Effectiveness of an experiential workshop for enhancing helping professionals’ self‐competence in death work in Hong Kong: a randomised controlled trial

Helping professionals require self‐competence in coping with the existential and emotional challenges of death work. Previous training often focused on knowledge and skills rather than on this competence. This study aimed to examine the effectiveness of a 3‐day workshop in Hong Kong to enhance helping professionals’ self‐competence in death work. A randomised controlled trial was conducted to examine the effects of the training between January and May 2014. Targeted participants were helping professionals who had been doing death work for at least 6 months. The 112 participants were openly recruited from hospitals and NGOs and were assigned to an intervention group or a waitlist control group. Data were collected at pre‐intervention and post‐intervention. Primary outcome was self‐competence in death work. All participants were grouped for analysing the changes in outcomes at pre‐intervention, post‐intervention and 3‐month follow‐up. Participants in the intervention group experienced a significant increase in the total score of the Self‐competence in Death Work Scale (SC‐DWS) and in scores of the Existential and Emotional subscales of SC‐DWS. The positive effects of training on self‐competence in death work were maintained at the 3‐month follow‐up. This study provides evidence of the effectiveness of training in enhancing helping professionals’ self‐competence in death work. Further research is required to examine the long‐term effects of training.     

Effects of web-based supervisor training on supervisor support and psychological distress among workers: a randomized controlled trial

BACKGROUND: A randomized controlled trial was conducted to determine the effects of web-based supervisor training on worksite mental health on supervisor support and psychological distress among subordinate workers. METHODS: Section chiefs in a computer engineering company were randomly assigned to either a training group (n = 9) or a non-training group (n = 7). The section chiefs in the training group participated in web-based self-learning training on worksite mental health. A total of 92 subordinate workers under the trained section chiefs (the intervention group) and 84 subordinate workers under the untrained section chiefs (the control group) completed a questionnaire at baseline and a 3-month follow-up. RESULTS: The score of supervisor support greatly decreased in the control group during the follow-up period, and the score changed very little in the intervention group, with a significant intervention effect (P = 0.032). This pattern was more pronounced for one particular item dealing with the extent to which a supervisor listens to personal problems of subordinate workers (the intervention effect, P = 0.012). No intervention effect was observed for the score measuring co-worker support, psychological distress, or other job stressors among subordinate workers (P > 0.05). CONCLUSIONS: It is suggested that the web-based training of supervisors on worksite mental health is useful in improving, or at least maintaining, supervisor support among subordinate workers.     

Increasing male involvement in family planning decision making: trial of a social-cognitive intervention in rural Vietnam

We tested a social-cognitive intervention to influence contraceptive practices among men living in rural communes in Vietnam. It was predicted that participants who received a stage-targeted program based on the Transtheoretical Model (TTM) would report positive movement in their stage of motivational readiness for their wife to use an intrauterine device (IUD) compared to those in a control condition. A quasi-experimental design was used, where the primary unit for allocation was villages. Villages were allocated randomly to a control condition or to two rounds of intervention with stage-targeted letters and interpersonal counseling. There were 651 eligible married men in the 12 villages chosen. A significant positive movement in men's stage of readiness for IUD use by their wife occurred in the intervention group, with a decrease in the proportions in the precontemplation stage from 28.6 to 20.2% and an increase in action/maintenance from 59.8 to 74.4% (P < 0.05). There were no significant changes in the control group. Compared to the control group, the intervention group showed higher pros, lower cons and higher self-efficacy for IUD use by their wife as a contraceptive method (P < 0.05). Interventions based on social-cognitive theory can increase men's involvement in IUD use in rural Vietnam and should assist in reducing future rates of unwanted pregnancy.     

