目的 探讨专项调查重点科室医务人员手卫生依从性及知识知晓情况结合院感信息系统在降低医院感染中的应用效果。方法 选取2018年1月—2020年12月本院重点科室收治的患者527例,根据入院时间进行分组,对照组采取常规院感管理,观察组采取基于院感信息系统的管理方式,并对重点科室的100名医务人员手卫生依从性及相关知识知晓情况进行专项调查,比较2组医务人员手卫生依从性、手卫生知识知晓程度及医院感染率的差异。结果 观察组医务人员执行各项操作的手卫生依从性、手卫生知识评分均高于对照组(P<0.05);观察组患者医院感染率低于对照组(P<0.05)。结论 采用专项调查重点科室医务人员手卫生依从性及知识知晓结合院感信息系统,能有效提高医务人员的手卫生依从性及相关知识知晓程度,降低医院感染的发生风险。
Objective To discuss the effect of applying special investigation on the hand hygiene compliance and knowledge of medical staff in key departments combined with nosocomial infection information system in reducing nosocomial infections. Methods A total of 527 patients admitted to the key departments from January 2018 to December 2020 were selected, and were grouped according to the time of admission.The control group received routine nosocomial infection management, and the observation group received the management based on nosocomial infection information system.A special survey of hand hygiene compliance and related knowledge was carried out on 100 medical staff in those department, and the differences in hand hygiene compliance, hand hygiene knowledge and nosocomial infection rates between the two groups were compared. Results The hand hygiene compliance and hand hygiene knowledge scores of the medical staff in the observation group were significantly higher than those in the control group (P<0.05). The infection rate of observation patients was lower than control patients (P<0.05). Conclusions The use of special survey on hand hygiene compliance and knowledge of medical staff in key departments combined with nosocomial infection information systems can effectively improve medical staff's hand hygiene compliance and related knowledge, reduce the risk of nosocomial infections, which is worthy of promotion.
目的 了解广州市白云区医护人员对艾滋病感染者/患者（PLWHA）的歧视态度情况,分析其影响因素,并为降低医护人员对PLWHA的歧视态度提供建议。方法 以Lau等设计的AIDS歧视态度量表和张燕等研制的医护人员对PLWHA治疗意愿量表为主设计的调查问卷,对广州市白云区的医护人员进行随机抽样调查,对结果进行描述,研究两量表得分与HIV知识水平的相关性。结果 广州市白云区7家医疗机构并接受培训议会的医护人员AIDS歧视态度量表和治疗意愿量表平均得分分别为（46.66±10.23）分和（32.74±5.89）分,医护人员性别和接受HIV培训的AIDS歧视量表得分存在统计学差异（P<0.01）,单位、性别和接受HIV培训与否的治疗意愿量表得分存在统计学差异（P<0.05）;HIV知识水平与AIDS歧视量表得分和治疗意愿量表得分存在相关性,相关系数值rs分别为-0.301（P<0.001）和-0.219（P<0.001）。结论 广州市白云区医护人员的性别、接受培训与否和HIV知识水平对AIDS歧视量表和治疗意愿量表得分均有影响。应加强白云区医护人员的艾滋病知识培训和各人群的权益保护,以降低医护人员对PLWHA的歧视态度。
Objective To understand the discriminatory attitudes of medical staff to people living with HIV/AIDS（PLWHA）in Guangzhou Baiyun District,analyze the influencing factors,and provide suggestions for reducing the discriminatory attitudes of medical staff to PLWHA．Methods Based on Lau's AIDS Discrimination Attitude Scale and Zhang Yan's Medical Personnel's Adjustment Questionnaire for PLWHA Treatment Willingness Scale,the questionnaire was designed to do a random sampling survey among medical personnel in Guangzhou Baiyun District,and the results were described by regression analysis,to study the correlation between the scores of the two scales and the level of HIV knowledge．Results The average scores of AIDS Discrimination Attitude Scale and Treatment Willingness Scale of medical staff in 7 medical institutions with training in Guangzhou Baiyun District were（46.66±10.23）and（32.74±5.89）respectively．There were statistical differences in AIDS discrimination scale scores of medical staff's gender and whether they received training or not（P< 0.01）,and there were statistical differences in Treatment Willingness Scale scores among institutions,gender and whether they received training or not（P< 0.05）．HIV knowledge level was correlated with the scores of AIDS Discrimination Scale and Treatment Willingness Scale,and the correlation coefficients were -0.301（P < 0.001）and -0.219（P < 0.001）．Conclusions Gender,training or not,and HIV knowledge level of medical staff in this area have an impact on the scores of the AIDS Discrimination Scale and the Treatment Willingness Scale．In order to reduce the discriminatory attitude of medical staff towards PLWHA,the AIDS knowledge and the protection of rights and interests of all groups should be strengthened.
