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Objective To explore the impact of the three-level assistance model based on the narrative nursing theory on the mental health status of medical staff.Methods 140 medical staff working in a third class hospital in Xiangyang City were selected as the research object.The three-level assistance model based on narrative nursing theory was used to intervene them from September 2021 to July 2022.The symptom self-assessment scales before and after the intervention were compared.Results Before the intervention,the total score of SCL-90(156.37±32.56)points and the scores of various symptom factors of medical staff were higher;After the intervention,the total score of SCL-90(133.35±43.48)points and the scores of various symptom factors were lower than those before the intervention and the difference was statistically significant(P<0.05).Conclusion The three-level assistance model based on narrative nursing theory can reduce the total score of SCL-90 and the scores of various symptom factors,improve the mental health status and mental health level.
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With the COVID-19 outbreak, many provinces and municipalities have announced the first-level response to public health emergencies. As the backbone of fighting the epidemic, medical staff are faced with many ethical dilemmas, such as the lack of medical protection materials, the high risk of virus infection, discrimination and so on, and their health and life rights and interests have been impacted. Starting with the concept of public health emergencies and the right to life and health, the theory and display basis of the right of life and health were discussed based on the practical guidelines of public health emergencies. Taking the COVID-19 epidemic as an example, this paper proposed measures for ensuring the right to life and health of medical staff in public health emergencies, so as to better cope with the epidemic of COVID-19 and protect the life and health of medical workers.
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The COVID-19 is a severe respiratory pathogen infection, showing a distinct "hospital cluster" transmission characteristics. This paper illustrated the concept of occupational exposure and COVID-19. Combined with the actual situation of COVID-19, the infection status of medical personnel in this outbreak was analyzed from three aspects: the transmission risk and infection rate of medical personnel, the clinical characteristics and the undiscovered super-spreader. Through the analysis of the present situation, this paper summarized the possible occupational exposure risk factors of medical personnel in COVID-19 from five aspects: biological occupational risk factors, chemical occupational risk factors, physical occupational risk factors, violence factors and psychological factors. From isolating the source of infection and cutting off the transmission route, the "safety supervisor" mechanism is established to avoid the risks of biological, chemical and physical occupational exposure, from providing professional psychological counseling for medical personnel to reduce their psychological stress, and from improving the relevant legal level to reduce the risk of medical personnel’s violent occupational exposure.
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Ideological and political education in medical discipline is the integration of "medical discipline" and "ideological and political education", the deepening of "ideological and political theories teaching in all courses" and "professional ideological and political education", and an important part of discipline construction and ideological and political education in medical colleges. This paper analyzed the value and inevitability of ideological and political education in medical discipline from the perspective of medical discipline, "three-all education" and medical personnel training, and expounded the connotation system and practical dimension of "ideological and political education in medical discipline" in the framework of subject form, object form, mediator form, theory form, practice form and system form.
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Objective@#To examine the correlation between anxiety and perceived stress among medical personnel in a tertiary specialized cancer hospital, so as to provide the evidence for improving psychological health among medical personnel. @*Methods@#In-service doctors, nurses and technicians were sampled from a tertiary specialized cancer hospital, and their demographics, perceived stress and sources of stress were collected using self-designed questionnaires. Anxiety was evaluated using the Self-rating Anxiety Scale (SAS), and the associations of anxiety with perceived stress and source of stress were examined using a multivariable logistic regression model. @*Results@#A total 800 questionnaires were allocated and 655 valid questionnaires were recovered, with an effective recovery rate of 81.88%. The respondents included 160 men (24.43%) and 495 women (75.57%), and 297 respondents (45.34%) were at ages of 30 to 39 years. There were 14 respondents with no or low level of stress (2.14%), 245 with general level of stress (37.40%), 289 with high level of stress (44.12%), and 107 with extremely high level of stress (16.34%). The prevalence of anxiety was 36.64% among respondents. Multivariable logistic regression analysis identified perceived stress at work (OR=2.205, 95%CI: 1.657-2.675), doctor-patient relationship (OR=2.259, 95%CI: 1.561-3.282) and interpersonal relationship (OR=2.272, 95%CI: 1.387-3.693) as a factor affecting anxiety among medical personnel. @*Conclusion@#The anxiety correlates with stress at work, doctor-patient relationship and interpersonal relationship among medical personnel in a tertiary specialized cancer hospital.
