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The Expense of Insulin in Individuals with Insulin-Dependent Diabetes in Fars Province based on Prescribed Prescriptions including Insulin 法尔斯省胰岛素依赖型糖尿病患者的胰岛素费用——基于包括胰岛素在内的处方
Pub Date : 2020-12-15 DOI: 10.18502/jebhpme.v4i4.4886
Sanaz Amiri, A. Mirahmadizadeh, Saeed Seyfi
Background: Diabetes is considered one of the most prevalent chronic diseases in the world, and if it is not cured, it can have many side effects and expenses. The current study has been conducted to calculate the cost of insulin applied in patients with insulin-dependent diabetes who are younger than 19 years old in 2016 and 2017. Methods: The current study is a descriptive and cross-sectional study We investigated all registered prescriptions of social security and health insurance in this study. The price of each insulin was calculated through the official website of the Food and Drug Administration (FDA). Ultimately, the cost of insulin has been calculated based on gender, age group, and insurance types under the age of 19 in patients with insulin-dependent diabetes and those without insulin-dependent diabetes. Data has been analyzed using SPSS24. The frequency command is used to obtain the percentages. Results: In this study, 1135105 insured cases younger than 19 years old were investigated, which females consisted almost half of the insured cases (51 %), and most of them were in the age group of 2-7 years (34 %), and 50 % of the participants in this study were covered by social security insurance. The treatment of each patient with insulin-dependent diabetes included a cost of $ 1187 and $ 1309, respectively, in 2016 and 2017, and $ 1.4 and $ 1.7 respectively (1$ = 42,000 Rials), for each person under the age of 19 in the general population. Conclusion: The results achieved by the mentioned study explained that nearly remarkable cost is spent on preparing insulin for patients with Type 1 Diabetes Mellitus every year. This amount is increasing, and it is essential to predict insulin needs for the future according to the insulin consumption changes.
背景:糖尿病被认为是世界上最普遍的慢性疾病之一,如果不治愈,它可能会产生许多副作用和费用。目前的研究是为了计算2016年和2017年年龄在19岁以下的胰岛素依赖型糖尿病患者使用胰岛素的成本。方法:本研究采用描述性和横断面研究方法,对所有登记在册的社会保障和医疗保险处方进行调查。每种胰岛素的价格是通过美国食品药品监督管理局(FDA)的官方网站计算出来的。最终,胰岛素的费用是根据性别、年龄组和19岁以下胰岛素依赖型糖尿病患者和非胰岛素依赖型糖尿病患者的保险类型来计算的。使用SPSS24对数据进行分析。frequency命令用于获取百分比。结果:本研究共调查19岁以下参保者1135105人,其中女性参保者几乎占参保者的一半(51%),其中2-7岁的参保者居多(34%),参保者占50%。2016年和2017年,每名胰岛素依赖型糖尿病患者的治疗费用分别为1187美元和1309美元,普通人群中19岁以下患者的治疗费用分别为1.4美元和1.7美元(1美元= 4.2万里亚尔)。结论:上述研究结果说明,1型糖尿病患者每年用于制备胰岛素的费用接近显著。这个数字还在增加,根据胰岛素消耗的变化来预测未来的胰岛素需求是很有必要的。
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引用次数: 0
Examining the Effect of Executing the Health Reform Plan on the Share of Insurances, Franchise, and Health Subsidies in Shahid Sadoughi University of Medical Sciences in Yazd in 2013-2016 检验2013-2016年执行医疗改革计划对亚兹德沙希德·萨多吉医科大学保险、特许经营和医疗补贴份额的影响
Pub Date : 2020-12-15 DOI: 10.18502/jebhpme.v4i4.4887
Ahmad Reza Motalehi, elham roshanian, M. Vafaeinasab, M. Saffari
Background: The Health Reform Plan was begun in 2014 as one of the most significant programs of the Ministry of Health to reduce hospitalization and out-of-pocket costs paid by people. Hence, we consider examining the economic consequences of this plan as one of the research priorities in this field. This study aimed to examine the effect of implementing the Health Reform Plan on the share of basic, supplementary insurances, franchise, and health subsidies from medical expenses in Shahid Sadoughi University of Medical Sciences in Yazd in 2013-2016. Methods: This study is a descriptive study conducted in a quantitative and cross-sectional method. The study population included patients' bills in hospitals affiliated to Shahid Sadoughi University of Medical Sciences in Yazd. All patient's hospitalization files were examined by the census method. Information was extracted from financial documents and data in the hospital's HIS system. We referred to the basic and supplementary insurance organizations of the province to complete the data. Descriptive statistics and were used to analyze the obtained data by using SPSS16 Software. Results: Generally, it was specified that the share of basic and supplementary insurances had not changed considerably due to the doubling of the whole costs of patients 'files, and basic insurances will pay on average 76 % of patients' costs. But, the patient's share of out-of-pocket payments has declined from 21 % to 11 %, which the Ministry of Health and Medical Education will pay this 10 percentage through the health subsidy to the affiliated centers. Conclusion: This study's results explained an increase in patient's health costs and a decrease in patient's out-of-pocket costs. Consequently, it is required to pay attention to methods to increase medical centers' efficiency to reduce health costs. Furthermore, large-scale/macro programs should be designed and implemented at the national level to reduce patient's out-of-pocket payments.
