武汉市四所三级医院住院患者陪护需求调查

目的 调查武汉市4所三级医院住院患者对陪护需求现状,以期提供有针对性的人性化服务.方法 根据马斯洛理论,自制“住院患者对陪护需求情况调查表”,对武汉市4所三级医院的526名住院患者进行问卷调查.结果 住院患者的陪护需求总体较高,其中患者对尊重需要维度的陪护需求最高(得分为2.41±0.39),但满足程度最低(得分为2.59±0.43),其次为爱与归属需要维度的陪护需求(得分为2.35±0.40),再次为安全需要维度的陪护需求(得分为2.34±0.35),生理需要维度的陪护需求程度最低(得分为2.08±0.32),但满足程度最高(得分为2.63±0.44).结论 护理人员应转变观念,高度重视患者的尊重需求;提高护理技术和服务水平,提供安全服务;提供多模式陪护,满足患者不同层次需求.     

军队离退休干部医疗保健需求与对策

目的分析军队离退休干部医疗保健需求情况,为提升和改善医疗保健水平提供依据和思路。方法通过调阅医院和干休所资料库、入户调查以及与卫生所医务人员的访谈,调查并收集了1所中心医院保障的12个干休所的344位离退休干部的医疗保健信息。结果离退休干部平均年龄86岁,人均患6.8种疾病并涉及各系统,48.26%的离退休干部生活不能完全自理,存在肢体瘫痪、认知障碍、语言障碍、视力障碍、听力障碍等不同程度的失能现象。急危重症患病率比例高,住院次数增加。家庭照料和护理功能日益弱化,医疗照护服务需求大。结论离退休干部的医疗保健需求呈现多元化特点;医院应完善医疗服务质量;干休所应进一步完善保健照护服务质量,提高干休所保健水平;积极推行远离体系干休所离退休干部军地"双体系"医疗保障社会化模式。     

经外周静脉置入中心静脉导管置管出院患者延续护理服务需求的调查

目的　调查经外周静脉置入中心静脉导管（PICC）置管出院患者对延续护理服务的需求,为探索PICC置管患者的延续护理服务模式制定相关措施提供依据。方法　对2所三甲综合性医院共165例PICC置管出院患者进行问卷调查,调查内容包括PICC置管出院患者一般情况,对延续护理服务内容、方式、满意度及需求。结果　PICC置管出院患者延续护理需求较高,各延续护理服务方式合计非常需要占39.77%,需要占39.09%,但满意度较低,不满意占46.34%,满意仅占34.4%;不同年龄患者对建立健康教育网络平台和家庭访视需求差异有统计学意义（P＜0.05）,不同地区患者对举办健康知识讲座、创建健康教育网络平台和病友俱乐部的需求差异有统计学意义（P＜0.05）,不同文化程度患者对延伸护理需求差异无统计学意义。结论　医院应建立PICC延续护理服务团队,根据患者需求及疾病情况制定个体化的延续护理服务方案,从而达到满足患者需求、提高PICC置管出院患者自我护理目的。     

不同住院人群护理服务满意度调查分析

目的了解不同住院人群的护理服务满意度,为对策制定提供参考。方法采用自行设计的护理服务满意度调查表对2011年10月21-26日的住院患者进行调查。结果不同年龄、不同文化程度、不同职业、不同家庭月收入、不同医疗费用负担方式、不同住院次数及不同陪护方式的患者的护理服务满意度存在统计学差异。结论住院患者的社会人口学特征对护理服务满意度有一定影响。医院应根据不同住院人群的护理服务期望和需求开展个性化护理,真正做到因人施护、因需施护,真正做到患者满意、社会满意、政府满意。     

无陪护护理模式对妇科医生和患者满意度的影响

目的评价在妇科实施无陪护护理模式的效果。方法对2010年8～12月996例妇科住院患者实施无陪护护理,实施后将医生和患者的满意度、护患矛盾发生次数与实施前比较。结果实施后医生对科室护理现状满意度为100%,患者对护理服务的评价明显提高。结论无陪护护理模式可以减少医患纠纷,提高护理效果,值得临床推广应用。     

职业病患者生存质量及延续护理服务需求调查分析

目的 了解深圳地区职业病患者生存质量情况及延续护理服务需求,为延续护理服务方案的制定提供依据。
方法 应用世界卫生组织生存质量评估简表（WHOQOL-BREF）、延续护理服务需求调查问卷,对在某医院住院的234例职业病患者进行问卷调查,并对调查结果进行统计学分析。
结果 234名职业病患者平均年龄（44.43±10.41）岁。女性、年龄 < 40岁、教育程度低、家庭月收入低、治疗年限长、尘肺病患者,以及不佩戴防护用品的职业病患者的WHOQOL-BREF生存质量得分较低（P < 0.01）。职业病患者生理维度、心理维度、社会关系维度、环境维度等4个维度得分均低于2010年中国成人（平均年龄为43.8岁）常模,且差异有统计学意义（P < 0.01）。多次反复住院、出院给予康复指导、定期复查、希望可以得到专业的延续护理服务的患者占多数。选择延续护理服务模式时,希望定期门诊复查的最多。
结论 深圳地区职业病患者生存质量及健康状况的主观评价不佳,他们对延续护理服务需求强烈。
     

