某部入伍新兵心理卫生服务状况及需求调查

目的：调查入伍新兵心理卫生服务状况及对心理卫生服务的需求。方法：采用质性研究和量性研究相结合的方法,对42名入伍新兵作半结构性访谈,编制《部队心理卫生服务状况和需求》调查表,采用调查表对1609名新兵进行调查。结果：9．4％的新兵心理健康知识比较了解;接近半数新兵（43．5％）对心理健康知识很感兴趣;新兵获取心理知识的途径依次为网络、心理知识讲座、报刊杂志、广播电视、面对面咨询;新兵最期望获得的心理知识依次为如何调节自己的情绪、如何建立良好的人际关系、如何塑造自己的个性和常见的心理障碍表现;新兵认为最有帮助的心理服务形式依次为一对一心理咨询、心理知识讲座、心理测验和团体心理活动;只有7．7％的新兵接受过心理卫生服务。结论：新兵对心理健康知识感兴趣,但认知度和利用度均较低,应通过网络、心理知识讲座等方式普及新兵需要的心理健康知识。     

灾后消防救援人员创伤后应激障碍分析

目的：对地震后消防救援人员创伤后应激障碍（PTSD）的发生率及心理健康状况进行分析。方法：选用创伤后应激评定量表（PCL-C）和中文版事件影响量表（IES-R）,对灾后三个月内消防员310人进行评估。结果：灾后三个月内PTSD症状的总发生率为35.3%;地震救援组和基层消防组IES-R得分显著高于一般院校组,但地震救援组和基层消防组得分无显著差异,PCL-C得分结果与之类似;恐惧、创伤经历和救援失败等是PTSD症状的影响因素。结论：消防员是职业心理创伤的高危人群,地震后消防救援人员PTSD症状发生率较高,应给予及时心理干预。     

灾后消防救援人员创伤后应激障碍分析

目的:对地震后消防救援人员创伤后应激障碍(PTSD)的发生率及心理健康状况进行分析。方法:选用创伤后应激评定量表(PCL-C)和中文版事件影响量表(IES-R),对灾后三个月内消防员310人进行评估。结果:灾后三个月内PTSD症状的总发生率为35.3%;地震救援组和基层消防组IES-R得分显著高于一般院校组,但地震救援组和基层消防组得分无显著差异,PCL-C得分结果与之类似;恐惧、创伤经历和救援失败等是PTSD症状的影响因素。结论:消防员是职业心理创伤的高危人群,地震后消防救援人员PTSD症状发生率较高,应给予及时心理干预。     

高原医学救援实战演练教学改革实践与分析

医学救援实战演练教学贴近实战,并综合各学科而设,是培养应急性医学救援人才的必备课程。以往演练暴露诸多问题,例如学员不能全面参与训练,学员对突发状况应对能力较弱,训练内容设置不合理以及考核方式不能反映学员训练的真实情况等问题。我们进行高原医学救援演练教学方法改革,采用多用途学习模块,学员全面参与演练科目的方式,整合课堂、临床相关方面知识技能,组织教学训练单元,建立规范化、标准化救治流程,删减调整不相关内容,可在短期内完成培训。最后,通过考核方式改革,采用全程考查并及时对参训人员进行反馈保证训练质量。     

中南大学湘雅系统医疗对口支援工作的创新

??????? 目的 探讨大学及附属医院如何在对口支援工作中发挥更好的作用的方法。方法 回顾性分析中南大学及附属医院在国家新医改背景下对医疗对口支援工作模式和机制的创新和效果。结果 该校通过模式和机制创新,医疗对口支援工作取得良好成效。结论 大学及附属医院利用学科建设和人才培养等优势,创新性地开展医疗对口支援工作,可取得更好成效。     

重大灾害中救援军人心理应激干预的原则与方法

军人作为一个特殊群体,要经常参与各种重大灾害的救援工作。这些重大灾害容易诱发部分军人产生异常心理应激反应,对军人个体心理和群体心理产生负面影响。本文主要分析了救援军人心理应激反应产生的原因、表现和发展过程,然后提出心理干预的原则和程序,最后重点探讨了心理干预的方法措施。     

