某医院住院病人满意度调查及其影响因素分析

目的了解医院住院及出院病人的满意度情况，为提高医疗服务质量提供参考。方法采用自制的调查表，分别调查医院的住院及出院病人满意度。结果本调查表测得克朗巴哈的α信度系数为0．98．调查表总分与各项目分的相关系数绝大部分大于0.5。绝大部分病人的满意度评分在8分以上。行风情况得分最高，医护人员（包括医生、护士和其它医务人员）次之，出入院处理和工作效率及辅助检查位居第3，后勤管理是第4位，收费情况得分最低。住院病人与出院病人对医院的评价没有统计学差异。影响病人总评分的关键因素是护士的技术水平、等候手术时问、经治医生检查是否认真负责、病房的整洁安静程度和是否有乱收费现象等指标。病人的建议集中在后勤管理方面。结论①本调查表的信度和效度较高，可尝试作为量表使用；②病人对该医院的总体评价较高，但对后勤管理和收费方面的评价相对较低并要求改进；③出院病人和住院病人对医院的评价没有差别；④提高病人满意度应该从技术、服务、效率和费用等方面入手。     

急诊病人满意度量表的设计与评价

目的 探讨急诊病人满意度量表研制的方法与内容。方法 急诊病人满意度的调查内容、量表设计、调查方式、满意度影响因素等所涉及的方法学问题。结果 急诊病人满意度调查内容为救护车服务、医生服务、辅助科室服务、护理服务、治疗结果与花费、知情权、就医环境、等待时间；量表条目的考核采用应答率法、CR值法、相关系数法和变异系数法；对量表信度的分析，采用Cronbach’s α系数评价量表和因素的内部一致性；对量表效度的分析，用探索性因子分析和验证性因子分析。结论 可信和有效的急诊病人满意度量表是评价急诊医疗服务的重要手段和可行方法。     

综合医院住院病人满意度量表研制初报

为客观地以服务对象为主体评价综合医院的医疗服务质量,本研究初步研制了住院病人满意度量表（ＩＰＳＱ）,通过预调查数据,对量表作为一种测量工具进行了较系统的科学评价,以广州市３所综合医院的９００例出院病人为调查对象,采用信函调查方式,初测有效回收率为３０％,再测有效回收率为４７％,项目应答率为９３．２％。内部一致性α信度系数频高,为０．９２;初测与再测之间无显著性差异（Ｐ＝０．１８３）,且密切相关（ｒ     

综合医院住院病人满意度第三方评价模型的建立与运用

目的建立一套符合医院实际情况的住院病人满意度第三方测评指标体系,并通过满意度评价,为医院决策提供科学依据。方法采取第三方调查的形式,围绕医院设施、技术水平、服务态度、医疗收费、医德医风等方面设计问卷,针对某综合医院展开调查。结果该问卷的信度、效度较好,某院总体评价较高。影响病人满意度总评分的因素主要是医院设施、医院流程、后勤服务等。结论该问卷可尝试作为量表使用;提高住院病人满意度应该从硬件、服务、效率和费用等方面入手。     

新型农村合作医疗满意度测评量表研究

目的为考核地方各级部门管理绩效提供明确的指标与有效测量工具。方法自行编制满意度测评量表,并用Cronbach’s alpha系数和因子分析对量表进行信度和效度检验。结果量表各向度、信度均属于中度或高度,总条目的Cronbach’s alpha系数为0.7348;因子分析表明调查量表包括6个领域,与专业理论大体一致;应用AMOS8.0软件对调查数据进行拟合,验证量表量的结构效度,分析结果显示拟合效果良好。结论该量表具有较好的信度和效度,可用做新型农村合作医疗满意度测量工具,应用于新型农村合作医疗的绩效评价研究。     

中文简短版慢性病资源调查量表在癌症患者中的应用评价

目的评价中文简短版慢性病资源调查量表在我国癌症患者中应用的信度和效度。方法采用中文简短版慢性病资源调查量表对400例癌症患者进行问卷调查,对结果进行信效度分析。信度包括内部一致性信度和分半信度;效度包括内容效度和结构效度。结果总量表的Cronbachα系数为0.904,分半信度为0.712;各因子与总量表之间的相关系数为0.581～0.782(P<0.01);各因子之间的相关系数为0.168～0.562(P<0.01);采用斜交旋转主成分分析法进行因子分析,提取公因子7个,累计贡献率为68.10%,各因子负荷系数为0.454～0.869。结论中文简短版慢性病资源调查量表具有较好的信度和效度,适宜作为我国癌症患者社会支持资源的评估工具。     

