Investigation and analysis of mental health status and related influencing factors of medical staff in Karamay City who assisted Ili during the outbreak of COVID-19

Background:To investigate the mental health status and its influencing factors of medical staff in Karamay City who assisted Ili during the outbreak of COVID-19,so as to provide a reliable basis for timely and effective psychological intervention.Methods:Applied questionnaire survey and used the“questionnaire star”platform to investigate the mental health status of medical staff assisting Ili by the General information,the PHQ-9,the GAD-7 and the SCL-90.And the relevant influencing factors were analyzed by univariate analysis and multiple linear regression analysis.Results:Factors such as whether they will support again,whether they need to provide psychological staff,and whether they have a sense of guilt for their families have a significant impact on the PHQ-9 of medical staff(p<0.05);Whether they will support again,whether they need psychological staff,and whether they feel bored and lonely during the closed loop management have a significant impact on the GAD-7 of medical staff(p<0.05);The SCL-90 was compared with the norm,and the scores of somatization,interpersonal sensitivity and terror factors of medical personnel were statistically significant(p<0.05),scores in other aspects(diet sleep)are obvious(1.63±0.72).Conclusion:During the period of COVID-19,the medical staff in Karamay City who assisted Ili had anxiety and depression,and their mental health was not optimistic,more attention and the necessary intervention should be given.

Prevalence and related factors of post-traumatic stress disorder among medical staff members exposed to H7N9 patients

Objective: This study aimed to evaluate the prevalence and related factors of post-traumatic stress disorder (PTSD) symptoms among doctors and nurses who were exposed to H7N9 patients during the H7N9 influenza epidemic.To provide scientific basis for promoting the physical and psychological health of these staff members.Method: The 102 medical staff workers who were exposed to H7N9 patients were recruited through convenient sampling between January 2015 and May 2016.We used a self-reported questionnaire,the PTSD Checklist-Civilian Version (PCL-C),to evaluate the PTSD symptoms among doctors and nurses from an intensive care unit (n =61),a respiratory department (n =20),and an emergency department (n =21).We then analyzed the related factors.Results: Around 20.59% of the tested doctors and nurses showed PTSD symptoms.The sample had a mean PCL-C score of 30.00 ± 9.95.The differences in the scores of doctors and nurses with different genders,ages,professional titles,contact frequencies,trainings,and experiences were statistically significant (P < 0.05,P < 0.01).Moreover,t-tests and one-way analysis of variance showed that nurses received higher scores than doctors,female participants received higher scores than male participants,and the participants with low professional title and high contact frequency,aged between 20 years and 30 years,with less than five years of work experience,having not received related training and with no related experience obtained higher PCL-C scores than the others (P < 0.05,P < 0.01).Conclusion: The PTSD level of doctors and nurses after their exposure to H7N9 patients was high,which warrant further research.Health and medical institutions should pay attention to the physical and psychological health of these staff members.

Are mindfulness and self-efficacy related to presenteeism among primary medical staff: A cross-sectional study

Objectives: In ensuring public welfare with primary medical and health services,the primary medical staff faces new tasks.Increasing workload,and therefore degrees of stress and burnout,can influence job satisfaction and lead to presenteeism,which is defined as the appearance to be on the job but not actually working.The purpose of this study is to investigate the current worling situation and the relationship between presenteeism and mindfulness of primary medical staff and determine the mediating effect of self-efficacy on this relationship.Method: A cross-sectional survey was performed with 580 primary medical staff from 9 hospitals in Shaanxi province,northwest China.Presenteeism,mindfulness,and self-efficacy were measured by using a general information questionnaire,the Five-Facet Mindfulness Questionnaire,the General Self-Efficacy Scale,and the Stanford Presenteeism Scale.Mediating effect was analyzed by a series of hierarchical multiple regressions.Results: A high level of presenteeism was found among 47.4% of the study participants.Presenteeism was negatively correlated with mindfulness(r--0.409,P < 0.001) and self-efficacy(r--0.678,P < 0.001).A positive correlation was found between mindfulness and self-efficacy(r-0.584,P< 0.001).When controlling for self-efficacy (β =-0.018,P> 0.05),the association was insignificant between presenteeism and mindfulness.Conclusion: The results identified the effect of mindfulness on presenteeism of primary medical staff is realized through self-efficacy,which also suggested to enhance self-efficacy on center location when developing management strategies for mental health education or training among primary medical staff.

