广西少数民族贫困地区县级公立医院医务人员工作满意度及相关因素研究

目的了解广西少数民族贫困地区县级公立医院医务人员满意度情况及相关因素,为完善县级公立医院卫生人力资源政策提供科学依据。方法按规模大小成比例的概率抽样的方法抽取5个样本县600名医务人员进行工作现状及满意度进行问卷调查,采用单因素及多因素回归模型探讨满意度相关影响因素。结果本研究共有效调查562人,医务人员总体满意度均分为(2.94±0.95),均分最低与最高的维度分别是工作回报满意度(2.40±0.77)及患者尊重满意度(3.31±0.87);医务人员工作满意度与性别、年龄、学历、工作类型相关;多因素回归分析显示工作回报是影响满意度最主要因素。结论广西少数民族贫困地区县级公立医院医务人员满意度居于一般水平,受性别、年龄、学历、工作类型等个体差异影响,建议针对性采取相关激励措施,改善医院奖惩制度及管理状况,提高医务人员工作满意度。     

养老院老年人的生活满意度及其影响因素

目的了解养老院老年人生活满意度及影响因素。方法采用方便抽样在华都颐年园抽取110名老年人进行问卷调查。调查工具采用自设的一般情况调查表和生活满意度量表。采用SPSS11.5建立数据库并对数据进行统计分析。结果养老院老年人生活满意度得分为(27.72±6.62)分,Backward多元回归分析显示健康状况、养老方式、月平均收入、食欲情况、遇事态度、是否孤独对生活满意度影响有统计学意义(P<0.05)。结论养老院老年人生活满意度总体水平较高并且受健康状况、养老方式、月平均收入、食欲情况、遇事态度、是否孤独等因素的影响,因此应该对老年人的身体、心理、饮食等方面加强护理,进一步提高老年人的生活满意度。     

社区老年人的睡眠质量及影响因素

目的了解社区老年人睡眠质量的现状,分析焦虑、抑郁对其睡眠质量的影响。方法采用分层随机整群抽样法对河北省唐山市市区内的6171例老年人进行问卷调查,使用匹兹堡睡眠指数(PSQI)评定睡眠质量。结果26.6%的老年人存在睡眠障碍;其中存在焦虑者456例,睡眠障碍占40.1%;存在抑郁者354例,睡眠障碍占42.9%,多因素分析显示:性别、年龄、生活满意度、家人关怀满意度、抑郁、焦虑是老年人睡眠障碍的危险因素(P<0.05),文化程度是保护因素(P<0.05)。结论焦虑、抑郁的老年人睡眠障碍发生率较高,应多提倡家人的关怀,提升生活满意度。     

新疆生产建设兵团基层预防接种工作人员职业满意度调查

目的 了解新疆生产建设兵团(以下简称兵团)基层预防接种工作人员职业满意度,为稳定和促进队伍建设提供参考。方法 采用自行设计调查问卷,利用“问卷星”微信小程序形成电子问卷,对全兵团14个师(市)的预防接种工作人员开展不记名网络问卷调查;采用描述流行病学方法分析预防接种工作人员职业满意度。结果 共调查256人,不同性别(χ2=0.005)、不同年龄(χ2=2.258)、文化程度(χ2=3.594)、专业方向(χ2=2.552)、职称(χ2=4.705)、是否专职(χ2=0.703)、工作年限(χ2=3.053)等满意度差异均无统计学意义(P>0.05),从事的岗位(χ2=11.288)、薪酬待遇(χ2=6.758)的满意度差异有统计学意义(P<0.05)。基层预防接种工作人员对同事关系、上级的业务指导与培训、医患关系满意度较高,平均得分分别为4.07分、4.07分、3.95分;薪酬待遇、休假制度、职称晋升机会为主要不满意因素,平均得分分别为3.23分、3.30分、3.34分。结论 新疆生产建设兵团基层预防接种工作人员职业满意度一般,应重视基层预防接种门诊工作人员薪酬待遇和休假制度方面的改善,提高职业满意度,增加工作积极性,为兵团广大职工群众提供优质的预防接种服务。     

