医师职业精神内源性驱动力的实证探讨

以"优质护理服务工程"、产科"一贯制"工作模式与传统工作模式为基础,分析了医务人员职业精神内源性驱动力的差异。结果表明:不同工作模式下心理契约有显著差异,变革组高于试点组;"医患交流互动"因素对工作行为发生积极变化的重要性有显著的差异,变革组高于传统组;在相同工作环境下,不同自尊水平的医务人员,其职业精神的表现有显著差异,自尊水平越高,员工满意度和工作敬业度得分越高、工作倦怠得分越低,即职业精神表现越好。提出医师职业精神的内源性驱动力来自3个方面:内部组织赋予医务人员的内心体验,外部顾客(患者)赋予医务人员的内心体验,医务人员自我人格特征。     

医务人员敬业度现状调查与分析

目的了解医务人员工作敬业度现状和特征,为医疗机构管理者提供员工管理对策建议。方法采取分层随机方式,通过问卷面对面调查了284位医务人员,以收集工作敬业度现状信息。结果医务人员敬业度平均得分49.35分(满分60分,得分率82.25%)。敬业行为前三位依次是"仔细叮嘱病人相关注意事项、自觉严格遵守医疗操作规范、及时反思医疗失误并担责任";得分最低是医务人员"热爱目前工作并对之感到满意"。不同性别、年龄、婚姻状况、学历、月收入及不同机构规模间医务人员敬业度差异无统计学意义,在从事不同专业、专业职称、所在机构类型方面工作敬业度差异具有统计学意义。结论当前医务人员工作敬业度总体较高;医务人员的工作满意度偏低,个人情绪对工作敬业度存在一定影响;不同背景下医务人员敬业度存在差异。     

盖洛普Q12在急诊护理管理中的应用研究

摘要 目的 将盖洛普Q12的12个管理维度应用于急诊护理管理,从12个方面满足护理人员需求,为护士提供一个人性化的、积极高效的工作环境,以提高护士们的敬业度及工作效率,从而也进一步提高医生、患者等对护理工作的满意度。方法 选定测评表测评当时现状及根据盖洛普Q12相关测评内容调整护理管理后各个时段的测评情况,将测评结果进行分析,不断改进,达到最佳管理效果。 结果 针对盖洛普Q12相关内容,采取行之有效的管理方法,对满意度低的项目进行重点管理,持续评估,不断改进,随着护士对盖洛普Q12满意度的提高,患者、医生对护士的满意度也不断提高,护士满意自己的工作。结论 护士长如果能掌握并运用好盖洛普Q12的12个管理维度,使护士们对所有12个问题都作出较为肯定的回答,那么护士敬业度,工作效率将有效提高,同时患者满意度、医生满意度也将得到明显提高。。     

急诊科护士精神薪酬满意度对工作满意度和离职意愿的影响

目的了解急诊科护士精神薪酬满意度的现状及对工作满意度和离职意愿的影响。方法采用护士精神薪酬满意度量表(psychological reward satisfaction scale,PRe SS)、工作满意度量表和离职意愿量表于2014年2—7月对烟台市六所医院的127名急诊科护士进行调查,资料采用x±s表示,peason相关及多因素回归分析,P0.05为差异有统计学意义。结果急诊科护士来自护士长的精神薪酬满意度得分为(2.98±0.84)分,来自医生的精神薪酬满意度得分为(2.38±0.49)分。来自护士长、医生的精神薪酬满意度与工作满意度呈正相关,且两者均是护士工作满意度的影响因素;来自护士长、医生的精神薪酬满意度与护士离职意愿呈负相关,其中来自护士长的精神薪酬满意度是影响离职意愿的主要因素。结论医院管理者应加强医生与护士之间的沟通,满足护士被尊重的精神需求,同时护理管理者也需要精神薪酬的长期激励作用,减少护士流失。     

不同岗位序列员工工作满意度及主要激励因素研究

目的探讨综合医院不同岗位序列员工工作满意度及激励策略。方法选取某三甲医院1 740名员工,采用方差分析比较不同岗位序列员工满意度差异。采用最小二乘法计算不同岗位序列员工满意度各条目得分。采用主成分分析法计算不同岗位序列员工满意度各构成指标在相应岗位总体满意度中的权重系数。结果医生、护士群体的工作满意度相对较低,技术员的满意度相对较高。各岗位激励指标,医生为“职称评定制度”、“保障部门支持”和“付出回报匹配”;护士为“绩效工资分配”、“职业安全保障”、“付出回报匹配”和“参与管理机会”;技术员为“职称评定制     

新疆某三甲医院员工满意度调查研究

目的了解新疆某医院员工总体满意度现状及不同群体特征满意度差异性,研究其主要影响因素,为完善医院管理提出建议。方法以整群抽样方法调查了新疆某医院员工1347名,运用统计描述、方差分析、非条件logistic回归及相关分析等方法进行研究。结果 46.1%的员工感到满意;不同工作类别、不同职称、不同职务和不同学历员工的满意度存在差异性,行政管理人员的满意度最高,最不满意的是医生;薪酬对员工满意度的影响最大;敬业度与总体满意度存在线性相关关系。结论医院员工对工作总体较为满意,薪酬是员工满意度的主要影响因素。     

