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Objective To determine the sub-health status and influencing factors among medical staff in community health service centers, and to provide scientific evidence for intervention measures and strategies of health promotion. Methods A questionnaire survey was conducted in 692 community medical staff from 8 community health service centers in Hongkou District, Shanghai.Sub-health condition scale was used to identify the incidence rate of sub-health.Simple job stress questionnaire was used to identify the incidence rate of occupational stress.The correlations between sub-health status and demographic and sociological factors, living habits, occupational stress and other factors were determined by multivariate logistic regression analysis. Results The incidence rate of sub-health among targeted community medical staff was 71.4%.The following factors were shown to be related to the incidence of sub-health: women (OR=2.24, 95%CI: 1.42-3.55), per capita living area ≤ 30 m2(OR=2.19, 95%CI: 1.24-3.87), daily average sleep time < 7 hours (OR=1.64, 95%CI: 1.10-2.46), habits of drinking alcohol (OR=1.58, 95%CI: 1.04-2.40), frequent overtime work (OR=1.79, 95%CI: 1.12-2.86) and occupational stress (OR=1.73, 95%CI: 1.16-2.58). Conclusion The incidence rate of sub-health among medical staff in community health service centers is high, and unhealthy living habits and occupational stress are the influencing factors.
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Objective To study the relationship between cytology of cervical lesion and HPV in female medical workers. Methods From Fudan University Hospital of Obstetrics and Gynacology the results of cervical cytology screening in 1 093 female medical staff in 2015-2017 and results of HPV screening in 1 085 cases in 2017 were collected.SurePath liquid-based cell preparation was used for cytology and the segr-21 typing kit was used for HPV detection.The relationship between the pathological results of cervical colposcopy biopsy and HPV infection was studied by single factor and multiple factor regression analysis. Results The rate of HPV infection for subjects in the study was 10.0% (108/1 085), with increase in age, the infection rate showed an insignificant rising trend(χ2=4.43, P=0.11).High-risk HPV infection accounted for 95.37% (103/108), and the major high-risk HPV infections were HPV 52, HPV53, HPV58, and HPV16 in descending order.The 3-year cytological positive rates were 1.5%, 1.6% and 4.0%, respectively.Sixty-six of the HPV and/or cytological positive cases underwent colposcopy biopsy, and the proportion of cytology being positive, HPV positive, HPV16 positive, cytology negative in 2015 and 2016 was 41.1%, 19.1%, 60% and 29.7%, respectively.Multiple logistic regression showed that cytology was an independent risk factor, OR=7.87 (95%CI:1.85-33.54). Conclusion The rate of HPV infection in medical staff is lower than that in the general population, but the composition ratio of high-risk HPV infection is very high.It is recommended that women should undergo HPV test regularly from sexual life; early detection of high-risk HPV infection could prevent the occurrence of cervical cancer.The sensitivity and specificity of cervical cytology screening prove to be higher than those of HPV screening in people with low infection rate, and the cytology screening cycle should not exceed one year.
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The purpose of the present work is to study the satisfaction with the working and living conditions as assessed by participants of the Zemsky Doctor program in rural areas. Materials and methods. The study has been carried out by the Tyumen State Medical University of the Ministry of Health of the Russian Federation in association with the Tyumen Public Health Department based on surveying 288 doctors participating in the Zemsky Doctor program in the Tyumen Region (excluding districts). Main results. As a result of the analysis, it has been revealed that one of the main factors of job satisfaction is opportunities of professional and career development. The analysis has shown that on average the program participants give a rather high assessment of the living conditions, although depending on municipal districts the satisfaction considerably differs. Conclusion. The working and living conditions in the rural areas under the study have been grouped according to the respondents' satisfaction. The main factors of dissatisfaction with the working and living conditions in the rural areas included career opportunities, leisure conditions, opportunity for professional growth, and the need for domiciliary duty. The obtained results can be used by the management of both medical organizations and municipal districts to solve the personnel problems in the area of the rural health care when taking relevant management decisions. Substantiation of the study novelty. The Zemsky Doctor program has been in force in the Russian Federation since 2012. Its implementation showed that the program had only partially solved the personnel problem in the area of the rural health care. Some participants of the Zemsky Doctor program prematurely terminated the concluded contracts. In this regard, it is necessary to carry out studies on the reasons of dissatisfaction with the working and living conditions in the rural areas.
