New South Wales Nurse Education Project

Abstract: The development of a teaching package for nurse educators on drug and alcohol problems is described and the contents of its 16 modules outlined.     

教育研究中的问题及评价

教育科学研究是探索和揭示教育过程中未被认识或未被完全认识的现象、本质和规律的一种活动。而问题研究又是教育科学研究的关键,能否选择一个真问题进行研究将直接决定教育科学研究的质量与成败。本文从问题的概念分析入手,从传统认识论中真理论的观点出发并综合多位学者的观点探讨了什么是真问题,最后粗浅地分析了教育课题研究中的真问题。     

The Renal Diabetic Nurse Specialist… A luxury or an essential player?

Diabetic Nephropathy is the single largest cause of Chronic Renal Failure. As the number of patients referred to a nephrologist increase, the needs of many diabetic nephropaths are not being met. The post of Renal Diabetes Nurse Specialist (DNS) was instituted in September 1999 to organise the management of and to meet all aspects of need of this group of patients. The role currently incorporates a daily ward round with the aim of reviewing all patients at least once during every admission to hospital. Ward‐based teaching with the patients occurs and six nurse‐led clinics covering all modalities are now in place and run alongside the Nephrologist. Patients are either referred directly to the nurse‐led clinic or are approached by the renal DNS whilst the patient is in the nephrology clinic. 71.4% of our diabetic patients have an improvement in their HbA1c after 21 months of working closely with the Renal DNS and multidisciplinary team. The average HbA1c at the beginning was 9.7%; the average is now 8%. It is clear that the role is being continuously stretched to its absolute limit. Our aim is to develop a broader service over time and we will, in the near future be employing a renal nurse with an interest in diabetes to work alongside the DNS for six months to particularly learn about the needs of our in‐patients.     

矿区居民预防艾滋病／性传播疾病同伴教育效果研究

目的　调查对矿区居民开展预防艾滋病 /性传播疾病同伴教育的效果。方法　以自愿报名的方式选取山西省大同市永定庄矿区矿工 2 5名 ,均为男性 ,平均年龄为 3 4 0± 8 3岁 ;矿工家属 2 5名 ,均为女性 ,平均年龄为 46 8± 1 1 7岁。在矿工组和矿工家属组中各随机抽取 1名作为同伴教育者进行培训。培训合格的同伴教育者以不同的形式对其余 2 4名同伴进行 1个小时的教育。于教育前和教育后 1周对每组的 2 4名同伴就艾滋病/性传播疾病的知、信、行做问卷调查。并于 1周后按单纯随机抽样方法在每组选取 8人分别进行访谈。结果　在同伴教育者中 ,关于艾滋病 /性传播疾病的一般知识答对率培训前为 2 6 4% ,培训后为 77 6% ;关于传播途径 ,培训前为 2 3 2 % ,培训后为 90 8% ;关于相关的预防措施 ,培训前为 3 5 4% ,培训后为 74 9%。所有的同伴教育者认为艾滋病 /性传播疾病健康教育是必要的 ,同伴教育是一种有效的方式。结论　在矿工及其家属中开展艾滋病 /性传播疾病同伴教育是有效的     

The need for basic sciences in the understanding and practice of anaesthesia

We conducted a survey using an unstructured, then a structured, questionnaire to determine the attitudes of 78 postfellowship anaesthetists to the Basic Sciences component of the part I examination for the FRCA. Seventy-two per cent replied. These anaesthetists felt that about 65% of the basic science syllabus was essential to the understanding and practice of everyday anaesthesia, but there was varying opinion as to the importance of specific topics. Cardiovascular, respiratory, central nervous system and renal physiology were all regarded as essential, as was the pharmacology of anaesthetic drugs. Topics regarded as irrelevant included biochemistry, endocrinology, membrane theory and immunology. Paradoxically, there were many topics which anaesthetists regarded as essential but on which they were unable to give a tutorial. There was little difference between the responses of consultants and trainees. This survey may help to identify a core syllabus on which the majority of anaesthetists agree but also suggests that the current syllabus is overloaded with detail that has no place in clinical practice.     

Advanced trauma life support

The experience of Advanced Trauma Life Support training received by three anaesthetists is discussed with particular reference to the teaching of airway management, the grade of staff who should attend the present courses and the relevance to the British hospital system. We conclude that these courses are useful but limited by their inflexibility and failure to recognise the difference in skill mix in the British setting.     

Diabetes Education: Whose Priorities Are Met?

Two hundred Type 2 diabetic patients newly referred to the diabetes centre at a large university teaching hospital were studied over an 8-month period. Patients completed a diabetes knowledge questionnaire, and specified their educational priorities by selecting six diabetes-related topics from a list of 14. After giving 1 h of individual education and using the same list, the educators selected six topics which they considered to be most important for that particular patient to know. Choice of educational priorities differed between the patients and the corresponding educator (p less than 0.001). In only 38% of cases did the educators' first three priorities coincide with those of the patients. The major discrepancies were in the selection of 'sick day management' and 'complications', especially favoured by patients, as against 'oral hypoglycaemic agents' and other therapy-related topics, especially favoured by educators. Diabetes knowledge was a determinant of educational priority for patients (p less than 0.001) but not educators. In contrast, only the educators' overall choices were affected by duration of diabetes (p less than 0.001). Diabetes treatment type influenced both patients' and educators' selection of priorities (p less than 0.001). We conclude that an educational strategy which relies on health professionals' perceptions to determine what diabetic patients need to know may be inadequate.     

Assessment in undergraduate psychiatric education

An assessment of medical students' psychiatric performance demonstrated no association between the ability to rate psychopathology or to observe interview behaviour and traditional written methods of academic achievement. This is in accordance with those few studies which have addressed this issue and indicates that there may well be at least three independent skills involved in clinical decision-making: the ability to engage in interpersonal interaction and elicit information; and the ability to acquire and use academic knowledge. This is consistent with work suggesting that maturational and learning processes influence clinical reasoning, and demonstrates that each component should be addressed in assessing students in psychiatry.     

健康教育防制儿童营养性贫血的可行性研究

本文以大规模随机化人群实验,用铁剂治疗、铁剂预防和空白对照的方法论证了健康教育做为儿童营养性贫血防制对策与措施的可行性.结果证实健康教育与药物治疗相比前者具有受益人群广泛、发挥作用长效、预防病种广谱、投入少效益高和人群依从性好等优点,比传统的药物治疗和预防更有推广价值,对儿童营养性贫血和类似的儿童常见病的防制是经济、有效的措施.特别是对大规模的人群实施干预只有健康教育是可行的.在预防和治疗疾病过程中也应转变唯药物有效的观念,重视心理和行为的作用,对健康教育给予应有的重视.