影响10—12岁学龄儿童行为的家庭因素分析

目的 探讨学龄儿童行为问题及影响因素。方法 采用Rutter儿童行为问卷（父母问卷）评价儿童行为,采用Moss家庭环境量表（FES）和自拟的儿童行为问题影响因素调查,调查10－12岁城市学龄儿童325名。结果 学龄儿童行为问题检出率为9．7％;儿童行为与家庭成员的情感表达程度、家庭人员间亲密度呈显著负相关（P＜0．05）;经多因素分析,儿童行为问题的影响因素主要有家庭成员情感表达、家庭道德观。结论 儿童行为与家庭环境有密切关系,和谐的家庭气氛、良好的家庭道德观念是促进儿童行为发育的有利条件。     

流动人口的计划生育管理分析

对1998年在上海闵行区开展的“以现居住地为主”的计划生育综合干预项目中外来育龄妇女的计划生育管理状况进行分析,综合运用定量与定性研究方法以了解她们的计划生育管理状况及对计生管理的态度和要求,评价计生管理干预对改善本市外来育龄妇女的计生管理状况及提高她们对计划生育管理的认知的效果。结果显示：通过管理干预,外来育龄妇女携带原籍计划生育证明的比例和持有计划生育信息卡的比例以及暂住证上加盖计划生育合格章的比例均明显增加,妇女对计划生育服务的满意度也明显增加。认为“以现居住地为主”的流动人口计划生育管理有助于计划生育管理,应进一步加强流入地与流出地的联络、协调与积极配合,加强流动人口的计生双向管理。     

体重指数与2型糖尿病关系的Meta分析

目的：研究糖尿病家族史、身高体重指数（BMI）在2型糖尿病发生中的作用。方法：应用Meta-分析对国内有关2型糖尿病发病与糖尿病家族史、体重指数及关系的8个病例对照研究结果进行定量综合分析。结果：糖尿病家族史、BMI与2型糖尿病发病合并的OR分别为2.55(2.16-3.01)、1.34(1.22-3.37）。结论：家族史和BMI均为2型糖尿病发病的危险因素。     

重庆市家庭医生团队成员职业倦怠现状及其影响因素分析

目的 了解家庭医生团队成员的职业倦怠现状,探讨其职业倦怠的影响因素。方法 采用整群随机抽样法,从重庆市8 171支家庭医生团队中随机地选取593支团队的全部成员作为调查对象;采用自行设计的基本情况问卷和李超平等翻译并修订的MBI - GS量表对其进行调查。结果 重庆市家庭医生团队成员职业倦怠阳性检出率为78.9%,其中职业倦怠中等程度8 290例（61.7%）。主城区团队成员职业倦怠阳性6 387例（47.5%）,阳性检出率80.1%;渝东北地区职业倦怠阳性3 628例（27.0%）,阳性检出率77.5%;渝东南地区职业倦怠阳性588例（4.4%）,阳性检出率75.2%。二元logistic回归分析结果显示, 性别、年龄、月收入、编制、岗位、择业主要原因以及地区是职业倦怠的主要影响因素 (P＜0.05)。结论 重庆市家庭医生团队成员的职业倦怠阳性发生率较高,一半以上成员表现为中程度职业倦怠。与其他两大地区比较,主城区职业倦怠阳性检出率最高。相关管理者应针对主要影响因素进行干预,减轻工作压力和紧张感,以缓解职业倦怠感。     

车祸致颅脑损伤患者家属心理健康状况与社会支持相关性研究

目的 了解车祸致颅脑损伤患者家属的心理健康状况和社会支持状况,探讨其相关性。方法 采用自编一般资料调查表、症状自评量表（SCL - 90）和社会支持量表（SSRS）,对225名到精神专科医院就诊的车祸致颅脑损伤患者家属进行问卷调查。结果 车祸致颅脑损伤患家属的SCL - 90总分为（178.45±82.56）分, SCL - 90总分、阳性项目数和9个因子分均显著高于肿瘤患者家属和全国常模(P＜0.05)。社会支持总分为（38.52±8.23）分,社会支持水平与家属的心理健康状况呈显著的负相关（r = - 0.416, P＜0.05）。多元线性回归分析显示,社会支持总分可以负向预测家属的心理健康状况（β = - 0.399,P＜0.05）。结论 车祸致颅脑损伤患者家属的心理问题发生率较高,应从个人、家庭和社会层面为家属提供社会支持资源。     

