Further testing of the Mental Health Problems Perception Questionnaire

AIM OF THE STUDY: This paper reports a two-part study relating to the further psychometric development of the Mental Health Problems Perceptions Questionnaire. BACKGROUND: The instrument was developed and used originally in a study to investigate the role of district nurses in caring for people with mental health problems, who live in rural settings. It is underpinned by an explicit theoretical framework in which therapeutic commitment, role support and role competency are core concepts. DESIGN: A two-part study is described. Part One used a test-retest method to examine the stability of the instrument on repeated administration. Part Two examined the instrument's internal reliability and construct validity by calculation of Cronbach's alpha coefficients and exploratory factor analysis. RESULTS: Satisfactory internal reliability for a new instrument was demonstrated. Exploratory factor analysis supported the previously proposed theoretical framework. Significant correlations were demonstrated between the scales which constitute the instrument, thereby providing further evidence of construct validity. CONCLUSIONS: The Mental Health Problems Perceptions Questionnaire provides a potentially useful instrument in relation to future educational, clinical and managerial research.     

Prevalence of Sexual Problems and Associated Distress in Aging Men Across 4 European Countries

BackgroundAmong older men, comparable cross-cultural investigations of sexual problems and associated distress that also include a multitude of relevant explanatory variables of these sexual problem and related distress are rare in the research literature.AimsTo investigate prevalence rates of sexual problems and associated distress among older men across 4 European countries (Norway, Denmark, Belgium, and Portugal) and assess for associated mental and physical health–related factors.MethodsMultinational cross-sectional questionnaire study using self-report measures.OutcomesPrevalence rates of sexual problems and associated distress levels.ResultsWe found a high prevalence of sexual problems persisting for months or longer across countries, but noted that many affected men experienced minimal or no distress related to these problems. We also found marked cross-cultural differences in reported distress about sexual problems, with southern European men (ie Portugal) reporting significantly more distress related to the majority of sexual problems investigated compared with northern European men (ie Denmark and Norway). Finally, we identified several relational, physical, and mental health problems associated with the reported number of sexual problems and the distress related to these problems.Clinical ImplicationsWe suggest that healthcare professionals also target distress when considering sexual problems among older men and contextualize these considerations within a multifactorial approach to general health in which (other) mental and physical health factors relevant to these patients’ sexual health and function are also jointly considered.Strengths & LimitationsStrengths of this study include the large sample size, inclusion of participants from 4 European countries, assessment of distress associated with sexual problems, and similar research design and method of data collection across the 4 included countries. Limitations of the study include the cross-sectional design, which precludes causal conclusions; the low response rate in the Portuguese sample; the lack of homosexual participants; and the lack of comprehensive assessments of dyadic factors that may be of relevance to sexual problems and associated distress.ConclusionThis study identified a high prevalence of sexual problems persisting for 3 months or longer among older men across 4 European countries, but also found that many of the men with sexual problems experienced minimal or no distress related to these problems.G.M. Hald, C. Graham, A. ?tulhofer, et al. Prevalence of Sexual Problems and Associated Distress in Aging Men Across 4 European Countries. J Sex Med 2019;16:1212–1225.     

痴呆患者进食问题评估与管理指南的系统评价

目的 对痴呆患者进食问题评估与管理相关指南进行质量评价和内容分析,为制订痴呆患者进食问题评估与管理规范提供依据。 方法 计算机检索国内外指南网、相关学会网站及数据库,搜集痴呆患者进食问题评估与管理相关指南,检索时限为建库至2018年12月19日。应用标准的质量评价工具对指南进行质量评价,汇总痴呆患者进食问题评估与管理的推荐意见。 结果 初检到450篇文献,最终纳入6篇指南、1篇专家共识、4篇最佳实践和2篇推荐实践。6篇指南均来自国外,使用临床指南研究与评估系统Ⅱ对其进行质量评价并计算各领域的平均得分,分别为范围和目的87.50%、参与人员61.58%、严谨性45.14%、清晰性78.70%、应用性35.07% 和独立性33.33%,总体质量均为B级;纳入的专家共识、最佳实践、推荐实践分别来自中国、美国和澳大利亚。进食问题评估与管理有关推荐意见涉及营养和进食问题评估、调整进餐环境、维持进食自主性、调整食物类型和提供方式、照护者支持、吞咽困难应对、营养补充剂、肠内营养8个方面。 结论 纳入的指南质量中等,在应用性、独立性和严谨性领域有待提高。关于进食评估与管理的推荐意见散在分布,缺乏针对具体进食问题的应对措施,部分推荐意见尚有争议。     

