创建无烟医院的探讨

通过创建"无烟医院"实践,总结出一套行之有效的方法。领导重视、医生的表率作用和规章制度是成功创建无烟医院的关键因素。     

三亚市创建无烟医院医生控烟效果评价

目的 通过调查三亚市创建无烟医院前后医生的吸烟相关行为变化评价医院控烟效果,为进一步制定并实施控烟干预措施提供依据.方法 2008年、2012年均从三亚市4所二、三级医院按性别和年龄分层随机抽取医生,由专业人员指导自行填写统一问卷.数据应用SPSS 11.5软件进行统计分析.结果 创建无烟医院后,2012年比2008年吸烟基本知识知晓率提高（82.07％和74.60％）,总吸烟率下降（15.63％和24.34％）,尤其是40岁以下医生吸烟率下降,戒烟率升高（12.87％和7.57％）.帮助患者控烟意识增强.但为患者制定控烟计划、使用控烟药物方面欠缺.结论 无烟医院创建有利于提高医务人员对吸烟及被动吸烟危害的认识,降低医务人员自身吸烟率以及促进其主动对患者进行控烟干预.     

长沙市10家无烟医院创建效果评价

目的对长沙市10家医院开展控烟干预工作,评价控烟效果,为创建无烟医院提供依据。方法开展以政策制定、健康教育、氛围营造为主的控烟干预活动,干预前后采用问卷调查医务人员吸烟和被动吸烟相关知识、态度和行为的变化,评价干预效果。结果干预后,目标人群现在吸烟率由16.8%下降至13.7%,对于吸烟以及被动吸烟危害的认识也有所提高。医务人员更认为自身应在控烟工作中发挥表率作用,在日常工作中主动帮助患者戒烟。同时,在实际诊疗工作中主动询问病人吸烟习惯的医务人员比例也得到提高。结论无烟医院创建有利于提高医务人员对烟草及被动吸烟危害的认识,降低医务人员自身吸烟率以及促进其主动对患者进行控烟干预。无烟医院创建经验值得在其他行业进行推广。     

创建“无烟医院”的经验和体会

根据《深圳经济特区控制吸烟条例》,开展创建无烟医院工作取得了成效。本文就相关做法和经验进行总结。     

无锡市8家市属医院无烟环境创建效果评价

目的了解干预项目实施后,无锡市8所市属三级医院无烟环境创建效果。方法分别于干预项目实施3个月、16个月聘请市民志愿者为观察员,进入医院,对其10类室内工作场所和公共场所进行暗访观察,上午和下午各观察3次,每次每类场所观察15 min。结果干预3个月后,18项无烟环境指标中6项达到100.00%;发现27名吸烟者,吸烟者有人劝阻比例为3.70%;干预16个月后,10项达到100.00%,发现11名吸烟者,吸烟者有人劝阻的比例为27.27%。结论无烟城市项目对无烟环境创建的综合干预措施是有效的,应针对两次环境观察中发现的难点(会议室、男厕所、楼梯)进行重点控烟干预。     

实行团体控烟创建无烟医院的体会

１９９４年上海市政府颁布了《上海市公共场所禁止吸烟的暂行规定》。我院于１９９５年下发了《关于创建无烟医院的几点意见》。几年来控烟工作虽然取得了一定的成效 ,但尚有一定的差距。在总结以往经验教训的基础上 ,于１９９８年７月制定了《吴淞中心医院创建无烟医院三年规划》 ,提出用三年时间分步实施规划 ,第一年在禁烟区内禁烟 ,第二年在室内禁烟 ,第三年跨入无烟医院行列。首先以健康教育开道 ,开展一系列的广泛宣传活动。在医院内悬挂一条固定宣传横幅 :“为了您和周围人的健康 ,请勿吸烟”。门诊电子移动屏幕输入控烟内容 ,医院各…     

商丘市无烟医疗卫生机构创建工作调查

目的了解商丘市创建无烟医疗卫生机构情况,了解医务人员、疾控人员吸烟情况,为进一步加强控烟工作提供依据。方法采用暗访和座谈相结合的方法对无烟医疗卫生机构创建情况进行调查;对医务人员、疾控人员吸烟情况调查采用调查问卷的方法。调查问卷采用商丘市疾控中心制定的《医务人员吸烟情况调查表》。结果 38家医疗卫生机构均设置有禁烟标志,37家机构张贴有控烟海报、标语或设置了宣传栏,26家机构设置了室外吸烟区,11家医疗机构设置了戒烟门诊或戒烟咨询电话,23家机构存在室内吸烟现象,15家有销售卷烟现象。调查医疗卫生工作人员556人,吸烟者141人,吸烟率25.40%,410人(73.70%)认为医务人员应该不吸烟,329人(59.20%)认为医院应设立吸烟区,在调查的人群中赞同控烟的有521人,占93.70%,不赞同控烟的有35人,占6.30%。结论商丘市医务人员吸烟率偏高,创建无烟医疗卫生机构工作需要进一步加强。     

