• 【护理工作环境、离职意向、工作倦怠和护理质量: 工作满意度的调节作用。】 复制标题 收藏 收藏
    DOI:10.1111/jnu.12528 复制DOI
    作者列表:Al Sabei SD,Labrague LJ,Miner Ross A,Karkada S,Albashayreh A,Al Masroori F,Al Hashmi N
    BACKGROUND & AIMS: PURPOSE:The purpose of this study was twofold: (a) to assess predictors of the turnover intention, burnout, and perceived quality of care among nurses working in Oman, and (b) to examine the potential moderating role of job satisfaction on the relationship between work environment and nurse turnover intention. DESIGN:A cross-sectional design was used to collect data from a sample of 207 nurses working in a public hospital in Muscat, Oman. METHODS:An electronic survey was used to assess nurses' perceptions of work environment, burnout, job satisfaction, turnover intention, and quality of care. FINDINGS:Participation in hospital affairs, a foundation for quality of care, and staffing adequacy were predictors of burnout among nurses and perceived quality of care. Logistic regression analysis revealed that working in a favorable environment was associated with less turnover intention, but only when job satisfaction was high. CONCLUSIONS:Improving nurse job satisfaction is a mechanism through which future interventions could enhance working conditions and promote better nurse retention. CLINICAL RELEVANCE:Organizational strategies are needed to increase nurse job satisfaction by empowering nurses to take more active roles in hospital affairs as a strategy to reduce turnover intention and enhance the quality of patient care.
    背景与目标:
  • 【与分割厚度皮肤移植相比,较低的供体部位发病率和较高的患者对表皮移植的满意度: 一项随机对照试验 (EPIGRAAFT试验)。】 复制标题 收藏 收藏
    DOI:10.1016/j.bjps.2020.03.006 复制DOI
    作者列表:Kanapathy M,Bystrzonowski N,Hachach-Haram N,Twyman L,Becker DL,Richards T,Mosahebi A
    BACKGROUND & AIMS: BACKGROUND:Split thickness skin grafting (SSG) is an important modality for wound coverage; however, it leads to donor site morbidity. Epidermal grafting (EG) is a promising option for autologous skin grafting which offers minimal donor site morbidity, though it is not known if EG is an effective clinical alternative for SSG. This study compared the efficacy of EG as an alternative to SSG in terms of wound healing outcomes, donor site morbidity, patient satisfaction and adverse events. METHODS:EPIGRAAFT is a Phase 2, randomized, open-label trial with two parallel groups: EG and SSG. Patients referred for skin grafting with a healthy granulating wound bed were included. The co-primary endpoints were the proportion of wounds healed and donor site healing time. The secondary endpoints include donor site morbidity measured using Vancouver Scar Scale, mean time for complete wound healing, patient satisfaction assessed using a validated skin grafting questionnaire and incidence of adverse events. RESULTS:Of the 61 patients screened, 44 patients were randomized. There was no difference in the proportion of wounds healed at 6 weeks (p=0.366) and 3 months(p=0.24) as well as the mean time for wound healing (p=0.12). EG resulted in lower donor site morbidity (p=0.001), faster donor site healing time (EG: 4.86 days vs. SSG: 21.32 days) (p<0.0001), and higher overall satisfaction (p<0.001). There were no adverse events reported. CONCLUSION:This study demonstrated that EG has superior donor site outcomes with faster donor site healing and lower morbidity compared to SSG, while having comparable wound healing outcomes. Patients receiving EG also experienced higher donor site satisfaction compared to SSG. ClinicalTrials.gov identifier: NCT02535481.