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Medical ethics is relevant to the physical and mental health of the public and is a major force in promoting the Healthy China Action Plan. According to the research and analysis on the medical ethics of professionals engaging in medicine, pharmacy, medical technology and nursing from five public hospitals in China, the medical ethics performance is good on the whole, but there are very few phenomena of medical ethics violation. There are three main influencing factors of medical ethics problems: utilitarian tendency of some medical personnel under the background of economic globalization and value diversification, lack of medical ethics cultivation in some medical colleges and public hospitals, and unsound mechanisms of leadership management, supervision and evaluation in some public hospitals. Suggestions for enhancing the construction of medical ethics in China’s public hospitals include deepening the reform of public hospitals oriented towards public welfare, innovating the cultivation of medical ethics, fostering the leadership and cooperation of the Communist Party of China organization and administrative departments, improving the organization and leadership mechanisms, strengthening the supervision and supervision mechanisms, and improving the reward and punishment mechanisms.
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Objective@#To examine the association of long working hours and shift work with occupational stress among medical staff in level A tertiary hospitals, so as to provide insights into promotion of physical and mental health among medical personnel. @*Methods@#One level A tertiary hospital was sampled using a stratified cluster sampling method from southern and northern Xinjiang Uygur Autonomous Region, and all medical personnel were recruited from these two hospitals. Participants' demographics, working duration, and working in shifts were collected using questionnaires, and occupational stress was measured using the Core Scale for Measurement of Occupational Stress proposed by National Institute for Occupational Health and Poison Control, Chinese Center for Disease Control and Prevention. The associations of long working hours (weekly working duration of >40 hours) and shift work with occupational stress were examined using a multiple linear regression model.@*Results@#A total of 2 529 questionnaires were allocated, and 2 262 were valid, with an effective rate of 89.44%. The respondents had a mean age of (35.12±8.71) years, and included 1 696 women (74.98%). Of all respondents, there were 722 doctors (31.92%), 1 033 nurses (45.67%), 361 medical or pharmaceutical technicians (15.96%), 1 808 with long working hours (79.93%) and 1 264 with shift work (55.88%). The score of occupational stress was (44.79±8.49) points, and the prevalence of occupational stress was 28.69% among respondents. Multiple linear regression analysis showed that after adjustment for age, marital status, length of service, position, smoking and physical exercise, long working hours (>40 h, β'=0.124; >48 h, β'=0.175; ≥55 h, β'=0.323) and shift work (β'=0.203) were influencing factors for occupational stress among medical personnel（P<0.05）; however, there was no interaction between long working hours and shift work (P>0.05). @*Conclusion@#Long working hours and shift work may increase the risk of occupational stress among medical personnel in level A tertiary hospitals.
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Objective Establishing an integrated assessment index system in order to strengthen the multi-dimen-sional evaluation for scientific research performance of medical staff in tertiary general hospital.Methods The method of documentary and Delphi are used in filtering the indexes of medical personnel's scientific research performance evaluation and the method of analytic hierarchy process is used in ascribing different weights for each index that the consistency is tested.Results There are two evaluation index systems in the Evaluation System of medical research performance in tertiary general hospital.The first one is Medical Staff's Scientific Research Ability Evaluation System.There are 51 indexes in the system,including 2 first-level indexes,1 second-level indexes and 38 third-level indexes.The second system is Scientific Research Performance Evaluation Index System,which have 70 indicators,including 4 first-level indicators,15 second-level indicators,51 third-level indicators.Conclusion The index system of scientific research performance evaluation has a high credibility,and can be popularized as an index of scientific research performance evaluation for medical staff in hospital based on the practice evaluation.The system could provide data support for hospital to implement more accurate scientific research management policy.
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Objective:To analyze the role of psychological detachment(PD) and career calling(CC) in the relationship between hospital workplace violence(HV) and turnover intention(TI), so as to provide references for developing effective intervention measures for medical personnel who have suffered from HV.Methods:From October and November 2022, convenient sampling was used to select medical staff from public hospitals in 16 provinces of China, and a questionnaire survey was conducted on HV, TI, PD, and CC. Pearson′s test was used for correlation analysis, and mediation effect analysis and moderated mediation effect analysis were used to explore the role of PD and CC in the relationship between HV and TI.Results:A total of 1 090 medical personnel were included in this survey, of whom 600(55.0%) had been subjected to HV. The findings showed that HV was positively correlated with TI( r = 0.27, P<0.05). From the analysis of mediation effect, HV had a negative predictive effect on PD( β =-0.82, P<0.05). PD had a negative predictive effect on TI( β =-0.31, P<0.05). PD partially mediated the association between HV and TI, with a mediation effect value of 0.25(17.39%). From the analysis of moderated mediation effect, interaction between HV and CC( β =-0.41, P<0.05) and the interaction between PD and TI( β = 0.17, P<0.05) had a moderating effect on the level of TI of medical personnel. Conclusions:HV was an important factor in predicting the TI of medical personnel, with PD partially mediating between HV and TI. The sense of CC played a moderating role between HV and TI, as well as between PD and TI.
