全国9省份医务人员职业忠诚度状况调查及分析

目的:考察当前我国医务人员职业忠诚度的基本状况及导致职业忠诚度不高的原因。方法:使用自编问卷进行整群抽样,运用SPSS19.0软件,χ2检验、Spearman相关性检验分析影响医务人员职业忠诚度的若干因素。结果与结论:医务人员职业忠诚度偏低,60.1%医务人员称不愿再次从医,70.4%称不愿子女从医。25~34岁的医务人员或护士的职业忠诚度偏低。工作压力与职业忠诚度呈负相关,薪酬公平感、权益保障、才能发挥情况与职业忠诚度呈正相关。     

某热电厂工人组织忠诚度与职业紧张、个性特征等因素关系研究

目的 探讨热电厂工人组织忠诚度与职业紧张、个性特征等因素关系.方法 采用整群抽样方法对某热电厂员工875名工人进行调查,用职业紧张测量工具、工作内容问卷和付出-回报失衡问卷等测试员工的组织忠诚度、职业紧张因素、紧张反应、个体特征、应付策略和社会支持等内容.结果 ①不同文化程度、年龄和工龄组间组织忠诚度评分差异有统计学意义(P＜0.05);②文化程度较低、年龄较大、工龄较长者组织忠诚度较高;③组织忠诚度与职业紧张因素、紧张反应、个性特征和缓解因素有相关(P＜0.01或P＜0.05);④不同组织忠诚度评分组间职业紧张因素、紧张反应、个性特征和缓解因素评分差异有统计学意义(P ＜0.001或P＜0.05);⑤多因素Logistic回归分析结果表明较低组织忠诚度工人发生心理健康不良、抑郁症状和工作不满意感相对危险度是较高组织忠诚度工人的2倍多.结论 组织忠诚度对职业紧张因素、缓解因素和紧张反应等有较大的影响.增进组织忠诚度可缓解职业紧张.     

医院员工满意度模型的实证研究

目的 提取内部服务质量因子，并对员工满意度模型进行实证研究。方法 以武汉市某三甲医院一线员工为调查样本，并对调查数据采取探索性因子分析、验证性因子分析、结构模型分析。结果 内部服务质量因子包括：工作与同事、管理支持、工作条件、工作回报，责权匹配；以内部服务质量-员工满意度-员工忠诚度的路径关系为基础的员工满意度模型存在。结论 要加强内部服务质量管理，从而提高员工满意度、忠诚度。     

感知价值对远程医疗患者满意度和忠诚度的影响研究

目的探讨感知价值不同维度对远程医疗患者满意度和忠诚度的影响,为远程医疗服务提供者提高服务质量提供参考和建议。方法采用问卷调查法采集数据,并运用结构方程模型验证各变量之间的相互关系。结果患者对远程医疗服务的满意度显著影响其忠诚度,功能价值和社会价值显著影响患者的满意度和忠诚度,而情感价值和效率价值对患者满意度和忠诚度的影响不显著。结论远程医疗服务提供方应优化服务流程以及在诊疗阶段给予患者更多的关怀,提升患者对远程医疗服务的满意度和忠诚度。     

广东省三级公立医院门诊患者满意度、忠诚度及认同度调查分析

[目的]了解广东省三级公立医院门诊满意度、忠诚度及认同度的情况,分析其影响因素,为提高公立医院竞争力提供参考。[方法]通过第三方调查公司随机抽样调查2017年广东省门诊患者满意度,对总体满意度及10项满意度指标进行描述性分析、Pearson分析和多元回归分析。[结果]门诊患者总体满意度得分为82. 26分,忠诚度为85. 07%,认同度为87. 32%。门诊满意度、患者隐私保护、服务态度、信息公布、服务流程、安保管理、医院环境、诊疗服务、服务效率、投诉管理、诊疗性价比影响门诊患者忠诚度及认同度。[结论]广东省三级公立医院门诊患者忠诚度及认同度水平不高,可针对影响门诊患者忠诚度及认同度的影响因素进行改善,以提高医院的影响力及竞争力。     