Review of possible psychological impacts of COVID-19 on frontline medical staff and reduction strategies

Like soldiers,frontline medical staff provide a first line of defense and have played a critical role in responses to the outbreak of coronavirus disease-2019 in December 2019.It is important to acknowledge the considerable pressure placed on frontline medical staff in the face of a new type of coronavirus that is highly infectious and for which no specific treatment is available.Here,we review the various kinds of psychological problems afflicting frontline medical staff who are combatting the severe acute respiratory syndrome epidemic.These include anxiety,insomnia,depression,interpersonal difficulties,and post-traumatic stress disorder syndrome.We further present a summary of countermeasures for alleviating these problems based on our findings.These countermeasures include ensuring the provision of adequate protective gear for frontline medical staff,developing timely and clear guidelines,strengthening social support,and providing clear criteria and additional training,focusing on the choice of frontline medical staff.An understanding of the psychological impacts of an epidemic situation and of relevant countermeasures will contribute to reducing the psychological pressures on frontline medical staff.Consequently,they will be able to cope better with outbreaks of infectious diseases in the future,to reduce the psychological pressure of the front-line medical staff,and to improve the treatment level.

Spread of Staphylococcus aureus between medical staff and high-frequency contact surfaces in a large metropolitan hospital

Objective:To examine whether bacteria are transferred between the hands of medical staff and high-frequency contact surfaces within and between departments of a major metropolitan hospital,and to further analyze the patterns of cross-transmission.Methods:Microbiological samples were collected from the hands of 112 hospital employees as well as from 120 high-frequency contact surfaces in four hospital departments.Samples were collected on agar plates,analyzed for the presence of Staphylococcus aureus or methicillin-resistant S.aureus(MRSA)by standard microbiology testing,and partially genotyped using pulsed-field gel electrophoresis.Results:Genetically identical MRSA was identified on the surface of an electrocardiography device in the medical intensive care unit and on the same type of device in the neurosurgical unit.Genetically similar S.aureus was identified on an infusion pump in the medical intensive care unit and on the hands of several doctors in a different department who regularly use that pump.Genetically identical S.aureus was also identified on bedside rail restraint in the medical intensive care unit and on the hands of the nurse in the neurosurgical unit.Finally,genetically similar MRSA was identified both on the surface of an electrocardiography device and on the suction apparatus in the medical intensive care unit.Conclusion:Cross-contamination of S.aureus or MRSA on medical workers'hands and contact surfaces was demonstrated within and between departments of a large metropolitan hospital.Improvements are needed in medical staff hygiene habits and in the cleaning of highfrequency contact surfaces to help prevent and control nosocomial infections.

Association of overtime work and obesity with needle stick and sharp injuries in medical practice

