医生角色认知刻板印象测量工具的编制及评价研究

目的 研制医生角色认知刻板印象测量工具。方法 运用半结构式访谈、自由反应法及特征词赋值形成医生角色认知刻板印象初始问卷。采用配额抽样抽取医生、护士、患者及公众共1 614名,应用医生角色认知刻板印象初始问卷及一般资料问卷进行调查,经典型特征筛选、项目分析及探索性因素分析,最终形成医生角色认知刻板印象测量工具。结果 探索性因素分析析出3个因子（职业形象定位、职业自律性、职业素养）、24个特征词,3个因子累积解释总方差63.841%,内部一致性系数0.959,折半信度0.922。结论 医生角色认知刻板印象测量工具具有较好的信效度,可用于测量我国不同地域、不同群体对医生角色认知刻板印象现状。     

大学生安全意识问卷编制北大核心

目的编制大学生安全意识问卷,并检验其信效度。方法采用问卷调查的方法,共施测1800名大学生,通过探索性因素分析和验证性因素分析对问卷的结构进行探索,对信效度进行检验。结果大学生安全意识问卷由3个因子构成,分别为安全认知监测、安全认知体验和安全认知知识,可解释总变异的58.06%。验证性因素分析结果显示,内部一致性系数在0.81~0.93之间,重测信度在0.74~0.81之间,问卷模型各项拟合指数良好(χ2/df=4.27,NNFI=0.91,NFI=0.91,GFI=0.92,CFI=0.92,RMSEA=0.074),各因子之间相关系数在0.65~0.94之间。结论大学生安全意识问卷具有良好的信效度,可以作为考察大学生安全意识的测量工具。     

大学生安全意识问卷编制

目的编制大学生安全意识问卷,并检验其信效度。方法采用问卷调查的方法,共施测1800名大学生,通过探索性因素分析和验证性因素分析对问卷的结构进行探索,对信效度进行检验。结果大学生安全意识问卷由3个因子构成,分别为安全认知监测、安全认知体验和安全认知知识,可解释总变异的58.06%。验证性因素分析结果显示,内部一致性系数在0.81~0.93之间,重测信度在0.74~0.81之间,问卷模型各项拟合指数良好(χ2/df=4.27,NNFI=0.91,NFI=0.91,GFI=0.92,CFI=0.92,RMSEA=0.074),各因子之间相关系数在0.65~0.94之间。结论大学生安全意识问卷具有良好的信效度,可以作为考察大学生安全意识的测量工具。     

新医改后患者满意度问卷初步编制及信、效度评价

目的初步编制新医改后患者满意度问卷,并评价其信度和效度,为患者对新医改后就医满意情况提供有效测量工具。方法在文献资料分析法、访谈法和问卷调查法的基础上初步确定新医改后患者满意度问卷的理论结构,运用德尔菲专家咨询、探索性因子分析和信、效度检验方法对广东省广州市3家二级及以上公立医院和6家社区卫生服务中心随机抽取的258例就诊患者对新医改后就医满意情况进行了分析,验证理论结构的合理性和正确性。结果通过项目分析和探索性因子分析,确定新医改后患者满意度问卷由公立医院改革、基本医疗保险、药物使用情况、医疗卫生行业监管和组织、中医药推广5个维度共23个条目组成,累积贡献率为83.223%;总量表Cronbach'sα系数为0.98,5个维度的Cronbach'sα系数分别为0.93、0.88、0.86、0.86、0.83,各维度与总量表的相关系数为0.881~0.937(均P0.01),该问卷具有较好的信度和效度。结论初步编制的新医改后患者满意度问卷具有良好的信、效度和可行性,可作为新医改后患者满意度的有效测量工具。     

中学生心理健康态度量表编制

目的编制适合于中学生的心理健康态度量表,为有关心理测量提供工具。方法在理论分析、开放式调查以及理论建构的基础上,编制中学生心理健康态度量表初始问卷,然后在因素分析基础上构建量表的基本维度,并进行信效度检验。结果探索性因素分析表明,中学生心理健康态度量表由认知偏差、情感支持、知识需求、寻求帮助4个维度构成,具有良好的信度和效度。结论中学生心理健康态度量表可作为测评中学生心理健康态度的有效工具。     

