护理人员工作中被针刺伤调查及对策

目的：了解护理人员被针刺伤的情况，为采取职业防护措施提供科学依据。方法：采用问卷调查法调查护理人员被针头伤的有关情况。结果：不同职称护理人员被针刺伤的情况存在差异高度显著性，P＜0．01；不同科室护理人员被针刺伤的操作环节比较均存在差异高度显著性，P＜0．01，绝大多数护理人员对针刺伤后的处理不规范。结论：护理人员应主动增强职业防护意识，加强职业防护管理；改进废弃的一次性医疗用品管理方法和尽快采用防刺性护理用具。     

The structure of memorized knowledge in students and clinicians: an explanation for diagnostic expertise

This paper provides for the first time evidence of a consistent difference in the memory structures of novice and expert clinicians. The diagnostic performance of first- and third-year clinical medical students, senior house officers, registrars and consultants on four clinical problems in general medicine was studied. Comparisons were made of all diagnostic interpretations offered and the forceful features (personally important pieces of information which act as a key to particular memory structures which in turn give rise to the clinical interpretation) from which these were derived. Results demonstrate that the numbers of interpretations made and the numbers of forceful features identified did not differ significantly between groups (P greater than 0.05). However, the actual interpretations made in three out of four cases, and the actual forceful features identified in all cases, did differ significantly between groups (P less than 0.05). The numbers of interpretations made by all groups were large and demonstrated enormous variability. Highly individualized multiple responses to clinical information are associated with easy diagnoses. We conclude that there is no difference between groups of differing clinical experience in the breadth of thought but that there are marked differences in the precise content and structure of thought. This allows coherent explanation of variation in diagnostic expertise with clinical experience. The significance of the findings is discussed.     

Inappropriate social and sexual responses to a female student by male patients with dementia and organic brain disorder

Little attention has been directed toward inappropriate social and sexual approaches by patients with dementia diagnoses and organic disorders of the brain. A female student who approached patients who had dementia and organic brain disorders was frequently approached and touched in a sexual manner that was distressing to her and led her to believe that she was behaving in a manner that elicited these responses. It is recommended that students and volunteers be prepared for experience in settings with patients with these diagnoses through individual or group discussion, training and role playing as a way of enhancing their experiences and avoiding unnecessary feelings of guilt and embarrassment.     

一个医学生眼里的医学伦理学教育

主要通过医学生的视角，从教学内容、教学方法等方面谈了对医学伦理学教育的感受和一些建议，并通过医学生的声音反映医学伦理学教育的成果以及存在的一些问题。     

护理人员“职业枯竭”的现状与对策

对我院护理人员从业满意度、职业生涯潜在威胁的分析，认为护理管理者在重视护理学科发展的同时，换个角度审视并理性思考护理人员中存在的不可回避的“职业枯竭”问题，以利从容应对，有效规避。提出保持“资源守恒”，个人用正确的方法应对压力，护理管理者全方位介入是解决护理人员“职业枯竭”问题的关键。     

社区传染性疾病技能培训问题调查

背景 社区卫生服务机构作为传染病防控工作的最基层单位,是传染病防治的前沿阵地和重要关口,基层医务工作者承担着辖区内疫情监测、预防接种、健康宣传及协助疾控部门调查处置暴发疫情和突发公共卫生事件等职责,在疾病群防群控、易感人群保护、传染源控制及健康宣教等方面发挥着积极作用,同时对有效防控传染病发挥关键作用。目的 了解基层医务工作者社区传染病的诊治能力,分析存在的问题和薄弱方面,有针对性地设计及开展传染病相关系列培训,提高基层传染病防控能力。方法 2021年11月—2022年3月以香港大学深圳医院全科医学科在2021年11月举办的国家级社区传染性疾病继续教育会议的所有参会者为研究对象。会前、会后通过问卷星二维码向参会者发放调查问卷,会前问卷内容包括参会者人口学特征,工作后是否参加过社区传染病培训,社区传染病诊治开展情况,社区传染病防治的主观态度（是否愿意管理社区传染病、对自己传染病诊治能力满意度）,传染病防治专业知识及会议内容相关知识,对慢性乙型肝炎的态度。会后问卷内容主要为会议内容相关知识、对慢性乙型肝炎的态度以及对本次线上会议满意度调查。会前共有301名基层医务工作者完成调查问卷,会前及...     

疾控人员职业倦怠潜在剖面分析及与工作特征的关系

目的 通过对疾控(CDC)人员职业倦怠进行潜在剖面分析识别不同的职业倦怠类别,探讨工作特征各维度与职业倦怠类别间的独立效应。 方法 采用中文版职业倦怠量表(MBI-GS)、工作特征量表和自编一般资料调查表对943名疾控人员进行调查。使用潜在剖面分析方法识别疾控人员职业倦怠潜在类别,多分类Logistic回归分析探讨工作特征各维度与不同职业倦怠类别间的独立效应。 结果 疾控人员职业倦怠存在3种类别:低倦怠型(Ⅰ,54.7%)、高倦怠型(Ⅱ,24.1%)和成就感低落型(Ⅲ,21.2%)。高工作反馈、高工作意义是个体进入高倦怠型组的独立保护因素(OR=0.561;OR=0.612),高工作负荷、高工作对个体控制及情绪表达的要求是个体进入高倦怠型组的独立风险因素(OR=1.693;OR=1.770);高工作自主性是个体进入成就感低落型组的独立风险因素(OR=1.810),高工作对个体控制及情绪表达的要求是个体进入成就感低落型组的独立保护因素(OR=0.582)。 结论 疾控人员可区分出3种潜在职业倦怠类别,工作特征不同维度与潜在职业倦怠类别间存在独立效应。     

