医护人员工作满意度与组织承诺关系研究

目的了解医护人员工作满意度和组织承诺现状并探讨两者之间关系。方法采用工作满意度量表和组织承诺量表对150名山东省潍坊市3所医院医护人员进行调查。结果医护人员的总体工作满意度和组织承诺均处于中等略偏上水平；相关分析表明，工作满意度总体及各维度与组织承诺均显著正相关；回归分析表明，工作关系、晋升、单位经营管理满意度对组织承诺具有显著的正向预测作用，同时发现工作环境满意度对价值承诺：年口努力承诺具有负向预测作用。结论医护人员工作满意度与组织承诺具有显著相关。     

小学生学习压力与心理健康的关系研究

为了探讨小学生学习压力与心理健康的关系,研究采用中小学生学习压力调查问卷与心理健康诊断测验(MHT),对240名4～6年级小学生进行调查。结果表明,小学生存在较大的学习压力,其中自身期望和社会压力水平较高。不同性别小学生在社会压力方面,男生高于女生。六年级小学生的考试压力高于四、五年级小学生。小学生的心理健康状况欠佳,心理健康总分检出率为14.6%。不同年级小学生在过敏倾向和冲动倾向上差异都有统计学意义(P=0.05)。小学生的学习压力与心理健康呈正相关,且小学生的学习压力与心理健康是相互预测、相互影响的。     

医学生自我宽恕与心理健康的相关研究

研究医学生的心理健康及其自我宽恕现状。了解影响医学生自我宽恕的因素。探索医学生自我宽恕与心理健康的相关性。方法:使用分层随机抽样法抽取300名医学生作为被试,发放症状自评量表及自我宽恕倾向量表进行测量。采用相关分析及回归分析法进行数据分析。结果显示:(1)医学生自我宽恕水平在性别上差异有统计学意义,在年级上有部分维度差异有统计学意义,在是否独生子女和生源地上差异无统计学意义;(2)医学生心理健康水平与自我宽恕水平存在显著相关。医学生心理健康与自我宽恕呈正相关。医学生自我宽恕水平在一定程度上能预测其心理健康水平。     

Facilitating culture-centered communication between health care providers and veterans transitioning from military deployment to civilian life

Objective

To describe returning veterans’ transition experience from military to civilian life and to educate health care providers about culture-centered communication that promotes readjustment to civilian life.

Methods

Qualitative, in-depth, semi-structured interviews with 17 male and 14 female Iraq and Afghanistan veterans were audio recorded, transcribed verbatim, and analyzed using Grounded Practical Theory.

Results

Veterans described disorientation when returning to civilian life after deployment. Veterans’ experiences resulted from an underlying tension between military and civilian identities consistent with reverse culture shock. Participants described challenges and strategies for managing readjustment stress across three domains: intrapersonal, professional/educational, and interpersonal.

Conclusions

To provide patient-centered care to returning Iraq and Afghanistan veterans, health care providers must be attuned to medical, psychological, and social challenges of the readjustment experience, including reverse culture shock. Culture-centered communication may help veterans integrate positive aspects of military and civilian identities, which may promote full reintegration into civilian life.

Practice implications

Health care providers may promote culture-centered interactions by asking veterans to reflect about their readjustment experiences. By actively eliciting challenges and helping veterans’ to identify possible solutions, health care providers may help veterans integrate military and civilian identities through an increased therapeutic alliance and social support throughout the readjustment process.     

Diabetes self-management: perspectives of Latino patients and their health care providers

Lifestyle modification programs tailored to experience, culture, psychosocial characteristics, and world-view can improve knowledge, self-care behaviors, and glucose control among Latinos with diabetes. Few data exist, however, on improving diabetes self-management among Latinos. In addition, views and practices of practitioners caring for these patients have received little attention. OBJECTIVE: This study describes findings from qualitative research to inform the refinement of self-management interventions tailored to Latino patients with type 2 diabetes. METHODS: Two practitioner focus groups assessed perceptions of patients' knowledge, attitudes, and behaviors. Four patient focus groups examined knowledge, beliefs, practices, barriers, and facilitators. Data were transcribed and subjected to content analysis. RESULTS: Thirty-seven patients seeking care at a community clinic participated, along with 15 health care practitioners. Important knowledge gaps regarding diabetes causation and self-management were identified. Negative attitudes towards self-management were common among patients. Key facilitators included strong religious faith and support of medical practitioners. Families both facilitated and prevented adoption of self-management practices. CONCLUSION: This study provides unique insights into the knowledge, attitudes, practices, and perceived barriers facing Latino patients and their providers regarding diabetes self-management. PRACTICE IMPLICATIONS: Study findings underscore the need to develop tailored programs for this population and to train practitioners on their implementation.     

