三级医院不同科室护士生活质量比较

目的 了解三级医院护士生活质量状况.方法 采用世界卫生组织生活质量测定简表(WHOQOL-BREF)对2家三级医院741名在职护士进行问卷调查.结果 非临床科室护士心理领域得分及生活质量总分显著高于临床科室护士(均P＜0.05),床位利用率高的手术科室护士心理领域得分及生活质量总分显著高于床位利用率低的手术科室护士(均P＜0.05).结论 不同科室是影响护士生活质量的重要因素.管理者应提高对护理工作的重视程度,进一步改善临床护士的工作条件,以提高其生活质量.     

新护士转型冲击状况与工作满意度的相关分析

目的调查新护士转型冲击及工作满意度现状,探讨两者的相关性,为制定针对性管理措施,提高新护士工作满意度提供参考。方法采用新护士转型冲击评价量表和工作满意度量表对228名新护士进行问卷调查。结果新护士转型冲击状况总分3.44±0.77,工作满意度总分3.45±0.45;工作满意度总分及各维度得分与转型冲击总分及维度得分呈负相关(P0.05,P0.01)。结论新护士转型冲击及工作满意度处于中等水平,转型冲击程度越高的新护士工作满意度越低。护理管理者需采取措施降低新护士转型冲击,以提高其工作满意度。     

护士工作家庭冲突与自尊的相关性研究

目的探讨护士工作家庭冲突与自尊的关系。方法采用工作家庭冲突量表、自尊量表对305名护士进行调查。结果护士工作家庭冲突中行为维度评分(15.52±4.53)分、时间维度(16.20±4.31)分、压力维度(16.65±3.80)分;工作-家庭冲突得分高于家庭-工作冲突;随着年龄、护龄的增加和职称的提高,冲突得分呈先升后降的趋势,已婚护士冲突高于未婚护士;自尊与工作家庭冲突的行为维度、压力维度、家庭-工作冲突和总分呈显著负相关(均P0.01)。结论自尊与工作家庭冲突显著负相关,提高护士自尊水平,可降低其工作家庭冲突。     

三级综合医院男女护士职业生活质量的对照研究

目的比较三级综合医院男女护士职业生活质量的异同,为制定针对性干预措施提供参考。方法采用一般资料调查表及护士职业生活质量量表,对广东省27所三级综合医院的628名男护士和与之匹配的628名女护士进行调查。结果男护士工作家庭平衡维度得分显著高于女护士(P0.01),其他3个维度得分及总分男、女护士比较,差异无统计学意义(均P0.05);两者自我评价有差异的条目主要分布在工作家庭平衡、工作量及工作环境维度。影响男护士职业生活质量的因素主要有对科室的喜欢程度及学历,影响女护士职业生活质量的因素主要有对科室的喜欢程度、职称、用工性质、月平均夜班天数以及是否独生子女(P0.05,P0.01)。结论广东省三级综合医院男护士工作家庭平衡优于女护士,影响男护士职业生活质量的因素少于女护士。建议护理管理者采取有针对性的干预措施,提高不同性别护士的职业生活质量。     

ICU护士工作满意度与创新行为的相关性研究

目的了解ICU护士工作满意度与创新行为的现状、影响因素及其相互关系。方法选取哈尔滨市4所三级甲等医院的340名ICU护士为研究对象,采用护士工作满意度和创新行为量表进行调查。结果 ICU护士工作满意度评分为(124.71±20.22)分,护士职称和劳动人事关系情况为主要影响因素(均P0.01);ICU护士的创新行为得分为(4.09±0.85)分,护士学历和职称为主要影响因素(均P0.01);ICU护士工作满意度得分及5个维度(家庭/工作平衡,工资及福利,成长及发展,工作被认可,管理)与创新行为总分呈正相关(P0.05,P0.01)。结论 ICU护士满意度略低但创新行为较好,提高护士的工作满意度,有利于促进其创新行为。     