Effects of web-based supervisor training on job stressors and psychological distress among workers: a workplace-based randomized controlled trial

Using workplaces as a unit for randomization, a randomized controlled trial was conducted to determine the effects of web-based supervisor training on the subject of worksite mental health on job stressors, supervisor support and psychological distress among subordinate workers. A total of eight workplaces of a sales and service company were randomly assigned to either training workplaces or non-training workplaces. Supervisors (n=23) at the training workplaces participated in web-based self-learning training on worksite mental health; supervisors (n=23) at the non-training workplaces did not. A total of 81 subordinate workers under the trained supervisors (the intervention group) and 108 subordinate workers under the non-trained supervisors (the control group) completed the Brief Job Stress Questionnaire (BJSQ) at baseline and at a three-month follow-up. No significant intervention effect was observed for any scale of the BJSQ measuring job stressors, supervisor or coworker support, or psychological distress among subordinate workers (p<0.05). The item score of work autonomy changed very little in the intervention group, while it decreased in the control group during the follow-up period, yielding a significant intervention effect (p=0.02). The item score for a friendly atmosphere in the workplace increased in the intervention group, while the score remained stable in the control group, yielding a significant intervention effect (p=0.02). While the present study failed to show any clear effect of the web-based training of supervisors on reduction of job stressors, it may be useful for maintaining worker autonomy and improving the friendliness of the worksite atmosphere.     

Effect Evaluation of a Self-Management Program for Dutch Workers with a Chronic Somatic Disease: A Randomized Controlled Trial

Purpose The objective of this study is to investigate the effect of a Self-Management Program for workers with a chronic disease. This program is based on the Chronic Disease Self-Management Program of Stanford University, modified for workers with a chronic somatic disease. Methods In a randomized controlled trial, the effectiveness of a Self-Management Program was evaluated. Participants were randomly assigned to the experimental group (n = 57) and the control group (n = 47). The experimental group received an intervention, the control group received care as usual. Primary outcome measures were self-efficacy at work and the attitude towards self-management at work. Secondary outcomes were the SF-12 health survey questionnaire, job satisfaction and intention to change job. The results were measured at baseline, after the intervention and 8 months after the intervention. Results The attitude towards self-management at work (enjoyment) improved after 8 months for the intervention group (p = 0.030). No other outcome variable differed significantly. As an interaction effect, it was found that low educated workers developed a better physical health quality (SF-12) in the intervention group compared with the control group. The attitude towards self-management at work (importance) improved in the intervention group for older and female workers and the attitude toward enjoying self-management at work improved for female workers only. Conclusion The results show that low educated workers, older workers and women benefit significantly more from the training than higher educated workers, younger workers and men.     

Effects of an educational intervention on female biomedical scientists’ research self-efficacy

Women and people of color continue to be underrepresented among biomedical researchers to an alarming degree. Research interest and subsequent productivity have been shown to be affected by the research training environment through the mediating effects of research self-efficacy. This article presents the findings of a study to determine whether a short-term research training program coupled with an efficacy enhancing intervention for novice female biomedical scientists of diverse racial backgrounds would increase their research self-efficacy beliefs. Forty-three female biomedical scientists were randomized into a control or intervention group and 15 men participated as a control group. Research self-efficacy significantly increased for women who participated in the self-efficacy intervention workshop. Research self-efficacy within each group also significantly increased following the short-term research training program, but cross-group comparisons were not significant. These findings suggest that educational interventions that target sources of self-efficacy and provide domain-specific learning experiences are effective at increasing research self-efficacy for women and men. Further studies are needed to determine the longitudinal outcomes of this effort.     

Rehabilitation Using High-Intensity Physical Training and Long-Term Return-to-Work in Cancer Survivors

Introduction Due to large and increasing numbers of cancer survivors, long-term cancer-related health issues have become a major focus of attention. This study examined the relation between a high-intensity physical rehabilitation program and return-to-work in cancer survivors who had received chemotherapy. Methods The intervention group, consisting of 72 cancer survivors from one hospital (8 men and 64 women, mean age 49 years), followed an 18-weeks rehabilitation program including strength and interval training, and home-based activities. An age-matched control group, consisting of 38 cancer survivors (9 men and 29 women), was recruited from two other hospitals. They received only standard medical care. All subjects were evaluated during a telephone interview on employment issues, conducted at ±3 years after diagnosis. The main outcomes were change in working hours per week and time until return-to-work. Results Patients in the intervention group showed significant less reduction in working hours per week [−5.0 h/week vs. −10.8 h/week (P = .03)]. Multivariate analyses showed that the training intervention, the age of patients, and the number of working hours pre-diagnosis could explain the improvement in long-term participation at work. Time until (partial) return-to-work was 11.5 weeks for the intervention group versus 13.2 weeks for the control group (P = .40). On long-term follow-up, 78% of the participants from the intervention group versus 66% from the control group had returned to work on the pre-diagnosis level of working hours (P = .18). Conclusion Rehabilitation using high-intensity physical training is useful for working patients to minimize the decreased ability to work resulting from cancer and its treatment.     

