Association of provider recommendation and offer and influenza vaccination among adults aged ≥18 years – United States

BackgroundInfluenza vaccination has been recommended for all persons aged ≥6 months since 2010.MethodsData from the 2016 National Internet Flu Survey were analyzed to assess provider vaccination recommendations and early influenza vaccination during the 2016–17 season among adults aged ≥18 years. Predictive marginals from a multivariable logistic regression model were used to identify factors independently associated with early vaccine uptake by provider vaccination recommendation status.ResultsOverall, 24.0% visited a provider who both recommended and offered influenza vaccination, 9.0% visited a provider who only recommended but did not offer, 25.1% visited a provider who neither recommended nor offered, and 41.9% did not visit a doctor from July 1 through date of interview. Adults who reported that a provider both recommended and offered vaccine had significantly higher vaccination coverage (66.6%) compared with those who reported that a provider only recommended but did not offer (48.4%), those who neither received recommendation nor offer (32.0%), and those who did not visit a doctor during the vaccination period (28.8%). Results of multivariable logistic regression indicated that having received a provider recommendation, with or without an offer for vaccination, was significantly associated with higher vaccination coverage after controlling for demographic and access-to-care factors.ConclusionsProvider recommendation was significantly associated with influenza vaccination. However, overall, 67.0% of adults did not visit a doctor during the vaccination period or did visit a doctor but did not receive a provider recommendation. Evidence-based strategies such as client reminder/recall, standing orders, provider reminders, or health systems interventions in combination should be undertaken to improve provider recommendation and influenza vaccination coverage. Other factors significantly associated with a higher level of influenza vaccination included age ≥50 years, being Hispanic, having a college or higher education, having a usual place for medical care, and having public health insurance.     

The relevance of psychosocial variables and working conditions in predicting nurses' coping strategies during the SARS crisis: an online questionnaire survey

OBJECTIVES: The purpose of this investigation was to examine the relationship between psychosocial variables and working conditions, and nurses' coping methods and distress in response to the severe acute respiratory syndrome (SARS) crisis in Canada. PARTICIPANTS AND PROCEDURE: The sample consisted of 333 nurses (315 women, 18 men) who completed an Internet-mediated questionnaire that was posted on the Registered Nurses' Association of Ontario (RNAO) website between March and May 2004. The questionnaire was restricted to respondents who had to authenticate their RNAO membership with a valid username and password before accessing the questionnaire. This served a dual purpose: to ensure that only RNAO nurses completed the questionnaire and thereby safeguarding the generalizability of the findings; and second, to prevent any one nurse from contributing more than once to the overall sample. RESULTS: Correlational analysis yielded several significant relationships between psychosocial variables and working conditions, and the traditional correlates of burnout and stress. Three multiple regression analysis revealed that the model we evolved--including higher levels of vigor, organizational support, and trust in equipment/infection control initiative; and lower levels of contact with SARS patients, and time spent in quarantine--predicted to lower levels of avoidance behavior, emotional exhaustion, and state anger. CONCLUSIONS: By employing models of stress and burnout that combine psychosocial variables and working conditions, researchers can account for significant amounts of variance in outcomes related to burnout. These findings highlight the importance of vigor and perceived organizational support in predicting nurses' symptoms of burnout. For healthcare administrators, this means that a likely strategy for assuaging the negative outcomes of stress should address nurses' psychosocial concerns and the working conditions that they face during novel times of crisis.     

Update 2007: Delights and Dangers of Internet Sex

Technology has developed so rapidly that many busy clinicians have been unaware of changes in the leisure behavior of their patients. A whole new world of enormous proportions is now at the fingertips of those who have access to a personal computer. They can explore, discover, link, and connect with family and friends, but also with all kinds of unknown adventurers, who wish to play; talk; flirt; and, yes, be sexual online.     

基于互联网医院的医护上门多系统集成平台研发及应用

目的 基于互联网医院构建一站式医护上门多系统集成平台,并评价其应用效果。方法 设计开发“医护上门”服务平台,实施患者居家护理服务。统计应用前6个月(采用电话预约方式实施居家服务)与应用后6个月服务患者的情况,比较患者满意度及护士认可度。结果 应用前开展项目12项,接受服务63例;应用后开展项目28项,接受服务299例。应用后患者满意度评分及护士认可度评分显著高于应用前(均P<0.01)。结论 医护上门平台实现了多系统、多学科的有效融合,可为患者提供专业、高效、便捷的居家护理服务,促进了居家护理服务业态的持续发展。     

