健康志愿者在社区健康促进活动中的实践与效果

目的探讨健康志愿者在社区健康促进活动中的实践与效果。方法对50名健康志愿者进行培训,培训后与社区医务工作者一起向居民开展健康促进活动。结果健康促进活动后,社区高血压、糖尿病患者疾病控制率较活动前高;居民健康知识和行为优于活动前,活动前后比较,均P〈O．05,差异具有统计学意义。结论发展健康志愿者参与健康教育与健康促进工作,对社区居民疾病的控制,健康知识知晓及健康行为形成等具有较大的促进作用。     

在校护生心理健康水平影响因素的路径分析

目的了解护生心理健康水平与心理社会因素的关系。方法采用症状自评量表、青少年生活事件量表和应对方式问卷、领悟社会支持量表、自尊量表对345名护生进行调查。结果成熟型应对方式、领悟社会支持量表得分、自尊量表得分与症状自评量表得分呈负相关,不成熟型应对方式、混合型应对方式、青少年生活事件量表得分与症状自评量表得分呈正相关。对症状自评量表得分有直接影响的变量按影响大小依次为成熟型应对方式、自尊、生活事件评分、社会支持总分,4个变量对心理症状均存在间接效应。结论成熟型应对方式、自尊、生活事件、社会支持是影响在校护生心理健康的重要因素。     

Structural model of factors relating to the health promotion behavior of reproductive health among Indonesian adolescents

ObjectivesWe aim to explore the factors related to the health promotion behavior of reproductive health (RH) among Indonesian adolescents via structural equation modeling.MethodsA cross-sectional quantitative study was used to measure 108 adolescents aged 12–16 years. We employed a self-administered questionnaire developed from the health promotion model (HPM) and the empowerment model (EM) on the basis of self-efficacy to determine the factors related to health promotion in maintaining RH behavior. Structural equation modeling (SEM) was used to examine relationships among the variables. The Analysis of Moment Structures (AMOS) approach was used to evaluate if the proposed model is suitable for the data based on goodness-of-fit indices.ResultsThe model is appropriate for the data. Three interrelationships emerge among independent variables (P > 0.05), namely, personal and cognitive behaviors (r = −0.01), cognitive and health promotion behaviors (r = 0.09), and affective and health promotion behaviors (r = −0.17). The strongest relationship is between empowerment and health promotion behavior (r = 0.72). Affection (interpersonal and situational influences), immediate competing demands and preferences, and empowerment (participation and control) are directly related to RH behavior maintenance. Meanwhile, willingness of adolescents, prior related behavior, personal factor, and commitment to a plan of action are indirectly related to RH behavior maintenance. The model explains 43.9% of the variance in maintaining RH behavior.ConclusionsThe HPM and EM models help determine the factors related to RH behavior maintenance among adolescents. Intervention to promote RH among Indonesian adolescents should begin from the level of child–parent–health care professional encounter for empowering the RH of adolescents.     

Health,health promotion and the elderly

• ? Health promotion is a mode of practice which is being increasingly examined by policymakers (DHSS, 1987; DoH, 1992).
• ? Although practitioners are being required to screen people over 75 years of age and are exhorted to reduce accidents in the elderly by 33% between 1990 and 2005 (DoH, 1992), there is evidence that they do not value this sort of work (Pursey & Luker, 1993).
• ? This paper looks at the findings from 178 interviews with people aged over 75 years, examining the importance of health and health promotion to the elderly.
• ? Further to the work of Cox et al. (1987), it is clear that people aged over 75 years continue to engage in a wide variety of activities which are designed to keep or improve their health.
• ? Elderly people's accounts of their health suggest that the real influence of social circumstances and environment must be assessed and planned for if health promotion activity is to have relevance and meaning to this group of people.
• ? Evidence is presented which indicates that the elderly are a group of people who would welcome health-promotion activity provided it is given in easily accessible forms.
• ? The notion of client participation is highlighted as a difficult area, which is likely to require particular skill in working with elderly clients. In the light of these findings, practitioners may need to examine their own attitudes to their work with the elderly.

