Issues concerning Migrant Workers' Participation in the New Rural Cooperative Medical System and Countermeasures——Based on the Survey in Wenjiang District and Jintang County, Chengdu City

We conduct questionnaire survey of migrant workers in Wenjiang District and Jintang County of Chengdu City,respectively,using the method of key-point investigation and the sampling survey. We describe the status quo of the sample migrant workers' participation in the New Rural Cooperative Medical System,analyze the issues concerning migrant workers' participation in the New Rural Cooperative Medical System,and put forward the countermeasures and recommendations as follows: using many types of medical insurance; establishing universal reimbursement points in strange land and premium-paying system for migrant workers; making the proportion of reimbursement open and transparent; establishing and improving medicare security system for migrant workers.

Interest of Systematic Chest Radiography during Periodic Medical Visits in Workers

Background: Systematic chest X-ray is the most prescribed examination by occupational physicians during periodic medical check-ups in our context, unlike in most countries where this practice has been discontinued. Objective: The objective was to determine the diagnostic yield and cost-effectiveness of chest radiography during periodic medical check-ups of workers in Ngaoundere. Materials and Methods: A cross-sectional and descriptive study was carried out in Ngaoundere Regional Hospital from January to December 2018, concerning all persons coming to perform a systematic chest X-ray in the context of the periodic medical check-up having been consented to participate in the study. Posteroanterior (PA) chest radiographs were obtained from all workers during this periodic medical check-up. The variables studied were: age, sex, clinical manifestations, antecedents, job type, cost, and chest X-ray results. Statistical analysis was performed using the Sphinx Plus2-Lexica-V5 Edition software. Results: 753 workers were selected for this study, of whom 88.04% were men and 11.96% were women, a sex ratio H/F is of 7.4, the average age was 39 ± 7.89 years with extremes of 24 and 56 years, the most frequent job type was the administration (38.37%), the storekeepers (17.92) and the drivers (15.27%), most of them were asymptomatic (97.47%), some had cough (2.52%), chest pain (2.12%), dyspnea (0.26%) and fever (0.13%). History was dominated by lung infection (2.39%), pleurisy (1.06%) and tuberculosis (0.79%). 7.43% of workers occasionally smoked tobacco and consumed alcohol. 41 cases of pathologies (5.44%) were found on the chest X-ray, including 1 case (0.13%) of evolutionary pathology, 40 cases (5.31%) of sequelae pathologies. When the results of the chest X-ray are compared with the clinical signs and the pathological history of the workers, it is found that the only case with evolutionary abnormalities on the chest X-ray showed clinical signs and that the other cases with sequelae abnormalities had either clinical signs or antecedents related to these abnormalities. The cost of a chest X-ray at the time of our study was 5,000 FCFA ($8.59), for a total of 3,765,000 FCFA ($6473.74) for all the X-rays performed. Conclusion: In view of the low rate of abnormalities on the chest X-ray and the sequelae nature of the pathologies, it can be said that the routine X-ray of the chest during the periodic medical check-ups has a low diagnostic yield and a low cost-effectiveness ratio and is not profitable. It should be non-systematic and case-by-case based on the clinical context and background of workers.

Research on social medical insurance of migrant workers --A case of Suqian city in Jiangsu province

City migrant workers, as one part of the city＇s development, economic development and other aspects of urban to make a great contribution, but the delay with the local residents do not enjoy the same level of medical care treatment is always blocked in outside the city＇s health care system, have less relevant departments, there is no practical system introduced regulations and policies, these things tell us to pay attention to the people, and the introduction of appropriate medical insurance of migrant workers possibly things, and timely medical security system of such groups and the local people medical protection for long support. Make medical insurance system can cities try it＇s best to help foreign workers Medicare, Medicare for the development of China has made a modest contribution.