重大灾害中救援军人心理应激干预的原则与方法

军人作为一个特殊群体,要经常参与各种重大灾害的救援工作。这些重大灾害容易诱发部分军人产生异常心理应激反应,对军人个体心理和群体心理产生负面影响。本文主要分析了救援军人心理应激反应产生的原因、表现和发展过程,然后提出心理干预的原则和程序,最后重点探讨了心理干预的方法措施。     

大型公立医院城乡对口支援二十年发展与反思

目的 探讨近20年城乡医院对口支援发展问题,为未来更深入有效开展城乡医院对口支援提供新思路。方法 通过搜集既往20年间的城乡医院对口支援文献,归纳文献相关信息及文献观点进行汇总、分类、分析。结果 有关文献年均产出3.47篇,且多为纪实性经验总结探讨,缺乏科学理论分析;文献见刊年代与相关政策颁发年代的轨迹吻合,且文献观点提出到问题解决跨越时段长,20年来根本问题一直未能得到有效解决。结论 城乡医疗机构对于对口支援活动具有较高政治灵敏性,但缺乏内生动力的主观能动活性。建议从城乡医院对口支援的政府指令计划性的配对机制源头开始革新,搭建城乡医疗供需信息平台,寻求城乡共赢点作为双方机构合作契机点,以点带面,让内在利益驱动对口支援工作的有效落实,同时建立城乡医院对口支援的配对启动与退出机制,有利于城乡医院对口支援的长期持续发展。     

浅析心理训练在排球教学中的重要性

排球运动员心理训练的内容在不同的训练阶段,针对不同的训练对象应有所区别。总的来说应包括:运动员成就动机与必胜信心;稳定而不断增长的情绪;勇敢顽强战胜困难的意志;出色的专项认知能力;良好的人际关系与适应能力;优良的个性品质等方面的培养和训练。     

三级医院急诊科护士灾害护理能力现状及影响因素分析

目的调查国内三级医院急诊科护士灾害护理能力现状及其影响因素。方法采用一般情况资料表、临床护士灾害护理能力评估量表对12个省市、18家三级医院的418名急诊科护士进行问卷调查,并对回收问卷数据进行统计分析。结果急诊护士灾害护理能力总体评分为(114.55±7.70)分,最高分和最低分别为159、93分。得分较高的灾害护理能力层面集中在灾难现场护理协作、心肺复苏、紧急转运、外伤处理、预检分诊、分级救护等;能力欠缺的护理层面主要集中在灾难基础及医学知识、灾害心理护理知识与技能、大规模人群感染控制、脆弱人群护理、灾难护理管理等。学历、年龄、工作年限、灾害救援经历是影响急诊护士灾害护理能力的独立因素。结论三级医院急诊护士灾难护理能力整体处于中等偏下水平,应通过多种形式开展灾害救援知识与护理技能培训,不断提升急诊护士对灾难护理的认知及技能水平,以增强其应对灾害的紧急救援与护理能力。     

Emergency and Disaster Planning at Ohio Animal Shelters

Results of a cross-sectional study to determine the level of emergency and disaster response planning at Ohio nonhuman animal shelters and the role Ohio agencies have in emergency and disaster response planning in their communities indicated a lack of preparedness coupled with underutilization of the agencies as a resource. A total of 115 agencies (68%) responded to a standardized survey mailed to 170 Ohio agencies. Most (68%) agencies agreed that emergency and disaster response planning was important to their organization, although only 13% of agencies had completed a written emergency and disaster response plan. The majority (80%) of agencies indicated they would provide critical resources in an emergency or disaster in their community. Only 38 (33%) of the responding agencies were aware of the PETS Act of 2006. Although many agencies indicated the importance of an emergency and disaster plan, there may be insufficient resources, including time and proper training, available to ensure plans are developed. Improved coordination among veterinarians, local veterinary medical associations, emergency preparedness agencies, and animal shelters would enhance the relief efforts in a crisis.     

