抓医德建设工程 促医院全面发展

介绍了同济医院医德建设工程的内容和从抓教育、抓组织、抓制度、抓专项治理方面入手抓落实,并以“活动”为载体,促进了医院全面发展和医院综合实力提高的经验和做法。     

河南省二级医院护士医院伦理氛围感知与隐性缺勤的相关性研究

目的 探讨河南省二级医院护士医院伦理氛围感知与隐性缺勤的现状及相关性。方法 采取多阶段分层随机抽样的方法在河南省抽取二级医院护士594名,采用一般资料调查表、医院伦理氛围量表、斯坦福隐性缺勤量表进行调查,采用相关性分析和多元线性回归分析探究护士医院伦理氛围感知与隐形缺勤之间的关系。结果 护士医院伦理氛围总分为(4.36±0.43)分,隐形缺勤为（14.83±4.76）分;不同科室、聘任方式、夜班数、科室工作年限以及饮食是否规律的护士隐形缺勤得分差异具有统计学意义（P＜0.05）;医院伦理氛围总分与隐性缺勤呈负相关(r = - 0.348,P＜0.001),各维度与隐性缺勤呈负相关（P＜0.001）;回归分析结果显示在去除混杂因素（科室工作年限、是否饮食规律、科室）后,医院伦理氛围可负向预测护士隐形缺勤（β = - 0.296,P＜0.001）。结论 医院伦理氛围可能是二级医院护士隐性缺勤的独立危险因素,医院管理者应关注护士对医院伦理氛围感知情况的变化,以降低隐性缺勤。     

Perceptions of the Hospital Ethical Environment Among Hospital Social Workers in the United States

Hospital social workers are in a unique context of practice, and one where the ethical environment has a profound influence on the ethical behavior. This study determined the ratings of ethical environment by hospital social workers in large nationwide sample. Correlates suggest by and compared to studies of ethical environment with nurses are explored. Positive ratings of the ethical environment are primarily associated with job satisfaction, as well as working in a centralized social work department and for a non-profit hospital. Religiosity and MSW education were not predictive. Implications and suggestions for managing the hospital ethical environment are provided.     

Paternalistic Leadership,Ethical Climate and Performance in Health Staff

Abstract

The aim of this study is to investigate the relationship between paternalistic leadership, ethical climate and performance among health staff. The implementation part of the study has been carried out on the health staff working in a public hospital taking place in the city of K?r?kkale (Turkey).The data attained from 460 participants have been assessed. As a result of the analyses; relationships between paternalistic leadership and dimensions of ethical climate (egoism, benevolence, principle climate) were positive and significance. In addition to, both the relationship between ethical climate dimensions and performance and between paternalist leadership and performance was significance.     

Hospital Social Work Practice in Zimbabwe

This article examines hospital work practice in Zimbabwe based on a literature review. It argues that the country is emerging from a ten year economic and political crisis which has affected the lives of the majority of the population. The health and education sectors have been the hardest hit since teachers, doctors, nurses as well as social workers have left the country in large numbers. The article highlights the various roles played by social workers in hospitals in Zimbabwe and the challenges they face in their day to day work. Solutions to these challenges are also suggested.     

Supervision of Lesbian,Gay, and Bisexual Social Work Students by Heterosexual Field Instructors

Abstract

This paper describes findings from a qualitative study of lesbian, gay, and bisexual (LGB) student-heterosexual field instructor dyads. Each dyad was assessed for its level of agreement in characterizing the student's experience in field placement. Disagreements were common, with more than half of the dyads having 2–5 areas of disagreement. The following factors seemed to impact the level of student-field instructor agreement: the field instructor supervisory style, the quality of the student-field instructor relationship, field instructor comfort with addressing LGB development and practice issues, the student's perception of the agency climate as gay-friendly, and the student's level of disclosure and stage in coming out.     