虚拟护理工作室预检分诊与分级派单制的居家护理服务实践

目的 探讨基于互联网平台的虚拟护理工作室的运营方式与实践效果。方法 2020年11月构建虚拟护理工作室平台,实施网上预约和线下服务。2021年2月针对实施中存在的问题,重组虚拟护理工作室成员,根据护士资质分成普通护士、市级专科护士和省级专科护士;由工作室护理长定岗线上预检分诊,实施分级派单;不同级别的护士上门实施护理,为患者提供延续性、全程、精确的居家照护服务。结果 线上预检分诊与分级派单制实施后,预约错误、退诊、退费发生率显著降低,实际服务例数、服务对象满意率显著提高,与实施前比较,差异有统计学意义(P<0.05,P<0.01)。结论 虚拟护理工作室实施线上预检分诊与分级派单制可以精准对接患者需求,减少不良事件,提高服务对象满意度。     

导管护理网约护士工作压力的质性研究

目的 深入了解导管护理网约护士的工作压力感受,旨在探讨缓解其压力的措施,为促进网约导管护理发展提供参考。方法 采用目的抽样方法,对11名导管护理网约护士进行质性访谈,并采用Colaizzi 7步分析法进行资料分析。结果 提炼出3个主题,包括压力源,来自于患方、安全保障和护士自身;压力导致的正性和负性反馈;压力应对,包括个人应对和管理层应对。结论 导管护理网约护士存在多方压力,宜多方合力缓解护士压力,促进网约导管护理的进步与发展,提高护理服务质量。     

Community pharmacists,Internet and social media: An empirical investigation

BackgroundUse of social media and Internet for health information sharing is expanding among patients, physicians, and other health care professionals. Research on professional use of social media by community pharmacists is limited.Objectives1) To determine the extent to which Texas (U.S. state) independent community pharmacists use text messaging, email, Facebook, Twitter, and/or other information technology for professional communication with patients and health care professionals and identify the perceptions of Texas independent community pharmacists toward such usage; 2) to determine the extent to which Texas independent community pharmacists develop and employ their pharmacy websites to provide drug information and patient care services.MethodsA 25-item survey with questions addressing the objectives of the study as well as basic demographic questions (gender, age, and type of pharmacy degree) was mailed to a random sample of 1196 independent community pharmacists in Texas in January 2012.ResultsThe study response rate was 23.7%, with 284 usable questionnaires returned. The majority of respondents reported that Internet access is available at their pharmacies (98% (278)), and 91% (258) are familiar with the term ‘social media’. To communicate with health care professionals, 56% (n = 160) of respondents use email, 34% (n = 97) use text messages and 5% (n = 14) use Facebook. To communicate with patients, 36% (n = 102) of respondents use email, 30% (n = 86) use text messages and 7% (n = 19) use Facebook. The perceptions of pharmacists who communicate with patients using electronic tools about information related to drug therapy once a month or more frequently were more positive than those of pharmacists who never or hardly ever communicate with patients via electronic tools about drug therapy (P < 0.05). Over 50% of independent pharmacists reported maintaining a pharmacy website.ConclusionsThis study is the first U.S. statewide assessment of the use of electronic communication and social media for professional pharmacist's communications and perceptions toward the use of social media in patient–pharmacist communications among independent community pharmacists in Texas. Future studies conducted in other states as well as nationwide will contribute to a better understanding of the use of electronic communication, Internet, and social media in the daily professional activities of independent community pharmacists.     

The Relationship between Recent Stressful Life Events,Personality Traits,Perceived Family Functioning and Internet Addiction among College Students

Internet addiction (IA) is an emerging social and mental health issue among youths. Analysis of risk factors, as well as their interactions, is crucial for understanding the development of IA. This study investigated the relationship between recent stressful life events, personality traits, perceived family functioning and IA in 892 college students. Subjects were classified into categories (non‐addicted, mild IA or severe IA) using the Chen Internet Addiction Scale. Stressful life events, personality traits and family functioning were assessed using the Adolescent Self‐Rating Life Events Checklist, the Eysenck Personality Questionnaire, and the Family Adaptability and Cohesion Scale, respectively. The results indicated that compared with non‐addicted subjects, subjects with severe IA (9.98%) had lower family functioning, lower extraversion, higher neuroticism and psychoticism, and more stressful life events, and subjects with mild IA (11.21%) had higher neuroticism and more health and adaptation problems. Neuroticism and health and adaptation problems were potential predictors of IA. An interaction effect between psychoticism and total life stress on IA was also found. These findings highlight the role of personality traits and life stress and their interactions in college students' IA. Further research should explore the mechanisms underlying the interaction effect of psychoticism with life stress on IA. Copyright © 2013 John Wiley & Sons, Ltd.