BACKGROUND Needle stick and sharps injuries(NSIs)may cause infections among medical personnel.Obesity and overtime work among medical personnel increase the incidence of work injuries.AIM To investigate whether overtime work and obesity increase the risk of NSIs.METHODS This cross-sectional study used the data of 847 hospital personnel,including 104 doctors,613 nurses,67 medical laboratory scientists,54 specialist technicians,and nine surgical assistants.Of them,29 participants notified the hospital of having at least one NSI in 2017.The data collected included age,overtime work,body mass index,medical specialty such as doctor or nurse,and professional grade such as attending physician or resident.Theχ2 and Fisher’s exact tests were used to compare categorical variables.Multiple logistic regression analysis and the Sobel test were used to assess the risk of NSIs.RESULTS Overtime work,body weight,and medical specialty were significantly associated with NSIs(P<0.05).After adjustment for risk factors,heavy overtime work was an independent risk factor for NSIs,and healthy body weight and nursing specialty were independent protective factors against NSIs.After adjustment for risk factors,medical personnel with healthy body weight has half as many NSIs as those with unhealthy body weight;the proportion of NSIs in doctors with healthy body weight was 0.2 times that in doctors with unhealthy body weight;the proportion of injuries among residents was 17.3 times higher than that among attending physicians;the proportion of injuries among junior nurses was 3.9 times higher than that among experienced nurses;the proportion of injuries among nurses with heavy overtime work was 6.6 times higher than that among nurses with mild overtime work;and the proportion of injuries among residents was 19.5 times higher than that among junior nurses.Heavy overtime work mediated the association of medical specialty with NSIs.CONCLUSION In addition to promoting the use of safety needles and providing infection control education,managers should review overtime schedules,and medical personnel should be encouraged to maintain a healthy weight.

Investigation of mental health status of medical staff from Hainan who aided Hubei province to fight against COVID-19

Objective:To analyze the mental health status of Hainan Provincial medical staff who aided Hubei Province to combat COVID-19.Methods:The Self-Rating Anxiety Scale(SAS),Self-Rating Depression Scale(SDS),Self-Reporting Questionnaire-20(SRQ-20)and PTSD Checklist-Civilian Version(PCL-C)were used to evaluate the mental health status of 243 medical staff who aided Hubei Province to combat COVID-19.Results:A total of 221 persons have completed the psychological assessment.The survey showed that 9.05%of the medical staff had different degrees of anxiety,16.29%had different degrees of depression,13.12%were abnormal in Self-Reporting Questionnaire-20,and 9.05%were abnormal in PTSD Checklist-Civilian Version.There were difference in scores of Self-Rating Depression Scale across different genders,age groups,profession and educational levels,But Regression analysis rejects the correlation.Conclusions:The mental health status of Hainan Provincial medical staff who aided Hubei Province to fight against COVID-19 was abnormal,regardless of gender,age,profession or education background.Preventative measures at an early stage are warranted to alleviate the psychological problems.

Stressors and Coping Strategies of Medical Staff in the COVID-19 Pandemic in Wuhan

Exploring whether medical staff perceive stress on the assigned medical tasks,what are the specific sources of stress,what are the tangible sources of support they expected to be helpful,and individual coping with stress to provide more accurate,personal support for psychological crisis.This study uses a cross-sectional descriptive survey adopting convenience sampling among the medical staff who worked for over seven days in the infected areas of one Grade 2A and three Grade 3A hospitals during the COVID-19 pandemic.The assessment includes attitude when receiving tasks,major stressors,factors relieving stress,and personal management of stress.A total of 104(76.8%)valid questionnaires are received.A majority(94.3%)of the medical staff held a positive attitude taking duty for granted but feeling nervous and afraid(81.1%).Contacting the infected(90.6%)and compensation(92.5%)are the main concerns.The major pressure sources are regarding safety for oneself(98.1%),colleagues(92.5%),and family(94.3%),as well as lack of effective treatment(92.5%),inadequate protective equipment(94.3%)and incomplete disinfection(94.3%).The main positive pressure adjustments include strict infection controlling measures(98.4%),maintaining a positive attitude(95.2%),actively attain more information 95.2%,and engage in recreational activities(93.6%),but more than 40%takes negative adjustments to vent their emotions and relieve anxiety,suggesting the importance of early psychological intervention.During the COVID-19 pandemic,the main stressors among medical staff are safety,uncertainty and shortage of resources.Positive coping includes taking effective protective measures and achieving thorough understanding of the virus.