云南省无烟医疗卫生机构创建进展

目的比较两轮暗访结果了解云南省无烟医疗卫生系统创建情况,为推进全省医疗卫生系统全面禁烟提供参考依据。方法 2011年、2013年使用国家级方案评分标准暗访全省16州市行政部门、公共卫生机构、医疗机构3类机构。结果 2011年全省暗访综合评分为57分,2013年为68.3分(满分100分)。2013年各类医疗卫生机构禁烟标识设置、室外吸烟区设置、吸烟状况得分均较2011年明显增加。2013年17.7%~39.7%的机构在重点场所未设置禁烟标识,在22.9%的机构内未发现任何控烟宣传材料,39.1%的机构室外吸烟区得分为0分。结论云南省无烟医疗卫生系统创建日见成效,各类机构间的差别逐渐缩小,但距建立100%无烟环境尚有差距,还需进一步加强政策的执行和监督。     

创建无烟医院 营造健康呼吸

烟草危害是当今世界最严重的公共卫生问题之一。中国有吸烟者35亿，每年约有100万人死于吸烟相关的疾病。未来30年内，由烟草带来的疾病和死亡会更加严重，所致医疗费用的增加和劳动力的丧失仍不容低估。然而，大多数吸烟者并没有真正意识到吸烟的危害，也未真正了解吸烟危害健康的严重性。     

Smoking care provision in smoke-free hospitals in Australia

BACKGROUND: The study aimed to (1) determine the current routine smoking care that smoke-free public hospitals in New South Wales (NSW), Australia, provide to inpatients who are smokers; (2) determine current strategies supporting such care; and (3) examine the association between smoking care provision and hospital characteristics and support strategies. METHOD: A cross-sectional survey of 169 senior hospital managers was undertaken. Survey items included smoking care practices such as identification of smoking status and provision of nicotine replacement therapy as well as hospital activities such as existence of policies and staff training. Hospital characteristics such as size and geographic location were also collected. RESULTS: Twenty percent of respondents reported provision of minimally 'adequate' smoking care, defined as providing five or more smoking care items to 80% or more of patients. Larger hospitals were significantly less likely to provide adequate smoking care. Nurse training, the existence of signs indicating a smoke-free site and signs indicating location of designated smoking areas were also associated with smoking care provision. The existence of three or more support strategies was associated with smoking care provision. CONCLUSION: Even in the context of a smoke-free hospital site, the majority of inpatients who are smokers receive inadequate smoking care. Considered investment is required for hospitals to implement strategies to institutionalise the routine provision of appropriate smoking care.     

Establishing smoke-free hospitals in Vietnam: A pilot project

In Vietnam, a pilot ‘smoke-free hospital’ model was implemented in nine hospitals in 2009–2010 to supply lessons learned that would facilitate a replication of this model elsewhere. This study aimed to assess smoking patterns among health professionals and to detect levels of second-hand smoke (SHS) exposure within hospital premises before and after the ‘smoke-free hospital’ model implementation. A pre- and post-intervention cross-sectional study was conducted in nine purposively selected hospitals. Air nicotine levels were measured using passive nicotine monitors; smoking evidence was collected through on-site observations; and smoking patterns were assessed through interviews with health workers. Despite the ‘smoke-free hospital’ intervention, smoking continued among health-care workers who were former smokers. Specifically, self-reported smoking prevalence significantly decreased post-intervention, but the number of daily cigarettes smoked at workplaces among male health workers remained unchanged. Post-intervention, smoking was more likely to take place outside buildings and cafeterias. However, air nicotine levels in the doctors' lounges and in emergency departments did not change post-intervention. Air nicotine levels at other sites decreased minimally. Tailored tobacco cessation programmes, targeting current smokers and mechanisms to enforce non-smoking, should be established to meet requirements of Vietnam's comprehensive National Tobacco Control Law effective in May 2013.     

