患者接受医院免费健康教育处方状况分析

目的　了解来北京大学第一医院就诊者及其家属对《健康教育处方》的认同状况。方法　对摆放健康教育处方前来院就诊者及其陪同家属 3 98人和摆放《健康教育处方》后主动索取《健康教育处方》的 5 49人进行问卷调查。结果　《健康教育处方》摆放前 ,97 74%的人认为候诊等待时烦躁 ,92 2 1 %的人抱怨缺乏阅读材料 ,97 99%的赞成摆放《健康教育处方》 ;摆放《健康教育处方》后 ,3 7 70 %的人候诊等待时感到烦躁 ,仅 9 47%的人抱怨缺乏阅读材料 ,98 1 8%的人赞成摆放《健康教育处方》。结论　在医院发放《健康教育处方》是可行的 ,由制药厂赞助《健康教育处方》印制的方式受到大多数就诊者的认可     

医院健康教育处方的应用效果分析

目的进一步了解健康教育处方在医院的使用效果。方法使用自制调查问卷,采用随机的方法,对来院就诊的患者及其陪同家属共658人进行问卷调查。结果健康教育处方自取率占候诊人群的70.67%;摆放健康教育处方前后患者候诊自觉烦躁情况差异有统计学意义。被调查者在就诊前获得的相关疾病宣传资料比较贫乏,有90.88%的候诊者希望获得健康教育处方。结论健康教育处方是一种较好的医院健康教育形式,深受候诊者的欢迎。     

南宁市城市结核病健康教育评价

目的评价南宁市城区结核病健康教育.方法通过问卷调查了解公众结核病的信息来源及对待结核病的态度,评价结核病健康教育的影响程度.结果 98.1%街头群众和 100%的结核患者认为对结核病的宣传是必要的 ,群众对结核病的知晓率平均为 77.0% ;85.6%的人对结核病的现状感到严重和很严重 ;89.2%对患病感到害怕和焦虑 ;98.2%患者首选到医院诊治.电视广播、报纸、街头宣传各有 32.6%、 19%、 18.7%的认可性,公益广告以 11.8%的认可性成为后起之秀.结论非知识分子群体是健康教育的重点对象.电视广播、街头宣传、报纸仍是传统有效的结核病健康教育形式.至今尚无一种超过 50%认可性的健康教育形式.     

中学生艾滋病健康教育及健教方法的效果评价

为了解中学生对艾滋病健康教育的接受程度,探讨什么样的健教方式最适合这一群体,对深圳某中学９４名初中生进行了健教前后的问卷调查。结果表明,健康教育在提高中学生的艾滋病知识水平上有极大作用,但一次性的健教活动对性态度的改变作用不大。讲座的方式比展板、录像、宣传小册子的效果为好。     

南宁市城区结核病健康教育评价

目的评价南宁市城区结核病健康教育。方法通过问卷调查了解公众结核病的信息来源及对待结核病的态度 ,评价结核病健康教育的影响程度。结果98.1 %街头群众和100 %的结核患者认为对结核病的宣传是必要的,群众对结核病的知晓率平均为77.0 %;85.6 %的人对结核病的现状感到严重和很严重;89.2 %对患病感到害怕和焦虑;98.2%患者首选到医院诊治。电视广播、报纸、街头宣传各有32.6 %、19%、18.7 %的认可性 ,公益广告以11.8 %的认可性成为后起之秀。结论非知识分子群体是健康教育的重点对象。电视广播、街头宣传、报纸仍是传统有效的结核病健康教育形式。至今尚无一种超过50%认可性的健康教育形式     

2006～2008年贺州市性病门诊就诊者艾滋病监测分析

目的 了解贺州市性病门诊就诊者艾滋病高危行为发生情况和艾滋病病毒(HIV)感染流行趋势,为制定艾滋病预防控制规划提供依据.方法 依照<国家级HIV综合监测点监测方案>,对性病门诊就诊者进行问卷调查,采集血液进行HIV及梅毒血清学检测.结果 贺州市性病门诊综合监测2006～2008年共发现HIV抗体阳性者28例,HIV阳性率为0.76%～3.65%;性病中非淋菌性尿道炎(NGU)的感染率逐年上升(χ2=8.27,P<0.05);35.11%～45.32%的人承认在最近3个月内有商业性行为,每次都用安全套的比例为6.15%～8.24%.结论 贺州市性病门诊就诊者HIV感染率较高,应在性病门诊推广VCT策略,开展健康教育和行为干预,增强人们的健康和自我保护意识.     

