吉林省医务人员吸烟现况及知识态度分析

为了更好地了解吉林省医务人员的吸烟状况,为进一步开展控烟工作提供科学依据,对吉林省50家医疗机构的3787名医务人员进行问卷调查,调查结果显示,男性医务人员吸烟率较高；医务人员对烟草危害认识不全面,控烟意识较为薄弱.应加强对医务人员烟害知识等方面的培训,以改变其吸烟行为、提高控烟责任意识.     

Comparing choice and questionnaire measures of the acceptability of a staff training procedure

We compared questionnaire and choice measures of acceptability while evaluating effects of staff familiarity versus unfamiliarity with the system used to monitor performance during a training program. Staff members rated both monitoring formats equally favorably on the questionnaire, whereas when given a choice, they frequently chose the familiar format and never chose the unfamiliar format. These results suggest that traditional questionnaire evaluations may not be sufficiently sensitive measures of acceptability relative to choice measures.     

AN INSTITUTIONAL STAFF TRAINING AND SELF-MANAGEMENT PROGRAM FOR DEVELOPING MULTIPLE SELF-CARE SKILLS IN SEVERELY/PROFOUNDLY RETARDED INDIVIDUALS

Although considerable attention has been given to the development of institutional staff training and management programs, the generalized effects of such programs on staff and resident behavior have seldom been examined. This study evaluated a program for teaching institutional staff behavioral training and self-management skills during self-care teaching sessions with severely and profoundly retarded residents. Following baseline observations in three self-care situations (toothbrushing, haircombing, handwashing), four direct care staff were sequentially taught to use verbal instruction, physical guidance, and contingent reinforcement in the toothbrushing program. During maintenance, staff were simultaneously taught to record, graph, and evaluate resident and their own behavior in the toothbrushing sessions. Staff were taught use of the training and self-management skills through a sequence of written instructions, videotaped and live modeling, rehearsal, and videotaped feedback. Observer presence and experimenter supervision were gradually decreased during the maintenance condition. Results indicated that during training and maintenance staff: (a) learned to use the training skills appropriately and consistently in the example situation (toothbrushing); (b) applied the skills in the generalization situations (haircombing and handwashing); and thereafter (c) maintained consistent and appropriate use of the skills with infrequent supervision. In addition, important changes in retarded residents' independent self-care responding occurred as staff training skills developed. Results are discussed in terms of their implication for future research and continued development of effective staff training and management programs.     

A COMPARISON OF THREE STAFF-MANAGEMENT PROCEDURES

Even though administrators must have effective staff-management procedures to ensure implementation of desired programs, many traditional staff-management procedures remain unevaluated. This study investigated the effectiveness of three such procedures. The administrator of an institution for the retarded (1) sent a memo instructing all staff to lead daily recreational activities, (2) sponsored a workshop teaching staff to lead such activities, and (3) assigned staff activity leaders and provided performance feedback to staff by publicly posting the daily average number of active residents on each ward. Neither the memo nor the workshops motivated staff to lead activities, but after staff were scheduled to lead such activities and given performance feedback, the average daily number of residents engaged in activities on four wards for 95 retarded persons increased from seven to 32. The administration of this facility has adopted similar procedures to maintain such activities on all wards.     

The comparative effectiveness of two modes of observer training on the Staff-Resident Interaction Chronograph

