New Public Health education in the Republic of Macedonia: expectations, experiences and perspectives

Development of a strategy in public health (PH) education is crucial for Macedonia in providing modern education for actual PH practice. Establishing a School of Public Health (SPH) is vital for a country in a health transition with high rates of preventable diseases. The main strategic goals in modern PH education in Macedonia should be capacity building, improving the competencies of PH professionals, serving communities, participating in the policy, and partnership development. Expectations were expressed through two key points: strengthening institutional capacity in the area of PH and institutional development of SPH. The organizational structure of the new Center of Public Health is based on existing human resources and infrastructure. Medical Faculty initiated development of a postgraduate PH teaching program [Master of Public Health (MPH)] provided by the newly formed Center of Public Health within the Medical Faculty Skopje. The Macedonian MPH program has been developed with modular-type courses as a part-time teaching program in four semesters within a 2-year period. This program is designed to cover all the basics of PH sciences and practice, including basic and elective courses, workshops, research forum. and master's thesis with a credit transfer system in PH education. The main assets for SPH development are knowledge and skills of the constantly improving teaching staff. Successful preliminary evaluation of the Macedonian SPH project, being qualified “as a model for SPH development,” led to full Association of Schools of Public Health in the European Region (ASPHER) membership. Sustainability of this program will require continuing support although a remarkable beginning has been achieved. The next strategic goal is continuing development of SPH with fiscal and academic autonomy and preparing formal ASPHER Public Health Education European Review (PEER). This SPH recognized the main communicating message of the New Public Health: “Moving with the time.” New Public Health is determined by a dual approach: to be modern, and to grow and to build the tradition in PH education. The development of Macedonian SPH represents a new orientation toward science, philosophy, culture, and life and promotes new spirit and movement in PH in this region of Europe.     

Investigating stress effect patterns in hospital staff nurses: Results of a cluster analysis

A comprehensive and reliable assessment of work stress, burnout, affective, and physical symptomatology was conducted with 260 hospital nurses. As previous attempts to categorize nursing stress and burnout by ward type have yielded inconsistent results, an alternative method for grouping nursing stress effects was sought. Cluster analysis was chosen as it offers a statistically sound means of delineating natural groupings within data. Sets of questionnaires measuring burnout, work stressors, and physical and emotional symptomatology were sent to all staff nurses at a large university hospital. Of 709 nurses employed there, a total of 260 nurses returned completed questionnaire packets. These nurses were separated into two equal groups using random sampling procedures. Cluster analysis of this data revealed groupings which were based on nursing stressors (particularly workload and conflict with physicians), social support, and patient loads. These cluster-analytic findings were replicated on both samples, and validated using data not used in the original cluster analysis. Results suggest that the effects of stress have more to do with the characteristics of the work environment and overall workload than with the degree of specialization on the unit. Results also suggest that intraprofessional conflict (i.e. with other nurses) is less psychologically damaging than is interprofessional conflict (i.e. conflict with physicians). Findings are discussed with respect to the burnout process and possible interventions.     

108所农村学校食堂及饮用水现状调查分析

目的为揭示农村学校食堂及学生饮用水安全隐患,健全卫生监督长效机制提供科学依据。方法按食品卫生监督量化评分标准设计检查内容和表格,对平江县108所学校的食堂卫生许可证、健康证持证情况、食堂基础卫生设施,学生饮用水及餐具消毒情况进行检测。结果学校卫生许可证持证率24.3%;有效健康证持证率73.1%;关键监督项目：食堂与污染源距离,三防设施、冷藏设施、专用洗涤池中学与小学分别为83.6%、58.8%;11.9%、11.8%;76.1%、32.3%;74.6%、35.3%;经统计学处理,中学与小学差异有显著性。学生饮用水总合格率57.0%,餐具消毒合格率中学36.4%,小学31.6%。结论关键监督项目达不到卫生要求,学生饮用水合格率低,致使卫生许可证持证率不高,学校存在安全隐患。因此,加强领导与监督管理,完善基础卫生设施,改水、改厕是平江县学校的当务之急。     

农村中学生的焦虑、抑郁情绪及其相关因素分析

目的探讨我市农村中学生的焦虑、抑郁情绪及其相关因素。方法在我市随机选取农村4所中学420名学生进行调查。运用抑郁自评量表（SDS）、焦虑自评量表（SAS）、青少年生活事件量表、应对方式问卷组成的调查问卷测查进行调查。结果 SAS、SDS得分与生活事件量表中的各因子呈正相关。另外,SAS、SDS得分与积极应对方式无明显相关性,而SAS、SDS得分与消极应对方式呈正相关。结论农村中学生焦虑、抑郁情绪与其生活事件和其应对方式密切相关。     

