某三甲医院各时段临床护理工作量的调查研究

通过测量不同科室不同时段的护理工作量,为护理人力资源管理提供科学依据。随机选取某三级甲等医院8个临床科室,采用观察法对每班护士进行一对一的现场跟踪调查,对8个临床科室不同时段的直接护理时间和间接护理时间进行测定,以分钟为单位记录,并计算得出护理工作量。不同科室不同时段护理工作量不同,不同科室同一时段护理工作量也不完全相同,同一科室不同时段护理工作量也不相同。10～12、12～14、19～21、23～1、7～9这五个时段各科室护理工作量集中,密集程度高,护士超负荷工作,而部分时段护士闲置,造成了护理人力资源浪费。医院相关部门可以通过定期对不同科室不同时段临床护理工作量的测量,来了解各科室所需要的护理人力,为配置护理人力资源提供客观数据支持。护理管理者应根据不同科室不同时段护理工作量的变化采取弹性排班。     

Functional Consequences of HIV-Associated Neuropsychological Impairment

This review focuses on the “real world” implications of infection with HIV/AIDS from a neuropsychological perspective. Relevant literature is reviewed which examines the relationships between HIV-associated neuropsychological impairment and employment, driving, medication adherence, mood, fatigue, and interpersonal functioning. Specifically, the relative contributions of medical, cognitive, psychosocial, and psychiatric issues on whether someone with HIV/AIDS will be able to return to work, adhere to a complicated medication regimen, or safely drive a vehicle will be discussed. Methodological issues that arise in the context of measuring medication adherence or driving capacity are also explored. Finally, the impact of HIV/AIDS on mood state, fatigue, and interpersonal relationships are addressed, with particular emphasis on how these variables interact with cognition and independent functioning. The purpose of this review is to integrate neuropsychological findings with their real world correlates of functional behavior in the HIV/AIDS population.     

Allocation of attention in familiar and unfamiliar traffic scenarios

Increased travel worldwide has led to an escalation of road traffic accidents, particularly among tourists driving in unfamiliar, opposite traffic flow driving scenarios. Ability to allocate attention to driving-relevant information and regions is predicted to be the main cause of tourist accidents, with a lack of attention directed to areas of space that are inhibited in familiar traffic conventions but relevant in overseas driving. This study investigated the influence of habit and expectancy on driver behaviour and allocation of attention in familiar (left-hand traffic; LHT) and unfamiliar (right-hand traffic; RHT) contexts. Twenty-eight drivers from the UK were presented with video clips of driving taken in the UK and in Poland and asked to judge whether it was safe to enter a roundabout in each clip. Half were given information about differences in LHT and RHT situations prior to the task. Judgement performance was not influenced by this information, however accuracy was higher for LHT and the RHT task was rated more difficult, supporting the notion that driving in unfamiliar surroundings is more effortful. In LHT both groups made more fixations to the right side of each roundabout, however in RHT, whilst the control group allocated attention in the same way, the intervention group made significantly more fixations to the left. Pre-drive preparatory information can therefore increase attention to the most relevant areas of space in unfamiliar driving contexts. This has implications for drive tourism and it is suggested that such information is made more explicit to drivers.     

Should I Drive Today? Development of a daily driving decisions model for older adults

BackgroundOlder adults in communities make daily decisions about how to meet their transportation needs so they can access services and stay socially connected. With the aging of populations in developed countries, the travel decisions of older adults will have increasing impacts. Research studies have identified different sets of factors that contribute to certain travel decisions, but little research has been directed towards understanding how individuals select information from all available factors, what information they include in their decisions under different circumstances, and the processes they use in making their transportation decisions.MethodsThis exploratory study involved 20 men and 17 women, mean age 78.6 years (range 70–96), who drove weekly. All participants were involved in each phase of the 3-phase study. In Phase 1, a review of the literature and interviews with the participants was used to collect information, and inductive thematic analysis was employed to construct a draft conceptual model of older driver decision-making. In Phase 2, participants completed a stated preference task of written scenarios to demonstrate their decision-making strategies. Results were tabulated and used to refine a final Daily Driving Decisions model. In Phase 3, a card sorting decision task was used to test the model with participants.ResultsThe final dynamic Daily Driving Decisions Model was confirmed to describe decision processes used by the participants in making decisions about how they would meet their transportation needs. The model describes three categories of factors used in decisions, labelled Motivators, Constraint/Enablers and Context, each containing four attribute themes. A significant finding was the variable use of the same item to either constrain or enable the decision to drive depending on the variation of other factors in the scenario. Participants demonstrated use of compensatory and noncompensatory (heuristic, habitual) decision processes that were accommodated by the model.ConclusionThe proposed Daily Driving Decisions Model addresses a gap in our understanding of how older drivers make their decisions about meeting their transportation needs. The model presents a template for classifying the types of information used, ignored or discarded by older adults, and the pathways that they take to arrive at their decisions. The model provides opportunities for further research in testing the influence of other factors such as urban/rural residence, income, health status and culture on driving decisions. Further, the model can be used by practitioners to gain insight into the decision-making behaviours of individuals and to develop interventions to enhance their decision-making skills.     

Do supplementary signs distract the driver?

