Background Overweight and obesity have become major public health concerns worldwide. Persistent stress can activate the human hypothalamic‒pituitary‒adrenal axis (HPA) and increase the intake of “self-rewarding food”, thereby raising the incidence of obesity. Health care workers (HCWs) experience higher workloads and mental stress than workers in many other industries, which may put them at increased risk for overweight/obesity. However, few studies have been carried out on overweight and obesity among HCWs in China, and the overall scenario and behind-the-scenes factors of their overweight and obesity are unknown. The aim of this study is to understand the epidemic of overweight and obesity and risk factors among Chinese HCWs. Methods Based on a cross-sectional web survey design, 23,234 HCWs from 100 health institutions in 5 provinces/autonomous regions/municipalities across China were sampled to answer a self-administered questionnaire that was purposely developed using a multi-staged clustered random-sampling method. Chi-square test and ANOVA were performed to compare variables between two or more groups. Univariate analyses were conducted to identify the influence of self-reported persistent stress and/or recurrent anxiety/depressed mood on lifestyle behaviors. A multivariate binary logistic regression model was used to analyse the risk factors of overweight/obesity. Results Among the respondents, 34.26% were overweight, and 11.22% were obese. Most of the respondents had regular exercise habits (68.17%), had habitually stayed-up late (65.06%) and had been affected by persistent stress and/or recurrent anxiety/depressed mood (62.04%). A higher proportion of those with persistent stress and/or recurrent anxiety/depressed mood than those without habitually staying-up late (76.18%); consumed take-out food (54.92%), fried food (49.93%), snacks or desserts (50.51%); drank sugary drinks (46.57%); smoked (14.27%); and drank alcohol (23.34%). Gender (Female) (OR: 0.314, 95%CI: 0.292–0.336), age (OR: 1.742–2.334, 95%CI: 1.544–2.858), education (OR: 0.620–0.728, 95%CI: 0.445–0.973), living and working area (OR: 1.271, 95%CI: 1.192–1.355), breakfast (OR: 0.898, 95%CI: 0.839–0.960), fried food (OR: 1.133, 95%CI: 1.048–1.224), and alcohol consumption (OR: 1.111, 95%CI: 1.017–1.214) were factors for overweight/obesity. All of the aforementioned results were significant ( P < 0.05). Conclusions The overweight/obesity rate of Chinese HCWs is rather high, which might be directly associated with lifestyle behaviors. However, these behaviors fundamentally originated from persistent stress and/or recurrent anxiety/depression, mediated by lifestyle behaviors. Substantial measures should be taken for stress reduction and mental health promotion for overweight/obesity prevention and control among HCWs.

ObjectiveTo explore the status and influencing factors of public health safety literacy (PHSL) among residents in four provinces of China for providing references to the development of appropriate intervention strategies. MethodsWe recruited 2 809 urban and rural residents aged 15 – 69 years in three provinces (Hubei, Guangdong and Sichuan) and Beijing municipality using stratified multistage cluster sampling and conducted an on-site self-administered electronic questionnaire survey among the residents during April – June, 2021. A scale with three domains (each with a maximum score of 40) was designed to assess the PHSL of the residents. T-test, one-way analysis of variance (ANOVA), and χ2 test were adopted in univariate analysis and logistic regression in multivariate analysis. Results For all the participants, the mean overall PHSL score was 81.61 ± 13.71 and the mean domain scores were 29.21 ± 5.89 for PHS perception, 25.10 ± 5.10 for PHS knowledge, and 27.30 ± 4.87 for PHS skills. There were 80.85% of the participants being assessed with basic PHSL (with the overall scale score of ≥ 72) and there were 86.69%, 61.05%, and 78.96% of the participants being assessed with basic PHS perception, knowledge, and skills (with the domain scores of ≥ 24); also based on the scale of overall score of ≥ 96 and domain scores of ≥ 32, the proportion of the participants with good PHSL was 15.70% and the proportions of participants with good PHS perception, knowledge and skills were 35.32%, 14.03% and 20.15%, respectively. Multivariate logistic regression analysis showed that PHSL was associated with residential region, sex, education and household income. The participants residing in Hubei, Sichuan, and Guangdong province were less likely to have basic/good PHSL, with the odds ratios (OR) of 0.485/0.422, 0.488/0.699, and 0.389/0.566 in contrast to those residing in Beijing municipality. The participants being female (versus male: OR = 1.336/1.283), with the education of higher than primary school education or below (junior high school: OR = 1.786/1.205; senior high or vocational or technical secondary school: OR = 2.204/2.013; college and above: OR = 2.932/3.710), with the annual household income of more than 30 000 RMB yuan (30 000 – 60 000: OR = 1.660/1.648; ≥ 120 000: OR = 1.865/2.145) were more likely to have basic/good PHSL. ConclusionFor 15 – 69 years old residents in four provincial administrative regions of China, the PHSL still needs to be improved and the residents′ PHSL is influenced mainly by gender, education, annual household income and residential region.