Analysis of Health Workers’ Perceptions on Medical Waste Management in Tanzanian Hospitals

This paper presents the perceptions of health workers (HWs) on medical waste management (MWM) issues in Tanzanian hospitals. The perceived total waste generation rates were lower than the actual measurements. Administrators perceived lower rates than implementers. The results indicated three categories of medical waste which are given due attention, that is, sharps waste, pathological and infectious waste. Other wastes like radioactive, chemical, pharmaceutical, pressurized containers receive very little attention. Container colour coding and labelling was negligible, while improvised containers are still in use. Medical waste is transported within hospitals manually, with little efforts on mechanized transportation. Poor waste storage was observed, while the prominent medical waste treatment technologies are medium temperature incinerators. Off-site transportation of medical waste is practiced, where the waste is finally dumped or buried. The hospitals are currently utilizing public-private partnership schemes for MWM in only one aspect of off-site transportation. Three main problems which require high attention include: Weaknesses in hospital management, poor MWM infrastructure, and lack of skills and knowledge on MWM among HWs. Knowledge and awareness among HWs on health hazards associated with poor MWM is low (with exception of cholera, HIV and typhoid). Few PPE types are supplied and used in the hospitals, leading to poor diseases prevention. There is also low knowledge among HWs on administrative issues related to MWM in Tanzanian hospitals.

Investigation and Countermeasures of Medical Staff’s Demand for Nursing Workers in Chifeng

In order to understand the current demand of the medical staffs for nursing workers in Chifeng and to explore the practical management mode of nursing workers,150 doctors and nurses were randomly selected from general tertiary hospitals in Chifeng to participate in a questionnaire survey.The objective of this study was to investigate the demand of nursing workers in tertiary hospitals in Chifeng and the satisfaction of medical staffs toward the existing nursing work.The results of the investigation were analyzed to provide countermeasures and suggestions for the nursing work in Chifeng.

Non-equilibrium Analysis of Migrant Workers ' Medical Insurance System under the Background of Citizenization

The participation of migrant workers in medical insurance of urban workers is a formal institutional arrangement. However,in reality,the insurance participation rate of migrant workers is low and the medical insurance taken by the migrant workers is not sufficient,which seriously hinders the process of the citizenization of migrant workers. The main reason lies in the unbalanced supply and demand of the current system. With the continuous advancement of the citizenization process,the rural migrant workers' demand for medical insurance has changed.However,our research found that the supply of medical insurance system for migrant workers is seriously inadequate,the system and the institutional environment are disconnected,the internal contradictions of the system are increasing,and a large amount of potential profits are accumulated under the current system. Potential profit is the motive force to promote institutional innovation and promote the reform of current system to strike a balance.

Medical assistance in fighting against COVID-19 in Wuhan,China:A frontline nurse’s experience and lessons learned

This article shared personal experiences of encountering challenges during the work at the frontline fighting against COVID-19 in Wuhan,China,and found solutions and suggestions to overcome the challenges during the period,including solutions to address challenges encountered during work,suggestions for smooth communication among different parties,and suggestions for optimizing work regulations and workflow and establishing behavior habits and professional knowledge and practices.These experiences would be helpful for health‑care workers to fight against the pandemic.

医务社工在白血病患儿管理中的角色与任务

儿童白血病的诊断和治疗给患儿及其家庭带来严重的心理和社会压力。医务社工通过提供日常教育、心理支持和社会资源等措施,在改善患儿的生活质量和社会适应能力中起重要作用。然而,医务社工在实际工作中面临人力资源短缺、专业能力不足、管理体制不完善、社会认同度低以及跨部门合作欠缺等问题。针对这些问题,提出了一系列对策和建议,包括优化政策支持、完善培训机制、改进管理制度、强化媒体宣传和促进社会协作,以推动医务社工在白血病儿童管理中的专业化发展,提升其服务质量。

“双工联动”协作模式在医院服务中的应用探析

随着我国经济的不断发展,人民对医疗服务质量要求不断提高,医学人文关怀逐渐被强化。在此背景下,医务社工与志愿者联动的“双工联动”模式应运而生。本文介绍了“双工联动”模式的国内发展现状,阐述了其优势,列举了其在医院服务中的应用,包括门急诊导医、住院病房服务、临终关怀和社区居民志愿服务等,并提出进一步优化招募培训体系、健全管理制度、建立智慧管理系统、完善志愿者保障机制等方面的建议。以推动医学人文服务持续健康发展,助力“健康中国”战略实施。