In 2005, the regulation of signage on German highways was changed and now allows supplementary signs. These signs are installed below direction signs and inform about the services offered on motorway service areas. Being advertisement, the supplementary signs bear the risk to distract drivers looking for directional information. To study the influence of supplementary signs, four experiments (N = 30) were conducted. Experiment 1 used the phenomenon of change blindness as an indicator for the allocation of attention. It could be shown that drivers searching for a specific direction direct nearly no attention to the supplementary signs. In experiment 2 and 3, the influence of the supplementary signs on perceptional threshold for directional information and on self-chosen perception times was measured. Neither the perceptional threshold nor perception times freely chosen by the participants were negatively affected by the supplementary signs. The last experiment analyzed the influence of supplementary signs on driver reaction in a critical driving situation in a driving simulator study. Here, supplementary signs had no negative impact on collision rate and reaction time. Based on the results, it is concluded that drivers use effective attentional strategies while searching for directional information. In the experiments no negative effects of the supplementary signs could be found.     

Effects of primary task predictability and secondary task modality on lane maintenance

The objective of this work was to investigate the effects of auditory and visuo-spatial secondary tasks on variability in lane position in predictable and unpredictable driving conditions. Sixty-six participants drove a simulated vehicle. Predictability was manipulated by adding wind gusts, and the secondary task load by either an auditory task (Experiment 1) or a visuo-spatial task (Experiment 2). Results demonstrated that in the predictable driving condition, lane position variability decreased when auditory secondary task load was given, but it was not affected by visuo-spatial secondary task load. In the unpredictable driving condition; however, while the auditory secondary task load did not affect lane position variability, visuo-spatial secondary task load increased it. The data suggests that the effects of cognitive load on lane maintenance may depend on the type of the secondary task beside predictability of primary task.     

Validating an older adult driving behaviour model with structural equation modelling and confirmatory factor analysis

The Multilevel Older Persons Transportation and Road Safety (MOTRS) model postulates a role for demographic, functional, and psychosocial factors in driving self-regulation. This study formally tested the constructs of the MOTRS model, and its ability to account for variation in older adult’s driving self-regulation. Four exogenous constructs dealing with sociodemographic and driving-related variables (driving space, dependency on other drivers, health, and driving performance) and three endogenous constructs of psychosocial appraisals (driving confidence, attitudes and beliefs towards driving) were used to predict driving self-regulation. A sample of 277 Australian drivers, aged 65 years or over, completed standardised questionnaires to assess these variables. Structural equation modelling was used to evaluate one of the model’s assumptions. Findings established that sociodemographic and driving-related factors influence older adults’ driving self-regulation by impacting psychosocial variables. A re-specified model accounted for 75% of the variance in self-reported driving self-regulation. When other variables were considered, attitude towards driving was the strongest single predictor of driving self-regulation. These findings provide an initial partial validation of the MOTRS model. The results indicate that psychosocial variables are important determinants of driving self-regulation by older adults. This model could guide future research into older adults’ driving self-regulation.     

Comparing simulator sickness in younger and older adults during simulated driving under different multisensory conditions

Driving simulators are valuable tools for traffic safety research as they allow for systematic reproductions of challenging situations that cannot be easily tested during real-world driving. Unfortunately, simulator sickness (i.e., nausea, dizziness, etc.) is common in many driving simulators and may limit their utility. The experience of simulator sickness is thought to be related to the sensory feedback provided to the user and is also thought to be greater in older compared to younger users. Therefore, the present study investigated whether adding auditory and/or motion cues to visual inputs in a driving simulator affected simulator sickness in younger and older adults. Fifty-eight healthy younger adults (age 18–39) and 63 healthy older adults (age 65+) performed a series of simulated drives under one of four sensory conditions: (1) visual cues alone, (2) combined visual + auditory cues (engine, tire, wind sounds), (3) combined visual + motion cues (via hydraulic hexapod motion platform), or (4) a combination of all three sensory cues (visual, auditory, motion). Simulator sickness was continuously recorded while driving and up to 15 min after driving session termination. Results indicated that older adults experienced more simulator sickness than younger adults overall and that females were more likely to drop out and drove for less time compared to males. No differences between sensory conditions were observed. However, older adults needed significantly longer time to fully recover from the driving session than younger adults, particularly in the visual-only condition. Participants reported that driving in the simulator was least realistic in the visual-only condition compared to the other conditions. Our results indicate that adding auditory and/or motion cues to the visual stimulus does not guarantee a reduction of simulator sickness per se, but might accelerate the recovery process, particularly in older adults.     

The influence of road familiarity on distracted driving activities and driving operation using naturalistic driving study data

This paper analyzed the influence of familiarity on the involvement of secondary tasks and driving operation using naturalistic driving study (NDS) data. Distracted driving activities were extracted from face videos captured in 557 trips, including 501 trips on familiar roads and 56 trips on unfamiliar roads. These trips were completed by 155 drivers using their own vehicles during daytime hours under good weather conditions. The data showed the frequency of distracted driving activities and duration time were higher on familiar roads compared to unfamiliar roads. More types of secondary tasks were found on familiar roads. Focusing on objects was the most common distracted driving activity on familiar roads. The average time drivers used to eat or drink was highest (8.67 s) on familiar roads. The time drivers spent checking their cell phone was high on both familiar roads and unfamiliar roads. Since driving operation is directly related to crash risk, this paper also analyzed the difference of driving operation on familiar roads and unfamiliar roads. The speed profiles were generated on well-known versus unfamiliar roads. It was shown that drivers were more likely to be speeding and select a short distance to deceleration near the intersections. The findings indicated that distracted driving phenomenon was more serious on familiar roads.