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。     

Participatory Organizational Change in Community-Based Health and Human Services: From Tokenism to Political Engagement

Community psychologists have long worked with community-based human service organizations to build participatory processes. These efforts largely aim at building participatory practices within the current individual-wellness paradigm of human services. To address collective wellness, human service organizations need to challenge their current paradigm, attend to the social justice needs of community, and engage community participation in a new way, and in doing so become more openly political. We use qualitative interviews, focus groups, organizational documents, and participant observation to present a comparative case study of two organizations involved in such a process through an action research project aimed at transforming the organizations’ managerial and practice paradigm from one based on first-order, ameliorative change to one that promotes second-order, transformative change via strength-based approaches, primary prevention, empowerment and participation, and focuses on changing community conditions. Four participatory tensions or dialectics are discussed: passive versus active participation, partners versus clients, surplus powerlessness versus collective efficacy, and reflection/learning versus action/doing.     

我国中小学生心理健康服务从业人员及工作状况调查

该研究的目的是考察我国中小学生心理健康服务从业人员及专业工作的基本情况,并比较其地区差异,分析存在的问题。调查包括来自重庆、甘肃、辽宁、福建、湖北以及西藏等6个省市自治区的596名被试。研究采用自编问卷调查中小学生心理健康从业队伍情况及其专业工作情况。结果发现各地区之间发展确实存在不均衡的状况,辽宁、福建等东部发达地区从业人员专业化水平相对较高;西藏、甘肃等地区则相对较为落后,特别体现在人员结构不合理、职称待遇偏低、缺少专业培训等方面。     

Individual attitudes and perceived social norms: Reports on HIV/AIDS‐related stigma among service providers in China

This study examined HIV/AIDS‐related stigma among Chinese service providers by comparing their personal attitudes toward people living with HIV/AIDS with their perception of social norms related to people living with HIV/AIDS. We randomly selected three provincial hospitals, four city/prefecture hospitals, 10 county hospitals, 18 township health clinics, and 54 village clinics from Yunnan, China. Doctors and nurses were randomly sampled proportionally to the doctor–nurse ratio of each hospital or clinic. Lab technicians were over‐sampled in order to include an adequate representation in the analysis. A total of 1,101 service providers participated in a voluntary, anonymous survey where demographic characteristics, individual attitude and perceived social norms toward people living with HIV/AIDS, discrimination intent at work, general prejudicial attitude and knowledge on HIV/AIDS were measured. A majority of the sample demonstrated a similarity between their personal views and what they thought most people in society believe. Multiple logistic regressions revealed that participants who were younger or reported personal contact with people living with HIV/AIDS were significantly more likely to report personal attitudes toward the population that were more liberal than their perceived social norms. Holding a more liberal personal attitude toward people living with HIV/AIDS than perceived social norms was significantly and negatively related to the level of discrimination intent at work, perceived discrimination at interpersonal level and the level of general prejudicial attitude toward people living with HIV/AIDS. Results underscored the importance of understanding social norms and personal attitudes in studying HIV‐related stigma and called for the incorporation of existing human capital into future HIV stigma reduction programs.     

Impact of neighborhood disadvantage on overt behavior problems during early childhood

Researchers have yet to examine the impact of neighborhood disadvantage on early child behavior problems (BPs) longitudinally. We examined the impact of neighborhood disadvantage on overt BPs in a low-income, urban sample of 281 African American and European American boys followed longitudinally from toddlerhood to school entry. Measures included census data and maternal report of BPs, sociocultural factors, parental criminality, and maternal depressive symptomatology. After controlling for age 2 overt BPs, family selection variables, and residential instability, neighborhood effects on boys' behavior emerged, but only at age 6 and only at the extreme of neighborhood disadvantage (i.e., underclass). Findings suggest boys in underclass neighborhoods are at risk for overt BPs as they make the transition to elementary school.     

Psychiatric disorders and the use of mental health services among children involved in bullying

This study had two aims: to evaluate the relationship between bullying and psychiatric disorders and to study the probability of using mental health services among children involved in bully/victim problems. The data consisted of interviews with 423 parents and 420 children. Diagnostic measures were based on the Isle of Wight Interview. Children involved in bullying as bullies, bully‐victims, and victims were compared with other children. Children involved in bully/victim problems were more prone to have psychiatric disorders than noninvolved children. The probability of being disturbed was highest among male bullies, followed by male bully‐victims and female victims (9.5‐fold, 7.9‐fold, and 4.3‐fold, respectively) compared with noninvolved same‐sex children. The most common diagnoses among children involved in bully/victim problems were attention deficit disorder, oppositional/conduct disorder, and depression. Furthermore, children involved in bully/victim problems were more likely to have used mental health services at some time during their lives and also during the previous 3 months. Special attention should be paid to children’s mental health when dealing with bullying problems at school. Referral pathways to mental health services and factors affecting the referral processes among children should be further studied. Aggr. Behav. 27:102–110, 2001. © 2001 Wiley‐Liss, Inc.     

政策环境对实现残疾人康复服务的影响

根据《上海市残疾人"人人享有康复服务"评价指标体系》,采用综合评价法,对上海市6个区残疾人康复工作进行评价。研究发现,残疾人康复政策环境实现率为96.3%,5个二级指标实现率均超过80%,三级指标达标率63.3%。应明确残疾人康复工作的重要性,将残疾人康复纳入政策工作计划,各区残疾人康复政策环境建设应协调平衡发展。     

Family,peer, and neighborhood influences on academic achievement among African-American adolescents: One-year prospective effects

Using a 1-year prospective design, this study examined the influence of family status variables (family income, parental education, family structure), parenting variables (maternal support and restrictive control), peer support, and neighborhood risk on the school performance of 120 African American junior high school students. In addition to main effects of these variables, neighborhood risk was examined as a moderator of the effects of parenting and peer support. Family status variables were not predictive of adolescent school performance as indexed by self-reported grade point average. Maternal support at Time 1 was prospectively related to adolescent grades at Time 2. Neighborhood risk was related to lower grades, while peer support predicted better grades in the prospective analyses. Neighborhood risk also moderated the effects of maternal restrictive control and peer support on adolescent grades in prospective analyses. These findings highlight the importance of an ecological approach to the problem of academic underachievement within the African American community.     

Task clarification, performance feedback, and social praise: Procedures for improving the customer service of bank tellers

Customer service for bank tellers was defined in terms of 11 verbal behavior categories. An audio-recording system was used to track the occurrence of behaviors in these categories for six retail banking tellers. Three behavior management interventions (task clarification, performance feedback, and social praise), applied in sequence, were designed to improve overall teller performance with regard to the behavioral categories targeted. Clarification was accomplished by providing clear delineation of the various target categories, with specific examples of the behaviors in each. Feedback entailed presentation of ongoing verbal and visual information regarding teller performance. Praise consisted of verbal recognition of teller performance by branch managers. Results showed that clarification effects emerged quickly, producing an overall increase in desired behaviors of 12% over baseline. Feedback and praise effects occurred more gradually, resulting in overall increases of 6% and 7%, respectively. A suspension of all procedures led to a decline in overall performance, whereas reinstatement of feedback and praise was again accompanied by performance improvement. These findings extend the generality of behavior management applications and help to distinguish between possible antecedent and consequent effects of performance feedback.