性服务工作者性病和艾滋病的干预研究

目的 了解性工作者的性病/艾滋病知识、态度、信念、行为等现状,积极探索对该人群进行预防性病、艾滋病及行为干预的有效办法,为今后在更大范围的高危人群中进行干预提供科学依据.方法 成立专职高危干预队伍,设计借鉴其他地区经验,深入目标人群进行系列外展服务,利用干预前后封闭式调查问卷评价干预效果.结果 发放干预前后问卷各522份,收回前后有效问卷387份.通过外展服务,娱乐场所从业人员对性病史滋病预防知识知晓率明显提高,对安全套及安全性行为预防性病艾滋病的传播的信念和态度有明显转变.结论 对娱乐场所从业人群开展系列专业外展服务可以提高该人群的防病意识,提升对性病史滋痛的知晓率,是高危人群干预的有效方法.     

Action Research: a valuable research technique for service delivery development

The evaluation of healthcare practice and service delivery is fraught with difficulties. Service development and / or delivery occurs within socially dynamic settings which are in a continual state of change. Service development also often involves large elements of improvisation. The action research approach is useful for health service research, as it supports collaboration between researchers and practitioners, and not only allows but makes explicit that the action researcher has both roles within the setting being studied. This paper discusses action research methodology and offers insight into principles that favor its use for service delivery development. This includes consideration of the interactive variables within studies of health care systems and the importance of evaluating relationships between stakeholders to understand how these factors or variables, which cannot be controlled for, are responsible for successful development of the service. Action research facilitates change and helps bridge the heory--practice gap. With the current dynamic changes within both the pharmacy profession and national health services, researchers may find the action research technique of value when considering new roles and innovative ways of engaging in collaborative, multi-disciplinary working to improve delivery of patient care.Accepted july 2004     

老年冠心病患者实施健康教育的远期效果分析

目的：探讨老年冠心病患者实施健康教育的远期效果。方法：110例老年冠心病患者被随机分为健康教育组（教育组）及对照组，每组各55例。在常规治疗的基础上教育组在住院期间及出院后4年内给予健康教育处方结合口头卫生宣教及科普板报知识等经常性的健康教育活动，而对照组不予健康教育。结果：教育组患者对冠心病知识的了解情况、饮食控制情况、规律服药治疗情况比对照组好（P＜0．01），出院后再次住院次数比对照组少（P＜0．01）。而情绪及吸烟量控制两组无显著性差异（P＞0．05）。结论：对老年冠心病患者实施经常性的健康教育是控制疾病恶化的重要措施。     

The 5-Step family intervention in primary care: II. The views of primary healthcare professionals

Background: This is the second of two papers using qualitative methods from a study of an intervention for family members affected by close relatives' substance misuse problems.

Participants: 168 primary healthcare professionals (PHCPs: GPs, practice nurses and health visitors) working in general practices in two areas of England, and who took part in the study.

Data sources: Recruitment and post-session forms completed by PHCPs; telephone interviews with each PHCP 12 weeks after recruitment of a family member; interviews with PHCPs at the end of the study.

Results: At the end of the project PHCPs were overwhelmingly positive about the family member intervention and about primary care as the appropriate site. Difficulties were encountered, however, in identifying and engaging affected family members, who were often excluded on grounds of the complexity of their problems or the level of their distress. Shortage of PHCP time and other practice-related factors added to the difficulty. Active work by a PHCP was often necessary in order to make the link between presenting symptoms of physical or mental ill-health and the existence of a family substance misuse problem. When family members were identified and recruited, PHCPs were usually positive about what was achieved. Nearly all were in favour of an approach that combined giving a self-help manual with some follow-up contact with a family member as needed.

Conclusions: Taken in conjunction with statistical outcome findings of significant reductions in symptoms and changes in ways of coping, plus qualitative analysis of the views of family members, the present results encourage the view that a flexible form of this intervention should be developed for use in primary healthcare, and that further work should build on existing strengths and attempt to overcome weaknesses identified.     

