In Search of the MCH Professional

One of the goals of the Maternal and Child Health Journal is to encourage professional development. This letter was written to the Editor in light-hearted spirit to convey the true challenge such a goal poses for the journal and the profession.     

Uniforms, status and professional boundaries in hospital

Despite their comparative neglect analytically, uniforms play a key role in the delineation of occupational boundaries and the formation of professional identity in healthcare. This paper analyses a change to the system of uniforms in one UK hospital, where management have required all professions (with the exception of doctors) to wear the same 'corporate' uniform. Focus groups were conducted with the professionals and patients. We analyse this initiative as a kind of McDonaldisation, seeking to create a new 'corporate' worker whose allegiance is principally to the organisation, rather than a profession. Our findings show how important uniforms are to their wearers, both in terms of the defence of professional boundaries and status, as well as the construction of professional identity.     

Occupational therapy students’ perceptions of occupational therapy

Background/aims: An understanding of students’ perceptions of occupational therapy on entry is required to recognise how professional socialisation occurs through curriculum. Findings pertain to a qualitative study investigating students’ perceptions of occupational therapy upon entry to two occupational therapy programmes in Australia. Methods: Students commencing Bachelor of Occupational Therapy and Masters of Occupational Therapy Studies programmes participated in the study (n = 462). A purpose‐designed questionnaire was distributed to students in the first lecture of each programme. Preliminary analysis comprised identification of keywords/phrases and coding categories were generated from patterns of keywords. Frequency counts and percentages of keywords/phrases within categories were completed. Results: Students’ responses were categorised as ‘what’ occupational therapists do; ‘how’ they do it; ‘why’ they do it; and ‘who’ they work with. In ‘what’ occupational therapists do students frequently described ‘helping’ people. Both undergraduate and graduate entry masters students used the term ‘rehabilitation’ to describe how occupational therapy is done, with graduate entry students occasionally responding with ‘through occupation’ and ‘modifying the environment’. Students perceived the ‘why’ of occupational therapy as getting back to ‘everyday activities’, with some students emphasising returning to ‘normal’ activities or life. Regarding the ‘who’ category, students also thought occupational therapists worked with people with an ‘injury’ or ‘disability’. Conclusions: Students entered their occupational therapy programmes with perceptions consistent with the general public’s views of occupational therapy. However, graduate entry students exposed to a pre‐reading package prior to entry had more advanced occupational therapy concepts than undergraduate students.     

大学生专业选择对心理应激的影响研究——基于《大学生职业生涯发展规划》课程的研究

目的:在《大学生职业生涯发展规划》课程的基础上,就大学生专业选择对心理应激的影响进行实证研究。方法:对来自工科、理科、文科的304名大学生进行问卷调查,运用SPSS22.0软件分析数据。结果:专业认同、心理适应和专业选择三大因素是大学生心理应激的主要影响因素。专业认同的影响包含专业美誉度、专业喜好度、专业投入度、专业认知度和专业匹配度五方面,影响大学生心理应激最重要的因子是专业喜好度(x2),其次是专业投入度(x3)。心理适应的影响包含生活适应力和心理健康两方面,大学生本身的生活适应力(x8)和心理健康(x9)都对预防心理应激有着重要影响。专业选择的影响包含专业性质和自愿选择两方面,对自己专业性质的满意度(x6)将尤为影响大学生的心理应激状况。结论:我们应当针对专业认同、心理适应、专业选择三方面来进行大学生心理应激的管理,做好心理应激的预防,改善专业选择对大学生心理应激的影响。     

Healthcare Chaplaincy as a Companion Profession: Historical Developments

Chaplains, like professionals in a range of industries, have long sought to maintain and build occupational power by articulating their professional mandate and advocating for their work. I describe how leaders of the Association of Professional Chaplains and its predecessor organizations used multiple strategies to articulate and re-articulate their professional mandate between 1940 and the present to become a companion profession, one that comes alongside another without seeking to challenge its jurisdiction. I find chaplains seeking to develop an economic base, aligning interests across distinct segments of the profession and creating new professional associations, lobbying for legislative support, and offering their services in institutional voids. They further adopted the language of healthcare around questions of identity, charting, and accreditation and, chaplains used not just the frameworks but the methods of healthcare—evidence based research—to try to demonstrate their value. This history can help chaplains and chaplaincy leaders today to form a more comprehensive sense of their history and think more strategically regarding how to make the case for their profession going forward.     

