非医疗技术因素对门诊患者满意度的调查与分析

?????? 目的 了解门诊患者对于非医疗技术服务的满意度现状,探讨影响门诊患者满意度的非技术因素。方法 对广州市某三甲医院2012年3—6月就诊的208名门诊患者进行问卷调查。结果 与“等候时间”、“诊疗费用”相关的满意度水平显著低于“服务态度”、“环境设施”类,且满意度水平存在着社会人口学差异。结论 医院应注重非医疗技术服务的改进,可从营造舒适就诊环境、加强医患沟通、降低医疗费用及合理门诊布局等方面入手。同时,优化门诊预约服务可有效提高门诊患者满意度。     

上海市二、三级医院肿瘤化疗病案质量现状与分析

目的 了解上海市二、三级医院肿瘤化学药物治疗（以下简称“化疗”）质量情况,完善肿瘤化疗质量控制体系。方法 依据上海市肿瘤化疗质控中心督查方案,对全市103家从事肿瘤化疗的二、三级医院开展了2015年肿瘤化疗质量现场核查,采用SPSS 13.0进行数据汇总和分析。结果 上海市二、三级医院之间,肿瘤专业科室和非专业科室之间,肿瘤化疗病案的质量存在显著的不平衡,主要问题包括知情同意书内容不完整（33.04%）,病理诊断不齐全或缺失（15.50%）,肿瘤分期不规范或未分期（56.27%）,化疗目的（42.44%）、化疗适应证（37.47%）和禁忌证（12.21%）不齐全或缺失,化疗疗效评价记录不全或未评价（24.10%）,中期评估记录不全或未评价（27.72%）,入院病史（16.28%）及化疗当日记录（32.04%）不完整或缺失等。结论 上海市医院肿瘤化疗病案的质量与医院的级别和是否为专科显著相关。各医院应该针对自身存在的问题,加强对化疗质量控制标准的学习。     

六西格玛管理法对围手术期服务质量改进的影响研究

目的 设计了综合医院围手术期六西格玛管理模式,并进行了试验研究,以评价应用效果。 方法 采用干预性研究方法,设立干预组和对照组。制定和筛选出评价指标,根据前后统计结果,判断总体改善和指标的变化情况。 结果 干预组总体有明显的改善,对照组总体改善不明显;干预组评价指标横比、纵比均有明显的改进。结论 围手术期六西格玛管理模式的应用可明显改善医院医疗服务质量,对医疗服务行为有较大的良性影响,并有利于医院文化建设。     

实习前护理专科生的焦虑状况及影响因素分析

目的 了解 护理专科生实习前心理健康状况,探讨其实习前焦虑程度的影响因素。方法 收集2013级某中专院校护理专业10个班和某高等职业院校护理专业5个班的调查问卷,最终整理所得有效样本为578份。应用SPSS19软件进行统计分析。结 果 护生实习前心理健康问题除人际敏感和抑郁之外,均高于全国青年常模（P ＜0.05）;护生的焦虑水平与护生的人格特点、年龄有关;回归分析得出护生的学历、生源地、独生子女等对焦虑程度有明显影响,差异有统计学意义（P ＜0.05）。结论 掌握影响护生产生焦虑程度的因素,为护生护理教育提供依据。     

专科护士职业认同与职业韧性关系中介研究

目的 探讨专业自我概念对专科护士职业认同、职业韧性的影响,为专科护士管理提供依据。 方法 采用一般资料问卷、职业认同量表、专业自我概念问卷、职业韧性量表,对277名参加专科护士培训班的专科护士进行调查,运用spss13.0进行相关和回归分析。 结果 专科护士年龄越大、工作年限越长、健康状况和有编制的职业韧性、专业自我概念得分越高（均P＜0.05）,健康自评越好、受教育水平越高、有编制的和在血液科、手术室等科室的其职业认同水平越高（均P＜0.05）,职业韧性得分与职业认同、专业自我概念得分呈正相关（r=0.383, 0.584,均P＜0.01）,中介效应结果分析表明专业自我概念（领导和灵活性维度）在职业认同和职业韧性之间中介效应显著（P＜0.05）,总的中介效应值为0.192,效果量50.1%。结论 专科护士的职业韧性与职业认同和专业自我概念密切相关,职业认同可通过专业自我概念来间接提高其职业韧性水平。     

减少择期手术临时取消病例的做法与体会

目的 分析外科择期手术临时取消的原因,降低择期手术取消率,提高手术室工作效率和医疗安全。方法 运用根本原因分析法对择期手术临时取消病例进行科学管理。结果 运用根本原因分析法找出择期手术临时取消的影响因素,并采取相应改进措施后,手术取消率呈下降趋势（Z=6.91,P＜0.05）。结论 通过根本原因分析法,找出择期手术临时取消的原因,提出相应管理措施,改善手术室工作流程,有效降低择期手术取消率,提高手术室工作效率,避免医疗资源浪费,确保患者医疗安全。     

护理人员个体因素对薪酬满意度影响的调查与分析

?????? 目的 通过对护理人员个体因素薪酬满意度的调查,了解护理人员个体因素对薪酬满意度的影响。 方法 应用方差分析和均值计算,判断护理人员个体因素的薪酬满意度及其影响。 结果 护理人员个体因素与薪酬满意度有显著差异（P﹤0.05）。年龄、工作年限、学历等因素对薪酬满意度的影响程度不同。 结论 护理人员对薪酬满意度整体满意度水平较低,年龄、工作年限、学历等因素是护理人员薪酬满意度的影响因素。     

