社会心理咨询机构的现状调查

目的 了解目前社会上的心理咨询机构发展现状及咨询人员对心理咨询市场的看法。方法 采用半结构化访谈，逐一走访15家社会心理咨询机构，以频数统计和类属分析的方式分析访谈资料。结果 目前专职的心理咨询人员仅占21.4％，门诊咨询是主要的咨询方式，咨费多集中在80～150元／小时，咨询人员50％以上采用兼容取向的心理咨询技术，平均每个咨询机构月咨询量约53人次，咨询机构经营状况处于“非盈利”状态的占到60％以上，学生和30～45岁的成年人是咨询机构的主要客源。结论 目前心理咨询市场存在缺乏市场规范、咨询人员良莠不齐等问题。咨询师们强烈呼吁国家成立管理机构、出台相应政策法规规范心理咨询往业。     

社会心理咨询的现状研究

目的:探讨目前社会心理咨询存在的问题.方法:调查某个咨询机构的156名来访者的基本资料和咨询情况进行频数统计和类属分析.结果:咨询机构经营处于亏损状态,咨询人流量少,而且以一次咨询居多,咨询脱落率高,咨询技术单一.结论:我国心理咨询行业总体来说还是处于缓慢发展阶段,应增强人们维护心理健康的意识,同时提高咨询师的专业技能和职业素质.     

上海市心理健康咨询机构及服务人员的现状调查

2002年4月7日,《上海市精神卫生条例》(以下简称《条例》)正式开始实施。2002年12月,根据《条例》,上海市卫生局制定并下发了《上海市心理健康咨询服务人员管理办法》,对上海市心理咨询从业人员的资格、操作规范及培训做出了较明确的规定。为进一步加强和规范本市心理健康咨询工作,了解、掌握本市心理咨询机构及从业人员的现状,为市卫生行政主管部门贯彻《条例》、对心理健康咨询服务人员持证上岗开展卫生监督专项执法检查做好准备,我们对上海市心理健康咨询机构及服务人员进行了调查,现报告如下。一、对象与方法(一)调查对象:①本市各级医…     

河北省民众对社会心理咨询的意愿及需求分析

目的 分析河北省民众对社会心理咨询的意愿和需求现状及影响因素。方法 采用社会心理咨询态度、意愿及需求问卷,以街头拦截和网络发放的方式,对河北省933名民众进行调查。结果 河北省民众仅有32.4%愿意进行社会心理咨询,对精神分裂、抑郁、自我认识问题咨询需求较高。社会心理咨询了解程度越低（OR=0.675, 95%CI:0.547~0.834）、自由职业（OR=2.378, 95%CI:1.217~4.648）和农民（OR=3.410, 95%CI:1.332~8.728）越不愿意进行咨询;而态度中机构信任性（OR=1.140, 95%CI: 1.056~1.229）、人际开放性（OR=1.223, 95%CI:1.129~1.324）、社会成见容忍性（OR=1.091, 95%CI:1.034~1.150）越积极、年龄≥50岁（OR=3.940, 95%CI:1.828~8.489）,越愿意进行咨询。女性（β=0.075）、受教育程度越高（β=0.109）、有间接求助经历（β=0.147）、咨询需求认知越高（β=0.198）,社会心理咨询的需求越高。结论 河北省民众社会心理咨询接纳度一般,意愿及需求不强烈,政府和社会心理咨询机构应加强相关宣教和服务水平,共促心理健康。     

重庆市心理咨询从业人员专业服务观调查研究

目的了解重庆市心理咨询人员专业服务观,为提高心理咨询质量提供参考。方法本研究用自编问卷从咨询主体、咨询对象和咨询服务3个方面对53名重庆市心理咨询从业人员进行调查。结果咨询师本科学历占84%,研究生占16%;咨询者对道德品质认同度极高;均参加过至少1种培训,但接受系统培训者不多;接受心理咨询以学生居多;咨询问题多为人际关系问题、学业问题、家庭婚恋问题。资深组和新手组在认知疗法和药物治疗上的差异有统计学意义(P<0.05);面对压力时在理论匮乏、技能不足、缺乏机会和收入不高上的差异有统计学意义(P<0.05)。学历的高低在面对压力时在理论匮乏、技能不足、人际关系和缺乏支持上的差异有统计学意义(P<0.05)。结论目前心理咨询市场存在咨询人员良莠不齐等问题,部分与咨询师从业年限、学历有关。     

