某银行571名职工健康体检结果分析及健康指导

目的了解合肥市某银行职工的健康状况,以便有针对性的制定健康教育对策,积极预防疾病发生。方法 2012年5月～7月对合肥市某银行571名职工集中进行健康体检,将体检结果采用顺位及构比法,按各年龄段主要异常结果检出率、部分异常结果男女检出率进行综合分析。结果571人体检其合格率为18.21%,检出有异常者467人,阳性病征检出率较高的为幽门螺旋杆菌(Hp)抗体阳性205人(35.90%),高脂血症137人(23.99%),脂肪肝123人(21.54%),颈椎退行性变117人(20.49%),心电图异常96人(16.81%),甲状腺疾病87人(15.24%),高血压71人(12.43%),肝功能异常60人(10.51%),高尿酸51人(8.93%),胆囊疾病49人(8.58%),血糖升高(包括糖尿病)44人(7.71%),泌尿系结石32人(5.60%)。各年龄段Hp抗体阳性、高脂血症、脂肪肝、高血压、血糖升高的检出率随着年龄的增长而增加。高脂血症、脂肪肝、高血压、高尿酸血症、血糖升高、肝功能异常的检出率男性明显高于女性,而甲状腺疾病的检出率女性高于男性。结论本调查对象的健康状况较差,加强职工的健康教育,指导建立良好的生活方式,对预防疾病发生,改善健康状况,提高生活质量意义重大。     

Health promoting hospitals: the role and function of nursing

Background. In 1986, the World Health Organisation's (WHO) Ottawa Charter for Health Promotion sought to create a framework that conveyed the notion of capacity building, related to specific settings, and a structured process for health promotion action. It provided the platform from which the health promoting hospital movement was later launched. Nearly two decades on, the health promoting hospital (HPH) movement has grown considerably and continues to expand, against the backdrop of having to adapt to the changing needs and demands of clients and the evolving social context of their communities. Many nurses, it is argued here, are often unaware of health promoting hospitals concepts or, when they are, do little to contribute to them. Method. A critical review of the available health promoting hospital and related literature has been conducted for discussion. Findings. The literature revealed that hospitals are being urged to reject practices based purely on health‐limiting and limited biomedical frameworks, in favour of moving towards models based on health promoting hospitals and public health‐orientated hospitals. This requires radical reform that focuses on the social and health policy context of organizations, the socio‐political empowerment of its employers and clients, and the personal/collective positive health and welfare of its employers and clients. Many health service agencies are beginning to emphasize population health within communities as part of a concerted move away from an original primary focus on acute inpatient hospital‐based service provision. Conclusion. Hospitals need to adapt and expand their efforts to focus on health promotion activities, in collaboration with the ever‐widening community networks of health and social agencies. This requires the commitment of all health care professional groups. Nurses who practice in the hospital setting should be aiming to initiate and promote radical health promotion reform as set out in the health promoting hospital movement. This paper argues that nursing per se could be making much larger inroads and efforts to affect and implement wide‐ranging health promotion activities in hospital organizations. Nurses should view the HPH movement as another opportunity truly to embrace evolving broad‐based health promotion concepts, as a means to forge and own their own health agenda, and also as a means to move beyond the traditional reliance of a limited health education role. Relevance to clinical practice. Hospitals and their employees must be seen to advocate, support and implement wide‐reaching social and community‐based reform, as part of a necessary commitment to ‘seamless’ health care provision. The health promoting hospital movement represents a collective vehicle for enabling such activities. If nurses wish to be at the forefront of current health service strategies they must be seen to embrace the radical health promotion reforms that are emerging from the current literature and put forward in this article.     

Predictors of self-assessed physical and mental health of Icelandic nurses: results from a national survey

Background

Recent health care organizational changes have been associated with stress and musculoskeletal disorders in nurses. However, studies are lacking on what factors are the most important predictors of poor self-assessed health among nurses.

Objectives

To describe and identify the self-assessed predictors of physical and mental health of nurses.

Participants and design

A cross-sectional design was used with a sample of 394 nurses, drawn from the registry of the Icelandic Nurses’ Association, representing 17% of the workforce of Icelandic nurses.

