医护合作关系的研究进展

随着护理学的发展,护士在疾病预防、治疗、康复中的重要作用日益凸显.护士兼具了照顾者、教育者、咨询者、管理者、研究者和改革者等多重角色.新的专业结构的形成和护士形象的提高,使得医护关系由最初的主导-从属模式逐渐向并列-互补模式转变[1].新的《医师法》和《护士条例》的先后出台,对医生、护士的专业角色和职能划分给予了更明确的司法界定.本综述旨在了解医护合作关系的发展现状,分析医护合作的有关影响因素,为促进更健康和适宜的医护合作关系,提出科学的方法和策略,对管理者提供参考和借鉴.     

灵性教育与死亡态度——从三级医院护士死亡态度现状引发的思考

【目的】了解三级医院临床护士死亡态度现状并分析其影响因素,探讨改善临床护士死亡心态的有效措施。【方法】采用方便抽样法,于2019年3-5月选择江苏省无锡市人民医院的803名护士作为研究对象,采用一般资料调查问卷和死亡态度描绘量表进行调查。【结果】 803名临床护士死亡态度各个维度的得分均接近中等水平,其中“逃离接受”维度得分最低（3.00±0.81）,“中性接受”维度得分最高（3.92±0.52）;多元线性回归分析显示,婚姻状况、关于死亡的过往教育情况、工作科室是护士“死亡恐惧”的影响因素,宗教信仰、工作科室是“趋近接受”的影响因素,婚姻状况是“死亡逃避”的影响因素、工作年限是“逃离接受”的影响因素。【结论】三级医院临床护士死亡态度现状不容乐观,合理的教育内容和手段（如灵性教育）将有望促进临床护士死亡态度的正向发展。     

The impact of humorous media on attitudes toward persons with disabilities

Purpose: To examine the relationship between disability-related humor and attitudes toward persons with disabilities in business students (i.e. “future employers”). Method: Students watched one of two films designed to reduce negative attitudes toward persons with disabilities (one humorous in tone and the other serious in tone) or no film at all, and completed a measure of attitudes toward persons with disabilities. Results: Results indicated that, after controlling for previous contact with persons with disabilities, age, and gender, students who watched the humorous film reported significantly more positive attitudes toward persons with disabilities. Conclusions: Disability humor may be an effective means of positively influencing attitudes toward persons with disabilities in future employers.

Implications for Rehabilitation

• The acceptance and integration of persons with disabilities into society continues to be limited by negative attitudes.

• Previous research has shown that employers with positive attitudes toward persons with disabilities may be more likely to hire a person with a disability than employers with negative attitudes.

• In this study, students who watched a humorous film reported significantly more positive attitudes toward persons with disabilities than students who watched a serious film or no film at all.

• Consequently, it may be beneficial to embed disability humor into job-placement strategies in order to improve attitudes and positively influence hiring decisions.

     

Comparisons of American,Israeli, Italian and Mexican physicians and nurses on the total and factor scores of the Jefferson scale of attitudes toward physician-nurse collaborative relationships

This cross-cultural study was designed to compare the attitudes of physicians and nurses toward physician-nurse collaboration in the United States, Israel, Italy and Mexico. Total participants were 2522 physicians and nurses who completed the Jefferson Scale of Attitudes Toward Physician-Nurse Collaboration (15 Likert-type items, (Hojat et al., Evaluation and the Health Professions 22 (1999a) 208; Nursing Research 50 (2001) 123). They were compared on the total scores and four factors of the Jefferson Scale (shared education and team work, caring as opposed to curing, nurses, autonomy, physicians' dominance). Results showed inter- and intra-cultural similarities and differences among the study groups providing support for the social role theory (Hardy and Conway, Role Theory: Perspectives for Health Professionals, Appelton-Century-Crofts, New York, 1978) and the principle of least interest (Waller and Hill, The Family: A Dynamic Interpretation, Dryden, New York, 1951) in inter-professional relationships. Implications for promoting physician-nurse education and inter-professional collaboration are discussed.     

Korean women's attitudes toward breast cancer screening tests

The purpose of the study was to explore Korean women's attitudes toward breast cancer screening tests from a feminist perspective. Twenty Korean women working in Dong-Dae-Moon Market in Seoul, South Korea were recruited using a convenience sampling method. Semi-structured in-depth interviews were conducted using an interview guideline that was developed for the study. The data were analyzed using a thematic analysis. The themes emerged from the analysis process included: "importance of breasts to women", "fearful, but not related to me", "bad previous experience", and "no need for a breast exam." Based on the findings, implications for nursing practice are proposed.     

Influencing physiotherapy student attitudes toward exercise for adolescents with Down syndrome

Background.?Negative attitudes of physiotherapists may prevent them from implementing exercise as an intervention among people with disabilities. The aim of this study was to examine whether physiotherapy student attitudes towards the barriers to exercise for adolescents with Down syndrome changed as a result of participating in a 10-week exercise programme.

