Objective To investigate the ego states of clinical nurses and to analyze their relations with clinical ability of communication.Methods In May 2015,data was collected by handing out questionnaires to 700 clinical nurses in a hospital before being analyzed to find out about nurses' ego states.Nurses from different departments and training backgrounds were compared to study the relationships between ego states and clinical ability of communication.Results Overall,there was significant difference in scores of five ego states between clinical nurses (P ＜ 0.05).Specifically,the score of Nurturing Parent ego state was the highest (17.14 ± 3.00),followed by Adult and Free Child ego state,Controlling Parent ego state (11.13 ± 2.80)and Adapted Child ego state (9.36 ± 3.97).The Nurturing Parent ego state scores of nurses in departments for cadres were higher than in other departments.Nurses who had received psychological training had higher Aduh ego state scores but lower Adapted Child ego state scores than those without psychological training.Nurturing Parent and Adult ego states had positive influence on clinical ability of communication,while those of Adapted Child and Controlling Parent had negative influence.Conclusions Nurses' ego states have significant effect on their clinical ability of communication,and ego states could be improved through psychological training.Furthermore,matching different departments with nurses with different ego states could potentially improve nursing quality.

目的 针对孕产妇对助产士门诊服务的特殊需求,研制孕产妇助产士门诊服务需求量表. 方法 采用质性研究,结合德尔菲法形成预试量表.然后选取90例到助产士门诊就诊的孕产妇进行预调查.采用项目分析、相关性分析、内部一致性检验、探索性因子分析、Spearman-Brown折半信度分析、效度检验等对量表进行检验.通过预实验在临床应用并对量表进一步修正. 结果 形成孕产妇助产士门诊服务需求正式量表,共30个条目.探索性因子分析提取了4个公因子,累计贡献率为76.3％.具有良好的信效度. 结论 孕产妇助产士门诊服务需求量表信效度良好,其临床应用可缩小助产士人才软水平的建设和健康的服务对象需求的差距,为管理部门制定切实可行,积极有效的妇女卫生保健政策提供参考.

目的 探讨孕产妇助产士门诊服务的需求现状并分析其相关因素.方法 采用目的抽样法,在2013年1月至2015年3月对319例孕产妇采用《孕产妇对助产士门诊服务需求调查表》进行调查.结果 年龄层次、学历、家庭人均月收入、分娩史是孕产妇助产士门诊服务需求的影响因素;不同的职业人群、不同的医疗费用支付类型对助产士门诊的服务需求差异无统计学意义.多元逐步回归分析结果显示,不同年龄层次、家庭人均月收入、分娩史进入了回归方程,其标准化回归系数分别为0.16、-0.27、-0.35.结论 不同年龄层次、家庭人均月收入、分娩史是影响孕产妇助产士门诊服务需求的重要因素.了解孕产妇对助产士门诊的服务需求,能够更好的持续改进助产服务质量.

[目的]确定助产服务质量保证的关键过程，从而为构建助产士服务质量保证体系提供理论支持。[方法]采用质量功能配置(QFD)理论构建助产服务质量矩阵、服务质量实施矩阵，用于进行过程需求分析，确定优化重点环节。[结果]影响助产服务质量要素的权数按照从大到小的顺序排列为：专业技能培训，人文知识培训，服务流程再造，为医院层级支持，管理制度落实。其中，影响助产服务质量的关键过程为专业技能培训和人文知识培训。[结论]基于 QFD 原理从孕产妇视角探讨如何优化助产服务质量流程，能够进一步改进服务质量，提高孕产妇满意度。

Objective To design a portable respirator that can facilitate both cardiopulmonary resuscitation and auxiliary oxygen inhalation.Methods Positive pressure design as well as pneumatically powered and controlled design were adopted for this respirator.Theoretical calculation of key components was carried out.The virtual prototype was established and the structure checked using the three dimensional design software Solidedge.Finally,the prototype was processed,assembled and tested.Results Experimental tests proved that the designed respirator was capable of cardiopulmonary resuscitation and auxiliary oxygen inhalation when oxygen supply pressure reached 3 -5.5 bar.It could achieve the expected technical indicators,such as the oxygen flow rate that was between 10 and 12 L/min.Conclusion The portable oxygen supply respirator has the advantages of a small size,light weight,simple operation,and automatic power supply.It has broad prospects of application.