重庆市心理咨询从业人员专业服务观调查研究

目的 了解重庆市心理咨询人员专业服务观,为提高心理咨询质量提供参考.方法 本研究用自编问卷从咨询主体、咨询对象和咨询服务3个方面对53名重庆市心理咨询从业人员进行调查.结果 咨询师本科学历占84%,研究生占16%;咨询者对道德品质认同度极高;均参加过至少1种培训,但接受系统培训者不多;接受心理咨询以学生居多;咨询问题多为人际关系问题、学业问题、家庭婚恋问题.资深组和新手组在认知疗法和药物治疗上的差异有统计学意义(P<0.05);面对压力时在理论匮乏、技能不足、缺乏机会和收入不高上的差异有统计学意义(P<0.05).学历的高低在面对压力时在理论匮乏、技能不足、人际关系和缺乏支持上的差异有统计学意义(P<0.05).结论 目前心理咨询市场存在咨询人员良莠不齐等问题,部分与咨询师从业年限、学历有关.     

心理卫生社团对大学生心理素质的影响

有研究表明,当前我国大学生心理健康不良比例很高［‘］,大学生心理障碍发生率在15％一月％之间【‘］,而高校从事心理咨询的人员甚少,不少高校尚未建立咨询机构和缺乏心理咨询人员。心理咨询人员多为教师,咨询的方式也多为定人、定时、定地,无法切实地融入学生的日常生活、学习之中,有其局限性。因而,组织大学生自愿参加的心理卫生社团,举办心理卫生讲座,开展心理卫生活动,在同学之间传播心理卫生知识,提高大学生心理调适能力,不失为高校大学生心理保健的另一新途径。本文将初步观察结果小结如下。l对象与方法1．l对象某大学…     

四川省县乡农村卫生人员继续医学教育现状调查

目的了解四川省农村卫生人员继续医学教育现状,为评估和改善现有农村继续医学教育体制提供依据。方法采用文献调研、专家咨询、问卷调查和小组访谈等方法,对四川省射洪县和仪陇县的12个乡镇卫生院163名卫生技术人员和224个村卫生站的230名乡村医生进行调查。结果大多数乡村卫生人员参与了继续医学教育培训,主要的培训方式是在职学习,其平均每周参与培训的时间在4h左右。58.9%的乡村卫生人员未主动制定过个人继续医学教育计划,70%以上的人认为参加了在职培训后对实际工作有指导作用;参与继教培训的费用80%以上由个人支付。结论农村卫生人员继教需求大,但应选择适合的培训内容和方式。国家及相关单位应加大对农村卫生人员继续医学教育培训的资金投入,采用多种方式改进农村卫生人员继续医学教育的状况,完善继教的评估和管理体制。     