The comparative effectiveness of two time-limited modes of training observers to code activity on the Staff-Resident Interaction Chronograph (SRIC) in residential treatment programs for mentally disabled adults was evaluated. The susceptibility of training procedures for consensual observer drift was also examined, as was the predictability of SRIC mastery from trainee characteristics. Two equated groups of undergraduate student trainees (N=15 each) participated in full-time training for 27 days, followed by two weeks of criterion testing in vivo and on videotapes. One group received training by experience personnel using procedures known to be effective (original method). The other group received training via a previously untested set of written and videotaped procedures that do not rely on experienced personnel (package method). Multivariate and univariate analyses of variance found both methods to be equally effective in the degree of mastery achieved by trainees, without evidence of observer drift. No meaningful predictions of coding mastery were found, but conceptual mastery was predictable from individual characteristics. Differences were obtained for both groups between in vivo versus videotaped criterion tests. The results document procedures that are both efficient and resistant to invalidity for complex observational methodology as well as feasible for standardizing assessment of staff functioning across residential settings.This article is based on a thesis submitted to the Graduate College of the University of Illinois at Urbana-Champaign in partial fulfillment of the requirements for the Ph.D. degree in psychology by the first author under direction of the second author. The third and fourth authors also participated as supervisors. Appreciation is extended to other members of the thesis committee, Fred Kanfer, W. Robert Nay, Julian Rappaport, and James Wardrop, for their comments and recommendations. This study was partially supported by Public Health Service Grants MH-25464 and MH-14257 from the National Institute of Mental Health, and by grants from The Joyce Foundation and the Illinois Department of Mental Health and Developmental Disabilities.     

EXPANDING THE IMPACT OF BEHAVIORAL STAFF MANAGEMENT: A LARGE-SCALE,LONG-TERM APPLICATION IN SCHOOLS SERVING SEVERELY HANDICAPPED STUDENTS

Experimental evaluations of behavioral staff management procedures usually have been limited to relatively small-scale demonstration studies. We evaluated a large-scale, long-term application of a staff management program designed to improve the functional utility of educational services for severely handicapped persons. The intervention, involving a brief in-service program followed by supervisory prompts and feedback, was implemented by three principals in four schools involving 21 classrooms. Implementation of the management procedures was consistently accompanied by increases in student involvement in functional educational tasks in each classroom. Further, the improved services continued throughout a 2-year follow-up period. Staff responses to a questionnaire indicated a high degree of staff acceptance of the management program. Results are discussed in terms of expanding the use of behavioral supervisory procedures from experimental demonstrations to actual adoption by existing human service agencies.     

烧伤患者家属需求与医务人员认知差异的调查研究

以重危患者家属需求量表调查烧伤住院患者家属需求和医务人员对家属需求的认知,寻找差异并提出对策,以期使医务人员更好地理解家属需求。结果显示,烧伤住院患者家属需求与医务人员对家属需求的认知存在28项差异(P<0.05);影响家属各维度需求差异的因素是家属年龄及患者是否曾入住其他病房(P<0.05);影响不同医务人员对各维度需求认知差异的因素是从事专业年限及职业类别(P<0.05)。因此,目前医务人员对烧伤住院患者家属需求有相当一部分无法给予认知和满足。建议建立基于家属教育和视频探视系统的探视制度,设置母婴同室病房;并引入医务社工,开展家属教育小组和巴林特小组。     

灾疫境遇中医务人员道德韧性的厘定与建构研究

灾疫境遇下,个体的生命安全受到严重威胁的同时,还时刻身处道德逆境,面临着道德上的拷问,极易产生道德创伤。道德韧性作为抵御道德创伤的关键,体现在我国军医面对一次又一次的灾疫救援中,具有坚毅信念与积极情感的"组合"、攻坚克难与抵御诱惑的"互补"和无悔抉择与令出行随的"协同"三大特点。以历次重大灾疫救援事件和本次新型冠状病毒救援行动为契机,提出提高道德认知、设置韧性培塑情境和组成命运共同体来培塑医务工作者个体的道德韧性。     

行政模式的转型与行政人员的道德责任

行政人员的道德责任不是一个内涵固定不变的范畴 ,随着行政模式的变迁 ,行政的方向和方式都在发生变化 ,对行政人员的道德责任也会有相应的要求 ,专制行政、精英行政和公共行政对行政人员的道德责任要求甚至是大相径庭的。就其核心道德责任而言 ,专制行政要求忠诚 ,精英行政追求效率 ,公共行政呼唤公正。在这个基础上 ,我们才能谈论中国公共行政中行政人员的道德责任及其实现的问题。     

应该发挥医院、医生在慢性病预防中的作用

从必要性分析、可行性分析、预防效果分析及存在的问题等方面探讨在我国必须要发挥医院、医生在慢性病预防中的作用,只有整合医疗资源与疾病预防控制资源,才能更好地预防慢性病。