老年尘肺患者生活满意度及其影响因素

目的了解老年尘肺患者生活满意度及影响因素。方法采用生活满意度指数A(LSIA)量表对吉林市职业病防治院门诊老年尘肺病例178例进行问卷调查。结果老年尘肺患者生活满意度得分为(23.60±7.83)分,多元回归分析显示人际关系、个人月收入、婚姻状况、居住方式、疾病分期对其生活满意度有影响(P<0.05)。结论老年尘肺患者生活满意度总体水平不高,并且受健康状况、人际关系、个人月收入、婚姻状况、居住方式等因素的影响,需要采取综合措施提高其生活满意度。     

青年医师健康发展相关因素的调查分析

目的找出影响青年医师健康成长相关因素,以创造更有利于青年医师健康发展的条件。方法采用问卷调查法,对柳州市区医院及周边县级医院临床第一线青年医师就职业态度、价值观取向、生活经济状况与政治需求、对医院及医师管理的参与意识四个方面做了详细的调查。结果青年医师健康发展受自身的职业态度、价值观取向、生活经济状况与政治需求和医院管理者的管理水平等多种因素的影响。结论探析青年医师健康发展的相关因素,以进行分阶段、有计划、定目标地系统培养,是培养21世纪新型医师人才的需要。     

北流市人民医院远程会诊服务就诊患者满意度调查分析

目的了解患者对县级公立医院开展的远程会诊服务的满意情况。方法自制调查问卷,对2017年1月至2018年10月在北流市人民医院远程会诊中心接受远程会诊的患者200例进行问卷调查,了解患者对县级公立医院开展的远程会诊服务的满意情况;会诊结束后14 d,回访患者,了解患者再就诊的行为意向。结果接受调查的患者年龄18～85岁,其中男124例,女76例,包括初中以下、高中或中专、大专及以上学历,事业单位、农民及其他职业患者。患者对远程会诊9个方面工作的满意度均在90%以上,其中对会诊中心工作人员服务满意度为97.0%,对会诊专家服务态度的满意度为96.0%,对会诊中心环境和设备安全的满意度为95.5%。会诊结束后14 d随访患者发现, 99.0%的患者表示再就诊时愿意接受远程会诊服务,同时乐意推荐给亲友。结论在县级公立医院开展远程会诊服务技术成熟,能让患者享受到三级医院专家的优质诊疗服务,患者对这种医疗服务的满意度高,能较好地实现优质医疗资源下沉、患者属地诊治的目标,促进我国医疗分级诊疗制度的全面落实。     

支援新疆汉族女性失能老年人生活满意度及影响因素

目的了解支援新疆(援疆)汉族女性失能老年人生活满意度状况,分析其影响因素。方法采用日常生活能力量表(ADL)对援疆汉族女性老年人进行失能筛查,对符合失能标准的284名女性老年人应用生活满意度指数B量表(LSRB)进行调查。结果援疆汉族女性失能老年人生活满意度得分〔(15.50±4.11)分〕与全国常模差异不显著(P0.05);单因素分析结果显示,在职状态、在职时单位性质、月收入、主要经济来源、医疗保障、来疆时间、失能时间及失能程度是影响其生活满意度的因素;经多因素Logistic回归分析得出:来疆时间、在职时单位性质及失能时间是影响援疆汉族女性失能老年人生活满意度的主要因素。结论应针对援疆汉族女性失能老年人制定相关政策,提高该人群的生活满意度。     

《内科执业医师技术培训考核标准》出版

本书内容包括内科执业医师技术培训考核标准 ;中医内科执业医师的诊疗技术操作 ;内科执业医师的诊疗技术操作 ;内科执业医师医用设备与技术应用 ;内科执业医师查房技能培训 ;内科执业医师从业医德修养与素质行为规范培训 ;内科执业医师的考核培训管理 ;内科执业医师的执业资格与执照考试 ;内科执业医师药事工作 ;内科医疗事故的防范与纠纷处理 ;内科执业医师培训与考核法规汇编等。全书共 3册 (附光盘 1张 ) ,定价 798元 (免收邮挂费 )。邮购地址 :北京 5 5信箱激流书店　金莉收 ,邮编 :10 0 0 5 3。开户银行 :招商银行展览路支行 ,帐号 :0 …     

