医学保障部员工满意度及相关因素研究

目的：对本院医学保障部人员进行“工作满意度”调查与分析,了解医学技术保障人员工作、生活满意度状况,从而为探索人员管理、增强工作针对性和发现激励新机制提供依据。方法：采用自行制订的“工作满意度”量表,对所属428名人员进行满意度调查,应用方差分析对数据进行统计处理。结果：①政治教育满意度显著高于工作环境和家庭生活满意度,工作环境和工作业务满意度显著高于家庭生活满意度;②工人个人业务单维满意度显著低于军人干部和职员。结论：医学保障人员对目前的工作有较好的满意度,需改变管理方法来提高工作环境和家庭生活满意度。     

永久起搏器植入术患者健康信息需求调查分析

目的了解患者术前对起搏器相关知识的需求方式及程度,有目的地加强健康教育,以增加自护知识,提高自护能力。方法自行设计问卷,对70例起博器植入术患者发放问卷:①患者希望获得起搏器知识的方式及其需求程度;②术前患者对起搏器健康知识需求情况。结果患者对健康信息需求的方式具有多样性,不同层次的患者对健康教育知识需求程度和健康知识内容需求不一样。结论正确评估患者的健康需求,“因人施教”。     

Distance education for the health care supervisor

Health care supervisors are being driven by the rapid changes in health care today. One demand is to complete their undergraduate degree or even a graduate degree. Few of us are able to devote the many hours required to attend on-campus classes full time. Now there is an alternative. Busy health care supervisors can now complete their undergraduate or graduate degrees from the comfort of their home--maintaining a job and family life.     

Sensitometric characteristics of medical roentgenographic and fluorographic films. Sensitivity of the amplifying screens combined with a film]

Factors affecting the degree of sensitivity of roentgenographic and radiofluorographic films and of their combinations with fluorescent screens are considered. A method of films exposure with a roentgenosensitometer permitting it to determine the sensitivity in conditions closely approaching the ones used in practice and corresponding to the minimum of the isoopaque is suggested. A way for determining the sensitivity of films in m2-mJ1 and lx-1-c-1 is indicated. Numerical values for the sensitivity of the films and their combinations with the screens are given. It is shown that with Eef = 38 keV, T = 20 degrees C, exposure time of 0.4--1 sec and optical density 1.00 over general focusing the lower limit of the X-ray RM-1film sensitivity to the light of CaWO4-screens is 38 m2-mJ-1 and of the fluorographic film Pphi-3 to the light of the Zn0-68Cd0-32S--Ag-screens -- 14.6 m2-mJ-1 or 30 lx-1-c-1.     

全国职业、放射卫生监督岗位人员结构分析

目的:了解全国职业、放射卫生监督岗位设置情况以及人员结构现状,分析存在的问题,为卫生监督机构职业放射卫生监督岗位的人才队伍建设提供依据。方法:通过普查,获取全国卫生监督机构职业卫生监督岗位和放射卫生监督岗位人员基本资料,分东中西部和省市县级进行描述和分析。结果:西部和县级设置职业、放射卫生监督岗位的机构比例最低;西部县级机构从事职业放射卫生监督、职业卫生监督、放射卫生监督工作的人员均数均不足2人;学历以专科和本科为主,分别占37.44%和35.92%;学位以无学位为主,占61.29%;专业以公共卫生与预防医学、临床医学为主,分别占39.53%和18.38%。结论:全国已有部分机构设置职业、放射卫生监督岗位,但部分机构的人数还不足,需继续加强人才队伍建设;人员的学历学位水平较低,而无专业的人员比例较高。     

Studies of the familial aggregation of chronic bronchitis and obstructive airways disease

The familial aggregation of chronic bronchitis and obstructive airways disease was investigated in a propositus population of 430 persons aged 45-54 years and 1340 of their first (1 degree), second (2degrees) and third (3 degrees ) order relatives. All subjects were screened in their homes using a modified British MRC respiratory disease questionnaire and a portable spirometer. 1 degree relatives of propositi with either chronic bronchitis or obstructive airways disease demonstrated up to a two-fold excess prevalence of chronic bronchitis when compared to 1 degree relatives of non-affected propositi. This excess prevalence of chronic bronchitis was independent of sex, cigarette smoking patterns, respiratory illness history, residence in a common household, geographical distribution within the study community and the presence of alpha1-antitrypsin Pi variants. The prevalence of chronic bronchitis in 1 degree relatives of diseased propositi was also greater than in 2 degrees relatives of diseased propositi, in whom the prevalence approximated that of the general population.     

