Health managers' attitudes toward robotics and artificial computer intelligence: An empirical investigation

An empirical investigation of the perceived role of robotics and artificial computer intelligence in the future of health care reveals factors favoring a positive attitude by health administrators. The study employed a two-part survey administered in late 1989 and early 1990 to health care managers in hospitals and nursing homes. Part One of the survey asked about the participant, his or her work habits and work environment. Part Two obtained a psychological profile of rationality vs. intuition in problem solving. Through bivariate and multivariate post hoc statistical tests, we discovered the following variables which significantly determined attitudes toward robotics and artificial computer intelligence: sex, number of employees supervised; perceptions of waste and inefficiency in the workplace; perceptions of time-consuming personnel problem; perceived need to make more efficient use of time, money, and facilities; and perceived favorable climate for innovation. Among the factors which did not have an effect on attitudes toward advanced technology were three measures of rationality vs. intuition in problem solving.     

Bringing Community Involvement into a Cretan Primary/Hospital Care Center: An Evaluation of Population Habits and Attitudes Toward Health Care

In a small Cretan township hospital combining secondary and primary care, a questionnaire was distributed to a consecutive visitor sample. The questionnaire requested information on the participants' personal smoking and other life habits, perceptions and expectations of the delivery of the health care services, and attitudes toward their own doctors and others who provide various health services. Three hundred and one individuals of both sexes who were 15 years and older participated in the study (participation rate, more than 97%). An interesting and varied response was recorded, covering a wide range of perceptions, opinions, and attitudes not only toward the services, but also toward the staff. Although a high confidence in and appreciation of both the primary care and hospital sections appeared in the study results, these attitudes should not be allowed to deteriorate. Therefore, specific actions should be undertaken: constant upgrading of the existing organizational context, implementation of promotional and educational programs, and use of the questionnaire as an effective tool for periodically assessing the population's attitudes, experiences, and expectations.     

The use of instant medical history in a rural clinic. Case study of the use of computers in an Arkansas physician's office

This study evaluated the acceptance of using computers to take a medical history by rural Arkansas patients. Sex, age, race, education, previous computer experience and owning a computer were used as variables. Patients were asked a series of questions to rate their comfort level with using a computer to take their medical history. Comfort ratings ranged from 30 to 45, with a mean of 36.8 (SEM = 0.67). Neither sex, race, age, education, owning a personal computer, nor prior computer experience had a significant effect on the comfort rating. This study helps alleviate one of the concerns--patient acceptance--about the increasing use of computers in practicing medicine.     

学龄前儿童家长口腔卫生知识、行为及态度调查分析

目的:了解学龄前儿童家长对口腔卫生知识认知水平、行为及态度,为针对性地开展儿童口腔卫生健康教育工作提供依据。方法:采用整群抽样的方法,在某市区抽取9所幼儿园大、中班共1120名学龄前儿童家长进行口腔卫生知识、行为及态度的问卷调查。结果:学龄前儿童家长在儿童口腔卫生知识方面,总知晓率为69.08%,但对"每次刷牙不少于3min"、"刷牙部位为内外咬合面"、"应选择含氟牙膏"等相关知识知晓率较低(分别为42.95%、46.96%、31.34%);在儿童口腔保健行为方面,"儿童剔牙选择牙线"的正确率为22.59%,儿童"睡觉前不吃零食"的正确率为79.20%和儿童"不应经常喝碳酸饮料"的正确率为72.32%;在儿童口腔保健态度方面,学龄前儿童家长具有积极的态度,但对于"是否需要给儿童添加特殊食品增进牙齿健康"方面,家长的意识相对较低,正确率为49.82%。结论:学龄前儿童家长的口腔卫生知识相对不足,学龄前儿童家长对儿童口腔保健的行为与态度还有待提高,应该针对性加强宣传与教育。     

健康教育在老年骨科患者护理中的应用探讨

目的 探讨健康教育在老年骨科患者护理中的应用.方法 选取我院200例老年骨科住院患者的临床资料,按治疗先后顺序分为试验组和对照组,每组100例,对照组进行常规临床护理,试验组在此基础上进行健康教育护理模式,选取两组患者的健康行为、临床满意度、护理前后心态改变作为对比指标.结果 采用健康教育护理模式的试验组患者在健康行为、临床满意度、护理前后心态改变上均优于对照组患者,组间差异有统计学意义.结论 对于老年骨科住院患者采用健康教育护理模式,患者表现上优于常规护理服务,适合在临床上推广使用.     