职场正念对公立医院护士心理韧性的影响研究

目的 探讨职场正念对护士心理韧性的影响及可能的机制。方法 通过一个横断面式的网络问卷调查收集资料,阶层线性回归法验证变量间的作用关系。结果 护士的职场正念均值水平为（4.74±0.63）,护士心理韧性均值水平为（3.44±0.89）;职场正念对护士心理韧性（β= 0.255,P＜0.01）具有正向预测作用。结论 职场正念可以有效提升护士的心理韧性水平,有助于护士抵御不良事件和负向情绪的侵袭,帮助她们快速从消极情绪中恢复。     

我国

目的 了解全国三级甲等医院现有网站的建设与使用情况以及全国各地区在医院网站建设方面的差距,并且指出在网站建设方面的存在的不足。方法 通过采用人工调研方式对全国653家三级甲等医院的网站建设情况进行调查,并使用比较研究法对调查数据进行分析。结果 在网站建设功能中“检索功能”完善情况较差,建设比例达12.6%;受众对于“交互功能”建设指标中“预约挂号”“医疗咨询”的需求较高,但全国三甲医院网站中分别只有73.6%和57.7%的医院设立了以上两个功能。结论 为了更好地与患者有效沟通,医院“交互功能”应得到进一步的重视和完善。     

音乐治疗效应的动物实验研究

近年来国内外关于音乐治疗效应的动物实验研究认为：音乐能影响动物的情绪;音乐还对动物的免疫功能、学习及记忆能力、以及动物的神经系统结构和功能等均有一定影响。该领域的研究有利于深入探索音乐疗法的作用机理。     

Time on task effects on safety

Reviewing the literature on time on task effects on safety shows contradictory evidence, especially with regard to 12 h shifts. It is argued that this might depend on methodological problems associated with the analysis of accident data, e.g. selectivity of samples, validity of data bases and study designs, especially for analyses at the company level. Analyses of aggregated data seem to indicate an exponential increase of accident risk with time on task beyond the normal working day. This is supported by some recent studies based on data from the Federal Republic of Germany.     

Perspectives on hair evolution based on some comparative studies on vertebrate cornification

Hair evolution contributed to the biological success of mammals. Hair origin from synapsid scales is speculative and requires extensive modifications of the morphogenetic process transforming lens-shaped dermis of scales into small dermal papillae in hair. Hair evolution from glands is hypothetical but is supported from studies on the signaling control of hair vs. glandular morphogenesis. Based on immunocytochemical and comparative studies, it is hypothesized that the onion-like organization of hair derived from glandular pegs which central part produced lipids and some keratin. In a following stage, involucrin, trichohyalin, and keratins were produced in the central cells of the gland and formed a solid medulla surrounded by keratinocytes of the inner root sheath. The origin of this protohair was possibly related to increased concentration of beta-catenin and other signaling molecules in epithelial cells following the evolution of a dermal papilla. The latter activated the keratogenic genes, already utilized in cells of the claws, in concentric layers of cells of the glandular peg. Lipidogenic genes were depressed. As new genes evolved in the genome of synapsids, new circular layers of keratinocytes containing specialized hard keratins and keratin-associated proteins were formed around medullary cells. The new keratinocytes probably originated the cortex separating medulla from the external cells that became the inner root sheath. The hypothesis indicates that in a following stage, the medulla was obliterated or replaced by cortical cells while the external part of the cortex formed a cuticular surface due to the different growth rate with inner root sheath cells.     

Studies on Biosynthesis on Biotin by Microorganisms

The accumulation of biotin-vitamers in the culture media of a large number of microorganisms (about 700 strains) was studied. The contents of the biotin-vitamers were quantitatively determined by microbiological assays with Lactobacillus arabinosus and Saccharomyces cerevisiae.

It was found that large amounts of biotin-vitamers were accumulated by various microorganisms such as Streptomyces, molds and bacteria, and that the yield of biotin-vitamers was enhanced by the addition of pimelic acid or azelaic acid to the media. It was also found that the main portion of the vitamers accumulated by many microorganisms did not support the growth of Lactobacillus arabinosus, while it did support that of Saccharomyces cerevisiae. The small amounts of true biotin were observed in the culture media of various Streptomyces and molds, but hardly in the culture media of bacteria.

The identification of biotin-vitamers accumulated by various microorganisms is described, and the distribution of the vitamers in microorganisms is also described.

The results presented in this paper show that the main component of the vitamers accumulated by many microorganisms is identified as desthiobiotin by anion exchange column chromatography, paper chromatography and chemical analysis. Small amounts of fraction B (unidentified vitamers) and Fraction D (biotin) were also detected in the culture media of various molds and Streptomyces. However, these fractions were not observed in the culture media of any bacteria tested.

It was also found that large amounts of an unknown biotin-vitamer was accumulated by various bacteria. The vitamer was avidin-uncombinable, and, from the paper electrophoretic studies, it was assumed that the vitamer might be an analogue of pelargonic acid.