护士工作繁荣现状及影响因素研究

目的 了解护士工作繁荣的现状及其影响因素。方法 便利抽样法选取济南市3所三级甲等综合医院427名护士为研究对象,采用一般情况调查表、工作繁荣量表、护士组织支持感问卷、反馈寻求行为量表对其进行调查。结果 护士工作繁荣得分为(53.67±9.73)分,护士工作繁荣与组织支持感总分、反馈寻求行为总分及各维度得分呈正相关(均P<0.01);多元逐步回归结果显示,是否喜欢护理工作、组织支持感、反馈寻求行为是护士工作繁荣的影响因素(P<0.05,P<0.01),可解释总变异的56.7%。结论 护士工作繁荣水平处于中等水平,护理管理者可针对影响因素进行干预,提高护士的工作繁荣水平,进而促进护士的成长发展和提升护理组织效能。     

不同生育情况护士的工作家庭冲突及相关因素研究

目的了解生育期临床护士的工作家庭冲突情况及与工作压力、社会支持的关系,为针对性干预提供参考。方法对2所三甲综合医院的416名内外科病房护士,采用工作家庭冲突问卷、护士工作压力源量表及社会支持量表进行调查。结果工作家庭冲突总分52.98±13.16,其中工作-家庭冲突得分显著高于家庭-工作冲突得分(P0.01);护士工作压力源总分74.76±15.31,护士社会支持总分42.44±6.14;未生育、生育1孩及生育2孩三组护士3种问卷得分比较,差异有统计学意义(P0.05,P0.01);护士工作压力源与工作家庭冲突呈正相关(均P0.01),社会支持与工作-家庭冲突呈负相关(P0.05)。结论护士的工作家庭冲突呈中等偏高水平,其更多地感受到工作对家庭的影响;已生育护士的工作家庭冲突、工作压力及社会支持度更高;其工作压力正向影响工作家庭冲突,社会支持可减缓工作干扰家庭程度。建议加大对已生育护士的社会支持,减缓其工作压力和工作家庭冲突。     

血液净化专科护士职业认同与离职意愿的相关性

目的探讨血液净化专科护士职业认同与离职意愿的现状及相关性。方法采用职业认同量表和离职意愿量表对102名血液净化专科护士进行调查。结果血液净化专科护士职业认同得分为(39.73±7.63)分。离职意愿得分为(13.16±3.44)分,得分率为54.83%;离职意愿Ⅲ维度得分最高(得分率为71.75%);53.92%的护士离职意愿处于较高及以上水平。职业认同与离职意愿总分、离职意愿Ⅰ和离职意愿Ⅱ呈负相关(均P0.01)。结论血液净化专科护士职业认同处于中等偏上水平,离职意愿处于中等水平,其职业认同与离职意愿呈负相关。应提高护士职业认同感,降低其离职意愿,稳定护理队伍。     

绵阳市不同等级医院临床护士工作满意度调查分析

目的 了解绵阳市护士工作满意度,比较不同等级医院护士工作满意度的差异,为护理管理者采取有针对性措施提供依据.方法 随机抽取绵阳市12所医院的1268名临床护士,采取问卷调查法,应用 MMSS问卷进行调查.结果 绵阳市临床护士工作满意度均分为(2.95±0.63)分,8个维度由高到低依次为:被认可与表扬、人际关系、参与决策、社会及专业交往、排班、工作与家庭平衡、专业与个人发展、福利待遇.三级医院护士工作满意度得分较一级医院高(P＜0.05).结论 护士工作满意度处于中下水平,不同等级医院的护理管理者应针对护士最不满意之处,制定相应的有效措施,以提高护士工作满意度,提升服务效率和护理质量.     

血液透析护士工作家庭冲突与工作投入及心理资本的相关性

目的探讨沈阳市血液透析护士工作家庭冲突、工作投入、心理资本状况及其相关性。方法采用工作家庭冲突量表、工作投入量表及心理资本量表对沈阳市238名三甲医院的血透护士进行调查。结果护士工作家庭冲突(24.24±6.42)分,心理资本(98.02±16.09)分,工作投入(56.69±11.50)分。工作家庭冲突各维度与工作投入、心理资本各维度呈负相关,心理资本各维度与工作投入各维度呈正相关(均P0.05)。心理资本在工作家庭冲突与工作投入间起部分中介作用。结论工作家庭冲突既可以直接影响血透护士工作投入水平,也可以通过心理资本的部分中介作用间接影响工作投入。护理管理者应重视血透护士心理资本的培养,以利于其在工作与家庭间的角色切换,降低工作家庭冲突对工作投入的负性影响。     