江苏省家庭医生签约服务的现状及对策

目的了解江苏省家庭医生签约服务推行现状,为推进家庭医生签约服务提供对策建议。方法在江苏省13市进行抽样调查,每市抽取8个已实施家庭医生签约服务的基层医疗卫生机构填写问卷调查表,主要内容包括居民签约情况、签约服务模式、家庭医生团队组建情况、家庭医生参与情况、机构促进签约措施、机构实施签约服务遇到的问题及建议6个方面。结果 69.7%的机构已签约总人口数/服务辖区常住人口数在30%以下,50.5%的机构已签约重点人口数/已签约总人口数在50%以上。54.5%的机构以团队为签约服务主体,85.9%的机构提供签约服务包。50.5%的机构更加注重保证已签约居民服务质量和满意度,81.8%主要签约重点人群。49.5%的机构有基本公共卫生经费支持。49.2%的社区卫生服务中心组建了6~10个签约服务团队,60.0%的乡镇卫生院组建了0~5个签约服务团队。65.7%的机构采取机构指派医生参与的方式,98.0%的机构家庭医生为非专职,同时兼职其他服务。大部分机构都采取"提供健康咨询与健康教育""部分检查项目免费或优惠""提供个性化的健康管理"三项措施,城乡机构在"提供健康咨询与健康教育"(χ2=7.24,P=0.01)和"试点阶段免费签约"(χ2=4.39,P=0.04)两方面存在差异。82.8%的机构建立了相应的津贴和奖金。82家机构认为"签约服务工作量大,人员短缺"。结论建议要及时总结,稳步推进家庭医生签约服务;加强人才培养,合理配置签约服务团队人员;完善激励机制,调动家庭医生积极性;持续落实促进措施,提高居民认知。     

卫生部医药卫生科技项目查新咨询单位机构改革策略探讨

采用自行设计的《卫生部医药卫生科技查新咨询单位基本情况调查表》,调查了解了国内21家卫生部医药卫生科技项目查新咨询单位对今后机构体制改革所提出的意见与建议等,分析我国卫生部医药卫生科技查新咨询机构目前存在的问题,探讨今后的发展方向及改革策略。     

Pharmaceutical industry self-regulation and non-transparency: country and company level analysis of payments to healthcare professionals in seven European countries

The European pharmaceutical industry uses the alleged efficacy of self-regulation to question the need for transparency laws similar to the US Physician Payment Sunshine Act. We conducted a comparative analysis of 20 large companies’ payment disclosures in seven European countries in 2017–2019. The data was extracted as part of eurosfordocs.eu, a novel transparency project that scrapes and integrates publicly available databases and disclosures. Our analysis of EUR 735 million showed marked differences in country payment patterns. For example, payment totals per registered doctor were substantially larger in Spain and lowest in Sweden. There were significant country and company differences in individualized data completeness. Only 19% of totals were reported with recipient names in Germany, compared to Ireland (59%), the United Kingdom (60%), Italy (67%), Switzerland (73%), Sweden (79%) and Spain (100%), with little or no improvement over time. Payment data in Spain was particularly difficult to extract. Thus, in no country did self-regulation generate comprehensive individualized data allowing for building an accurate picture of financial relationships between the industry and healthcare professionals. We conclude that the cultures and policies of countries and companies create structural problems of data inaccessibility and incompleteness within the self-regulatory framework. Therefore, this study supports calls for a Europe-wide “Sunshine Act” to achieve real transparency of drug company payments.     

Assessing business responses to HIV / AIDS in Kenya

A consulting firm conducted interviews with managers of 16 businesses in 3 Kenyan cities, representatives of 2 trade unions, focus groups with workers at 13 companies, and an analysis of financial/labor data from 4 companies. It then did a needs assessment. The business types were light industry, manufacturing companies, tourism organizations, transport firms, agro-industrial and plantation businesses, and the service industry. Only one company followed all the workplace policy principles recommended by the World Health Organization and the International Labor Organization. Six businesses required all applicants and/or employees to undergo HIV testing. All their managers claimed that they would not discriminate against HIV-infected workers. Many workers thought that they would be fired if they were--or were suspected to be--HIV positive. Lack of a non-discrimination policy brings about worker mistrust of management. 11 companies had some type of HIV/AIDS education program. All the programs generated positive feedback. The main reasons for not providing HIV/AIDS education for the remaining 5 companies were: no employee requests, fears that it would be taboo, and assumptions that workers could receive adequate information elsewhere. More than 90% of all companies distributed condoms. 60% offered sexually transmitted disease diagnosis and treatment. About 33% offered counseling. Four companies provided volunteer HIV testing. Almost 50% of companies received financial or other external support for their programs. Most managers thought AIDS to be a problem mainly with manual staff and not with professional staff. Almost all businesses offered some medical benefits. The future impact of HIV/AIDS would be $90/employee/year (by 2005, $260) due to health care costs, absenteeism, retraining, and burial benefits. The annual costs of a comprehensive workplace HIV/AIDS prevention program varied from $18 to $54/worker at one company.     