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Humans , Adult , Middle Aged , Personal Satisfaction , Rural Population , Surveys and Questionnaires , Rural Health Services , Program Accreditation , Professional Training , Job SatisfactionABSTRACT
Objective To scientifically assess the degree of " overwork" and its influencing factors of doctors and nurses at county hospitals. Methods Six county hospitals were selected as the research objects. Descriptive analysis, chi-square test and ordered multi-class regression were used to analyze the degree of " overwork" and its influencing factors of doctors and nurses. Results 48. 3％ (156 / 323)of the doctors at these hospitals were working more than 60 hours per week. Work hours per week of the doctors were significantly longer than those of the nurses. At the same time, the workload of doctors based on the fatigue self-assessment scale was also significantly higher than that of the nurses, while 61. 9％ (200 / 323) of the doctors were exposed to a very high workload, and so were 33. 3％ (118 / 354) of the nurses. There were significant differences in the workload of doctors and nurses in terms of their gender, age, education level, seniority and number of children. And the work hours per week were an important factor affecting the workload of doctors and nurses. Conclusions We should formulate a reasonable work hours for doctors and nurses, especially focusing on young and middle-aged doctors.
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Objective: To design a hospital management information system based on attitude and perceived behavior control, and to explore the influence of the application of hospital management information system on the work performance of medical personnel. Methods: Through constructed hospital management information system and applied the work performance model of medical personnel to design questionnaire from three points of view included attitude, habits, subjective norm and perceived behavior control. And then the internal consistency and validity of the scale of measurement indexes of the questionnaire were tested, and the methods of statistical modeling and parameter estimation were adopted to carry out path analysis. Results: The results of primary estimation for the change situation of main medical indexes of application information system in earlier, middle and later stage indicated that the reliability of variates that were selected in this research was higher, and the consistency of interior of various variates was higher. At the three stages, earlier, middle and later stage, that information system was implemented, the person-time of leaving hospital, the number of inpatient surgery and the outpatient amount of expert displayed rising trend. And the drug proportion, average stay time decreased 9.45%, 3.36% and 16.16% and 4.27% respectively. Conclusion: Whether the hospital information system can be applied, the personal subjective factors of medical personnel play an important role.
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Objective To develop a scale suitable for evaluating the scientific research ability of medical workers in Liaoning Province,analyze its reliability and validity to provide a scientific and objective measurement method for the evaluation of scientific research ability of medical workers in Liaoning Province.Methods A survey of 6 577 medical workers in 2 grade and up medical institutions of Liaoning province was carried out by completing a self-assessment scale form of research capacity,5 812 effective questionnaires were collected,335 out of which were used for exploratory factor analysis,5 477 were used for confirmatory factor analysis and reliability and validity analysis.Results The scale of Cronbach's a coefficient is 0.982,the retest reliability is 0.967,the cumulative contribution rate of the four factors extracted by exploratory factor analysis was 80.195％.The validation factor analysis showed that the model fit well (GFI=0.907,AGFI=0.881,CFI=0.962,RMESA=0.076,NFI=0.960,IFI=0.962).Conclusions The research capability scale for Liaoning medical workers has good reliability and validity,which can be used in the evaluation of the research capability of the medical workers in Liaoning province.
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Objective To investigate the concentration on clinical service of both medical workers and patients,for the purposes of better quality of care and concentration of medical workers,and better mental feelings of the patients′ and doctor-patient relationship.Methods 1 000 medical workers and patients were sampled from 8 hospitals of four regions in Jiangsu province by stratified randomization for questionnaire survey.The purpose is to study the clinical concentration of medical workers in terms of interpretation,listening,emotion and empathy,and compare the differences between doctors and patients regarding clinical concentration.Results 48.5% of the medical workers and 44.8% of the patients said that medical workers would interrupt the patients within 2 minutes.Time constraints of clinical consultation contribute to poor disease information collection,medical explanation and informing.The investigation found the difference between doctors and patients in clinical concentration is significant statistically(χ2=104.329,P=0.000),while medical workers were unaware of their lack of concentration to patients.18.2% of the patients complained that medical workers could hardly or refuse to understand their feelings.Conclusions Medical workers are advised to respect their patients by offering total concentration on diagnosis and treatment;to respect their career with sufficient concentration on diagnosis and treatment;and to respect medical science to offer medical humanistic care.