An Automated Detection Approach of Protective Equipment Donning for Medical Staff under COVID-19 Using Deep Learning

Personal protective equipment(PPE)donning detection for medical staff is a key link of medical operation safety guarantee and is of great significance to combat COVID-19.However,the lack of dedicated datasets makes the scarce research on intelligence monitoring of workers’PPE use in the field of healthcare.In this paper,we construct a dress codes dataset for medical staff under the epidemic.And based on this,we propose a PPE donning automatic detection approach using deep learning.With the participation of health care personnel,we organize 6 volunteers dressed in different combinations of PPE to simulate more dress situations in the preset structured environment,and an effective and robust dataset is constructed with a total of 5233 preprocessed images.Starting from the task’s dual requirements for speed and accuracy,we use the YOLOv4 convolutional neural network as our learning model to judge whether the donning of different PPE classes corresponds to the body parts of the medical staff meets the dress codes to ensure their self-protection safety.Experimental results show that compared with three typical deeplearning-based detection models,our method achieves a relatively optimal balance while ensuring high detection accuracy(84.14%),with faster processing time(42.02 ms)after the average analysis of 17 classes of PPE donning situation.Overall,this research focuses on the automatic detection of worker safety protection for the first time in healthcare,which will help to improve its technical level of risk management and the ability to respond to potentially hazardous events.

The investigation of 1027 medical staff about knowledge grasping and attitude of cancer pain

Objective: To get the message of knowledge and attitude about pain of the medical members from basic medi- cal service sites by questionnaire investigation. To point out concrete directions for generalization and post-education of the three-tiered principles of analgesics treatment of WHO. Methods: We designed a questionnaire about cancer pain treatment. We used it to make inquire in 1040 medical staff from different medical agencies. SPSS software was used to analyze all data. Results: 1027 questionnaires were fit for data analysis. 91.4% of staff working in the primary medical agencies, 95.0% with professional title of assistant professor or lower title, and 83.7% younger than 50-year old. The data displayed that basic knowledge of cancer pain are poorly mastered. More than half investigates cannot evaluate the pain degrees correctly, and have many erroneous understandings about pain. Conclusion: The training of pain treatments for the medical staff working in primary medical agencies should be enhanced because of their poor grasping. Primary agencies should increase the varieties of analgesic drugs and change their attitude and conception of analgesic drugs administration.

Medical Malpractice:A Comparative Perspective Between China and the United States

At the beginning of the 1970s,the United States turned onto the winding road of medical malpractice compensation.With the goal of properly dealing with this issue,the United States embarked on a process of continuous reform.In recent years,the number of disputes over medical malpractice liabilities in China has increased considerably.However,dealing with these disputes in accordance with the provisions of the current law is not going smoothly,and maybe we can learn from the experiences of the United States.The relevant measures for the solutions to medical malpractice in the United States and China will be analyzed from a comparative perspective.These include enactments of medical malpractice,the classification of medical malpractice,the doctrine of liability fixation,the burden of proof,the criterion of judging negligence,the liability subject,the authentication system,expert witnesses,standards of compensation,and suggested reforms in the system of the medical malpractice liability,including stipulating the medical malpractice liability of administration in the Civil Code,optimizing the criteria of recognizing negligence,applying organizational fault liability,establishing pilot projects of no-fault medical liability,developing an open mechanism for medical malpractice disclosures and improving the capacity to deal with medical chaos.