    背景与目标:
  • 【急诊医学临床药师对护理满意度的影响】 复制标题 收藏 收藏
    DOI:10.1007/s11096-019-00927-y 复制DOI
    作者列表:Treu CN,Llamzon JL,Acquisto NM,Lazar JD
    BACKGROUND & AIMS: BACKGROUND:In the United States, emergency medicine clinical pharmacists have become more common over the last several decades. Despite being a vital component of the emergency department interdisciplinary team, there is very limited information published regarding the direct impact emergency medicine clinical pharmacists have on other emergency department-based professions. OBJECTIVE:To determine if the addition of an emergency medicine clinical pharmacist improves nursing satisfaction with pharmacy services. SETTING:The study was conducted at a 422-bed urban teaching hospital consisting of approximately 60 emergency medicine nurses. METHODS:This was a prospective study that evaluated nursing satisfaction prior to the initiation of an emergency medicine clinical pharmacist and one year after implementation. The survey consisted of 29 questions and was designed to assess three areas of pharmacy: general pharmacy, pharmacy information technology, and emergency medicine clinical pharmacy services. For the majority of questions, a 5-point Likert scale ranging from 1 representing strongly disagree to 5 representing strongly agree was utilized. Responses for the 5 point Likert scale were further tabulated into either positive or negative responses. All emergency department nurses employed during the study period (September 2015 and 2016) were eligible to participate anonymously. MAIN OUTCOME MEASURE:The main outcome assessed was the difference in satisfaction scores between study periods. RESULTS:A total of 52 surveys were returned over the course of the study (22 [36.7%] in the pre-intervention group versus 30 [50%] in the post-intervention group). All general pharmacy questions were improved at one year with timely resolution of pharmacy related issues, medication procurement, and satisfaction with pharmacy services achieving statistical significance. Pharmacy information technology questions were significantly improved with respect to satisfaction with the automated medication dispensing system inventory, prevention and resolution of medication stock outs, and ease of medication removal compared to baseline. The perceived impact of emergency medicine clinical pharmacy services in the pre-intervention group was validated after the one-year implementation period. CONCLUSION:An emergency medicine clinical pharmacist increases nursing satisfaction with central pharmacy and pharmacy technology services and was able to maintain the nurses' perceived expected role of the clinical pharmacist.
    背景与目标:
  • 【[西班牙南部农村和城市青少年坚持地中海饮食,生活满意度,人体测量学以及身体和久坐活动]。】 复制标题 收藏 收藏
    DOI:10.3305/nh.2013.28.4.6486 复制DOI
    作者列表:Grao-Cruces A,Nuviala A,Fernández-Martínez A,Porcel-Gálvez AM,Moral-García JE,Martínez-López EJ
    BACKGROUND & AIMS: BACKGROUND:The Mediterranean diet is one of the healthier diet models. Mediterranean food patterns are suffering a deterioration that can especially affect children and adolescents. OBJECTIVE:Determine adherence to the Mediterranean diet in adolescents of southern Spain and its relationship with the residence area, sex, age, life satisfaction, anthropometry, and habits of physical activity and sedentary activities. METHODOLOGY:A total of 1973 adolescents (11-18 years) of southern Spain participated in this descriptive cross-sectional study. Cut-off value between rural and urban locations was 10000 inhabitants. Adherence to the Mediterranean diet was calculated from the KIDMED questionnaire. Life satisfaction, physical activity, and sedentary activities also were measured through valid and reliable questionnaires. Body mass index and % body fat were measured using the TANITA BC-420-S body analyzer. RESULTS:30.9% of the adolescents reported an optimal quality diet, percent higher in rural locations (P < 0.05). Adherence was lower in older adolescents (P < 0.001), it was not different between sexes or according to anthropometric variables. Adolescents more satisfied with their lives (P < 0.001), more active (P < 0.001), more studious (P < 0.001), and less sedentary in front of a screen (P < 0.001) showed greater adherence to the Mediterranean food pattern. CONCLUSION:The majority of adolescents need to improve their nutritional quality. Compared with these subjects, the adolescents most adherent to the Mediterranean diet had a healthier lifestyle and they showed greater life satisfaction. :Introducción: La dieta mediterránea es uno de los modelos más saludables de dieta. Los patrones alimentarios mediterráneos están sufriendo un deterioro que puede afectar especialmente a niños y adolescentes. Objetivo: Determinar la adherencia a la dieta mediterránea de los adolescentes del sur de España y su relación con el área de residencia, sexo, edad, satisfacción con la vida, características antropométricas y hábitos de actividad física y sedentaria. Métodos: Un total de 1.973 adolescentes (11-18 años) del sur de España participaron en este estudio descriptivo transversal. El punto de corte entre poblaciones rurales y urbanas fue 10.000 habitantes. La adherencia a la dieta mediterránea fue calculada a partir del cuestionario KIDMED. Satisfacción con la vida, actividad física y sedentarismo también mediante cuestionarios fiables y válidos. Índice de masa corporal y % de grasa corporal fueron medidos utilizando el analizador corporal TANITA BC-420-S. Resultados: El 30,9% de los adolescentes reportó una dieta de calidad óptima, porcentaje superior en poblaciones rurales (P < 0,05). La adherencia fue menor en los adolescentes de mayor edad (P < 0,001), sin diferir entre sexos ni según las variables antropométricas. Los adolescentes más satisfechos con sus vidas (P < 0,001), más activos (P < 0,001), más estudiosos (P < 0,001) y menos sedentarios delante de una pantalla (P < 0,001) mostraron mayor adherencia al patrón alimentario mediterráneo. Conclusión: La mayoría de adolescentes necesitan mejorar su calidad nutricional. En comparación con estos sujetos, los más adheridos a la dieta mediterránea llevaban un estilo de vida más saludable y mostraron mayor satisfacción con sus vidas.