慢性肾脏病知信行调查问卷的研制及信、效度检验

目的研制适用于慢性肾脏病患者及高危人群的知信行问卷,检测其信、效度。方法以文献翻阅、专家咨询、患者讨论为基础初步编制慢性肾脏病知信行问卷;采用便利抽样法抽取上海闵行H社区卫生服务中心就诊的100名慢性肾脏病患者进行问卷调查;采用Cronbach'sα系数、分半信度进行信度检测,采用内容效度、探索因子检验问卷效度。结果本问卷包含认知、信念、行为3个子问卷,问卷共30个条目,每个子问卷各有10个条目。问卷内部一致性信度为0.849,各子问卷的内部一致性信度分别为0.805、0.833和0.909,各子问卷的内容效度系数分别为0.876、0.818和0.922。对全问卷及各子问卷进行因子分析,累积贡献率分别为65.50%、56.38%、69.29%和71.71%,每个项目的共性方差均超过0.4。结论慢性肾脏病知信行调查问卷具有良好的信、效度,可作为评鉴慢性肾脏病患者及高危人群认知、信念、行为状况的可靠工具。     

肿瘤科护士共享决策知信行问卷的编制及信效度检验

目的 编制肿瘤科护士共享决策知识、态度和行为的调查问卷,并检验其信效度。 方法 以知信行理论为指导,通过文献回顾、质性访谈、两轮德尔菲法专家函询确定问卷条目,调查河南省郑州市4所三级综合医院257名肿瘤科护士分析信效度以确定问卷条目。 结果 最终形成共24个条目的问卷,其中知识维度11个条目,态度维度6个条目,行为维度7个条目;问卷探索性因子分析共产生3个因子,累计方差贡献率为57.657%,各条目的内容效度(I-CVI)在0.857～1.000之间,问卷平均内容效度(S－CVI)为0.929,问卷Cronbach’s α系数为0.941,重测信度为0.894。 结论 编制的问卷具有良好信效度,可作为评价肿瘤科护士共享决策知信行现状的研究工具。     

新毕业护士角色转换压力问卷的编制及其信效度的研究

目的编制适用于我国大陆地区新毕业护士角色转换压力问卷并检验其信效度。方法依据Karasek的"工作负荷-控制-支持"理论,综合对8名新毕业护士的访谈结果,以及现有相关评价工具拟定条目池,通过专家咨询、预调查形成问卷初稿。对296位新毕业护士进行调查,测定问卷信效度。结果适用于大陆地区新毕业护士角色转换压力问卷共包括35个条目,探索性因子分析共产生4个公因子,方差累计贡献率为45.157%。总问卷的Cronbach'sα系数为0.894、分半信度系数为0.729、重测信度系数为0.875、内容效度比为0.954。结论本研究所编制的新毕业护士角色转换压力问卷具有较好的信效度,符合心理学测量要求,可作为量性测评我国大陆地区新毕业护士角色转换压力的工具。     

上海市黄浦区成人基本医疗健康素养监测问卷编制及信效度分析

目的 通过自编问卷检验问卷测量性能,为了解黄浦区居民基本医疗健康素养水平提供测量工具。 方法 根据构建的黄浦区基本医疗健康素养评估指标体系设计初始评估问卷(57题),采用方便抽样方法抽取社区居民200人开展预测试;通过项目分析筛除冗余题项,形成基本医疗素养评估问卷(38题)。应用问卷对上述200位社区居民施测,并抽取50名两周后复测,分析问卷的信效度;方便抽取黄浦区某二级医院医护人员100人、社区慢性病患者50人施测,分析区分效度。应用SPSS 17.0进行项目难度、区分度分析及信效度分析。Cronbach’s α系数、Guttman分半系数和组内相关系数ICC值用以测量信度;利用内容效度、结构效度和区分效度分析检验效度。 结果 通过项目分析,共剔除22个条目,结合专家意见和专业知识,增加3条,最终38个条目进入指标体系终稿,形成“黄浦区成人基本医疗健康素养监测项目评估问卷”。全问卷的Cronbach’s α系数为0.709,重测信度为0.994;一级指标得分与总分的相关系数为0.728和0.643,2个一级指标间得分相关系数为0.213。 结论 本研究问卷针对城市居民基本医疗素养的测量而设计,是评估居民基本医疗素养的有效工具,丰富了国内基本医疗素养调查的内容,具有较好的信度、效度,对开展居民基本医疗素养的评估及干预措施有理论和实践上的指导意义。     

大学生父亲依恋理论构建及问卷的初步编制

目的 编制针对大学生群体的父亲依恋问卷,并检验其信、效度,为大学生父亲依恋的研究提供量化工具.方法 在文献综述、开放式调查、专家咨询等基础上构建问卷,以Cronbach＇ sα系数检验问卷的信度,以内容效度和结构效度检验问卷的效度.结果 问卷由26个项目组成,包括依赖、独立、沟通、牵挂、支持、观念6个维度,共解释方差的60.422％.总问卷的Cronbach＇ s d系数为0.854,6个维度的Cronbach＇ sα系数分别为0.856,0.763,0.788,0.749,0.715,0.686,验证性因素分析结果支持6因素模型.结论 编制的大学生父亲依恋问卷具有良好的信度和效度,可以为进一步研究提供依据与基础.     