Public perceptions of Australia's doctors, hospitals and health care systems

OBJECTIVE: To assess public perceptions of Australia's doctors, hospitals and health care systems. DESIGN AND PARTICIPANTS: A cross-sectional national telephone survey of a random sample of 800 Australian adults in August 2007. MAIN OUTCOME MEASURES: Ratings of subjective trust in health care providers, public and private hospitals, private health insurers and Medicare; attitudinal ratings for the current health care system, and public and private health care systems. RESULTS: Australians reported high trust in doctors (general practitioners more than specialists), low trust in alternative practitioners, moderate trust in hospitals (private more than public), and greater trust in Medicare than in private health insurers. Older adults had the greatest trust in physicians, hospitals and Medicare, but all age groups held similar attitudes toward public and private health care systems. Support for the current health care system with its mix of public and private funding was moderately strong, but all respondents reported weak pro-private attitudes and very strong pro-public attitudes. CONCLUSIONS: Public perceptions of Australian medical professionals, institutions and systems are generally positive. This sample did not endorse an individual user-pays private health system, but strongly favoured a universal public health system that is collectively funded by the public purse.     

Advance directives: the views of health care professionals.

OBJECTIVES: This study examined the views and experiences of 20 physicians and 20 nurses at a major Canadian teaching hospital regarding the use of advance directives in clinical care. DESIGN: The participants were purposively drawn from four clinical specialties: family and community medicine, oncology, intensive care and geriatrics. Detailed interviews were conducted in person. Content analysis was used to code the data, which were further analysed with both quantitative and qualitative techniques. MAIN RESULTS: Thirty-nine of the 40 participants favoured the use of advance directives in clinical care; physicians had somewhat less positive attitudes than nurses toward such directives. Advance directives were thought by participants to be helpful in resolving disagreements between patients and their families about treatment options; in making patients more comfortable, both physically and psychologically, during the process of dying; and in opening up communication and trust among patients, their families and health care professionals. Concerns about the use of advance directives focused on the lack of clarity in some patients' instructions, the absence of legal status for directives, the possible interference with a practitioner's clinical judgement, the adequacy and appropriateness of patients' information about their circumstances, and the type of intervention (passive or active) requested by patients. CONCLUSIONS: New regulations and legislation are making the use of advance directives more widespread. Health care professionals should participate in the development and implementation of these directives. Continuing professional education is essential in this regard.     

Satisfaction with clinical encounters among residents and geriatric patients

A total of 69 clinical encounters between 15 internal medicine residents and 69 geriatric patients were examined to determine the residents' attitudes toward specific patients and to assess their mutual satisfaction with the clinical encounter. The residents rated their attitudes toward each patient and indicated their beliefs about the patients' health status, adjustment to medical care, and expected benefits of health education activities. In general, both the residents and the patients expressed satisfaction with their clinical encounters. Little similarity in the satisfaction ratings of the residents and patients was found. The patients tended to express higher levels of satisfaction than the residents. The residents' perceptions of the expected benefits of health education and attitudes toward the patient were found to be statistically significant predictors of the residents' satisfaction. These findings suggest that specific attitudes and beliefs of residents toward their geriatric patients are linked to the residents' satisfaction and hold important implications for medical training.     

北京市京郊某区卫生技术人力资源现状调查

目的 了解北京市京郊某区卫生技术人力资源现状,为卫生行政部门合理配置卫生技术人力资源提供参考.方法 对2008年京郊某区卫生技术人员进行整群抽样调查,分析其机构性质、聘任关系、专业类别、年龄、学历和职称的特点.结果 社会资本举办的医疗机构和公立医疗机构内编制外人员占有较高比例,区-乡-村三级医疗预防保健网的总体水平逐层降低,乡村两级卫生技术人员素质总体偏低.结论 应当采取有效措施改善卫生技术人力资源结构,重点解决乡村两级卫生技术人员数量不足的问题;建立农村医学教育连续统一体,实现卫生技术队伍素质的整体提高.     

First-year family medicine residents' use of computers: knowledge, skills and attitudes.