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Many voting activities such asThe Best Medical Workers put medical workers onto moral high ground,while medical dispute,medical anomie and other news pushed them to the abyss of criticism.These are all involved in the pan-moralization of medicine-related consensus of mass media.Taking specific opinion as example,this paper listed the pan-moralization characteristics including judging the complicated problems with ethical standard merely,evaluating behaviors of physicians and patients with idealistic principles,determining the whole moral outlook from the individuals,analyzed the reason of social emotional outbursts,traditional moral interference,media ethics anomie,and lack of public rationality,and finally proposes the strategies to avoid pan-moralization of medicine-related consensus from the micro and macro level.
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Objective The present study aimed to examine the path relationship and mechanism of action of psychologi-cal capital between organization support and work engagement among medical workers,and then to propose management meas-ures about promoting work engagement of medical workers for hospitals. Methods 800 medical workers from Guangxi and Chongqing were randomly investigated with questionnaires including scales of psychological capital, organization support and work engagement. And the researcher did data analysis by SPSS 19. 0 and AMOS 17. 0. Results Pearson analysis showed that they were all significant positive correlations between organization support and psychological capital(r=0. 46,P<0. 01),organ-ization support and work engagement(r=0. 63,P<0. 01),psychological capital and work engagement(r=0. 60,P<0. 01). Path analysis showed that medical workers' psychological capital predicted their work engagement (β=0. 61,P<0. 01),and or-ganization support predicted their psychological capital(β=0. 19,P<0. 01) and work engagement (β=0. 30,P<0. 01) . Mean-while,organization support had indirect effect on work engagement through psychological capital among medical workers,and the indirect effect was 0. 12,accounting for 27. 87% of the total effect. Conclusion For medical workers,organization support had a direct effect on work engagement,and a indirect effect on work engagement through psychological capital. Therefore,en-hancing work engagement of medical workers not only need to increase organizations' support such as hospitals,but also pay more attention to develop medical workers' psychological capital.
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Objective The present study aimed to examine the path relationship and mechanism of action of psychologi-cal capital between organization support and work engagement among medical workers,and then to propose management meas-ures about promoting work engagement of medical workers for hospitals. Methods 800 medical workers from Guangxi and Chongqing were randomly investigated with questionnaires including scales of psychological capital, organization support and work engagement. And the researcher did data analysis by SPSS 19. 0 and AMOS 17. 0. Results Pearson analysis showed that they were all significant positive correlations between organization support and psychological capital(r=0. 46,P<0. 01),organ-ization support and work engagement(r=0. 63,P<0. 01),psychological capital and work engagement(r=0. 60,P<0. 01). Path analysis showed that medical workers' psychological capital predicted their work engagement (β=0. 61,P<0. 01),and or-ganization support predicted their psychological capital(β=0. 19,P<0. 01) and work engagement (β=0. 30,P<0. 01) . Mean-while,organization support had indirect effect on work engagement through psychological capital among medical workers,and the indirect effect was 0. 12,accounting for 27. 87% of the total effect. Conclusion For medical workers,organization support had a direct effect on work engagement,and a indirect effect on work engagement through psychological capital. Therefore,en-hancing work engagement of medical workers not only need to increase organizations' support such as hospitals,but also pay more attention to develop medical workers' psychological capital.
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Objective To explore the factors that may influence the compliance of medical workers in dealing with classifying medical wastes. Methods One hundred and sixteen medical workers participated in this investigation by applying self-designed questionnaire and live observation mode. Influential factors were evaluated by multi-factors analysis. Results The compliance percent of 116 medical workers was only 69.9%(351/502), which caused by low awareness of medical wastes. As much as 20.12 % (101/502) medical workers made mistakes when dealing with infectious wastes. Working experience, awareness of medical wastes, instruments and working load were associated with compliance of medical workers (P<0.05). Conclusions Low compliance of medical workers dealing with medical wastes were related to lacking working experience, low awareness of medical wastes, inappropriate instruments and heavy working load. In this case, improving management system of medical wastes, regular training and assessment, adding instruments and identification of medical wastes, increasing medical workers and simplifying the working process are effective approaches in increasing compliance of medical workers in dealing with medical wastes and improving quality of nursing management.
