论著
目的 了解越秀区助产机构医务人员对艾滋病母婴阻断知识及患者相关权益知识掌握情况,为更好地贯彻落实消除艾滋病母婴传播工作提供下一步工作策略和措施依据。方法 于2022年7月—8月,对广州市越秀区5家助产机构妇产科、保健科和医务科的医务人员进行艾滋病母婴阻断知识政策及HIV感染孕产妇相关权益知识的问卷调查。结果 465名医务人员对个别艾滋病母婴阻断政策了解不足,包括“人类免疫缺陷病毒(HIV)感染孕产妇到定点医疗机构终止妊娠或住院分娩时可以获得一定的减免”(知晓率79.78%)、“HIV感染孕产妇的宝宝可以免费领取一定数量的奶粉”(知晓率66.88%);医务人员对HIV感染孕产妇的生育相关权益认识严重不足,对HIV感染孕产妇生育权益认识正确的仅有45.59%。临床护士群体对上述艾滋病母婴阻断政策及HIV感染孕产妇相关权益的知晓率低于临床医生及其他医务人员,组间比较差异有统计学意义(P<0.05)。结论 越秀区助产机构医务人员对艾滋病母婴阻断知识有一定的了解,但掌握不够完整、全面,对HIV感染患者的生育权认识严重不足,应进一步加强对助产机构医务人员、尤其是护士群体关于艾滋病母婴阻断政策知识及患者相关权益的培训,以更好地贯彻落实消除艾滋病母婴传播工作,保障HIV感染患者的权益。
Objective To understand the knowledge of medical staff of midwifery institutions in Yuexiu District about AIDS prevention of mother-to-children transmission(PMTCT)and patients' rights and interests,in order to provide the basis for the following work strategy and measures for better implementation of the elimination of mother-to-child transmission of HIV.Methods From July to August in 2022,a questionnaire survey about knowledge and policies of AIDS PMTCT and rights of HIV infected pregnant women was conducted among the medical staff of obstetrics and gynecology department,health care department and medical department in five midwifery institutions in Yuexiu District of Guangzhou City.Results A total of 465 medical workers had insufficient understanding of some policies on PMTCT of AIDS,including HIV-infected pregnant women can obtain certain fee waiver when they go to designated medical institutions to terminate pregnancy or hospitalized deliver(awareness rate of 79.78%),HIV-infected pregnant women's babies can receive a certain amount of free milk powder(awareness rate of 66.88%).There was a serious lack of awareness of reproductive rights of HIV-infected pregnant women among medical staff,and only 45.59% of them had correct understanding.The awareness rate of the PMTCT and the rights and interests of HIV-infected pregnant women among clinical nurses was significantly lower than that among clinicians and other medical staff.Conclusions The medical staff of midwifery institutions in Yuexiu District have some knowledge about the PMTCT of AIDS,but their knowledge is not complete and comprehensive,and their understanding of the reproductive rights of HIV-infected patients is seriously inadequate,so it is necessary to further strengthen the training of medical staff in midwifery institutions,especially nurses,on the policy knowledge of PMTCT of AIDS and the related rights and interests of patients,in order to better implement the elimination of mother-to-child transmission of AIDS and protect the rights and interests of infected patients.
