社区患者对护士服务满意度调查

目的了解和分析卢湾区瑞金街道社区患者对护士服务情况的满意度，为改进社区卫生服务提供依据。方法2003年8～9月调查了250位门诊患者对护士服务的满意程度，并进行统计分析。结果不同年龄、不同就诊科室的患者对护士服务态度的满意度存在差异；不同文化程度的患者对护士服务态度满意度的差异无显著性；不同年龄、不同文化程度、不同就诊科室的患者对护士技术水平满意度的差异有显著性。结论社区卫生服务中应针对个体全面改善护士的服务态度，提高服务质量。     

护士心理紧张状况及其影响因素评价

目的探讨护士心理紧张状况及其影响因素。方法采用职业紧张量表(OSI-R)与卡特尔16种人格因素量表(16PF)对743名护士进行调查。结果 (1)与成渝两地技术人员常模比较,护理人员的心理紧张反应得分(26.65±6.63)明显高于常模值(22.98±6.61)(P<0.01);(2)工作环境、任务不适、任务冲突、责任感、紧张性人格特质以及医院等级等与护士的心理紧张反应呈正相关(P<0.05),社会支持、理性处事、稳定性人格特质与护士心理紧张反应呈负相关(P<0.05)。结论护士的心理紧张反应高于其他技术人员,与其工作环境、任务不适、任务冲突、责任感及护士的人格特征、社会支持、理性处事有关。     

糖尿病患者人格特征探析

大量研究[1] 表明,糖尿病患者伴有较明显的心理社会问题,表现为孤独、抑郁。自杀率增加、认知功能受损、性心理异常、生活质量下降等。复旦大学于2 0 0 2～2 0 0 3年对糖尿病患者的人格心理状态进行了研究,现报告如下。对象与方法1 对象　复旦大学附属中山医院全科医学社区卫生服务中心能合作的Ⅱ型糖尿病患者1 64例,全部符合WHO糖尿病诊断标准(1 985年) ;其中男性1 0 2例,女性62例;年龄为3 3～85岁;病程0～3 9年。2 调查方法和内容　运用卡氏1 6种人格因素测试(1 6PF)量表,测量患者1 6种根源人格特质和8种复合人格特质的分值。3 资料…     

清醒手术患者手术时的心理护理

目的研究手术室护士术前心理干预对非全身麻醉下施术患者满意度的影响.方法选择非全身麻醉下施术的清醒患者180例,随机分为两组各90例,实验组患者于术前1d由手术室护士进行心理干预,对照组按常规施术,然后比较两组患者术中SAS量表分值及对手术室的满意度.结果实验组患者术中SAS量表分值明显低于对照组(P＜0.01),术后随访满意度明显高于对照组(P＜0.01).结论手术室护士术前对患者进行心理干预,能有效缓解患者术中焦虑和提高患者对手术室的满意度.     

有效沟通六习惯在恶性血液病患者心理护理中的应用

目的探讨运用有效沟通六习惯在恶性血液病患者心理护理中的应用价值。方法通过2016年1月至10月对南京医科大学第一附属医院老年血液科16名护士进行"有效沟通六习惯"理念培训、分组模拟训练,而后选取科室50名恶性血液病患者,入院时运用汉密尔顿焦虑量表进行评分,对有焦虑的患者按"有效沟通六习惯"理念实施心理护理。患者出院时再次进行焦虑量表评分和患者满意度调查。结果培训后的护士通过运用有效沟通六习惯对患者实施心理护理后患者出院时汉密尔顿焦虑量表评分较入院时降低(P0. 05),患者对护士关于有效沟通的四项维度的满意度较实施前有所提高(P0. 05)。结论护士运用有效沟通六习惯对有焦虑的恶性血液病患者实施心理护理可以改善患者焦虑抑郁、悲观消极的心理状态,增强患者战胜疾病的信心,提高患者对护理人员的满意度。     

