助推手卫生的行为干预策略

保持手卫生是感染防控的重要策略,但是如何提高其依从性成为预防传染性疾病和减少医疗机构获得性感染的一大挑战。以行为科学为基础的手卫生助推干预以更“隐性”的方式将洗手转变为一种可自动触发的行为习惯,弥补了以知识分享和健康宣教为主的传统手卫生干预策略的诸多局限性。基于影响机制的不同,手卫生助推干预策略可分为提供决策信息、优化决策选项、影响决策结构、提醒决策方向4个大类的框架体系。多模式助推策略的有效性也已在实践中得到印证,但目前还非常缺乏在中国社会文化情境下开展的助推洗手行为的干预研究,今后可尝试基于行为科学理论有针对性地在医院、学校和社区等公共场所开展此类干预研究和实践,为感染防控、疾病预防和改善公共健康做出相应的贡献。     

INCREASING NURSES' USE OF FEEDBACK TO PROMOTE INFECTION-CONTROL PRACTICES IN A HEAD-INJURY TREATMENT CENTER

This study established regular implementation of a simple feedback procedure by supervisory nurses with their assistants at a head-injury treatment center. Five nurses were trained to distribute brief written comments to their assistants about infection-control practices, including using gloves to avoid contact with body fluids. Following low rates of written feedback, nurses met with the trainer weekly to set goals for using the system, to review feedback rates, and to examine contingent letters of appreciation. Written feedback increased from 0.09 to 0.58 per day. When outcome data on glove use were subsequently added to the feedback provided to nurses, nurses' feedback on glove use increased and overall glove use by assistants increased by 36.7% for 66.7% of assistants who responded to feedback. Assistants rated feedback as highly accurate and indicated some interest in receiving future feedback. However, nurses and assistants expressed a preference for oral over written feedback.     

The interface between physical and mental disorders: The need to dismantle the biopsychosocialneuroimmunological model of disease

This article argues for the necessity of cognitive-behavioral assessment for a thorough understanding of how psychological factors mediate disease process across a wide range of diseases including coronary artery disease, breast cancer, and human immunodeficiency disease. Based on empirical data presented as part of the APA Presidential miniconvention, “To Your Health: Psychology through the Life Span,” the conclusion is that psychological treatment can help extend life. Stress management programs can positively influence adherence to treatment regimens and positively influence the human immune system response during the course of treatment and recovery from illness. Even in the face of life-threatening circumstances such as liver transplantation, Stage II and III breast cancer, and after HIV infection has been diagnosed, the quality of life can be remarkably improved. Physicians and psychologists must work together to produce the beneficial effects of the synergy between mind-body processes.     

新生儿真菌血症的调查与分析

了解新生儿真菌血症的流行病学特征,为制定有效的预防措施提供科学依据。采取回顾性调查及病例对照研究方法,分析我院2008年~2010年新生儿真菌血症患者及对照的临床资料、实验室检查结果。结果早产儿及极低体重儿易发生真菌血流感染,感染菌株以非白色念珠菌为最常见,预防性抗真菌药的目标人群可定为早产儿、极低体重儿及细菌性菌血症患儿。     

胸腔闭式引流术后感染相关因素的探讨与对策

胸腔闭式引流术是一项有创性操作,多种因素可能会引起胸膜腔及肺内感染。为了预防及处理胸腔闭式引流术后的相关性感染,我们从临床角度讨论更换胸腔闭式引流瓶的间隔时间、胸腔闭式引流管口的消毒、胸腔引流液逆流的预防、胸腔引流管的更换以及由于留置胸腔闭式引流引起的肺内感染的处理等问题,为临床医护人员对该项操作提供参考和对策。     

宿主和寄生物的辩证关系

寄生物（包括寄生虫,细菌,真菌,立克次体,病毒等）虽依赖宿主而生存,却不一定对宿主致病,有的反而对宿主有益,根据达尔文的进化论,“自然选择”要求生物在进化中要不断适应环境,适应是生存最重要的条件,不能适应必将死亡,据此,本文对一些常见的自然因素对于宿主和寄生物两方面进行了初步分析,包括寄生物在宿主体内的繁殖速度,寄生物所引起的宿主的症状,其生现象的出现等,并对晚近发现的朊病毒,发生“星际传染性”的     

Adult urinary incontinence: Assessment,intervention, and the role of clinical health psychology in program development

Urinary incontinence (UI) is a disorder receiving little attention from clinical health psychologists. This paper establishes the importance of addressing the issue of UI within the clinical and research practices of clinical health psychologists. Over 10 million Americans suffer from loss of bladder control. Incontinence affects over half of older individuals in long-term care institutions, about one-third of hospitalized elderly, and up to 30% of Americans over the age of 60 living at home. Because of social stigma and misconceptions attached to urinary incontinence, it is estimated that less than half of those affected see a physician about their condition. Since UI is generally associated with medical, social, psychological, and economic consequences, a multidisciplinary perspective is important because these factors are integral in the selection of appropriate treatment. Definitions of UI, its incidence and costs, and brief reviews of treatment and management techniques are presented. Psychological sequelae and treatments are presented as a foundation for developing further treatment and research approaches. Guidelines for collaboration and consultation by clinical health psychologists with medical professionals in the area of UI are also discussed.     

Body image and risky sexual behaviors: an investigation in a tri-ethnic sample

The impact of negative body image on risky sexual behaviors has not been extensively investigated. The present study examined the relationship between two aspects of body image, appearance shame and appearance investment, and potentially risky behaviors. The study employed a tri-ethnic sample of 1547 women seeking services at two family planning clinics. Logistic regression was utilized to examine the relationship between potential risk behaviors and shame and investment. Results supported that these aspects of body image were significant predictors of inconsistent condom use, having multiple sex partners in the past year, and having sex after drinking alcohol or using drugs, and that demographic variables (e.g., age, marital status, ethnicity) could not fully account for these relationships. The importance of future research investigating the relationships among body image, perceived relationship security, affect-management strategies, and risky sexual behaviors is emphasized.     

论现代传染病防治中医患关系的特点

现代传染病防治中传统的医患关系的内涵和外延都发生了一定的变化,无论是医方还是患方都体现出强烈超医学性和社会性,在社会大防治的概念下医患之间出现一定的界限模糊甚至角色重叠。现代传染病的发展给我们提供了审视医患关系的新视角,引发人们关于医学发展、社会道德的深层次的思考。