论著
目的 检验家庭睡眠习惯调查(FISH)在评估孤独症谱系障碍(ASD)患儿睡眠评估中的信度和效度。方法 随机抽取在清远市妇幼保健院儿童语言行为科干预的199例2~6岁ASD共患睡眠障碍患儿,其照顾者同时完成FISH和儿童睡眠习惯问卷(CSHQ),2周后再次同时完成上述两个问卷,以检验FISH的信度和效度。结果 验证性因素分析的结果表明,五因素模型拟合良好(χ2=79.05,df=44,χ2/df=1.80, P<0.001,SRMR=0.06,GFI=0.94,IFI=0.89,RMSEA=0.06),总量表及各分量表有较高的内部一致性信度(0.71~0.77)和重测信度(0.79~0.88)。FISH的白天习惯分别与CSHQ的入睡延迟、夜醒呈负相关,入睡前习惯分别与CSHQ的睡眠抵触、睡眠焦虑、白天睡眠呈负相关,睡眠常规分别与CSHQ的睡眠抵触、入睡延迟、睡眠焦虑呈负相关,睡前父母行为分别与CSHQ的睡眠抵触、睡眠焦虑呈负相关,总分与CSHQ总分呈负相关,差异均有统计学意义(P<0.05)。结论 FISH具有较好的信度和效度,可作为ASD患儿睡眠习惯的评估工具。
Objective To test the reliability and validity of the famity inveritory of sleep habits(FISH) in the sleep assessment among children with autism spectrum disorder (ASD). Methods A random sample of 199 children with ASD and sleep disorders intervened in the Children's Language and Behavior Department of Maternal and Child Health Hospital of Qingyuan City were selected, their caregivers completed the FISH and the children's sleep habit questionnaire(CSHQ) at the same time, and completed the above two questionnaires again 2 weeks later to test the reliability and validity of the FISH. Results The results of confirmatory factor analysis showed that the five-factor model fits well (χ2=79.05, df=44, χ2/df=1.80, P<0.001, SRMR=0.06, GFI=0.94, IFI =0.89, RMSEA=0.06), the total scale and each subscale had high internal consistent reliability (0.71~0.77) and test-retest reliability (0.79~0.88). The daytime habits of FISH were negatively correlated with sleep delay and waking up at night of CSHQ respectively, the habits before sleep of FISH were negatively correlated with sleep conflict, sleep anxiety and daytime sleep of CSHQ respectively, the sleep routine of FISH was negatively correlated with sleep conflict, sleep delay and sleep anxiety of CSHQ respectively, the parents' behavior before sleep of FISH was negatively correlated with sleep conflict and sleep anxiety of CSHQ respectively, and the total score of FISH was negatively correlated with CSHQ, with statistically significant differences (P<0.05). Conclusions The FISH had good reliability and validity, and can be used as an assessment tool for children with ASD.
论著
目的 评估产后女性的认知功能,并分析其认知功能受损的特点,以及分析可能的影响因素。方法 病例组选取健康单胎足月顺产初产妇、二胎产妇,对照组选取一般资料匹配的未生育女性,选用蒙特利尔认知评估(Montreal Cognitive Assessment Test,MoCA)北京版、伯明翰认知评估量表(Birmingham Cognitive Screen test,BCoS)普通话版评估认知功能。结果 实际入组病例组80例产妇,均完成MoCA量表,共42例产妇完成BCoS量表,对照组30例均完成MoCA、 BCoS评估。产妇组(80例)MCA得分为(26.26±2.28)分,低于未生育女性对照组MoCA分数(27.47±1.28)分(P<0.05),产妇组认知障碍发生率为30%高于对照组6.7%(P<0.05)。初产妇组MoCA分数(26.52±2.13)分,认知障碍发生率为26%,二胎产妇组MoCA分数(25.83±2.49)分,认知障碍发生率为36.7%,两者对比无明显差别(P>0.05)。产妇组(80例)在MoCA量表视空间与执行功能分项得分低于对照组(P<0.01);产妇组BCoS评分在故事瞬时回想、苹果删除总数、听觉注意、规则转换、手势模仿5个分项低于对照组(P<0.05)。产妇的受教育年限、分娩镇痛麻醉、总产程时间是产后认知功能下降的影响因素(P<0.05)。结论 ①产后妇女可能发生认知功能障碍,但初产妇与二胎产妇的认知障碍发生率无明显差别。②MoCA量表可以用于产妇产后认知功能筛查,BCoS量表可做为全面评估产妇产后认知功能的工具,产妇产后认知受损主要在视空间、注意力、执行功能(实践与行动能力)、记忆力领域。③产妇的受教育年限、分娩镇痛麻醉、总产程时间是产后认知功能下降的影响因素。
Objective To evaluate the cognitive function of postpartum women, and analyze the characteristics of cognitive dysfunction and the possible affecting factors. Methods The case group selected healthy single-born full-term primiparae (50 cases) and second birth parturient (30 cases), and the control group (30 cases) selected non-fertile women with general data matching. The Montreal Cognitive Assessment Test (MoCA) Beijing version and Birmingham Cognitive Screen test(BCoS) were used to evaluate cognitive function. Results Of the 80 cases in the case group, all completed the MoCA test, only 42 cases completed the BCoS test. The 30 cases in the control group all completed the MoCA and BcoS.The MoCA score of the case group (80 cases) was (26.26±2.28), which was lower than that of the control group (27.47±1.28) (P<0.05). The incidence of cognitive impairment in the case group was 30%, higher than the control group 6.7% (P<0.05). The MoCA score of the primiparae group was (26.52±2.13); the incidence of cognitive impairment was 26%; the MoCA score of the second birth parturient group was (25.83±2.49); the incidence of cognitive impairment was 36.7%.There was no significant difference in the MoCA score and the incidence of cognitive impairment between primiparae and second birth parturient (P> 0.05).The case group had lower scores on visual space and executive function of MoCA test than the control group (P<0.01).The score of BCoS test in the case group was lower than that in the control group in the five items of the instantaneous recall item of the story, apple deletion, auditory attention, Birmingham rule conversion and gesture imitation (P<0.05).The years of education, labor analgesia, and the total duration of labor were the factors that affected the cognitive function of postpartum women (P<0.05). Conclusion ①Postpartum women may have cognitive dysfunction, but there was no significant difference in the incidence of cognitive impairment between primiparae and second birth parturient group. ②The MoCA test can be used for the screening of cognitive impairment of postpartum women, and the BCoS test can be used as a tool to comprehensively evaluate the cognitive function of postpartum women. The cognitive impairment of postpartum women was mainly in the fields of visual space, attention, executive function (practice and action ability), and memory. ③The years of education, labor analgesia, and the total duration of labor were the factors that affect the cognitive function of postpartum women.
论著
目的 调查临床护士对新型冠状病毒肺炎的知信行现状,为制定相关培训策略提供依据。方法 采用便利抽样法,2020年3月选取我院的1 007名临床护士作为研究对象,采用一般资料及临床护士对新型冠状病毒肺炎知信行问卷对其进行调查。结果 1 007名临床护士对新型冠状病毒肺炎的知识、态度、行为得分分别为(28.82±9.22)分、(52.04±5.52)分、(55.38±7.93)分,新型冠状病毒肺炎知信行总分为(136.24±14.52)分。不同年龄、职称、职务、工作年限、何时参加过穿脱防护服操作培训及考核新型冠状病毒肺炎知识得分比较,差异均有统计学意义(P<0.05);工作年限、何时参加过穿脱防护服操作培训及考核,其新型冠状病毒肺炎态度得分比较,差异均有统计学意义(P<0.05);是否参加过穿脱防护服操作的培训及考核、何时参加过穿脱防护服操作培训及考核、是否参加过咽拭子采集的培训及考核的新型冠状病毒肺炎行为得分比较,差异均有统计学意义(P<0.05)。结论 临床护士对新型冠状病毒肺炎的知识得分处于较低水平,态度和行为得分较好,建议护理管理者需加强临床护士对新型冠状病毒肺炎的知识学习及相关培训,以提高护士知识及技能水平。
Objective To investigate the current status of nurses' knowledge, attitude and behavior to new coronavirus pneumonia, to provide the basis for formulating relevant training strategies. Methods In March 2020, 1 007 clinical nurses in our hospital were selected as the research object. The general information and questionnaire about the new coronavirus pneumonia were investigated in these nurses. Results Scores of 1 007 nurses answered the knowledge, attitude and behavior to new coronavirus pneumonia were(28.82±9.22),(52.04±5.52), and(55.38±7.93), respectively. The total score of knowledge, attitude, and behavior to the new coronavirus pneumonia was(136.24±14.52). The differences of scores of knowledge about new coronavirus pneumonia between different ages, job titles, duties, working years, and when they participated in the training and evaluation of wearing and taking off protective clothing were statistically significant (P<0.05). There was a statistically significant difference in the attitude scores of the new coronavirus pneumonia between different working years and when they participated in training and evaluation of wearing protective clothing (P<0.05). There were statistically significant differences in the behavior scores to new coronavirus pneumonia between whether and when they have participated in the training and evaluation of wearing and taking off protective clothing, and whether they had participated in the training and evaluation of pharyngeal swab collection (P<0.05). Conclusion Nurses' knowledge scores for new coronavirus pneumonia are at a low level, but their attitude and behavior scores are higher. It is recommended that new coronavirus pneumonia knowledge and related training should be strengthened for nurses to improve nurses' knowledge and skills.