Idiopathic scoliosis in adults

Author's opinion is that the disease will very slightly progrediate after adolescent age. Greater progression can be observed only in scoliosis cases higher than 50 degrees. The grown up patient get used to this physical state and it doesn't mean cosmetical handicap. Side effects of adult scoliosis can be pain and less frequently cardio-respiratoric problems. This latter can result in patient's being unable to continue working. Side effects are related to the degree of curving but mainly they come about in cases with more than 50-60 degrees of scoliosis. Consequently much effort should be made by the traditional way or by surgical treatment to stop children patients developing serious curve. Moderate scoliosis can be no handicap for grown ups.     

Task uncertainty and rationality in medical problem solving.

QUALITY ISSUE: Medical problem-solving situations are characterized by various degrees of 'task uncertainty'--i.e. uncertainty related to the definition of a problem, the effect of a technology, the value of a solution, and so on. The need for professional discretion varies and depends on the degree of perceived task uncertainty. SUGGESTED SOLUTION: In this report it is argued that, in order to obtain rationality in problem-solving processes, differences in the degree of task uncertainty need to be met by variation in the structure of the health care organization. IMPLICATIONS: The main implications of this view are that (under norms of rationality) problem-solving processes with low task uncertainty must be organized in one way and processes with high task uncertainty in another. Furthermore, processes with high and low task uncertainty also need to be evaluated according to different standards. Some hypotheses regarding the different organizational requirements are presented.     

Higher medical and surgical degrees in the University of Sydney

Three hundred and twenty-six higher medical and surgical degrees were awarded by the University of Sydney between 1883 and 1977. A questionnaire was sent to 209 graduated known to be alive to gather data regarding their prior and subsequent careers. As many of the graduates were in their fourth decade before commencing the research studies for the M.D. thesis, there would appear to be reasons for recommending the Ph.D. degree, with its three years of supervised course work, to prospective higher degree candidates. 286 B.Sc. (Med.) degrees were awarded midway through the medical course between 1949 and 1974. This earlier introduction to research probably does more to encourage and academic or research career than the M.D. degree which currently appears to be a prerequisite to a University appointment. Some concern is raised by the comment of 27% of M.D. graduates who claimed no personal scientific benefit from their studies.     

The determination of the sensitivity and specificity of the interpretation rules parameters in a study of the medical equipment testing

The interpretation systems of medical instruments are traditionally assessed by their sensitivity and specificity in definitions of the binary classification scheme. However, should the system's conclusions on the presence of a pathology be extended by a multitude of degrees of its pronouncement, such scheme is unacceptable. A three-digital classification scheme with isolated degrees of pronounced and weak pathology signs reflects, firstly, an understanding of the interpretation error value between these two degrees and, secondly, the harmlessness of errors inside each degree. The discussed logical and probabilistic models of constructing the quality parameters ensure the continuity in respect to the indices of the binary classification scheme, however, it can be stated that the probabilistic parameters are more preferable.     