就诊者检验报告单保存与手卫生现状调查分析

目的 了解就诊者对检验报告单的保存方式及接触后手卫生现状,探讨保障就诊者就医安全的对策.方法 对医院普通门诊就诊者(实验组)和卫生科就业体检者(对照组)随机抽样法进行问卷调查,原始数据采用SPSS软件进行统计分析.结果实验组和对照组对检验报告单的生物安全性不了解的分别占66.90%和78.72%,将其与他物品混杂存放的比例分别为80.80%和94.86%;接触后未采取手卫生的分别占81.11%和91.78%;71.00%和87.00%的就诊者认为医院有必要在检验报告单上标示生物安全性,并提供洗手及消毒设施.结论 医院有责任对就诊者普及手卫生及医院感染教育,增补专用洗手设施,提高就诊者对生物安全的认识及洗手依从性.     

龙岩城区社区工作人员健康教育培训效果评价

[目的]评价健康教育对社区居委会工作人员健康知识、行为和态度影响的效果。[方法]将296名调查对象随机分成教育组和对照组进行问卷调查。[结果]教育组健康知识水平提高,健康教育态度得到改善。[结论]对社区居委会工作人员开展健康教育培训是必要的,培训方法和形式是有效的,对促进社区健教的深入开展具有重要意义。     

医患关系视角下的医院管理

[目的]对比分析医院管理者、一般医务工作者和患者与家属三方对于医患关系的现状和影响因素的认识,探索在医院管理过程中改善医患关系的思路与方法. [方法]运用现状调查方法,进行现场问卷调查. [结果]总体来说,管理者与医务工作者认为当前的医患关系更为紧张,最重要的影响因素是卫生政策和国家投入,而患者及其家属认为价格因素最为重要,其次为医生的责任心和态度.[结论]医院管理者应更多的发挥主观能动性,从细节处着手,以患者的需求为导向,着力改善自身的医疗小环境,从而自下而上推动整个社会医患关系的良性发展.     

长沙市基因检测相关知识态度调查及其影响因素分析

目的了解长沙市居民及医院内患者及其家属对基因检测服务的知晓率、态度及其影响因素。方法采用分层整群随机抽样方法,对长沙市城镇居民、医院内患者及其家属进行问卷调查。结果共有399名受访者完成了调查问卷,调查人群对基因检测知晓率为47.9%,持积极态度者占73.4%。Logistic回归分析结果显示:文化程度(OR=0.535,P0.001),婚姻状况(OR=2.224,P=0.002)与基因检测服务的态度有关。结论长沙市居民、患者及其家属对基因检测服务持有较强的积极态度,对基因检测认知程度偏低,不了解基因检测的内容和定义并没有影响他们对于基因检测乐观的态度。     

The effect of a rural preceptorship during residency on practice site selection and interest in rural practice

Rural areas of the United States face serious shortages in health care personnel. This report evaluates the effect of a rural preceptorship during the second or third year of a family practice residency on interest in rural practice and on practice site selection. A majority of participants (n = 123) felt that this experience influenced their choice of a practice site. Furthermore, a large majority felt that it increased their interest in rural practice opportunities. Rural preceptorships during residency are a timely solution to increase the number of family physicians interested in rural practice.     

Nurses' perceptions of hospice palliative care volunteers

A total of 50 nurses (hospital and home care) responded to a survey designed to measure: (1) their attitudes toward, and knowledge of, hospice palliative care volunteers; (2) the types of tasks they felt it was appropriate for volunteers to perform; and (3) how valuable they felt different members of the hospice palliative care team are. In addition, they were asked to respond to some open-ended questions (eg, "Do you feel that it is appropriate for hospice palliative care volunteers to know patient medical information?"). The nurses' responses to the "Attitude/Knowledge" part of the survey revealed that they generally held positive attitudes toward volunteers. The majority of the nurses felt that it was appropriate for volunteers to perform most of the tasks listed, except for hands-on patient care. Nurses rated the value of nurses, family members, doctors, and pharmacists significantly higher than volunteers. Fifty-three percent of the nurses felt that volunteers should know patient medical information, and 77% thought that volunteers should have the opportunity to provide input regarding patient care. Also, 75% of the nurses felt that volunteers made their jobs easier, and 56% felt that volunteers should be included in team meetings. When asked to list the topics covered in a hospice palliative care volunteer training program, 73% of the nurses indicated that they were not sure or did not know what topics were covered, indicating a lack of knowledge regarding volunteer training.     