[目的]探讨孕产妇在连续性助产服务模式下的各项服务需求。[方法]采用自行编制的助产士服务需求量表进行问卷调查。[结果]产妇服务需求中排名前两位的是分娩先兆及分娩方式的选择和分娩镇痛。[结论]在连续性助产服务模式下，只有了解孕产妇的服务需求，才能够为孕产妇提供更多的分娩期保健知识。

Objective To explore the Kano model analysis in the application of midwife outpatient service quality management. Methods Kano questionnaire was consisted of 24 items, including five parts, environment facilities, service evaluation, service technology, the team service, delivery service′quality. Using the Kano model analysis, the impact factors of the midwife outpatient service quality in five different quality attributes were determined. It included property and had the opposite answer to the question, charisma, essential properties and one property. Results By identifing the quality index classification of the pregnant women with satisfactory service quality to midwife outpatient service, attributable to a property were 1,2,3,4,8,9,10,14,20,21;attributable to mandatory attributes were 13, belonging to the charm of the property had 5,6,7,11,12,15,16,17,18,19,22,23,24. Midwives outpatient had most of charisma attribute, 54.2%(13/24) of the total;The second was one attribute, 41.7% (10/24) of the total. The technology level of midwife was essential attribute. Conclusions Kano mode analysis technology will be introduced to the midwife outpatient service quality management to provide decision reference for improving the quality of the hospital management level, improve maternal satisfaction, improve the obstetric operation efficiency.

平衡计分卡是20世纪90年代初出现的一种绩效衡量和战略管理工具,在众多的企业、政府和非赢利组织中得到了广泛的应用;90年代末期开始,医疗组织中也越来越多地引入和使用平衡计分卡,并取得了良好的效果.本文以杜克儿童医院、安大略医疗系统和英国全民健康服务(national health service,NHS)系统为例,介绍了国外医疗机构开发和实施平衡计分卡的有关背景、思路和效果,并对国外医疗机构开发和利用平衡计分卡的步骤和基本经验作了总结.

住院患者的心理活动与疾病的严重程度、家庭经济状况及个人心理素质息息相关.笔者收集2008-10至2012-10 住院患者1200例进行心理分析和护理干预,旨在对临床护理有一定的借鉴作用,现报告如下. 1 临床资料 1200例住院患者,涉及心内、呼吸内科、普外科、神经外科等临床科室六个病区,男540例,女660例,年龄15～90岁,平均48.4岁,其中,心内科200例,诊断高血压、冠心病148例,心律失常52例;呼吸内科150例,肺肿瘤21例,支气管肺炎97例,肺心病32例;神经内科350例,脑出血186例,脑梗塞144例,帕金森症20例;神经外科112例:脑外伤90例,脑肿瘤10例,脑出血12例;普外科264例:急腹症4例,胆道结石186例,消化道肿瘤74例;泌尿外科120例:泌尿系结石100例,泌尿系肿瘤20例.

现代战争一方面改变着战争形态，另一方面也对操作武器系统的军人素质提出了更高要求。未来战场形势瞬息万变，职业需要常常使军事作业人员处于艰苦、孤立、危险、残酷的境地，对军人心理构成极大的压力，战斗与非战斗减员大幅增加[1-2]。文献显示，特殊军事环境或战争导致精神和心理障碍的比例呈逐步上升的趋势。美军驻伊拉克部队的心理健康调查表明，52％士兵士气低落；17％出现创伤应激反应；75％得不到心理健康专家、医师的帮助，导致自杀率居高不下。仅2003年4—12月，平均每10万驻伊美军士兵中就有17人自杀。“5·12”抗震救灾期间，我军人员创伤后应激障碍（PTSD）患病率较平时显著增高，病程迁延且自然缓解率低[3]。因此，军人心理健康维护工作已经成为各国军事心理学研究的重中之重[4]。

静脉血栓是指血液在深静脉腔内不正常凝结,阻塞静脉腔导致的回流障碍.多发于下肢深静脉,可造成肢体功能不全和并发肺栓塞,甚至危及生命[1].上肢深静脉血栓的发生占下肢深静脉血栓形成的1%～2%,较为少见[2].我科于2011-02收治右锁骨下静脉、腋静脉、贵要静脉血栓形成1例,通过早期诊断、积极治疗和针对性护理,疗效满意.

平衡计分卡(balanced score card, BSC)概念的提出为现代组织的绩效衡量提供了一种新的方法和工具[1].一些医院及其管理者也逐步认识到BSC在医院日常管理、绩效考核、战略执行及人才培养等许多方面的作用,并在理论和实践上对医院推行BSC的可行性进行了探讨[2,3].但大陆地区医疗机构对于BSC的应用起步较晚,在BSC的制定及方案实施方面都处在探索过程中,很少有成功实施的报道及案例研究.台湾地区的部分医院较早引入了BSC,并取得了明显的效果.笔者试图对台湾地区医院开发和实施BSC的主要特点和经验进行系统总结与分析,为BSC在医院管理中的应用提供经验和指导.

