复原膏应用于自然分娩产后34例临床研究

目的:观察复原膏应用于自然分娩产妇产后的临床疗效。方法:将68例自然分娩产妇随机分为对照组和观察组各34例,对照组给予产妇常规治疗,观察组在对照组治疗的基础上给予复原膏口服,治疗7 d观察产妇的泌乳量和子宫复原情况。结果:观察组产妇平均每日的泌乳量正常者27例,泌乳不足者4例,缺乳者3例,对照组产妇正常者18例,泌乳不足者13例,缺乳者3例,观察组产妇每日的泌乳量多于对照组,差异具有统计学意义(P0.01);观察组56 d内子宫复原32例,对照组24例,观察组产妇子宫复原情况的疗效好于对照组,差异具有统计学意义(P0.01)。结论:复原膏不但可提高产妇的泌乳量而且可以提高产妇子宫复原率,这有利于产妇身体的恢复和婴儿的成长,疗效显著。     

职场精神力对主观幸福感的影响:情绪劳动为中介变量

目的:从资源保存理论的视角来检验情绪劳动在职场精神力和主观幸福感之间的中介作用。方法:采用职场精神力量表、情绪劳动量表和主观幸福感量表调查了211名五星级酒店和银行的一线服务人员。结果:1职场精神力对员工的主观幸福感产生正向影响;2职场精神力对员工的深层扮演产生正向影响,对员工的表层扮演产生负向影响;3深层扮演和表层扮演分别在职场精神力和主观幸福感之间发挥中介作用。结论:职场精神力是情绪劳动的前因变量,它增加员工深层扮演的同时会降低表层扮演。职场精神力会提升员工的主观幸福感。深层扮演和表层扮演是解释职场精神力对员工主观幸福感产生影响的内在作用机制。     

Low Health Literacy and Evaluation of Online Health Information: A Systematic Review of the Literature

Background

Recent years have witnessed a dramatic increase in consumer online health information seeking. The quality of online health information, however, remains questionable. The issue of information evaluation has become a hot topic, leading to the development of guidelines and checklists to design high-quality online health information. However, little attention has been devoted to how consumers, in particular people with low health literacy, evaluate online health information.

Objective

The main aim of this study was to review existing evidence on the association between low health literacy and (1) people’s ability to evaluate online health information, (2) perceived quality of online health information, (3) trust in online health information, and (4) use of evaluation criteria for online health information.

Methods

Five academic databases (MEDLINE, PsycINFO, Web of Science, CINAHL, and Communication and Mass-media Complete) were systematically searched. We included peer-reviewed publications investigating differences in the evaluation of online information between people with different health literacy levels.

Results

After abstract and full-text screening, 38 articles were included in the review. Only four studies investigated the specific role of low health literacy in the evaluation of online health information. The other studies examined the association between educational level or other skills-based proxies for health literacy, such as general literacy, and outcomes. Results indicate that low health literacy (and related skills) are negatively related to the ability to evaluate online health information and trust in online health information. Evidence on the association with perceived quality of online health information and use of evaluation criteria is inconclusive.

Conclusions

The findings indicate that low health literacy (and related skills) play a role in the evaluation of online health information. This topic is therefore worth more scholarly attention. Based on the results of this review, future research in this field should (1) specifically focus on health literacy, (2) devote more attention to the identification of the different criteria people use to evaluate online health information, (3) develop shared definitions and measures for the most commonly used outcomes in the field of evaluation of online health information, and (4) assess the relationship between the different evaluative dimensions and the role played by health literacy in shaping their interplay.     

米非司酮联合依沙吖啶用于瘢痕子宫孕中期引产的临床观察

摘 要 目的： 观察米非司酮联合依沙吖啶用于瘢痕子宫中期妊娠引产的疗效和安全性。方法: 84例患者随机分为对照组和观察组各42例,对照组予羊膜腔内注射依沙吖啶引产;观察组在对照组治疗基础上加服米非司酮引产。比较两组患者用药至宫缩发动时间、用药至胎儿娩出时间、辅助用药率、胎儿体质量、产后出血量、引产成功率,引产不良事件,药品不良反应发生率等的差异。结果: 与对照组相比,观察组用药至宫缩发动时间、用药至分娩时间明显较短,清宫率及引产不良事件总发生率降低（P<0.05）。结论:与单用依沙吖啶相比,米非司酮联合依沙吖啶用于瘢痕子宫中期妊娠引产更为安全有效。     