中国医院住院患者体验和满意监测量表的信效度评价

目的评价"中国医院住院患者体验和满意监测量表"的信度与效度,为改进量表、推广应用提供依据。方法采用邮寄方式对出院患者进行问卷调查,使用SPSS数据分析软件,分别对量表的内部一致性、折半信度、内容效度及结构效度进行评价。结果量表总体Cronbach’sα系数为0.956,所包含6个维度的Cronbach’sα系数均大于0.8。分半信度为0.971。各条目与量表总体的相关系数介于0.51~0.79之间。以所有条目为变量进行因子分析,共提取5个公因子,其累计贡献率为66.2%,各条目至少在其中一个公因子上负荷值大于0.4。结论量表具有良好的信度和效度,适用于中国医院住院患者满意度的测评。     

医院员工对医疗服务质量满意度影响因素的信度与效度评价

目的研究当前医院员工对医疗服务质量满意度影响因素的信度和效度的评价步骤、方法及应用,从众多的员工满意度调查中搜寻充分、有效的证据,为医院管理者提供管理决策和服务策划的依据。方法从内部服务质量、工作态度、部门协作、经营管理、科室文化和员工忠诚度6个维度选出30个项目构成指标体系初始内容,通过专家调查、预调查分析,筛选出18个项目形成正式调查量表。结果正式调查结果Cronbachα系数为0.923,经因子分析,因子负荷和结构与量表内容基本吻合,维度内相关性强于维度间相关性,支持该量表的有效性和广泛适用性。结论本研究项目医院员工对医疗服务质量满意度及其影响因素的信度和效度评价,是可信的和有效的。     

综合医院住院病人满意度统计查询软件的研发

研发网络模式下触摸屏端住院病人满意度量表(EIPSQ)，管理端的统计查询软件，使病人满意度调查和相应的数据处理及评价工作自动化、规范化、制度化、程序化，使病人满意度统计查询向信息化和网络化方向发展。     

付出-获得不平衡量表中文版的信度和效度

目的 评价付出-获得不平衡（ERI）量表中文版的信度和效度.方法 采用中文版ERI量表对4782名不同职业人群进行工作压力的横断面调查,量表包括付出、获得和超负荷三部分23个条目.运用可靠性分析来评价ERI量表的信度,运用因子分析方法来评价ERI量表的结构效度.结果 研究中获取的调查数据支持付出-获得不平衡模式的理论假设;中文版ERI量表中付出和获得子量表的信度和效度均较高,但是超负荷子量表的信度和效度均不高.结论 ERI量表中付出、获得子量表可以直接应用于中国人群的调查,但是超负荷子量表中条目不能直接用于中国人群的调查.     

The human drama of genetics: 'hard' and 'soft' media representations of inherited breast cancer

This paper examines media coverage of 'breast cancer genetics', and explores its implications for public understanding. We present a content analysis of coverage in British newspapers and look at a variety of popular forms, including women's magazines, television soap opera and radio drama. Genetic/inherited risk receives a great deal of coverage across a wide range of media formats and outlets. Much of this attention has focused on individuals from 'high risk families' and dilemmas around prophylactic mastectomies. Through examining media coverage, combined with interviews with media personnel and their sources, we show why this story proved so attractive to the media and highlight the different production values which influence coverage. Finally, we introduce preliminary findings from focus group discussions to demonstrate how such 'human interest' framing has engaged audience attention and influenced public understandings. The paper concludes by highlighting the implications for analysing, predicting, and engaging with, media representations of science.     

Die sogenannte Vinylchlorid-Krankheit—eine berufsbedingte Systemsklerose?