Are medical students adequately trained to prescribe at the point of graduation? Views of first year foundation doctors

BACKGROUND: Drugs are the major therapeutic intervention provided by most doctors throughout their careers. The General Medical Council expects all medical students to be competent to prescribe at the point of graduation. AIMS: The aim of this study was to assess the views of Foundation Year 1 (FY1) doctors who had recently graduated from the University of Edinburgh about their training and competence in relation to the use of drugs based on their early clinical experience. METHOD: A questionnaire was constructed based on Tomorrow's Doctors 2002 and distributed to FY1 doctors who graduated in August 2005. RESULTS: Responses were received from 100 (39.8%) of the doctors who graduated in 2005. Only 32% respondents considered themselves 'competent to prescribe' at the point of graduation. Less than 50% of respondents felt comfortable in providing information about possible treatments to allow patients to make informed decisions about their care. The majority of respondents complained about a lack of formal teaching and practice at basic clinical skills relating to drug therapy. CONCLUSION: Many graduates feel under-prepared to take on prescribing responsibilities after graduation. These findings emphasise the need to ensure that all medical curricula are able to provide sufficient learning opportunities and robust assessment in this important area of clinical practice.     

Family involvement in the care of healthy medical outpatients

BACKGROUND: Although the involvement of patients' family members in office visits has been examined extensively, less is known about the involvement of family members in supporting patients' medical care outside of office visits. OBJECTIVE: This study examines two questions: What types of family involvement do family members have in the medical care of relatively healthy older outpatients, and does self-rated health moderate patients' reactions to this family involvement? METHODS: Patients from a large sample of medical practice outpatients (N = 1572) were assessed to determine perceived emotional support, involvement of family members in their medical care, as well as the presence of depressive symptoms. RESULTS: Approximately 50% of patients had some family involvement in their medical care (e.g. taking part in medical decisions, reminding the patient to take medication). Marital status was a stronger predictor of family involvement than self-ratings of poor physical health. Additionally, there was no evidence that older patients who report good health have less favourable reactions to family involvement in their medical care. CONCLUSION: Family involvement in medical care occurs routinely and is most likely to involve a spouse, and is consistent with family interaction patterns among older adults. These findings also suggest that when providers invite family members to support treatment outside the office visit, these invitations are appropriate for older adult patients across a continuum of good to poor health.     

医院门诊就诊者流感相关知识及行为状况调查

目的了解医院就诊者流感传播和预防知识认识及行为状况。方法采用开放式调查方法 ,用自行设计的调查表对来北京大学第一医院就诊的患者进行问卷调查。结果认为流感是通过飞沫传染他人的占98.1%,认为戴口罩可以在很大程度上阻断传播的占96.3%,认为身边流感患者通过打喷嚏、咳嗽传染自己的占75.0%,关注公共场所空气污染的占96.5%。家庭中感冒患者戴口罩的占21.4%,感冒者外出戴口罩的占42.8%,退热后有较重感冒症状但坚持上班(上学)的占82.1%,不同年龄段和不同受教育程度人员感冒在家中戴口罩的比例存在统计学差异;不同年龄段人员感冒时外出戴口罩的比例存在统计学差异。结论被调查者中了解流感相关知识与传播途径的人员所占比例较大,但采取预防行为的人较少。应加大力度强化感冒患者戴口罩意识和行为;对流感患者应有相应隔离政策;强化预防流感宣传教育。     

