继续医学教育管理系统在护理学分管理中的应用

继续教育学分情况已成为护理人员晋职、晋升的重要依据,而继续教育学分的管理是一项繁琐的工作,为了规范、高效、便捷管理医学教育学分,2008年4月起江苏省常州市开始了应用计算机继续医学教育管理系统（ICME）对继续医学教育进行学分管理,采用IC卡记录学分,通过网络进行数据传输,系统、方便、科学的管理学分。2年来我院通过使用ICME系统进行继续教育学分管理,取得了较好的效果,现报告如下。     

健康教育对精神分裂症患者陪护亲属认知水平的影响

目的 探讨针对性健康教育对精神分裂症患者陪护亲属认知水平的影响,为提高其监护质量提供依据.方法将100名精神分裂症患者陪护亲属随机分为观察组和对照组各50名,观察组开展一对一针对性健康教育和心理护理,对照组予以常规健康教育讲座.观察患者住院全程.于患者出院前1 d采用自拟调查表评定两组陪护亲属的认知状况,统计两组患者自杀、外走、伤人、毁物发生率. 结果患者出院时,观察组陪护亲属对精神分裂症的概念、治疗、转归及预防的认知状况评分均显著高于对照组（P〈0.01）;患者的自杀未遂、外走行为、外走企图、伤人行为、伤人倾向、毁物现象、毁物倾向的发生率均显著低于对照组（P〈0.05或0.01）. 结论 针对性健康教育能显著提高精神分裂症患者陪护亲属的认知能力与监护质量,对预防意外事件的发生具有显著效应,更有利于帮助患者早日回归社会.     

艾滋病知识讲座对提高大学生艾滋病知识水平的效果评价

目的 研究在大学生中开展艾滋病知识讲座的可行性及有效性。方法 对某工业大学126名大学生开展艾滋病知识讲座,并对讲座前后学生的艾滋病知识得分作一一配对比较。结果 专题讲座对学生提高艾滋病知识水平相当有效。所有学生都欢迎此类讲座,有82％的学生认为最需要了解艾滋病的预防知识。此外,有部分学生承认自己曾看过黄色出版物,并有26％的学生赞同婚前性行为。结论 在大学生中开展艾滋病知识讲座非常必要而且有效。     

Changing physician practice of physical activity counseling

We conducted a prospective controlled trial to determine whether an educational intervention could improve resident physician self-efficacy and counseling behaviors for physical activity and increase their patients' reported activity levels. Forty-eight internal medicine residents who practiced at a Department of Veterans Affairs hospital received either two workshops on physical activity counseling or no intervention. All residents completed questionnaires before and 3 months after the workshops. The 21 intervention physicians reported increased self-efficacy for counseling and increased frequency of counseling compared with the 27 control physicians. Approximately 10 patients of each resident were included in the study and surveyed before and 6 months after the intervention. Of 560 patients, 465 (83%) returned both questionnaires. Following the intervention, there were no significant differences between patients of intervention and control physicians on any outcome measures. We conclude that educational interventions can improve physicians' reported self-efficacy of physical activity counseling but may not increase patient physical activity levels. Alternative approaches that emphasize overcoming the substantial barriers to exercise in chronically ill outpatients clearly will be important for facilitating changes in physical activity.     

Changing home treatment of childhood fevers by training shop keepers in rural Kenya

BACKGROUND: Malaria control in Africa relies primarily on early effective treatment for clinical disease, but most early treatments for fever occur through self-medication with shop-bought drugs. Lack of information to community members on over-the-counter drug use has led to widespread ineffective treatment of fevers, increased risks of drug toxicity and accelerating drug resistance. We examined the feasibility and measured the likely impact of training shop keepers in rural Africa on community drug use. METHODS: In a rural area of coastal Kenya, we implemented a shop keeper training programme in 23 shops serving a population of approximately 3500, based on formative research within the community. We evaluated the training by measuring changes in the proportions of drug sales where an adequate amount of chloroquine was purchased and in the percentage of home-treated childhood fevers given an adequate amount of chloroquine. The programme was assessed qualitatively in the community following the shop keeper training. RESULTS: The percentage of drug sales for children with fever which included an antimalarial drug rose from 34.3% (95% CI 28.9%-40.1%) before the training to a minimum of 79.3% (95% CI 71.8%-85.3%) after the training. The percentage of antimalarial drug sales where an adequate amount of drug was purchased rose from 31.8% (95% CI 26.6%-37.6%) to a minimum of 82.9% (95% CI 76.3%-87.3%). The percentage of childhood fevers where an adequate dose of chloroquine was given to the child rose from 3.7% (95% CI 1.2%-9.7%) before the training to a minimum of 65.2% (95% CI 57.7%-72.0%) afterwards, which represents an increase in the appropriate use of over-the-counter chloroquine by at least 62% (95% CI 53.7%-69.3%). Shop keepers and community members were strongly supportive of the aims and outcome of the programme. CONCLUSIONS: The large shifts in behaviour observed indicate that the approach of training shop keepers as a channel for information to the community is both feasible and likely to have a significant impact. Whilst some of the impact seen may be attributable to research effects in a relatively small scale pilot study, the magnitude of the changes support further investigation into this approach as a potentially important new strategy in malaria control.     