冠心病患者人格特征的研究

目的探索冠心病患者的人格结构特征。方法采用Cattell-16PF人格因素量表评定冠心病组和健康对照组的16种主要的人格特质，对两组结果进行t检验。结果本文的16PF评定结果表明，冠心病组的L怀疑性、Q4紧张性和O忧虑性明显高于健康对照组，而M幻想性明显低于健康对照组。结论提示冠心病患者具有高怀疑性、高紧张性、高忧虑性和低幻想性的人格特征；指导冠心病患者改变其紧迫感和紧张困扰的人格特征，尽量保持一个平和的心态是防治冠心病的重要手段之一。     

健康教育是改善医患关系的有效途径

为了解患者对医护人员服务态度的满意度 ,探讨改善医患关系的有效途径 ,2 0 0 0年新疆维吾尔自治区城市社会经济调查队进行了“首府医院患者满意度调查” ,内容包括 :综合服务质量、收费价格、综合环境及医护人员医德医风。对象与方法1 对象　乌鲁木齐市 8家综合医院的 5 0 0名患者。2 方法　采用问卷式抽样调查。结　　果1 护士服务态度满意率均低于医生服务态度满意率 ,从调查中还得知 ,按门诊、住院、出院患者划分 ,门诊患者对医生和护士的服务态度满意率分别为 70 0 0 %和4 0 6 7% ,住院患者满意率分别为 83 4 1%和71 36 %。　　2 …     

创建护理示范病房前后住院患者满意度调查的探讨

目的 通过对患者在创建护理示范病房前后对各项护理内容的满意度调查及比较,探讨创建护理示范病房对提高医疗服务质量的意义.方法 将2011年2月普外科创建护理示范病房后510名住院病人的满意度调查问卷与2010年同科室510份随机满意度调查问卷进行护士服务态度等5个内容的结果统计和对比分析.结果 创建护理示范病房后住院病人对护理服务的5个项目满意度均较前有显著提高(P＜0.05),其中对服务态度和健康教育差异有统计学意义(P＜0.01).结论 创建护理示范病房后患者的满意度有明显提高,对提高医疗护理服务质量有显著效果.     

法医专业大学生心理健康水平研究

目的：了解法医专业大学生的心理健康水平。方法：以SCL－90量表及16PF量表为测试工具,采用对照研究方法。结果：法医专业本科生毕业前夕测试与入学时测试对照,SCL－90各因子分值的下降以强迫、人际、抑郁3项因子分最显（P＜0．05,P＜0．01）,仅焦虑分值仍高于在职法医（P＜0．05）及全国常模（P＜0．01）;16PF结果以稳定性,敢为性,实验性,独立性,自律性分值上升及怀疑性,紧张性分值下降最显（P＜0．01,P＜0．05）。结论：法医专业大学生在校期间心理健康水平明显提高,“四个结合”的教育方针可能起到干预作用。     

航天发射参试官兵的人格特点

目的调查航天发射参试官兵的人格特点,为航天发射参试官兵的心理选拔提供依据。方法采用卡特尔16种人格因素问卷(16PF)对某卫星发射中心在位的324位官兵进行测试,采用SPSS 21.0软件进行方差分析和t检验分析数据。结果 (1)航天发射参试官兵B、C、G、I、L、O、Q2、Q3因子的得分显著高于军人常模,A、E、H、N、Q1因子的得分显著低于军人常模(P0.05,P0.01);(2)航天发射参试军官、士官和士兵A、B、C、L、O、Q2、Q4、X1、X2、X4、Y1、Y3、Y4因子的得分差异有显著性(P0.05,P0.01);(3)航天发射参试官兵20岁及以下组、21~30岁组和30岁组在C、H、M、O、Q2、X1、X2、Y1、Y3因子的得分差异有显著性(P0.05);(4)航天发射参试官兵本科及以上组、大专组和高中及以下组A、B、C、H、L、N、O、Q2、X1、X2、X4、Y1、Y3、Y4因子的得分差异有显著性(P0.05)。结论航天发射参试官兵与军人常模相比具有聪慧性、稳定性、有恒性、怀疑性、忧虑性、独立性、自律性等人格特征;在不同职别、年龄和学历之间个性特征有明显差异。     