河北省城市社区居民临终关怀需求

目的分析河北省邯郸市、邢台市、保定市、石家庄市、张家口市、沧州市6个城市社区居民的临终关怀认知、接受程度及影响社区居民对待死亡态度和选择临终关怀模式的因素。方法分别对河北省不同城市的社区居民进行问卷调查,采用SPSS17.0软件进行分析。结果河北省城市居民对临终关怀的整体了解程度较高。不同职业、学历、医疗保险、收入水平、家中是否有临终人、生活自理情况的城市居民在对临终关怀的了解程度方面差异有统计学意义(P<0.05)。城合、医保是河北省城市居民对待死亡态度的影响因素(P<0.05)。生活自理情况是居民选择最适合临终关怀模式的影响因素(P<0.05)。结论应加强对临终关怀的宣传力度,尤其是针对学历和收入水平低的人群。     

Marital and parental satisfaction of married physicians with children

OBJECTIVE: To evaluate personal and professional factors associated with marital and parental satisfaction of physicians. STUDY DESIGN: Cross-sectional study. PARTICIPANTS: A survey was sent to equal numbers of licensed male and female physicians in a Southern California county. Of 964 delivered questionnaires, 656 (68%) were returned completed. Our sample includes 415 currently married physicians with children, 64% male and 36% female. MEASUREMENTS AND MAIN RESULTS: Ratings of marital and parental satisfaction were measured on a 5-point Likert scale, 5 being extremely satisfied. Prevalence of work and home life factors was also evaluated. The mean score for marital satisfaction was 3.92 (range 1.75-5.0). Approximately half of the physicians reported high levels of marital satisfaction (63% of male physicians and 45% of female physicians). The gender difference disappeared after adjusting for age differences. Two factors were associated with high marital satisfaction: a supportive spouse (odds ratio [OR] 10.37; 95% confidence interval [CI] 2.66, 40.08) and role conflict (OR 0.61; 95% CI 0.42, 0.88). The mean score for parental satisfaction was 3. 43 (range 1.0-5.0), and approximately two thirds of both male and female physicians reported at least moderate levels of parental satisfaction. The major factors associated with parental satisfaction were a supportive spouse (OR 2.24; 95% CI 1.32, 3.80), role conflict (OR 0.35; 95% CI 0.23, 0.53), salaried practice setting (OR 2.14; 95% CI 1.21, 3.81), marriage to a spouse working in a profession (OR 2.14; 95% CI 1.21, 3.81), and marriage to a spouse working as a homemaker (OR 2.33; 95% CI 1.20, 4.56). Number of hours worked was not found to be related to either satisfaction score, but rather to an intervening variable, role conflict. CONCLUSIONS: For physicians with children, our study indicates that minimizing the level of role conflict and having a supportive spouse are associated with higher levels of marital and parental satisfaction. Working in salaried positions and marriage to a spouse who is either working in a profession or who is a stay-at-home parent are also related to high parental satisfaction.     

Teaming as a Mechanism to Promote Professional Identity Development

ABSTRACT

Objective: The purpose of this exploratory study was to evaluate teamwork in gerontological practice. Methods: Participants (N = 475) were recruited through an online survey link sent through organizations and institutions serving older adults. Results: Findings demonstrated that age, length of time in profession and having a more positive view of teamwork made a positive difference in level of professional identity. Qualitative analysis demonstrated that personal and professional growth was identified thematically as an important element of teamwork. Conclusions: This study identifies that professionals working in aging services professions who practice teamwork identify value in teaming both personally and professionally. Identifying teaming experiences as relevant to professional identity development is important for elder workforce development and retention.     

From best evidence to best practice - what are the obstacles?

There are numerous obstacles to overcome when implementing measures resulting from new evidence in clinical practice - some relate to practitioners in hospitals and primary care, others to patients, their relatives and public opinion. Many post-myocardial infarction (MI) patients are still discharged from hospital without any specific recommendations for risk-factor management, despite the fact that the hospital stay provides an excellent window of opportunity for treatment. Conversely, the primary-care physician may assume that as these measures were not implemented in hospital, they are unimportant. Even if recommendations for risk modification are made, the patient's attitude towards risk reduction can reduce its effectiveness. The HELP study found that the public had a reasonable knowledge of coronary heart disease (CHD) and the risks involved. However, their attitude was remarkably indifferent; even in post-MI patients, 24% were aware of lipid-lowering treatments, but did not take them, while 38% were not even aware of this form of therapy. Despite this, the medical profession was found to be the most credible source of information about CHD. Healthcare professionals, therefore, have an obligation to ensure patients receive the maximum benefit from medical advances by working together to overcome the barriers.     