福州市臭氧暴露对人群非意外死亡的健康效应评价

目的 探讨臭氧(O3)暴露对人群非意外死亡健康效应评价.方法 选取2016-2019年福州市常住人口死因、空气污染物和气象数据,采用广义线性模型(generalized linear model,GLM)分析居民非意外死亡与第t日O3浓度Zt(O3)的相关性,进行年龄和性别的分层分析.结果 4年间O3 8 h平均(O3...     

医院员工忠诚度测评模型研究

本文从医院人力资源管理的角度,通过对现代医院人力资源管理特点及员工忠诚度理论的研究,尝试建立测评医院员工忠诚度的指标体系模型。在文章中,力求探索新的思维模式和评价方法,运用模糊综合评价法结合实例调查数据对指标体系进行量化与应用研究。     

环丙沙星使用量与大肠埃希菌对其他抗菌药物耐药性的相关性研究

目的了解我院大肠埃希菌耐药性的变迁和现状,并探讨其发展与抗菌药物用量之间的关系. 方法采用回顾性调查方法,对医院10年中8种抗菌药物的年用量与这些药物对大肠埃希菌的敏感性进行统计分析,计算抗菌药的DDDs,并用直线回归对耐药率与DDDs进行相关性分析. 结果 10年中8种抗菌药物的使用频度变化趋势不同,AMP、PIP、CFZ、CTX的使用频度总体呈波浪下降态势,CIP、CAZ呈上升态势,GEN、AMK用量变化不大,但大肠埃希菌对这些抗菌药物的耐药率,呈增长态势,只有CAZ和AMK对大肠埃希菌,敏感性＞90%;对耐药率和DDDs做相关性分析,其中只有CIP组数据显示:用量与耐药率的变化有显著的相关性(P<0.01);且与其他5种β-内酰胺酶类抗菌药物的耐药率相关;其他组数据无统计学意义. 结论 1994～2003年间大肠埃希菌对8种抗菌药物的耐药率逐年增长,CIP使用量的变化不仅与它本身的耐药性变迁相关,也与其他5种β-内酰胺酶类抗菌药物的耐药性变迁,有不同程度的相关性.     

中学生网络成瘾与抑郁的相关性研究

目的 了解中学生网络成瘾与抑郁的相关性,为加强中学生心理卫生教育提供科学依据.方法 采用网络成瘾量表和抑郁量表,对3 798名中学生进行问卷调查,采用多元方差分析、相关分析和非条件Logistic回归分析方法分析网络成瘾与抑郁的相关性.结果 中学生网络成瘾、抑郁检出率分别为5.2%和38.4%;不同网络使用情况、不同性别网络成瘾和抑郁水平差异均有统计学意义;网络成瘾与抑郁存在正相关,成瘾组与未成瘾组抑郁因子得分差异有统计学意义.结论 中学生网络成瘾和抑郁发生情况不容乐观,网络成瘾与抑郁之间存在统计学关联.     

混合响应类型的多水平模型在重复测量资料中的应用和实现

目的将混合响应类型的多水平模型应用到具有两个不同类型结局变量的重复测量资料的分析中。方法对原始资料的格式作适当变换,构造一个水平1虚拟变量,将2个结局变量作为水平1上的观察单位,各时间点的重复测量为水平2单位,受试者为水平3单位,用MLwiN2.25软件拟合混合响应类型的三水平模型,对试验组和对照组的疗效,以及受试者的年龄、性别、观察指标的基线值,时间、组别和时间的交互效应进行分析。结果该模型在考虑了两个不同类型的结局变量在各个水平上的相关性后,可以对两个结局变量同时进行影响因素分析,获得解释变量对两个结局变量影响的估计,且只要数据缺失随机则估计是有效且无偏的。结论由于混合响应类型的多水平模型允许结局变量具有不同类型,并且把数据间的相关性分解为重复测量相关性和结局变量间相关性两部分,可有效地进行重复测量资料的动态变化趋势分析,分析结果更为细致。     