Zusammenfassung Es wurden 13 Arbeiter untersucht, die zwischen 1 3/4 und 18 Jahren in einem PVC-herstellenden Betrieb beschäftigt waren. 8 von ihnen wiesen sklerodermieartige Hautveränderungen (Abb. 2) auf, die histologisch charakterisiert sind durch Verbreiterung und Homogenisierung der kollagenen Faserbündel (Abb. 3 u. 4) sowie Fragmentation und Rarefizierung der elastischen Fasern (Abb. 5). Bei 7 Patienten bestanden trommelschlegelartige Auftreibungen einzelner Fingerendphalangen (Abb. 1). 11 Patienten zeigten Durchblutungsstörungen der Extremitäten (4 von diesen ein Raynaud-Syndrom) und 6 Patienten Acroosteolysen einzelner Fingerendphalangen (Abb. 6, Tabellen 1–3).Darüber hinaus bestand bei allen Patienten eine Thrombocytopenie, bei 12 Patienten eine Splenomegalie, bei 11 Patienten eine Einschränkung der Leberfunktion (erhöhte BSP-Retention). An der Leber ließ sich histologisch bei den 5 laparoskopierten Patienten eine deutliche Fibrosierung der Portalfelder nachweisen. Bei 4 Patienten bestanden Oesophagusvaricen (Tabellen 4 u. 5). 8 Patienten zeigten eine Partialinsuffizienz mit Hinweisen für vorwiegend restriktive Veränderungen.Die hier beschriebenen Veränderungen gehen weit über das bisher bekannte Acroosteolysesyndrom hinaus. Es wird der dringende Verdacht geäußert, daß langfristige Vinylchlorid-Exposition dieses komplexe Krankheitsbild verursacht. Daher wird für diese systemische Krankheit die Bezeichnung Vinylchlorid-Krankheit vorgeschlagen.Wir danken Frau E. Voigtländer für die Herstellung der klinischen und histologischen Abbildungen.     

Empathic processes: perception by medical students of patients'' anxiety and depression

Perceptions by medical students of patients' affective states were investigated, and the effect of the students' own emotions on such perceptions. One hundred and one fourth-year medical students rated the levels of anxiety and depression of three women patients presented on videotape, rated their own levels of anxiety and depression and completed a questionnaire on aspects of the rating process. Students had widely different and often inappropriate perceptions of patients' levels of anxiety and depression. Students who consistently overrated anxiety or depression in patients, compared to those who consistently underrated, were themselves significantly more anxious or depressed. These data suggest a need in medical education for systematic teaching of empathic skills and for recognition of potential bias in clinical decision-making arising from the clinician's own emotional state.     

The reported incidence of work-related ill-health in Scotland (2002-2003)

BACKGROUND: Although incidence data for work-related ill-health in the UK are available, more detailed information for smaller geographical areas has hitherto been unpublished. AIMS: To estimate the incidence of work-related ill-health reported by clinical specialists in Scotland, 2002-2003. METHODS: THOR (The Health and Occupation Reporting network) is a UK wide reporting scheme for work-related ill-health. In 2002-2003, 241 out of 2162 physicians in THOR were based in Scotland. We have summarized the reported cases and calculated incidence rates for categories of ill-health by age, gender and industry. The UK Labour Force Survey (2002) was used to provide denominator data, with comparisons made between rates for Scotland and the rest of the UK. RESULTS: In 2002-2003, 4043 estimated cases were reported from Scotland. Mental ill-health was most frequently reported (41%); followed by musculoskeletal disorders (31%), skin disorders (16%), respiratory disease (10%), hearing disorders (2%) and infection (1%). The reported average annual incidence rate per 100,000 employees for all work-related ill-health in Scotland was 86.0. The highest reported rate for mental ill-health was found for employees in public administration and defence (76.7 per 100,000), and health and social work (72.3 per 100,000). The construction industry had the highest reported rate of musculoskeletal disorders (41.6 per 100,000), while hairdressers appeared at most risk of developing occupational contact dermatitis (rate=86.4 per 100,000). CONCLUSIONS: Despite its limitations, THOR has indicated types of work-related ill-health and related industries for targeted disease prevention in Scotland.     

Function of the protein RPE65 in the visual cycle

A protein called RPE65 performs a key role in the trans-cis isomerization of retinol in the retinal pigment epithelium of the eye. The palmitoylation of RPE65 serves to switch off the visual cycle in darkness and to switch it on in the light.     