Survey of the Sleep Quality of Medical Staff in a Grade A Tertiary Hospital during the Novel Coronavirus Pneumonia Outbreak

This study aimed to investigate the sleep quality of medical staff in China who are combatting novel coronavirus pneumonia(COVID-19).To perform this,a survey of 127 medical staff from three separate wards(the general ward,isolation ward,and fever clinic)of a Grade A tertiary hospital in China was conducted.The survey questionnaire measured general characteristics and included the Pittsburgh Sleep Quality Index(PSQI).We consequently found that global PSQI scores differed significantly between the different wards(χ2=44.561,P<0.001).Whilst the medical staff in the general ward did not report any sleep disturbances,those in the isolation ward and the fever clinic both exhibited various degrees of sleep disturbance(global PSQI score>7).Medical staff in the isolation ward had the worst sleep quality(mean rank=91.74),followed by those in the fever clinic(mean rank=70.52)and the general ward(mean rank=39.10),respectively.The primary sleep disturbances reported by the medical staff from the isolation ward included difficulty falling asleep(24 cases,71.42%),waking early or at night(28 cases,80%),and nightmares(18 cases,51.42%).In addition,31.42%(11 cases)of the medical staff from the isolation ward had less than six hours of sleep a night,and 65.71%(23 cases)felt that their sleep quality was poor;meanwhile,for the staff from the fever clinic these ratios were 16.67%(seven cases)and 33.33%(14 cases),respectively.In contrast,among medical staff in the general ward,98%(49 cases)reported sleeping for more than six hours a night,and 96%felt that their sleep quality was good.In conclusion,of the medical staff providing treatment for COVID-19,those in isolation wards and fever clinics are more likely to experience sleep disturbances.

Analysis on Occupational Well-being Status and Influencing Factors of Medical Staff in Tuberculosis Departments

Objective:To investigate the status of occupational well-being of medical staff in tuberculosis department and analyze its influencing factors,so as to provide a basis for improving the occupational well-being of medical staff in tuberculosis department.Methods:In May 2020,we adopted the method of cluster sampling to select staff members from the tuberculosis departments of the Affiliated Hospital of Hebei University and infectious disease hospital.A total of 139 medical staff were recruited as the research subjects,and were investigated using medical staff occupational well-being scale.Results:The total score of occupational well-being was 76.4697 points,There were statistically significant differences(P<0.05)in occupational well-being score among tuberculosis medical staff with different age,years of work,job title,night shift,marital status,and occupational type.The influencing factors of occupational well-being were the night shift,years of work,occupational type,and marital status(P<0.05).Conclusion:The overall level of occupational well-being of tuberculosis medical staffs is moderate,and occupational well-being is affected by night shift,years of work,occupational type and marital status.It is recommended that managers take targeted measures to improve the occupational well-being of tuberculosis medical staff.

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.

上海市医疗卫生机构职工休息室建设需求与对策建议

目的调查分析上海市医疗卫生机构职工休息室建设需求和管理现状,为改善医务职工的工作环境和工作条件提供方法和经验。方法对各级医院和医疗急救中心的医务职工进行线上电子问卷调查,内容包括休息室现状及对休息室需求等,共回收有效问卷1434份。对9家医疗卫生机构开展现场调查,并与休息室建设负责人、管理负责人等15名相关人员进行访谈。结果所调查的医务职工中,13.7%没有时间休息,16.9%在休息室中休息,医疗机构现有职工休息室建设存在设置不均衡、总体数量少、使用率有待进一步提高等问题。医务人员对休息室的需求主要集中于面积、布局、室内环境、功能等方面,其中不同工作特性医务人员的休息需求有所不同。医务职工休息室建设与推行难点主要为用房紧张、法规标准不明确、管理困难、医务职工休息需求不被重视。结论在医务职工休息室规划建设上,建议加大政策支持力度,建立规范化管理制度,并通过加强组织领导、多方协同合作,确保休息室建设改善工作能有效落实。在具体建设方面,应满足医务职工多元需求,可因地制宜规划设计、合理划分功能分区。此外,还应重视宣传总结,营造“健康工作,科学休息”的积极氛围。