上海市某区医疗机构医务人员职业信用评价指标体系构建

随着我国市场经济转型,医疗机构医务人员职业信用出现危机。作为管理部门,有必要制定相关评价体系,监管医务人员职业行为,提高医疗机构诚信水平。以上海市某区卫生系统为例,在查阅文献梳理国内外相关理论研究和实践应用、专家咨询的基础上,构建某区医疗机构医务人员职业信用评价指标体系,体系共4个一级指标及15个二级指标,以期为医疗机构日常诚信监管提供参考依据。     

卫生专业技术资格评审影响因素研究

目的 分析卫生专业技术资格评审结果的影响因素.方法 对2010年北京部分三级甲等医院及科研机构的评审数据,分申报级别进行Logistic单因素回归分析.结果 级职评审结果与年龄,专业类别,工作经历,参评学历,考试成绩,论文总数,参评论文质量水平,参评论文是否真实、客观,专业技术工作情况等有关.结论 评审过程基本上客观、公正,评审结果能反映申报入的能力和水平.     

Occupational therapy students' perspectives regarding international cross-cultural experiences

Background: The purpose of this study was to investigate the perspectives of occupational therapy students who have engaged in international, cross‐cultural learning and service experiences. Methods: This study utilized a qualitative, phenomenological design. Nine semi‐structured interviews were conducted with students who engaged in international learning opportunities. The interviews were coded and analyzed using a constant comparative analysis approach. Results: Three central themes emerged from the data anlysis. Connectedness is the process of forming relationships with others while engaging in cross‐cultural experiences. Students formed relationships with faculty, other students, and people within the community. Cultural awareness is the recognition and understanding of a different culture and responding to those differences. Students attempted to understand the new culture in comparison to their own lived experiences. Complexity portrays cross‐cultural opportunities as dynamic, multi‐faceted and intricate. This was demonstrated as the students raised additional questions about the conflict between their own culture and the new culture they entered. Students also identified limited orientation, support and structure with such experiences and the conflicting roles between volunteer, student, and team member. Conclusions: The ability to connect with others when building relationships in diverse cultural contexts held meaning for the students; however, the students also expressed conflict in trying to make sense of the new culture as it often challenged personal beliefs and constructs. The complexity and challenges of engaging in these opportunities needs to be recognized and further explored to assess how curricula and faculty best supports culturally responsive care.     

Why Medical Schools Are Tolerant of Unethical Behavior

The exposure to unethical and unprofessional behavior is thought to play a major role in the declining empathy experienced by medical students during their training. We reflect on the reasons why medical schools are tolerant of unethical behavior of faculty. First, there are barriers to reporting unprofessional behavior within medical schools including fear of retaliation and lack of mechanisms to ensure anonymity. Second, deans and directors do not want to look for unethical behavior in their colleagues. Third, most of us have learned to take disrespectful circumstances in health care institutions for granted. Fourth, the accreditation of medical schools around the world does not usually cover the processes or outcomes associated with fostering ethical behavior in students. Several initiatives promise to change that picture.     

The Perceived Status of Occupational Therapy: Myth Versus Reality

A survey of 136 Australian occupational therapists explored their perception of their autonomy and status, through questions concerning role definition; peer network and peer review; professional association and industrial affiliation; skills and procedures characteristic of the profession; views on others' perception of their role; credentials to practise; salary and years of practice. The authors conclude that the profession has a high opinion of its status and autonomy, a belief that it has a unique set of skills (though not aims), and adequate credentials to practise. They also suggest, however, that there is reason to question the extent to which this professional self-image is well founded.     