郊区新建三级医院—社区—家庭一体化导管延续护理的探索

目的 :探索构建医院—社区—家庭一体化导管延续护理的服务模式,深化优质护理服务。满足带管出院患者的导管护理需求。提升社区护士的导管护理及延续护理能力。方法 :医院、社区成立联合导管延续护理小组,对医院周边4家卫生服务中心的护理人员进行导管护理、延续护理培训。通过在卫生中心建立导管维护点及社区护理人员访视,对带管出院患者进行延续护理。结果 :延续护理2013年11月到2014年12月开展期间,社区护士共访视了87例带鼻胃管出院患者,其中21例带有导尿管。PICC维护点共维护了45例患者,并发症发生率4.4%。患者对出院后的延续服务总体满意度达90%,对社区护士访视次数、维护技术、指导效果和服务态度满意度分别为87.3%、89.5%、91.2%和93%。结论 :导管的延续护理拓展了延续护理的领域,提高了社区护士的理论知识和基本技能,提升了居民对社区医疗机构的信任度,加强了综合医院与社区医疗机构的沟通合作。     

浅析脑卒中患者陪护人员的照顾行为

目的 调查脑卒中陪护人员照顾行为,了解其行为技能与脑卒中患者的康复关系.方法 采用调查问卷对主要陪护人员进行调查,包括两部分内容：诸如陪护人员的年龄、文化程度等一般情况,陪护人员的照顾行为.结果 陪护人员缺乏疾病相关知识及应对技能,严重影响者患者的生活质量及疾病的康复.结论 有针对性的开展对陪护人员专业知识宣教及培训活动,提高他们的应对技巧,从而提高脑卒中患者的生存质量.     

军队医院在军队离退休干部“三位一体”医疗模式中的作用

"三位一体"医疗模式,是根据军队离退休干部的需求,在干休所离退休干部家庭中为其设置家庭病房,由军队医院负责管理指导,干休所负责具体实施,离退休干部家庭成员共同参与管理服务的医疗模式。"三位一体"医疗模式与现代老年医学以患者为中心的个体化医疗保健服务模式相接轨,对处于"双高期"的老干部医疗、保健和康复意义重大。"三位一体"医疗模式的建立,是军队医院的宗旨所系、职责所在,军队医院在其中起着十分重要的作用。在实施过程中医院要健全组织,明确各级人员任务;与干休所及离退休干部家庭相互协调,规范建立家庭病房;加强对干休所医务人员督促指导,定期培训,落实各项工作制度,不断提高为离退休干部的服务质量。     

局部注射得宝松治疗7种皮肤病疗效观察

目的 针对住院惠者对陪护的需求,客观地评价现代医院的陪护问题.方法 对180例住院患者进行陪护需求问卷调查,了解其陪护需求的原因,并对采集的资料进行系统分析.结果 住院期间患者对陪护提出了较高需求,陪护需求率远大于卫生部规定的标准(81.8%).结论 陪护制度应遵循"以人为本"这一发展方向进行变革,尽量满足病人的需要,提高护理服务质量.     

Calcium intake in the elderly: validation of a dietary questionnaire

Epidemiological studies of calcium and osteoporosis have been hampered by the lack of a suitable tool for assessing calcium intake. This report describes a new frequency and amount questionnaire for measuring present and past calcium intake in the elderly. The validity of the questionnaire was tested against two commonly used standards of dietary assessment, five-day duplicate diets and seven-day weighed dietary inventories. The resulting correlation coefficients were, respectively, r = 0.76 and r = 0.69, while that for repeatability was r = 0.84. Furthermore, the questionnaire categorized subjects into thirds of the distribution of intake with almost no gross misclassification. It is suggested that the present findings may be extended to the majority of normal, healthy elderly subjects, implying wide application for the questionnaire in the assessment of calcium intake in the elderly.     

Self-reported health problems among Swedish miners one year after unemployment

Unemployment is considered to be a public health concern sincedeterioration in the health of the unemployed is often anticipated.However, for some groups, such as miners, unemployment mightimprove health due to a cessation of potentially harmful occupationalexposures. This study evaluates the health of 79 miners in oneSwedish iron-ore mine, and 226 age-matched controls from thegeneral population, during one year after the closure of themine. The participants received a questionnaire regarding medicalhistory and subjective symptoms at the beginning of the studyperiod, and after one year. Statistically significant negativeeffects on self-reported health attributable to unemploymentwere not found, although neuropsychiatric symptoms were morecommon among the unemployed miners. The miners reported a statisticallysignificant improvement in grip force (p=0.031). They had asignificantly higher prevalence of symptoms associated withmining related exposures when compared with the population controls;pain in the upper extremities [relative risk (RR)=2.27, 95%confidence interval (Cl)=1.44–3.59), back pain (RR=1.84;Cl=1.237–2.75), vasospastic disease of the fingers (RR=2.05;Cl=1.18–3.57) and obstructive respiratory symptoms (attacksof dyspnea and wheezing: RR=3.67; Cl=1.167–11.6).     