济宁市社区卫生服务居民满意度调查分析

目的通过对社区卫生服务的满意度的调查,分析居民利用社区服务的影响因素。方法设计调查问卷,深入社区居民家中、公共场所等对家庭成员及社区卫生服务利用情况进行调查。结果济宁市城市居民年龄、文化程度、婚姻状况、职业、医疗保险形式与在社区卫生服务站就诊率无相关性。卫生服务站机构的就诊率高达92.20%;到卫生服务站就诊主要原因是方便;居民对就诊环境、医疗设备、技术水平、服务态度等比较满意。结论济宁市城市社区居民对社区卫生服务满意度高,城市社区卫生服务的发展前景广阔。     

Infection control knowledge, attitude, and practice among Nepalese health care workers

This study was designed to assess the knowledge, attitudes, and infection control practices among Nepalese health care workers (HCWs). The study comprised a questionnaire survey of 324 staff from acute care hospitals in Kathmandu, Nepal. A total of 158 doctors and 166 nurses participated, 27% of whom had received infection control training. Only 16%, 14%, and 0.3% of the respondents achieved maximum scores for knowledge, attitude, and practice items, respectively. Staff had good knowledge and positive attitude toward most aspects of infection control, although only half had heard of methicillin-resistant Staphylococcus aureus. Logistic regression revealed that profession, age, and having studied abroad significantly predicted markers of infection control knowledge, attitudes, and practice. This is the first survey of infection control practice among Nepalese HCWs and provides useful baseline data by professional group. There is ample opportunity for improvement in current practice, which should be recognized by hospital managers and Nepalese health authorities.     

浙江省基层医师对抑郁症和老年期痴呆诊治技术的需求调查

目的调查浙江省基层医务人员对抑郁症和老年期痴呆诊治技术的需求情况。 方法自行设计《抑郁症和老年期痴呆诊治技术需求问卷》（包括20项技术）,选择浙江省10个地市的医务人员为调查对象,发放问卷612份,回收590份,其中有效问卷533份。对不同级别医院、不同属性医院、不同专业、不同职称、不同年资医师对各项技术的需求百分比进行比较分析。计数资料的比较均采用χ²检验。 结果不同级别医院、不同属性医院、不同专业、不同职称、不同年资医师对各项技术的需求百分比均明显高于不需求的百分比。除无抽搐电休克技术外,不同级别医院对抑郁症与老年期痴呆诊治技术的需求百分比无明显差异;三级医院医师对无抽搐电休克技术需要的百分比明显高于二级医院、街道医院及社区医院医师对无抽搐电休克技术需要的的百分比（χ²=11.42、6.92、8.75,均P<0.01）。除无抽搐电休克技术外,不同属性医院对抑郁症与老年期痴呆诊治技术的需求百分比无明显差异;精神专科医院对无抽搐电休克技术的需要百分比明显高于综合医院及社区医院对无抽搐电休克技术的需要百分比（χ²=14.11、11.19,均P<0.01）。除无抽搐电休克技术外,不同专业医师对抑郁症与老年期痴呆诊治技术的需求无明显差异;精神科医师对无抽搐电休克技术的需要百分比明显高于内科医师（χ²=8.90,P<0.01）。除抑郁症精神访谈技术外,不同年资对抑郁症与老年期痴呆其他相关技术的需求百分比无明显差异;工作年资1～3年的医师对抑郁症精神访谈技术的需要百分比明显低于10年以上年资组医师的需要百分比（χ²=6.09,P<0.05）。 结论浙江省基层医务人员对抑郁症和老年期痴呆诊治技术具有较大的需求,通过问卷调查可以了解医务人员的具体需求,以便在下一步的培训中更能有的放矢,提高培训效果。     

柔性管理在门诊管理中的实施价值分析

目的探讨柔性管理在门诊管理中的实施价值。 方法2013年1月至2015年10月,对新疆自治区人民医院门诊部实施柔性管理模式,对实施前后门诊管理工作质量的变化进行记录与对比。 结果柔性管理实施之后,医护人员对门诊服务的满意度显著高于实施前,差异有统计学意义(P<0.05);柔性管理实施之后,门诊患者对门诊管理的满意度显著高于实施前,差异有统计学意义(P<0.05)。 结论在门诊管理工作中实施柔性管理不但可以提升医护人员的满意度,还能提升患者的满意度,从整体上提升门诊管理工作质量,值得推广。     