大病保险该由谁做:不同商业保险的比较分析

目的:对人寿和人保两家公司承担的大病保险进行比较分析,以发现不同商业保险公司在承担大病保险过程的问题和不足,以期为改进大病保险政策提供建议。方法:描述性分析法和风险经济学的方法分析大病保险效果。结果:两家保险公司大病保险2014-2016年覆盖473.68万城乡居民,累计为71 124人次报销费用4.60亿元,大病医疗费用在基本医保基础上提高了15.00%,有效降低了参保者大病经济风险。但是保险公司亏损7 507.24万元,人寿比人保亏损严重,大病保险政策地区和城乡居民收入差异太大。建议:进一步完善大病保险的管理,实现政府、企业和参保者之间的良好博弈与合作。根据大病保险实际运行情况,合理改进政策设计。     

An Evaluation of Breastfeeding Promotion Through Peer Counseling in Mississippi WIC Clinics

Objective: This study evaluates the effectiveness of a peer counseling program at increasing breastfeeding by participants in the Mississippi Special Supplemental Nutrition Program for Women, Infants and Children (WIC). Methods: Data from the 1989–1993 Pediatric Nutrition Surveillance System were analyzed to compare breastfeeding rates in clinics with and without peer counseling programs. A questionnaire completed by program staff to describe the program in greater detail helped identify characteristics associated with greater success. Results: The incidence of breastfeeding rose from 12.3% to 19.9% in those clinics with peer counseling programs, but only from 9.2% to 10.7% in clinics without a program. Clinics that started a program earlier showed greater changes in breastfeeding incidence. However, the presence of lactation specialists or consultants in the clinic appeared to be more important than the presence of less-trained peer counselors. Peer counselors who spent more than 45 minutes per participant were more effective than those spending less time. Conclusions: The peer counseling program significantly increased the incidence of breastfeeding, particularly in clinics with lactation specialists and consultants. Success can be enhanced by ensuring that peer counselors spend a great deal of time with the participants.     

Church-based telephone mammography counseling with peer counselors

Little is published about step-by-step implementation of telephone counseling interventions to promote community-based health activities. This article describes the authors' experience of implementing a church-based telephone mammography counseling intervention with peer counselors representing three principal racial or ethnic groups: African American, Latino, and Anglo (White). Twenty-six women from 12 churches in the Los Angeles area were recruited and trained to deliver the counseling annually over a two-year period to 570 women participants who were recruited from participating churches (n = 15). The counseling sessions were conducted from church-based telephone centers in key geographic locations in our program area. Training and supervision proved challenging: most of the Latino counselors had fewer than seven years of education and spoke only Spanish, while most of the other counselors had at least some college and spoke only English. Culturally specific and small group interactions, role plays, and a more modular approach to training were the most effective ways to enhance counselors' skills. Latina participants' mammography adherence rates were lowest, and their barriers reflected their low socioeconomic status; as Latina counselors shared basic information about mammograms and where to obtain them at little or no cost, the counseling exchanges tended to be nonconflictive and supportive. Black and White participants were generally more knowledgeable and adherent with screening guidelines than Latinas. We found that it was possible to implement this intervention with diverse groups and conclude with lessons learned that may inform others considering such a strategy.     

Enhancing smoking cessation rates in primary care.