The effect of training for a participatory ergonomic intervention on physical exertion and musculoskeletal pain among childcare workers (the TOY project) – a wait-list cluster-randomized controlled trial

ObjectiveMany employees have high physical exertion at work and suffer from musculoskeletal pain (MSP) leading to sickness absence with large costs. Participatory ergonomics is a potentially effective intervention for reducing physical exertion, MSP and sickness absence. The main aim of this study was to investigate the effectiveness of a 20-week workplace participatory ergonomic intervention among childcare workers on physical exertion and MSP.MethodsIn a two-arm cluster-randomized trial, 190 workers were recruited from 16 childcare institutions and randomly assigned to either a 20-week participatory ergonomics intervention consisting of three training workshops or a control group receiving usual care. Primary outcomes were physical exertion during work, maximal pain intensity, number of pain regions, and pain-related work interference. Secondary outcomes were MSP-related sickness absence, need for recovery (NFR), employee involvement, and self-efficacy. We followed the intention-to-treat principle and adhered to the registered study protocol (ISRCTN10928313).ResultsAfter 20 weeks, half the workers noticed some positive changes in their work. However, there were no statistically discernible effects in physical exertion, maximum pain intensity, pain-related work interference, or number of pain regions. We found a significant reduction of MSP-related sickness absence in the intervention compared to the control group [-0.48 days per month (95% confidence interval (CI), -0.8– -0.1]. We found no significant effects in NRF or involvement of employees, but self-efficacy was reduced in the intervention compared to the control group [-0.2 (95% CI, -0.3– -0.0)].ConclusionThis 20-week training for a participatory ergonomic intervention in childcare workers did not show effects on physical exertion and MSP, but was both feasible and effective in reducing MSP-related sickness absence.     

本体感觉联合核心稳定性训练对大学生平衡能力的影响

目的 探讨本体感觉联合核心稳定性训练对大学生静态平衡能力、动态平衡能力的影响,为研究身体平衡能力及预防运动损伤提供实验依据.方法 2019年8月招募山东体育学院112名非体育专业学生,采用随机数字表法将52例被试分为干预组,60例为对照组.干预组做本体感觉训练联合核心稳定性训练,对照组做核心稳定性训练.比较两组被试训练...     

铁路调度人员职业紧张评估及心理干预研究

目的 评估铁路调度人员职业紧张状况,并进行干预,评估职业紧张管理训练对调度人员职业紧张及心理健康水平的干预效果。
方法 采用职业紧张量表（OSI-R）对6个铁路局调度员的职业紧张状况进行评估;采用职业紧张管理训练法对某铁路局21名调度人员进行试点干预,内容包括职业紧张认知行为训练和放松技术训练。另选取同一铁路局的21名调度人员作为对照组,不进行干预,分析两组人员干预前后心理健康测试量表（SCL-90）及OSI-R得分情况。
结果 铁路调度人员OSI-R的职业任务问卷、应对资源问卷得分分别为（150.62 ±24.15）分和（124.01 ±19.68）分,低于一般职业人群常模;紧张反应问卷得分为（97.73 ±23.49）分,高于一般职业人群常模;以上差异均有统计学意义（P < 0.01）。三份问卷各子项中,责任感子项,心理、躯体紧张反应子项得分均较常模高,差异均有统计学意义（P < 0.01）。OSI-R得分方面,干预组在干预后的工作环境子项分、人际关系紧张反应子项得分降低,休闲娱乐子项得分升高,与干预前比较,差异均有统计学意义（P < 0.05）;但是干预后干预组仅自我保健得分高于对照组（P < 0.05）。SCL-90得分方面,干预组在干预前后的心理健康水平各因子得分差异均无统计学意义（P > 0.05）,对照组和干预组之间各因子得分在干预后差异也均无统计学意义（P > 0.05）。
结论 调度人员工作负荷强度不大,但职业紧张反应较严重,应对资源较为有限。心理干预对降低调度人员的职业紧张水平有一定的效果,但对职工的心理健康水平改善无明显效果。在个体水平干预的基础上,结合紧张因素积极开展组织干预,应是实施铁路行车调度人员职业紧张干预的主要方向。
     