2017—2019年北京某高校教职工健康体检结果分析

目的 掌握中国人民大学教职工的健康状况及变化趋势,为改善教职工的生命质量、提出合理的健康教育和促进策略提供数据支持。方法 将2017—2019年参加体检的中国人民大学的教职工(含离退休人员)纳入研究,对获得的体检资料进行分析,采用χ2趋势检验分析异常指标在2017—2019的变化趋势。结果 2017—2019年有效体检的教职工人数分别为6 082,6 088和6 507人,各年的平均年龄在44～45岁左右,其中女性多于男性。全体职工在2017—2019年3年间高血压检出率分别为16.29%、15.85%、20.01%;高血糖检出率分别为12.20%、17.34%、29.29%;尿酸偏高检出率分别为16.36%、20.28%、20.81%;心电图异常的检出率分别为14.24%、17.58%、19.43%,检出率均逐年递增;而血脂异常检出率分别为44.33%、32.29%、32.1%;血清谷丙转氨酶偏高的检出率分别为9.48%、7.62%、7.82%,检出率呈现降低趋势(P<0.05)。2017—2019年,在各个年龄组中高血糖检出率最低为2017年<35岁组(0.81%),最高为2019年≥60岁组(48.55%);尿酸偏高的检出率最低为2017年<35岁组(15.04%),最高为2018年≥60岁组(24.4%),均明显上升,血脂异常和谷丙转氨酶偏高的检出率在各个年龄组呈下降趋势(P<0.05),血脂异常检出率最低为2019年<35岁组(15.96%),最高为2017年50～59岁组(50.79%);谷丙转氨酶偏高检出率最低为2018年≥60岁组(7.62%),最高为2019年35～49组(12.08%)。校正了年份、年龄和性别后,高血压、高血糖、血脂异常、尿酸偏高、谷丙转氨酶偏高和心电图异常的检出率均随着BMI的升高而递增(P<0.05),各项指标在肥胖组的检出率分别为30.83%、33.7%、58.51%、45.67%、27.97%和21.0%。结论 2017—2019年本校教职工的健康状况不容乐观,高血压、高血糖、尿酸偏高和心电图异常的检出率均呈现上升的趋势,血脂异常的检出率呈现逐年下降,35岁以下教职工心电图异常检出率升高明显。     

南京市公立医院医务人员内外部工作动机对工作投入的影响研究

目的 分析公立医院医务人员的内外部工作动机对工作投入的影响机制及内外部动机之间的关系,为提高医务人员的工作投入提供借鉴。方法 利用工作动机量表和工作投入量表,采用分层抽样方法,选取南京市3家三级医院、4家二级医院和16家社区卫生服务中心的医务人员进行问卷调查。结果 结构方程模型显示,内部动机和外部动机对工作投入的各个维度的路径系数分别为0.42、0.35、0.33（P＜0.001）和0.21、0.23、0.29（P＜0.001）,内部动机和外部动机的交互项对工作投入的路径系数为- 0.13（P = 0.003）。说明医务人员内部动机、外部动机对工作投入各维度:工作活力、工作奉献和工作专注都有正向影响;外部动机与内部动机协同影响医务人员的工作投入。结论 医院应关注医生内部动机与外部动机间的差异以及工作动机对医生工作投入的影响的不同,有针对性地采用不同的激励手段,全面提升医务人员的职业素养。     

Enhancing Behavior Change Skills in Health Extension Workers in Ethiopia: Evaluation of an Intervention to Improve Maternal and Infant Nutrition

Maternal and infant nutrition are problematic in areas of Ethiopia. Health extension workers (HEWs) work in Ethiopia’s primary health care system, increasing potential health service coverage, particularly for women and children, providing an opportunity for health improvement. Their roles include improving maternal and infant nutrition, disease prevention, and health education. Supporting HEWs’ practice with ‘non-clinical’ skills in behavior change and health communication can improve effectiveness. This intervention study adapted and delivered a UK-developed training intervention for Health Extension Workers (HEWs) working with the United Nations World Food Programme in Ethiopia. The intervention included communication and behavioral training adapted with local contextual information. Mixed methods evaluation focused on participants’ reaction to training, knowledge, behavior change, and skills use. Overall, 98 HEWs were trained. The intervention was positively received by HEWs. Pre-post evaluations of communication and behavior change skills found a positive impact on HEW skills, knowledge, and motivation to use skills (all p < 0.001) to change women’s nutritional behavior, also demonstrated in role-play scenarios. The study offered substantial learning about intervention delivery. Appropriate cultural adaptation and careful consideration of assessment of psychological constructs are crucial for future delivery.