医生职业用语中的伦理问题

论述了医生职业语言的基本特征，分析了诊断和治疗过程两个环节中医患语言的基本特征，总结了医生职业用语基本的伦理原则。     

Demotivating factors among government doctors in Negeri Sembilan

Motivation, especially on the relationship of remuneration of government doctors to it, has long been an issue of concern. This study sought to elucidate the demotivating factors in service and the perceived discrepancy in income. It was conducted amongst doctors serving in the Ministry of Health, Negeri Sembilan, using self-administered questionnaires. Factors considered demotivating were remuneration, workload and recognition given. Career development, promotion prospects, issues with superiors, resources and patient attitudes were other factors identified. On average, respondents expect an income of 1.63 times more than their current drawn salary and 87.2% cited rewards as a recommendation to improve their satisfaction in service. In-service training was desired by almost all. Though the medical profession has traditionally been viewed as altruistic in nature, doctors in service are voicing out their views and perception, and they should be heard.     

马尔康市少数民族地区村医健康素养调查

目的 通过调查马尔康市少数民族村医健康素养现状，为促进少数民族地区健康教育提供科学依据。方法 采用整群抽样方法，2018年10月16日至11月1日以参加2018年四川省深度贫困县"一村一医"合格村医培训工程的村医76名作为调查对象，以《健康66条——中国公民健康素养读本》为基础，自编问卷开展调查。问卷包括健康基本知识和理念、健康生活方式和行为、健康基本技能3个维度。分析不同人口学特征村医三个评价纬度差异及各项问题知晓情况。结果 马尔康市少数民族村医达到健康素养水平基本要求的比例为0.0%；达到基本技能素养水平基本要求的比例为9.0%，达到基本知识和理念素养水平基本要求的比例为6.6%、达到健康生活方式和行为素养水平基本要求的比例为0.0%；不同年龄、不同学历的少数民族村医在健康素养总得分差异有统计学意义（P<0.05）；少数民族村医健康素养总得分与文化程度呈正相关（r=0.430，P<0.05）；不同人口学特征的少数民族村医在健康生活方式和行为得分差异无统计学意义（P>0.05）。结论 马尔康市少数民族村医健康素养水平总体较低，应加强针对少数民族村医的健康教育工作。     

Type 2 diabetes mellitus risk assessment among doctors in Ondo state

IntroductionDiabetes Mellitus (DM) has become a disease of public health importance in Nigeria. Early identification of DM risk is important in the reduction of this disease burden. This study assessed ten-year risk of developing type 2 DM among some medical doctors in Ondo State.MethodsThis was a cross-sectional study that assessed ten-year risk of developing type 2 DM among some doctors using the Finland Diabetic Risk Score form. Known diabetics were excluded from the study. Body mass index (BMI), waist circumference (WC), blood pressure and total DM risk score were determined for each participant.ResultsOne hundred and ninety-two doctors participated in the study with a male: female ratio of 1.3:1. Majority (92.2%) were below 55 years, 22 (11.5%) were obese, 32(16.7%) had central obesity, 46(24%) reported physical inactivity, 49(25.5%) had family history of DM, 141(73.4%) do not take fruits and vegetables regularly. Forty-three (22.4%) were found to have elevated blood pressure while 6(3.1%) had elevated blood glucose. Fifty-seven (29.7%) of the participants had increased ten-year DM risk. Significant predictors of increase DM risk were age ≥ 45 years (AOR:9.08; CI 3.13–26.33; p = <0.001); BMI ≥25kg/m² (AOR:11.41; CI:4.14–31.45; p = <0.001); family history of DM (AOR:9.93; CI:3.25–30.39; p = <0.001); abdominal obesity (AOR:6.66; CI:2.08–21.29; p= < 0.001); and infrequent dietary intake of fruits and vegetable (AOR:3.11;CI:1.03:9.37: p = 0.04)ConclusionThere was increased 10-year DM risk in about 30% of the participants. Lifestyle modification such as physical activity and regular consumption of fruits and vegetables should be encouraged among doctors.     

上海市南汇地区乡村医生结核病认知及影响因素调查

为了解辖区内乡村医生结核病防治知识知晓情况,分析其影响因素,为开展乡村医生结核病健康教育提供依据,我们对上海市南汇地区乡村医生的结核病知识知晓情况作了调查。     

A study of needle stick injuries among non-consultant hospital doctors in Ireland

Introduction  

NCHDs are exposed to a great number of blood-borne infections. Needle stick injuries are possibly the main route of acquiring such infections from a non-consultant hospital doctors (NCHDs) perspective. This study examines NCHDs experiences surrounding needle stick injuries.     