The impact of health literacy on knowledge,Attitude and decision towards hospice care among community‐dwelling seniors

The aim of this study was to investigate the relationships between health literacy and hospice knowledge, attitude and decision in community‐dwelling elderly participants. This cross‐sectional study enrolled 990 community‐dwelling elderly participants in three residential areas, with a mean age of 71.53 ± 7.22 years. Health literacy was assessed using the Mandarin version of the European Health Literacy Survey Questionnaire. Knowledge, attitude and decision towards hospice care were assessed using an interviewer‐administered questionnaire. Partial least squares were used for data analysis. More than half of the respondents had sufficient knowledge of hospice care (60.7%) and a positive attitude (77.3%) and positive decision (85%) towards hospice care. In the structural equation model, general health literacy positively predicted knowledge (β = 0.73, p <0.001), attitude (β = 0.06, p = 0.038) and decision (β = 0.14, p < 0.001) towards hospice care. General health literacy had a greater overall effect on hospice decision (β = 0.57) than hospice knowledge (β = 0.54). In addition, disease prevention health literacy also demonstrated a higher level of influence on hospice decision (β = 0.59) than hospice knowledge (β = 0.53). Health literacy was associated with hospice knowledge, attitude and decision. Incorporating health literacy interventions into hospice promotion strategies is recommended.     

Applying mental model methods to characterize understanding of gene-environment influences: the case of podoconiosis in Ethiopia

The rapid pace of genomic discovery has raised public expectation and concerns about the utility of new discoveries and their potential to exacerbate health disparities. Improving literacy concerning gene and environmental (GxE) contributors to disease is needed to avoid commonly observed deterministic misconceptions about genomics. Mental models approaches that incorporate community engagement processes could be used to inform GxE literacy-building interventions. We used a mental models approach to describe and systematically compare expert and lay understanding of GxE interactions, using the example of podoconiosis, a non-infectious lymphedema endemic in highland Ethiopia. Methods included: (1) specifying elicitation questions for a literature review, (2) eliciting an expert model, (3) eliciting a lay model, and (4) comparing the two models. We used a coding scheme to identify lay participants’ knowledge gaps, misunderstandings, and extra knowledge relative to the expert standard. Results indicated that lay participants’ viewed poverty as an important susceptibility factor and considered heredity and contagion to have a joint causal influence. Experts did not endorse either of these viewpoints. Conventional expert-based interventions aimed to correct misconceptions about behaviors important for prevention may be stymied by lay views that social environmental factors have more important influences on health outcomes. GxE literacy interventions that consider multiple levels of influence including social determinants of health and personal resilience to augment health education strategies are needed in diverse settings. Novel communication approaches will be needed to help target audiences disentangle long-held conceptions of heredity and contagion.     

围生期产妇健康素养量表条目筛选

目的：对围生期产妇健康素养量表条目池进行条目筛选,形成条目更可靠、更准确的围生期产妇健康素 养量表。方法：运用Delphi法,请14名妇幼专家对研究者自行编写的56个条目的需要性和重要性进行两轮函询,保 留50个条目。用该条目池对350名产后1~3 d的产妇进行横断面调查,选取其中10%的调查对象1周后重测。在这些数 据基础上,运用χ2检验法、相关系数法(2种)、因子分析法、Cronbach’s α系数法、重测信度法6种方法进行条目筛 选,保留3种或3种以上方法均不需删除的条目,组成最终量表。结果：重测结果Person相关系数为0.507(P=0.004)。 通过6种筛选方法删除的条目数量分别为：1)χ2检验法删除9条;2)相关系数法1删除25条;3)相关系数法2删除1条;4) Cronbach’s α系数法删除19条;5)因子分析法删除8条;6)重测信度法删除37条。最终由33个条目组成围生期产妇健 康素养量表。结论：运用6种条目筛选方法获得了精简后的量表,但距离推广应用还有很大距离,需要在人群中进行 大样本调查,进行信效度检验。