精神科医生及护士职业倦怠状况调查

目的：了解精神科医护人员职业倦怠现状及其相关影响因素,为早期干预提供依据。方法对中山市精神卫生医疗机构150名精神科医护人员采用自编一般资料采集表及职业倦怠问卷进行调查分析。结果本组医护人员职业倦怠总体检出率为100％,其中轻度职业倦怠6．7％,中度职业倦怠86．7％,重度职业倦怠6．7％。有配偶医护人员的职业倦怠问卷人格解体因子及成就感降低因子评分与无配偶医务人员比较差异有显著性（P＜0．05）,不同工作年限医护人员的成就感降低因子评分比较差异有显著性（P＜0．05）。相关分析显示：医护人员文化程度与耗竭因子分呈显著负相关（P＜0．05）,年龄及工作年限与人格解体因子分呈显著正相关（P＜0．01）,工作年限与成就感降低因子分呈显著负相关（P＜0．05）。结论精神科医护人员普遍存在中等程度职业倦怠,且突出地表现为人格解体和成就感降低,其中以无配偶者更易出现,与年龄、文化程度、工作年限密切相关。     

A meta-analysis of job burnout using the MBI scale

BACKGROUND AND AIM: The aim of this study was to investigate the theoretical dimensionality of burnout measurement (MBI). The objective of the study was to check the working hypothesis according to which the subscales of the Maslach Burnout Inventory (MBI) such as "emotional exhaustion" and "cynicism" (depersonalization) were not correlated with that of "personal achievement" (professional efficacy). To do so, we performed a meta-analysis [Maslach and Jackson, The Maslach Burnout Inventory, 1981, 1986]. METHODS: The sample included 12,112 participants (sample size range from 100-3312 participants; estimated mean=448.59; standard deviation=648.51). Doctheses, Francis, Interscience, Kluweronline, Medline, PsycInfo, and ScienceDirect were searched to identify papers. Exploring references identified 83 publications (1998-2001). Two keywords were used: "Maslach Burnout Inventory" and "organizational stress". The criteria for this meta-analysis included: using the MBI "human services survey (HSS)" for professional care givers, "educators' survey (ES)" for professional educators, "general survey (GS)" for other workers). RESULTS: About 58% of the population concerned professional caregivers, 13% professional educators, 11% social workers, and 18% correctional officers and other workers. In this meta-analysis, effect sizes should be reported with the number of studies and confidence intervals to test the consistency and reliability of the mean estimated (effect size). In this case, each correlation can be corrected. The meta-analysis can therefore be conducted on this corrected correlation. The aim will be to control any artefact and sampling error. Meta-analysis showed that the value of the corrected correlation is not always negative in the case of a relation between the dimension of "emotional exhaustion" and "personal achievement" (professional efficacy). In the case of the dimension "emotional exhaustion" and "cynicism" (depersonalization), we observed that the value of the corrected correlation studies and confidence intervals showed that this dimension was always correlated positively in the studies included. For the relationship between the value of corrected correlation studies and confidence intervals of the dimension of "cynicism" (depersonalization) and "personal achievement" (professional efficacy), the studies included showed that they were always correlated negatively. These results confirm the hypothesis studied. CONCLUSION: The study revealed two points: (1) the homogeneity of the studies included concerning the fact that assessment of emotional exhaustion and cynicism (depersonalization) are always correlated positively; (2) the heterogeneity of the studies included concerning the fact that personal achievement is correlated with the other subscales of burnout (MBI). This study confirms the hypothesis.     

精神科护士人口学资料与工作压力源和心身耗竭相关性研究

目的探讨精神科护士人口学资料与工作压力源和心身耗竭的相关性,为维护精神科护士的身心健康,提高工作质量提供依据。方法采用中国护士压力源量表和心身耗竭量表对89名精神科护士的压力状况及心身耗竭程度进行测评分析。结果压力源量表排前10位的压力源主要为护理专业方面和患者护理方面的问题;心身耗竭量表测评,精神科护士与Maslach参考值比较情绪的疲倦感有显著性差异（P〈0．01）;年龄、护龄与情绪疲倦感呈显著正相关（R=0．283、0．305,P＜0．01）,文化程度与压力源呈显著正相关（P＜0．05或0．01）,护龄与压力源呈显著负相关（P〈0．05）;不同文化程度和护龄对压力的反应有显著性差异（P〈0．05或0．01）,性别、职称与工作压力源与心身耗竭无关。结论精神科护士心身耗竭和工作压力源与年龄、护龄、文化程度相关,与性别、职称无关,不同文化程度和护龄对压力的反应有显著性差异。医院管理者及护士自身应引起足够的重视。     

