Relationship between acute stress and sleep disorder in grass-root military personnel:Mediating effect of social support

Background: To explore the relationship between acute stress, social support and sleep disorder in grass-root military personnel, and construct the relational model through structural equation modeling. Methods: A total of 2,411 grass-root military personnel were randomly selected by cluster sampling, and administered the Chinese Military Personnel Sleep Disorder Scale, Military Acute Stress Scale and Social Support Rating Scale.Results: The total score of acute stress scale was positively correlated with the total score and factor scores of sleep disorder scale(r=0.209~0.465, P【0.01); The total score of social support scale was positively correlated with the total score of acute stress scale and the total score and factor scores of sleep disorder scale(r=0.356~0.537, P【0.01). The analysis of mediating effects showed that lack of social support partially mediated between acute stress and the factors of sleep disorder. The analysis of structural equation model showed that acute stress not only had a direct effect on sleep disorder(the path coefficient was 0.29, P=0.000), but also on lack of social support(the path coefficient was 0.39, P=0.000); lack of social support had a direct effect on sleep disorder(the path coefficient was 0.48, P=0.000).Conclusions: Acute stress and lack of social support are two significant factors of sleep disorder in grass-root military personnel. Well-established social support could alleviate sleep disorder induced by acute stress. Lack of social support was a partial mediator between acute stress and sleep disorder.

Health personnel-targeted education interventions on inpatient suicide prevention in general hospitals:A scoping review

Background:Inpatient suicide is an important part of patient safety management in general hospitals.Incidence of inpatient suicide can be decreased by health personnel mastering inpatient suicide prevention strategy.To enhance health personnel’s inpatient suicide prevention strategy,education intervention is a common method.Educational interventions in the researches varied in contents,duration and outcome measurements.However,there has been not synthesis of education interventions targeting health personnel on inpatient suicide prevention.Objective:Prevention of inpatient suicide is a critical priority in patient safety management in general hospitals.Incidence of inpatient suicide can be decreased by effective strategies mastered by health personnel through education interventions.Educational interventions in researches varied in contents,duration and outcome measurements.We aimed to review education interventions targeting health personnel on inpatient suicide prevention.Methods:A scoping review was used to analyze existing researches on education interventions targeting health personnel focusing on inpatient suicide prevention in general hospitals.Cochrane Library,PubMed,Embase,CINAHL,China National Knowledge Infrastructure,WanFang,and Chinese Scientific Journal Database were searched in Oct 2019.According to the inclusion and exclusion criteria,the searched studies were screened by two reviewers.And then,two researchers conducted the data extraction independently by using a table format,including the first author,year of publication,study design,participants,education intervention,etc.Results:Twelve studies were included in this scoping review.The contents of education interventions on inpatient suicide prevention included three aspects:suicide knowledge,suicide assessment,and skills for coping with suicide.The duration of education interventions ranged from 1.5-h to 32.0-h.The effects of education interventions were mainly focused on participants’knowledge,attitudes and skills of suicide prevention.Conclusion:The evidence showed that education interventions on inpatient suicide prevention had positive impact on health personnel’s knowledge,attitude and skills about inpatient suicide prevention in general hospitals.However,the best health personnel-targeted education intervention on inpatient suicide prevention in general hospitals was yet to be determined.In the future,it is necessary to combine evidence in this review and the actual condition in clinical practice.

Needs assessment and expectations regarding evidence-based practice knowledge acquisition and training activities:A cross-sectional study of healthcare personnel in China

Objectives Evidence-based healthcare contributes to the improvement of healthcare quality and informs healthcare decision-making.The provision of timely high-quality evidence is always required to fulfil the ever-changing needs and expectations of healthcare personnel.This study aimed to assess the needs and expectations of healthcare personnel regarding evidence-based healthcare in China.Methods We conducted a cross-sectional online survey from December 8,2020 to January 15,2021 involving 901 participants across China.Healthcare providers,policy makers,researchers and educators,and full-time postgraduate medical and nursing students working/living in China were eligible to participate.A self-developed questionnaire was used.Results Participants generally agreed that health-related research evidence was beneficial.Evidence-based resources,such as Cochrane resources,were only known or used by about half of the respondents due to difficulties related to availability and accessibility.Various types of resources,topics of evidence,and themes of workshops were of particular interest to most of the participants.Conclusions The dissemination and translation of evidence,provision of more support in evidence availability,offering evidence-based training,and determining the most in-demand research areas have been identified as priority areas of work which could fulfil the needs and expectations of healthcare personnel in China.

