职场正念对护士工作使命感影响及组织认同中介效应

目的 探讨职场正念对护士工作使命感的影响并检验组织认同的中介效应。方法 通过一个横断面式的网络问卷调查收集资料,采用阶层线性回归法验证变量间的作用关系。结果 职场正念能够显著正向预测组织认同（β=0.348,P＜0.01）和工作使命感（β=0.281,P＜0.01）;组织认同能够显著正向预测工作使命感（β=0.534,P＜0.01）;组织认同在职场正念与工作使命感的关系中扮演部分中介角色。结论 职场正念可以提升护士组织认同与依附,进而间接促进工作使命感。同时,职场正念可以通过提升核心自我评价、提高职业生涯韧性和维护护士职业适应进而直接提高她们的工作使命感。     

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。     

职场正念对护士离职意向影响及知觉压力中介效应

目的 探讨护理职场正念对知觉压力和离职意向的影响,并检验知觉压力的中介机制。方法 采用横断面网络问卷调查收集数据,使用阶层线性回归法验证变量间的相互关系。结果 护士的职场正念处于较高水平（M=4.74,SD=0.63）;职场正念对护士知觉压力（β= -0.244,P＜0.01）和离职意向（β= -0.235,P＜0.01）具有负向预测作用,知觉压力扮演了部分中介效应（β=0.076）。结论 职场正念可以抑制护士的知觉压力水平,并能降低护士个体的离职意向。     

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。     

哈尔滨市辖区ICU护士职业价值观现况分析

目的 评估哈尔滨市辖区ICU护士职业价值观现状,提出改善ICU护理人力资源管理的对策和依据。方法 采用Weis护士职业价值观量表修订版（NPVS-R）从哈尔滨市辖区内随机抽取130名ICU护士进行问卷调查。结果 结果显示问卷调查发现哈尔滨市ICU护士职业价值观平均得分99.17,总体对职业价值认同感较好,其中行动主义维度总体得分最高;不同人口学特征的护士对职业价值观的认同情况有显著差异。结论 研究证实目标地区ICU护士职业价值观认同情况较好;提示医院管理者应注重ICU护士的职业价值观,将其视为引导护士改善工作质量,提升工作绩效的有力工具。     

不同工作模式对医务人员职业精神的影响

??????? 目的 探讨不同工作模式下医务人员职业精神表现的差异。方法 以“优质护理服务工程”、产科“一贯制”工作模式和传统工作模式为基础,通过访谈法和问卷调查对护士和医生两个群体进行统计分析。结果 （1）工作模式对医务人员工作积极性变化和员工满意度有显著影响,试点工作模式得分均高于传统模式。（2）护士和医生员工满意度的原因各不相同：护士偏重工作本身方面,包括工作条件改善、工作内容多样和工作自主性增强;医生偏重自身发展方面,包括医院政策、晋升机会和绩效分配的合理性。（3）工作模式对医务人员工作敬业度和工作倦怠影响不显著,但是对工作敬业度中个别条目影响显著,并且护士和医生各不相同。结论 社会各界应重视医改中工作模式变化对医务人员职业精神产生的影响。     

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。     

医疗纠纷案例处理方式的Meta分析

目的 综合分析协商、调解、诉讼等医疗纠纷处理方式的使用情况,以期为完善医疗纠纷处理机制提供参考。方法 搜索近年研究医疗纠纷的相关文献,运用Meta分析方法对医疗纠纷案例研究中的数据进行统计和处理,分析各种医疗纠纷处理方式的使用分布情况。结果 在引入医疗纠纷人民调解之前,文献研究中各种处理方式所占比例分别为：双方协商解决65%、卫生行政调解23%、诉讼19%。而在引入医疗纠纷人民调解之后,文献研究中各种处理方式所占比例分别为双方协商解决75%、医疗纠纷人民调解17%、卫生行政调解1%、诉讼6%。结论 医患双方协商解决仍为目前医疗纠纷的主要处理方式,随着医疗纠纷人民调解的逐步发展,多元化的医疗纠纷处理机制将日趋完善。     

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。     

Action Research as a Professional Development Activity

Reflective teachers are always searching for ways to improve their teaching. When this reflection becomes intentional and systematic, they are engaging in teacher research. This type of research, sometimes called action research, can help bridge the gap between theory and practice by addressing topics that are relevant to practicing teachers. This article synthesizes literature within music education and general education to address (a) the conceptual underpinnings of action research, (b) characteristics of action research and teacher research, (c) action research critiques, and (d) implications for teacher research as a form of professional development.     