背景:卫生改革计划于2014年启动,是卫生部减少住院和自付费用的最重要方案之一。因此,我们认为研究该计划的经济后果是该领域的研究重点之一。本研究旨在检验2013-2016年实施医疗改革计划对亚兹德Shahid Sadoughi医科大学医疗费用中基本保险、补充保险、特许经营和医疗补贴份额的影响。方法:本研究采用定量、横断面方法进行描述性研究。研究对象包括亚兹德Shahid Sadoughi医科大学附属医院的病人账单。采用普查方法对所有患者的住院档案进行检查。信息是从医院HIS系统的财务文件和数据中提取的。我们参考了全省的基本保险和补充保险组织来完成数据。采用SPSS16软件对所得数据进行描述性统计和统计学分析。结果:一般情况下,基本保险和补充保险的份额并未因患者档案总费用翻倍而发生较大变化,基本保险平均承担患者费用的76%。但是,患者自付费用的比例从21%下降到11%,保健医学教育部将通过向附属医院提供健康补助来支付这10%。结论:本研究的结果解释了患者医疗费用的增加和患者自付费用的减少。因此,需要注意提高医疗中心效率以降低医疗成本的方法。此外,应在国家层面设计和实施大规模/宏观方案,以减少患者的自付费用。
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引用次数: 0
Survey of the Impact of Myocardial Infarction on Patients’ Quality of Life: A Single-Centre Cross-Sectional Study 心肌梗死对患者生活质量影响的调查:单中心横断面研究
Pub Date : 2020-12-15 DOI: 10.18502/jebhpme.v4i4.4889
H. Jalilian, A. Imani, H. Mir, Elnaz Javanshir, M. Mamene, S. Heydari
Background: A heart attack is one of the most common cardiovascular diseases, affecting different dimensions of the patients’ quality of life due to the disease’s disabling and limiting nature. Therefore, this study aimed to examine the impact of myocardial infarction on patients’ quality of life referring to the Shahid Madani Medical & Training Hospital, in East Azerbaijan Province in 2017, in Iran. Methods: This was a cross-sectional study. A total of 220 patients with a heart attack were selected in this study. Sampling was conducted using the systematic random method. Data were collected using the Minnesota Living with Heart Failure Questionnaire (MLHFQ). Descriptive statistics (frequency, mean) and statistical analyses (Mann-Whitney test, Spearman correlation, and Generalized Linear Models Regression) were performed at a significance level of P-value < 0.05 using SPSS22. Results: In this study, the mean score of the total effect of a heart attack on the patients’ quality of life was 30.09 ± 17.73. The mean score of the effect of a heart attack on the patient’s quality of life in the physical, emotional, and general subscales was 34.85 ± 24.24, 26.63 ± 27.73, and 27.51 ± 17.83, respectively. There was a statistically significant association between education status (P-value = 0.006), income status (P- value = 0.000), and the mean score of the effect of a heart attack on the patient’s quality of life; also a positive and significant correlation was found between age (CC = 0.135, P-value = 0.046), the number of hospitalization (CC = 0.187, P-value = 0.006) and the mean score of the effect of a heart attack on the patient’s quality of life. Conclusion: A heart attack has a considerable impact on the patients’ quality of life, particularly on the physical dimension. Hence, health professionals should pay more attention to these vulnerable groups and offer rehabilitation services suitable to these groups to reduce the impact of the disease.