Methods

Data were collected with a self-administered questionnaire, addressing symptoms, illness and treatment, lifestyle and sleep, work and working environment, family and quality of family life. Data were analysed according to nurses’ assessment of their physical and mental health (very good/good; poor/very poor) by use of analysis of variance, chi-square and stepwise multiple linear regression.

Results

21.7% of participants assessed their physical health as poor or very poor and 14.3% assessed their mental health as such. Those who assess their physical or mental health poor/very poor, as compared to the others, reported more symptoms in general, less regular exercise, as well as more use of medication, more visits to physicians, trouble with sleeping, conflicts between work and family life, work absence, and they experience their work as more strenuous. Experiencing symptoms is an important predictor of both physical and mental health of nurses.

Conclusion

Various factors, including work-, family- and socio-cultural environment, play a role in how nurses assesses their health. During our present time of nurse shortage it is imperative that the authorities take special measures in order to improve the work environment of nurses.     

Development of the Rural-Urban Demand Indicator (RUDI)

In this article we describe development of RUDI (Rural-Urban Demand Indicator), a multivariate interval level measure of demand for health services. RUDI ranks counties by population and purchasing power and was developed for use in a wide variety of health-related research and for policy analyses. RUDI is based on microeconomic theory and Grossman's (1972) extension of the theory, that the family produces health and that the family's demand for health services is derived from the demand for health. Two factors define RUDI: DEMOS (demographics) and EWB (economic well-being). These two factors accounted for 66.2% of the variance observed in 1990 census data. A variety of other analyses offer evidence of known- groups, convergent, factorial, and predictive validity. © 1998 John Wiley & Sons, Inc. Res Nurs Health 21: 453–466, 1998     

Assessment and measurement of health literacy: An integrative review of the literature

Research linking health literacy to health knowledge, health behaviors, health outcomes, health disparity, health status, and increasing health-care costs is prevalent around the globe. Given the importance of health literacy, it is prudent to examine the tools available to assure that patients are health-literate. This article provides an integrative review in order to investigate what has been developed to evaluate health literacy in the health-care setting. The research questions considered include: (i) Which instruments or screening tools are available to assess or measure health literacy in the clinical setting?; and (ii) What are the psychometric properties, advantages, and limitations of the identified tools? A number of databases are utilized to locate research specific to this topic. The research is analyzed, the findings are summarized, and the limitations are mentioned. The implications, recommendations, and the need for future research are discussed.     

Documentation of Health Risks and Health Promotion Counseling by Emergency Department Nurse Practitioners and Physicians

Purpose: The purpose of this study was to examine medical record documentation of health risk factors and health promotion discharge counseling by nurse practitioners and physicians practicing in an emergency department in the U.S. midwest.
Methods: In this two-group comparative study researchers examined random-stratified medical records 305 nonacute ambulatory patients for selected health risk factors, including smoking, alcohol use, elevated blood pressure, obesity, and dental caries.
Results: Fifty-nine percent of this sample of relatively young adults (mean age = 33) had one or more health-risk factors. According to medical record documentation, only 22% of these adults, with nonacute problems, received health promotion counseling. Multivariate analyses indicated that nurse practitioners were slightly more likely to provide smoking cessation counseling than were physicians.
Conclusions: Many opportunities for identification of health risks and follow-up counseling, as recommended in Healthy People 2000 and by the U.S. Preventive Services Task Force, were not documented. To meet the new goals of Healthy People 2010, health care providers in all settings should identify health risk factors and document health promotion counseling during every patient encounter.     

The role of child health nurses in enhancing mothering know-how

Supporting early parenting and promoting family health is an important aspect of contemporary child health nursing in Australia. Recent studies suggest that within a service climate that increasingly funds targeted, population-based needs rather than universal needs, child health nurses are concerned about maintaining individual nurse-client relationships, particularly with individual families. There is however, limited evidence available to use in response to these concerns. In this paper the way a group of middle-class mothers of infants, who, in today's health service climate, may not be a target group for health services, develop their caregiving know-how, is discussed. The findings presented suggest that both expert and lay knowledge have a part to play in supporting women in their early mothering. Women such as these, in essence, need a clearing-house to help them sift through the overwhelming information they access, respond to, and turn into everyday practices that work. Well placed child health nursing services may achieve this. While there is significant support for this claim in the literature, mechanisms for effective support remains the challenge. A key may be found in nurses focusing on the promotion of communicative or interactive health literacy as an outcome of their programs.     