目的 分析"中国公众公共卫生安全素养自制量表"的项目功能差异(DIF),检验量表题项质量,为开发公共卫生安全素养(PHSL)调查工具提供依据.方法 通过经典测试理论和项目反应理论相结合的方法编制了单维的中国公众公共卫生安全素养量表.使用自制的初始量表(30个题项),于2021年4—6月随机抽取湖北、广东、北京和四川省的2809名常住居民进行调查.利用SPSS 23.0进行PHSL得分分析,两组间比较采用t检验,多组间比较采用单因素方差分析.利用R4.1.2软件mirt和scDIF test包对量表题项进行不同人口学特征的DIF检验.结果 调查对象PHSL的平均得分为(34.44±7.59)(满分44分).不同性别、年龄、文化程度、职业、地区、城乡、家庭年均总收入的公众PHSL得分差异均有统计学意义(P<0.001).其中,女性高于男性,文化程度较高人群高于较低人群,农民低于其他职业人群,湖北地区高于其他地区,城镇居民高于农村居民.所有题项均不存在性别、收入和城乡的DIF(P>0.05);8个题项存在年龄的DIF(P<0.05);8个题项存在文化程度的DIF(P<0.05);6个题项存在职业的DIF(P<0.05);4个题项存在地区的DIF(P<0.05).结论 中国公众公共卫生安全素养自制量表题项稳定性较好,适合推广使用.

健康城市是促使城市与人的健康协调发展的治理策略.韩国自20世纪80年代引入健康城市理念,在推进健康城市行动上发展迅速,建设成效显著.本文主要介绍韩国健康城市建设推进模式、策略路径、目标内容、评价标准及方式、成效及经验,以期为我国健康城市建设提供借鉴参考.

目的 评价2019年河南省嵩县高血压患者自我管理的健康教育效果,为高血压患者有效管理提供参考.方法 从河南省洛阳市嵩县随机抽取干预村和对照村,每个村随机抽取16名高血压患者,根据排除标准确定对照组和干预组研究对象分别为90名和151名.干预村除开展常规健康教育外还实施为期3个月(2019年10—12月)的高血压患者自我管理教育干预.干预前后通过问卷调查对干预效果进行评估.结果 干预后,干预组和对照组的西药治疗率分别为98.7％和71.1％,控制饮食率分别为62.9％和26.7％,运动率分别为67.5％和20％,1周内测量血压的比例分别为70.2％和57.8％,均为干预组高于对照组,差异有统计学意义(P<0.05).吸烟和饮酒情况,干预后两组差异无统计学意义.干预后,干预组高血压健康知识得分为(12.2±1.9)分,高于对照组的(7.3±3.4)分(t=-14.439,P<0.001).结论 高血压自我管理教育能够有效提高患者高血压相关知识的掌握,推动患者采取更积极主动的措施和更有利于健康的生活方式进行高血压的治疗和管理.

目的 分析柳州市二级及以上公立医院医护人员健康教育能力自我认知的现状,为后期制定针对性的医护人员健康教育能力提升培训方案提供参考依据.方法 采用方便抽样的方式,对柳州市8家二级及以上公立医院的临床医生和护士进行健康教育能力、态度及技巧自评调查与分析.结果 共调查医务人员2840人,其中临床医生1000人、护士 1840人.护士计划和实施能力自评得分分别为(21.56±1.68)分和(47.46±6.56)分,均高于医生的(20.51±2.82)分和(45.31±7.12)分(P＜0.001);医生的评估和评价能力自评得分为(38.93±2.58)分和(22.19±2.58)分,均高于护士的(36.11±3.62)分和(20.00±3.86)分(P＜0.001).中高级职称医护人员各维度能力自评得分均高于初级及以下医护人员;不同文化程度医生的评估能力差异无统计学意义(t=1.92,P=0.056),计划能力是大专及以下高于本科及以上(t=2.41,P=0.016),实施及评价能力是本科及以上更高;本科及以上护士的各维度能力自评均得分高于大专及以下;二级医院医生和护士的评估能力、计划能力和评价能力自评得分均低于三级医院,但是实施能力自评得分高于三级医院(t=0.62,P=0.000).61.1％的医务人员接受过医院或相关机构组织的健康教育技能培训.结论 柳州市公立医院医护人员有较强的健康教育意愿,但是接受培训不足,有必要系统化和差异化地开展医护人员的健康教育与健康促进工作培训,提升全市医护人员整体健康教育服务能力.

