人一区二区视频在线观看| 久久久a久久爽久久v久久| 成人一区二区视频在线观看| 伦理电影大哥的女人| 神马国产精品三级电影在线观看| 国产精品一及| 99久久无色码亚洲精品果冻| 中文字幕精品亚洲无线码一区| 国产色婷婷99| 日本黄大片高清| 亚洲一级一片aⅴ在线观看| 18禁在线无遮挡免费观看视频| 国产老妇伦熟女老妇高清| 亚洲美女搞黄在线观看| 亚洲无线观看免费| 精品久久国产蜜桃| 狂野欧美激情性xxxx在线观看| 中文乱码字字幕精品一区二区三区 | 天堂√8在线中文| 成人漫画全彩无遮挡| 一级毛片我不卡| 欧美3d第一页| 免费人成在线观看视频色| 国产精品乱码一区二三区的特点| av在线蜜桃| 色噜噜av男人的天堂激情| 有码 亚洲区| 亚洲婷婷狠狠爱综合网| 99热6这里只有精品| 日韩欧美国产在线观看| 国产成人一区二区在线| 午夜福利在线观看免费完整高清在| 国产真实伦视频高清在线观看| 精品午夜福利在线看| 搡老妇女老女人老熟妇| 麻豆成人午夜福利视频| 成年av动漫网址| 欧美变态另类bdsm刘玥| 小说图片视频综合网站| 97人妻精品一区二区三区麻豆| 精品久久国产蜜桃| 97热精品久久久久久| 日本黄色片子视频| 久久久久久久久中文| 全区人妻精品视频| 看非洲黑人一级黄片| 日日干狠狠操夜夜爽| 久久精品久久久久久久性| 日韩在线高清观看一区二区三区| 人妻夜夜爽99麻豆av| 精品久久久久久电影网 | 国产大屁股一区二区在线视频| 伊人久久精品亚洲午夜| 亚洲精品久久久久久婷婷小说 | 日韩欧美精品免费久久| 女的被弄到高潮叫床怎么办| 亚洲国产日韩欧美精品在线观看| 久久热精品热| 一边亲一边摸免费视频| 成人无遮挡网站| 亚洲不卡免费看| 日日摸夜夜添夜夜添av毛片| 日本黄色视频三级网站网址| 亚洲欧美精品专区久久| 黑人高潮一二区| av卡一久久| 欧美3d第一页| 精品久久久久久久人妻蜜臀av| 白带黄色成豆腐渣| 欧美日韩在线观看h| 中文精品一卡2卡3卡4更新| 国产精品美女特级片免费视频播放器| 青春草视频在线免费观看| 男女啪啪激烈高潮av片| 少妇的逼好多水| 六月丁香七月| 中文字幕亚洲精品专区| 一个人看视频在线观看www免费| 神马国产精品三级电影在线观看| 国产男人的电影天堂91| 日韩高清综合在线| 九九爱精品视频在线观看| 日韩,欧美,国产一区二区三区 | 男插女下体视频免费在线播放| 国产精品永久免费网站| 国产毛片a区久久久久| 婷婷色麻豆天堂久久 | 欧美高清性xxxxhd video| 小蜜桃在线观看免费完整版高清| 永久网站在线| 色吧在线观看| 一区二区三区乱码不卡18| 九九爱精品视频在线观看| 欧美高清成人免费视频www| 亚洲av二区三区四区| 色噜噜av男人的天堂激情| 乱人视频在线观看| 少妇熟女欧美另类| 小蜜桃在线观看免费完整版高清| 亚洲欧美精品自产自拍| 国产av不卡久久| 国产亚洲精品久久久com| 99热这里只有是精品50| 国产极品精品免费视频能看的| 婷婷色综合大香蕉| 一二三四中文在线观看免费高清| 精品99又大又爽又粗少妇毛片| 欧美日韩综合久久久久久| 一本—道久久a久久精品蜜桃钙片 精品乱码久久久久久99久播 | av在线天堂中文字幕| 久久精品久久久久久久性| 亚洲欧美成人精品一区二区| 自拍偷自拍亚洲精品老妇| 国产精品女同一区二区软件| 久热久热在线精品观看| 精品酒店卫生间| 精品一区二区免费观看| 