Knowledge Practical Attitude of Health Professionals on Breast Cancer at the Hospital of the District of the Commune IV of Bamako

Introduction: The level of knowledge and attitude of health professionals about breast cancer are important determinants. General objective: To study the knowledge, attitude and practice of health professionals of the hospital of the district of the commune IV on breast cancer. Methodology: This was a cross-sectional, prospective, descriptive, qualitative and quantitative study. The study period was from 01 October 2022 to December 2022. Results: In one week of survey, 110 health workers (intern, obstetrician nurse, general practitioners and specialists) received the survey sheet, 80 health workers informed it, a participation rate of 73%. The male sex was most represented at 63.75% with a sex ratio of 1.76. The average age was 39.59 years with extremes of 22 and 61 years. The clinical signs evoked by the participants were: breast nodule (81.25%), followed by breast discharge (48.75%). In relation to risk factors: interns and obstetrician nurses had no good knowledge, 51.72% of general practitioners had good knowledge, 43.48% of specialist doctors had good knowledge, and 5.88% of the wise had good knowledge. Conclusion: Breast cancer is a common pathology around the world, health professionals are at the forefront of the fight against breast cancer, and this fight cannot be effective without trained personnel.

Barriers to nurse-patient communication in primary healthcare centers in Bahrain:Patient perspective

Objectives:Effective and efficient communication is a core element in healthcare systems,especially between healthcare providers and patients.This study aimed to identify communication barriers be-tween nurses and patients in primary healthcare centers in Bahrain.Methods:This is a cross-sectional study conducted across primary healthcare centers in Bahrain.Four hundred and two patients were recruited using convenience sampling.A self-administered question-naire comprising 29 items on communication barriers was used.Results:A total of 402 patients consented to participate.The majority of participants reported the following statements had large effects on communication:“shortage in the number of nurses compared to the large number of patients”(254/401,63.3%),“lack of desire of nurse to communicate with patients”(246/402,61.2%),and“negative attitude of the nurse toward the patient”(238/401,59.4%).Further,“difference in language between nurses and patients,”“lack of self-confidence by nurses,”and“nurses overwhelmed by work”were ranked as top three statements with a significant influence on commu-nication between nurses and patients.Conclusions:Communication between healthcare providers and patients is pivotal for an optimal healthcare service.Based on the findings of this study and the literature,we recommend formal training of health care workers in improving communication skills and including this not only in medical cur-riculum but also in the form of continuing medical education(CMEs)1.

Challenges faced by community health nurses to achieve universal health coverage in Myanmar:A mixed methods study

Objective:This study aimed to identify the challenges of community health nurses(CHNs)in delivering effective community health care to achieve universal health coverage(UHC)in Myanmar.Methods:A total of 30 CHNs from township health centers in the northeastern,southern,and western parts of Myanmar were purposefully recruited for quantitative and qualitative interviews.Quantitative data were processed using Microsoft Excel software,and qualitative data were analyzed using thematic analysis.This study is registered with researchregistry6201.Results:Around the country,30 CHNs uncovered their hardships in implementing primary health care to achieve UHC.Over 90%of the participants agreed to the problem of inadequate health infrastructure,while half of them felt unmotivated when they encountered role conflicts among various cadres of healthcare providers and poor opportunities for career promotion.Major problems arose from the lack of standard professional education at the entry point to community settings because most CHNs did not achieve specialized training in providing public health services.Complications are incapable of evaluating health services for policy-making and the inability to conduct health research to develop evidencebased practices.Insecure work and living conditions,unsupportive community relationships,and undereducation in professional practices were supportive major themes explored by CHNs to achieve a deeper understanding of the barriers to UHC.Not only the health system itself but also the population and other geographical factors have contributed to many challenges to CHNs.Conclusion:Myanmar’s CHNs face many challenges in achieving UHC.These challenges are not confined to the health sector.Some situations,such as geographical barriers and transportation problems,remain persistent challenges for healthcare providers.This study highlights the fact that current health systems should be strengthened by qualified healthcare providers and sufficient infrastructure.Meanwhile,public empowerment plays a critical role in promoting health development.