目的 从社会组织网络嵌入性的角度,探讨公立医院医务人员工作内外匹配（包括组织匹配和区域匹配）在人际信任与隐性医学知识共享行为之间的中介效应,完善公立医院医务人员隐性医学知识共享机制的研究。方法 采用问卷调查方式对公立医院医务人员进行调查,运用SPSS 17.0软件进行数据分析,采用AMOS 22.0建立公立医院医务人员工作内外匹配在人际信任与隐性医学知识共享行为之间的中介效应回归方程。结果 公立医院医务人员人际信任与隐性医学知识共享行为之间有显著的正相关关系,标准化回归系数为0.446（P <0.001）。加入工作内外匹配变量后,公立医务人员人际信任对隐性医学知识共享行为的标准化回归系数由0.446（P <0.001）降到0.189（P<0.01）。结论 公立医务人员人际信任正向预测隐性医学知识共享行为;组织匹配、区域匹配在公立医务人员人际信任与隐性医学知识共享行为之间具有部分中介效应。
Objective To explore a new path of interpersonal trust impact on knowledge sharing behavior-being from the perspective of job embeddedness．Methods Questionnaire survey was used to investigate the medical staff in public hospitals．SPSS 17.0 software was used to analyze the data．AMOS 22.0 was used to establish the regression equation of intermediary effect between interpersonal trust and tacit medical knowledge sharing behavior of medical staff in public hospitals．Results There was a significant positive correlation between interpersonal trust and tacit medical knowledge sharing behavior．The standardized regression coefficient was 0.446（P <0.001）．When added the fitting to organization and community,the standardized regression coefficient decreased from 0.446（P <0.001）to 0.189（P <0.01）．Conclusions The interpersonal trust of public medical staffs positively predicts the tacit medical knowledge sharing behavior．Organizational matching and regional matching have partial mediating effect between interpersonal trust and tacit medical knowledge sharing behavior of public medical staff.
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．
目的 了解疫情期间医护人员代谢综合征(MS)、高同型半胱氨酸血症(HHcy)的患病率、二者关系及靶器官损害。方法 选取2020年1月—2021年11月在天津市某三级综合医院的1 544名医护人员作为研究对象。测量人体指标,测定血液生化、免疫等指标。分析MS及其组分的患病率、HHcy的患病率及靶器官损害。采用χ2检验,比较MS组、HHcy组与对照组靶器官损害的差异。采用Logistic回归模型分析MS与HHcy的关系。结果 三级综合医院医护人员疫情期间MS患病率为23.7%,MS组分:中心性肥胖、高血压/高血压病、高甘油三酯、低高密度脂蛋白和高空腹葡萄糖/糖尿病的患病率分别为49.4%、19.3%、24.3%、0.5%和37%。HHcy的患病率为29.7%。MS组、HHcy组与对照组靶器官损害程度差异有统计学意义(P<0.001)。HHcy与MS无直接相关性。结论 疫情期间医护人员MS和HHcy患病率较高,与对照组相比有明显的靶器官损害,HHcy不是MS的独立危险因素。
Objective To explore the prevalence of metabolic syndrome (MS) and hyperhomocysteinemia (HHcy), their relationship and target organ damage among medical staff during the pandemic. Methods A total of 1 544 medical staff in a third-class general hospital in Tianjin from January 2020 to November 2021 were selected as the object of study. The indexes of human body were measured, and the indexes of blood biochemistry and immunity were detected. The prevalence of MS and its components, the prevalence of HHcy and target organ damage were analyzed. χ2 test was used to analyze the difference of target organ damage among MS group, HHcy group and control group. The relationship between HHcy and MS was analyzed by Logistic regression model. Results The prevalence of MS among medical staff in the third-class general hospital during the pandemic was 23.7%. The prevalence of central obesity, hypertension / hypertension disease, high triglyceride, low high density lipoprotein cholesterol and high fasting plasma glucose/diabetes were 49.4%, 19.3%, 24.3%, 0.5% and 37%, respectively. The prevalence of HHcy was 29.7%. There was significant difference in target organ damage among MS group, HHcy group and control group (P<0.001). There was no direct correlation between HHcy and MS. Conclusions During the pandemic period, the prevalence of MS and HHcy in medical staff were high, and there was obvious target organ damage in those staff compared with the control staff. HHcy is not an independent risk factor of MS.