论著
目的 了解广州市区全血乳糜血报废的趋势变化和献血人群特征,并分析其背后的原因,为进一步减少全血乳糜血报废提供参考依据。方法 通过广州血液中心信息系统检索,统计2017—2019年期间中心全血乳糜血报废量、报废率等相关数据,并分层统计性别、年龄、献血方式与报废的关系,提出有效减少乳糜血报废的对策。结果 2017—2019年期间广州血液中心共采集制备3 003 998单位血液,因乳糜血原因报废的血液达69 311单位,报废率2.31%,占总报废的44.02%。其中,男性献血者乳糜血报废率显著高于女性献血者,报废血液主要为18~40岁年龄段的无偿献血,约一半报废血来自团体献血者。结论 加大献血知识的宣传,特别是团体献血者;做细献血前征询工作和献血后跟踪随访;关注男性和年轻献血者,进一步减少全血乳糜血报废几率。
Objective To evaluate the trend of scrapped chylemia blood in whole blood collection and the characteristics of blood donors in urban area of Guangzhou, analyze the reasons behind so as to provide reference for further reducing chylemia blood scrapped. Methods Search the whole blood collection and scrapped chylemia blood data from 2017 to 2019 through the information system of Guangzhou Blood Center, stratifiy gender,age,donation way, and look for solutions. Results 3 003 998 U blood component were collected and prepared from 2017 to 2019. Totally 69 311 U chylemia blood were scrapped due to chylemia blood, accounting for 44.02% of the total discarded blood. Scrapped chylemia blood rate were significantly higher among male blood donors than among female donors,and mainly aged from 18-40 donors. About half of the discarded blood came from group donors. Conclusion Greater efforts to publicize especially for group donors,careful consultation before blood donation and follow-up after blood donation should be taken. We should pay close attention to male and young blood donors, so as to further reduce the possibility of scrapped chylemia blood.
临床诊疗
目的 描述下肢深静脉血栓(deep vein thrombosis,DVT)患者抗凝药服药知识、信念与依从性的现状并探讨三者间的相关性,为提高下肢DVT患者服药依从性提供依据。方法 采取方便抽样的方法,抽取2019年7月—2020年5月广州市某三甲医院随诊的下肢DVT患者100例。采用一般资料调查表、抗凝药服药知识问卷、中文版服药信念特异性问卷、中文修订版8条目Morisky服药依从性量表进行问卷调查。结果 下肢DVT患者的抗凝药服药知识平均得分为(0.72±0.11)分,处于良好水平;服药信念得分为(2.06±4.34)分,处于中等水平;服药依从性得分为(6.52±1.08)分,处于中等水平;服药知识与服药信念呈正相关(r=0.301,P<0.01),与服药依从性呈正相关(r=0.232,P<0.05);患者的服药信念与服药依从性呈正相关(r=0.373,P<0.01)。结论 提高下肢DVT患者抗凝知识水平可以提高患者的服药信念和服药依从性,提高患者的服药信念可以提高患者的服药依从性。
论著
目的 结合临床现状分析影响护士护患沟通能力的相关因素,并根据影响因素制定相关应对方案。方法 采用《护士临床沟通能力量表》对广州市某三甲医院的941名护士进行调查。结果 护士沟通能力得分为(4.19±0.43)(评分范围为1~5分),其中情感支持能力维度得分最低(4.05±0.37),护士性别、婚姻状况、职称、职务和培训次数不同,其护患沟通能力得分有差异(P<0.05))。结论 护士的情感支持能力有待提高,性别、婚姻状况、职称、职务和接受培训的次数是护患沟通能力的影响因素,管理者应根据护士特征应加强对护士的培训,以提高其护患沟通能力。
Objective Combined with the clinical situation, this paper analyzes the relevant factors that affect the nurse-patient communication ability, and makes relevant countermeasures according to the influencing factors. Methods 941 nurses in a tertiary hospital in Guangzhou were surveyed using the Nurse Clinical Communication Competence Scale. Results The communication competence score of nurses in the hospital was (4.19±0.43) (the score was ranged from 1 to 5), among which nursing staffs' emotional support competence were scored in lowest (4.05±0.37). There was statistically significant in communication competence between nurses with different gender, marital status, job title, position and training times. (P<0.05). Conclusion The emotional support competence of nurses needs to be improved. The gender, marital status, professional title, position and number of trainings are the influencing factors of nurse-patient communication ability. Nursing managers could improve nurses' communication competence by increasing the training of nurses according to their charateristics.