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Objective: To study the current status, hotspots and frontiers in the field of occupational health and safety (OHS) research among medical staff. Methods: A comprehensive search on OHS of domestic and international literature on medical staff was conducted using the China National Knowledge Infrastructure and Web of Science databases from 2002 to 2022. The collected literature was subjected to bibliometric analysis and visualized using CiteSpace 6.1.R6 software. Results: A total of 5 858 articles related to medical personnel OHS comprising 2 144 Chinese articles and 3 714 English articles, were included. The publication of Chinese articles showed an initial increase followed by a decline, while English articles exhibited a sustained increase followed by a sudden decline. Domestic research mainly focused on hospitals and academic institutions, with few collaboration between institutions and regions in China. Research abroad demonstrated strong collaboration and exchange between countries and institutions. The OHS related research hotspots were occupational exposure, occupational health, and occupational safety of medical personnel at home and abroad. The key department of interest was operating rooms, and the key group personnel was nurses. Advanced research in foreign countries has extended to fields such as personal protective equipment and medical personnel sleep issues. Conclusion: There is still a gap on OHS research among medical staff between China and foreign countries. Domestic scholars need to grasp the academic frontiers, strengthen collaboration and exchange among domestic institutions, regions, and international counterparts, enlarge the research scope and content to ensure the OHS of medical personnel.
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Objective:To understand the cognition and training status of basic life support among medical staff in Linfen, Shanxi Province, and to provide reference for the development of targeted training strategies and programs.Methods:A questionnaire survey was conducted among medical staff in 12 county hospitals in Linfen, Shanxi Province by convenience sampling method. The survey included the general characteristics of departments and medical staff, previous basic life support training assessment and cognitive status.Results:A total of 839 medical staff were included, 756 (90.1%) completed the survey, 183 (24.2%) were doctors and 573 (75.8%) were nurses. Most personnel lacked awareness of environmental safety, emergency response system start-up, adequate compression, airway management, and electrical defibrillation.Conclusions:The cognitive status of basic life support of medical staff in Linfen county is not optimistic. It is necessary to construct an applicable precision training course and retraining assessment system to improve the cognitive level and practical operation ability.
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Objective: To analyze the risk factors of blood-borne occupational exposure among medical staff and explore the relevant intervention measures. Methods: In June 2020, the data of blood-borne occupational exposure and related factors reported by medical staff in a grade Ⅲ, Grade A general hospital from 2011 to 2019 were analyzed by retrospective investigation. Results: Among 431 cases of blood-borne occupational exposure, 69.37% were nurses. It mainly occurred in medical staff with 0-4 years of service, accounting for 63.57%; The main place of occupational exposure was in the ward 47.56%; Sharp instrument injury was the main occupational exposure route 91.65%. Occupational exposure department was mainly surgery department 17.87%; The main source of exposure was hepatitis B virus (HBV) 37.12%, followed by treponema pallidum 20.19%. Statistical analysis results show that: Exposure sites (χ(2)=43.585, P<0.01) , exposure sources (χ(2)=22.693, P<0.01) , treatment methods after exposure (χ(2)=18.866, P<0.01) , Flushing (χ(2)=31.963, P<0.01) and disinfection (χ(2)=14.216, P<0.01) were significantly different. Conclusion: The effective measures to reduce blood-borne occupational exposure are to strengthen occupational protection training of medical staff, standardize operation procedures, strengthen supervision of key groups and departments, improve reporting, monitoring and follow-up systems to realize informatization, and do a good job in risk control.
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Humans , Blood-Borne Pathogens , Medical Staff , Needlestick Injuries , Occupational Exposure/prevention & control , Retrospective Studies , Risk FactorsABSTRACT
Background Despite the growing occupational stress of medical personnel, there is no occupational stress risk management index system for medical personnel in China, and the related risk management work is unfounded. Objective To construct a work-related stress risk management index system for medical personnel in China based on Delphi method. Methods On the basis of literature review and expert interview, an index pool of work-related stress risk management for medical personnel was preliminarily constructed. Through two-round Delphi method, experts' opinions on the importance, operability, familiarity, and judgment basis of candidate indicators were collected, and an index system for work-related stress risk management of medical personnel was constructed. Results Fifteen expert opinions were collected in each of the two rounds, with a recovery rate of 100%. The expert authority coefficients were all >0.9. In the first round, the importance score was 9.78±0.35, the coefficient of variation was 0-0.22, and the Kendall coordination coefficient was 0.215 (P<0.01); in the second round, the importance score was 9.82±0.26, the coefficient of variation was 0-0.13, and the Kendall coordination coefficient was 0.208 (P<0.01). Finally, the index system of work-related stress risk management for medical personnel was composed of 10 first-level indexes, 28 second-level indexes, and 47 third-level indexes. The 10 first-level indexes were job demand, job control, organizational support, interpersonal relationships, role conflict, doctor-patient conflict and medical disputes, work-life conflict, professional self-identity, workplace environment, and social environment, respectively. Conclusion A preliminary refined work-related stress risk management index system for medical personnel in China has been established, but the indicators will be further modified by verification and application of the indicator system.