背景:心脏病是最常见的心血管疾病之一,由于其致残性和限制性,影响着患者生活质量的不同维度。因此,本研究旨在研究2017年伊朗东阿塞拜疆省Shahid Madani医疗培训医院心肌梗死对患者生活质量的影响。方法:采用横断面研究。本研究共选取了220例心脏病发作患者。采用系统随机抽样方法进行抽样。数据采用明尼苏达州心衰患者生活问卷(MLHFQ)收集。使用SPSS22进行描述性统计(频率、平均值)和统计分析(Mann-Whitney检验、Spearman相关和广义线性模型回归),p值< 0.05为显著性水平。结果:本组心脏病发作对患者生活质量的总影响平均得分为30.09±17.73。心脏病发作对患者身体、情绪和一般生活质量影响的平均得分分别为34.85±24.24、26.63±27.73和27.51±17.83。受教育程度(P值= 0.006)、收入状况(P值= 0.000)与心脏病发作对患者生活质量影响的平均得分有统计学显著相关;年龄(CC = 0.135, p值= 0.046)、住院次数(CC = 0.187, p值= 0.006)与心脏病发作对患者生活质量影响的平均评分呈显著正相关。结论:心脏病发作对患者的生活质量有相当大的影响,尤其是对身体方面的影响。因此,卫生专业人员应更多地关注这些弱势群体,并提供适合这些群体的康复服务,以减少疾病的影响。
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引用次数: 1
Survival Rate of Patients with Acute Leukemia: A Case Study in Iran 伊朗急性白血病患者的生存率
Pub Date : 2020-12-15 DOI: 10.18502/jebhpme.v4i4.4888
M. Ranjbar, M. Barouni, V. Moazed, H. Fallahzadeh, S. Sheikholeslami
Background: Acute leukemia is a kind of aggressive disease that includes high rates of fatalities in the world, in particular in Iran. This research was done to determine the survival rate of patients with acute leukemia in Iran. Methods: 85 adult patients who were first diagnosed with acute leukemia in Shahid Bahonar hospital of Kerman during March 2012 until March 2013 were evaluated in a retrospective descriptive study to measure the death/life status in a 5-year period (2012-2017). The required data was gathered from medical records of patients, HIS system data, and the cancer registry system, and the Kaplan-Meier estimator and Log Rank test were used to calculate the survival rate using SPSS23. Results: Survival rate was completely 45.9 % for patients with acute adult leukemia. It was 47.08 % in acute myelogenous leukemia (AML) and it was 43.06 % in acute lymphocytic leukemia (ALL). The 1,2,3,4 and 5-year survival of acute leukemia was respectively 87.1 %, 69.4 %, 62.4 %, 56.5 % and 45.9 %. Conclusion: Iran's health system should design and plan to increase the survival of patients with acute leukemia by improving the methods and facilities to diagnose and treat it more quickly and more effectively.
背景:急性白血病是一种侵袭性疾病,在世界范围内具有很高的死亡率,特别是在伊朗。这项研究是为了确定伊朗急性白血病患者的生存率。方法:对2012年3月至2013年3月在克尔曼Shahid Bahonar医院首次诊断为急性白血病的85例成年患者进行回顾性描述性研究,测量其2012-2017年5年期间的死亡/生活状况。从患者病历、HIS系统数据和癌症登记系统中收集所需数据,采用Kaplan-Meier估计和Log Rank检验,使用SPSS23计算生存率。结果:急性成人白血病患者的生存率为45.9%。急性髓性白血病(AML)为47.08%,急性淋巴细胞白血病(ALL)为43.06%。急性白血病患者1、2、3、4、5年生存率分别为87.1%、69.4%、62.4%、56.5%、45.9%。结论:伊朗的卫生系统应设计和计划通过改进方法和设施来更快、更有效地诊断和治疗急性白血病,从而提高急性白血病患者的生存率。
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引用次数: 1
Nursing Leadership Models in Promoting and Improving Patient’s Safety Culture in Healthcare Facilities; A Systematic Review 护理领导模式在促进和改善医疗机构患者安全文化中的作用系统回顾
Pub Date : 2020-12-15 DOI: 10.18502/jebhpme.v4i4.4891
Y. Yodang, N. Nuridah
Background: Nurse leader has an important role in encouraging patient’s safety culture among nurses in the healthcare system. This literature review aims to identify the nursing leadership model and to promote and improve patient safety culture to improve patient outcomes in health care facilities including hospitals, primary health care, and nursing home settings. Methods: Searching appropriate journals through some journal databases were applied including DOAJ, GARUDA, Google Scholar, MDPI, Proquest, Pubmed, Sage Journals, ScienceDirect, and Wiley Online Library, which were published from 2015 to 2020. Results: Fourteen articles meet the criteria and are included in this review. The majority of these articles were retrieved from western countries, the US, Canada, and Finland. This review identifies three nursing leadership models that seem useful to promote and improve patient safety culture in health care facilities which are transformational, authentic, and ethical leadership models. Conclusion: The patient safety influences health care outcomes. The evidence shows the leadership has positive relation to patient satisfaction and patient safety outcomes improvement. The transformational, authentic, and ethical leadership models seem to be more useful in promoting, maintaining, and improving patient safety culture in health care facilities.