The impacts of organizational culture and neoliberal ideology on the continued existence of incivility and bullying in healthcare institutions:A discussion paper

Countless research studies have demonstrated the detrimental effects of incivility and bullying in healthcare.Despite the abundance of proposed solutions to this issue,many healthcare leaders continue to fail in mitigating the existence of such negative behaviors in the workplace.Personality attributes of perpetrators and victims have received attention,but much less research has examined the organizational and neoliberal causations of incivility and bullying in healthcare.Being the largest occupational group in the health sector,nursing professionals have the greatest influence and are crucial in ending these behaviors.This discussion paper outlines the effects of incivility and bullying in healthcare and provides a critical analysis on how organizational culture and neoliberal ideology influence the pervasiveness and persistence of these negative behaviors.The analysis reveals that organizational cultures that misuse power,disregard equality,and facilitate oppression,foster the existence of incivility and bullying in the workplace.Such cultures permit perpetrators to misuse their authority to control resource allocation,ignorance to social inequalities,and the silence of victims.Furthermore,the neoliberal concept of deregulation,austerity,and individualism further these behaviors.The neoliberal reforms have led to underfunding of anti-bullying programs and policies,use of bullying behaviours as management strategies,and victim-blaming for profit maximization.Financial cutbacks have resulted in denial and acceptance of uncivil and bullying behaviours in healthcare institutions,which endangers the rights of healthcare providers to a safe workplace environment.To curtail these negative behaviors,robust anti-bullying policies and programs must be strictly enforced and sustained in practice.Further exploration on the association of organizational culture and neoliberal principles to incivility and bullying in healthcare is greatly warranted.

COVID-19 vaccination and associated factors in Turkish healthcare workers practicing chest medicine

Objective: To evaluate the COVID-19 vaccination status and related characteristics of Turkish healthcare workers practicing chest medicine.Methods: A cross-sectional online survey was conducted among the Turkish Thoracic Society members. The survey was started on May 17, 2021, and kept open for seven weeks. The 39-item survey included the COVID-19 vaccination status and demographic, clinical, and occupational characteristics. Results: Of 378 healthcare workers participated in the survey, 354(93.7%) reported receiving at least one dose of the COVID-19 vaccine. A total of 323(91.2%) healthcare workers received CoronaVac vs. BioNTech/Pfizer in 31(8.8%). In the CoronaVac group, 77(23.8%) contracted COVID-19 when not fully vaccinated, and 13(4.0%) when fully vaccinated;however, 16(51.6%) healthcare workers in the BioNTech/Pfizer group got COVID-19 when not fully vaccinated, but any fully vaccinated participants did not contract COVID-19(P=0.003). Regarding vaccine dosing, 328(86.8%) were fully vaccinated, while 50(13.2%) were not. Multiple regression analysis for being a non-fully vaccinated healthcare worker demonstrated a significant relationship with having any SARS-CoV-2 infection history(adjusted OR 9.57, 95% CI 3.93-23.26, P<0.001) and being a non-physician healthcare worker(adjusted OR 5.86, 95% CI 2.11-16.26, P=0.001), but a significant negative relationship with full-time working at the time of survey(adjusted OR 0.13, 95% CI 0.03-0.56, P=0.006). Conclusions: Although a majority of healthcare workers were fully vaccinated, occupational and non-occupational characteristics were related to being non-fully vaccinated. Active surveillance regarding the COVID-19 vaccination in healthcare workers is necessary to address specific parameters as barriers to vaccination.