    背景与目标:
  • 【在美国,直接面向消费者的广告对他汀类药物使用的影响。】 复制标题 收藏 收藏
    DOI:10.1097/MLR.0000000000000752 复制DOI
    作者列表:Chang HY,Murimi I,Daubresse M,Qato DM,Emery SL,Alexander GC
    BACKGROUND & AIMS: IMPORTANCE:The value of direct-to-consumer advertising (DTCA) of prescription drugs is widely debated, as is the effect of DTCA on prescription sales and health care utilization. OBJECTIVE:We examined the association between DTCA intensity for statin medications and prescription sales and cholesterol-related health care utilization. DESIGN, SETTING, AND PARTICIPANTS:We conducted an ecological study for 75 designated market areas from 2005 to 2009 in the United States using linked data regarding televised DTCA volume, non-DTCA marketing and promotion, retail, mail order and long-term care prescription drug sales, prescription drug and ambulatory care health care utilization, and contextual factors such as health care density and socioeconomic status. Main outcomes and measures were volume of sales, number of dispensed prescriptions, and high cholesterol-related outpatient visits. Analyses were conducted in 2016. RESULTS:The intensity of rosuvastatin and atorvastatin ad exposures per household varied substantially across designated market areas. After adjustment for socioeconomic, demographic, and clinical characteristics, each 100-unit increase in advertisement viewership was associated with a 2.22% [95% confidence interval (CI), 0.30%-4.19%] increase in statin sales. Similar patterns were observed between DTCA and statin dispensing among the commercially insured. DTCA was associated with increases in high cholesterol-related outpatient visits among adults 18-45 years of age (3.15% increase in visits per 100-unit increase in viewership, 95% CI, 0.98%-5.37%) but not among those 46-65 years of age (0.51%, 95% CI, -1.49% to 2.55%). CONCLUSION:DTCA for statins is associated with increases in statin utilization and hyperlipidemia-related outpatient visits, especially for young adults.
    背景与目标:
  • 【抢劫暴露对创伤后压力与工作满意度之间关系的调节作用。】 复制标题 收藏 收藏
    DOI:10.2486/indhealth.2019-0096 复制DOI
    作者列表:Montani F,Sommovigo V,Setti I,Giorgi G,Argentero P
    BACKGROUND & AIMS: :Research has disregarded the boundary conditions of the effects of post-traumatic stress symptoms (PTSS) at work. Addressing this issue, the present study examines the moderating impact of the (shared vs. isolated) exposure to robbery on the relationship between PTSS and employee job satisfaction. Drawing on the conservation of resources theory, we argue that PTSS would positively affect employee job satisfaction when the robbery is experienced collectively. To test our predictions, we conducted a two-wave study-with a lag of two months between measurements-on 140 employees from a national bank in Italy. Results from hierarchical regression analyses supported our prediction: the exposure to robbery moderated the relationship between PTSS and job satisfaction. While within the "isolated exposure" group the job satisfaction score was higher among less symptomatic victims, within the "shared exposure" group those with high PTSS reported higher job satisfaction levels than those with low PTSS. We discuss the implications of these findings for theory and practice.