OBJECTIVE: To identify the computer knowledge, skills and attitudes of first-year family medicine residents. DESIGN: Cross-sectional survey of family medicine residents during the academic year 1993-94; sampling began in July 1993 and ended in October 1993. SETTING: Canada. PARTICIPANTS: All 727 first-year family medicine residents, of whom 433 (60%) responded. OUTCOME MEASURES: Previous computer experience or training, current use, barriers to use, and comfort with and attitudes regarding computers. RESULTS: There was no difference in age or sex between the respondents and all first-year family medicine residents in Canada. French-speaking respondents from Quebec were underrepresented (p < 0.001). Only 56 respondents (13%) felt extremely or very comfortable with computer use. The most commonly cited barriers to obtaining computer training were lack of time (243 respondents [56%]) and the high cost of computers (214 [49%]) but not lack of interest (69 [16%]). Most residents wanted more computer training (367 [85%]) and felt that computer training should be a mandatory component of family medicine training programs (308 [71%]). CONCLUSIONS: Computer knowledge and skills and comfort with computer use appear low among first-year family medicine residents in Canada, and barriers to acquisition of computer knowledge are impressive. Computer training should become an integral part of family medicine training in Canada, and user-friendly applicable computer systems are needed.     

Age as a factor in breast cancer knowledge, attitudes and screening behaviour.

OBJECTIVE: To determine whether there are age-related differences in knowledge, attitudes and behaviour with respect to breast cancer and whether the differences reflect the age-specific Canadian recommendations on breast cancer screening. DESIGN: Telephone survey. SETTING: Two cities and five towns and their surrounding areas in Alberta. PARTICIPANTS: The age-specific, randomly selected sample comprised 1284 women aged 40 to 75 years who did not have breast cancer. Of the 1741 eligible women who were contacted, 1350 (78%) agreed to participate; 66 were excluded because of age ineligibility or a history of breast cancer. MAIN OUTCOME MEASURE: Frequency of knowledge, attitudes and behaviour with respect to breast cancer, by age group. RESULTS: Knowledge of breast cancer risk factors was generally low and decreased with age. Few women were aware of the Canadian recommendations on breast self-examination, physical examination of the breasts by a health care practitioner and mammographic screening. Older women believed they were less susceptible to breast cancer than younger women and were less likely to have positive attitudes toward screening. Self-examination was performed 9 to 15 times per year by 424 women (33%), and 810 (63%) had been examined by a health care professional in the past year. Although 664 (52%) had undergone mammography, the proportion decreased with age after age 59. The main barriers to mammography were lack of physician referral and the woman's belief that the procedure is unnecessary if she is healthy. CONCLUSIONS: Education is needed to increase breast cancer knowledge, promote the Canadian recommendations for early detection of breast cancer and decrease negative beliefs about the disease. Changes in the behaviour of women and physicians are needed to increase the use of breast self-examination, clinical breast examination by a health care professional and mammographic screening. Reaching women in the upper range (60 to 69 years) of the target group for mammographic screening should be a focus in promoting early detection of breast cancer.     

Physician and Nurse Job Climates in Hospital-Based Emergency Departments in Taiwan: Management and Implications

This study evaluates how emergency physicians and nurses perceive their job climates in their hospital-based emergency departments (ED). In total, 208 emergency physicians and 234 emergency nurses were surveyed, applying a validated survey instrument covering the job facets of medical and nursing autonomy, professional accomplishments and outcomes, leadership, communication, management, hospital policies and regulations, and external health policy environments germane to emergency medicine. The findings reveal that the average satisfaction score for professional growth and accomplishments was ranked highest by emergency physicians, and job communication within EDs was ranked highest by emergency nurses. Several emergency medical professional characteristics, including age, education, medical authority, employment duration, full-time or part-time statuses, perceived workloads, and hospital accreditation levels, were all related to job satisfaction in this surveyed population. New insights generated from this study could provide increased guidance to hospital and ED unit managers toward enhancing wellness and limiting dissatisfaction and disharmony relative to long-term career survival and the well-being of ED specialists.     