Internal marketing, nurse loyalty and relationship marketing: an exploratory study of German nurses

Nurse loyalty and retention are critical issues facing the healthcare industry. A lack of continuity in the nursing staff compromises the quality of the care, results in significant costs, and leads to patient concerns about the viability of the healthcare facility. Conversely, a motivated and committed nursing staff creates a solid foundation for implementing initiatives for the improvement of healthcare quality. This article employs the "Relationship Marketing Paradigm" as a framework to understand and enhance nurse loyalty through internal marketing efforts. The results indicate that financial, social and structural bonds have significant, albeit different, impacts on nurse loyalty. Managerial implications and future research directions are discussed.     

A person-centered workplace: the foundation for person-centered caregiving in long-term care

OBJECTIVE: This study seeks to understand what role managers and the work setting they create play in a nursing facility that seeks to make a transition to person-centered care. DESIGN: The study uses a human-relations framework to test 3 propositions: Managers play a critical role in the satisfaction, loyalty and commitment (ie, the engagement) of their staff; managers construct a person-centered workplace that deepens staff engagement; and engaged staff promote the well-being of the residents. SETTING AND PARTICIPANTS: The study draws on responses of Certified Nurse Assistants (CNAs) and families of residents collected in 2 satisfaction surveys conducted in 156 nursing facilities. It also uses state inspection survey data from the same facilities. MEASUREMENTS: The analysis uses measures of satisfaction, loyalty, and commitment as well as 6 scales of quality; 3 as they pertain to staff and 3 as they pertain to families. Data reduction, correlational, and risk analyses assess how managers and the work environment affect CNA engagement and the quality of caregiving. RESULTS: Management approach and the work environment are powerful predictors of CNA satisfaction, loyalty, and commitment. The work environment also correlates with how families and state surveyors evaluate quality in a nursing facility. CONCLUSION: The managers and the work setting they create hold primacy in the work life of the CNAs. Caring managers fashion a person-centered workplace conducive to turn workers into devoted caregivers. When the workplace adds quality to the life of caregivers, the caregivers add quality to the life of the resident.     

Activities of daily living and costs in nursing homes

Functionality, as measured by activities of daily living (ADL), is the most important predictor of the cost of nursing home care. Data from a field-test version of the federally mandated Minimum Data Set (MDS) were examined using analysis of variance (ANOVA) and recursive partitioning methods to determine the relationships between ADL limitations and nursing cost (wage-weighted nursing time) among nursing home residents (n = 6,663). From this analysis, an index based on limitations in four ADLs was created. The developed ADL index is a readily determined measure of functional status useful in allocating nursing staff within nursing homes and in comparing the functional status of groups of residents, explaining 30 percent of variance in nursing costs among nursing home residents.     

The preservation of order: the use of common approach among staff toward clients in long-term psychiatric care

The authors performed this grounded theory study to gain a deeper understanding of the kinds of social processes that lead to a need among psychiatric nursing staff to reach a common approach on how to act toward individual clients in long-term psychiatric care. They present a theory about the development of such common approaches among staff. The main findings were that in psychiatric group dwellings, when the internal order is perceived as having been disturbed, the staff preserve or restore the internal order by formulating and reaching a common approach. The staff negotiated with each other to achieve an agreement on how to act and behave toward the individual client. The authors isolate and describe different types of order-disturbing incidents and the common approaches taken by the staff in dealing with them. However, their data also show that staff often had difficulties in maintaining a common approach over time.     