Ages and stages in professional child care training

A model is described for the systematic training of child care workers through increasingly comprehensive levels of skills and competences. Two “case histories” are provided to illustrate levels of training, beginning with the child care worker aide learning to work with a small group of children, and moving through family intervention skills, treatment team leader, unit leader responsibilities, and finally a clinical-managerial position as program manager or treatment director.     

阿尔茨海默病的住院护理干预现状(综述)

阿尔茨海默病(AD)是一组病因未明的原发性退行性脑变性疾病,多起病于老年期.该病目前可被明确诊断,但病因还未确定,尚无根治措施;而对AD患者有效的护理干预已成为延缓病情进展,提高生活质量的重要手段.该文将从住院AD患者的生活护理、安全护理、精神症状护理、并发症护理和体能训练等几个方面的护理干预现状进行综述.     

Understanding the 'four directions of travel': qualitative research into the factors affecting recruitment and retention of doctors in rural Vietnam

Background

Motivation and retention of health workers, particularly in rural areas, is a question of considerable interest to policy-makers internationally. Many countries, including Vietnam, are debating the right mix of interventions to motivate doctors in particular to work in remote areas. The objective of this study was to understand the dynamics of the health labour market in Vietnam, and what might encourage doctors to accept posts and remain in-post in rural areas.

Methods

This study forms part of a labour market survey which was conducted in Vietnam in November 2009 to February 2010. The study had three stages. This article describes the findings of the first stage - the qualitative research and literature review, which fed into the design of a structured survey (second stage) and contingent valuation (third stage). For the qualitative research, three tools were used - key informant interviews at national and provincial level (6 respondents); in-depth interviews of doctors at district and commune levels (11 respondents); and focus group discussions with medical students (15 participants).

Results

The study reports on the perception of the problem by national level stakeholders; the motivation for joining the profession by doctors; their views on the different factors affecting their willingness to work in rural areas (including different income streams, working conditions, workload, equipment, support and supervision, relationships with colleagues, career development, training, and living conditions). It presents findings on their overall satisfaction, their ranking of different attributes, and willingness to accept different kinds of work. Finally, it discusses recent and possible policy interventions to address the distribution problem.

Conclusions

Four typical 'directions of travel' are identified for Vietnamese doctors - from lower to higher levels of the system, from rural to urban areas, from preventive to curative health and from public to private practice. Substantial differences in income from formal and informal sources all reinforce these preferences. While non-financial attributes are also important for Vietnamese doctors, the scale of the difference of opportunities presents a considerable policy challenge. Significant salary increases for doctors in hard-to-staff areas are likely to have some impact. However, addressing the differentials is likely to require broader market reforms and regulatory measures.     

儿科临床营养教学体系的构建及效果分析——以重庆医科大学附属儿童医院为例

[目的]探索建立规范的儿科临床营养教学体系,以提高营养系本科生的儿科临床营养综合水平。[方法]根据以往教学经验及在带教过程中发现的问题,重新构建"多学科训练、临床营养思维训练、启发参与式教学、互联网融合"等综合教学模式的教学体系。在新教学体系实施4年后,对比干预组和对照组学生参与、理论、操作、就业意向等有无变化。[结果]干预组参与实习人数和天数较对照组明显增加(P<0.05),且临床营养知识及操作技能较对照组有较大的提高(P<0.05)。干预组学生选择医院就业的比例比对照组高(干预组32%,对照组11%),但两组总的就业意向构成比差异无统计学意义。干预组学生不选择医院就业的主要原因为"工作压力",而对照组为"担心技能不足"。[结论]规范的儿科临床营养教学体系的构建可以提高营养系本科生的儿科临床营养综合水平,但促进相关人员就业仍需要继续扩大专科影响力,从而引导政策支持。     