健康体检中心护士压力源调查分析

目的 了解健康体检中心护士工作压力源,为采取针对性应对措施减轻护士工作压力提供依据.方法 采用护士工作压力源量表对福州市8所医院的235名健康体检中心护士进行问卷调查.结果 健康体检中心护士80.00％处于高度或中度压力水平,压力源依次为护理专业及工作方面、病人护理方面、工作量及时间分配方面、工作环境及资源方面、管理及人际关系方面.低学历护士在工作量及时间分配方面得分较高（P＜0.01）;护士在病人护理方面和管理及人际关系方面得分高于护师（P＜0.01）;年龄≤25岁、护龄1～5年的护士在工作量及时间分配方面和管理及人际关系方面得分高于年龄＞ 25岁、护龄＞5年的护士（P＜0.01）.结论 健康体检中心护士压力较大,主要来源于护理专业及工作、工作量及时间分配等方面,要关注低学历、低职称、护龄短、年轻护士压力的缓解.     

东莞市学校生活饮用水卫生管理状况调查

目的了解东莞市学校生活饮用水卫生状况,为制定保障学校生活饮用水安全措施提供依据。方法采用现场检查和问卷调查相结合的方法对东莞市550间学校的生活饮用水卫生状况进行调查,调查结果用Excel 2003进行建库分析。结果东莞市550间学校中应用市政水厂供水作为生活饮用水的有537间．自建水厂供水或自备井水作为水源水有14间;有277间学校未建立水污染事件防范措施和报告制度;部分从业人员未持健康证和卫生知识培训证上岗;二次供水管理不规范;由水处理器处理后提供直饮水的学校卫生许可证持证率较低。结论东莞市学校生活饮用水卫生安全存在一定隐患,卫生行政部门和教育部门必须互相协调,加强监管,提高学校的思想认识,以保障学校生活饮用水安全。     

门、急诊注射室护患纠纷的原因分析及防范措施探讨

目的：分析护患纠纷的原因,提出防范措施,使护理工作正常有序的进行。方法：回顾性分析门（急）诊注射室护患纠纷的原因。结果：涉及服务方面问题28例,占74%,技术性因素5例,其他5例。结论：门（急）诊注射室护患纠纷的防范措施是增强服务意识,提高服务质量的同时加强业务学习和操作技能训练严格执行规章制,加强学习医疗法规知识和护患沟通的技巧。     

汉、维、哈三族中学生教养方式与应付方式的关系

目的探讨汉、维、哈三族中学生教养方式与应付方式的关系。方法对146名汉族、115名少数民族中学生进行教养方式（EMBU）及简易应付方式问卷（SCSQ）测试。结果①F1、F3、F4、M1、M2、M3、M5的民族差异显著;积极应付方式的民族差异不显著（F=2．170,P〉0．05）,而消极应付方式的民族差异显著（F=4．608,P〈0．01）;②F1与积极应付方式正相关（B=0．169）,M2与消极应付方式呈正相关（B=0．157）。结论F1、F3、F4、M1、M2、M3、M5的民族差异显著;消极应付方式的民族差异显著;F1与积极应付方式正相关,M2与消极应付方式呈正相关。     

精神科医生与护理人员心理健康状况调查

目的探讨某精神病院精神科医生与护理人员心理健康状况及人格特点的差异。方法采用匹兹堡睡眠质量指数(PSQI)、症状自评量表(SCL-90)、卡特尔十六种人格因素量表(16PF)对某精神病院184名职工进行施测。结果①精神科医生与护理人员在睡眠总分、SCL-90总分、总均分、躯体化等因子上的得分无差异(t=-0.016,-1.303,-1.290,-1.344;P0.05);②精神科医生在H因素,次级人格因素Ⅱ(内向外向),次级人格因素Ⅲ(安详机警)上的得分高于护理人员,在I因素上的得分低于护理人员(t=3.605,2.356,2.447,-2.656;P0.05)。结论精神科医生与护理人员的心理健康水平相当。在个性特征方面精神科医生更具有敢为性,开朗、外倾,更加果断刚毅。护理人员则更加敏感细腻。