人性化护理打造便捷就医服务流程

目的通过发挥医院护理人员的优势,推进"流程便捷化、环境温馨化、服务人性化"便民利民措施,为患者提供温馨、便捷、安全的服务。方法开展多项创新服务项目,贯穿于院前-院时-院后的连续服务中,以营造人性化服务的整体氛围。结果提高了护理服务质量和护士素质,提高了患者的满意度和忠诚度。结论实行人性护理服务,充分发挥护理人员的主观能动性,注重服务全过程中给予护理服务对象人性关怀,可以收到满意的效果。     

Explaining turnover intention in Korean public community hospitals: occupational differences

OBJECTIVES: Personnel in public hospitals had relatively low job satisfaction despite of tenure employment. High turnover rates degrade hospital image and incur additional costs related to recruitment and training. The purposes of this study were to describe the occupational differences and to identify factors affecting turnover intention among public hospital personnel. METHOD: A questionnaire survey was conducted as part of Administrative Services Quality Evaluation Program by Seoul metropolitan municipality from 1 November to 1 December in 2003. The subjects were 1251 entire hospital personnel in four hospitals. The questionnaire was designed to measure job satisfaction, organizational commitment, turnover intention, and demographic characteristics. Logistic regression analysis was performed to determine factors influencing turnover intention. RESULTS: There were significant differences in job satisfaction, organizational commitment, and turnover intention according to the occupations. The turnover intention rates were highest among physicians, followed by paramedicals and nursing staffs and then administrators. The significant factors affecting turnover intention were involvement and loyalty among physicians, hospital type, satisfaction with systems and loyalty among nursing staffs, satisfaction with relationship and loyalty among administrators, and loyalty among paramedicals. CONCLUSION: There were different moderators that influence turnover intentions of hospital personnel. Loyalty had the most important effect upon turnover intention in all occupations.     

分级护理在临床医生中的知行调查与思考

目的调查临床医生对分级护理的认知及执行情况,为推进分级护理工作提供参考。方法根据《护理分级》内容及相关文献,自行设计调查问卷,对325名临床医生分级护理认知和执行情况进行调查。结果临床医生对分级护理知晓率仅58.71%;57.23%的医师对患者护理级别的判定是与护士合作沟通完成;不同年龄、职称、科室的临床医生对分级护理的执行情况有差异（P<0.05）。结论临床医生对分级护理的总体知晓率偏低。医疗机构需加强培训,督促医师更多关注诊疗服务细节,还需促使决策主体加强合作。     

震后基层医院护理人员科研意识现状调查与分析

目的了解震后灾区基层医院护理人员科研意识状况,为对策制定提供参考。方法对绵阳市所属7个县市基层医院护理人员进行问卷调查。结果震后基层护理人员有较强的科研意识,但相关知识严重缺乏,有强烈的培训需求。结论对口支援应增加论文写作相关知识的培训;基层医院需积极引入高学历、高职称护理人才,优化人力资源配置,并积极开展继续教育和培训。     

Customer convergence: patients, physicians, and employees share in the experience and evaluation of healthcare quality

This article explores the interrelationships between three categories of service quality in healthcare delivery organizations: patient, employee, and physician satisfaction. Using the largest and most representative national databases available, the study compares the evaluations of hospital care by more than 2 million patients, 150,000 employees, and 40,000 physicians. The results confirm the relationship connecting employees' satisfaction and loyalty to their patients' satisfaction and loyalty. Patients' satisfaction and loyalty were also strongly associated with medical staff physicians' evaluations of overall satisfaction and loyalty to the hospital. Similarly, hospital employees' satisfaction and loyalty were related to the medical staff physicians' satisfaction with and loyalty to the hospital. Based upon the strength of the interrelationships, individual measures and subscales can serve as leverage points for improving linked outcomes. Patients, physicians, and employees, the three co-creators of health, agree on the evaluation of the quality of that service experience. The results demonstrate that promoting patient-centeredness, enhancing medical staff relations, and improving the satisfaction and loyalty of employees are not necessarily three separate activities in competition for hospital resources and marketing leadership attention.