THE STATUS OF RURAL NURSING IN AUSTRALIA: A REVIEW

ABSTRACT: While much has been written about the practice roles of remote area nurses in Australia, less is known about the role and function of the rural nurse. The majority of rural nurses practise in rural hospitals, community health settings and nursing homes. In contrast, the remote area nurses work setting is generally involved with Aboriginal and Torres Strait Islander primary health care services. Rural nurses' practice setting is usually located in a larger organisation than that of the remote area nurse. There is usually at least one medical practitioner in the town or on-call close by. Nurses who are employed in the smaller rural hospitals have what has been described as a 'specialist generalist' role. This means that they are required to be multi-skilled and competent in a wide range of nursing and non-nursing practice. In contrast, nurses who work in base/provincial hospitals, may have either a generalist or specialist role. This paper provides a summary of the literature on Australian rural nurses and develops some of the themes contained therein.     

Role Involvement and Well-Being in Middle-Aged Women

ABSTRACT

Objectives: The aim of this research was to shed light on the relation of social role experiences and health to well-being outcomes of 198 middle-aged (40–55 years old) Swiss women living in various familial contexts (double-track women, i.e., partnered working mothers, homemakers, single mothers, single women).

Results: Our results revealed that the way roles were experienced was primarily a function of a specific living context and satisfying social resources. Double-track women and homemakers showed the highest social role satisfaction rates and had better health and well-being outcomes than other women. Common to all groups was a considerable difference between actual and desired role investment.

Discussion: The findings are discussed in terms of a resource-oriented model of well-being.     

Female labor force participation and suicide

To test the role conflict and role enhancement hypotheses, this paper examines the link between female labor force participation and suicide. Using a special tabulation of age/sex-specific suicide data for metropolitan areas in the United States, we estimate separate multivariate regression models for women and men in 1970 and 1980. Our findings show that in 1970 the level of female labor force participation among married women with small children is not related to the female suicide rate but is related to the male suicide rate in a positive direction. By 1980 the relationship between female labor force participation and the male and female suicide rate is negative, suggesting that the well-being of both men and women is enhanced by role accumulation among women.     

Rural generalist nurses' perceptions of the effectiveness of their therapeutic interventions for patients with mental illness

OBJECTIVE: To explore generalist nurses' perceptions of their efficacy in caring for mentally ill clients in rural and remote settings, and their educational needs in the area of mental health care. DESIGN: A self-administered questionnaire adapted from the Mental Health Problems Perception Questionnaire; a Likert scale used to rate the perceptions of nursing staff of their own ability to adequately treat and care for patients experiencing mental illness. Setting: The Roma and Charleville Health Service Districts, Queensland, Australia. SUBJECTS: Nurses (Registered Nurses, Assistants in Nursing and Enrolled Nurses) in the Roma and Charleville health service districts (n = 163). MAIN OUTCOME MEASURES: Generalist nurses' perceptions regarding their therapeutic commitment, role competency and role support. Results: Seventy per cent of respondents indicated that limited knowledge of mental health problems was an issue preventing nursing staff in rural and remote settings from providing optimum care to patients with mental illness. Twenty-nine per cent of respondents indicated that they had never received or undertaken training or education in relation to the care, treatment or assessment of patients with mental illness. CONCLUSION: Rural nurses do not feel competent, nor adequately supported, to deal with patients with mental health problems. In addition, the nurses' education and ongoing training do not adequately prepare them for this sphere.     

The Use of Activities in the Treatment and Rehabilitation of Psychiatric Patients: An Overview

Activities have always been basic to the professional nature of occupational therapy. However, occupational therapists have, on the one hand, been criticized for over-valuing the media they use and, on the other hand, for discarding the use of activities and therefore discarding their professional essence. In an attempt to highlight the importance of “doing” in therapy, an overview of activities from a number of perspectives is presented, together with the contribution that activities make in the treatment and rehabilitation of psychiatric patients. The importance of structured and well co-ordinated programmes is stressed and the need for a better understanding of rehabilitation in psychiatry is suggested.     