A Qualitative Study of the Triage of Patients with Non-Traumatic Acute Abdomen

Objective: To explore the work experience of medical staff in the emergency department of a general hospital in the triage of patients with non-traumatic acute abdomen to formulate corresponding intervention measures and branch evaluation tools. Methods: With descriptive phenomenology as the research method, semi-structured interviews were conducted with the medical staff in a tertiary hospital in Nanjing from February 1st to 10th, 2023, and Colaizzi seven-step analysis was used to analyze the data. Results: A total of 17 emergency medical staff were interviewed in this study. Four themes were derived from the analysis of the data: the etiology of acute abdomen is complex, so it is difficult to categorize them: acute abdomen requires immediate treatment, but the treat will be delayed if the categorization is inaccurate;the high pressure of nurses and the accuracy in categorizing the patients are problems that should be addressed. Conclusion: The categorization of patients with non-traumatic acute abdomen is challenging. Therefore, it is necessary to carry out corresponding intervention and formulate appropriate departmental evaluation tools to improve the accuracy of categorization of patients with acute abdomen.

34起持刀伤医案件及相关因素分析

目的通过持刀伤医案件分析,探索针对性措施,防范严重伤医案件发生。方法从中国裁判文书官方网站收集2010―2019年持刀伤医相关的医患纠纷及刑事案件,共获得持刀伤医裁判文书35份,涉及34起案件,将案件相关数据录入Excel 2007进行统计分析。结果2010―2019年,34起持刀伤医案造成5人死亡、12人重伤、24人轻伤和10人轻微伤,涉及41名罪犯、4个罪名、6类医疗机构、4种犯罪动机、37把刀具和15个犯罪地点。结论犯罪数据在6类分组中各有特点,犯罪动机主要为报复和泄愤,背后的直接原因是病人及其家属对医疗过程不理解、对医疗行为不认同以及对医疗结果不满意。

新型冠状病毒肺炎定点收治医院医患心理援助服务模式的构建与应用

2019年底暴发的新型冠状病毒肺炎疫情对患者和一线医务人员以及隔离在家的人员产生了明显的心理影响。2020年2月,国家卫生健康委员会从上海、四川和湖南等地调派150名精神心理医师驰援武汉。为指导新型冠状病毒肺炎定点收治医院专业团队有序开展心理援助工作,实现疫情下患者及医务人员及时、规范、高效的心理救助,上海援鄂心理医疗队在执行援助任务过程中逐步探索形成了包括任务目标、工作原则、工作流程、组织实施及具体技术等内容在内的一整套行之有效的心理援助服务模式,并应用于心理干预实践中,取得了良好的效果。

A good death from the perspective of healthcare providers from the internal medicine department in Shanghai:A qualitative study

Objective:This study aimed to explore the understanding of healthcare providers working in the internal medicine department in Shanghai regarding a good death.Methods:The data of the study was collected using face-to-face semi-structured interviews.Through purposive sampling,16 physicians and 13 nurses who had experiences of caring for adult patients with life-threatening illnesses at the end-of-life stage in Shanghai were interviewed.The interviews were analyzed using qualitative content analysis.Results:Six characteristics of a good death emerged:no suffering,companionship and care,no worries or concerns,dying with dignity,involvement and acceptance,and less impact on the family.Eighteen categories were identified:dying without experiencing suffering;being relieved of symptoms and suffering;being relieved of psychological suffering;avoiding the use of futile treatment and resuscita-tion;being cared for and accompanied by family;receiving good health care;having a meaningful life without regrets;making good arrangements for family issues;having a chance to say goodbye;having a quality life before death;dying in a decent environment;the personal will to be respected;maintaining the integrity of the body;death of the patient being accepted by the family and healthcare providers;the death occurred despite the best efforts to care for the patient;limited financial and care burden;shortly affected quality of life of the patient;and improved family cohesion.Conclusion:Family members’early involvement in caring for patients at the end-of-life stage helps achieve a good death.For patients with a terminal illness,avoiding unnecessary medical treatment and resuscitation could be the first step in achieving better patient death and promoting the development of advanced care planning in the mainland of China.