     

The relationship between personal traits and job satisfaction among Taiwanese community health volunteers

Aim. The purpose of the study was to understand the relationship between job satisfaction and personal traits in health volunteers in one community in Taiwan. Background. Among different kinds of community resources, the human resource is most essential for the process of developing healthy communities and cities. However, it is not easy to keep voluntary workers as part of health programmes even though they have been trained. Previous research has shown that to increase the job satisfaction of such a person, the volunteer needs to improve effectively his/her need to achieve. The need to achieve is an important part of a person's personal traits. Methods A cross‐sectional survey design was used to interview 317 health volunteers in various community health centres in I‐lan county, northern Taiwan. The research instruments of this study included the ‘locus of control orientation scale’ for personality measurement, the ‘achievement orientation scale’ and the ‘job satisfaction scale’. Results. Most of the sample volunteers were female with an average age of 49·55 years; the majority was married and living with their spouses. In terms of the volunteers’ personal traits, most of them are internal control orientation. The job satisfaction of the volunteers who took part in this research was extremely high. Significant variables correlating with job satisfaction in this study were gender, educational level, religious preference, participation in training, working to promote community health, the willingness to work, the frequency of participating in job training, and cooperation with other volunteer partners. The explainable variance for the prediction of job satisfaction from a combination of achievement orientation and the frequency of collaboration with other people was 9·1%. Relevance to clinical practice. The results suggest that there is a need to strengthen cooperative relationships among volunteer by initiating well‐planned volunteer training programmes and growth groups with the aim of enhancing their interpersonal relationships.     

Epigenetics,maternal prenatal psychosocial stress,and infant mental health

This paper provides a summary of literature on epigenetic effects and infant health outcomes of maternal psychosocial stress during pregnancy. A search of literature yielded a large body of publications between 2008 and 2018. Relevant articles were selected, and additional sources were located from ancestry searches of reference lists. Results implicate maternal prenatal stress as a source of epigenetic mechanisms that affect fetal brain development and program risk for emotional dysregulation and mental disorders over a lifetime and across generations. Implications for nursing practice are explored at multiple levels of policy advocacy, public education, primary prevention, screening and intervention.     

Relationship between psychosocial factors and health behaviours for women experiencing menopause

This study investigated the psychosocial factors related to the health behaviours of women at menopause. These health behaviours included choice of intervention by women for menopause, particularly consultation of health professionals, use of hormone replacement therapy and preferred information sources. A postal questionnaire was distributed to a structured random population-based sample of 400 women in the 45-54 years age group living in south-east Queensland, Australia. Explanatory variables were: attitudes to menopause, social functioning, mental health, vitality, preventive health practices and lifestyle factors. This study found that information, preventive health practices, attitudes towards menopause, exercise, number of children living at home, years of formal education and working in paid employment, were related to the health behaviours of women at menopause. The study concludes that a number of related psychosocial factors not associated with hormonal changes may influence the health behaviours of menopausal women. It will be important for nurses, other health professionals and counsellors to decide how best to respond to these findings in consultation with the women affected by their decisions.     

Discordance between self-evaluated health and doctor-evaluated health in relation to general health promotion

Objective – To describe the occurrence of “health realists”, “health pessimists” and “health optimists” in a non-patient population by identifying cases of concordance and discordance between doctor-evaluated health and self-evaluated health and to describe the distribution of selected life-style-related physiological risk factors among these health-groups.

Design – Comparative study.

Setting – Primary health care.

Subjects – 456 middle-aged persons registered with a general practitioner (GP) were after a general health screening invited to a health discussion. Prior to the health screening the participants had assigned their health status to one of five categories ranging from “very poor” to “excellent”. After the health discussion the GP rated the participants’ general health status on a visual analogue scale. On basis of this information patients were classified as “health realists”, “health optimists” and “health pessimists”.

Results – 54% of the participants could be classified as “good-health realists”, 14% as “poor-health realists”, 22% as “health optimists”, and 10% as “health pessimists”. “Poor-health realists” had the greatest accumulation of risk factors, followed by “health optimists”, “health pessimists” and “good-health realists”. Among the “health pessimists” there was a significantly higher risk score of future cardiovascular disease and poor physical endurance compared with the “good-health realists”.