浅析医疗设备维修中存在的问题

随着现代医学的迅猛发展,各类先进的医疗设备不断进入医院,医疗设备在现代临床诊疗活动中有着举足轻重的作用。在迅速更新各类医疗设备的同时,与之配套的设备维修工作也越来越频繁而重要。维修工作直接影响着设备的使用及医疗技术的应用,并能直接或间接影响医院的经济效益等现实问题,然而在对医疗设备的维修中还存在着各种各样的问题,严重制约着维修效率,影响着医疗技术的应用。本文结合多年维修工作实际分析了医疗设备维修中存在的问题,并提出了相应的解决措施,对医院医疗设备维修的发展具有借鉴意义。     

西安市统筹城乡医疗保障制度的现状、问题与路径

从西安实地调研来看,医疗保障逐步覆盖城乡,职工医保、居民医保和新农合制度运行渐趋平稳。由于人群特征的影响,职工、居民和农民的健康状况和医疗需求具有差异性,进而对制度的利益诉求不同,导致三项制度竞争日益凸显。这需要从偿付机制切入,设计回应人群利益诉求的偿付平台,构建＂人人享有健康＂的受益平衡机制,统筹整合城乡医疗保障制度。     

对医院用药中药物相互作用问题的思考

目的:提高对药物相互作用的认识,促进合理用药。方法:对我国医院用药中药物相互作用存在的问题进行分析。结果与结论:我国对合理用药中的药物相互作用认知度较低,需从多角度加强药物相互作用研究;转变认知理念,引起各级政府部门和医药人员重视;推行临床药师制,重构药学服务模式;扩宽研究领域,加强药物相互作用机制和中西药相互作用研究;加快信息化建设,组建药物相互作用数据库;扩大普及教育,提高社会公众的药物知识等。     

病案复印常见的问题及改进措施简

从患者、临床医师、病案管理人员三个方面分析病案复印中的常见问题,主要有患者证件携带不齐全、患者信息不全或错误、病案归档不及时或病案资料不完整、病案管理人员的工作压力增大.从而提出通过建立院内宣传系统、提高病案质量、提高病案管理人员自身素质等办法,快捷、方便、高效地为患者提供病案复印.     

体格检查记录用语问题及改进措施

体格检查记录需按系统循序、客观真实且用规范化用语进行书写。在记录过程中,存在主要用语问题：⑴使用不规范医学用语;⑵错误描述;⑶记录顺序颠倒;⑷记录不全;⑸用词模棱两可;⑹用病名或症状学名称代替体征;⑺非客观真实记录;⑻勉强将体征分度;⑼笼统描述;⑽存在争议记录。只有关注和重视每一环节,齐抓共管,通过提高书写者对记录用语规范化的重要性认识、重视临床技能规范化培训、不断更新医学和人文知识、完善制度管理、出版社出版精品教材和医学期刊的编辑率先垂范等,体格检查记录用语规范化才能成为现实。     

内科系统医疗谈话记录存在的问题和管理策略

目的 分析医疗谈话记录存在的问题,探讨管理策略。方法 对5 个科室2013 年8 月-2013 年11 月的203 份谈话记录存在的问题进行分类统计。结果 谈话记录存在问题共39 份,问题发生率19.2%（39/203）,其中存在一项问题29 份,发生率14.3%（29/203）,存在两项及两项以上问题10 份,发生率4.9%（10/203）。所有谈话记录中共存在问题54 项,平均每份1.4 项（54/39）,69.2%（27/39）有沟通无完整的记录。结论 医务工作者充分履行告知义务,认真做好医疗谈话并形成文字记录,提高病历记录质量,减少医疗纠纷。     

医院实施药学服务的影响因素与对策

目的:探讨和分析目前医院在实施药学监护、药学服务中存在的问题,提出相应的对策。方法:选取一家二级甲等医院,总结其临床药学服务、药学监护等相关情况。主要应用演绎及归纳的方法分析开展药学监护与药学服务的困难及其出现的问题。同时提出相应解决对策以提升该院的药学服务质量及监护水平。结果:药学服务开展过程中出现的问题有:药师的团队意识及专业技能低,培训不够系统化,临床药师人才不足;药学服务的工作分配粗糙;药物检测等基础研究条件差,研究水平低;未充分运用信息化与自动化;医院药物制剂技术及条件不足,药学服务未得到普及。针对以上问题的解决措施有:药师的工作应当引起医院的关注,增强其业务技能,改善工作环境;强化医院的基础硬件条件,充分借助现代信息与医疗科技手段;增加临床药师的实验室研究水准;医学制剂学应得到重视。结论:只有大型医院才有条件实施药学服务项目。需要有关权威部门制定相关法律条例,明文规定实施药学服务的详细内容、步骤及执行规范。