Road to a smoke-free fire service for Florida: policies and progress

In 1986 the Professional Fire Fighters of Florida (PFFF), a labor organization of 11,000 members, passed an unprecedented resolution to create a "smoke-free fire service." The PFFF's commitment arose from its (i) concern for the health of fire fighters, (ii) need to address the issue of smoking to protect the fire fighters' "Heart and Lung Law," and (iii) attempt to avert criticism of its proposed presumptive "Cancer Bill." In 1987 the PFFF gained support for its resolution from a council representing chiefs, fire instructors and inspectors, and volunteer fire fighters. Prior to the "smoke-free" resolution, one fire department in Florida required that new fire fighters be non-smokers. Since the resolution passed, 14 departments added this requirement. In 1989 the PFFF succeeded in getting a landmark bill passed requiring that new fire fighters be non-users of tobacco for at least one year prior to application. Important implications of the PFFF's efforts to create a "smoke-free fire service" are also discussed.     

产后避孕的国内外指南

产后避孕方法的选择受妇女生理状态和哺乳的影响,产后即时或尽早落实常规避孕措施,对预防人工流产及其并发症有重要作用。本综述对产后避孕的国内外指南进行复习和比较,重点讨论经产妇可优先选择的宫内节育器(intrauterine contraceptive device,IUD)、雌孕激素复方和单纯孕激素避孕方法及女性绝育术在产后不同时期使用的医学标准,为临床医生在产后帮助妇女选用安全、适宜的避孕方法提供指导。     

国际公共卫生新进展

本文从公共卫生挑战、传染病防控、疾病监测、慢性病防治、全球健康、健康素养、精准医学等领域,对近年来国际上公共卫生领域的新进展进行介绍,以期为我国公共卫生工作提供借鉴与经验。     

纳米材料安全性的国内外研究动向

随着越来越多的纳米材料和产品的发展及其进入商业领域，关于纳米材料和超细颗粒物对人类和生态潜在毒性的研究日益增多，人们开始关注对纳米材料的安全性评价问题。本文综述了国内外关于纳米材料安全性研究方面的动向，并提出了今后工作的建议。     

Drug prescribing in hospitals: an international comparison.

This paper presents a comparison of prescribing habits for patients hospitalized in medical wards of university hospitals in America and Scotland. American patients received almost twice as many drugs both during and prior to hospitalization than did comparable Scots. The differences between the countries were consistent for symptomatic and for more specific therapies. As compared to Scotland, drug therapy in America costs patients more in terms of financial outlay and adverse drug effects. The data do not permit evaluation of the relative benefits to the patients of the different quantities or types of drug used for similar circumstances in these countries.     

National and state prevalence of smoke-free rules in homes with and without children and smokers: Two decades of progress

ObjectiveThe home is the primary source of secondhand smoke (SHS) exposure for children. We assessed national and state progress in smoke-free home (SFH) rule adoption in homes with and without children and adult smokers.MethodsData came from the 1992–1993 and 2010–2011 Tobacco Use Supplements to the Current Population Survey, a U.S. national probability household survey. Households were defined as having a SFH rule if all household respondents aged ≥ 18 indicated no one was allowed to smoke inside the home at any time. Households with children were those with occupants aged < 18. Smokers were those who smoked ≥ 100 lifetime cigarettes and now smoked “everyday” or “some days”.ResultsFrom 1992–1993 to 2010–2011, SFH rule prevalence increased from 43.0% to 83.0% (p < .05). Among households with children, SFH rules increased overall (44.9% to 88.6%), in households without smokers (59.7% to 95.0%), and households with ≥ 1 smokers (9.7% to 61.0%) (p < .05). Among households without children, SFH rules increased overall (40.8% to 81.1%), in households without smokers (53.4% to 90.1%), and households with ≥ 1 smokers (6.3% to 40.9%) (p < .05). Prevalence increased in all states, irrespective of smoker or child occupancy (p < .05). In 2010–2011, among homes with smokers and children, SFH rule prevalence ranged from 36.5% (West Virginia) to 86.8% (California).ConclusionsConsiderable progress has been made adopting SFH rules, but many U.S. children continue to be exposed to SHS because their homes are not smoke-free. Further efforts to promote adoption of SFH rules are essential to protect all children from this health risk.     

医院卫生人力成本研究现状及存在的问题

本文从医院卫生人力成本的概念、研究的内容和研究的方法三个方面对医院卫生人力成本的现状进行了简要的介绍并分析了目前的研究中存在的问题。