医护人员工作倦怠研究现状

工作倦怠近30年已形成一独立的研究领域,从1990年在波兰举行的第一届欧洲工作倦怠会议至今,在理论、测量工具、影响因素、干预措施上都取得了长足进展,本文对国外近10年来医护人员工作倦怠的现状、测量、影响因素、干预及未来发展趋势进行介绍。     

Breast Density and Breast Cancer Risk: A Practical Review

New legislation in several states requiring breast density notification in all mammogram reports has increased awareness of breast density. Estimates indicate that up to 50% of women undergoing mammography will have high breast density; thus, with increased attention and high prevalence of increased breast density, it is crucial that primary care clinicians understand the implications of dense breasts and are able to provide appropriate counseling. This review provides an overview of breast density, specifically by defining breast density, exploring the association between breast density and breast cancer risk, both from masking and as an independent risk factor, and reviewing supplemental screening options as part of a larger framework for counseling patients with dense breasts.     

微弹簧圈对脑动脉瘤的疗效及对日常生活能力的影响

目的:探讨微弹簧圈对脑动脉瘤的治疗效果及并发症发生率的影响.方法:回顾性分析2014年8月至2016年2月在我院接受弹簧圈溶栓治疗的脑动脉瘤患者的临床资料,并根据其治疗过程中所用微弹簧圈的差异分为电解可脱微弹簧圈组和机械可脱微弹簧圈组.观察两组患者的治疗效果、NIHSS评分、日常生活能力、并发症发生率的差异.结果:机械可脱微弹簧圈组再通率为86.2%,电解可脱微弹簧圈组再通率为电解可脱微弹簧圈组,两组间比较无明显差别(P>0.05);两组患者治疗前NIHSS评分无明显差别,治疗后,两组患者的NIHSS评分均较治疗前降低(P<0.05);两组患者治疗后进食、洗澡、修饰、穿衣等日常生活能力评分无明显差别(P>0.05);电解可脱微弹簧圈组患者动脉瘤再破、弹簧圈脱出和脑血管痉挛发生率明显低于机械可脱微弹簧圈组,差异具有统计学意义(P<0.05).结论:电解可脱微弹簧圈和机械可脱微弹簧圈对脑动脉瘤均有较好的治疗效果,而电解可脱微弹簧圈并发症发生率低,具有较好的临床应用价值.     

Efficacy of Internet-Delivered Mindfulness for Improving Depression in Caregivers of People With Spinal Cord Injuries and Chronic Neuropathic Pain: A Randomized Controlled Feasibility Trial

Objectives

To explore the feasibility and efficacy of web-based mindfulness training for carers of people with spinal cord injury (SCI).

医护人员职业倦怠变迁的横断历史研究

目的:考察2004-2013年医生职业倦怠的3个维度得分随年代的变化趋势。方法:搜集2004-2013年有关于医生职业倦怠的研究报告,经过筛选和排除,再对研究报告进行了横断历史的元分析,分析得分与年代变迁的相关性和变化量并进行不同类别医生间的比较。结果:控制样本量后,综合医院全体医生情绪衰竭与年代相关为-0.618,职业效能感与年代相关为-0.443,去个性化与年代相关不显著。10年各维度下降了0.338~2.048分,平均下降了0.319~2.149个标准差。结论:1医生情绪衰竭情况有所改善,责任感保持稳定,但是职业效能感显著下降;2综合医院男性医生情绪衰竭和去个性化变化状况优于女性医生,而职业效能感下降得更多;3精神专科医生的情绪衰竭和职业效能感变化随年代的变迁更加显著。     

A test of carver and scheier's self-control model of stress in exploring burnout among mental health nurses

A sample of Australian psychiatric nurses completed a questionnaire which included operational measures of elements of Carver and Scheier's self-control model of stress including the frequency dimension of the subscales of the Maslach Burnout Inventory — emotional exhaustion, depersonalization, and diminished accomplishment. Other scales completed by participants included independent subscales contained in the Positive and Negative Affectivity Scale and the private and public self-focus and social anxiety subscales of the Self-Consciousness Scale (Revised). Two interpretable canonical variates labelled emotional exhaustion–depersonalization and diminished accomplishment were derived from analysis of the date. Each element of the self-control model showed an expected contribution to an emotional exhaustion–depersonalization canonical variate, whereas reported levels of only positive affectivity and private self-focus made a notable contribution to explanation of variance on the diminished accomplishment canonical variate.