BACKGROUND: The Agency for Health Care Policy and Research (AHCPR) guidelines on smoking cessation recommend that primary care physicians provide both brief advice against smoking and follow-up care for all smokers. Surveys show that although physicians understand the importance of smoking cessation, the actual implementation of these guidelines is limited. The main objective of our study was to evaluate the comparative effectiveness of 2 different approaches to smoking cessation counseling: practice-based and community-based. METHODS: Both smoking cessation approaches consisted of 1 recruitment session and 6 computer-assisted counseling sessions. In the practice-based approach, counseling was provided by office nurses and telephone counselors; in the community-based approach, the counseling was given by telephone counselors only. Four practices in 3 mid-Michigan communities participated, including 120 physicians and 487 patients who were smokers. The physicians were trained to provide brief advice for smoking cessation consistent with the AHCPR guidelines; the nurses and telephone counselors were trained in relapse prevention, computer skills, and individual case management. Sixty-two percent of the participants obtained free nicotine replacement therapy. RESULTS: At 6 months, quit rates (7-day smoke-free status) were 35% in the practice-based group and 36% in the community-based group. Participants who completed at least 4 sessions showed higher quit rates than those who did not. CONCLUSIONS: Nurses in primary care practices and counselors can be trained to deliver effective relapse-prevention counseling during office visits and by telephone. Our study showed an increase in the reported rates of smoking cessation by using these counseling methods.     

Exposure to styrene and chronic health effects: mortality and incidence of solid cancers in the Danish reinforced plastics industry.

OBJECTIVES--To study the occurrence of non-malignant diseases and solid cancers in workers exposed to styrene in the Danish reinforced plastics industry. METHODS--All 36,610 workers of 386 reinforced plastics companies and 14,293 workers not exposed to styrene from similar industries were followed up from 1970 to 1990. This industry is characterised by simple exposure conditions, exposure to high concentrations of styrene, and a high proportion of small companies, and the exposure assessment was based on experts' classification on a company level. The mortality from non-malignant causes and the incidence of solid cancers were compared with the national rates. Poisson models were used for internal comparisons. RESULTS--A total of 3031 deaths and 1134 newly diagnosed cases of solid cancer were reported in the workers in the reinforced plastics industry. In companies where 50% or more of the workers produced reinforced plastics an increased mortality rate ratio (MRR) for degenerative disorders of the nervous system (multiple sclerosis, parkinsonism, and motor neurone disease; MRR 1.8, 16 cases, 95% confidence interval (95% CI) 0.9-3.8) and an increased incidence rate ratio (IRR) for pancreatic cancer (IRR 2.2, 17 cases, 95% CI 1.1-4.5) was found. For both disease categories increased occurrence was also found among long term workers, workers of the 1960s (the period with the highest exposure to styrene), and workers with a latent period of more than 10 years after the start of employment. No other non-malignant diseases or solid cancers showed these patterns. CONCLUSION--The findings have to be interpreted with caution, due to the company based exposure assessment, but the possible association between exposures in the reinforced plastics industry, mainly styrene, and degenerative disorders of the nervous system and pancreatic cancer, deserves attention.     

Exposure of Danish workers to trichloroethylene, 1947-1989

The aim of this study was to investigate the exposure of Danish workers to trichloroethylene (TCE) and the factors that affected such exposure. Data from Danish health authorities were evaluated for use in an epidemiological study of possible adverse health effects of TCE. The paper files relating to 1,075 air measurements taken between 1947 and 1989 at 150 companies were examined to extract information about calendar year, company, industry, type of measurement, and worker. Multiple regression models were used to analyze the effects of various factors on the concentration of TCE. TCE concentrations decreased over the four decades studied. The geometric mean was 329 mg/m3 for measurements taken 1947-1959, and 260 mg/m3, 53 mg/m3, and 23 mg/m3, respectively, for the three subsequent decades. Regression analyses showed that 1) TCE concentrations decreased on average 4 percent per year before 1964 and 15 percent per year afterward; 2) area and personal measurements gave similar concentrations (for the same calendar period, industry, and duration of measurement); 3) longer-duration measurements were associated with lower TCE concentrations; 4) high TCE concentrations occurred in the iron and metal industry; and, 5) in this industry men were exposed to concentrations two times those of women. Moreover, this study indicated that both the exposure level and the proportion of exposed workers in Danish companies increased with decreasing number of employees. Epidemiological studies of health effects of TCE may benefit from evaluating potential risk within different strata of calendar time, number of company employees, sex, and type of industry.