Academic Degrees and Clinical Practice Characteristics: The University of Washington Physician Assistant Program: 1969-2000

CONTEXT: The physician assistant profession has been moving toward requiring master's degrees for new practitioners, but some argue this could change the face of the discipline. PURPOSE: To see if there is an association between physician assistants' academic degrees and practice in primary care, in rural areas, and with the medically underserved. METHODS: Surveys were sent to 880 graduates of the first 32 University of Washington physician assistant classes through 2000. Respondents noted their academic degree at program entry and the highest degree attained at any time up to the time of survey. Relationships between practice characteristics and academic degree levels were tested by unadjusted odds ratios and logistic regression after controlling for year of graduation and sex. RESULTS: Of the 478 respondents, 54% worked in primary care, about 30% practiced in nonmetropolitan communities, and 42% reported providing care for the medically underserved. Respondents with no degree (33% of total at entry, 24% at survey) were significantly more likely than degree holders to work in primary care and nonmetropolitan areas. Respondents with no degree at program entry were significantly more likely, and those with no degree at the time of the survey were marginally more likely, to self-report work with the medically underserved. CONCLUSION: Respondents with no academic degree are significantly more likely to demonstrate a commitment to primary, rural, and underserved health care. These findings may inform the national debate about the impact of required advanced degrees on the practice patterns of nonphysician providers.     

The danger of wearing an anorak

Campaigns to reduce road traffic accidents have paid little attention to the way headgear could interfere with vision. Binocular visual field measurement was undertaken in six healthy volunteers wearing four different types of anorak. All four anoraks greatly reduced the horizontal and superior field of vision. The anorak producing the worst reduction resulted in a width of vision of 99 degrees and only 15 degrees of vision above eye level, versus 167 degrees and 52 degrees respectively without an anorak. Anorak wearers should turn their heads to look sideways before crossing the road.     

基层中医药服务能力提升工程下患者对社区中医师信任度评价分析

目的评价基层中医药服务能力提升工程下,患者对社区中医师的信任度及中医预防保健服务对其的影响。方法于2017年9月,用维克森林医师信任量表(WFPTS)中文版测量浙江省三地22家社区卫生服务中心的1391例患者对社区中医师的信任度。定量变量描述采用均数和标准差,定性变量描述采用构成比。采用t检验、方差分析、Kruskal-Wallis检验比较差异。结果WFPTS中文版用于社区中医师的信效度良好。患者对社区中医师信任度的总均分为(38.00±6.42)分,仁爱、技能维度分别为(19.14±3.41)分、(18.82±3.50)分;信任度在患者人口学特征和对社区中医预防保健服务知晓的数量、途径和利用上,差异有统计学意义;患者的性别、年龄、对社区中医预防保健服务的知晓率和利用等因素,影响社区中医师的信任度。结论患者对社区中医师的信任度较高。提高社区中医预防保健服务的知晓率和利用率,有利于提升患者对社区中医师的信任度。建议加强宣教,多渠道提升社区中医师的技能水平。     

四种方法计算总体率可信区间的比较研究

目的 比较一次近似法、校正一次近似法、二次近似法和二项分布精确法计算总体率95％可信区间的精密度、可信度和相对误差，并探讨一次近似法和校正一次近似法的应用条件和注意事项。方法 用SAS软件编制Monte Carlo模拟抽样程序，比较4种方法的可信度；以精确法为标准，计算其他方法的精密度和相对误差。结果 校正一次近似法的可信度、精密度与精确法相似，相对误差明显小于一次近似法和二次近似法。二次近似法不论是可信度还是精密度均明显差于精确法，并具有显著的相对误差。结论 在进行率的区间估计时，建议采用校正一次近似法。     

江西省九江市流动人口艾滋病知识掌握程度及干预效果评价

目的了解流动人口对艾滋病基本知识的掌握情况,探索针对流动人口的有效艾滋病干预措施。方法采取整群抽样的方法抽取九江市浔阳区娱乐场所从业人员、建筑工人、工厂务工人员3类流动人口共1864人。自行设计调查问卷,于干预前后对调查对象使用同一问卷进行艾滋病基本知识认知度调查和获取知识主要途径调查。结果调查对象文化程度较低,以初中及以下文化程度为主;多数为青壮年;以农村户口为主（占90.8%）。干预前流动人口艾滋病基本知识知晓率偏低,干预后明显提高（P〈0.01）。干预后,艾滋病知识知晓率在流动人口的不同工种间有不同程度的提高,以建筑工人提高的幅度最高。干预前不同工种流动人口获取艾滋病知识的主要途径是电视,干预后主要途径为培训。结论针对不同工种流动人口采取培训、发放宣传品等不同侧重点的干预方法,是提高流动人口艾滋病认知度,增强防病意识,预防控制艾滋病的重要措施。     

