急诊科护士对新发传染病知信行调查问卷的编制

目的 编制急诊科(emergency department,ED)护士对新发传染病(emerging infectious diseases,EID)知信行(knowledge attitude practice,KAP)调查问卷,并进行信效度检验。方法 以KAP理论为基础,通过文献回顾、德尔菲专家函询形成问卷初稿;于2021年5月方便抽样上海市3所三级甲等综合医院293名ED护士进行预调查,完成问卷条目筛选和信效度检验。结果 形成含有34个条目的ED护士对EID知信行调查问卷,其中知识维度12个条目、态度维度10个条目、行为维度12个条目。问卷整体Cronbach's α系数为0.926,各维度Cronbach's α系数为0.617~0.968;问卷整体分半信度为0.846,各维度分半信度为0.614~0.958。问卷水平内容效度指数(scale-level content validity index,S-CVI)为0.99,条目水平内容效度指数(item-level content validity index,I-CVI)为0.99~1.00;探索因子分析显示,知识、态度、行为3个维度分别提取公因子4个、1个、2个,累计方差贡献率分别为50.192%、78.319%、73.341%,问卷整体累计方差贡献率67.242%;验证因子分析显示,问卷整体及各维度拟合度较好。结论 EID知信行调查问卷具有良好的信效度,可作为ED护士对EID KAP的评估工具。     

Business knowledge in surgeons

BACKGROUND: Surgeons and residents in training receive little, if any, formal education in the economic side of clinical practice during medical school or residency. As medical professionals face shrinking reimbursement, loss of control over health care decisions, and limited resources, surgical specialties must reevaluate the need to teach their members business survival skills. Before designing business related-teaching modules, educators must know the exact gaps in knowledge that exist among surgeons. METHODS: This article reports a survey of 133 surgeons in the Midwest who were asked to rate their knowledge base in 11 business topics relevant to the practice of medicine. RESULTS: The survey showed that the average surgeon perceives himself or herself to be poorly equipped to understand basic financial accounting principles, financial markets, economics of health care, tools for evaluating purchases, marketing, budgets, antitrust and fraud and abuse regulations, and risk and return on investments. CONCLUSIONS: Armed with this data, teaching faculty, health care systems, and medical specialty societies should design business education seminars to better position surgical specialists and trainees to communicate with insurers, hospital administrators, health care organizations, and their own personal financial advisors.     

综合医院手术室医护人员对仪器设备知识需求的调查分析

目的通过调查分析手术室医护人员对仪器设备相关知识需求的情况,探讨手术室仪器设备管理的有效方法。方法随机选择手术室护士60名和外科手术医生60名,对其进行手术室仪器设备相关知识需求问卷的调查,分析他们在实际工作中对此方面的了解与需求情况。结果手术室医护人员都希望了解仪器设备相关知识;均希望采用厂家人员授课的方法进行培训。在培训内容、管理形式上,手术室护士和医生的得分有统计学差异(P<0.05或P<0.01),其中护士希望得到的培训内容排名前3位的是:仪器设备的正确操作流程、仪器设备的存放位置和基本配套、仪器设备基本故障处理和维修处理程序,医生希望得到的培训内容排名前3位的是:仪器设备基本故障处理和维修处理程序、仪器设备的正确操作流程、通用和专科仪器设备。护士最希望的管理模式是手术室专科组长协同护士长或专职人员共同管理,医生最希望的管理模式是调派专职技术人员管理。结论手术室仪器设备的管理应综合各方面因素,充分了解手术室护士和实际使用者外科医生的需求,针对性地制定出相关管理措施和培训方法,提高仪器设备的管理效率,进一步营造手术配合的和谐氛围。     

Improvement in Smallholder Farmer Knowledge of Cattle Production,Health and Biosecurity in Southern Cambodia between 2008 and 2010

Farmer knowledge surveys were conducted in 2008 and 2010 in Cambodia to evaluate the impact of a research project studying interventions that can improve cattle production and health, including biosecurity and practices relating to risks of transmission of transboundary diseases. The project hypothesis is that by increasing the value of smallholder‐owned large ruminants through nutritional interventions and improved marketing, knowledge‐based interventions including risk management for infectious diseases such as foot‐and‐mouth disease (FMD) can be implemented into a more sustainable pathway for rural development. Between 2008 and 2010, significant improvements in farmer knowledge and attitudes were recorded in three villages in three provinces of southern Cambodia. This was achieved through participatory ‘applied field research’, ‘on the job’ training plus ‘formal’ training programmes. No cases of FMD were recorded during the study period in the ‘high‐intervention’ (HI) villages despite the common occurrence of the disease in a nearby ‘low‐intervention’ and many other villages in the three provinces. Whilst it is likely that protection of these villages from FMD infection was from increasing the herd immunity by vaccination, it could also have been partly because of a decrease in risk behaviours by farmers as a result of their increasing knowledge of biosecurity. The research indicates that smallholder farmers are motivated by nutritional interventions that improve the value of their cattle ‘bank’ and offer better marketing opportunities. This provides a more receptive environment for introduction of disease risk management for infectious and other production limiting diseases, best implemented for smallholder farmers in Cambodia by intensive training programmes. In lieu of a widespread public awareness programme to deliver mass education of smallholder farmers in disease prevention and biosecurity, livestock development projects in South‐East Asia should be encouraged to include training in disease risk management as an important intervention if the current momentum for trade in large ruminant livestock and large ruminant meat is to continue to progress and contribute to addressing global food security concerns.     