<正>只有当一个人的形象转化为医院的集体形象,从而形成了强大的群体优势,才能成为铸造品牌的基础。近年来,在塑造医院品牌的进程中,礼仪培训越来越受到重视。第43届南丁格尔奖章获得者张利岩提到过,礼仪培训是外塑形象的一个重要途径,是医院文化的重要内容。每一名医护人员的形象展示着医院的形象,只有当一个人的形象转化为医院的集体形象,从而形成强大的群体优势,才能成为铸造品牌的

<正>"五常法"起源于江户时代的日本,其主要内容包括常组织、常整顿、常清洁、常规范和常自律。2000年初,经由香港学者何广明著述《现代管理"五常法"》将其概念引入我国,并经香港地区玛嘉莉医院、屯门医院以及内地一些医院等医疗机构的实际应用,确实起到

<正>中心静脉导管相关性血流感染(central venouscatheter-related blood stream infection,CVCRBSI)是临床护理工作中所面临的主要问题。同俏静等[1]指出,ICU中心静脉置管者较未置管者的血流感染发生率高出20～30倍。集束干预策略是用最新的经循

Objective To discuss the effect of leaderless group discussion to select head nurses and find out operational criterion. Methods Applying leaderless group discussion as a main method to judge and select head nurses in the hospital. Kendall W was used as a measure factor to analyze the reliability. Result The estimators who attended leaderless group discussion got high reliability and validity. The reliability and validity in ability aspect was higher than individuality characteristic aspect. Conclusions Leaderless group discussion is fit for estimating interactive ability. It is more compatible to use leaderless group discussion to select head nurses in hospitals.

Objective To analyze the construct validity and empirical validity of structured interview in selecting head nurse and to give suggestions about further improving its evaluation index system.Methods With the method of factor analysis,the construct validity of structured interview was analyzed.Taking the work performance of head nurse a year after appointment as criterionm,we studied on the emperical validity of structured interview with survey questionnaire.Results Results of factor analysis revealed that structrued interview mainly evaluated 4 potential qualities of the interviewed by 7 evaluation indexes and each index factor could well evaluate a potential quality.The outcomes of survey questionnaire showed that 95.8% of employing units were very satisfied with the work performance of head nurse selected by structured interview and 87.5% of the selected head nurses were evaluated excellen by employing units.Conclusion Structured interview has good construct validity and emperical validity,but evaluation indexes need further improving.

市场竞争归根到底是人才的竞争,人力资源已经成为医院发展的核心资源,尤其是核心管理团队(医院中高层管理人员)更成为医院最宝贵的资源.目前选人方式和工具很多,医院在选人和用人(尤其是中高层管理人才的选拔)过程中,越来越意识到传统的单一的心理测验、个性测验、面试技术、纸笔测试等人才测评方法存在着明显的不足,而评价中心技术正日益受到青睐.我院自2003年起应用评价中心技术科学选拔护士长,取得了很好的效果[1～3].

Objective To select head nurses with the potential for development and to establish a scientific,standardized and rational system for selecting head nurses.Method Through establishment of evaluation items,design and implementation,written tests,interviews,psychological tests,and democratic discussions,the professional compctence of 32 candidates for head nurses was evaluated.Result The find evaluation report included data analysis and experts' opinions.All the competitors had the competence above the good level.Conclusion The ultimate objective of competence evaluation is to provide quantization basis for selection,promotion,and training of professional pezsonnel,thereby realizing the optimal allocation and in-depth development of human resources.

Objective Based on classical test theory,the main factors influencing the reliability of structured interview for selection of head nurses were analyzed.Methods The marks given to 52 candidats by the examiners in this hospital were used as the research data.The degrees of difficulty and differentiation of guestions,the homogeneity reliability and inter-rater reliability were analyzed.Finally,validity study was carried out on the performance one year after going to their duty posts.Results The structured interviews,showed high homogeneity reliability,with an α coefficient of 0.922.The degrees of difficulty and differentiation affected the consistency of scoring.The structured interview was unsatisfactory as a method for examining the professional skills.Conclusions As the post of head nurse is a job typical of highly technical operation.The major factors influencing the reliability of examiners in structured intervious are the qualities of questions and examiners,and the operational defiaition of examination elements.