以慈善助医服务为导向的医务社工职业融入

当前,医务社工在医院系统面临接受度不高、难以被理解和信任的困境。慈善文化是医院发展的软实力,慈善医疗的核心在于以患者为中心,为患者提供助医、人文服务,医务社工理应承担这部分“非临床治疗”的责任。南京市儿童医院将慈善助医变为医务社工的职业方式,社工通过临床实务工作获得职业认知,整合社会资源成为医院生产力,搭建多学科合作平台,打破在医疗系统内的融合僵局,为职业融入探索本土化路径。     

Hospital Social Work: Contemporary Roles and Professional Activities

Since its inception in the 1900s, hospital social work has been impacted by the ever changing hospital environment. The institution of Diagnostic Related Groups (DRGs), the era of reengineering, and the constant struggle toward health care reform make it necessary to evaluate and substantiate the value and efficacy of social workers in hospital settings. This study identifies current roles and activities carried out by social workers in acute hospital settings from across the nation in the aftermath of reengineering. Findings suggest the primary role of respondents in this study to be discharge planning with little to no involvement in practice research or income-generating activities.     

Does fear of retaliation deter requests for ethics consultation?

Background Reports suggest that some health care personnel fear retaliation from seeking ethics consultation. We therefore examined the prevalence and determinants of fear of retaliation and determined whether this fear is associated with diminished likelihood of consulting an ethics committee. Methods We surveyed registered nurses (RNs) and social workers (SWs) in four US states to identify ethical problems they encounter. We developed a retaliation index (1–7 point range) with higher scores indicating a higher perceived likelihood of retaliation. Linear regression analysis was performed to identify socio-demographic and job characteristics associated with fear of retaliation. Logistic regression analysis was performed to determine whether fear of retaliation was associated with less likelihood of seeking consultation. Results Our sample (N = 1215) was primarily female (85%) and Caucasian (83%) with a mean age of 46 years and 17 years of practice. Among the sample, 293 (48.7%) RNs and 309 (51.3%) SWs reported access to an ethics consultation service. Amongst those with access, 2.8% (n = 17) personally experienced retaliation, 9.1% (n = 55) observed colleagues experience retaliation, 30.2% (n = 182) reported no experience with retaliation but considered it a realistic fear, and 50.8% (n = 305) did not perceive retaliation to be a problem. In logistic regression modeling, fear of retaliation was not associated with the likelihood (OR = 0.64; 95% CI = 0.22–1.89) or frequency of requesting ethics consultation (OR = 0.81; 95% CI = 0.27–2.38). Conclusion Fear of retaliation from seeking ethics consultation is common among nurses and social workers, nonetheless this fear is not associated with reduced requests for ethics consultation.     

医德医风电子考评系统在医德考评中的应用

目的探讨医德医风电子考评系统在医德考评中的应用。方法通过运用计算机及医院局域网络完成医德考评的自我评价、科室评价、支部评价和医院评价的四级评价,系统自动完成数据统计分析和档案管理等工作。结果实现了医德考评的动态化、量化和网络化管理,促进医院行风建设和整体管理水平的提高。结论考评系统无须单独安装计算机客户端,节省人力物力,实施与操作简便。     

A Discussion of Professional Issues of Hospital Social Workers in Saudi Arabia

Health care has evolved rapidly in Saudi Arabia, based on a Western model of service that incorporates multidisciplinary professional teams. Social work practice forms part of patient care. Within the cultural context of Saudi Arabia, social work education is developing and so too is the role of the practitioner in the hospital system. However, little is known about how social workers are integrated into the hospital setting. This study explores how Saudi social workers perceive their role and how they describe their practice. A quantitative methodology was employed using a self-administered questionnaire design. Analyses showed a number of perceived limitations that precluded effective performance in practicing social workers; these included difficulties related to updating job skills, followed by a perceived deficiency in current supervisory support.     