Epidemiological Profile of Obesity among Health Staff at the YaoundéCentral Hospital and at the YaoundéUniversity Teaching Hospital

Background: Obesity is a real pandemic and with ever increasing prevalence. Health professionals play a vital role in the fight against this condition. They are also affected by obesity and could be even more affected than the general population. These health workers sometimes have a wrong perception of their own weight which interferes with their ability to counsel their patients. The purpose of this study was to determine the prevalence and factors associated with obesity among health care workers and increase their awareness of the problem. Methodology: This was a cross-sectional study conducted at the Yaoundé Central Hospital (YCH) and the Yaoundé University Teaching Hospital (YUTH) during a 6 months period. The data were collected through a questionnaire structured according to WHO STEP wise approach to chronic disease risk factor surveillance (STEPS). We measured weight, height, waist circumference, and blood pressure according to the WHO STEPS procedure. The Chi square test and logistic regression were used to measure the association between the qualitative variables. A p value 0.05 was considered statistically significant. Results: A total of 350 health personnel participated in this study. The prevalence of obesity was 30.3%. That of abdominal obesity was 46.9%. The factors independently associated to overall obesity were age > 40 years [OR = 2.22 95% CI (1.28 - 3.87)], nursing assistant profession [OR = 2.31 95% IC (1.21 - 4.41)] and high blood pressure [OR = 3.38 95% CI (1.16 - 9.84)] and to abdominal obesity, age > 40 years [OR = 3.35 95% CI (1.96 - 5.71)], female gender [OR = 5.47 95% CI (2.95 - 10.14)], marriage [OR = 1.84 95% CI (1.08 - 3.14)], and High blood pressure [OR = 3.76 95% CI (1.01 - 13.94)]. Conclusion: Obesity is very common among YCH and YUTH staff. Staff awareness and the introduction of proper lifestyle promotion programs are more than ever needed to win the fight against obesity.

The development of an evidence-informed Convergent Care Theory:Working together to achieve optimal health outcomes

Background Healthcare is a complex and divergent system with uncertainty,unpredictability,and multi-layered stakeholders.The relationships among the stakeholders are multifaceted and dynamic,requiring continual interpersonal connections,networks,and co-evolution.It is pivotal to have an evidence-informed theory to explain the phenomenon,uniting the multifaceted stakeholders’efforts.Purpose To describe the development of an evidence-informed theory,the Convergent Care Theory,assembling healthcare stakeholders to work together and achieve optimal health outcomes.Methods The Convergent Care Theory was developed using a theory synthesis approach based on empirical research and literature reviews published by the theory-proposing author.The empirical evidence was categorized into:patients and families,healthcare providers,healthcare organizations,and patients’and healthcare providers’self-care.Results The Convergent Care Theory includes four concepts:all-inclusive organizational care,healthcare professional collaborative care,person-centered precision care,and patients’and healthcare providers’self-care.Achieving convergent care is a process requiring all stakeholders to work together.Six major facilitators emerged from the research evidence:competence,compassion,accountability,trusting,sharing,and engaging.Conclusion This article introduced the development process of the evidence-informed Convergent Care Theory.Healthcare systems are complex,with multiple stakeholders’needs to meet.The Convergent Care Theory strives to unite healthcare stakeholders,bond resources,and join forces to achieve optimal healthcare outcomes.The underpinning of the theory is a caring culture,which is an underlying code for organizational and team behaviors and the foundation of optimal health outcomes.

Predictive Factors for Viral B and C Infection in Health Workers in a University Hospital in Ivory Cost

Purpose: To evaluate the serological status of hepatitis B and C and to identify the risk factors for viral B and C infection in health workers at the university hospital. Material and Method: Mono-centric cross-sectional study carried out at Bouaké University Hospital from March 2nd to May 16th, 2016, concerning the health staff of the Bouaké University Hospital. Cross-sectional study mono-centric concerning the serological status of viral hepatitis B and C from the period from March 2nd to May 16th, 2016 of the health staff of the University Hospital of Bouaké. It has benefited from data from PNLHVi (national program against viral hepatitis) as part of its awareness campaign. The data were analyzed by SPSS software version 20.0. Results: Of the 1107 health workers, 632 had been included, representing a participation rate of 57.1%. The average age of the staff was 37.8 years with extremes ranging from 18 to 66 years. The sex ratio (H/F) was 0.8. Accidents with blood exposure were noted in 52.4% of cases. The maximum vaccine coverage was 16.1%. The prevalence of HBsAg was 8.4%. Contact with HBV was present in 3/4 of the staff. Anti HCV Ab was positive in 1.4% of the staff. Males, age over 50 and over 20 years of seniority were associated with HBV. Also, HBV infection was significantly higher in boys and girls (81.7%), nurses (78.3%) and nursing aides (73.8%), (p = 0.022). HCV infection was significantly correlated with emergency services. Conclusion: Age, gender, seniority, paramedic qualification, and high risk of exposure to body fluids were correlated with viral B infection while emergency department membership was a factor risk of HCV infection.