Parents are key players in the prevention and treatment of weight-related problems

There is growing agreement among experts that an obesogenic environment, which encourage excess food intake and idealizes thinness, plays a crucial role in the epidemic of childhood obesity and eating disorders. Because parents provide a child's contextual environment, they should be considered key players in interventions aimed at preventing or treating weight-related problems. Parenting style and feeding style are crucial factors in fostering healthy lifestyle and awareness of internal hunger and satiety cues and de-emphasizing thinness. Effective interventions for prevention and treatment of weight-related problems should be approached from a health-centered rather than a weight-centered perspective, with the parents as central agents of change. This paper reviews the environmental risk factors and parents' role in the prevention and treatment of children's weight-related problems.     

The Role of Stress in the Commission of Subsequent Acts of Child Abuse and Neglect

Data from 1,874 clients, reported to authorities and treated for abusive or neglectful treatment of children, were examined to determine the role of stressin the commission of subsequent actsof abuseand neglect.Several case, client, and family characteristics were examined. It was hypothesized that the presence of stressful events would not only have a significant effect on the commission of subsequent acts of child maltreatment but would explain much of the observed variance. The results indicated that the presence of stressful events, as well as seriousness of the initial incident of child abuse, had significant effects (both at the p<.000 level) on the commission of subsequent acts of child maltreatment. However, the presence of stressful events did not explain most of the observed variance. In fact, the inclusion of the variable of stressful events only increased the variance explained by 6%.     

Final responsibility for treatment choice: the proper role of medical doctors?

Aims To analyse whether the traditional allocation of decision‐making responsibility is still justifiable. And, if not to analyse the strength of claims made by other health care professions and by patients. Background Traditionally doctors have been responsible for choices of treatment, both in terms of deciding and in terms of taking responsibility for the decisions. But modern health care work often takes place in teams involving health care professionals from different professions as well as the patient. In such teams it may not be obvious who should be responsible for treatment choice. Methods  Philosophical analysis of epistemic, ethical and organizational arguments, including analysis of the historical origins of these arguments. Results The epistemic, ethical and organizational arguments for maintaining a primary decision making role for doctors are not sound. Other health care professionals can, in some circumstances make stronger and more justified claims. The arguments against allocation decision making authority to patients are also invalid or unsound in many circumstances. Conclusion There are many situations in which final responsibility for treatment choice should rest with health care professionals who are not doctors and with patients.     

医患关系视角下的医院管理者角色期待

医院管理者在构建和谐医患关系中发挥着重要作用,是组织架构的优化者、环境变化的调适者、决策执行的督导者、和谐人际的引领者。本文通过对医院管理者角色定位、履职影响因素的分析,提出管理者应做好“五个关注”,推动医患关系趋于和谐稳定。     

Physicians and Family Caregivers: Two Perspectives of Physicians' Roles in Long-Term Care

ObjectivesWe explored the roles of attending physicians of long-term care (LTC) residents in supporting their family caregivers (FCGs).DesignIn this mixed-methods study, we conducted surveys and focus group interviews with physicians and FCGs.Setting and ParticipantsThere were 78 FCGs and 18 physicians in the survey, and 18 FCGs and 9 physicians in the focus groups. They were recruited from 5 urban LTC settings.ResultsAlthough 83.3% of physicians reported they had experience caring for FCGs, 71.8% of FCGs perceived they had not received support from the physicians. There was no statistically significant difference between the FCGs' and physicians' mean responses to the mirrored survey questions. Both groups gave similar ratings, means neutral and agree indicative of ambivalence, on physician's knowledge to identify FCGs who need assistance, ability to assess FCG stress, and aid those experiencing distress and needing advocacy. Analysis of the focus groups revealed the overarching theme: ambiguity about the LTC residents' physicians' role in supporting FCGs. Although physicians noted that residents and families come as a unit, there was ambivalence about the physician's role in supporting FCGs. FCG roles in LTC are also vague. There were 3 sub-themes: “accord on the surface”; “tension in the interface”; and “smoothing the relationship.” Both groups thought FCG medical care was beyond the purview of the resident's physician. Physicians and FCGs provided different explanations for the tensions in the FCG/physician interface. Physicians attributed tension to FCG stress and inadequate knowledge, whereas FCGs thought physicians' communication could be improved. Suggestions to smooth the relationship were to align FCG expectations to reality of LTC and different staffing models.Conclusions and ImplicationsFamily physicians, policy makers, and FCGs will need to work on polices to ensure LTC physicians' roles in supporting FCGs and FCGs' roles in LTC are delineated and supported.