Full work analysis of resident work hours

BACKGROUND: Resident duty hour restrictions, while intended to improve patient safety and resident well-being, may decrease time available for patient care and education. Our objective was to perform in-depth analysis of how a pediatric surgical resident utilizes his time in hopes of eliminating waste, and in effect, add educationally relevant hours. MATERIALS AND METHODS: Work done by a senior pediatric surgical resident was prospectively collected using three methods. The duty hours logged by the resident for a full academic year were analyzed. A detailed work analysis was performed by an independent observer who videotaped the resident. Finally, the resident recorded and categorized his daily activities during the month in which the videotaping occurred. RESULTS: 18.9 h (1134.9 min) of videotaped data were collected. The total time spent directly related to patient care, including the operating room, was 656 min. One hundred seventy-five min were spent on education, both didactic and teaching on the wards. The resident spent 139.8 min traveling within the hospital; 132.7 min were categorized as communication; only 1.5% of time was deemed pure waste. A total of 344.75 h (20,685 min) were self-reported and categorized. Didactic education comprised 6.7% of total time while less formal teaching is embedded in the clinical activities of consultation, rounds, and clinic. CONCLUSIONS: Increased efficiency in the operating room, where the most time was spent, coupled with workflow redesigns that decrease travel and time spent on the phone would increase time available for education and patient care.     

与博士生谈谈临床

如何成为一名外科医师？对一些刚刚获得博士学位（Ph．D．）的研究生来说回答这个问题并不容易。由于培训体系的问题,博士生通常缺乏系统的外科训练,并且未经过严格的资质准入考试。当他们开始从事临床工作时,往往存在角色转换,亟需提高自身的临床能力。怎样才能尽快完成这一转换过程？博士生应该从提高临床能力着手,扎扎实实地做起：放下架子,虚心学习;学会观察;练好基本功;勇于实践;阅读和写作;注意职业精神的培养。     

The calculation of left ventricular stroke work index

The relation between left ventricular mean systolic pressure (LVSP) determined by planimetric integration and systolic and diastolic pressure measured in a peripheral artery (SAP and DAP) was calculated using data published by Ross & Braunwald in 1964. The relation was LVSP = SAP-0.32 +/- 0.06 (s.d.) X (SAP-DAP). The formula SAP- 0.32 (SAP-DAP) was used to calculated LVSP, and the correlation between measured and calculated LVSP was found to be 0.91 (P less than 0.001). It is concluded that LVSP can be calculated with reasonable accuracy from measurements of arterial pressure in patients without aortic stenosis. At present three different formulas are in use for the calculation of left ventricular stroke work index (LVSWI). The pressure work is defined as SAP, LVSP or mean arterial pressure minus mean pulmonary capillary wedge pressure or left ventricular end diastolic pressure. This makes comparisons between different studies with respect to LVSWI difficult or impossible.     

急诊科护士体面劳动感知现状及影响因素研究

目的 调查急诊科护士的体面劳动感知现状并分析其影响因素。方法选取河南省二级及以上医院的384名急诊科护士为研究对象,采用一般资料调查表、体面劳动感知量表、中国护士工作压力源量表、中文版磁性要素量表进行调查。结果急诊科护士体面劳动感知得分为（49.08±12.21）分。回归分析结果显示,工作年限、月收入、遭受工作场所暴力、外出学习次数、工作压力与健康工作环境是急诊科护士体面劳动感知得分的主要影响因素（调整R2=0.545,均P＜0.05）。结论急诊科护士体面劳动感知水平较低,护理管理者应采取针对性干预措施,提高其体面劳动感知水平,促进护理服务质量。     