Australian emergency doctors' and nurses' acceptance and knowledge regarding brain death: a national survey

Healthcare staff's acceptance of brain death (BD) being a valid determination of death is essential for optimized organ and tissue donation (OTD) rates. Recently, resources to increase Australian OTD rates have been aimed at emergency departments (ED) as a significant missed donor potential was discovered. A cross-sectional survey was conducted to assess Australian ED clinicians' acceptance and knowledge regarding BD. Most (86%) of the 599 medical and 212 nursing staff accepted BD, but only 60% passed a 5-item-validated BD knowledge tool. BD knowledge was related to the acceptance of BD. Accepting BD influenced attitudes toward OTD, including willingness to donate. BD acceptance and knowledge were related to education/training regarding OTD, years of experience in EDs, experience with OTD-related tasks, and increased perceived competence and comfort with OTD-related tasks. Of concern, more than half of respondents who did not pass the BD test reported feeling competent and comfortable explaining BD to next of kin; of respondents who had recent experience with this, more than a third failed the BD test. Despite being generally positive toward OTD, Australian ED clinicians do not have a sound knowledge of BD. This may be hampering efforts to increase donation rates from the ED.     

口部刺激联合健康教育对孤独症患儿口腔健康行为的影响

目的探讨口部刺激联合健康教育对孤独症患儿口腔健康行为的影响。方法将72例孤独症患儿随机分为对照组(37例)和干预组(35例)。对照组对患儿照顾者行口腔保健知信行健康教育,干预组在对照组的基础上实施口部触觉刺激干预,连续干预2个月。比较干预前后两组患儿口腔健康行为及照顾者口腔保健知信行评分的差异。结果干预后两组照顾者口腔保健知信行评分显著高于干预前,干预组显著高于对照组(均P0.01)。干预后两组患儿口腔保健行为评分显著高于干预前,干预组显著高于对照组(P0.05,P0.01)。结论将口部触觉刺激技术结合口腔健康知信行健康教育,用于孤独症患儿口腔健康行为干预和照顾者指导,能提高孤独症患儿口腔健康行为及照顾者口腔保健知信行程度。     

医疗护理员核心能力评价指标体系的构建

目的 构建一套科学、系统的医疗护理员核心能力评价指标,为医疗护理员的培养、考核和能力评价提供参考。方法 通过文献回顾、半结构式访谈,形成医疗护理员核心能力评价指标初稿。2022年9～11月,采用德尔菲专家函询法对7个省份的20名专家进行问卷函询,运用层次分析法确定各级指标权重。结果 共开展2轮函询,问卷有效回收率分别为100.00%和95.24%,第2轮专家权威系数为0.929,肯德尔和谐系数为0.230（P＜0.05）。最终构建理论知识、实践技能、综合能力和人文特质4个一级指标、13个二级指标、50个三级指标。结论 构建的医疗护理员核心能力评价指标体系意见集中,可信度较高,对医疗护理员的培养、考核和能力评价具有指导意义。     

Knowledge of intensive care unit nurses about medical device-related pressure injury and analysis of influencing factors

To investigate ICU nurses' knowledge level with regard to device-related pressure injuries in northern, central, and southern China and analyse its influencing factors. A total of 261 ICU nurses participated in this cross-sectional survey A convenience sampling method was used to select ICU nurses as respondents from one hospital in each of the six cities of Taiyuan, Wuhan, Xianning, Guangzhou, Foshan, and Huizhou. Data were collected using the MDRPI Knowledge Questionnaire. The questionnaire was developed by the investigators based on a summary of evidence of MDRPI, which has been reviewed and validated by experts. The obtained data were analysed using SPSS software. The average rate of the correct response about MDRPI was 60.54% (15.74 ± 2.90). The lowest percentage of correct responses was on the “concept and staging” dimension rated 28% (0.56 ± 0.67). The “skin assessment” dimension rated 39.2% (1.57 ± 0.84). Multiple linear regression analysis showed that the factors influencing the MDRPI knowledge of ICU nurses included hospital grade, the highest educational attainment, whether or not they had wound care certification, when they last attended MDRPI training or lectures, and whether or not they had attended MDRPI training or lectures. The level of knowledge of nurses about MDRPI was insufficient. Training of ICU nurses on MDRPI should be emphasised at the institutional level. MDRPI training contents should be based on clinical evidence and updated timely. There is a need to focus on the training of wound care certification and education.