    背景与目标: : 研究忽略了创伤后应激症状 (PTSS) 在工作中的影响的边界条件。针对这一问题,本研究探讨了抢劫 (共享与孤立) 暴露对PTSS与员工工作满意度之间关系的调节影响。根据资源守恒理论,我们认为,当集体经历抢劫时,PTSS会对员工的工作满意度产生积极影响。为了检验我们的预测,我们对意大利一家国家银行的140名员工进行了两波研究-两次测量之间间隔了两个月。分层回归分析的结果支持了我们的预测: 抢劫的暴露减轻了PTSS与工作满意度之间的关系。在 “孤立暴露” 组中,症状较少的受害者的工作满意度得分较高,而在 “共享暴露” 组中,具有高PTSS的人报告的工作满意度水平高于具有低PTSS的人。我们讨论了这些发现对理论和实践的影响。
  • 【护士从业者和管理式护理: 患者满意度和坚持护士从业者护理计划的意图。】 复制标题 收藏 收藏
    DOI:10.1111/j.1745-7599.2007.00245.x 复制DOI
    作者列表:Hayes E
    BACKGROUND & AIMS: PURPOSE:To explore patient satisfaction, intention to adhere to nurse practitioner (NP) plan of care, and the impact of managed care on NPs' patients in multiple settings, the final phase of a three-part study of NPs and managed care. DATA SOURCES:Postvisit questionnaires and narrative comments about patient satisfaction with NP communication, overall satisfaction with visit, recall of plan of care, intention to adhere to NP's recommendations, and impact of managed care on ease of obtaining healthcare resources. CONCLUSIONS:Patients were very satisfied with NP communication and with their healthcare visit. They mostly intended to adhere to the NP-recommended plan of care but less so to recommended lifestyle changes. Patients trusted their NPs, valued their expertise, were confident in the NPs' care, and believed that the NPs considered their best interests. They appreciated that the NPs took time to listen to their concerns and helped them to obtain healthcare resources. Most patients were not greatly impacted by managed care and obtained needed healthcare resources with little difficulty. IMPLICATIONS FOR PRACTICE:Although the first two phases of this study found that many NPs had strong negative attitudes toward managed care, these attitudes were not conveyed toward patients in this sample. NPs, however, will continue to face new challenges as third-party payers attempt to reduce healthcare costs, further testing NP adaptability and resourcefulness.
    背景与目标:
  • 【护士对血液透析单位工作环境的看法与护士离职,患者满意度和住院之间的关系。】 复制标题 收藏 收藏
    DOI: 复制DOI
    作者列表:Gardner JK,Thomas-Hawkins C,Fogg L,Latham CE
    BACKGROUND & AIMS: :While the nephrology nursing shortage persists despite the continued growth of the population of individuals with Stage 5 chronic kidney disease, there is a paucity of empirical data regarding nephrology nurses' perceptions of their work environments. Moreover, there are no studies that have examined the relationship of work environment attributes to patient and nurse outcomes in dialysis settings. The purpose of this study was to examine the relationships between staff nurses' perceptions of dialysis work environments, nurses' intentions to leave their current jobs, nurse turnover, patient satisfaction, and patient hospitalization rates. A descriptive, correlational design was used. Nurse level and facility level data were obtained. The sample for nurse-level data consisted of 199 registered nurses in staff nurse roles in 56 dialysis facilities of a national dialysis company. The sample for facility-level analysis consisted of 46 dialysis facilities, and nurse-level data were aggregated for facility-level analysis. The Practice Environment Scale-Nursing Work Index (PES-NWI) was used to measure nurses' perceptions of the dialysis work environment. Nurses' intention to leave their jobs and facility-level turnover rates were the nurse outcomes examined in this study. Facility-level patient satisfaction and hospitalization rates were the patient outcomes examined. Correlation coefficients were computed to measure the relationships between study variables, and independent t-tests were performed to examine subgroup differences in work environment perceptions. Overall, nurses rated the work environment somewhat favorably. Nurses who expressed intention to leave their jobs rated the work environment more negatively compared to nurses who intended to stay. Significant correlations were found between nurses' perceptions of the dialysis work environment, nurses' intention to leave their jobs, nurse turnover rates, and patient hospitalizations. Study findings suggest that nurses' perceptions of the dialysis work environment are important for nurse and patient outcomes in dialysis settings. Further research is needed to explore the predictive ability of the work environment for nurse and patient outcomes in hemodialysis units.
