目的:了解黑龙江省社区卫生服务机构生殖健康咨询服务能力现状,为黑龙江省有针对性地提高生殖健康咨询服务的可及性和有效性提供参考建议.方法:2020年7—9月采取随机抽样方法在黑龙江省抽取7个地市,每个地市随机选取2所社区卫生服务机构,对生殖健康服务相关医务人员开展问卷调查.结果:对301份有效问卷进行统计学分析,调查对象生殖健康服务相关知识正确率最高的为健康促进知识(28.2％).调查对象生殖健康咨询服务培训率为26.6％.可以提供的生殖健康咨询服务第1位是避孕节育咨询(93.4％).调查对象的咨询概念化能力评分均值为(30.79±13.62)分,咨询实践操作能力均值为(48.99±19.00)分,总分均值为(79.78±31.72)分.统计分析发现,生殖健康咨询能力与年龄、工作岗位、是否获得生殖健康咨询员/咨询师资格和是否接受生殖健康咨询服务培训等有关,进一步分析发现,后两个变量是咨询能力自我评估得分的主要影响因素(P<0.05).调查对象最希望得到的工作支持为医院领导对相关科室的协调(94.0％).结论:黑龙江省社区卫生服务机构生殖健康服务人员相关知识较为薄弱,咨询概念化能力及咨询实践操作能力有待提高.应加强基层社区卫生服务机构相关人员培训,促进生殖健康咨询服务职业化、专业化发展,提升生殖健康咨询服务供给水平.

目的:了解黑龙江省社区居民接受生殖健康服务的现状,为制定人群生殖健康服务战略提供政策依据.方法:2020年7月—9月采用随机抽样的方法抽取黑龙江省7个地市,每个地市随机选取2个社区卫生服务机构,针对社区居民开展问卷调查.结果:针对1281份有效问卷进行统计学分析,在7个地市中,居民已接受的生殖健康服务以政策法律宣传(72.3％)、健康教育(44.9％)和定期生殖系统检查为主,但仍有38.4％的居民未接受相关服务;已接受服务的居民半数以上对服务感到满意;"希望得到的生殖健康知识"分别是优生及保健(55.40％)、生殖道感染及性传播疾病和艾滋病(36.1％)、孕期及产褥期保健(23.5％)和生殖健康相关政策(21.7％);调查对象希望获得生殖健康知识或信息的渠道首选为"宣传折页"(46.3％),其次为"报刊杂志"(33.8％);领取避孕药具的方式分别是"卫生室/医院免费领取"(56.7％)、"自动发放机免费领取"(43.9％)和"在单位免费领取"(35.0％).居民是否接受政府提供的免费生殖健康服务受性别和婚姻状态的影响(P<0.05);女性宫颈癌的知晓情况受教育水平、婚姻状态及社交网络软件使用频率的影响(P<0.05).结论:相当一部分居民未接受生殖健康服务的现状.提示应通过社区卫生服务中心等医疗机构的服务和政府主导的生殖健康教育互联网平台及新媒体宣传等方式,针对不同人群的不同需求开展生殖健康咨询和教育工作,提高居民生殖健康知识水平,预防生殖健康疾病.

移动互联网的建设突飞猛进,移动智能终端设备的覆盖范围越来越广,各种移动互联网应用诞生于各行各业,也对专科医学教育的发展产生了一定的影响.本文阐述了移动互联网的发展现状和基本条件应用于专科医学教育,并探讨了移动互联网应用技术在专科医学教育在中应用案例.

随着信息时代的来临,互联网开始影响生活的方方面面,教学模式也受到了"互联网+"的影响.由于网络课程的便捷性、自主性,越来越多网络课程受到了家长及学生的喜爱.外科护理教学作为护理学专业中重要的实践类学科之一,对于学生的动手能力、操作能力及思维能力都有极高的要求.因此,本文探讨"互联网+"模式下外科护理的教学改革.

Objective To explore the application effect of urinary diary for improve the neobladder function in patients with the orthotopic ileal neobladder.Methods By convenience sampling,58 patients with full bladder resection in situ ileum new bladder surgery were selected and randomly divided into control group (n=28) and observation group(n =30).Patients in control group received neobladder function training.Patients in observation group received neobladder function training,record urinary diary,and adjust training plan according to urinary diary of each phase.The neobladder function were evaluated in all patients after three months.Results The observation group's micturition time interval,urine volume of every time,urination at night,urinary continence rate in daytime and night-time had significant differences compared with the control group(all P＜0.05);Compared with the control group,bladder capacity were increased,residual urine volume were reduced,maximum urinary flow rate were faster in the observation group(all P ＜0.05).Conclusion Correct record urinary diary can improve the neobladder function in patients with the orthotopic ileal neobladder.

目的 建立尿路造口护理技术的学习曲线,为尿路造口护理培训提供参考.方法 选择40名尿路造口患者家属为培训对象,运用尿路造口模型进行培训,2次为1个学习阶段,分成A～F 6个阶段;比较6个阶段尿路造口护理技术的10项内容达标率、操作时间、操作得分及操作合格率.结果 6个阶段尿路造口护理技术的10项内容达标率、操作时间、操作得分及操作合格率比较,差异有统计学意义(P＜0.05,P＜0.01);绘制学习曲线显示,6次培训后,操作时间、操作得分及操作合格率出现拐点而后趋于平稳.结论 尿路造口患者家属运用造口模型进行造口护理的学习曲线约为6次.

Objective To learn about the sources of work pressure and the coping ways of nurses in high quality nursing ward so as to take effective measures and relieve or eliminate the work pressure for the nursing managers of hospital. Methods A total of 100 nurses in high quality nursing ward of the affiliated union hospital of Fujian Medical University were investigated with the job stressors scale and coping style questionnaire of self-designed. Results(1) The major sources of work pressure of nurses in high quality nursing ward were the nursing service pattern,performance appraisal and nursing service(4.12±0.72,4.02±0.90,3.98±1.00 points,respectively).(2) There were no significant differences in the scores of positive coping and negative coping among nurses with different professional title in high quality nursing ward(F=0.32,P=0.12,F=0.73,P=0.89 respectively).(3)There were significant differences in the scores of positive copingamong nurses with cultural degree in high quality nursing ward(F=4.84,P=0.03,F=4.17,P=0.04 respectively),and in the scores of positive coping(F=3.85,P=0.04,F=3.33,P=0.04 respectively). Conclusions The nursing managers of hospital should pay attention to the sources of work pressure and take effective measures to help the nurses in high quality nursing ward to adopt positive coping styles and reduce work pressure.