Method.?Data were collected as part of a randomised controlled trial. Twenty physiotherapy students (2 men, 18 women; mean age 19.5±1.3 years) volunteered to act as mentors. Each mentor was matched with an adolescent with Down syndrome from the same metropolitan suburb, who had been randomly allocated to either the intervention or the control group. The 10 adolescents and students in the intervention group all completed a 10-week, twice a week progressive resistance exercise training programme. The 10 adolescents and students in the control group continued with their usual activities. The students completed the 18-item Exercise Barriers Scale at baseline and after 10 weeks.

Results.?There was a positive change in attitudes, significant at the p <0.05 level, favouring the intervention group on 9 of the 18 items on the Exercise Barriers Scale.

Conclusions.?After engagement in a 10-week exercise programme with an adolescent with Down syndrome, physiotherapy students identified fewer barriers that would prevent adolescents with Down syndrome from exercising. Results indicate that contact with adolescents with Down syndrome during clinical placement can positively influence attitudes towards exercise for people with Down syndrome among physiotherapy students.     

医生和护士对医护合作所持态度的对比研究

目的调查和比较医生和护士对医护合作所持有的态度,以及影响医护合作态度的因素。方法通过医护合作态度问卷调查,对各种因素进行方差分析,筛选出影响医生、护士对医护合作态度的因素。结果护士对医护合作的态度量表得分比医生的高,表现在5个条目的得分差异。结论护士比医生对医护合作的态度更积极。医生对护士工作重要性的认同,是影响医生对医护合作态度的因素；而护士的学历、工作满意度、情绪是影响护士对医护合作态度的因素。     

Korean university students' knowledge and attitudes toward breastfeeding: a questionnaire survey

Infant feeding decisions depend on knowledge and attitudes toward breastfeeding. The purpose of this study was to explore Korean university students’ knowledge and attitudes toward breastfeeding by gender and major. This was a cross-sectional comparative study among 341 university students. The instrument was a modified self-administered breastfeeding knowledge and attitudes questionnaire. Female students were slightly more knowledgeable and had somewhat more positive attitudes compared to male students. Students in health-related fields showed more knowledge than students in other disciplines, but their attitudes did not differ in majority. A significant correlation was found between the students’ knowledge and their attitudes.     

The Connecticut survey of public attitudes toward chiropractic

This paper reports the results of a public opinion survey of attitudes toward chiropractic, commissioned by the Connecticut Chiropractic Association and carried out by the Institute for Social Inquiry at the University of Connecticut. Telephone interviews with 500 randomly selected households elicited responses from a representative sample of Connecticut residents. While 28% of the respondents stated they were not at all familiar with chiropractic, 21% (that is, 104 of the 500) had visited a chiropractor at least once. A total of 40% of the respondents or a member of their family had gone to a chiropractor. Of the respondents who went, 78% rated their treatment as effective, 89% were satisfied with the amount of personal attention they received, 72% were satisfied with the cost of their treatment, and 72% said they would go again for the same or similar problem. When those who are familiar with chiropractic were asked their overall opinion of it, 78% of those who expressed a definite opinion were favorable; however, only 61% of this group thought "most people in Connecticut" have a favorable opinion of chiropractic. When those familiar with chiropractors but who had never been to one were asked if they would go to one for a problem chiropractors treat, 59% said they would go and 68% of those who were familiar said they would encourage a friend to go. Respondents' factual information and attitudes about what chiropractors do were probed in depth.(ABSTRACT TRUNCATED AT 250 WORDS)     

Nurses' attitudes towards sexual relationships between patients in high security psychiatric hospitals in England: an exploratory qualitative study

Background

The issue of relationships between patients in long-term care settings can present nurses with numerous challenges. However, addressing this element of patient care is recognised as an important element of nursing in this sphere of practice. What nurses think about patient sexual relationships and the difficulties of incorporating these into care is closely linked to the care they provide. However, the issue of patients sexual relationships within high security psychiatric hospitals is a relatively poorly researched area of clinical practice.

Aim

To explore the attitudes towards patients’ sexual relationships held by nurses working in high security psychiatric hospitals in England.

Methods and participants

A qualitative methodology was employed with data collected from 10 in-depth interviews with nurses working within secure psychiatric hospitals in England. Interview data were subjected to thematic analysis.

Results

Practitioners reject permissive policy in relation to patients’ sexual relationships on account of perceived perpetuation of abuse and exploitation. Practices and attitudes are dominated by personal (lay) values that seek to restrict patient experience and undermine professional mores whilst also seeming to uphold a professional duty of care.