2009—2018年广西公立医疗机构放射作业人员职业健康检查结果分析

目的分析2009—2018年广西壮族自治区(以下简称广西)公立医疗机构放射作业人员职业健康检查情况,为制订相应的职业健康管理措施及职业健康防护提供依据。方法收集2009—2018年9259名广西公立医疗机构放射作业人员的职业健康检查结果,比较不同性别、年龄、工龄、工种的放射作业人员各项体检结果情况。结果广西公立医疗机构放射作业人员职业健康检查中腹部B超异常、晶状体混浊、尿常规异常发生率较高;男性放射作业人员的血压异常率、肝功能异常率、腹部B超异常率、肾功能异常率高于女性,血常规异常率、尿常规异常率、甲状腺异常率低于女性(P<0.05);不同年龄放射作业人员的血压异常率、晶状体混浊率、染色体畸变率、肝功能异常率、腹部B超异常率、肾功能异常率差异有统计学意义(P<0.05),不同工龄放射作业人员的血压异常率、晶状体混浊、染色体畸变率、肝功能异常率、腹部B超异常率、尿常规异常率、肾功能异常率、甲状腺异常率差异有统计学意义(P<0.05),其中,血压异常率、晶状体混浊率、腹部B超异常率随着年龄、工龄的增加而增加;不同工种放射作业人员晶状体混浊率、腹部B超异常率、尿常规异常率、甲状腺异常率差异有统计学意义(P<0.05)。结论广西地区公立医疗机构放射作业人员健康检查结果中男性多项指标的异常率高于女性,血压异常率、晶状体混浊率、腹部B超异常率随着年龄、工龄的增加而呈上升趋势。相关部门应对不同工种人员进行有针对性的防护意识培训及作业风险评估,切实保护放射工作人员的职业健康。

湖北省医疗机构护工队伍建设现状调查

目的调查湖北省医疗机构护工队伍建设现状,以促进护工行业的规范化发展。方法2023年8-9月,以便利抽样方法,抽取湖北省17个地市州医疗机构的护理管理者及护工,采用由中华护理学会决策咨询工作委员会编制的医疗机构调查问卷及护工调查问卷进行调查。结果有效调查1398所医疗机构,其中仅395所医疗机构配备有护工。护工队伍人员结构以女性、年龄≥50岁、初中及以下文化程度、<5年工作年限为主;工作模式偏向一对一服务、24 h制、非固定休息;应聘渠道主要为通过他人介绍,以患者自聘和社会化管理为主;管理机构主要是第三方中介公司(62.62%);培训覆盖率达78.27%,以岗前一次性培训为主,考核率为49.62%;薪资水平以2000~5000元为主;53.78%的护工没有缴纳或由自己缴纳保险;近60%的医疗机构对护工服务态度及服务质量满意。结论医疗机构的护工管理制度待完善,人员结构待调控,协调机制待优化,队伍建设续航能力待保障,劳动保障待健全。有必要建立护工管理体系,统一准入标准,构建科学化工作模式,创新培训与考核制度,构建科学合理的劳动保障制度,以促进优质护理服务。

医疗保险提高灵活就业人员幸福感了吗?——来自CLDS数据的证据

医疗保险作为我国社会保障制度的一项重要内容,能否提升灵活就业人员的幸福感是检验其效用的重要标尺之一。基于2018年的中国劳动力动态调查(CLDS)数据,运用普通最小二乘(OLS)研究医疗保险对灵活就业人员幸福感的影响,研究结果显示:基本医疗保险显著提升了灵活就业人员的幸福感,医疗保险对不同收入、年龄、家庭规模的灵活就业人员幸福感的影响呈现一定的异质性。为了更好地发挥医疗保险的功能、提升灵活就业人员的幸福感,政府应鼓励参保,适当降低缴费比例,加强医疗保险政策的宣传和解读。