在男护生中开展护理情感教育对其职业态度的影响

目的 探讨在男护生中开展护理情感教育对其职业态度的影响.方法 将2005级48名男护生随机分为实验组和对照组,每组24名.实验组有针对地进行护理情感教育,对照组没有进行针对性的情感教育.观察两组学生在有无情感教育的情况下其职业态度的差异性.结果 两组学生在职业态度上有明显差异性,实验组学生职业态度明显比对照组好.结论 护理情感教育对于男护生的职业态度具有积极影响.     

微创临床路径对颈椎间盘突出症患者遵医行为的影响

目的 探讨实施微创临床路径对颈椎间盘突出症患者遵医行为的影响.方法 将92例颈椎间盘突出症患者随机分为观察组和对照组,每组46例,观察组按照微创临床路径实施健康教育,对照组实施传统的医疗护理模式.比较两组患者遵医行为、出院时症状改善情况、患者的住院天数、180 d内复发率.结果 观察组患者遵医行为、出院时症状临床控制率、住院天数均明显低于对照组,与对照组相比有显著差异(P<0.01).结论 应用微创临床路径实施健康教育可显著改善颈椎间盘突出症患者遵医行为,增强治疗效果,降低住院天数和疾病复发率.     

循证护理的发展与循证护理教育的现状

循证护理在临床实践上已经逐渐开展起来,对以经验为主护理方式提出了挑战,同时部分院校也开始开展循证护理教育.本文就循证护理及循证护理教育的进展,循证护理教育的方式方法进行综述,对所面临的问题进行分析及探讨.     

健康信念模式在帕金森病患者健康教育中的价值研究

目的 研究健康信念模式在帕金森病患者健康教育中的价值.方法 将88例帕金森病患者随机区组配对方法分为干预组和对照组各44例,对照组给予常规护理,干预组在常规护理的基础上运用健康信念模式对其进行健康教育,采用自行设计的调查表,以问卷调查的方式比较两组患者对疾病知识知晓率、药物的认识、自我期待、治疗依从性等指标.结果 干预组对疾病知识知晓率、药物的认识、效能期待、治疗依从性均较对照组高,两组比较,差异有统计学意义(P＜0.01或P＜0.05).结论 应用健康信念模式对帕金森病患者进行健康教育是提高帕金森病患者治疗依从性的有效手段.     

A survey on the diagnostic ability of tuberculosis in the county-level medical institutions in China

目的 调查分析我国县级结核病定点医疗机构结核病诊断能力情况,为制订结核病预防控制策略和措施提供依据。方法 2019年7—12月,课题组进行了全国基层结核病诊断服务能力现况调查,描述2019年我国2316家县级结核病定点医疗机构(不包括我国西藏自治区及港澳台地区)从事结核病临床、影像学、实验室的医生人员数量及其分布情况,以及结核病辅助检查的开展情况。结果 2316家县级结核病定点医疗机构中,从事结核病临床、影像学、实验室的医生学历以本科和大专为主,分别占64.14%(24014/37439)和23.57%(8823/37439),职称以初级以下、中级为主,分别占44.07%(16501/37439)和36.15%(13533/37439)。在2316家县级结核病定点医疗机构中,能开展结核病计算机X线摄影(CR)、数字X线摄影(DR)、CT/MRI检查者分别占29.79%(690/2316)、88.77%(2056/2316)、75.86%(1757/2316);能开展结核菌素试验(PPD试验)、γ干扰素释放试验(IGRA)、抗结核抗体感染检测者分别占70.73%(1638/2316)、23.01%(533/2316)、66.02%(1529/2316);能开展支气管镜、B型超声检查者分别占36.10%(836/2316)、81.26%(1882/2316)。结论 县级结核病定点医疗机构结核病防治专业技术人员不足,缺乏高层次人才,结核病实验室诊断能力及结核病影像学检测能力均有待提高。