Conclusion

Lay understandings are constructed as moral rights and priorities that are of higher order concern than professional values or the rights of the individual. This constitutes a clash of values and the minimisation of professional mores within the clinical context raises questions about the role of professional teaching, knowledge and policy in relation to professional socialisation.     

The decline in attitudes toward physician-nurse collaboration from medical school to residency

ABSTRACT

While interprofessional collaboration is a critical aspect of optimal patient care, practicing physicians often have sub-optimal attitudes regarding the importance of collaboration with their nursing colleagues. The impact of clinical training on medical students’ and residents’ attitudes toward physician-nurse collaboration has not been investigated. The primary goal of our study was to examine if learners at different stages in their medical training had more or less favorable attitudes regarding interprofessional collaboration (IPC). A secondary goal was to compare residents in procedural versus non-procedural specialties to determine if attitudes toward IPC varied by specialty type. Third-year medical students and residents at a large public university completed the Jefferson Scale of Attitudes Toward Physician-Nurse Collaboration. Student (n = 129) and resident (n = 292) scores were compared using Student’s t-tests. Resident responses were further analyzed by specialty type. Students’ perceptions of the physician-nurse relationship were significantly more favorable than the views of residents, particularly in the “Authority” and “Responsibility” domains. Residents in procedural specialties had less favorable attitudes toward physician-nurse collaboration than those in non-procedural specialties. Our findings highlight the importance of developing effective interventions for improving interprofessional collaboration during medical training.     

An assessment of public attitudes toward automated external defibrillators

OBJECTIVE: We assessed the familiarity of the general public with automated external defibrillators (AEDs) and their willingness to use them. METHODS: Shoppers were asked to complete a survey in an AED-equipped suburban shopping mall. RESULTS: 359 surveys were analyzed. Of the participants, 11% were healthcare professionals, 51% had training in CPR or first aid, and 44% had no medical training. Sixty percent were able to define defibrillator adequately. Seventy-one percent stated they would be likely to use an AED to resuscitate a stranger. The most common concerns were fear of using the machine incorrectly (57%) and fear of legal liability (38%). After being told of liability protection from the federal Cardiac Arrest Survival Act, 84% stated they would be likely to use the AED. This increased further to 91% if the participants were given an opportunity to receive training. CONCLUSION: Although a substantial number of people in this setting were willing to use an AED, education regarding legal liability and proper use of the machines increased the reported likelihood of use. Further public education may be necessary to provide optimally effective public access defibrillation programs.     

医护合作型分级护理决策模式对产妇分娩结局的影响

目的：探讨产科医护人员共同制定护理级别临床实践及效果。方法将在产科病区住院的129例产妇采用电脑产生随机数的方法分为常规组（62名）和合作组（67名）,常规组采用传统方法根据医生医嘱实施护理分级,合作组应用医护合作型分级护理决策方式进行护理分级,即责任护士通过Barthel指数量表对产科住院患者进行评分,医生依据此评分,根据患者病情决定护理级别。比较两组产妇产后出血量及对护理的满意度。结果两组产妇的护理级别比较,差异有统计学意义（ uc ＝3．54,P＜0．05）。合作组产妇产后出血量为（377．5±83．9） ml,感染的并发率为2．99％;常规组产妇产后出血量为（456．9±78．3）ml,感染并发率为8．06％,两组比较差异有统计学意义（t/χ2分别为6．93,4．18;P＜0．05）。合作组患者满意度为97．01％,常规组为90．32％,两组比较差异有统计学意义（χ2＝4．20, P＜0．05）。结论分级护理的制定应全面评估患者的病情及生活自理能力,医护合作型分级护理决策模式可降低产妇并发症发生的风险,提高护理分级的科学性、合理性,提高护理质量及患者满意度。     

Health professionals' attitudes toward older people and older patients: A systematic review

Attitudes toward older people and older patients among healthcare professionals are of concern throughout the world, but there are no recent systematic reviews which have examined and compared the attitudes across the various healthcare professionals who provide healthcare to older people. A comprehensive literature search (2000–2011) was undertaken on electronic databases (CINAHL, MEDLINE, EMBASE, British Nursing Index, PsycINFO, Chinese Biomedical database, China Medical Academic Conference and China Academic Journal) using a combination of terms. We identified 2179 articles indexed with these terms. Initial screening was undertaken by two researchers and then checked by a third researcher. In total, the reviewers selected 117 articles which, on the basis of their abstracts, appeared to meet the criteria for inclusion. We obtained the full texts and two reviewers assessed each full text paper to further examine whether it met all the criteria. The final review identified 51 studies. Publications over the last 10 years show that attitudes towards older people and older patients range from neutral to positive among healthcare professionals and highlight the need for well-designed studies of both qualified and student healthcare professionals recruiting random samples across multiple sites and utilizing validated instruments consistently to permit comparison over time and across countries.