快速康复外科卫生经济学效益分析

目的:在医改背景下及价值导向型医疗理念下探讨快速康复理念推行前后结直肠恶性肿瘤手术病种在疗效、住院天数、费用、成本等方面的效益.方法:构建多元非线性回归模型,对同济大学附属第十人民医院的626例结直肠恶性肿瘤手术病案资料进行相关性分析.结果:优化的围手术期处理方案对促进患者快速康复、缩短住院天数、降低均次费用与运营成本...     

个性化音乐疗法结合中医情志护理对ICU患者心理及睡眠的影响

目的:探究个性化音乐疗法结合中医情志护理对ICU患者心理和睡眠的改善效果。方法:将123例ICU患者依据随机数字表法分为2组,对照组61例采用常规护理联合中医情志护理干预,观察组62例在对照组的基础上采用个性化音乐疗法。对比2组护理前后心理状态评分、睡眠质量、住院时间、ICU综合征发生情况和护理满意度。结果:观察组出院时,抑郁、躯体化、焦虑、人际关系敏感、强迫症状、敌对、偏执方面评分优于对照组,差异有统计学意义(P<0.05);在精神病性、恐怖方面比较,差异无统计学意义(P>0.05)。与护理前比较,2组睡眠质量评分较前改善(P<0.05),观察组出院时,入睡时间、睡眠质量及睡眠质量总分明显优于对照组,差异有统计学意义(P<0.05)。观察组住院时间、ICU综合征发生率及护理满意度明显优于对照组,差异有统计学意义(P<0.05)。结论:个性化音乐疗法结合中医情志护理在ICU病患的心理健康状态方面的调整有积极的影响,对病患的睡眠情况的改善也有很好的帮助,降低了ICU综合征发生率,缩短了住院时间。     

儿童口腔健康影响程度量表的研制

目的评价儿童口腔健康影响程度量表（CPQ11- 14）中文版的信度和效度,探讨其在中国儿童中应用的可行性。方法对CPQ11- 14进行翻译、回译、文化调适和改造,建立儿童口腔健康影响程度量表中文版。使用该量表和口腔健康自我评价表对南宁市218名11～14岁中、小学生进行口腔健康检查和口腔健康相关生存质量调查,考评量表的信度和效度。结果口腔健康影响程度量表的重测信度系数为0.82（P<0.001）,内部一致性Cronbach′s α系数为0.79。通过因子分析提取的5个因子显示,口腔健康影响程度量表存在预想的连带关系和逻辑关系。量表得分与自我评价的口腔健康状态、自我感觉口腔健康对生活质量的影响间有明显相关性,其相关系数分别为- 0.33和0.50（P<0.000 5）。量表得分与龋失补牙指数呈明显正相关（P<0.001）,与中学组错畸形情况（美牙指数）也呈正相关（P<0.05）。结论本量表具有良好的信度和效度,为在中国进一步推广应用提供了理论依据。     

农村老年人健康状况及卫生保健需求调查

目的了解农村老年人的健康状况和卫生保健需求。方法采用自设问卷对528名60岁及以上的农村老年人进行调查。结果59．28％的老年人患有一种或几种慢性疾病,56．82％的老年人常有孤独感、衰老感、抑郁感、无能为力感等负性情绪;65．63％的老年人支付医疗费用困难。卫生保健需求依次是定期体格检查、急救处理、上门服务、健康教育、定期家访。结论农村老年人存在不同程度的身心健康问题,对卫生保健有较大需求,应根据老年人的经济状况和需求提供多种形式、多层次的卫生保健服务。     

情景模拟教学法在卫生管理专业《管理秘书实务》课程教学中的应用研究

【】为使学生实现理论知识的实践转化,提高学生的解决实际问题的能力,将情景模拟教学法应用于卫生管理专业《管理秘书实务》的课堂教学中。本文通过准备、实施、评价三个阶段,将知识点进行整合和演绎,有助于学生加强知识巩固,同时提高了课堂的趣味性,强化了学生的团队精神和参与意识,较好的实现了教学目标。情景模拟教学法的课堂应用发挥了学生的主体作用,得到了学生的肯定,对提高卫生管理专业学生的教育教学质量不失为一种好方法。     

Brief Report: Prosocial nudges and visual indicators increase social distancing,but authoritative nudges do not

Social distancing reduces the transmission of COVID-19 and other airborne diseases. To test different ways to increase social distancing, we conducted a field experiment at a major US airport using a system that presented color-coded visual indicators on crowdedness. We complemented those visual indicators with nudges commonly used to increase COVID-19–preventive behaviors. Analyzing data from 57,146 travelers, we find that visual indicators and nudges significantly affected social distancing. Introducing visual indicators increased the share of travelers practicing social distancing, and this positive effect was enhanced by introducing nudges focused on personal benefits (“protect yourself”) and public benefits (“protect others”). Conversely, an authoritative nudge referencing the Centers for Disease Control and Prevention (“don’t break CDC COVID-19 guidelines”) did not change social distancing behavior. Our results demonstrate that visual indicators and informed nudges can boost social distancing and potentially curb the spread of contagious diseases.     