Calcium intake in the elderly: validation of a dietary questionnaire

Epidemiological studies of calcium and osteoporosis have been hampered by the lack of a suitable tool for assessing calcium intake. This report describes a new frequency and amount questionnaire for measuring present and past calcium intake in the elderly. The validity of the questionnaire was tested against two commonly used standards of dietary assessment, five-day duplicate diets and seven-day weighed dietary inventories. The resulting correlation coefficients were, respectively, r = 0.76 and r = 0.69, while that for repeatability was r = 0.84. Furthermore, the questionnaire categorized subjects into thirds of the distribution of intake with almost no gross misclassification. It is suggested that the present findings may be extended to the majority of normal, healthy elderly subjects, implying wide application for the questionnaire in the assessment of calcium intake in the elderly.     

The occurrence of antimicrobial substances in toilet,sink and shower drainpipes of clinical units: A neglected source of antibiotic residues

Antibiotics represent one of the most important drug groups used in the management of bacterial infections in humans and animals. Due to the increasing problem of antibiotic resistance, assurance of the antibacterial effectiveness of these substances has moved into the focus of public health. The reduction in antibiotic residues in wastewater and the environment may play a decisive role in the development of increasing rates of antibiotic resistance. The present study examines the wastewater of 31 patient rooms of various German clinics for possible residues of antibiotics, as well as the wastewater of five private households as a reference.To the best of our knowledge, this study shows for the first time that in hospitals with high antibiotic consumption rates, residues of these drugs can be regularly detected in toilets, sink siphons and shower drains at concentrations ranging from 0.02?μg·L^?1 to a maximum of 79?mg·L^?1. After complete flushing of the wastewater siphons, antibiotics are no longer detectable, but after temporal stagnation, the concentration of the active substances in the water phases of respective siphons increases again, suggesting that antibiotics persist through the washing process in biofilms. This study demonstrates that clinical wastewater systems offer further possibilities for the optimization of antibiotic resistance surveillance.     

Self-reported health problems among Swedish miners one year after unemployment

Unemployment is considered to be a public health concern sincedeterioration in the health of the unemployed is often anticipated.However, for some groups, such as miners, unemployment mightimprove health due to a cessation of potentially harmful occupationalexposures. This study evaluates the health of 79 miners in oneSwedish iron-ore mine, and 226 age-matched controls from thegeneral population, during one year after the closure of themine. The participants received a questionnaire regarding medicalhistory and subjective symptoms at the beginning of the studyperiod, and after one year. Statistically significant negativeeffects on self-reported health attributable to unemploymentwere not found, although neuropsychiatric symptoms were morecommon among the unemployed miners. The miners reported a statisticallysignificant improvement in grip force (p=0.031). They had asignificantly higher prevalence of symptoms associated withmining related exposures when compared with the population controls;pain in the upper extremities [relative risk (RR)=2.27, 95%confidence interval (Cl)=1.44–3.59), back pain (RR=1.84;Cl=1.237–2.75), vasospastic disease of the fingers (RR=2.05;Cl=1.18–3.57) and obstructive respiratory symptoms (attacksof dyspnea and wheezing: RR=3.67; Cl=1.167–11.6).     

Excès de cas humains et animaux de tularémie en France au cours de l’hiver 2007–2008 : émergence ou phénomène isolé ?

Context

Tularemia is a zoonosis affecting humans and hares in France. We describe the results of surveillance in both species, in 2007 and 2008.

Methods

Human tularemia cases are mandatorily notifiable in France since 2003. In hares, surveillance relies on volunteer hunter associations in all districts of the country. Data from mandatory reports and volunteer surveillance in 2007/2008 were analyzed and compared with previous results.

Results

In 2007/2008, 144 cases were reported in humans and 117 cases in hares. This was a 100% increase compared to previous years. Human cases differed from those of previous years only by the frequency of contact with breeding animals. Human cases without any documented risk exposure were also more frequent.

Conclusion

An increase of tularemia cases occurred in 2007/2008 in both species. Complementary studies are needed to identify the species reservoir in France to understand the causes of this peak of cases.     