Evaluation of a communication skills seminar for students in a Japanese medical school: a non-randomized controlled study

Background  

Little data exist for the effectiveness of communication skills teaching for medical students in non-English speaking countries. We conducted a non-randomized controlled study to examine if a short intensive seminar for Japanese medical students had any impact on communication skills with patients.     

Cross-border alliances in health care: international co-operation between health insurers and providers in the Euregio Meuse-Rhine

On behalf of the European Commission, a Cross-Border Health Care Project was undertaken to explore how citizens living in the Euregio Meuse-Rhine can obtain improved access to health services in the Member States concerned: Belgium, Germany, and The Netherlands. Main attention of the project is focused on practical issues of cross-border health care. The first results have shown that the new cross-border health alliances resulted in improved possibilities for patients to access more health care facilities than before. The creation of health care alliances could also be an example for future collaboration between the countries in Western, Central, and Eastern Europe. This paper also analyses the rights of patients on cross-border care in the Euregion.     

A longitudinal study of the relationship between support reciprocity and mental health among elementary and high school students

At both the beginning and the end of a school year, 124 sixth-year elementary school students and 242 first-year high school students completed questionnaires regarding mutual support in friendships and stress responses. For elementary school students, support reciprocity did not correlate significantly with stress responses at either the beginning or end of the school year. For high school students, support reciprocity related significantly to stress responses at the end of the year but not at the beginning. These results suggest that the relationship between support reciprocity and mental health is influenced by the developing relationship between two people as well as the state of each individual's development at the time of mutual support.     

Communication between patients,peers, and care providers through a mobile health intervention supporting medication-assisted treatment for opioid use disorder

IntroductionOur team developed the HOPE app as a clinic-based platform to support patients receiving medication assisted treatment (MAT) for opioid use disorder. We investigated the app’s two communication features: an anonymous community message board (CMB) and secure messaging between patients and their clinic team.MethodsThe HOPE (Heal Overcome Persist Endure) app was piloted with patients and MAT providers. Text from the CMB and messaging were downloaded and de-identified. Content analysis was performed using iteratively developed codebooks with team consensus.ResultsThe pilot study enrolled 28 participants; 25 were “members” (patients) and 3 were providers (physician, nurse, social worker). Of member-generated CMB posts, 45% described the poster’s state of mind, including positive and negative emotions, 47% conveyed support and 8% asked for support. Members’ secure messages to the team included 52% medical, 45% app-related, and 8% social topics. Provider’s messages contained information exchange (90%) and relationship-building (36%).DiscussionThrough the CMB, members shared emotions and social support with their peers. Through secure messaging, members addressed medical and social needs with their care team, used primarily for information exchange but also relationship-building.Practice implicationsThe HOPE app addresses communication needs for patients in MAT and can support them in recovery.     

Russian-American health care: bridging the communication gap between physicians and patients

OBJECTIVES: The objectives of this article are two-fold: (1) to gather in one place reliable information about Russian-Americans' past medical practices and their current outlook on health care and to provide health care professionals with an overview of the major afflictions suffered by this ethnic group; and (2) to educate Russian-speaking patients about the American heath care system and social services geared towards immigrants by locating and evaluating free, culturally appropriate patient education Web sites available in Russian. METHODS: In order to draw data on specific diseases and conditions affecting the Russian-speaking population, the author searched various scholarly health-related electronic databases. A number of well-established U.S. government consumer-health Web sites were searched to locate patient education resources that can be utilized by recent Russian immigrants. RESULTS: The author provides an overview of the major health problems encountered by the Russian-speaking population before emigration and potential health concerns for Russian immigrant communities. In addition, the author provides a scholarly exploration of patient education materials available in Russian. CONCLUSION: In this increasingly diverse society, physicians are faced with the challenge of providing culturally sensitive health care. Multicultural Web-based health resources can serve as a valuable tool for reducing communication barriers between patients and health care providers, thus improving the delivery of quality health care services. Recommendations for further research are indicated. PRACTICE IMPLICATIONS: The author offers recommendations for practitioners serving Russian-speaking immigrants. Suggestions on utilization of Web resources are also provided.     

Universal health care and reform of the health care system: views of medical students in the United States.