家庭心理教育在精神分裂症患者康复中的作用

探讨家庭心理教育对精神分裂症康复的影响,方法采用对照研究的方法,对病人家属进行家庭心理教育,应用ＢＲＰＳ和Ｍ－ＳＤＳＳ量表对病人进行评定。结果在两年间的历次评定中,研究组病人ＢＰＲＳ和Ｍ－ＳＤＳＳ量表评分明显低于对照组。结论家庭心理教育对促进精神分裂症病人康复具有积极意义。     

发展家庭医学之必然趋势

发展全科医学的必要性已逐渐为社会所共识,从家庭的特性和时代的要求两个方面阐述了发展家庭医学的必然趋势。     

Single-handed practices – their contribution to an undergraduate teaching network in the first year of the new curriculum

OBJECTIVES: The new curriculum at King's College School of Medicine and Dentistry, which commenced in September 1996, requires all medical undergraduates to have a general practice placement throughout the 5 years of their medical education. DESIGN: This paper discusses recruitment, training and support of teaching practices for the new curriculum, reviews the distribution of single-handed general practices in the network and, via a selection of monitoring and evaluation procedures, discusses the implications of a policy which is inclusive of single-handed practices. The findings relate to the experience of the first semester of the first year of the new curriculum. It also examines the contributions that single-handed practices have made to the teaching network and the kind of support needed, if single-handed practices are to continue to contribute to the King's teaching network. SETTING: King's College School of Medicine and Dentistry. SUBJECTS: Medical undergraduates. RESULTS: The findings of this paper revealed that over a third of general practice provision is via single-handed practices in South-east London. Within the undergraduate teaching network, 10% of practices are single-handed. Students are welcomed and receive a learning experience comparable to those students in larger practices. Attendance at training events has proved difficult for some of these tutors, but the extra input from the department, in order to address this deficit, has not been onerous. Indeed, single-handed practices have not been unique with regard to difficulties in attendance at training events. CONCLUSIONS: The study concludes that single-handed practices can make satisfactory provision for undergraduates in the new curriculum and there is no evidence from this study to suggest otherwise.     

Headache and family history

In two headache questionnaire surveys we inquired about the occurrence of headache in the mothers, fathers, siblings and children of the respondents. In total, 633 people completed valid questionnaires, 260 in the first survey and 373 in the second. The hypothesis was that familial headache occurrence would be positively associated with headache frequency. In each survey, the regression of headache frequency on the number of parents having headache was highly significant. Neither sex nor the sibling and children variables were significant predictors. In the cross-tabulations of the parental occurrence of headache with headache frequency we saw a clear "break-point" between the "no headache" and the headache frequency categories studied. For the final analyses the dichotomy "headache/no headache" was related in fourfold tables to headache occurrence in the father and the mother separately, and to the number of headache parents. The positive associations were not simply due to the large number of migraine cases since they remained after removing the migraineurs.     

A factor analytic study of teaching in off-campus general practice clerkships

The Preceptor-evaluation questionnaire (PEQ) was developed at the University of Mississippi Medical Center to evaluate the clinical teaching behaviour of general practice doctors in private practice who have one or more third-year medical students per year in their offices for a required general practice clerkship. The PEQ was designed to provide feedback to these doctors and the sponsoring department in an effort to improve teaching in this setting. Developed from the input of family practice doctors who have supervised students in their offices and from a review of related literature, the instrument was given to students to determine the level of importance they attributed to each teaching characteristic. A principle components factor analysis and subsequent varimax rotation produced six significant teaching factors in this setting. These six factors were:

• 1 demonstrates a humanistic orientation toward patients and staff;
• 2 demonstrates a humanistic orientation toward student;
• 3 provides opportunity for practice;
• 4 motivates and stimulates student's thinking;
• 5 communicates effectively with student; and
• 6 demonstrates comfort and confidence in the roles of doctor and teacher.

The factor relating to the humanistic orientation toward student has not appeared as a separate factor in other studies of clinical teaching. This may be due to the unique aspects of the relationship between student and doctor in this setting which may not occur in other settings. The PEQ and similar reliable and valid instruments can provide valuable information for the doctors in these off-campus teaching situations as well as provide useful programme planning information for the sponsoring academic departments. This information may also be valuable for off-campus residency training.