医院多学科专业技术人员订单培养模式的构建

2006年，教育部《关于全面提高高等职业教育教学质量的若干意见》（教高［2006］16 号文）明确提出要“改革人才培养模式，积极推行订单培养”。这份纲领性文件出台后，全国各级各类职业院校都在用不同的形式对这种教学模式进行探索。总结了北京大学人民医院在教育部高教司的支持下，探索医院多学科卫生专业技术人员订单培养模式的经验与存在的问题，为医院卫生专业技术人才培养提供了新思路。     

Professional obligations in the conservation of fishes

Species and habitat endangerment have reached a point where complacency toward conservation efforts is unacceptable. Powerful political forces oppose conservation of biodiversity, requiring a more coordinated effort to protect increasingly endangered biota. This calls for enhanced communication as conservation biologists in government agencies grasp for information that can best be produced by the university scientist. Ethics and reality now demand that scholarship of application be given at least equal consideration with scholarship of discovery. The same intense interest that inspires research carries with it a strong, implied obligation to pass on to future generations a biota undiminished from the one we inherited. Yet academe is fraught with researchers who, seemingly oblivious to deteriorating ecosystems and motivated to meet advancement requirements, often lose sight of a deeper, less egocentric direction. Advocacy in any form, they fear, may serve to compromise both objectivity and reputation, a situation often overlooked by critics within government who remain unaware of traditions and intransigence within the academy. Undergraduate curricula, and faculty selection and advancement criteria need to be restructured as a means of reaching an acceptable middle ground. Otherwise, we may soon find ourselves in the untenable position of having made major contributions to the literature of a rapidly disappearing biota that might have been saved by utilizing less flawed protocols and attitudes. A broadening of philosophies, goals, and values is mandatory, lest we lose sight of our mutual responsibility: the long-term integrity and welfare of the marvelous biological resource that comprises our stewardship and continues to evade our absolute comprehension.     

Standard of Care,Professional Obligations,and Distributive Justice

The problem of standard‐of‐care in clinical research concerns the level of care that investigators ought to provide to research subjects in the control arm of their clinical trials. Commentators differ sharply on whether subjects in trials conducted in lower income countries should be provided with the same level of care as subjects in trials conducted in higher income countries. I consider an argument that commentators have employed on both sides of this debate: professional role arguments. These arguments claim to justify a conclusion to the standard‐of‐care problem solely by appeal to the professional obligations that investigators possess. I argue that prominent versions of professional role arguments cannot justify a solution to the problem of standard‐of‐care that is both determinate and reasonable simply by appeal to the professional obligations of investigators. Instead, to do so, one must also (1) determine the level of care or types of treatment that individuals are entitled to as a matter of distributive justice, and (2) identify which agents possess the duties that correspond to these entitlements. The level of care that investigators owe to subjects in the control arm of their clinical trials is thus in part dependent on the level of care that these subjects are entitled to as a matter of distributive justice, and whether it is the investigators who possess the corresponding distributive obligation to provide them with the care that they are entitled to.     

生物科学类专业期刊网络化现状调查与分析

通过网上实际检索的方法,对108种生物学专业期刊的网络化状况进行了调查研究,并针对其存在问题提出了一些改进对策。     

Professional Hubris and its Consequences: Why Organizations of Health‐Care Professions Should Not Adopt Ethically Controversial Positions

In this article, I argue that professional healthcare organizations such as the AMA and ANA ought not to take controversial stances on professional ethics. I address the best putative arguments in favor of taking such stances, and argue that none are convincing. I then argue that the sort of stance‐taking at issue has pernicious consequences: it stands to curb critical thought in social, political, and legal debates, increase moral distress among clinicians, and alienate clinicians from their professional societies. Thus, because there are no good arguments in favor of stance‐taking and at least some risks in doing so, professional organizations should refrain from adopting the sort of ethically controversial positions at issue.     

北京三级公立医院专业型行政管理人员工作满意度调查

目的 研究北京三级公立医院专业型行政管理人员工作满意现状,提出改进建议。方法 对北京市三级公立医院184名行政管理人员进行问卷调查。结果 北京三级公立医院专业型行政管理人员对工作整体较满意,且其综合满意度高于业务转型,但对福利、薪酬、晋升、工作流程不满意。结论 （1）医院应鼓励行政管理人员进修管理专业,并对其进行职业规划管理;（2）建立独立的管理职称晋升系列和合理的行政管理人员绩效考核制度;（3）进行工作流程再造;（4）提高行政管理人员工资待遇,构建良好的薪酬管理体系。     

医疗保险专业委员会的工作实践与思考

如何保证医、保、患三方和谐发展，建立良好沟通平台，这是我国医疗保险制度建立实施过程中面临的主要问题。天津市医保专业委员会在3年工作中进行了探索和尝试，取得较好业绩。从医疗保险专业委员会成立的背景、工作职责、工作内容、存在的问题4个方面作了介绍，并提出了改进建议。     

Academic Freedom and the Professional Responsibilities of Applied Ethicists: A comment on Minerva

Academic freedom is an important good, but it comes with several responsibilities. In this commentary we seek to do two things. First, we argue against Francesca Minerva's view of academic freedom as presented in her article ‘New threats to academic freedom’ on a number of grounds. We reject the nature of the absolutist moral claim to free speech for academics implicit in the article; we reject the elitist role for academics as truth‐seekers explicit in her view; and we reject a possible more moderate re‐construction of her view based on the harm/offence distinction. Second, we identify some of the responsibilities of applied ethicists, and illustrate how they recommend against allowing for anonymous publication of research. Such a proposal points to the wider perils of a public discourse which eschews the calm and careful discussion of ideas.     

临床专业学位研究生培养与住院/专科医师培训的比较研究

通过对临床专业学位研究生培养与住院/专科医师培训模式的比较研究,尝试对两者进行同一化管理,将利于量化临床型研究生临床能力培养情况,提高招生吸引力,利于挑选优秀临床型研究生,与住院医师规范化培训对象招录工作相衔接。