Occupational health hazards in mining: an overview

This review article outlines the physical, chemical, biological, ergonomic and psychosocial occupational health hazards of mining and associated metallurgical processes. Mining remains an important industrial sector in many parts of the world and although substantial progress has been made in the control of occupational health hazards, there remains room for further risk reduction. This applies particularly to traumatic injury hazards, ergonomic hazards and noise. Vigilance is also required to ensure exposures to coal dust and crystalline silica remain effectively controlled.     

Manufacture and use of nanomaterials: current status in the UK and global trends

This paper provides an overview of the production and use of nanomaterials (NMs), particularly in the UK. Currently, relatively few companies in the UK are identifiable as NM manufacturers, the main emphasis being the bulk markets in metals and metal oxides, and some niche markets such as carbon nanotubes and quantum dots. NM manufacturing in the UK does not reflect the global emphasis on fullerenes, nanotubes and fibres. Some assumptions have been made about the types of NM that are likely to be imported into the UK, which currently include fullerenes, modified fullerenes and other carbon-based NMs including nanotubes. Many university departments, spin-offs and private companies have developed processes for the manufacture of NMs but may only be producing small quantities for research and development (R&D) purposes. However, some have the potential to scale up to produce large quantities. The nanotechnology industry in the UK has strong R&D backup from universities and related institutions. This review has covered R&D trends at such institutions, and appropriate information has been added to a searchable database. While several companies are including NMs in their products, only a few (e.g. manufacturers of paints, coatings, cosmetics, catalysts, polymer composites) are using nanoparticles (NPs) in any significant quantities. However, this situation is likely to change rapidly. There is a need to collect more information about exposure to NPs in both manufacturing and user scenarios. As the market grows, and as manufacturers switch from the micro- to the nanoscale, the potential for exposure will increase. More research is required to quantify any risks to workers and consumers.     

深圳公立医院管理体制改革制度设计

深圳公立医院管理体制改革实行政事分开、管办分开,在理事会架构下按法定机构模式组建市医管中心,落实公立医院运营管理自主权.作者从当前公立医院管理体制的弊端入手,介绍了深圳市进行公立医院管理体制改革的基本思路及改革方案设计的主要举措,深入剖析了的改革方案的特点,并对改革效果进行了预测.     

Effects of nitrogen dioxide on red blood cells of rats: Changes in components of red cell membranes during in vivo exposure to NO2

Red cell membranes, prepared from red blood cells of rats exposed to 4, 10, or 20 ppm nitrogen dioxide (NO₂) for 1 to 10 days, were examined for evidence of changes in membrane components. Appreciable changes were not found in contents of phospholipid and cholesterol during exposure to 10 ppm NO₂. By contrast, protein content altered with the time of exposure. Moreover, changes in protein composition were observed by employing sodium dodecyl sulfate — polyacrylamide gel electrophoresis. Twenty-four-hour exposure to NO₂ at the concentration above 10 ppm resulted in a marked increase in the percentage of lysophosphatidylethanolamine (LysoPE) to the total phospholipids. The prolonged exposure to 10 ppm NO₂ gave rise to a further increase in LysoPE, whereas the percentage of phosphatidylethanolamine (PE) showed a gradual decrease. A 1-day exposure to 4.0 ppm NO₂ also caused an increase in sialic acid content and decreases in those of PE and hexose. In addition to contents of these components the percentage of LysoPE increased 5 days after exposure and the elevated values were maintained up to the end of exposure period. These results demonstrate that red blood cells in circulation exhibit different membrane properties in terms of lipid and carbohydrate composition during 10 days of exposure to 4.0 ppm NO₂.     

Investigating clusters in the workplace and beyond

Clusters of disease are common and occur in the workplace and in the general community. They often arouse considerable concern among the population. Investigations have sometimes lead to exciting new knowledge, but in general the investigation of clusters is difficult and often unrewarding, especially for community clusters. In the workplace, investigations are more likely to find associations and even new causes, but still many clusters remain enigmatic. Despite this, there are many reasons for investigating clusters, including allaying community concern and identifying uncontrolled exposures. A structure for investigating clusters in the workplace is suggested.