    背景与目标: : 尽管患有5期慢性肾脏病的人群持续增长,但肾脏病护理短缺仍然存在,但有关肾脏病护士对其工作环境的看法的经验数据很少。此外,没有研究检查透析环境中工作环境属性与患者和护士结果之间的关系。这项研究的目的是研究护士对透析工作环境的看法,护士离职的意图,护士更替,患者满意度和患者住院率之间的关系。采用描述性、相关设计。获得护士级别和设施级别数据。护士级数据的样本由一家国家透析公司的56个透析设施中的199名担任护士角色的注册护士组成。用于设施级别分析的样本由46个透析设施组成,并汇总了护士级别的数据以进行设施级别分析。实践环境量表-护理工作指数 (pes-nwi) 用于衡量护士对透析工作环境的看法。护士离职的意图和机构级别的更替率是本研究中检查的护士结果。设施级别的患者满意度和住院率是检查的患者结局。计算相关系数以衡量研究变量之间的关系,并进行独立的t检验以检查工作环境感知的亚组差异。总体而言,护士对工作环境的评价有些不错。与打算留下的护士相比,表示打算离职的护士对工作环境的评价更为负面。在护士对透析工作环境的看法,护士离职的意愿,护士更替率和患者住院之间发现了显着的相关性。研究结果表明,护士对透析工作环境的看法对于透析环境中的护士和患者结果很重要。需要进一步的研究来探索血液透析单元中工作环境对护士和患者结果的预测能力。
  • 【门诊部用户满意度快速量表的效度和一致性。】 复制标题 收藏 收藏
    DOI:10.24875/GMM.19005144 复制DOI
    作者列表:García-Galicia A,Díaz-Díaz JF,Montiel-Jarquín ÁJ,González-López AM,Vázquez-Cruz E,Morales-Flores CF
    BACKGROUND & AIMS: Background:User satisfaction is key to define and assess the quality of care; however, there is no patient satisfaction rapid scale in Mexico. Our objective was to determine the validity and consistency of an outpatient department user satisfaction rapid scale (ERSaPaCE). Method:Comparative, observational, cross-sectional, prolective study. In phase 1, a rapid scale model was developed, which was submitted to experts in medical care for assessment; the instrument was pilot-tested in 10-patient groups, using as many rounds as required until it obtained 20 approvals. In phase 2, the resulting questionnaire and the Outpatient Service User Satisfaction (SUCE) scale were applied to outpatient department users. ERSaPaCE was reapplied by telephone 10 days later. Descriptive statistics, Cronbach's a, Spearman's correlation and intra-class correlation coefficient (ICC) were used. Results:Two-hundred patients were recruited, out of which 53 % were aged 31-60 years; 51.5 % were women and 48.5 % men, all of them users of the outpatient services from 13 specialties. Cronbach's a for ERSaPaCE was 0.608, whereas ICC was 0.98 (p = 0.000). Convergent validity was 0.681 (p = 0.000) using Spearman's rho. Conclusion:ERSaPaCE was a valid and consistent instrument for the assessment of outpatient department user satisfaction. Antecedentes:La satisfacción del usuario es clave para definir y valorar la calidad de la atención, sin embargo, no existe una escala rápida de satisfacción del paciente en México. El objetivo fue determinar la validez y consistencia de la Escala Rápida de Satisfacción del Paciente de Consulta Externa (ERSaPaCE). Método:Estudio comparativo, observacional, transversal, prolectivo. En la fase 1 se elaboró un modelo de escala rápida, que se sometió a la valoración de expertos en atención médica; se realizaron pruebas piloto con 10 pacientes por ronda, tantas veces como fuera necesario hasta lograr 20 aprobaciones. En la fase 2 se aplicó el cuestionario resultante y la escala de Satisfacción del Usuario de Consultas Externas (SUCE) a usuarios de consulta externa; la ERSaPaCE se reaplicó telefónicamente siete a 10 días después. Se utilizó estadística descriptiva, a de Cronbach, Spearman y coeficiente de correlación intraclase (CCI). Resultados:Se reclutaron 200 pacientes, 53 % con edad de 31 a 60 años, 51.5 % mujeres y 48.5 % hombres de la consulta externa de 13 especialidades; a de Cronbach de ERSaPaCE = 0.608, CCI = 0.98 (p = 0.000) y validez convergente = 0.681 (p = 0.000) por rho de Spearman. ­. Conclusiones:ERSaPaCE fue un instrumento válido y consistente para evaluar la satisfacción del usuario de consulta externa.