Measuring the efficiency of dental departments in medical centers: a nonparametric analysis approach

Data envelopment analysis (DEA), a cross-sectional study design based on secondary data analysis, was used to evaluate the relative operational efficiency of 16 dental departments in medical centers in Taiwan in 1999. The results indicated that 68.7% of all dental departments in medical centers had poor performance in terms of overall efficiency and scale efficiency. All relatively efficient dental departments were in private medical centers. Half of these dental departments were unable to fully utilize available medical resources. 75.0% of public medical centers did not take full advantage of medical resources at their disposal. In the returns to scale, 56.3% of dental departments in medical centers exhibited increasing returns to scale, due to the insufficient scale influencing overall hospital operational efficiency. Public medical centers accounted for 77.8% of the institutions affected. The scale of dental departments in private medical centers was more appropriate than those in public medical centers. In the sensitivity analysis, the numbers of residents, interns, and published papers were used to assess teaching and research. Greater emphasis on teaching and research in medical centers has a large effect on the relative inefficiency of hospital operation. Dental departments in private medical centers had a higher mean overall efficiency score than those in public medical centers, and the overall efficiency of dental departments in non-university hospitals was greater than those in university hospitals. There was no information to evaluate the long-term efficiency of each dental department in all hospitals. A different combination of input and output variables, using common multipliers for efficiency value measurements in DEA, may help establish different pioneering dental departments in hospitals.     

Are specialist physicians missing out on the e‐Health boat?

Background:  Nationally health systems are making increasing investments in the use of clinical information systems. Little is known about current computer use by specialist physicians, particularly outside the hospital setting.
Aims:  To identify the extent and reasons physician Fellows of the Royal Australasian College of Physicians (RACP) use computers in their work.
Methods:  A self-administered survey was emailed from the RACP to all practising physicians in 2007 that were living in Australia and New Zealand who had consented to email contact with the College.
Results:  The survey was sent to a total of 7445 eligible physicians, 2328 physicians responded (31.3% response rate), but only 1266 responses (21.0%) were able to be analysed. Most 97.5% had access to computers at work and 96.5% used home computers for work purposes. Physicians in public hospitals (72.6%) were more likely to use computers for work (65.6%) than those in private hospitals (12.6%) or consulting rooms (27.3%). Overall physicians working in public hospitals used a wider range of applications with 70.5% using their computers for searching the internet, 53.7% for receiving results and 52.7% used their computers to engage in specific educational activities. Physicians working from their consulting rooms (33.6%) were more likely to use electronic prescribing (11%) compared with physicians working in public hospitals (5.7%).
Conclusions:  Fellows have not incorporated computers into their consulting rooms over which they have control. This is in contrast to general practitioners who have embraced computers after the provision of various incentives. The rate of use of computers by physicians for electronic prescribing in consulting rooms (11%) is very low in comparison with general practitioners (98%). One reason may be that physicians work in multiple locations whereas general practitioners are more likely to work from one location.     

Factors enabling home death of the elderly in an institution specializing in home medical care: Analysis of apprehension of the bereaved family

Aim:   To determine the factors enabling home death despite caregiver apprehension about home medical care.
Methods:   This study was an anonymous mailed survey of bereaved family members (the caregiver) of patients who died in a home medical care setting provided by an institution specializing in home medical care in Japan (home death rate, ∼80%). We analyzed the relationships between caregiver apprehension about home medical care, overall satisfaction with home medical care and the place of death.
Results:   Higher caregiver apprehension about home medical care and lower overall satisfaction with home medical care were significantly associated with dying in a hospital. In addition, the home death group with apprehension about home medical care significantly rated higher overall satisfaction with home medical care than the hospital death group. Meanwhile, there was no difference in the overall satisfaction with home medical care between those with or without apprehension about home medical care in the home death group. Factors influencing overall satisfaction with home medical care in the home death group with apprehension about home medical care were: (i) being free from pain or symptoms (partial regression coefficient: 0.83); and (ii) fulfilled medical care service system (partial regression coefficient: 0.40).
Conclusion:   These results suggest that caregiver satisfaction with home medical care is an essential factor to enable home death of the patient despite the caregiver apprehension about home medical care.