论著
目的 通过对医院保洁员针刺伤危害认知和相关知识问卷调查,检视保洁员自身和其管理者存在的问题,提出有针对性整改措施。方法 采用现场问卷调查的方法,对我院三个院区共304名病房保洁员进行调查,其中男保洁员82人(占27.0%),女保洁员222人(占73.0%)。上岗前接受针刺伤防护知识培训62人(占20.4%),没有接受培训242人(79.6%),P<0.05差异有统计学意义。结果 调查显示,保洁员在工作中曾发生过针刺伤共174人(占57.2%);发生针刺伤后没有上报107人(占35.2%);防护知识缺乏及自我防护意识欠缺,其中不知晓针刺伤的危害性101人(占33.2%);在处理锐器垃圾不戴手套有81人(占26.6%);处理锐器盒时机不正确220人(占72.4%);不知道发生针刺伤后如何处理91人(占29.9%),P<0.05差异有统计学意义。男性保洁员对针刺伤防护认知低于女性保洁员,其中不清楚针刺伤的危害性男性41人(占50.0%),女性占60人(占27.0%),处理锐器垃圾不戴手套男性30人(占36.6%),女性51人(占23.0%);两组比较,差异有统计学意义(P<0.05)。结论 医院保洁员在处理医疗垃圾工作中,针刺伤风险系数高。医院对保洁员上岗前针刺伤培训非常必要,但岗前培训不能完全让保洁员在工作中长期保持对针刺伤的安全认知和防范意识。医院应加强对保洁员工作岗位动态培训和监管,尤其对男性保洁员。管理者不断尝试运用新的管理手段,在思想上建立流程式思维和工作方法,日常工作中不断强化保洁员对针刺伤的防护意识,减少针刺伤的发生,从而保障了保洁员的身心健康。
Objective To investigate the problems of cleaners and their managers,and put forward targeted rectification measures through questionnaire survey on the hazard cognition and related knowledge of needle stick injuries of cleaners in hospitals. Methods On-site questionnaire survey was used to investigate a total of 304 ward cleaners in our hospital. Among them,82 were male cleaners (27.0%) and 222 were female cleaners (73.0%). 62 people (20.4%) were trained in acupuncture protection before taking up work,and 242 people (79.6%) were not trained. There was statistically significant P<0.05. Results The survey showed that a total of 174 cleaning staffs had acupuncture injuries (57.2%)); 107 people (35.2%) were not reported after acupuncture injuries. For lack of knowledge and self-protection awareness,of which 101 people (33.2%) were not aware of the dangers of acupuncture injuries; There were 81 people (26.6%) didn't wear gloves when handling sharps trash;and 220 people (72.4%) had incorrect timing of sharps boxes; 91 people (29.9%) did not know how to handle after a needle stick injury. Male cleaners had a lower awareness of needle stick injuries than female.There were 30 male cleaners (36.6%) and 51 females (23.0%) who did not wear gloves when handling sharps. 41 men (50.0%) and 60 women (27.0%) were not aware of the harmfulness of needle stick injuries. Those difference between the two groups was statistically significant (P<0.05). Conclusion The risk of needle stick injuries is high for hospital cleaners in the treatment of medical waste. It is very necessary to take acupuncture injuries for the cleaning staffs before they take up their posts,but the pre-job training cannot completely keep the cleaning staffs' awareness and prevention awareness of acupuncture injuries for a long-term. Hospitals should strengthen the dynamic training and supervision of cleaning staff,especially for male cleaners. Managers need to constantly try use new management methods to establish process-type thinking and working methods in their minds. In daily work,they continuously strengthen the cleaning consciousness of needle stick injuries and reduce the incidence of needle stick injuries,thereby protecting the physical and mind health of the cleaning workers.