Worker education in the primary prevention of occupational dermatoses

This paper reports the evaluation of a skin care education programmeconducted on a fine chemicals manufacturing site where over1,000 employees are located. Approximately 60% are involvedin chemical manufacture. Over a 12 month period production staffreceived training in prevention of occupational dermatoses linkedto a site-wide poster initiative. The incidence of new casesof occupational dermatoses fell from 0.055 (70 cases in 1,277employees) to 0.021 (27 cases in 1,277 employees) before andafter the intervention respectively (p<0.0001). After otherfactors such as chemicals handled, observer bias and changesin reporting related to socioeconomic climate were taken intoaccount it is concluded that this study demonstrates the importanceof worker education as a tool for primary prevention of disease.Training materials such as video and poster presentations maybe effectively used in the chemical manufacturing industry asan adjunct to prevention and control of exposure to substanceshazardous to the skin. Such methods may also be used in otherindustries where there are significant risks of dermatoses.     

Regional Variation in Travel-related Illness acquired in Africa,March 1997–May 2011

To understand geographic variation in travel-related illness acquired in distinct African regions, we used the GeoSentinel Surveillance Network database to analyze records for 16,893 ill travelers returning from Africa over a 14-year period. Travelers to northern Africa most commonly reported gastrointestinal illnesses and dog bites. Febrile illnesses were more common in travelers returning from sub-Saharan countries. Eleven travelers died, 9 of malaria; these deaths occurred mainly among male business travelers to sub-Saharan Africa. The profile of illness varied substantially by region: malaria predominated in travelers returning from Central and Western Africa; schistosomiasis, strongyloidiasis, and dengue from Eastern and Western Africa; and loaisis from Central Africa. There were few reports of vaccine-preventable infections, HIV infection, and tuberculosis. Geographic profiling of illness acquired during travel to Africa guides targeted pretravel advice, expedites diagnosis in ill returning travelers, and may influence destination choices in tourism.     

The design of hazard risk assessment matrices for ranking occupational health risks and their application in mining and minerals processing

Two hazard risk assessment matrices for the ranking of occupational health risks are described. The qualitative matrix uses qualitative measures of probability and consequence to determine risk assessment codes for hazard-disease combinations. A walk-through survey of an underground metalliferous mine and concentrator is used to demonstrate how the qualitative matrix can be applied to determine priorities for the control of occupational health hazards. The semi-quantitative matrix uses attributable risk as a quantitative measure of probability and uses qualitative measures of consequence. A practical application of this matrix is the determination of occupational health priorities using existing epidemiological studies. Calculated attributable risks from epidemiological studies of hazard-disease combinations in mining and minerals processing are used as examples. These historic response data do not reflect the risks associated with current exposures. A method using current exposure data, known exposure-response relationships and the semi-quantitative matrix is proposed for more accurate and current risk rankings.     

Acute symptoms following work with pesticides

BACKGROUND: Serious accidental poisoning by pesticides is rare in the UK, but more minor pesticide-related illness may be under-reported. Anecdotally, use of sheep dip has been linked with flu-like symptoms. AIM: To explore the frequency, nature and determinants of acute symptoms following work with pesticides. METHODS: A postal survey of men in three rural areas of England and Wales provided data on occupational use of five categories of pesticide, occurrence of 12 specified symptoms within 48 h of using pesticides and tendency to somatize. Risk factors for pesticide-related symptoms were assessed by modified Cox regression. RESULTS: Of 10 765 responders (response rate = 31%), 4108 had at some time used pesticides occupationally, including 935 (23%) who reported symptoms following such work on at least one occasion. In two areas, acute symptoms were most frequent following use of sheep dip (29 and 32% of users), but in the third area the rate was significantly lower (13% of users). The relative frequency of symptoms was similar for all five categories of pesticide, and flu-like symptoms did not cluster unusually among users of sheep dip. Risk of pesticide-related symptoms increased with somatizing tendency (prevalence ratio for highest versus lowest category 2.4, 95% confidence interval 2.0-3.0) and was higher in men who had used pesticides most often or handled concentrate. CONCLUSION: Acute symptoms are common following work with pesticides, but in many cases the illness may arise through psychological rather than toxic mechanisms.