高校医护人员职业倦怠调查情况分析

目的 调查重庆市高校医护人员职业倦怠现状,为高校管理者采取有效措施预防和降低医护人员职业倦怠以及提高医疗质量提供参考。方法 采用问卷调查的方式对重庆市672名高校医护人员进行调查,数据用spss12．0统计软件进行统计。结果医护人员在职业倦怠3个维度情感耗竭、情感疏远、个人成就感降低得分分别为（15．43±7．13）分,（15．80±8．21）分,（35．59±9．39）分,职业、性别、职称、工作年限在职业倦怠3个维度的差异均无统计学意义（p〉0．05）。结论 重庆市高校医护人员职业倦怠程度轻,职业、性别、职称、工作年限对职业倦怠无影响。     

重庆市高校医护人员工作压力与工作倦怠的相关研究

目的 了解重庆市高校医护人员工作压力和职业倦怠现状,探讨工作压力与职业倦怠的相互关系.方法 采用单维度工作压力量表和马斯勒职业倦怠量表,对重庆市高校医院(卫生科)的医护人员536名进行问卷调查.结果 医护人员职业倦怠量表中情感耗竭、去人性化、个人成就感降低3个维度的得分分别为(15.43±7.13),(15.80±8.21),(35.59±9.39)分;53.6%的被试压力轻微,28.0%的被试压力较大;工作压力与职业倦怠的3个维度(情感耗竭、去人性化、个人成就感降低)相关系数分别为0.523(P＜0.01),0.341(P＜0.01),0.020(P＞0.05).结论 工作压力与职业倦怠的情感耗竭、去人性化2个维度呈正相关,尤其是工作压力可以很好地预测情感耗竭.     

庆阳市医务人员职业紧张现状调查

目的了解甘肃省庆阳市医务人员职业紧张状况及其影响因素,为缓解医务人员职业紧张,改善职业健康提供科学依据。方法应用职业紧张通用量表(MBI-GS),采用便利抽样方法,对庆阳市七县一区的市、县、乡级医院的医务人员进行调查,应用SPSS 19.0统计软件对数据进行分析。结果共调查18所医疗机构,收集有效问卷494份。494名医务人员中有443名(89.68%)医务人员有职业倦怠,245名(49.60%)有中度及以上职业倦怠,处于较严重水平。3个维度的均分:情绪衰竭(12.65±8.13)分,玩世不恭(6.86±6.09)分,成就感低落(22.48±9.03)分。工作年限≤5年的医务人员情绪衰竭得分低于5～10年组,差异均有统计学意义(P0.05);工作年限≤5年组的医务人员玩世不恭得分均低于5～10年、10～15年组,差异有统计学意义(均P0.05)。文化程度为硕士及以上的医务人员成就感低落得分低于本科、大专及以下人员,差异有统计学意义(P0.05)。职称为正高的医务人员成就感低落得分均高于副高、中级及初级组,差异有统计学意义(P0.05)。不同性别、职业、婚姻状况医务人员在情绪衰竭、玩世不恭、成就感低落3个维度的得分比较,差异均无统计学意义(均P0.05)。结论甘肃省庆阳市医务人员职业紧张情况较严重,管理部门可针对工作年限久、学历水平高、职称低的医务人员采取针对性的干预措施,缓解医务人员职业压力,保护医务人员职业健康,提高医疗服务水平。     

广西从事艾滋病工作医护人员职业倦怠现状及影响因素分析

目的了解广西从事艾滋病工作医护人员职业倦怠的现状及其影响因素,为职业倦怠的防控提供科学依据。方法2019年1月11日—3月14日,从广西区内艾滋病抗病毒治疗定点医疗机构的工作交流微信群中招募324名医护人员作为调查对象,通过微信网络平台发放自制的电子问卷,以网上自填方式进行基本情况和职业倦怠量情况的调查,采用SPSS 23.0软件进行统计分析,单因素分析采用t检验、方差分析和非参数检验,多因素分析采用有序logistic回归模型分析。结果共收集到问卷324份,其中有效问卷324份,有效率为100.00%。在324名调查对象中,99.07%的医护人员出现职业倦怠,其中16.67%为轻度职业倦怠,37.35%为中度职业倦怠,45.06%为重度职业倦怠。情绪耗竭维度得分为(28.93±10.86)分,人格解体维度得分中位数为13.5分,个人成就感降低维度得分(34.60±8.46)分。多因素有序logistic回归模型分析结果显示,与30岁以下医护人员相比,40岁以上和30～40岁者职业倦怠发生的可能性分别是0.28倍和0.47倍,为保护因素;与从事艾滋病相关工作年限3年以下医护人员相比,工作5年以上和3～5年者职业倦怠发生的可能性分别是3.08倍和2.34倍,为危险因素。结论广西从事艾滋病工作医护人员职业倦怠现象较为普遍,应重点关注低龄组和从事艾滋病工作年限长者,可通过提供情感支持、心理健康培训和提高工作待遇等方式应对职业倦怠的发生。     