深圳市某三甲医院医务人员人力资源管理认知程度及工作敬业度的相关性研究

目的 分析深圳市某三甲医院医务人员的人力资源管理认知程度及敬业度现状,并探索两者间关系,为优化人力资源管理策略,提高医务人员敬业度提供参考。方法 根据随机抽样原则,于2017年9月选取深圳市某三甲医院在职医务人员为研究对象,通过问卷调查获取调查对象的基本信息、人力资源管理认知程度以及敬业度信息,采用t检验、方差分析、Spearman等级相关分析和多元线性回归分析方法对数据进行统计分析。结果 455名医务人员中,人力资源管理认知总分为(87.91±12.31)分,人力资源管理认知得分在性别和文化水平方面差异有统计学意义(P<0.05)。敬业度总分为(31.81±9.46)分,敬业度得分在年龄和文化水平上差异有统计学意义(P<0.05)。人力资源管理认知总分及各维度得分与工作敬业度总分及各维度得分均呈显著正相关(P<0.001)。多因素线性回归分析结果显示,晋升与培训、绩效考核与薪酬管理2个维度与敬业度总分及各维度得分均呈显著正相关(P<0.05)。结论 医务人员人力资源管理认知程度对其敬业度具有显著影响,医院应重点建立有助于提升医务人员素质和专业技能的晋升与培训制...     

广州市社区精神卫生预防和康复医务人员工作压力和职业满意度调查分析

目的探讨广州市社区精神卫生预防和康复医务人员的工作现状、满意度水平,为广州市精神卫生立法在保障卫生人力资源发展的政策上提出理论依据。方法 2014年4月对广州从事精神疾病防治工作的279名社区精防医生进行问卷调查,收集不同人口特征的医务人员的工作压力、职业满意度现状,计量资料采用t检验、方差分析、Pearson相关分析,P0.05为差异有统计学意义。结果广州市社区精防医务人员工作压力评分为(45.03±12.26)分,不同年收入医务人员的工作压力评分[(47.23±12.39)、(45.29±11.97)、(39.32±10.97)、(35.73±6.89)分]比较,差异有统计学意义(P0.05)。职业满意度评分为(34.25±7.39)分,不同年龄、学历、年收入医务人员职业满意度评分比较,差异均有统计学意义(均P0.05)。工作压力评分与工作满意度呈负相关(r=-0.683,P0.05);职业满意度与激励缺失压力(r=-0.576)、工作环境和氛围(r=-0.328)、不稳定造成的压力(r=-0.239)、工作本身及负荷度(r=-0.176)均呈负相关;"工作外在满意度"和"工作内在满意度"与整体工作压力评分呈均负相关(r=-0.533、-0.429,P0.05)。结论根据医务人员对工作的满意度情况,应采取针对性的管理措施及激励机制,提高医务人员工作积极性,从而提高医疗服务质量,促进精神卫生事业的持续健康发展。     

我院临床医务人员工作满意度调查分析

目的 了解临床医务人员的工作现状、满意度水平,分析影响满意度的主要因素,以便更好的为患者提供优质服务、有针对性的制定相关政策和采取相应措施提供科学依据.方法 分层随机抽样抽取我院288名医生、护士和医技人员,利用“李克特量表”5点测量法进行抽样调查,发放无记名调查问卷,使用SPSS和SAS等统计软件进行数据处理,多因素分析采用logistic回归.结果 职工工作的总体满意度得分(x±s)为3.64±0.68,评价很高.医务人员对现行工作状况很满意,工作报酬和福利等方面满意度较低,且满意度与学历、职称、岗位及工龄没有直接的影响.结论应根据医务人员对工作的满意度情况,分别采取针对性的管理措施及激励机制提高他们的工作积极性,从而提高医疗服务质量,促进我院卫生事业的健康发展.     

湖北省城乡基层医务人员工作满意度研究*

目的测量湖北省基层卫生机构医务人员的工作满意度状况,发现影响因素,为提高湖北省基层医务人员工作满意度提供政策依据。方法根据经济发展情况选取湖北省武汉市、黄冈市和荆州市3个地区共12家基层卫生机构,其中,城市社区卫生服务中心和农村乡镇卫生院各6家,对408名医务人员进行满意度问卷调查。结果湖北省基层卫生服务机构员工的总体工作满意度评分为65.99分,程度为一般满意,其中,城市总满意度为64.66分,农村总满意度为66.05分;各个维度中,员工对个人胜任(72.79分)和人际关系(70.92分)满意度最高,而对薪资(37.01分)和工作强度(43.69分)满意度最低。根据logis-tic回归分析结果可见,工作环境、技术水平、工作回报和职业发展均对工作满意度有较大程度的影响。结论湖北省城乡基层卫生服务机构工作人员工作满意度水平一般,需要进一步重视基层卫生机构职工的工作回报和职业发展。     

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.     

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.