Excès de cas humains et animaux de tularémie en France au cours de l’hiver 2007–2008 : émergence ou phénomène isolé ?

Context

Tularemia is a zoonosis affecting humans and hares in France. We describe the results of surveillance in both species, in 2007 and 2008.

Methods

Human tularemia cases are mandatorily notifiable in France since 2003. In hares, surveillance relies on volunteer hunter associations in all districts of the country. Data from mandatory reports and volunteer surveillance in 2007/2008 were analyzed and compared with previous results.

Results

In 2007/2008, 144 cases were reported in humans and 117 cases in hares. This was a 100% increase compared to previous years. Human cases differed from those of previous years only by the frequency of contact with breeding animals. Human cases without any documented risk exposure were also more frequent.

Conclusion

An increase of tularemia cases occurred in 2007/2008 in both species. Complementary studies are needed to identify the species reservoir in France to understand the causes of this peak of cases.     

Occupational health hazards in mining: an overview

This review article outlines the physical, chemical, biological, ergonomic and psychosocial occupational health hazards of mining and associated metallurgical processes. Mining remains an important industrial sector in many parts of the world and although substantial progress has been made in the control of occupational health hazards, there remains room for further risk reduction. This applies particularly to traumatic injury hazards, ergonomic hazards and noise. Vigilance is also required to ensure exposures to coal dust and crystalline silica remain effectively controlled.     

Manufacture and use of nanomaterials: current status in the UK and global trends

This paper provides an overview of the production and use of nanomaterials (NMs), particularly in the UK. Currently, relatively few companies in the UK are identifiable as NM manufacturers, the main emphasis being the bulk markets in metals and metal oxides, and some niche markets such as carbon nanotubes and quantum dots. NM manufacturing in the UK does not reflect the global emphasis on fullerenes, nanotubes and fibres. Some assumptions have been made about the types of NM that are likely to be imported into the UK, which currently include fullerenes, modified fullerenes and other carbon-based NMs including nanotubes. Many university departments, spin-offs and private companies have developed processes for the manufacture of NMs but may only be producing small quantities for research and development (R&D) purposes. However, some have the potential to scale up to produce large quantities. The nanotechnology industry in the UK has strong R&D backup from universities and related institutions. This review has covered R&D trends at such institutions, and appropriate information has been added to a searchable database. While several companies are including NMs in their products, only a few (e.g. manufacturers of paints, coatings, cosmetics, catalysts, polymer composites) are using nanoparticles (NPs) in any significant quantities. However, this situation is likely to change rapidly. There is a need to collect more information about exposure to NPs in both manufacturing and user scenarios. As the market grows, and as manufacturers switch from the micro- to the nanoscale, the potential for exposure will increase. More research is required to quantify any risks to workers and consumers.     

深圳公立医院管理体制改革制度设计

深圳公立医院管理体制改革实行政事分开、管办分开,在理事会架构下按法定机构模式组建市医管中心,落实公立医院运营管理自主权.作者从当前公立医院管理体制的弊端入手,介绍了深圳市进行公立医院管理体制改革的基本思路及改革方案设计的主要举措,深入剖析了的改革方案的特点,并对改革效果进行了预测.     

Effects of nitrogen dioxide on red blood cells of rats: Changes in components of red cell membranes during in vivo exposure to NO2

Red cell membranes, prepared from red blood cells of rats exposed to 4, 10, or 20 ppm nitrogen dioxide (NO₂) for 1 to 10 days, were examined for evidence of changes in membrane components. Appreciable changes were not found in contents of phospholipid and cholesterol during exposure to 10 ppm NO₂. By contrast, protein content altered with the time of exposure. Moreover, changes in protein composition were observed by employing sodium dodecyl sulfate — polyacrylamide gel electrophoresis. Twenty-four-hour exposure to NO₂ at the concentration above 10 ppm resulted in a marked increase in the percentage of lysophosphatidylethanolamine (LysoPE) to the total phospholipids. The prolonged exposure to 10 ppm NO₂ gave rise to a further increase in LysoPE, whereas the percentage of phosphatidylethanolamine (PE) showed a gradual decrease. A 1-day exposure to 4.0 ppm NO₂ also caused an increase in sialic acid content and decreases in those of PE and hexose. In addition to contents of these components the percentage of LysoPE increased 5 days after exposure and the elevated values were maintained up to the end of exposure period. These results demonstrate that red blood cells in circulation exhibit different membrane properties in terms of lipid and carbohydrate composition during 10 days of exposure to 4.0 ppm NO₂.     

Investigating clusters in the workplace and beyond

Clusters of disease are common and occur in the workplace and in the general community. They often arouse considerable concern among the population. Investigations have sometimes lead to exciting new knowledge, but in general the investigation of clusters is difficult and often unrewarding, especially for community clusters. In the workplace, investigations are more likely to find associations and even new causes, but still many clusters remain enigmatic. Despite this, there are many reasons for investigating clusters, including allaying community concern and identifying uncontrolled exposures. A structure for investigating clusters in the workplace is suggested.