Status of Health Promotion Established after the Family Health Strategy

Objective: To summarize the scientific knowledge concerning the promotion of health after establishing the Family Health Strategy. Method: This is an integrative review conducted in databases: LILACS, MEDLINE/PubMed, SciELO and Cochrane, using following key words: Family Health Strategy;Health Promotion and Health Personnel. Results: After the criteria established 23 articles were selected, identifying strengths, weaknesses and challenges of health promotion after establishing the Family Health Strategy. Conclusion: Despite the effectiveness of health promotion practices in many health units of the family still persist the curative care model.

Demographic and risk characteristics of healthcare workers infected with SARS-CoV-2 from two tertiary care hospitals in the United Arab Emirates

BACKGROUND Understanding the transmission dynamics of severe acute respiratory syndrome coronavirus 2(SARS-CoV-2)infection among healthcare workers(HCWs)and their social contacts is crucial to plan appropriate risk-reduction measures.AIM To analyze the socio-demographic risk factors and transmission of SARS-CoV-2 infection among HCWs in two tertiary care hospitals in Dubai,United Arab Emirates.METHODS The demographic and clinical characteristics were available for all HCWs in both facilities from the human resources department.A cross-sectional survey was conducted from January-April 2022 among HCWs who tested positive through Reverse Transcriptase Polymerase Chain Reaction of the nasopharyngeal swab for SARS-CoV-2 between March 2020 and August 2021 in two tertiary-level hospitals.The survey included questions on demographics,work profile,characteristics of coronavirus disease 2019(COVID-19),and infection among their household or co-workers.The survey also checked the knowledge and perception of participants on the infection prevention measures related to SARS-CoV-2.RESULTS Out of a total of 346 HCWs infected with SARS-CoV-2,286(82.7%)HCWs consented to participate in this study.From the sample population,150(52.5%)of participants were female,and a majority(230,80.4%)were frontline HCWs,including 121 nurses(121,42.4%).Only 48(16.8%)participants were fully vaccinated at the time of infection.Most infected HCWs(85%)were unaware of any unprotected exposure and were symptomatic at the time of testing(225,78.7%).Nearly half of the participants(140,49%)had co-infection among household,and nearly one-third(29.5%)had coinfection among three or more household.Another 108(37.8%)participants reported crossinfection among co-workers.The frontline HCWs were significantly more infected(25.1%vs 8.6%,P<0.001)compared to non-frontline HCWs.Another significant risk factor for a high infection rate was male sex(P<0.001).Among the infected frontline HCWs,a significantly higher proportion were male and shared accommodation with family(P<0.001).COVID-19 vaccination significantly reduced the infection rate(83.2%vs 16.8,P<0.001)among HCWs.Most participants(99.3%)were aware about importance of appropriate use of personal protective equipment.However,only 70%agreed with the efficacy of the COVID-19 vaccination in preventing an infection and severe disease.CONCLUSION The risk profiling of the HCWs infected with SARS-CoV-2 found that working at frontline and being male increase the rate of infection.COVID-19 vaccination can effectively reduce the rate of transmission of SARS-CoV-2 among HCWs.

突发公共卫生事件背景下公立医院医疗物资供应冲突管理

文章基于突发公共卫生事件状态下公立医院医疗物资供应冲突发生的环境、事发经过、情境结果及冲突条件等要素,运用冲突管理有关理论探索冲突的构成要素及其结果、冲突中人员管理的一般性方法及冲突解决途径。在研究中不难发现,强制型管理风格在应对医疗物资全方位供应复杂性工作面前适用性略显不足,知识型员工在保健与激励因素共同负强化下使得人员管理更加如履薄冰,合作型冲突管理能够较为有效地解决冲突窘境。组织中的各类冲突在所难免,冲突的发生与领导管理风格、组织目标一致性、团队成员的激励程度、人际关系的维系与促进等因素息息相关,应关注冲突的管理方法,通过替代性方案建设性地加以解决至关重要。

