职业使命感与职业延迟满足在主动性人格和护士自我职业生涯规划间的链式中介效应分析

目的 探讨职业使命感、职业延迟满足在主动性人格对护士自我职业生涯规划影响机制中的多重中介作用。方法 采用方便抽样法,于2018年2月选取安徽省5家三级甲等医院的护士作为研究对象。采用一般资料调查问卷、主动性人格量表、自我职业生涯规划量表、职业使命感量表和职业延迟满足量表,对3 692名研究对象进行调查,构建并检验链式中介模型。结果 本组3 692名护士自我职业生涯规划总分为（45.62±12.52）分,主动性人格总分为（51.15±11.04）分;职业使命感总分为（38.34±8.91）分;职业延迟满足总分为（24.93±5.01）分。主动性人格对自我职业生涯规划的间接效应成立,总的间接效应为0.349;职业使命感的特定中介效应占总间接效应的38.11%;职业延迟满足的特定中介效应占总间接效应的23.78%;职业使命感和职业延迟满足在主动性人格与自我职业生涯规划中的链式中介作用占总的间接效应的38.11%。结论 护士自我职业生涯规划得分处于中等水平,职业使命感、职业延迟满足在主动性人格和护士自我职业生涯规划间的多重中介效应成立。建议护理管理者识别不同人格类型的护士,帮助其强化职业使命感和培养职业延迟满足行为,进而提高自我职业生涯规划水平。     

音乐放松缓解作业人员应激情绪的研究

目的研究音乐放松对缓解特殊作业人员应激情绪的作用。方法在参加神舟十一号载人航天飞行任务的工作人员中招募志愿者15人,任务过程中和任务后各进行1次音乐放松。在音乐放松前、后采集主观体验指标和唾液皮质醇指标,音乐放松过程中采集心率变异性指标。结果音乐放松后,心率(heart rate,HR)降低[(71.08±7.97)beats/min vs.(68.15±7.05)beats/min)],相邻NN间期差的均方根(root mean square of successive differences,RMSSD)升高[(29.15±13.27)ms vs.(36.86±14.22ms)],高频功率(high frequency,HF)升高[(219.05±180.39)ms~2vs.(329.01±235.87)ms],差异均有统计学意义(P0.05)。唾液皮质醇(cortisol)水平降低[(6.50±1.04)ng/mL vs.(6.01±0.65)ng/mL],差异接近显著(P=0.079)。结论音乐放松对于缓解作业人员应激情绪具有积极作用,对于下丘脑-垂体-肾上腺(hypothalamo-pituitary-adrenal,HPA)轴和自主神经系统均有影响。     

Doctors’ and nurses’ perceptions of military pre-hospital emergency care – When training becomes reality

The aim of this study was to identify physicians’ and nurses’ perceptions of military pre-hospital emergency care before and after an international mission. A qualitative empirical study with a phenomenographic approach was used. The results after pre-deployment training can be categorised as (1) learning about military medicine and (2) taking care of the casualty. The results after an international mission can be categorised as (1) collaborating with others, (2) providing general health care and (3) improving competence in military medicine. These results indicate that the training should be developed in order to optimise pre-deployment training for physicians and nurses. This may result in increased safety for the provider of care, while at the same time minimising suffering and enhancing the possibility of survival of the injured.     

孕妇血清中HBV－DNA与乙型肝炎疫苗阻断母婴传播HBV的效果

血清ＨＢｓＡｇ、ＨＢｅＡｇ双阳性母亲的新生儿分别于出生时、１月龄、６月龄各接种１剂２０μｇ乙型肝炎（乙肝）疫苗后随访２ａ。随机抽取母婴乙肝病毒（ＨＢＶ）传播阻断成功的６４例、失败的２９例。用斑点杂交测定孕妇临产时血清ＨＢＶ－ＤＮＡ水平。结果表明疫苗阻断母婴传播成功组孕妇血清ＨＢＶ－ＤＮＡ水平明显低于失败组提示孕妇血清ＨＢＶ－ＤＮＡ水平高可能是疫苗阻断母婴传播失败原因之一。     

Apport de la tomographie par émission de positons dans la prise en charge de la sarcoïdose

FDG-PET, now hybrid positron emission tomography/computed tomography (PET-CT), has become an established diagnostic tool in oncology. Fluorodesoxyglucose (¹⁸F-FDG) is not specific for malignant lesions, as uptake of the tracer depends on its accumulation in cells with an increased glucose metabolism as it is also the case in infectious and inflammatory lesions, like sarcoidosis. Thus, FDG-PET has been proposed for internal medicine indications, one of whom is sarcoidosis. The main characteristics of FDG-PET are its better sensitivity compared to ⁶⁷Ga scintigraphy and its ability to be used as an earlier marker of therapeutic response as compared with anatomy-based and conventional scintigraphic imaging. However, FDG-PET should be used in atypical or advanced stage of the disease. Future prospective studies should be awaited before integrating FDG-PET in clinical routine for treatment outcome and disease activity assessment in sarcoidosis. New radiopharmaceutical probes are under development and will improve the performance of PET.