医务人员HIV/AIDS防护知识与职业暴露的相关性分析

目的：了解医务人员HIV/AIDS防护知识与职业暴露的现况及其相关性。方法：对开封市3所医院的在岗医务人员进行回顾性问卷调查。结果：①被调查的287名医务人员中,AIDS基本知识的正确回答率较高,但“标准预防的概念”和“HIV职业暴露后报告程序”正确回答率较低。88.3%的人有防护意识,一半的医务人员“非常重视”HIV/AIDS自我防护。②177人2年内有职业暴露的经历,暴露总次数为492次,每人每年平均暴露1.39次。暴露发生最多的为护士（63.2%）,主要方式为针刺切割伤（40.3%）和经损伤后的皮肤接触（33.7%）暴露。③医务人员HIV/AIDS防护知识中“防护意识”、“自我防护态度”与发生职业暴露之间均存在关联性（P〈0.001）。结论：医务人员HIV/AIDS职业暴露的危险性较大,应提高医务人员的防护意识,以减少职业暴露的发生。     

虚拟现实技术联合情志干预对卒中后抑郁患者恢复效果的影响

目的:观察虚拟现实技术联合中医情志干预对卒中后抑郁患者恢复效果的影响。方法:将卒中后抑郁患者90例,按照随机奇偶数字法分为2组。对照组45例给予常规护理干预,观察组45例在对照组的基础上联合虚拟现实技术+情志护理干预。比较2组汉密尔顿抑郁量表(HAMD)评分、汉密尔顿焦虑量表(HAMA)评分、神经功能缺损(NIHSS)评分及遵医行为评分。结果:护理干预后,2组HAMA、HAMD、NIHSS评分均较治疗前明显降低(P<0.05),观察组各项评分均低于对照组(P<0.05)。护理干预后,观察组按时用药、合理饮食、配合锻炼、定期复诊评分及总分值均明显高于对照组,差异有统计学意义(P<0.05)。结论:虚拟现实技术联合情志干预可有效改善卒中后抑郁患者抑郁症状,改善遵医行为,促进受损神经功能恢复。     

In safe hands: a qualitative study on older adults’ experiences of a tailored primary health care unit

Objective: Today’s health care system faces challenges in meeting the needs of older people with multimorbidity. To better cope with these needs, tailored primary health care with geriatric competence and person-centred care has been suggested. The aim of this study was to explore older patients’ experiences of a tailored primary health care unit.Design: This was a qualitative study using semi-structured individual interviews and qualitative content analysis.Setting and patients: Nineteen patients were recruited from a tailored PHC unit for people aged 75 years or older in a region in central Sweden.Methods: The interview data were analysed using inductive category development.Results: In the analysis, the theme In safe hands when in need of primary health care emerged. The interviewees expressed a desire to participate in their own care. Easy access, enough consultation time and a calm environment, along with the PHC professionals’ welcoming and attentive approach enhanced their feeling of being in safe hands. PHC professionals were perceived as having geriatric knowledge and taking responsibility for the care of older patients. Although the interviewees experienced that they received attention for their health conditions, a need for a more preventive approach to care emerged.Conclusion: Older patients highly appreciated their tailored PHC unit and they emphasised that it was an improvement compared to the ordinary PHC centre. This study provides insights into older patients’ experiences, which may be helpful in the ongoing process of improving care for older patients in PHC.

KEY POINTS

• Older patients attending a tailored Primary health care (PHC) unit felt acknowledged, unlike in the ordinary PHC centre, which facilitated their participation in their care.
• The calm environment, specialist geriatric competence and ample patient contact time enabled them to feel secure and taken care of.
• Older patients expressed a need for an incorporation of social services and health promotion visits at the tailored PHC unit.

     

情景模拟教学在大学生“性与健康”课程中的运用

目的在大学生“性与健康”课程中开展情景模拟教学,评价教学效果。方法2010年2月至2011年6月问,在上海交通大学开设面对所有专业本科生的“性与健康”通识核心课程。授课过程中开展情景模拟教学,学期末收集学生对于情景模拟的心得体会及反馈意见,进行整理分类。结果所有课程小组均认真完成情景模拟,所表演的内容包括：大学生同性恋问题、意外怀孕及避孕知识介绍等。根据教学反馈,所有学生均较为认可这样的教学方式。结论情景模拟教学能显著提高学生的学习兴趣和热情,加深学生对知识的掌握和理解,提高学生的表达能力,培养团队合作能力。