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With the COVID-19 outbreak, many provinces and municipalities have announced the first-level response to public health emergencies. As the backbone of fighting the epidemic, medical staff are faced with many ethical dilemmas, such as the lack of medical protection materials, the high risk of virus infection, discrimination and so on, and their health and life rights and interests have been impacted. Starting with the concept of public health emergencies and the right to life and health, the theory and display basis of the right of life and health were discussed based on the practical guidelines of public health emergencies. Taking the COVID-19 epidemic as an example, this paper proposed measures for ensuring the right to life and health of medical staff in public health emergencies, so as to better cope with the epidemic of COVID-19 and protect the life and health of medical workers.
ABSTRACT
The COVID-19 is a severe respiratory pathogen infection, showing a distinct "hospital cluster" transmission characteristics. This paper illustrated the concept of occupational exposure and COVID-19. Combined with the actual situation of COVID-19, the infection status of medical personnel in this outbreak was analyzed from three aspects: the transmission risk and infection rate of medical personnel, the clinical characteristics and the undiscovered super-spreader. Through the analysis of the present situation, this paper summarized the possible occupational exposure risk factors of medical personnel in COVID-19 from five aspects: biological occupational risk factors, chemical occupational risk factors, physical occupational risk factors, violence factors and psychological factors. From isolating the source of infection and cutting off the transmission route, the "safety supervisor" mechanism is established to avoid the risks of biological, chemical and physical occupational exposure, from providing professional psychological counseling for medical personnel to reduce their psychological stress, and from improving the relevant legal level to reduce the risk of medical personnel’s violent occupational exposure.
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Ideological and political education in medical discipline is the integration of "medical discipline" and "ideological and political education", the deepening of "ideological and political theories teaching in all courses" and "professional ideological and political education", and an important part of discipline construction and ideological and political education in medical colleges. This paper analyzed the value and inevitability of ideological and political education in medical discipline from the perspective of medical discipline, "three-all education" and medical personnel training, and expounded the connotation system and practical dimension of "ideological and political education in medical discipline" in the framework of subject form, object form, mediator form, theory form, practice form and system form.
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El presente ensayo es una reflexión de la violencia en, desde, hacia y entre el personal de salud. Para lograr una aproximación, se consideran distintas fuentes de información, desde reportes periodísticos, estudios empíricos y, por supuesto, postulados conceptuales producidos para otras situaciones y campos de conocimiento. El análisis se realiza en diferentes ejes, el primero con referentes para situar el problema en el marco de propuestas enunciativas y conceptos relevantes; el segundo presenta la perspectiva del paciente o usuario; en el tercero se presentan algunos elementos de los profesionales de la salud. Por último, en último eje se delinean situaciones de las instituciones en salud, como espacio donde se desarrolla y vehiculiza la violencia, en tanto generadora y ámbito donde se ejerce tanto para los profesionales de la salud como para los pacientes usuarios. Finalmente se esbozan unas conclusiones que permiten situar el tema en sus implicaciones y consecuencias. Estos ejes nos permiten sugerir que el estudio de la violencia requiere un abordaje complejo, ya que deja un saldo de víctimas y victimarios siendo las propias instituciones en salud las generadoras de violencia alejando a los actores sociales de actos solidarios y humanizados.
This essay is a reflection about violenceexpressed inside and outside health institutions with an impact on health professionals and patients. We considered different sources of information: journalistic reports, empirical studies and conceptual postulates produced for other situations and fields of knowledge. The analysis is carried out in different axes, first, with references to place the problem within the framework of enunciativeproposals and relevant concepts; the second presents the perspective of the patient; the third presents some elements of health professionals. Finally, in the last axis, situations of health institutions are outlined, as a space where violence is developed and conveyed, as a generator and an area where it is exercised both for health professionals and patients. As conclusions we leave sketches that allow us to place the subject in its implications and consequences. These axes allow us to suggest that the study of violence requires a complex approach, since it leaves a balance of victims and perpetrators, the health institutions themselves being the generators of violence, distancing social actors from acts of solidarity and humanization.