心理干预对眶骨骨折患者围手术期的影响

目的:探讨心理干预在眶骨骨折患者围手术期心理应激反应的影响。方法:自2011年8月至2013年02月我院共收治眶骨骨折手术患者60例,随机分为干预组和对照组各30例。干预组分别在术前1日、术后1日进行心理干预,对照组除了不接受心理干预外,其余护理措施同干预组。对两组患者术前焦虑值及生命体征指标(心率)进行测定。应用SPSS12.0软件包进行数据处理。结果:两组患者术前生命体征指标无明显差异,而术前1日和术后1日干预组焦虑值及生命体征指标明显优于对照组。结论:心理干预能改善眶骨骨折患者围手术期的焦虑状态和恐惧情绪,并且能够稳定其生命体征,使患者顺利渡过围手术期,促进术后恢复,在围手术期护理工作中发挥着积极作用。     

Knowledge Levels and Training Needs of Disaster Medicine among Health Professionals,Medical Students,and Local Residents in Shanghai,China

Background

Disaster is a serious public health issue. Health professionals and community residents are main players in disaster responses but their knowledge levels of disaster medicine are not readily available. This study aimed to evaluate knowledge levels and training needs of disaster medicine among potential disaster responders and presented a necessity to popularize disaster medicine education.

Methods

A self-reporting questionnaire survey on knowledge level and training needs of disaster medicine was conducted in Shanghai, China, in 2012. A total of randomly selected 547 health professionals, 456 medical students, and 1,526 local residents provided intact information. The total response rate was 93.7%.

Results

Overall, 1.3% of these participants have received systematic disaster medicine training. News media (87.1%) was the most common channel to acquire disaster medicine knowledge. Although health professionals were more knowledgeable than community residents, their knowledge structure of disaster medicine was not intact. Medical teachers were more knowledgeable than medical practitioners and health administrators (p = 0.002). Clinicians performed better than public health physicians (p<0.001), whereas public health students performed better than clinical medical students (p<0.001). In community residents, education background significantly affected the knowledge level on disaster medicine (p<0.001). Training needs of disaster medicine were generally high among the surveyed. ‘Lecture’ and ‘practical training’ were preferred teaching methods. The selected key and interested contents on disaster medicine training were similar between health professionals and medical students, while the priorities chosen by local residents were quite different from health professionals and medical students (p<0.001).

Conclusions

Traditional clinical-oriented medical education might lead to a huge gap between the knowledge level on disaster medicine and the current needs of disaster preparedness. Continuing medical education and public education plans on disaster medicine via media should be practice-oriented, and selectively applied to different populations and take the knowledge levels and training needs into consideration.     

Intelligent Decision-Making Models for Disaster Management

ABSTRACT

Providing emergency relief to the victims of natural disasters is a hugely complex process fraught with many challenging aspects: multiple uncertainties, little reliable information, scarcity of resources, a variety of involved entities, and so on. Nowadays there is a lot of information that could be used to improve decision-making in disaster management, but usually it is not available at the right moment, in the right way, or it is partially known or vague. In this article we analyze the decision-making process for disaster management from the general view of intelligent decision-making to the specific characteristics of this context. This specificity deals with a new kind of logistics, and it is shown how this humanitarian logistics, specifically designed with the aim of alleviating suffering of vulnerable people, is a growing new research area to develop new decision aid models for disaster management, identifying new and relevant differences with other types of logistics. To illustrate these claims, two models are introduced, one for assessment of consequences in the earlier stage after a disaster (focused on the unknown, one of the main characteristics in disaster management), and another one for last mile distribution of humanitarian aid (focused on the multicriteria nature of decision-making on disaster management).     

Arrangement Characteristics of Temporary Relief Facilities: A Case Study of the Sewol Ferry Disaster Using Space Syntax Modeling

The purpose of this study was to provide a quantitative assessment of the spatial placement characteristics of temporary disaster relief facilities that were built after the Sewol ferry disaster. Among space syntax analysis indicators, we selected control value, global real relation asymmetry (RRA), local RRA, and intelligibility to use in this study. We also assessed each relief facility's accessibility by facility type and use of spatial openness. As a result of our analysis of 193 relief facilities that were classified into 9 facility types, we discovered that the types requiring control over who could access them due to their facility characteristics had RRA values confirming that such facilities used space appropriately. Furthermore, most of the facility types, including the types needing openness or awareness, showed results that were appropriate for each assessment indicator. Our study is the first to examine relief facilities, whose placements are often temporary and expedient in response to large-scale disasters, with the lens of spatial characteristics analysis. The assessment methodology used in this study can be generalized, applied regardless of region, and used as a placement plan for future temporary relief facilities.     