护理人员工作场所欺凌现状及与职业倦怠和职业抱负的相关性

目的了解护理人员工作场所欺凌现状,并分析其与职业倦怠及职业抱负之间的相关性。方法采用便利抽样法,2018年3—8月,选取恩施土家族苗族自治州中心医院168名护理人员作为调查对象,采用自行设计的一般资料调查表收集护理人员的基本情况;分别采用负性行为问卷、工作倦怠量表和职业抱负量表调查护理人员的工作场所欺凌、工作倦怠和职业抱负情况。结果 168名护理人员负性行为得分为36.89±8.54,其中未受欺凌者89名(52.98%),遭受欺凌者71名(42.26%),遭受严重欺凌者8名(4.76%);不同性别、工作年限、学历、职称和聘用类型的护理人员的负性行为得分比较差异均有统计学意义(均P0.05);168名护理人员职业倦怠情感衰竭维度得分为11.32±4.03,去个性化维度得分为6.64±2.01,个人成就感降低维度得分为14.02±5.06,职业抱负得分为18.50±4.90,遭遇不同欺凌程度护理人员的职业倦怠得分及职业抱负得分比较差异有统计学意义(P0.05);护理人员的工作场所欺凌得分与职业倦怠及职业抱负得分呈显著相关性(P0.05)。结论护理人员遭受工作场所欺凌情况较为普遍,工作场所欺凌会对职业倦怠和职业抱负产生影响,可以通过减少工作场所欺凌来降低护理人员的职业倦怠情况并提高护理人员的职业抱负水平。     

武汉市护理人员职业嵌入评估及其影响因素

目的研究武汉市护理人员职业嵌入水平现状,并探讨其影响因素,以期为减少护理人员流失提供参考依据。方法于2015年3—9月对武汉市3所综合性医院共264名护理人员进行问卷调查。采用一般资料问卷、职业嵌入量表以及留职意愿量表,调查护理人员的一般情况、职业嵌入以及留职意愿现状。结果 264名护理人员职业匹配、联结、牺牲3个维度平均得分分别为(22.73±2.97)、(20.70±2.96)、(15.59±3.81)分,职业嵌入总得分为(59.02±8.00)分;不同性别、年龄、学历、职称、聘用方式、婚姻状况、工作性质、工作年限的护理人员职业嵌入各维度得分以及职业嵌入总分,差异均有统计学意义,(均P0.01);264名护理人员留职意愿总均分为(17.33±3.21)分,留职意愿得分与匹配、联结、牺牲以及职业嵌入总分均呈正相关性(P0.05);同时,年龄、职称、聘用方式为职业嵌入的保护性因素,婚姻状况、工作性质以及工作年限为职业嵌入的危险性因素,差异有统计学意义(P0.05)。结论临床一线护理管理者应该重视对护理人员职业嵌入水平的评估,通过提高护理人员对职业的认可度,加强同行间的联系,提升护理人员的职业价值,从而提高护理人员的职业嵌入水平。     

区级精神卫生中心医护人员职业倦怠情况探讨

目的:探讨区级精神卫生中心医护人员的职业倦怠情况及相关因素.方法:采用马斯勒职业倦怠量表(Maslach Burnout Inventory,MBI)及一般情况问卷为评定工具,对114名区级精神卫生中心医护人员进行了调查,建立数据库并进行统计分析.结果:在倦怠的3个维度中,未婚医务人员低成就感维度分数显著高于已婚医务人员;不同职称之间低成就感维度差异具有显著性,其中,初级职称分数最高,倦怠程度最强;不同工作年限医护人员之间情绪衰竭维度中差异具有显著性,其中工作年限为5～9年及20～29年组别分数最高,倦怠程度最强.结论:区级精神卫生中心医护人员在职业倦怠项目上存在不同维度的职业倦怠,应建立健全相关管理体制,使医护人员有良好的心境投入工作,提高医疗质量.     