背景:在医疗保健系统中,护士领导在鼓励患者安全文化方面发挥着重要作用。本文献综述旨在确定护理领导模式,并促进和改善患者安全文化,以改善包括医院、初级卫生保健和养老院在内的卫生保健机构的患者预后。方法:采用DOAJ、GARUDA、谷歌Scholar、MDPI、Proquest、Pubmed、Sage journals、ScienceDirect、Wiley Online Library等期刊数据库检索2015 - 2020年出版的期刊。结果:14篇文章符合标准并被纳入本综述。这些文章大多来自西方国家,如美国、加拿大和芬兰。本综述确定了三种护理领导模式,它们似乎有助于促进和改善卫生保健设施中的患者安全文化,即变革型、真实型和道德型领导模式。结论:患者安全影响医疗保健效果。证据显示,领导与患者满意度和患者安全结局改善呈正相关。变革型、真实型和道德型领导模式似乎在促进、维护和改善卫生保健机构的患者安全文化方面更有用。
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引用次数: 1
Designing a Database based on Medical Staffs’ Experiences: Commentary on COVID-19 基于医务人员经验的数据库设计——新冠肺炎疫情评论
Pub Date : 2020-09-12 DOI: 10.18502/JEBHPME.V4I3.4161
S. Panahi, H. A. Rizi
The article's abstract is not available.
这篇文章的摘要没有。
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引用次数: 0
Emerging and Re‐emerging Diseases: Policies and Strategies for Future 新发和再发疾病:未来的政策和战略
Pub Date : 2020-09-12 DOI: 10.18502/JEBHPME.V4I3.4160
R. Khodayari-zarnaq, Gita Alizadeh, Gisoo Alizadeh
The emerging infectious diseases and their number one causes pose a challenge to international stability worldwide. The epidemic of emerging and re-emerging diseases causes many problems for health systems, especially for the medical staff, which require global action in this regard. Emerging infectious diseases are a growing problem for the global community that accompanies the increasing danger of severe health, environmental, economic, and social impacts. An ideal emerging disease preparedness and response environment would strive for collaboration among all sectors impacted by the area unit as a business and social commitment to enhance the capacity of nations and communities to respond to threats as they arise. This article highlights the significant issues that should be considered in emerging and re‐emerging diseases, which could help the policymakers to set effective policies for dealing with the diseases and to evaluate the impact of previous health interventions better at the community level.
新出现的传染病及其头号原因对世界范围内的国际稳定构成挑战。新发和再发疾病的流行给卫生系统,特别是医务人员带来了许多问题,这需要在这方面采取全球行动。新出现的传染病是全球社会日益严重的问题,伴随着严重的健康、环境、经济和社会影响的危险日益增加。理想的新出现疾病防范和应对环境应力求在受地区单位影响的所有部门之间开展合作,作为一项商业和社会承诺,以加强国家和社区应对威胁的能力。本文强调了在新发和再发疾病中应该考虑的重要问题,这可以帮助决策者制定有效的政策来应对疾病,并在社区层面更好地评估以前的卫生干预措施的影响。
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引用次数: 1
Identifying Barriers to Development of the Public-Private Partnership in Providing of Hospital Services in Iran:A Qualitative Study 确定在伊朗提供医院服务方面公私伙伴关系发展的障碍:一项定性研究
Pub Date : 2020-09-12 DOI: 10.18502/JEBHPME.V4I3.4162
A. Sadeghi, P. Bastani, O. Barati
Background: In recent years, public-private partnerships (PPPs) have been used to expand hospital services in many countries. Despite the achievements and implications, there have always been many challenges in implementing it. The purpose of this study was to identify the barriers and challenges in the development of public-private partnerships in hospital services in the country of Iran. Methods: This is a qualitative study conducted in 2015- 2016 by the content analysis method. The research population included experts and health professionals and those who have contributed to the development of PPPs model in hospital services (public and private). Of these, eighteen were selected using a purposive sampling approach and were interviewed semi-structured. The MAXQDA10 software was used to analyze the transcribed interviews. Results: Four main themes and sixteen sub-themes were identified concerning the barriers to developing public-private partnerships in the provision of hospital services in the country. They are cultural and social barriers, political and legal barriers, financial and investment barriers, and structural and process barriers. Conclusion: Officials and policymakers should identify the obstacles facing participatory patterns and then provide a suitable platform for nongovernmental organizations. This action can lead to an increase in the level of readiness of hospitals in Iran to implement this model.