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Objective To systematically describe and analyze the patient safety culture assessment outcomes of medical workers in China,so as to provide scientific evidence for developing corresponding intervention measures.Methods Such databases as Web of Science,PubMed,Ovid,EBSCO,Google Scholar,CBM,VIP,CNKi and WanFang Data were used to collect studies published before December 2014,on patient safety culture assessment of medical workers in mainland China.Two reviewers independently screened,extracted and cross-checked the data,and the disagreements were resolved by discussion or by consulting a third reviewer.The qualitative synthesis method was used to analyze the study results.Results Of the total 1 721 records,65 studies were included,and most of them were cross-sectional studies.The patient safety culture assessment instruments were foreign scales by the translation and revision for the Chinese version for 52 studies,and self-made questionnaire for the other 13 studies.The main factors influencing the patient safety culture of Chinese medical workers included seniority,department,educational background,experience of patient safety training and so on.Conclusions Many studies have been carried out for patient safety culture,but the research obj ects mostly are nursing staffs,without extensive research on other professional medical workers.Hospitals should strengthen the teams,the patient safety training,and build patient safety culture that is fair and open to safeguard patient safety.
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Objective To learn the size and income of off-staff medical workers in a survey of public county-level general hospitals in China.Methods Human resources investigation of public county-level general hospitals,with SPSS data analysis of the outcomes.Results From 2011 to 2013,the proportion of off-staff medical workers increased from 31.44% to 36.69%,of whom the highest proportion was found in China′s western region,accounting for 40.69%;the ratio of off-staff practicing physicians increased from 14.24% to 16.64%,of whom China′s central region accounted for 19.92%;the ratio of off-staff nurses increased from 43.03% to 49.77%,of whom China′s western region accounted for 55.88%.In 13.7% of the hospitals,income of off-staff medical workers was less than a half of that for permanent staff;41.32% and 26.31% of the hospitals surveyed were fully covered with social insurance and housing fund account respectively.Conclusions Off-staff labor is a distinct feature at such hospitals,making imperative a HR system reform of public hospitals.The discriminative income and welfare between permanent and off-staff medical workers calls for a fundamental change to the income and welfare system.
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Objective To learn the awareness,attitude and behavior changes of medical workers to the family doctor service and the influential factors on their utilization of such service since the service is in place.The purpose is to provide theoretical basis to establish the family doctor service model and the incentive mechanism in line with the development of community health service in Beijing.Methods Eight community health centers were sampled randomly from three representative areas of Haidian,Xicheng and Daxing districts,which were grouped randomly as one intervention group and one control group.All the medical workers surveyed were subj ect to the research.The control group was managed as to the existing management mode,and the intervention group was classified and managed according to the new family doctor service model.A questionnaire survey was made to collect data from the baseline and final stages.Comparisons were made among the districts,institutions,and before-after intervention of the institutions themselves to evaluate the effects of the service model and incentive mechanism.Results The survey found a higher awareness by medical workers to such service,higher recognition and satisfaction, and lower rate of services provided by medical workers.The logistic regression analysis found the influential factors for willingness of medical workers to work as family doctors,include group difference, workload changes after signoff as family doctors,residents′acceptance of the community first visit system,recognition or not for whether a family should have a community service team,residents′acceptance,and the general comments on family doctor service (P< 0.05 ).Conclusions Higher incentives of community doctors to embrace family doctor service,calls for the medical workers to change their perception,better incentive mechanism and greater promotion efforts for family doctors′services.
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Objective To find out the satisfaction changes among young medical workers and explore the influence of the healthcare reform on such people.Methods A survey was conducted by means of random sampling among 716 medical workers under 45 years old from 6 hospitals,and combined with the survey data in 2009,young medical workers′satisfaction changes and the influencing factors were analyzed.Results Young medical workers′satisfaction is generally low,with declining satisfaction of social respect as well;satisfaction of medical workers in community medical institutions and secondary medical institutions was found declining dramatically.Conclusions Healthcare reform should pay more attention to these young people in terms of their own satisfaction,especially for those working at primary healthcare institutions.