人文关怀及健康教育在神经外科中的应用

目的对人文关怀及健康教育在神经外科中的应用及效果进行调查和分析。方法以调查问卷方式对本院2010年6月～2011年10月期间神经外科120例患者人文关怀及健康教育效果进行评价。结果患者满意率较高的项目为每日清单执行情况(92.5%),饮食及休息指导(89.17%),主动了解病情(86.67%),医师诊疗服务态度(85.83%);患者满意率较低的项目为对病情解释(47.5%)及用药和检查征求意见(58.33%)。调查结果表明本院神经外科人文关怀及健康教育效果较为理想。结论人文关怀和健康教育有助于提高医疗服务质量,减少护患纠纷。     

Relationships between various attitudes towards self-determination in health care with special reference to an advance directive

OBJECTIVES: The subject of patient self-determination in health care has gained broad interest because of the increasing number of incompetent patients. In an attempt to solve the problems related to doctors' decision making in such circumstances, advance directives have been developed. The purpose of this study was to examine relationships between public attitudes towards patient autonomy and advance directives. SUBJECTS AND MAIN OUTCOME MEASURES: A stratified random sample of 600 adults in northern Sweden was surveyed by a questionnaire with a response rate of 78.2%. The subjects were asked about their wish for control of their health care, their concerns about health care, their treatment preferences in a life-threatening situation (both reversible and irreversible), and their attitudes towards the application of advance directives. RESULTS: Numerous relationships between various aspects of self-determination in health care (desire for control, fears of over-treatment, and choice of treatment level) in general and advance directives, in particular, were found. Those who wanted to have a say in their health care (about 94%) also mainly supported the use of an advance directive. CONCLUSIONS: The fact that almost 30% of the respondents were undecided concerning their personal use of advance directives points to a lack of knowledge and to the necessity of education of the public on these issues.     

Coverage and utilization of the health insurance among migrant workers in Shanghai, China

Background  According to the regulations of the Chinese and Shanghai governments, migrant workers employed in Shanghai should all be entitled to Shanghai Migrant Worker Hospitalization Insurance (SMWHI) without premium and the vast majority should also have the New Rural Cooperative Medical System (NRCMS). This study aimed to examine the status of the coverage and utilization of health insurance among migrant workers employed in Shanghai.

Methods  Quantitative and qualitative research methods were employed in the study. A survey of 1020 migrant workers employed in Shanghai was conducted in 2010 with a structured questionnaire. Focus group discussions were held with respondents who were unable to maintain health insurance coverage through NRCMS or SMWHI. In-depth interviews were held with village heads and employers of the migrant workers, migrant workers who were hospitalized within the last year, and various individuals employed by the insurance agencies.

Results  The study found that 72.9% and 36.5% of migrant workers were covered by NRCMS or SMWHI, respectively, while 16.7% of them had no health insurance. The coverage by NRCMS among migrant workers correlated significantly with education level and workplace, while the coverage by SMWHI correlated significantly with the length of employment in Shanghai and workplace. The qualitative results confirmed that migrant workers were the main group who were not covered by NRCMS, and the coverage by SMWHI was completely dependent upon the employers of the migrant worker. The results also showed that health insurance utilization among migrant workers was strongly limited by hospital location.

Conclusions  We observed that the status of health insurance among migrant workers was not accordant with theory, and that Chinese health insurance policy should be further reformed in order to realize full coverage and equal utilization of health insurance among migrant workers in China.

     

Formal handling routines in Jamaican infants. Knowledge, attitudes and behaviour

This study aimed to determine the frequency of use and the knowledge, attitudes and behaviour regarding the Formal Handling Routines (FHR) in rural and urban Jamaican infants. Analysis was made of the area of residence and educational level of the caregivers. The study included 194 caregivers, thirty-three community rehabilitation workers (CRWs) and 30 health care workers (HCWs). Depending on the level of understanding of the respondents, questionnaires were either self-administered or a personal interview was conducted. Caregivers with tertiary education differed significantly from the other caregivers both in frequency of use of the FHR and knowledge, attitudes and behaviour. Caregivers with tertiary education used the routine much less and had more negative attitudes towards it. This might be due to their better financial position, which allowed them to have helpers who cared for their children. HCWs also had significantly more negative beliefs about the FHR than CRWs and caregivers. It is possible that HCWs carried over their knowledge, attitudes and behaviour to the caregivers but if they did, it did not influence the majority of caregivers.     

Computers a cornerstone of evidence-based care, conference told.