Conclusion – Discordance between doctor-evaluated health and self-evaluated health was found in 32% of the cases studied. “Health pessimists” had more risk factors than “good-health realists” even though the GPs had rated their general health status as good in both cases.     

Real mental health promotion requires a reorientation of nursing education, practice and research

The evidence for the individual, social and economic benefits of mental health promotion is now well established. The indication is that a broader public health approach that addresses social and environmental factors related to mental health and well-being is required. Mainstream mental health services, however, continue to operate in relative isolation, allocating the greatest proportion of funding and resources to the treatment of mental illness and disorder. Relevant to health promotion, this paper explores the bidirectional link between physical and mental health and the social determinants of mental health. The growing interest in the positive aspects of health and well-being which focuses on wellness rather than illness is also discussed. One example of how mental health nurses can adopt principles of positive mental health to education, practice and research is presented. The author proposes that as the largest professional group in health care, nurses must become more actively involved in initiatives that reorientate practices and services away from an illness culture towards the adoption of wider mental health promotion principles.     

Investigating the impact of psychosocial risks and occupational stress on psychiatric hospital nurses' mental well-being in Japan

A cross-sectional survey was conducted, with the aim to examine what stressors in the workplace and demographic factors were associated with signs and symptoms of poor well-being among psychiatric nurses. A structured questionnaire was distributed to nurses within six psychiatric hospitals in Japan. Information was collected on demographic information, work characteristics and two dimensions of well-being: feeling uptight and emotional exhaustion. Three hundred and sixty-one questionnaires were completed by participants. High rates of emotional exhaustion in psychiatric nurses were found to be predicted by young age, high psychological demands paired with low social support in the workplace, job strain (a proxy to occupational stress) and job strain paired with low social support. In addition, high rates of being tense/uptight were associated with high psychological job demand, low psychological job control, low social support in the workplace, high job strain and high job strain paired with low social support. The current study has found evidence of significant relationships between demographic factors and several work and organizational stressors and poor mental health among Japanese psychiatric nurses.     

Mental health promotion of Iranian university students: the effect of self-esteem and health locus of control

The purpose of this study was to investigate the effect of self-esteem and health control belief on promoting students' mental health. In so doing, 144 students from two medical universities in the north-east of Iran were recruited into study. They were pair-matched and randomly assigned to case and control groups. The data were collected through Goldberg's General Health Questionnaire-28, Multidimensional Health Locus of Control and Rosenberg's Self-Esteem Scales. The results showed that there were significant differences between the groups before and after the intervention. The external components of health locus of control (chance and powerful others) showed a significant decrease but the internal health locus of control and self-esteem revealed a significant increase after the intervention (P < 0.0001). Moreover, the students' mental health had a significant increase after 3 months of intervention (P < 0.0001). The findings emphasize that the programme can improve the health locus of control beliefs, self-esteem and mental health promotion of the students. This will require additional monitoring and uninterrupted attempts to be effective.     

糖尿病前期人群社区健康促进效果评价及模式探讨

目的 评价社区健康促进在糖尿病前期患者管理中的干预效果,同时对糖尿病前期人群健康促进模式进行探讨.方法 将121例糖尿病前期患者随机分为干预组和对照组,干预组进行为期2年的健康促进干预,对两组患者干预前后行为指标和生化指标进行评价.结果 干预组糖尿病知识知晓率、经常锻炼率、血压控制率均有明显提高,差异有统计学意义.干预后糖尿病前期人群的餐后2 h血糖下降,干预组糖尿病年转化率较对照组有下降,差异均有统计学意义,空腹血糖、体质量指数、腰围、糖化血红蛋白指标比较差异无统计学意义.结论 全科团队式社区健康促进干预患者依从性较好,可以改变社区糖尿病前期患者的认知和行为,使糖尿病前期人群的餐后2 h血糖下降、糖尿病年转化率下降.