Semen quality and sedentary work position

Increased scrotal temperature can, in experimental settings, markedly disturb the production of semen. Sedentary work position may increase the temperature of the scrotum, but previous studies have failed to determine whether changes in scrotal temperature caused by sedentary work actually do affect semen quality. This study was carried out to elucidate the possible harmful effects of sedentary work on sperm count and other semen characteristics. In 1981-1983 a semen sample was obtained from 3119 men who attended an infertility workup in one of four Danish fertility centres. A total of 2517 men returned a postal questionnaire with information on life style, leisure time activities, occupational history and job duties. Information on job specific work position was obtained from The Danish Work Environment Cohort study 1990 (DWECS). In this analysis DWECS data for a total of 1747 men was included from men aged 18-39 years with >30 h of work per week. For all job titles represented in the DWECS, the mean proportion of sedentary work was estimated. The sperm cell concentration was 30.6 million/mL among men in the quintile with lowest job specific sedentary work compared with 40.5 million/mL in the highest quintile. The difference was, however, not statistically significant. Stratification on infertility period, educational level of the man, fertility centre, and fertility-related disease of the spouse did not influence the results. The analyses do not suggest that sedentary work is a risk factor for abnormal semen characteristics.     

Reaping the benefits of meaningful work: The mediating versus moderating role of work engagement

This study examined whether meaningful work may improve one's quality of life outside of the workplace (i.e., work‐to‐life enrichment). More importantly, we proposed and tested competing hypotheses regarding the role of work engagement in the relationship between meaningful work and work‐to‐life enrichment. Specifically, we investigated whether work engagement served as a mediator of this relationship, as suggested by the job demands‐resources model, or instead a moderator, as suggested by conservation of resources theory. Two‐wave survey data were collected from 194 respondents recruited via Amazon Mechanical Turk. Analyses showed that meaningful work was positively related to work‐to‐life enrichment over time (i.e., 3 months later). Additionally, work engagement mediated but did not moderate the relationship between meaningful work at Time 1 and work‐to‐life enrichment at Time 2. We suggest that organizations foster a sense of meaningfulness in employees to facilitate engagement and in turn enrich employees' lives beyond the workplace. Therefore, not only organizations, but individuals as well may reap the benefits of meaningful work.     

The impact of disaster support work

Limited available evidence suggests that disaster support work may have negative effects. This study attempts to examine the impact of disaster-related stress on helpers offering psychological support to victims of two major disasters, and to identify potential moderating factors. Sixty-seven social workers were surveyed, measures being taken of psychological symptomatology and wellbeing, personality variables, social support, life events, and various aspects of disaster support work. Comparison with normative data suggested that subjects were experiencing significant levels of stress. Two major sources of disaster-related stress were identified: role-related difficulties and contact with clients' distress. Approximately one third of the variance in helper response could be explained by variables reflecting coping style, prior life events and the aforementioned aspects of disaster support work. Follow-up data at 12 months demonstrated persisting high levels of stress.     

新护士工作准备度及其影响因素调查

目的 了解新护士工作准备度现状，并分析其影响因素。方法 选取湖北省5所三级甲等医院工作1年内的护士，使用一般资料调查表、中文版毕业护士工作准备度量表进行调查。结果 314名新护士工作准备度得分为(268.93±68.64)分。logistic回归分析显示，其他医院工作经历、家庭支持程度、与同学是否相处融洽是新护士工作准备度的主要影响因素(P<0.05,P<0.01)。结论 新护士工作准备度处于中等水平，影响因素较多。护理管理者应为新护士提供更多的社会支持，提高工作准备度。     

Longitudinal relations between psychosocial work environment,stress and the development of musculoskeletal pain

Exposure to psychosocial stressors at work is hypothesized to be related to the development of musculoskeletal pain through the mechanism of work‐related stress. This hypothesis has received support in cross‐sectional studies. Few longitudinal studies that specifically address this hypothesized mediating mechanism are however reported in the literature. The aim of the present study was to test this hypothesis in a longitudinal process model. A 3‐wave mixed occupations cohort‐study was performed with a baseline questionnaire survey in 2004; and with 2‐year follow‐ups in 2006 and 2008. A latent variable process model was tested using structural equation modeling. Since focus of the study was on the process of pain development, only those participants considered pain free at baseline were included (n = 1 133). The results indicate that exposure to high work demands may cause long‐term work‐related stress. The hypotheses that work demands and control influence the development of pain, and that this relation is mediated by work‐related stress were not supported. No indications of reversed causality were found. In order to further elucidate the hypothesized stress mechanism, future research needs to focus on the development of site‐specific musculoskeletal pain in longitudinal studies including repeated measures with shorter lags between measurement waves. Copyright © 2010 John Wiley & Sons, Ltd.