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OBJECTIVE: To explore the relationship of job stressors,the coping styles and social supports among medical workers in primary and secondary schools in Guangzhou City. METHODS: A total of 211 medical workers from 168 primary and secondary schools in Guangzhou City were selected as study subjects by random sampling method. The relationship of job stressors,the coping styles and social supports were investigated by the Scale for Occupational Stressors in Clinical Medical Workers,the Ways of Coping Questionnaire and Social Support Questionnaire. RESULTS: The total scale score of job stressors was( 90. 5 ± 16. 7),medium level and above of stress scale( total score≥95. 0) accounted for 41. 2%( 87 /211). The median scores of positive coping dimension score and negative coping dimension score were 2. 0 and 1. 0,the total score of social support was( 41. 2 ± 9. 8). The medium level and above of social support scale( total score ≥32. 0)accounted for 86. 3%( 182 /211). The multiple stepwise regression analysis results showed that the clinicians and the parttime school doctors had higher job stress than those medical workers who were not majored in clinic and full-time school doctors( P < 0. 05). The medical workers with higher monthly income and higher score of social support showed higher job stress( P < 0. 05). The medical workers with higher social support had lower job stress( P < 0. 05). CONCLUSION: High job stress was found in the medical workers in primary and secondary schools in Guangzhou City. Positive coping styles and social supports has important role in relieving job stress of school medical workers.
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Objective:To understand general hospital medical staff status quo and characteristics of blood -borne occupational exposure , analysis its ethics factor , to make the prevention countermeasures of blood -borne oc-cupational exposure to provide scientific basis .Methods:From January 2013 to December floor all the medical staff of blood -borne occupational exposure cases were retrospectively analyzed .Results:A total of 101 medical staff blood-borne occupational exposure , which is given priority to with the nurse , accounted for 60 .40%;More con-centrated in under 30 employees, accounted for 70.29%;Occupational exposure personnel distribution in the ma-jority with surgical department (42.57%), followed by the physician (36.63%);Wards (60.40%), the operat-ing room (15.84%) and therapy (11.88%) are the sites of occupational exposure often happen;Sharp injury in the composition of the ratio of 87.12%, in the first place, in which a proportion (23.76%), pull out the needle (18.81%) and blood (15.84%), surgical suture (14.85%) and transfusion injection (13.86%) as the sharp injury of frequent occurrence of occupational exposure;Exposure is given priority to with hepatitis b ( 61 .38%) . Conclusion:Medical staff blood-borne occupational exposure risk is high , the hospital infection control personnel must pay attention to occupational exposure of the whole education , strengthen the administration of the occupation-al exposure of ethics , reduce the risk of occupational exposure and injury .
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Objective Introducing the job embedded scale to explore the dropout intention of medical workers at tertiary hospitals.Methods Correlation analysis, analysis of variance and regression analysis were used to analyze with a job embedded scale, the dropout intention of medical workers of a Beijing hospital.Results There was a significant negative correlation between job embedding and dropout intention of such people(r=-0.223).The predictive ability of on-the-job embeddedness is better than off-the-job embeddedness.Fit-organizational, sacrifice-organizational, fit-community and sacrifice-community were significantly negatively correlated with dropout intention.There are differences in the relationship between job embedding and dropout intention of medical workers of different individual attributes.Conclusion Job embedded scale can effectively predict the dropout intention of medical workers, offering a usable tool to predict the dropout of these people.
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In order to show the social situation and public opinions for the decision-makers of medical reform, the viewpoints of main media, NPC and PCC members, and Internet users were analyzed according to the real-time monitoring data of public opinions on health-related topics ( new rural cooperative medical system, basic public health service, and rural medical workers) during the NPC and PCC, which showed the public awareness of health reform in grass-roots units of China.
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Objective To provide references for policy decision and hospital countermeasures by analyzing violence to medical workers as reported on the web.Methods A total of 135 violence events, including 37 cases of vicious incidents, from 2001 to 2014 were found from the web. The time distribution trend,categories of medical workers involved and hospital grade were analyzed,with the patients'point of view covered as well.Results It was found that such violence events tend to rise rapidly,especially vicious incidents.Of the 135 events,21 9 medical workers casualty of the medical institutions were reported,with doctors and nurses being the most victims up to 205 persons,accounting to 93.61% of the total casualty.Such events were most commonly found at tertiary hospitals,and dissatisfaction with treatment outcomes was the key cause.Conclusion Temporary solutions can only curb the trend,as fundamental solution of such events will take a long time and great efforts.