Building postgraduate capacity in medical and public health research in Vietnam: an in-service training model

In Vietnam, needs to update medical and public health research capacity, but advanced training in research methodology in universities is still very limited. The first university-certified research training course aimed at physicians was conducted in Ho Chi Minh City in 2000. This paper describes the processes, outcomes and lessons learned from the project, to enable the training course to be repeated to increase research capacity among health professionals in Vietnam and other developing countries. Based on needs assessment, the 9-month, part-time course offered advanced training in practical research skills, including epidemiology, biostatistics and qualitative research methods. Thirty-seven trainees (teaching staff, interns and clinicians) completed the course, which included four group research projects. With active support from university management, the course was rigorous and participation was excellent. Trainees's knowledge of research methodologies increased, and their self-evaluation of achievement of the training objectives was high. The total score of the epidemiology and biostatistics test improved from 56% (median) in the pre-course test to 83% in the post-course test. The group research project results were disseminated through a conference and publication in peer-reviewed journals. The course has since been repeated twice as a 1-month intensive course to accommodate trainees from distant regions. This type of rigorous in-service research training at universities and teaching hospitals in developing countries appears to be an effective, sustainable approach. It also holds promise for producing research data that are responsive to a country's own needs and which are likely to be applied in health policy and practice. Further evaluation of the impact and cost of such models is indicated.     

Medical social work practice and SARS in Singapore

This article reports on the findings of a qualitative study exploring the impact of SARS on social work practice in five different hospitals in Singapore. The study sought to examine the range of interventions adopted by 28 medical social workers and the theoretical orientations underpinning them. The findings discussed include the impact of infection control practices on social work intervention, the range of interventions undertaken, respondents' reflections and self-awareness, the role of values and ethics, creativity and training, and their recommendations for future emergencies. While the findings of the study relate specifically to hospital social work practice, the crisis and trauma nature of the work makes it applicable to a broader range of practice in these areas and a range of populations. The findings from this study could also inform the development of training programs for social work and other clinical health workers, and emergency management planning.     

压力管理训练对小学教师压力应对方式的影响

目的探讨压力管理训练对小学教师压力应对方式的影响，以提高教师的压力应对能力。方法设置训练组小学教师35名和对照组教师39名，进行6次为期12周的压力管理训练，内容包括认识压力、认知重构和解决问题技能等内容，干预前后分别评估教师应对方式。结果接受压力管理训练的教师较对照组更多采用指向问题的应对方式。结论压力管理训练有助于提高教师的压力应对能力。     

The Vietnam Era Twin Registry: a resource for medical research

The Vietnam Era Twin Registry consists of 4,774 male-male twin pairs born between 1939 and 1957 with both brothers having served in the United States military during the Vietnam War. The registry was originally developed to provide the best control group for Vietnam-exposed servicemen to study the long-term health consequences of service in Vietnam. Recognizing the potential value of the registry for other areas of medical research, the Department of Veterans Affairs in 1988 opened the registry for use by both VA and non-VA investigators. The existence of centralized VA data bases for deaths and VA hospitalizations will strengthen future followup of the twins. This article describes the characteristics of the registry population and the process for accessing the registry.     

表象训练对中风恢复期康复疗效的临床观察

目的观察不同条件作业的功能锻炼对中风恢复期的作用和效果,有效评价表象训练对中风恢复期肢体功能障碍影响和作用。方法采用简单随机同期对照试验方法,将80例患者随机分为试验组40例和对照组40例。试验组采用表象训练条件作业视听觉功能锻炼互动的方法,对照组采用无表象条件作业康复训练法。结果两组间基线资料差异无统计学意义(P﹥0.05),具有可比性。试验组的总有效率为92.68%,对照组的总有效率为71.14%(P﹤0.01),躯体功能评定显示试验组优于对照组(P﹤0.01)。结论表象训练条件作业的方法较无表象条件作业康复训练法作用和疗效显著,说明表象训练条件作业的方法对中风恢复期肢体功能障碍患者有效的功能训练方法。