目的 了解医务人员临床工作中血源性职业暴露的情况、暴露后的心理健康状况及其影响因素,采取干预措施,保障医务人员身心健康。方法 对医院2013年1月—2017年12月上报的79例血源性职业暴露者,在1个月内进行现状调查,同时采用自填式问卷症状自评量表(SCL-90)对调查对象进行调查,对其暴露后的心理影响程度进行评估。结果 医务人员在发生血源性职业暴露后其中躯体化因子、人际关系敏感因子、抑郁因子、焦虑因子在职业暴露前后的比较及与未发生职业暴露的医务人员相比较,均有不同程度的提高,差异均有统计学意义(P<0.001)。单因素分析显示影响血源性职业暴露后医务人员的心理健康状况的因素有年龄、职业、工龄、既往发生职业暴露史和患者患传染病种类(P<0.05)。其中年龄在21~25岁年龄的医务人员的得分较高,职业为医生和陪护工人的得分较高,工龄在1~5年的得分较高,既往发生过职业暴露的医务人员得分较高,患者患传染病类型为梅毒及暴露源不明的得分较高。结论 医务人员在发生血源性职业暴露后,其心理健康状态可受到较大影响;工龄、既往发生职业暴露史和患者患传染病种类是医务人员发生血源性职业暴露后心理状况健康的独立影响因素。医院管理者在重视预防及减少职业暴露的同时,更应关注血源性职业暴露后的心理变化,及时提供心理支持和医疗帮助。
目的 探讨中青年医护人员血尿酸(UA)水平与心血管危险因素的关系。方法 利用国人缺血性心血管疾病发病危险的评估方法及简易评估工具“心血管危险积分”评价982名中青年医护人员的心血管危险因素,计算其危险评分积分值,用四分位法根据UA值将研究对象分为四组,比较不同分组间的临床资料,分析UA水平与心血管危险因素的关系。结果 UA水平与心血管危险因素存在正相关(P＜0.01);Ⅲ、Ⅳ组心血管危险积分均高于Ⅰ、Ⅱ组,差异有统计学意义(P＜0.01)。结论 UA增高是心血管疾病的一个重要危险因素,重视高尿酸血症的防治,对预防中青年医护人员的心血管疾病的发生具有重要意义。
Objective To study the relationship between serum uric acid levels and risk factor of cardiovascular disease in young and middle-aged medical staff. Methods Using of risk assessment method and simple assessment tools of cardiovascular risk score of Chinese ischemic cardiovascular disease, the study appraised risk factors of cardiovascular disease about 982 young and middle-aged medical staffs, calculated the risk score integral value. The study divided objects of study into four groups with quartile's method according to serum uric acid levels, compared clinical data between different groups, analyzed the correlation between uric acid level and cardiovascular risk factors. Results Serum uric acid level and cardiovascular risk factors had positive correlation(P<0.01); Ⅲ,Ⅳ group's cardiovascular risk score were higher than Ⅰ, Ⅱ group; the difference had statistics significance(P<0.01). Conclusion Hyperuricemia is an important risk factors in cardiovascular disease. Paying attention to hyperuricemia prevention has important significance to prevention of cardiovascular disease in young and middle-aged medical staff.