Computers are poised to become key players in the delivery of health care, but are physicians ready for them? A recent conference on medical communication in the electronic era examined the potential of computers to assist in diagnosis, provide continuing medical education, disseminate evidence and research findings, and simplify practice management. However, delegates were told that even though many medical practices are computerized, it is often staff members and not physicians who use the technology. For computers to gain wider acceptance for medical purposes, physicians need to be made comfortable with their use at an early stage of training.     

肿瘤医院医护人员对预立医疗照护计划态度与行为意向的调查分析

  目的  本研究以调查浙江省某肿瘤专科医院医护人员对预立医疗照护计划(advance care planning,ACP)的态度及其行为意向,为姑息照护领域开展相关工作提供参考。  方法  采用随机抽样法,在2019年8—11月以浙江省某肿瘤专科医院的520名医护人员为调查对象,采用一般资料调查表、医务人员预立医疗照护计划态度与行为意向调查问卷进行调查研究。  结果  有99.8%的医护人员认为了解患者的生命意愿非常重要,有98.5%的医护人员认为医疗决策应是患者、家属及医生共同讨论后制定,且96.3%的医护人员赞同家属应该参与其中。肿瘤医院医护人员对ACP行为参与率为26.6%,在协助患者预先设立生命意愿意向方面,78.5%愿意、6.0%不清楚、15.6%不愿意。肿瘤医院医护人员实施ACP态度和行为意向影响单因素分析显示,不同工作年限、婚姻、文化程度、丧亲经历、对预先设立医疗照护计划认知的医护人员对ACP的态度及行为得分差异有统计学意义(均P < 0.05)。多因素分析调查发现已婚、高学历、有丧亲经历、认知预先设立医疗照护计划影响肿瘤医院医护人员实施ACP的态度和行为意向。  结论  医护人员对晚期癌症患者实施ACP的态度及行为意向总体呈现较为积极的接纳态度,医护人员推行ACP的态度会受学历及婚姻状况等影响。在患者治疗上医护人员存在一些分歧, 更倾向于ACP的实施,也更愿意帮助患者签署生命意愿。      

非规律产检对子痫前期妊娠结局的影响

目的：：探讨非规律产检对子痫前期患者母婴妊娠结局的影响。方法：选取2011年1月至2014年12月在承德医学院附属医院住院治疗并分娩的子痫前期患者674例,对患者年龄、职业、收入情况、是否规律产检、产检医院级别、分娩孕周、母婴并发症等进行分析。结果：非规律产检患者与无固定职业、收入低、文化程度低有关。非规律产检孕妇母体并发症中低蛋白血症发生率高于规律产检患者(P<0.05),差异有统计学意义。新生儿并发症发生率高于规律产检患者(P<0.05),差异有统计学意义。结论：非规律产检子痫前期患者母婴并发症发生率高于规律产检的子痫前期患者。非规律产检子痫前期患者中无固定职业、收入低、文化程度低所占比例高于规律产检的子痫前期患者。     

Information-seeking behaviors and attitudes of physicians toward drug information centers in Saudi Arabia

OBJECTIVE: To assess the drug information-seeking behavior of physicians in Saudi Arabia and the information resources they were using to obtain information about new drugs. The physicians' awareness of the existence of drug information centers (DICs) and their attitudes toward these centers were also investigated. Physicians were also surveyed concerning their future information needs. METHODS: The study was conducted between September 2002 and June 2003. A questionnaire was sent to 2,000 registered physicians. Data were collected on demographics, drug information resources currently used by physicians, attitudes towards DICs and future information needs. RESULTS: Response rate was 65.9%. Only 70% of the physicians were aware of the existence of DICs in KSA and 33.9% have used this service before with request rate of 0.3/month during the last 6 months prior to survey. Physicians relied heavily on books (79%), periodicals (59.2%), symposia (55.1%) and pharmacists (35.3%). Physicians searched for information 17.5 times during the last 6 months and only 57.3% were using computers and 40% had no access to the Internet at work. CONCLUSION: Physicians in KSA had passive attitudes toward DICs. These centers are under-utilized by health care professionals, in part due to the lack of awareness of their existence by physicians. Drug newsletters and continuing education programs in information-retrieval and evaluation based on evidence-based medicine techniques to promote DIC's services should be instituted.