新时期军区总医院经营发展理念选择

经过近百年的发展,南京军区南京总医院积淀了"博爱"的底蕴。本文从发展的大思路,竭尽全力为患者服务,全方位培养高素质人才,义不容辞承担社会责任等方面,阐述医院践行博爱理念的具体举措,旨在以此为基础,进一步提升医院核心竞争力和对外服务形象。     

医德医风建设与医院无形资产积累

目的:医德医风有积极的经济学内涵,深圳市某院将2003年定为“医德医风教育年”,研究对比医德教育前后医院的各项社会效益、经济效益指标。对象:医院全体工作人员。方法:制定医德教育年活动实施方案,课题组收集、统计3年数据分析。结果:2002、2003年和2004年基本医疗环境一致,但2003年门诊与住院人次增长最多、抢救患者最多,且经济收入增长最快,效益最好。从每在岗人员经济收入(元)、每百元固定资产经济收入(元)和病床周转次数比较,也是2003年最高,平均住院日与2002年持平,有利患者减轻经济负担。结论:通过3年医院社会效益、经济效益指标对比,医德医风教育年中各项社会效益、经济效益指标明显变化,有显著性差异,医德医风教育有利于医院无形资产积累。医德医风具有反复性、复杂性、时效性和艰巨性的特点,从2003年、2004年效益对比可以显著发现这一点,欲获得稳固的长久的社会经济效益就必须将医德医风常抓不懈,将医德医风建设规范化、制度化是今后医德医风建设的主要途径。     

Social Work in the Veterans Administration Hospital System: Impact of the Work

Social workers in the Veterans Administration (VA) hospital system are faced with numerous challenges to best address the ongoing health and mental health needs of those who serve in the military. Social workers in the VA system serve diverse roles on the multidisciplinary medical teams and mental health services and are integral to the VA hospital environment. Most social workers feel positive about their work and their contributions to the care of the military. Despite positive feelings about their work, social workers are also prone to compassion fatigue and burnout as the work, especially with returning veterans from Afghanistan/Iraq, often extracts a toll. This article details the experience of social workers in the VA hospital system; it describes the impact of the work on the social workers, noting levels of compassion satisfaction, compassion fatigue, and burnout.     

护士对医务社工的认同与需求情况调查

目的了解护士对医务社会工作介入医院服务的认同情况,以及在护理服务中的需求,为医院护理工作引入医务社工服务提供依据。方法自行设计问卷,对广东地区三所已引入社工服务医院的189名护理人员进行调查。结果护士对医务社工的认同程度较高;在护理工作中,对引入医务社工服务有着较强的要求。结论和谐的医患关系与现代生理-心理-社会的健康模式需要更多元的服务方法来共同维护才能更好地达到效果,医务社工的引入丰富了以人为中心的护理服务内涵,对护理工作整体水平的提高有重要的现实意义。     

The Ambulatory Integration of the Medical and Social (AIMS) model: A retrospective evaluation

An exploratory, retrospective evaluation of Ambulatory Integration of the Medical and Social (AIMS), a care coordination model designed to integrate medical and non-medical needs of patients and delivered exclusively by social workers was conducted to examine mean utilization of costly health care services for older adult patients. Results reveal mean utilization of 30-day hospital readmissions, emergency department (ED) visits, and hospital admissions are significantly lower for the study sample compared to the larger patient population. Comparisons with national population statistics reveal significantly lower mean utilization of 30-day admissions and ED visits for the study sample. The findings offer preliminary support regarding the value of AIMS.     

HEAD AND NECK CANCER

This paper deals with the crisis of cancer and the communication loss faced by the laryngectomized patient. It considers the particular issues for the patient and his family and how the use of crisis intervention can reinforce the coping patterns ofthe patient and his family.     

The Development and Teaching of the Ethical Principles and Guidelines for Family Scientists*

This article describes the development of the Ethical Principles and Guidelines for Family Scientists that the National Council on Family Relations Board of Directors unanimously approved. Furthermore, it discusses the importance of ethics education for family professionals and provides suggestions for educators. Finally, the ethical principles and guidelines are delineated. We argue that the development of a scholarship on ethics education is important for current and future family scientists.     

临床医生岗前培训中病历书写缺陷分析

目的加强住院医生及进修医生对病历书写的基本功训练。方法随机抽取我院近两年来由住院医生及进修医生书写的病历600份并进行分析。结果有书写缺陷的病历为312份,缺陷率为52%,其中现病史书写缺陷率最高,为34%。结论住院医生及进修医生应加强岗前培训,重点掌握现病史的采集及描述,以提高病历书写质量。