领悟社会支持对突发公共卫生事件中一线人员正念干预效用中的中介效应

目的研究正念干预在突发公共卫生事件中一线人员中的效果,并考察领悟社会支持在正念干预效用中的中介效应。方法选择2021年3月至2022年4月在医院一线工作的200名医务人员为研究对象,按照随机数字表法分为对照组和观察组,每组100名。对照组给予常规心理干预,观察组给予正念干预。干预后比较两组医护人员的正念水平、领悟社会支持能力、睡眠质量和心理情况。分析以上四者之间的相关性,采用中介效应模型分析领悟社会支持在正念干预效用中的中介效应。结果干预后,观察组医护人员的正念水平和领悟社会支持量表评分明显高于对照组(P<0.05),观察组分别为(89.59±8.45)分和(88.48±8.53)分,对照组分别为(71.35±7.47)分和(76.34±7.58)分。观察组医护人员的睡眠质量和焦虑-抑郁-压力量表评分明显低于对照组(P<0.05),分别为(7.35±1.24)分和(16.46±2.29)分,对照组分别为(13.56±2.31)分和(29.48±3.05)分。医护人员的正念水平与领悟社会能力呈正相关,两者分别与焦虑-抑郁-压力和睡眠质量呈负相关。领悟社会支持在正念水平和正念干预效果中发挥中介效应,正念与睡眠质量的总效应值为-0.347,与焦虑之间为-0.439,与抑郁之间为-0.508,与压力之间为-0.395。结论正念干预能可直接或通过领悟社会支持能力间接作用,显著提高突发公共卫生事件中一线人员改善其睡眠质量及负面情绪,具有重要临床应用价值。

突发公共卫生事件下急进高原作业的医务人员急性高原反应与心理状况调查

目的对突发公共卫生事件下急进高原作业的医务人员的急性高原反应(AMS)与心理状况进行调查,旨在为预防AMS的发生及制订心理干预策略提供科学依据。方法研究对象为2022年8月26日至9月9日紧急进入拉萨市开展医疗支援工作的医务人员。通过AMS临床症状量表将得分0~10分的受试者纳入轻微高原反应(SAMS)组,≥11分的受试者纳入高原反应(AMS)组。调查两组一般资料及情绪状态自评量表、压力感受量表-10(PSS-10)、9项患者健康问卷(PHQ-9)、7项广泛性焦虑障碍量表(GAD-7)评分。结果共调查175名医务人员,其中SAMS组108名,AMS组67名,PHQ-9检出抑郁情绪发生率为49.71%,GAD-7检出焦虑情绪发生率为18.86%。与SAMS组相比,AMS组无高原经历的比例、PHQ-9阳性率、PSS-10评分以及情绪自评量表中疲劳、失眠、食欲减退、担心被感染维度评分均更高,差异有统计学意义(P<0.05)。二元logistic回归分析显示,PSS-10评分(OR=1.091,95%CI 1.020~1.167,P=0.011)及无高原经历(OR=2.614,95%CI 1.047~6.529,P=0.040)是急进高原作业的医务人员发生AMS的危险因素。结论急进高原作业的医务人员容易发生AMS,且存在突出的焦虑抑郁情绪,缺少高原经历及压力感知突出者AMS更显著,有必要对其开展针对性的预防及心理干预。