放射防护教育的重要性及针对不同专业医务人员的培训策略

目前越来越先进的医学影像及电离辐射应用于临床诊断和治疗,在众多被提出用于辐射暴露管理的策略中,教育和培训对辐射防护和剂量减少尤为重要。然而研究显示医务人员普遍出现缺乏基本放射防护方面的知识。因此,如何进行放射防护的教育和培训,是当前大型综合性医院需探讨实践的重要问题。文章通过分析电离辐射暴露造成的医务人员或患者的伤害,进而阐述了医务人员进行教育培训的必要性,医务人员应进行辐射物理学、放射生物学、放射防护以及辐射相关的国家法律法规的知识培训。另外,除了以上主题,放射防护的教育培训计划也必须考虑到每个医学专业的需求和要求,因此文章也详细分析了各专业医务人员应具备的辐射相关知识及教育培训内容,这将对临床上如何更好地做好放射防护具有积极重要的意义。

困境与应对:医务社工开展志愿者管理的伦理实践

医院志愿者管理是医务社工的主要工作之一,在实际工作中常因一些伦理难题而处于两难境地,制约着医院志愿者组织的科学化发展。以浙大二院“广济之舟”志愿服务联盟一线医务社工经验为基础,同时调查其他公立医院,归纳整理伦理问题,分析其产生原因,并提出改进策略。医院的志愿服务伦理困境主要是人情与规范的双重关系冲突、激励机制与非酬价值观的冲突、参与动机与组织目标的冲突。医院志愿者管理中的伦理困境归咎于尚未形成标准化的实务操作体系。就上述伦理困境,结合公立医院志愿服务发展经验,提出合理化应对策略,为医院志愿服务管理提供参考。

新型冠状病毒感染疫情常态化防控背景下社区医务人员心理健康状况及影响因素分析

背景自新型冠状病毒感染(简称新冠感染)疫情发生以来,身处防控一线的社区医务人员面临着直接接触病毒的风险,存在工作强度大、工作时间长、心理压力大等问题,因此探究社区医务人员的心理健康状况及其内在联系对精准实施心理干预具有重要意义。目的了解新冠感染疫情常态化防控期间社区医务人员心理健康状况并探讨其影响因素。方法于2021年12月,采用多阶段随机抽样法,选取296名中山市社区医务人员作为调查对象,采用一般资料调查表、自行编制的社区医务人员新型冠状病毒感染疫情防控工作压力调查问卷、广泛性焦虑量表(GAD-7)和患者健康问卷抑郁症状群量表(PHQ-9)对其进行网络问卷调查,采用多因素Logistic回归分析探讨社区医务人员新冠感染疫情防控工作感知压力水平及焦虑、抑郁情绪状态存在情况的影响因素。结果中山市社区医务人员新冠感染疫情防控工作高感知压力的检出率为10.1%(30/296);中度及以上焦虑和抑郁的检出率分别为7.1%(21/296)和9.5%(28/296);性别、抑郁情绪状态存在情况和新冠感染疫情防控工作感知压力水平是社区医务人员焦虑情绪状态存在情况的影响因素(P<0.05);疫情期间从事日常诊疗工作情况、疫情期间从事“三人小组”上门排查工作情况、焦虑情绪状态存在情况和新冠感染疫情防控工作感知压力水平是社区医务人员抑郁情绪状态存在情况的影响因素(P<0.05);焦虑、抑郁情绪状态存在情况是社区医务人员新冠感染疫情防控工作感知压力水平的影响因素(P<0.05)。结论社区医务人员新冠感染疫情防控工作压力与焦虑和抑郁负性情绪之间彼此关联、相互影响、相互作用,且疫情防控工作任务与人力资源的相对不足等因素加剧了社区医务人员负性情绪的叠加效应,卫生健康行政部门应结合疫情常态化防控阶段社区卫生服务机构的发展特点及暴露出的突出问题,着力构建新形势下社区卫生服务机构的长效投入和发展机制,加强对医务人员的心理干预指导。