亚洲va在线va天堂va国产| 亚洲精品一区蜜桃| 亚洲av日韩在线播放| 69人妻影院| 丝袜喷水一区| 国产av在哪里看| 亚洲婷婷狠狠爱综合网| 真实男女啪啪啪动态图| 国产一级毛片七仙女欲春2| 国产男人的电影天堂91| 99热这里只有是精品在线观看| 国产成人午夜福利电影在线观看| 91午夜精品亚洲一区二区三区| 精品免费久久久久久久清纯| 国产91av在线免费观看| 你懂的网址亚洲精品在线观看 | 成人综合一区亚洲| 中文亚洲av片在线观看爽| av免费观看日本| 免费观看性生交大片5| 中文字幕亚洲精品专区| 亚洲av二区三区四区| 亚洲一级一片aⅴ在线观看| 日本一二三区视频观看| 日韩视频在线欧美| 又粗又爽又猛毛片免费看| 淫秽高清视频在线观看| 国产亚洲一区二区精品| 少妇熟女aⅴ在线视频| 久久亚洲精品不卡| 日韩欧美精品免费久久| 色尼玛亚洲综合影院| 日本黄色视频三级网站网址| 又粗又硬又长又爽又黄的视频| 欧美xxxx性猛交bbbb| 欧美激情国产日韩精品一区| 少妇人妻一区二区三区视频| 一区二区三区乱码不卡18| 赤兔流量卡办理| 国产一区二区三区av在线| 亚洲va在线va天堂va国产| 欧美变态另类bdsm刘玥| 成人国产麻豆网| 午夜精品在线福利| 国产成人一区二区在线| 国产成人91sexporn| 大香蕉97超碰在线| 成人午夜精彩视频在线观看| 美女大奶头视频| 日韩av在线大香蕉| videos熟女内射| 永久网站在线| 最近视频中文字幕2019在线8| 欧美成人精品欧美一级黄| 99久久成人亚洲精品观看| 成人二区视频| 九草在线视频观看| 国产成人免费观看mmmm| 精品一区二区三区视频在线| 久久久久免费精品人妻一区二区| 26uuu在线亚洲综合色| 国产精华一区二区三区| 麻豆成人av视频| 国产一区亚洲一区在线观看| 国产精品一区www在线观看| 岛国毛片在线播放| 99热网站在线观看| 嫩草影院入口| 老女人水多毛片| 两个人的视频大全免费| 国产精品国产三级国产av玫瑰| 桃色一区二区三区在线观看| 国产老妇女一区| 淫秽高清视频在线观看| 特大巨黑吊av在线直播| 亚洲电影在线观看av| 国产亚洲91精品色在线| 超碰97精品在线观看| 三级男女做爰猛烈吃奶摸视频| 国产成人福利小说| 成人亚洲精品av一区二区| 欧美三级亚洲精品| 最近视频中文字幕2019在线8| 国产精品久久电影中文字幕| 国产精品一区二区性色av| 激情 狠狠 欧美| 欧美极品一区二区三区四区| 亚洲国产高清在线一区二区三| 久久久久久久午夜电影| 国产v大片淫在线免费观看| 全区人妻精品视频| 国产亚洲最大av| 亚洲精品一区蜜桃| 天天躁夜夜躁狠狠久久av| 久久精品久久精品一区二区三区| av在线老鸭窝| 亚洲精品日韩在线中文字幕| 狠狠狠狠99中文字幕| 国产色爽女视频免费观看| 国产伦精品一区二区三区视频9| 亚洲一区高清亚洲精品| 国产精品久久久久久久电影| 亚洲内射少妇av| 久久久久久久国产电影| 国内精品美女久久久久久| 我要搜黄色片| 男女那种视频在线观看| 精品人妻视频免费看| 日韩亚洲欧美综合| 免费无遮挡裸体视频| 噜噜噜噜噜久久久久久91| 观看免费一级毛片| 美女大奶头视频| 中文字幕精品亚洲无线码一区| 人体艺术视频欧美日本| 狠狠狠狠99中文字幕| 中文字幕av在线有码专区| 久久久久久久久久黄片| 在线免费观看不下载黄p国产| 国产精品.