重庆市三甲医院肿瘤科护理人员心理资本与职业倦怠和离职意愿的关系

目的调查三甲医院肿瘤科护理人员心理资本与职业倦怠和离职意愿的相关性。方法采用便利抽样法对重庆市三甲医院192名肿瘤科护理人员进行调查,采用心理资本调查问卷、职业倦怠量表和离职意愿调查问卷,进行t检验、方差分析和Pearson相关分析。结果不同年龄、职称、学历、婚姻状况、工作年限的肿瘤科护理人员心理资本、职业倦怠和离职意愿得分分别为4.62±0.66、12.23±8.62和2.68±0.96,差异有统计学意义(P0.05)。其中心理资本各维度由高到低得分依次是自我效能维度、希望维度、乐观维度和韧性维度。心理资本各维度得分与职业倦怠和离职意愿呈负相关(P0.05)。结论医院管理者应重视护理人员心理资本的培养,关注护理人员身心健康,有效预防职业倦怠和离职意愿的产生,减少人才流失。     

咸阳市护士职业倦怠与职业稳定性现状调查

目的调查陕西省咸阳市护士职业倦怠和职业稳定性现状,探讨职业倦怠与职业稳定性之间的关系。方法采用分层抽样和整群抽样法,于2017年6—9月选择咸阳市8家二级以上医院共1 163名护士作为调查对象,通过问卷调查了解其职业倦怠和职业稳定性的现状及其关系。结果咸阳市护士职业倦怠发生率为66.72%,其中成就感降低最严重,评分为22.41±6.15;职业稳定性评分为15.60±3.41,其中辞去目前工作的可能性评分为5.54±1.59,获得外部工作的可能性评分为5.40±1.54,寻找其他工作的动机评分为4.65±1.21。男性、年龄≥35岁、本科和离异护士的职业倦怠各维度评分较高,而女性、年龄25～29岁、硕士、离异和丧偶护士职业稳定性各维度评分较低。不同科室和岗位的护士在情感耗竭、人格解体、离职意愿Ⅰ和Ⅱ比较,差异均有统计学意义(均P0.05),不同工龄、职称护士在职业倦怠各维度和离职意愿Ⅲ方面比较差异有统计学意义(均P0.05)。职业倦怠和职业稳定性呈负相关(r=-0.209,P0.05)。多元回归分析结果显示,对职业稳定性的影响作用从大到小依次是情感耗竭、人格解体和成就感降低。结论咸阳市护士职业倦怠较严重,职业倦怠与职业稳定性呈显著负相关,其中寻找其他工作的可能性较大。对职业稳定性的影响作用从大到小依次是情感耗竭、人格解体和成就感降低。     

三峡库区基层公卫服务人员职业倦怠状况分析及对策建议

目的了解地处三峡库区的重庆市万州区基层医疗机构从事基本公共卫生服务人员职业倦怠状况,探讨其职业倦怠影响因素,减轻其职业倦怠状况,让其更好地为广大居民健康服务。方法采用普查的方式,自编一般人口学资料问卷及李超平翻译并修订的国际通用职业倦怠普适量表(Maslach Burn-out Inventory-general Survey,MBI-GS)对重庆市万州区1 266名基本公共卫生服务人员的职业倦怠情况进行问卷调查。结果万州区基层医疗机构基本公共卫生服务人员情绪衰竭维度平均得分(1.51±1.39)分,玩世不恭维度平均得分(1.03±1.21)分,成就感低落维度平均得分(3.70±1.94)分;各个维度中、高度倦怠程度比例分别为32.0%、19.3%、48.2%。结论基层医疗机构从事基本公共卫生服务人员在情绪衰竭、成就感低落2维度比较严重,职业倦怠现象明显存在,其中性别、工作地点、学历、职称、薪酬等是其职业倦怠的主要影响因素。     

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.