PURPOSE: Nearly 46 million Americans did not have health insurance in 2004. Recent studies have documented physicians' support for various remedies, including universal health care. The authors undertook this study to assess medical students' views on these topics. METHOD: In 2002, the authors surveyed a national random sample of first-year and fourth-year medical students (from the American Medical Association Masterfile) to determine their views about health care reform options, including universal health care. Response data were weighted and compared using chi-squared tests; statistical significance was set at p < or = .05. RESULTS: Of 1,363 medical students, 770 completed the questionnaire (response rate = 56.5%). In rating the importance of several health care issues, more than 80% of both first-year and fourth-year students rated the expansion of health care coverage as important. Nearly all first-year (90%) and fourth-year (88%) students agreed with the statement, "Everyone is entitled to adequate medical care regardless of ability to pay." Most students favored health care reform that would achieve universal health care, with first-year students (70%) somewhat more likely than fourth-year students (61%) to support universal health care (p = .012). Students were less likely to believe that physicians support universal health care, and more likely to believe that the public does. CONCLUSIONS: Both groups of students generally support the expansion of health coverage to the uninsured and some form of universal health care. This may be relevant both to policymakers in their considerations of health care reform and to medical educators concerned with teaching students about health policy issues.     

The relationship between residents' characteristics, their stress experiences, and their psychosocial adjustment at one medical school

Empirical research focused on the stressful aspects of residency training has largely ignored the interactions between residents' psychosocial and demographic characteristics, stressful experiences, emotional responsivity, and coping styles. This article presents the results of a questionnaire, completed by 165 residents, that consisted of the Profile of Mood States, the Hassles Scale, the Ways of Coping Questionnaire, and a series of questions regarding demographic data, social support system features, and residency stress factors. The residents reported that time demands and indebtedness were the major sources of stress in their residency programs. Social support variables were significantly related to the degrees to which the residents successfully coped with daily stress factors. While the women residents reported higher stress levels than did the men, they did not report higher levels of emotional distress. Finally, the lengths of time residents had spent in training were significantly related to the levels of their mood disturbances and daily hassles.     

Use of seven types of medical jargon by male and female primary care providers at a university health center

ObjectivesThe purposes of this study were to investigate extent and type of jargon use among primary care providers at a university health center, to evaluate the association of jargon use with patient outcomes, and to identify differences in jargon use between male and female providers.MethodThe study employed a causal comparative design. Audio recordings of 87 primary care interviews were transcribed and coded using Pitt and Hendrickson's seven-category medical jargon classification framework.ResultsNearly 80% of appointments included at least one instance of unexplained jargon, with an average of more than four uses of jargon per visit. The most frequently used types of jargon were technical terminology and medical vernacular. Acronyms and abbreviations, medicalized English, and unnecessary synonyms were also regularly used. Just under half of distinct jargon terms were explained. Male providers used nearly 50% more jargon per minute than female providers, and they used more technical jargon than did their female colleagues. However, they explained that jargon just as frequently as female providers.ConclusionsWhereas previous studies have frequently limited the operational definition of jargon to two or three types, the comprehensive typology proposed by Pitt and Hendrickson provides a useful tool for identifying a wide range of jargon usage. Future research should examine the outcomes of this range of jargon types in more varied, less educated patient populations, and across different types of healthcare providers.Practice implicationsWith jargon used on average more than once every four minutes in our sample, and only half of jargon terms explained, medical jargon may be more of a problem even in primary care contexts than providers themselves realize. Male providers especially may want to make efforts to become more conscious of their jargon use and take care to explain terms, in an effort to facilitate more effective patient-provider communication and improved patient outcomes.     

Enhancing palliative care education in medical school curricula: implementation of the palliative education assessment tool.

The authors report the results of a Robert Wood Johnson Foundation-funded project that catalyzed New York State medical schools to develop and implement strategic plans for curricular change to enhance palliative care education. The project used the Palliative Education Assessment Tool for curricular mapping of palliative care education throughout each school's four-year curriculum and used site visits to facilitate strategic planning within each institution. Of the 14 New York State medical schools, 13 participated in the project. Ten provided strategic plans for change, with a total of 71 specific goals (median = 5 per school). Of these goals, 67 (94.4%) had been implemented or were in the active-planning process one year after the plans were created. Overall, palliative care content was enhanced in four curricular areas: basic science courses, ethics and humanities courses, clerkship rotations, and faculty development in palliative care. The process of self-assessment, curriculum mapping of a specific thematic area, and strategic planning for change appears to have successfully enhanced the palliative care content in the medical schools' curricula.     

A possible relationship between figure drawing data collected in medical school and later health status among physicians

Figure drawings obtained while subjects were in medical school were scored using two different scales: (a) Sophistication-of-Body-Concept, a scoring system that measures the overall quality of the drawings; and (b) Conventionality/deviancy of the drawings, as determined by the relative frequency with which 42 different characteristics occurred in the total sample of drawings. Figure drawings were obtained from 1951 to 1964. As of 1984, subjects were classified into 1 of 11 health outcome (disease) categories plus a "healthy" category. Statistical analysis included one-way analyses of variance and multiple logistic regression in which age and cigarette consumption were controlled. Several statistically significant differences among groups were noted with respect to Conventionality/deviancy, but not with respect to Sophistication-of-Body-Concept.