射频热凝固治疗子宫良性疾病规范护理的探讨——附1 100例分析

目的对射频热凝固治疗子宫良性疾病的规范护理问题进行探讨。方法对1100例经射频热凝固治疗子宫良性疾病患者实施规范护理流程管理前、后的相关护理问题进行对比分析。结果在各类别子宫良性疾病的治疗中,实施规范护理流程管理后的患者(研究组),术中出血量、配合程度,术后疼痛、尿潴留、阴道流血的发生百分率,以及施术时间等比较,显著好于实施规范护理流程管理前的患者(对照组)(P<0.05)。结论规范护理流程管理的实施,有助于降低该类患者并发症的发生率、缩短施术时间、提高治疗的有效率。     

心脏瓣膜置换术后服用华法林抗凝指导及健康教育

目的探讨出院抗凝指导对机械瓣膜置换术后患者的重要性。方法对112例患者进行抗凝宣教、心理指导、饮食与用药指导及并发症的观察指导等健康教育。使其掌握心脏机械瓣膜置换术后服用抗凝药物华法林的方法及抗凝的意义,同时监测凝血功能的重要性和必要性。减少因服药不当导致的并发症,延长机械瓣膜的使用寿命。结果通过出院时的抗凝指导,112例机械瓣膜置换术后患者掌握了用药等方面的注意事项,提高了患者抗凝监测的依从性．减少了瓣膜置换术后并发症的发生。结论对人工心脏瓣膜置换术后患者进行抗凝健康教育,可使患者认识抗凝治疗的重要性。学会自我保健,能够减少术后并发症的发生,对延长瓣膜的使用时间、提高患者生命质量至关重要。     

全国卫生监督机构行政后勤岗位人员结构分析

目的:了解不同地区和级别卫生监督机构行政后勤岗位人员数量和结构现状及差异,分析存在的问题,为卫生监督机构行政后勤岗位人才队伍建设提供依据。方法:通过普查,获取全国卫生监督机构行政后勤岗位人员基本资料,分东中西部和省市县级进行描述和分析。结果:全国平均每卫生监督机构行政后勤岗位6.19人;行政后勤岗位人员年龄集中在30～49岁;专科和无学位人数最多,分别占35.49%和64.26%;公共卫生与预防医学专业人数最多,占18.87%。结论:行政后勤岗位卫生监督人员年龄梯度不合理,中、西部地区和县级学历和学位水平低,不同地区和级别专业结构差别较大。     

Management education for nurses: hospital executives' opinions and hiring practices

Because registered nurses are assuming expanded roles in hospital management, the appropriate educational preparation for these roles has become a widely debated issue. A national survey of hospital CEOs and CNOs was conducted to assess their personal preferences for management education for nurses and to gather information about their hospitals' policies and practices in hiring nurses for management positions at various levels within the hospital (from unit-level management to executive level). Both CEOs and CNOs preferred the joint MSN/MBA degree option as the best model for graduate management education for nurses, and they perceived greater demand in the future for hospital nurses with graduate management degrees. However, hospital policies and practices with regard to degree requirements and preferences for nurses hired in management positions at all levels varied widely.     

2388例围绝经期妇女健康状况调查结果分析

目的 探讨女性围绝经期综合征发生水平及自身保健情况.方法采用自行设计问卷对2388例围绝经期妇女进行调查.结果 2388例妇女中有1884例妇女有不同程度的围绝经期症状,占78.9%,50岁以上者均有症状,40～50岁者存在不同程度的围绝经期症状,40岁以下者有中度或轻度围绝经期症状.对相关的知晓度和告知度分别为16.7%和35.2%.结论围绝经期女性健康及保健状况不容乐观,这一现象应引起医学界乃至全社会关注.