论著
目的 调查口腔专科医院门诊不同层级护士急救能力的现状,进一步探讨优化口腔门诊护士急救培训模式。方法 选取2019年1月—2020年1月我院口腔门诊护士97名,采用自设问卷调查及现场操作技能评估对护士进行考核,调查护士的急救能力。结果 口腔科门诊不同层级护士的急救能力(包括相关知识与操作能力)差异有统计学意义(P<0.05)。其中,N1级(工作1~<3年)的护理人员急救能力低于N2级(工作3~5年)的护理人员。N3级(工作6~10年)的急救知识考核分、操作考核分略低于工作N2级护士,但差异无统计学意义。而不同年龄、学历、职称、科室的护士急救能力的差异无统计学意义。结论 口腔门诊护士急救培训应分层级进行,特别应加强N1级以下护理人员的急救技能培训,保证护士急救培训效果同质化,对口腔门诊诊疗中提高医疗安全及护理质量具有重要意义。
Objective To investigate the current status of the first-aid ability of nurses at different levels in outpatient clinics of stomatological hospitals, and to further explore the optimization of the training model of first-aid nurses in outpatient clinics. Methods A total of 97 nurses in our outpatient clinic from January 2019 to January 2020 were selected. The nurses were assessed by self-designed questionnaire surveys and on-site operation skills assessment to investigate the nurses' first aid ability. Results The difference in first aid ability (including relevant knowledge and operation ability) of nurses at different levels in the dental clinic was statistically significant (P<0.05). Among them, the first-aid ability of nursing staff of N1 grade (working 1 ~<3 years) is lower than that of nursing staff of N2 grade (working 3 ~ 5 years). The N3 level (working 6~10 years) first aid knowledge assessment and operation assessment scores are slightly lower than those of working N2 nurses, but the difference is not statistically significant. There was no statistically significant difference in the first aid ability in nurses of different ages, educational backgrounds, titles, and departments. Conclusion The first-aid training of nurses in oral clinics should be conducted in different levels, especially the first-aid skills training of nurses below N1 level. We should be strengthened to ensure the homogenization of nurse's first-aid training effect, which is of great significance to improve medical safety and quality of care in oral clinics.
医学教育
目的 调查临床医学生医患沟通能力的现状,分析其影响因素。方法 采用《医患沟通技能评价表(SEGUE量表)》对广州市某三甲医院的155名临床医学生进行调查。结果 临床医学生沟通技能总成绩得分率只有58.9%,在5个维度中,沟通结束方面得分率最高,为82.9%,而理解病人方面得分率最低,只有45.5%。性别、接受医患沟通相关培训次数不同的临床医学生,其沟通能力差异有统计学意义(P﹤0.05)。结论 临床医学生的医患沟通能力总体水平有待提高,特别是在理解病人方面。性别和参加医患沟通培训次数是临床医学生沟通能力的影响因素,应加强对医学生在共情能力、情感支持、移情等方面能力的培训,以提高医患沟通能力。
Objective To investigate the status of medical students' doctor-patient communication skill and analyze the influencing factors. Methods An investigation on 155 clinical medical students in a level 3 hospital in Guangzhou was conducted using the Doctor-patient Communication Skills Evaluation Scale (also called SEGUE Scale). Results The clinical medical students’ scoring rate of communication skill was only 58.9%. Among the five dimensions, the scoring rate of communication skill end was the highest, which was 82.9%, while the scoring rate of understanding patients was the lowest, which was only 45.5%. The difference in communication skill between clinical medical students with different gender and the training times related to doctor-patient communication was statistically significant (P<0.005). Conclusion The overall level of doctor-patient communication skill among clinical medical students was needed to be improved, especially on understanding patients. Gender and training times on doctor-patient communication training were the influencing factors of communication skills of medical students. Medical students’skills include empathy and doctor-patient communication skills, etc.