目的 分析精益管理的模式在围生期门诊管理的应用与效果.方法 对2015年1月-2016年12月完成产检的孕妇进行满意度和就诊体验调查.对照组为实施精益管理前,2015年1-4月期间,按孕产妇保健手册单号随机抽取的产检孕妇2914例,实验组为实施精益管理后,2015年5月-2016年6月期间,按孕产妇保健手册单号随机调查的产检孕妇2363例.采用例数和率对分类资料进行统计,采用卡方检验分析实验组与对照组满意度的差异.结果 实施精益管理后调查对象对护士技术与服务态度、对医务人员沟通服务的满意度、对医务人员诊疗技术的满意度、对医疗全过程的满意度分别为85.6％、83.7％、88.5％和88.5％,均高于实施精益管理前对照组的满意度,且差异有统计学意义(P ＜0.001).实施精益管理后有84.6％的患者可以根据病情选择医生,按预约时间准时看诊的比例明显增高,实施前后差异有统计学意义(P ＜0.001).结论 将精益管理的理念与方法运用到围生期诊疗和护理服务中,可以显著提高服务质量和效率,提高就诊患者满意度.

孕妇学校是我国围产保健体系中心一个重要构成部分,为孕产妇提供相关知识及降低孕产期并发症发挥了重要作用,然而孕妇学校的各地域的发展水平不同.通过查阅近20年有关孕妇学校的文献,发现目前有关孕妇学校的发展现况研究多聚焦在孕妇学校教学模式、课程内容需求情况、授课师资、授课时间及孕妇学校硬件设施上,关于孕妇学校标准化管理模式报道较少.本文对孕妇学校发展现况进行全面详实的论述,同时介绍目前孕妇学校发展的新思路,提出应尽快制定我国孕妇学校健康教育标准化管理模式提供新认识.

AbstractBackgroundChina’s emergency management of severe acute respiratory syndrome (SARS) was heavily criticized, whereas the H7N9 response was praised by the international community.AimsThe aims of this study were to examine and compare the strengths and weaknesses of risk communication conducted in response to SARS and H7N9 and their associated social impacts on affected communities in China.MethodA qualitative comparative case study approach was employed in the present study, using a set of 8 risk communication principles selected from international literature to suit the Chinese context for the comparative analysis of emergency responses of SARS and H7N9.ResultsThe study found significant differences in the risk communication conducted in the 2 cases. The SARS outbreak fully exposed China’s lack of experience in public health risk communication. By contrast, the Chinese government’s risk communication strategies had improved significantly during the H7N9 outbreak.DiscussionTrust is the basis for communication. Maintaining an open and honest attitude and actively engaging stakeholders to address their risk information needs will serve to build trust and facilitate multi-sector collaborations in dealing with a public health crisis.ConclusionsFrom SARS to H7N9, risk communication practices in China greatly improved, which, in turn, lessened adverse social impacts and improved outcomes in emergency management of public health crises. (Disaster Med Public Health Preparedness. 2018;12:587–598)

<span id="ChDivSummary" name="ChDivSummary" class="abstract-text">风险沟通是危机应急管理的重要组成部分,是国际卫生条例重要内容之一,已被世界卫生组织（WHO）确定为指导公共卫生应对传染病威胁的一项核心能力。WHO风险沟通原则包括:建立信任、及时公布信息、保持透明、关注公众和提前预案。本文总结分析了WHO风险沟通原则在中国首例输入性中东呼吸综合征（MERS）防控中的成功应用,为风险沟通在公共卫生应急风险管理中发挥的作用提供依据。</span>