    背景与目标:
  • 【以消费者为基础的精神卫生教育人力源。】 复制标题 收藏 收藏
    DOI:10.1007/BF01411073 复制DOI
    作者列表:Signell KA
    BACKGROUND & AIMS: :This paper outlines a program for promoting mental health in the population by "giving away our skills" as mental health professionals. This kind of program can be started on a shoestring by a community mental health center, family service agency, or adult education program. It consists of teaching parent-child communication courses, with selected parents then becoming instructors to build a network of nonprofessional personpower. The paper explores strategies of setting up programs. It explores the shifting role of the professional toward a colleague relationship with nonprofessionals. Finally, it presents research on the program's effectiveness with parents and the impact on the lives and self-images of the nonprofessional instructors themselves.
    背景与目标: : 本文概述了通过 “放弃我们的技能” 作为精神卫生专业人员来促进人口精神卫生的计划。这种计划可以由社区精神卫生中心,家庭服务机构或成人教育计划开始。它包括教授亲子交流课程,然后由选定的父母成为讲师,以建立非专业的人格力量网络。本文探讨了项目设置的策略。它探讨了专业人员在与非专业人员建立同事关系方面的角色转变。最后,它介绍了该计划对父母的有效性以及对非专业教师本身的生活和自我形象的影响的研究。
  • 【压力生活事件,污名和生活满意度与精神病披露意愿之间的关系: 香港的一项社区研究。】 复制标题 收藏 收藏
    DOI:10.1111/eip.13008 复制DOI
    作者列表:Suen YN,Chan KWS,Siu LTT,Lo LHL,Cheung C,Hui LMC,Lee HME,Chang WC,Wong PS,Chen YHE
    BACKGROUND & AIMS: AIM:The preference of and potential barriers to disclosure of psychotic illness vary across cultures. Studying its patterns and correlates can guide the design of future culture-specific intervention and public education approaches to improve willingness to disclose and thereby reducing the duration of untreated psychosis (DUP). METHODS:A population-based, random telephone survey was conducted with a total of 1514 respondents in Hong Kong in January 2018. Cross-sectional data on willingness to disclose psychotic illness, life satisfaction, stigmatizing attitude and recent experience of stressful life events (SLEs) were analysed against age and gender using structural equation modelling (SEM). RESULTS:Unwillingness to disclose to anyone was reported by 12% of the participants. Family was reported as the preferred disclosure candidate by most respondents. Our model, which showed a good fit to the data demonstrated that stigmatizing attitude and life satisfaction were directly associated with willingness to disclose illness. Younger age was correlated with more recent experience of SLEs, lower life satisfaction and less willingness to disclose illness. Women's disclosure willingness was positively associated with their life satisfaction, which was sensitive to recent exposure to single SLE. In contrast, men's was negatively associated with their stigmatizing attitude, which increased significantly upon exposure to two or more recent SLEs. CONCLUSION:Encouraging the public to help their family to seek treatment should be a focal point of a successful mental health public education campaign. Cultural-specific and integrated interventions should be developed targeting the vulnerable groups including people with high recent life stress, particularly woman and those with younger age.