一线医务工作者的心理应激反应、影响因素及干预策略的研究进展:以新冠感染疫情为例

通过检索国内外新型冠状病毒感染疫情防控一线医务工作者心理健康相关文献,系统总结并分析一线医务工作者的心理应激反应、影响因素及干预策略。疫情防控一线医务工作者呈现出急慢性心理应激反应,包括失眠、疲劳等躯体症状,以及抑郁、焦虑、创伤后应激等心理症状。个体、工作和社会3个层面的风险和保护因素影响心理应激反应。线上和线下心理干预有助于缓解一线医务工作者压力。目前研究多聚焦于疫情暴发期,关于疫情长期影响的追踪研究较为匮乏;干预研究更多报道方案的开发和执行,而较少涉及干预效果的循证检验,未来可考虑结合数字化技术开发干预方案并检验干预效果。

252名医疗放射工作人员的血象及淋巴细胞微核率检测

目的对贵州省252名放射工作医务人员的血象及淋巴细胞微核率进行检测,并分析可能的影响因素。方法选取接受职业健康体检的252名从事医疗放射工作人员为研究对象,根据其工种分为诊断放射学组(n=68)、介入放射学组(n=15)及其他放射工作组(n=169);使用全自动生化分析仪检测外周血象常规指标,采用微量全血培养法检测其外周血淋巴细胞微核率,并根据不同工种、年龄以及接害工龄分组对结果进行Kruskal-Wallis H秩和检验与χ^(2)检验,采用Spearman秩相关进行相关性分析。结果252名放射工作医务人员的外周血象结果均在正常范围内,不同工种、年龄组被检者白细胞、红细胞、血红蛋白及血小板计数比较,差异无统计学意义(P>0.05);不同接害工龄被检者的白细胞、红细胞、血红蛋白比较,差异无统计学意义(P>0.05);不同接害工龄被检者的血小板计数比较、差异有统计学意义(P<0.05),血小板数与接害工龄呈负相关关系(r=-0.170,P=0.007);微核率分析显示,不同工种被检者外周血淋巴细胞微核率、微核率异常率比较,差异无统计学意义(P>0.05);不同年龄组被检者的微核率、微核率异常率比较,差异有统计学意义(P<0.05),微核率与年龄呈正相关关系(r=0.179,P=0.004);不同接害工龄被检者微核率比较、差异无统计学意义(P>0.05),但微核率异常率比较、差异有统计学意义(P<0.05)。结论医疗放射工作人员的接害工龄与血小板负相关,年龄与淋巴细胞微核率、微核异常率正相关,且工龄增加、微核异常率也增加。

广州市基层医务工作者工作资源对离职意愿的影响研究

目的基于资源保存理论、工作要求-工作资源理论以及自我决定理论分析工作资源对离职意愿的影响,以及要求-能力匹配的调节作用,为降低基层医务工作者的离职意愿提供实证依据。方法采用多阶段分层随机抽样法选取广州市600名基层医务工作者,利用工作资源量表、离职意愿量表和要求-能力匹配量表进行问卷调查,运用SPSS 22.0进行描述性统计、相关和多元线性回归分析。结果广州市基层医务工作者工作资源的3个维度:社会支持(β=-0.296,P=0.017)、工作控制(β=-0.392,P=0.001)和工作发展机会(β=-0.362,P=0.001)与离职意愿呈负相关;要求-能力匹配起调节作用,增强了社会支持(β=-0.211,P<0.01)、工作控制(β=-0.313,P<0.01)和工作发展机会(β=-0.158,P<0.01)与离职意愿间的负相关关系。结论基层医务工作者感知到工作资源水平越高,则离职意愿越低,要求-能力匹配起增效作用。建议提升基层医务工作者的社会支持,适度保证基层医务工作者在工作中的自主权,给予他们更多的上升通道,增加相应的培训以提升其要求-能力匹配度,从而降低其离职意愿。