基于DRG的临床医师高级职称评审实践探索

目的基于疾病诊断相关分组(DRG)相关指标对临床医师高级职称评审进行实践探索。方法选取医院173名需晋升高级职称的临床医师作为研究对象,利用DRG相关指标进行专业能力综合评价。结果 DRG评价指标经过量化后,晋升副主任医师和主任医师的结果具有一致性。结论 DRG可以应用于临床医师高级职称评审工作,为医院科学开展人才考核提供参考依据。     

医院感染管理专职人员专业胜任力评价体系的构建

目的 构建医院感染管理专职人员专业胜任力量化评价体系,通过科学评价为专职人员培养提供科学依据。方法 利用文献资料和经验总结构建评价要点,通过专家咨询法筛选评价要点并计算评价要点的权重系数,由专家组为各评估要点设计等级化的评价内容选项并赋予分值。每项评价要点得分与权重的乘积即为此要点得分,所有评价要点得分合计计算被评价者总得分。结果 评价体系包括“基础条件”“医院感染识别能力”“医院感染监测能力”“医院感染防控技术应用能力”,“应急处置能力”“组织协调能力”“质量改进能力”“教育培训能力”和“感染防控专业科研能力”共9个维度,25项评价要点,每项评价要点包含3项等级量化评分内容。专家问卷咨询的内部一致性信度Cronbach’s α系数为0.873,总内容效度指数(S-CVI)为0.868,条目内容效度(I-CVI)范围为0.71～1。结论 本研究构建的量化评价体系信度、效度结果满足要求,评价体系科学可行,用于医院感染管理专职人员专业胜任力的科学评价,可以有效识别能力短板,确定培养方向和重点,为医疗机构医院感染管理专职人员的人才培养和梯队建设提供科学依据,促进医院高质量发展。     

Practitioner Training for Use of Evidence-Based Practice in Occupational Therapy

The purpose of this integrative review was to examine the evidence-based practice (EBP) training literature for occupational therapy practitioners in order to describe the relationships between EBP use in practice and practitioner training for EBP. A systematic search of literature related to EBP training in occupational therapy was followed by a research evaluation, review of case examples, and qualitative content analysis. Findings suggest that comprehensive, contextually-relevant, and collaborative training approaches are necessary for practitioners to address implementation of EBP. Research investigating the mechanisms of practitioner training and ways to measure the relationships between training, changes in how practitioners use evidence-based practices, and client outcomes and other quality indicators is recommended.     

Language, identity and representation: occupation and occupational therapy in acute settings

Aim:   This article presents findings from a participatory action research study into the experience and use of occupation, theory and evidence in the everyday practice of a group of occupational therapists working in a large metropolitan hospital delivering a range of acute services, in Melbourne, Australia.
Methods and findings:   Narrative data gathered from 11 individual interviews and 10 group discussions were analysed through numerous iterative cycles to explore research issues and evaluate research actions. This article discusses why the participating occupational therapists chose to change the language they used to describe their practice from a focus on 'function' to a focus on 'occupation'. This change improved the therapists' levels of confidence, strengthened their professional identities and provided for a sense of renewed empowerment within the organisation.
Conclusions:   The findings suggest that occupational therapists in acute settings can utilise language more effectively to augment their ability to promote the vital and unique contribution that occupational therapy has to make. Such small, yet powerful changes can empower occupational therapists to address long-standing dilemmas of representation and enable transformative practices.     

浅谈专科护理建设

随着临床医学分科的不断细化,专科护理建设是护理管理者必须重视和探讨的问题,本文从护士培训层次、专科技能训练、专科理论知识培训、专科护理记录、教学科研等几个方面来加强专科护理建设,取得了一定的效果.