目的 探讨女性医务人员月经改变的影响因素及与心理状态的相关性。方法 对深圳市3家医院女性医护人员进行随机抽样得到869份问卷调查样本，均为知情自愿参与本项调查研究。统计女性医务人员出现女性月经改变的比率和月经改变的基本特征，并采用单因素和多因素分析的方法分析影响月经改变因素。并以抑郁症筛查量表（PHQ-9）评估女性医护人员的心理状态，分析女性医务人员月经改变与心理状态评分间相关性。结果 869名女性医护人员中有293例发生月经改变，改变率为33.72%，其中月经周期改变94例、经期时间改变86例、月经量改变68例、痛经改变45例。将869例女性医护人员分为月经正常组和月经改变组，经单因素分析，两组间的年龄、职业、值夜班频率、既往病史、新冠感染等比较差异无统计学意义（P＞0.05）。月经改变组的护士占58.36%高于月经正常的24.48%，月经改变组的新冠一线抗疫人员占64.51%高于月经正常的27.08%，月经改变组合并妇科疾病史的占比20.82%（61例）高于月经正常组的占比11.98%（69例）。而月经改变组的护士、新冠一线抗疫人员、合并妇科疾病史、新冠感染的比较差异有统计学意义（P＜0.05）。多因素分析显示，职业为护士、合并妇科疾病史、新冠一线抗疫人员的P值分别为0.001、0.004、＜0.001，故而职业为护士、合并妇科疾病史、新冠一线抗疫人员是女性医务人员月经改变的危险因素。月经改变组PHQ-9评分为9.10±2.57，月经正常组PHQ-9评分为5.98±1.06，月经改变组PHQ-9评分高于月经正常组（P＜0.001）。两组受试者PHQ-9评分比较差异具有统计学意义，月经改变组PHQ-9评分中0～4分受试者为26.3%，月经正常组为47.2%，月经改变组PHQ-9评分中0～4分者比例小于月经正常组，差异具有统计学意义（P＜0.05）。结论 女性医务人员中职业为护士、合并妇科疾病史、新冠一线抗疫人员是月经改变的主要危险因素，且月经改变与心理状态有密切的相关性，需引起医疗机构的关注。
Objective To analyze the influencing factors of menstruation changes of female medical staff and the correlation with their psychological status．Methods The female medical staff in three hospitals of Shenzhen were randomly sampled to get 869 questionnaires，with informed and willing to participate in this research．The rate of female menstruation changes and the basic characteristics of menstruation changes in female medical staff were calculated，and the influencing factors of menstruation changes were analyzed by single factor and multi factor analysis．And the psychological status of female medical staff was using the Depression Screening Scale （PHQ-9），and the correlation between menstrual changes and psychological status scores of female medical staff were analyzed．Results Among 869 female medical staff，293 had hemorrhagic menstrual disease，with a change rate of 33.72%．Among them，94 had changes in menstrual cycle，86 had changes in menstrual period days，68 had changes in menstrual volume，and 45 had changes in dysmenorrhea．These 869 female medical staff were divided into normal menstruation group and menstrual change group．Through single factor analysis，there was no statistical difference between the two groups in terms of age，careers，night shift frequency，previous medical history，COVID-19 infection （P＞0.05）．The percentage of nurses in the menstrual change group was 58.36%，higher than that of 24.48% in the normal menstruation group．The percentage of frontline medical staff combating COVID-19 in the menstrual change group was 64.51%，higher than that of 27.08% in the normal menstruation group．And the percentage of menstrual change group with a history of combined gynecological diseases was 20.82% （61 cases），higher than that of the normal menstruation group was 11.98% （69 cases）．And the difference was statistically significant when comparing the ratio of nurses，the frontline medical staff combating COVID-19，the history of gynecological diseases，and COVID-19 infection in the menstrual change group （P＜0.05）．Multivariate analysis showed that the occupation of nurses，frontline medical staffs combating COVID-19，and history of gynecological diseases were the risk factors for menstrual changes．The PHQ-9 score of the menstrual change group was higher than that of the normal menstrual group，and the difference was statistically significant．Conclusions The main risk factors for menstrual changes are nurses，frontline anti-epidemic staff，and women with gynecological disease history．Menstrual changes are closely related to mental status，attention from healthcare organizations．