离散选择实验在卫生人力资源领域的应用进展

背景运用离散选择实验(DCE)对卫生人员工作选择倾向性进行研究,可以为制定农村及偏远地区吸引和留用卫生人员相关政策提供科学且有效的依据。目的对DCE应用于卫生人力资源领域的研究进行梳理、总结和归纳,以期为将来的相关研究提供参考。方法于2022年2—4月,系统检索Web of Science、PubMed、中国知网、万方数据知识服务平台、维普网中与DCE应用于卫生人力资源领域相关的文献。提取纳入文献的研究对象、分析模型、选择项设置及研究结果等。结果最终纳入44篇文献,文献发表时间为2000—2020年。研究对象主要为在职卫生工作者、学生;纳入文献中,6篇是标签式,其余为一般式;属性数量为4~8个;水平数量以2~4个居多(88.6%,39/44)。高收入国家的研究中将全科医生团队合作、工作量作为工作属性;中低收入国家的研究中工作属性选择最多的是住房(21次),其次是设施、药物等的配备(19次)、学习/培训机会(16次)。各文献的工作属性均纳入了收入(工资)。形成的工作属性框架包含4个层面:社会层面,包括医院规模、社会支持/尊重、身份确认(编制或成为永久员工);工作层面,包括工作地点、工作条件、工作量、工作(管理)氛围、团队合作、上级指导(针对基层卫生工作者);职业发展层面,包括晋升年限、培训(继续教育)机会、学术和研究机会;生活层面,包括收入、住房、交通、子女教育。分析模型运用最多的是Mixed Logit Model(19次),其次是Conditional Logit Model(9次)、Generalized Multinomial Logit Model(3次)。结论该领域研究结果的异质性较大,难以得出统一结论。而且DCE在卫生人力资源领域的应用仍需进一步在全球范围内推广,相关研究十分有限,得到的证据尚需进一步研究的证实。

ABC分类绩效管理法对医务人员服务质量、心理健康及工作满意度的影响

目的:探究基于ABC分类绩效管理法对医务人员的影响。方法:选取2021年3月-2022年3月某院200名在职医务人员,随机分为对照组和观察组,各100例,对照组采用统一医院绩效管理模式,观察组给予基于ABC分类绩效管理法。比较两组服务质量[医疗服务质量量表(CQS)]、心理健康[焦虑自评表(SAS)和抑郁自评表(SDS)]、主观幸福感[主观幸福感量表(GWB)]、工作满意度[明尼苏达工作满意度问卷短式量表(MSQ)]及同情疲劳状况调查[职业生命质量量表中文版(ProQOL)]。结果:干预后与对照组相比,观察组CQS各维度评分明显较高(t=-6.944,-6.920,-7.220;P<0.05),SAS评分和SDS评分明显较低(t=4.894,4.145;P<0.05),GWB各维度评分明显较高(t=-8.548,-4.699,-5.972,-6.778,-9.472,-6.377;P<0.05),MSQ各维度评分明显较高(t=-7.939,-8.925,-7.151;P<0.05),ProQOL各维度评分明显较低(t=10.441,9.667,5.661;P<0.05)。结论:针对医务人员给予基于ABC分类绩效管理法,可明显改善其服务质量,促进心理健康,增加主观幸福感,提升工作满意度,改善同情疲劳状况。

“大健康”视域下环境土壤科学教学改革的一点思考

为全面提升中华民族健康素质、积极参与全球健康治理、切实履行《2030年可持续发展议程》的国际承诺,中共中央、国务院提出全面实施“健康中国战略”。在教育领域尤其是环境科学教育方面,亟需进行改革以适应“大健康”视域下的发展需求,更新教育思想、人才培养模式和视野提升路径成为大势所趋。该文旨在探讨“大健康”理念和土壤环境与健康的融合,分析其对环境土壤科学课程教学的指导作用。在此基础上,提出三位一体的环境土壤科学课程教学改革思路:构建基于“大健康”理念的复合型人才培养知识体系,拓展产学研一体化的应用型人才实践素质,以及融入信息化手段,优化课程考核评价体系。希望通过上述改革方案的实施,达到有效提高教学效果、全面提升学生综合素质和培养符合社会发展需求的高素质环境科学与工程领域人才的目的。

专业人员进行功率负荷参数指导的运动健康干预方案的培训实践

目的:针对采用功率负荷参数开展运动健康干预指导活动的机构和人员,研制一套简便易行的培训方案。方法:总结本团队自身前期实施以功率负荷参数为指导的运动健康干预活动过程中,在培训机构选择、专业人员要求、授课形式、授课内容方面的经验和教训,结合主动健康、运动医学、临床医学理论等相关知识,得出具体培训方案。结果:形成了涵盖培训目的、培训阶段和方式及培训内容等方面的详细培训体系,供有志于从事以功率负荷参数为指导的运动健康干预服务人员参考。