久久久| or卡值多少钱| 一级爰片在线观看| 久久精品国产自在天天线| 99在线视频只有这里精品首页| 日本熟妇午夜| 国产亚洲午夜精品一区二区久久 | 久久久亚洲精品成人影院| 亚洲国产最新在线播放| 人人妻人人看人人澡| 亚洲成人精品中文字幕电影| 春色校园在线视频观看| 只有这里有精品99| 99久国产av精品国产电影| 人人妻人人澡人人爽人人夜夜 | 男人舔奶头视频| 久久久国产成人免费| 全区人妻精品视频| 国产免费视频播放在线视频 | 真实男女啪啪啪动态图| 男人舔女人下体高潮全视频| 三级国产精品片| 一区二区三区高清视频在线| 六月丁香七月| 免费看光身美女| 一级二级三级毛片免费看| 中文字幕久久专区| av免费在线看不卡| 免费黄网站久久成人精品| 久久国产乱子免费精品| 国产黄色视频一区二区在线观看 | 久久综合国产亚洲精品| 国产精品电影一区二区三区| 搡女人真爽免费视频火全软件| 99热6这里只有精品| 国产成人精品久久久久久| 天天躁日日操中文字幕| 中国美白少妇内射xxxbb| 99在线人妻在线中文字幕| 99久久成人亚洲精品观看| 五月伊人婷婷丁香| 三级国产精品片| 在线观看av片永久免费下载| 国产亚洲精品久久久com| 国产精品一区二区在线观看99 | 日韩一本色道免费dvd| 禁无遮挡网站| 一级黄色大片毛片| 国产黄片视频在线免费观看| 国产亚洲精品av在线| 国产精品日韩av在线免费观看| 成人美女网站在线观看视频| 一本—道久久a久久精品蜜桃钙片 精品乱码久久久久久99久播 | 国产伦精品一区二区三区四那| 国产精品人妻久久久影院| 99久久成人亚洲精品观看| 精品国产三级普通话版| 国产一级毛片在线| 欧美日本亚洲视频在线播放| 午夜爱爱视频在线播放| 你懂的网址亚洲精品在线观看 | 一级毛片aaaaaa免费看小| 五月玫瑰六月丁香| 99热这里只有是精品50| 久久婷婷人人爽人人干人人爱| 国产单亲对白刺激| av播播在线观看一区| 非洲黑人性xxxx精品又粗又长| 精品人妻偷拍中文字幕| 久99久视频精品免费| 国产熟女欧美一区二区| 日韩高清综合在线| 美女脱内裤让男人舔精品视频| 毛片一级片免费看久久久久| 久久鲁丝午夜福利片| 搡老妇女老女人老熟妇| 国产午夜精品论理片| 我要看日韩黄色一级片| 午夜免费男女啪啪视频观看| 国国产精品蜜臀av免费| 国产欧美日韩精品一区二区| 久久精品影院6| 欧美97在线视频| 欧美精品国产亚洲| 黄色欧美视频在线观看| 亚洲精品色激情综合| 国产一区有黄有色的免费视频 | 女人久久www免费人成看片 | av在线亚洲专区| 美女xxoo啪啪120秒动态图| 国产亚洲精品av在线| 乱人视频在线观看| 色5月婷婷丁香| 免费观看人在逋| 伊人久久精品亚洲午夜| 69人妻影院| 99久久九九国产精品国产免费| 99国产精品一区二区蜜桃av| 伊人久久精品亚洲午夜| av在线播放精品| 欧美激情久久久久久爽电影| 女人十人毛片免费观看3o分钟| 国产精品国产高清国产av| 亚洲aⅴ乱码一区二区在线播放| 亚洲av二区三区四区| 久久99热这里只频精品6学生 | 伊人久久精品亚洲午夜| 免费观看性生交大片5| www.av在线官网国产| 欧美激情在线99| 18+在线观看网站| 日韩三级伦理在线观看| 夜夜爽夜夜爽视频| 美女黄网站色视频| 亚洲av电影不卡..在线观看| 日日啪夜夜撸| 久久久国产成人精品二区|