医生心理授权、角色压力源与职业倦怠的关系研究

目的探索医生心理授权、角色压力源与职业倦怠的关系。方法采用方便取样的方法,用职业倦怠量表（MBI—GS）、心理授权量表和角色压力源量表对山东省潍坊市350名医生进行调查。结果心理授权中的工作意义[（10．80±3．12）分]与自主性[（9．33±3．19）分]均与职业倦怠的3个维度呈显著负相关（r=-0．28--0．47,P〈0．01）,自我效能[（11．42±2．67）分]与玩世不恭[（1．61±1．21）分]、成就感低落[（3．62±1．51）分]呈显著负相关（r=-0．23,-0．51,P〈0．01）,工作影响[（8．04±3．18）分]与情绪衰竭[（1．89±1．19）分]、玩世不恭呈显著负相关（r=-0．17,-0．25,P〈0．01）。角色压力源中的3个维度与情绪衰竭、玩世不恭均呈显著正相关（r=0．15-0．45,P〈0．01）,角色模糊（19．09±3．76）与成就感低落呈显著正相关（r=0．42,P〈0．01）。心理授权中自我效能与自主性对职业倦怠有显著地负向预测作用（P〈0．01）;角色压力源中角色超载（15．24±4．62）与角色模糊对职业倦怠有显著地正向预测作用（P〈0．01）。结论心理授权、角色压力源与职业倦怠密切相关,并且有重要的预测作用。     

Potential for violence causing fear among Canadian doctors who perform abortions.

The November shooting of a Vancouver physician has caused increased fear among doctors who perform abortions in British Columbia. There is also concern within the Society of Obstetricians and Gynaecologists that the recent violence and ongoing harassment will drive doctors from the abortion field. Some anti-abortion advocates support violence against those who perform abortions but spokespersons for the movement say they represent "fringe" views. One BC anti-abortion coalition now requires people to sign a pledge of nonviolence before participating in its conferences or other events.     

浙江两地区基层医生对前列腺疾病认知现状调查

目的 调查和了解目前浙江两地基层医生对前列腺疾病诊疗现状的认知情况,为进一步提高基层医生诊疗能力提供指导。方法 选取湖州、绍兴等地157名基层医生,以微信问卷形式进行调查。调查内容包括前列腺疾病的分型、病因的认识、诊断和治疗方法以及相关并发症处理等。结果 大部分医生能够对前列腺炎作出诊断,并进行相关检查及治疗;对于良性前列腺增生,有33.76%的被调查者不知道IPSS评分,有17.2%的被调查者从未参加过任何相关知识培训,大部分医生能够完成疾病诊疗相关的问题,但是被调查对于良性前列腺增生会引起何种类型的尿失禁尚无统一的认识;前列腺癌方面,被调查者对于目前我国前列腺癌发病率、老年人PSA检查的选用等问题了解较为深入,而前列腺癌生化复发、去势抵抗以及Gleason分级等概念了解程度较低。结论 目前浙江两地基层医生对前列腺疾病的病因、发病机理、诊治认知等方面仍需进一步提高,尤其在面对前列腺癌时,多数医生还未能够掌握一套完整的诊疗体系,因此要发挥医联体建设的优势,针对前列腺相关疾病,并对广大基层医生进行相关培训,提高医生临床医疗水平。     

Associations of stress and burnout among Australian-based doctors involved in after-hours home visits

Background

The after-hours house call (AHHC) service in Australia is growing, but studies have never explored the doctor variables associated with burnout and stress within the service. This study fills this knowledge gap.

Aims

To determine the doctor variables associated with burnout and stress among doctors involved in AHHC.

Methods

A quantitative, questionnaire-based survey of all 300 doctors engaged in AHHC through the National Home Doctor Service (NHDS), Australia’s largest home visiting doctor-service provider. The Maslach Burnout Inventory (MBI) was used to assess burnout over a 12-month period from October 2013 to September 2014. Ordinal logistics regression was used to identify significant associations.

Results

There were 168 valid responses received, giving a 56 per cent response rate. The most significant factor associated with reduced stress and burnout is the adoption of self-protection measures while on the job. Such measures include the use of chaperones, the use of panic alarms or buttons, adopting de-escalation techniques, and reliance on relevant surgery policies. Other associations with reduced stress include the attainment of postgraduate fellowships (vocational registration), working less than 24 hours per week, being in legally recognised partnerships, and being male. Conversely, having general practice as a career, being under 40 years of age, and obtaining primary medical degrees from Australia (as opposed to overseas) are all associated with increased burnout for doctors involved in AHHC.

Conclusion

A number of doctor variables have been found to significantly reduce burnout in AHHC Among these, the adoption of self-protective measures and the attainment postgraduate fellowships, where possible, should be encouraged among practitioners involved in the service.     

村医生结核病认知情况及影响因素的分析

目的 了解村医生结核病认知水平及影响因素.方法 采用多阶段整群分层随机抽样方法选取样本,使用自制调查问卷采取面对面询问方式调查.结果 13.3%的村医生结核病防治知识判断正确率低于60%.有90%以上村医生掌握了结核病基本知识,但现代结核病控制策略(directly observed treatment,short-course,DOTS)部分内容掌握情况较差.影响村医生结核病认知因素为从医年限、技术职称、是否参加过防治结核病相关知识培训等.结论 村医生结核病认知水平尚不能适应目前国家结核病预防控制形势,应安排从医年限长、技术职称高的村医生从事结核病防治工作,加强对村医生防治结核病相关知识培训.