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Humans , Professional-Patient Relations , Violence/statistics & numerical data , Delivery of Health Care/organization & administration , Health Facilities/statistics & numerical data , Power, Psychological , Workplace Violence/trends , Health Policy , Health ServicesABSTRACT
The quality of public cardiopulmonary resuscitation training plays an important role in improving the survival rate of patients with cardiac arrest. Various forms of training have been carried out all over China, which plays a great role in promoting the work of cardiopulmonary resuscitation. However, there is still a lot of room for improvement in the quality management and effect sustainability of training. This paper reviews the current situation and deficiencies of quality management of public cardiopulmonary resuscitation training, and the role of training quality in enhancing people's self-confidence in learning and rescue, training contents, training methods, quality evaluation indicators, evaluation methods, and quality influencing factors and retraining time requirements, and so on. And it puts forward some practical suggestions on the quality management of public cardiopulmonary resuscitation training in China. Such as it will more emphasize standardized training, deliberate practice, proficient training, National Training, long-term maintenance of knowledge and skills, and using useful tools to improve the quality of cardiopulmonary resuscitation training, etc. In order to improve the training quality management level of the public, so that the trainees can really master cardiopulmonary resuscitation skills, so as to improve the rescue rate and survival rate of patients with cardiac arrest. To promote the sustainable development of people's health.
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In response to the major national strategic needs of "Healthy China" and "Innovation-Driven Development", Sichuan University, as a pilot university of "Excellent Doctor Education and Training Plan-Top Innovative Medical Personnel Training", has been exploring the training strategies since 2012. On the basis of the international theory of "The Third Generation of Medical Education based on Health System", we have innovatively put forward the new era of "Med+" education theory based on research-oriented hospitals (with medical/research/translational facility) and the two-level training paradigm from "cultivating professionalism" to "notch up to top" by planting three cultures. We have also developed a competency training system of "Five Integrated Curricula and Five Teaching & Learning Strategies". We have shifted from "didactic teaching" to "formative learning", edifying excellent doctors with "professionalism culture". We have initiated two kinds of top-notch plans, constructed a "1+2+3" innovation and entrepreneurship education system, explored "transformative learning" to incubate compound top-notch personnel with "innovative culture", opened up a "school-hospital unified" administrative system, built a PDCA closed-loop of quality control supported by mobile technology, and recast the "quality culture" to ensure shifting from "cultivating professionalism" to "notch up to top".
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Objective To evaluate the effectiveness of anti-pressure protective mask for medical personnel fighting against the coronavirus disease 2019 (COVID-19). Methods Convenience sampling method was used to select 120 military frontline anti-epidemic medical personnel supporting Wuhan medical team from Jan. 26 to Feb. 24, 2020, and they were evenly divided into blank group, control group and observation group. The blank group did not use anti-pressure dressings, the control group wore face protection equipments after using hydrocolloid dressings, and the observation group wore face protection equipments after using anti-pressure protective mask. At the end of the intervention, the facial comfort, facial pressure injuries, and adverse effects were compared between the three groups. Results At the end of the intervention, the facial comfort score was 6.00 (6.00, 7.00) in the blank group, 5.00 (4.00, 5.00) in the control group, and 1.00 (0.50, 2.00) in the observation group, with significant differences found among the three groups (H=97.392, P<0.001). According to the further inference of the rank mean, the blank group had the largest facial comfort rank mean (96.68), while the observation group had the smallest facial comfort rank mean (20.88). At the end of the intervention, three cases (7.5%, 3/40) in the blank group had no facial injury, 28 cases (70.0%, 28/40) had facial pressure injury at stage 1, and nine cases (22.5%, 9/40) at stage 2; 27 cases (67.5%, 27/40) in the control group had no facial injury and 13 cases (32.5%, 13/40) had facial pressure injury at stage 1; 37 cases (92.5%, 37/40) in the observation group had no facial injury and three cases (7.5%, 3/40) had facial pressure injury at stage 1. There was significant difference in the incidence of facial pressure injuries among the three groups (χ2=71.863, P<0.001). The observation group had the lowest facial pressure injury rate among the three groups. There was no skin allergic reaction in the three groups and none of them was infected with COVID-19. Conclusion Anti-pressure protective mask can effectively reduce the incidence of facial pressure injuries and improve the facial comfort when wearing facial protective equipment, and it can be used for protecting frontline anti-epidemic medical personnel.