Exercise counselling by family physicians in Canada

BACKGROUND: Exercise counselling is not frequently conducted by family physicians in several countries. Little is known about the exercise counselling practices of family physicians in Canada. The objective of this study was to assess physician confidence, current versus desired practice, and barriers related to the counselling of exercise by family physicians in Canada. METHODS: The study was a cross-sectional survey that included a random selection of family physicians in six provinces. A total of 330 family physicians completed the questionnaire, resulting in a response rate of 61.1%. A family physician was defined as a physician who practices family medicine at least 75% of their practice time. RESULTS: A total of 58.2% believed only 0-25% of their patients would respond to their counselling and 42.4% felt "moderately knowledgeable" to exercise counsel. Only 11.8% counselled 76-100% of their patients about exercise, but 43.3% thought they should be counselling 76-100% of their patients. Barriers to exercise counselling that rated most important included lack of time (65.7%) and lack of exercise education in medical school (64.8%). CONCLUSIONS: Family physicians indicated their current level of exercise counselling is suboptimal and confidence levels in exercise counselling were not high. Future educational opportunities for physicians may assist in improving exercise counselling.     

Patients' evaluation of information provided by medical doctors on the invasive ventilator for amyotrophic lateral sclerosis. An analysis of a survey of patients and their families in Japan

OBJECTIVE: The study aim was to evaluate by ALS patients' satisfaction regarding information about invasive ventilators provided by medical doctors. METHODS: Semi-structural interviews were conduced for 12 cases (11 patients and 9 family members provided information) at three areas in Japan. RESULTS: 1) Most patients were unsatisfied with the information by doctors; 2) some cases felt strong distrust of doctors' attitudes; 3) more than half of the cases complained of insufficient information. CONCLUSION: This study suggests that in the informed consent for ALS patients, doctors' negative attitudes to life prolongation adversely impact on ALS patients. Roles of service providers, patients and family members should be reconsidered for cases of ALS and other incurable diseases.     

The family history in family practice: a questionnaire study

OBJECTIVES: Our aims were to investigate family medical history taking in general practice, and to evaluate the value attached to the family medical history as an aid to decision making in general practice. METHOD: A postal questionnaire survey was conducted among all 291 GPs working within the Calderdale and Kirklees Health Authority area. Each questionnaire was followed by a reminder. The main outcome measures were answers to questions on routine and opportunistic family history taking and a question about transmitting knowledge about genetic risk to other members of the family. Questions were also posed about the value attached to the family medical history as an aid to decision making. RESULTS: A total of 193 GPs returned the questionnaire (response rate 66.3%). On registration, 94.3% of GPs indicated that enquiries were made about a family history of coronary heart disease. Breast and colorectal cancer were specifically asked about by 48.4% and 30.7% of GPs, respectively. One-fifth of respondents indicated that they asked a general question about family medical history. A little over one-quarter of respondents indicated that they made opportunistic enquiries about the family history or suggested that the patient should inform other members of the family about possible risks. In the scenarios highlighted in this study, the majority of respondents felt that the family medical history had value as an aid to decision making. This was particularly the case for checking a patient's cholesterol (92.1%) and for initiating referrals in younger patients with possible cancer-related symptoms (three-quarters of respondents). CONCLUSION: GPs value the family medical history as an aid to decision making. Unfortunately, apart from enquiries about coronary heart disease, routine or opportunistic family history taking is not occurring in practice. Mechanisms need to be sought to extract information from the family medical history so that it can be more effectively used by GPs.      

Family practice physicians' perceptions and practices regarding health promotion for the elderly

This study assessed 321 family practice physicians' perceptions and practices regarding health promotion in the elderly; specifically, whether health promotion is perceived to be beneficial for this segment of the population. A random sample of 250 male and 250 female members of the American Academy of Family Physicians was surveyed. The internal reliability of the questionnaire was assessed, yielding a Cronbach alpha of .84. Respondents were 46% male and 54% female, and 67% of them had completed a residency program. Three-fourths (77%) of the respondents were between 25 and 50 years of age. The majority believed that health promotion counseling is of value to patients of all ages (88%) and that medical schools should devote more attention to preventive medicine (69%). These physicians identified lack of third-party payment, lack of sufficient staff, lack of competence in prescribing prevention programs for the elderly, and finding counseling the elderly about preventive health issues not professionally gratifying as barriers to health promotion of the elderly. All health promotion practices but one listed on the questionnaire were perceived as important by at least half the physicians. Until compensation for health promotion is available and physicians perceive themselves as competent concerning health promotion in the elderly, it is likely their clinical practices and recommendations will lag behind their favorable attitudes toward the topic.