高血压的社区管理与医院内科门诊管理效果比较

目的 评价健康教育在社区高血压患者管理中的效果。方法 随机抽取北京复兴医院月坛社区卫生服务中心管理的高血压患者603例作为研究对象,以同期该院三里河内科门诊就诊的高血压患者617例作为对照,进行血压测量和问卷调查。结果 社区高血压患者高血压知识知晓率明显好于内科门诊高血压患者(P<0.01);其生活方式(遵医行为、体育锻炼、食盐量等)较好;血压控制情况也好于门诊患者(P<0.01)。结论 规范、定期的健康教育可以提高高血压患者对高血压知识的知晓情况,改善高血压患者的不良行为习惯;利用社区卫生服务站固定的合作关系及新型医患模式有利于健康教育、健康知识普及和取得治疗成效。     

护理健康教育模式的研究及应用

借鉴国外先进护理模式，研制适合我国医疗制度改革需要的护理健康教育工作模式，推行高质量、高效率工作方法，建立标准化护理健康教育工作程序、管理及评价体系、工作职责条文、记录表格等，并选择5家省、市级医院作为主要试点对象，对全国10个省、市、地区医院的3000名护理人员进行随机抽样调查。结果 93％省级医院和84％市级医院护士对研制的护理健康教育模式满意，80％地区级医院护士认为模式中的主要项目可以应用。结论：研制的护理健康教育模式可以在不同等级医院和社会应用推广。     

全反式维甲酸对防治经皮冠脉介入治疗后再狭窄的临床疗效观察

目的观察不同剂量全反式维甲酸（ATRA）对防治经皮冠脉介入治疗（PCI）后再狭窄（Rs）的疗效。方法2004年7月至2005年9月连续入院行PCI的冠心病300例。随机分为全反式维甲酸正常剂量组（10mgt．i．d p．o，甲组）、强化剂量组（20mgt．i．d p．o，乙组）、对照组（丙组）。6个月后分别比较甲乙丙三组的再狭窄率、心脏事件发生率和心功能。结果300例患者中男性228例、女性72例。住院期间甲乙丙三组比较：心绞痛9％VS8％VS9％；再次急性心肌梗死（AMI）O％VS2％VS1％；再次缺血性血运重建（TVR）3％VS2％VS3％；心源性死亡4％VS6％VS4％，P〉0．05，无显著统计学差异。随访期间三组比较：心绞痛12％VS9％VS20％；再次AMII％VSO％VS1％；心源性死亡2％VS4％VS4％，P〉0．05，无显著统计学差异；再狭窄率3／33（9．1％）VS2／30（6．7％）VS12／32（37．5％）；TVR3％VS2％VS11％，P〈0．05，有显著统计学差异。结论常规剂量ATRA防治再狭窄安全有效。     

Special needs of adolescent and young women in accessing reproductive health: promoting partnerships between young people and health care providers.

This article considers the unique challenges and opportunities that health care providers (HCPs) face when they address the sexual and reproductive health and rights of young women accessing services. Some of the difficulties that HCPs encounter in their work are highlighted, including poor remuneration, the impact of their personal biases and the effect of an under-equipped working environment. The financial, logistical and emotional challenges young people face in accessing services are also described, as well as some small changes that could promote fruitful partnerships between HCPs and their young clientele. Also considered is how international documents concerning reproductive health can be utilized as advocacy tools to ensure that, when governments speak of making young people's needs a priority, resources are also made a priority-so that reproductive health can become a reality for all young people.     

黑龙江省2006年卫生总费用筹资水平和结构分析

目的为了反映黑龙江省卫生总费用的筹资水平、构成,对黑龙江省2006年卫生总费用进行测算,并对测算结果进行分析,进而提出相应的政策建议。方法本研究运用卫生总费用核算方法中的筹资来源法核算黑龙江省卫生总费用。结果黑龙江省的卫生总费用筹资总额2006年达到了264.98亿元,人均卫生总费用达到了693.12元;卫生总费用占GDP比重为4.28%;政府预算卫生支出占卫生总费用比重为16.11%;社会卫生支出占24.71%;居民个人现金卫生支出占59.18%。就卫生总费用占GDP比重和人均卫生总费用这两项指标来看,与全国相比,黑龙江省表现为双低现象。结论黑龙江省在发展经济的同时,应进一步增加政府对卫生事业的投入;调整黑龙江省卫生总费用筹资结构,平衡政府、社会以及个人在卫生筹资中的责任;进一步完善医疗保障制度,通过各种途径减轻城乡居民的疾病经济负担。     

Parental education and children's online health information seeking: Beyond the digital divide debate

Research has shown that increasing numbers of teenagers are going online to find health information, but it is unclear whether there are disparities in the prevalence of online health seeking among young Internet users associated with social and economic conditions. Existing literature on Internet uses by adults indicates that low income, less educated, and minority individuals are less likely to be online health seekers. Based on the analysis of data from the Pew Internet and American Life Project for the US, this study finds that teens of low education parents are either as likely as or even more likely than teens of high education parents to seek online health information. Multiple regression analysis shows that the higher engagement in health seeking by teens of low education parents is related to a lower prevalence of parental Internet use, suggesting that some of these teens may be seeking online health information on behalf of their low education parents. Implications of these findings are discussed in relation to the issues of the digital divide and digital empowerment.