    背景与目标:
  • 【美国外科医生按性别划分的职业满意度,个人生活因素和工作生活融合实践之间的关联。】 复制标题 收藏 收藏
    DOI:10.1001/jamasurg.2020.1332 复制DOI
    作者列表:Johnson HM,Irish W,Strassle PD,Mahoney ST,Schroen AT,Josef AP,Freischlag JA,Tuttle JE,Brownstein MR
    BACKGROUND & AIMS: Importance:Burnout among US surgeons is alarmingly high, particularly among women, and work-life integration conflicts contribute to career dissatisfaction. Objective:To evaluate associations between surgical career satisfaction and personal life factors such as time requirements for outside interests, household chores, and parenting responsibilities and to explore similarities and differences between men and women. Design, Setting, and Participants:This cross-sectional survey study of practicing US surgeons was conducted between June 4 and August 1, 2018. The 257-item online survey was sent to 25 748 fellows of the American College of Surgeons. A 31-item subanalysis was performed from August 13 to November 4, 2019. Main Outcomes and Measures:Degree of career satisfaction was measured on a 5-point Likert scale. Professional and personal life factors associated with career satisfaction were evaluated with gender-stratified multivariable proportional odds models. Results:Among 3807 respondents, 3166 self-identified as male (83%) and 639 (17%) as female. Fewer women reported career satisfaction (483 [77%] vs 2514 [82%]) and relatively more women reported problematic interruption of personal life owing to work (315 [50%] vs 1381 [45%]). A higher proportion of women reported being primarily responsible for meal preparation (282 [46%] vs 355 [12%]) and housekeeping (149 [24%] vs 161 [5%]). On multivariable analyses, factors independently associated with career satisfaction were generally similar between genders. Stronger collegial support of work-life integration efforts was significantly associated with higher career satisfaction for both genders (P < .001), although the odds ratio (OR) for women was higher than for men (OR, 4.52; 95% CI, 2.60-7.87 vs OR, 2.45; 95% CI, 1.88-3.21). For men and women, increasing age was significantly associated with higher career satisfaction (men: OR, 1.04; 95% CI, 1.03-1.05; P < .001; women: OR, 1.04; 95% CI, 1.02-1.06; P = .001), and insufficient time for family owing to work was associated with lower satisfaction (men: OR, 0.66; 95% CI, 0.49-0.90; P = 009; women: OR, 0.49; 95% CI, 0.30-0.81; P = .006). For women only, there was a significant association between primary responsibility for at least 1 household chore and lower career satisfaction (OR, 0.66; 95% CI, 0.45-0.98; P = .04). Conclusions and Relevance:In this study, although women had relatively lower surgical career satisfaction than men, the associations between career satisfaction and personal life factors were largely similar. Collegial support of work-life integration efforts appeared to be the most influential factor, particularly for women. Optimization of work-life integration may not only decrease physician burnout but also promote gender equity in surgery.
    背景与目标:
  • 【在一组具有运动医学认证的医生中,性别对职业机会,实践选择和工作满意度的影响。】 复制标题 收藏 收藏
    DOI:10.1097/00042752-200104000-00006 复制DOI
    作者列表:Pana AL,McShane J
    BACKGROUND & AIMS: OBJECTIVE:To examine the gender differences in practice patterns, experiences, and career opportunities for family physicians who practice sports medicine. DESIGN:Descriptive, self-administered questionnaire. PARTICIPANTS:Family physicians with Certificate of Added Qualification (CAQ) in sports medicine were surveyed. The survey was sent to all women with a CAQ in Sports Medicine and a random sample of 20% of the men with CAQs in sports medicine. MAIN OUTCOME MEASURE:Survey consisted of multiple choice, Likert scale, and opened-ended questions. The data was analyzed with contingency tables, with gender as the dependent variable. RESULTS:Response rate to the survey was 75%, which included 42 females and 102 males. Demographics of our population demonstrated some gender differences. Males were of higher average age (41.1 vs. 38.1), and more likely to be married and have children. Practice types, location, and time spent in sports medicine did not differ with the exception of training room and event coverage. Males were more likely to cover all levels of training room except at the Division I level, where the percent of males and females covering training rooms were equal. Males were also more likely to cover all types of sporting events. Job satisfaction and reasons for choosing current jobs did not show significant gender differences. However, factors affecting career opportunities did vary. Professional relationships with athletic trainers and coaches were perceived to be different by males and females surveyed. CONCLUSIONS:Our survey of sports medicine physicians showed some gender differences in practice patterns relative to training room and sporting event coverage. Surprisingly, there were not many differences in the factors that affected job choice and factors affecting job opportunities with the exception of gender itself. However, our study does not conclude how or when gender begins to affect the female sports medicine physician's career opportunities.