Barriers and Facilitators to the Incorporation of Environmental Health into Public Health Nursing Practice

ABSTRACT Objectives: To describe the environmental health (EH) demands placed on public health nurses (PHNs) as well as the barriers and facilitators to incorporating EH into PHN practice. Design and Sample: A cross‐sectional multimode (Web and pencil/paper) survey was used to collect data from PHNs in 1 rural western state. Research participants included 141 PHNs from a total of 228 survey invitations (61% response). Measures: A 39‐item questionnaire was developed to measure the frequency of EH demands experienced by PHNs as well as the barriers and facilitators to the incorporation of EH into PHN practice and standard demographics. Results: Significant numbers of PHNs reported less than baccalaureate preparation (29%), suggesting that EH competencies cannot be assumed. PHNs are often asked for basic EH information and cite lack of time and lack of interest on the part of the populations being cared for as barriers to incorporating EH into their practice. Facilitators included free or inexpensive continuing education programs offered via the Internet and additional Internet resources or staff resource people. Conclusion: PHNs represent a significant portion of the public health workforce and have implied and explicit mandates to address EH issues in their practice. Resources should be directed toward helping PHNs become better prepared to address the current and future EH needs of populations.     

A Literature Review of Health Literacy of Adolescents During Pregnancy

Adolescents who are pregnant are a vulnerable population at risk for poor health literacy. Health literacy is an important determinant of health, and poor health literacy among adolescents is correlated with high-risk health behaviors and adverse health outcomes into adulthood. A review of the literature showed a significant gap in research related to health literacy in pregnant adolescents. The limited findings indicate the need for additional research attention on health literacy in pregnant adolescents and upstream approaches to improve adolescent health literacy, such as incorporating health literacy education into secondary schools. To strengthen approaches that build health literacy capacity, it is imperative that future research focuses on pregnant adolescents’ health literacy related to health behaviors, health outcomes, measurement instruments, health literacy frameworks, and targeted interventions.     

PDCA式健康教育模式在体检中心健康管理中的应用效果及对体检者身心健康的影响

目的探讨PDCA式健康教育模式在体检中心健康管理中的应用效果。方法将326例体检者按照体检时间分为对照组(2018年1月至2018年3月)与观察组(2018年4月至2018年6月),各163例。对照组采用常规健康教育模式,观察组采用PDCA式健康教育模式。比较两组的应用效果。结果观察组的体检时间短于对照组,体检效率及体检可信度评分均高于对照组(P<0.05)。体检后,两组的疾病知识知晓情况及体检报告阅读能力评分均升高,HAMA、HAMD评分均降低,且观察组优于对照组(P<0.05)。观察组的体检满意度评分均高于对照组(P<0.05)。结论PDCA式健康教育模式在体检中心健康管理中的应用效果显著,能有效提高体检者的健康知识知晓度和体检满意度,改善其心理状态。     

发挥护理专业优势强化"四个贴近"夯实新世纪城市卫生服务基础

介绍了大庆市卫生局发挥护理专业优势 ,把护理工作延伸到社区 ;发挥护士素质特长 ,把健康理念落实到社区 ;发挥护士特有的潜能 ,全心全意服务于社区。通过社区护理工作 ,使卫生服务更加贴近社区、贴近家庭、贴近百姓、贴近生活。保证全市人民“生能顺利、病能医治、老能康乐、死能安息。”的具体做法和成效。     

The ethics of sin taxes

ABSTRACT The current global economic crisis is forcing governments to consider a variety of methods to generate funds for infrastructure. In the United States, smoking-related illness and an obesity epidemic are forcing public health institutions to consider a variety of methods to influence health behaviors of entire target groups. In this paper, the author uses a public health nursing model, the Public Health Code of Ethics (Public Health Leadership Society, 2002), the American Nurses' Association (ANA) Code of Ethics (2001), and other relevant ethical theory to weigh and balance the arguments for and against the use of sin taxes. A position advocating the limited use of sin taxes is supported as a reasonable stance for the public health professional.