Factors Associated with Nursing Activities in Humanitarian Aid and Disaster Relief

Background

Although nurses play an important role in humanitarian aid and disaster relief (HA/DR), little is known about the nursing activities that are performed in HA/DR. We aimed to clarify the nursing activities performed by Japanese nurses in HA/DR and to examine the factors associated with the frequency of nursing activities.

Methods

A self-administered questionnaire survey was completed by 147 nurses with HA/DR experience. The survey extracted information on demographic characteristics, past experience (e.g., disaster medical training experience, HA/DR experience), circumstances surrounding their dispatched to HA/DR (e.g., team size, disaster type, post-disaster phase, mission term), and the frequency of nursing activities performed under HA/DR. The frequency of nursing activities was rated on a 5-point Likert scale. Evaluation of nursing activities was conducted based on the “nursing activity score”, which represents the frequency of each nursing activity. Factors related to the nursing activity score were evaluated by multiple logistic regression analysis.

Results

Nurses were involved in 27 nursing activities in HA/DR, 10 of which were performed frequently. On analysis, factors significantly associated with nursing activity score were nursing license as a registered nurse (OR 7.79, 95% CI 2.95–20.57), two or more experiences with disaster medical training (OR 2.90 95%, CI 1.12–7.49) and a post-disaster phase of three weeks or longer (OR 8.77, 95% CI 2.59–29.67).

Conclusions

These results will contribute to the design of evidence-based disaster medical training that improves the quality of nursing activities.     

医学研究生灾难医学知识的初步调查及对策

目的了解医学研究生对灾难医学相关知识的认知情况。方法通过发放调查问卷,对我校2008-2011年入学的458名医学研究生进行灾难医学相关知识调查分析。结果医学研究生对灾难医学的基本概念、基本急救技术、灾后心理援助以及传染病的预防及处理相关知识掌握较好,但对灾难伤员的检伤分类、灾难医学管理相关知识掌握明显不足。结论医学研究生掌握灾难医学相关知识已明显提高,但仍存在不足,应加强医学研究生急救技能培训、开设灾难医学选修课,以提高我国灾难医学救援整体水平。     

Pre-Positioning Disaster Response Facilities and Relief Items

ABSTRACT

Large-scale disasters cause enormous damage to people living in the affected areas. Providing relief quickly to the affected is a critical issue in recovering the effects of a disaster. Pre-disaster planning has an important role on reducing the arrival time of relief items to the affected areas and efficiently allocating them. In this study, a mixed integer programming model is proposed in order to pre-position warehouses throughout a potential affected area and determine the amount of relief items to be held in those warehouses. Time between the strike of the disaster and arrival of relief items at the affected areas is aimed to be minimized. In addition, using probabilistic constraints, the model ensures that relief items arrive at affected areas within a certain time window with certain reliability. Considering instable fault lines on which Istanbul is located, the proposed model is applied to the Istanbul case for pre-positioning warehouses a priori to the possible expected large-scale earthquake.     

心理干预对脑卒中抑郁焦虑情绪的康复作用及对患者治疗依从性的影响研究

目的:探讨心理干预对脑卒中抑郁焦虑情绪的康复作用及对患者治疗依从性的影响。方法:我院老年科、神经内科、康复医学科治疗的脑卒中并出现抑郁焦虑情绪障碍的患者120例,随机分为观察组和对照组,各60例,两组患者均入院以后给予脑血管药物进行常规治疗和日常功能训练;观察组同时给予心理干预并根据病情应用抗抑郁抗焦虑药物等。于干预前、干预后3个月、6个月、1年分别对两组患者用SCL-90量表、总体幸福感指数量表、Barthel指数量表对患者进行评估,并评估患者治疗依从性。结果:干预后,观察组SCL-90各因子评分及总分均较干预前明显降低(P0.05),对照组SCL-90各因子评分及总分与干预前比较无统计学差异(P0.05)。干预前两组患者总体幸福感评分和Barthel评分比较无统计学差异(P0.05),干预后3个月、6个月和1年观察组总体幸福感评分和Barthel评分均明显高于对照组(P0.05)。观察组患者在治疗期间总体依从率明显高于对照组(P0.05)。结论:心理干预能够有效的改善脑卒中患者早期康复病人抑郁和焦虑的情绪,提高患者治疗的依从性。