    背景与目标:
  • 【小剂量坦索罗辛治疗症状性前列腺增生的满意度: 多中心横断面调查的结果。】 复制标题 收藏 收藏
    DOI:10.1111/j.1742-1241.2012.02985.x 复制DOI
    作者列表:Kim JH,Park JY,Oh MM,Lee JG,Kwon SS,Bae JH
    BACKGROUND & AIMS: AIMS:To evaluate the efficacy and treatment satisfaction with low-dose (0.2 mg) tamsulosin in patients with symptomatic benign prostatic hyperplasia (BPH), and to investigate individual lower urinary tract symptoms according to treatment satisfaction. METHODS:A cross-sectional study was conducted in a total sample of 2574 patients from multiple centres. International Prostate Symptom Score (IPSS), prostate volume, uroflowmetry and combined medications were reviewed. Detailed questionnaires were used to assess treatment satisfaction and IPSS 8 weeks after treatment with low-dose tamsulosin. RESULTS:After 8 weeks of treatment with low-dose tamsulosin, IPSS improved significantly. Among the 2574 patients, 1,630 (63.42%) were satisfied and 940 patients (36.50%) were dissatisfied with low-dose tamsulosin. The reasons for dissatisfaction included efficacy problems (84.66%) and side effects (3.72%). Treatment satisfaction was affected by symptom duration, baseline IPSS, and prostate size (p = 0.0441, < 0.001, < 0.009, respectively). IPSS voiding (IPSS-V) and IPSS storage (IPSS-S) after treatment differed significantly depending on the degree of satisfaction (p < 0.001). IPSS-V after treatment did not improve in patients who were 'not satisfied' or 'totally not satisfied' (p = 0.170, 0.240, respectively). All the individual IPSS items except urgency (p = 0.1436) varied significantly with the degree of satisfaction (p < 0.001). CONCLUSIONS:Treating symptomatic BPH with low-dose tamsulosin improved IPSS, but more than one-third of patients were dissatisfied with the treatment. The main reason for dissatisfaction was efficacy problems, and the degree of satisfaction was related to symptom duration, baseline IPSS, and prostate size, and also to IPSS-V. In patients with severe LUTS, the tamsulosin dose should be increased earlier.
    背景与目标:
  • 【预测医院卫生信息技术采用对患者满意度的影响。】 复制标题 收藏 收藏
    DOI:10.1016/j.artmed.2012.08.001 复制DOI
    作者列表:Roham M,Gabrielyan AR,Archer NP
    BACKGROUND & AIMS: OBJECTIVES:To develop and explore the predictability of patient perceptions of satisfaction through the hospital adoption of health information technology (HIT), leading to a better understanding of the benefits of increased HIT investment. DATA AND METHODS:The solution proposed is based on comparing the predictive capability of artificial neural networks (ANNs) with the adaptive neuro-fuzzy inference system (ANFIS). The latter integrates artificial neural networks and fuzzy logic and can handle certain complex problems that include fuzziness in human perception, and non-normal and non-linear data. Secondary data from two surveys were combined to develop the model. Hospital HIT adoption capability and use indicators in the Canadian province of Ontario were used as inputs, while patient satisfaction indicators of healthcare services in acute hospitals were used as outputs. RESULTS:Eight different types of models were trained and tested for each of four patient satisfaction dimensions. The accuracy of each predictive model was evaluated through statistical performance measures, including root mean square error (RMSE), and adjusted coefficient of determination R(2)(Adjusted). For all four patient satisfaction indicators, the performance of ANFIS was found to be more effective (R(Adjusted)(2)=0.99) when compared with the results of ANN modeling in predicting the impact of HIT adoption on patient satisfaction (R(Adjusted)(2)=0.86-0.88). CONCLUSIONS:The impact of HIT adoption on patient satisfaction was obtained for different HIT adoption scenarios using ANFIS simulations. The results through simulation scenarios revealed that full implementation of HIT in hospitals can lead to significant improvement in patient satisfaction. We conclude that the proposed ANFIS modeling technique can be used as a decision support mechanism to assist government and policy makers in predicting patient satisfaction resulting from the implementation of HIT in hospitals.
    背景与目标:

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