背景:近年来,许多国家采用公私伙伴关系(ppp)来扩大医院服务。尽管取得了成就和影响,但在执行过程中始终存在许多挑战。这项研究的目的是确定伊朗在医院服务方面发展公私伙伴关系的障碍和挑战。方法:采用内容分析法,于2015- 2016年进行定性研究。研究对象包括专家和卫生专业人员,以及那些为(公立和私立)医院服务公私合作模式的发展做出贡献的人员。其中,18人被选择使用有目的的抽样方法和半结构化访谈。使用MAXQDA10软件对访谈记录进行分析。结果:确定了四个主要主题和16个次级主题,涉及在该国提供医院服务方面发展公私伙伴关系的障碍。它们是文化和社会障碍、政治和法律障碍、金融和投资障碍以及结构和过程障碍。结论:官员和决策者应该确定参与模式面临的障碍,然后为非政府组织提供合适的平台。这一行动可提高伊朗医院实施这一模式的准备程度。
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引用次数: 2
Self-care Behaviors and Influential Factors among Nurses Working in the Hospitals of Tehran 德黑兰医院护士自我保健行为及其影响因素
Pub Date : 2019-09-25 DOI: 10.18502/jebhpme.v3i3.1507
B. Ahmadi, H. Rafiemanesh, R. Shamlou, Yones Kor, Mozhgan Letafat Nezhad, Mojtaba Mehtarpour
Background: Nurses' self-care assessment and elimination of obstacles with appropriate interventions will have a great impact on their own health as well as the recipients of health services. This study was designed to evaluate self-care status among nurses in selected hospitals in Tehran, Iran. Methods: This cross-sectional study was carried out on 310 nurses working in Tehran University of Medical Sciences hospitals. Data were collected by a questionnaire with 70 questions that was conducted to evaluate the health level in five dimensions. Data were analyzed by using the statistical tests of MANOVA and Pearson’s correlation. Results: The average scores of nurses' self-care in men and women were 244.1 and 245.3, respectively. The highest average score was for the supportive relationships dimension. There was a significant relationship between gender and self-care dimensions (P-value = 0.077). The average scores of self-care for nurses working in the emergency department, general department, surgical department, intensive care unit, and other sectors were 238.5, 247, 240.6, 245.6 and 251.1, respectively. There was a positive relation between supportive relationships dimension, age, and years of employment. In addition, there was a negative relation between the number of children and supportive relationships dimension (P-value < 0.05). Conclusion: This study showed that self-care among nurses in the hospitals of Tehran University of Medical Sciences was moderately high, in a good and acceptable situation. However, there were poor scores in some areas and further study of the nurses’ self-care and its promoting strategies is still required.
背景:护士的自我护理评估和障碍的消除与适当的干预将有很大的影响自己的健康,以及卫生服务的接受者。本研究旨在评估伊朗德黑兰选定医院护士的自我护理状况。方法:对德黑兰医科大学附属医院310名护士进行横断面调查。数据是通过一份有70个问题的问卷收集的,该问卷从五个方面评估健康水平。数据分析采用方差分析和Pearson相关检验。结果:男性护士自我护理平均得分为244.1分,女性护士自我护理平均得分为245.3分。平均得分最高的是支持关系维度。性别与自我照顾各维度存在显著相关(p值= 0.077)。急诊科、综合科、外科、重症监护病房和其他科室护士的自我护理平均得分分别为238.5分、247分、240.6分、245.6分和251.1分。支持关系维度与年龄、工作年限呈正相关。此外,子女数量与支持关系维度呈负相关(p值< 0.05)。结论:本研究显示德黑兰医科大学附属医院护士的自我保健水平为中高,处于良好和可接受的状态。但也有部分地区得分较低,需要进一步研究护士的自我护理及其促进策略。
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引用次数: 2
The Study of Factors Affecting the Job Performance of Nurses Working in Selected Teaching Hospitals in Tehran 德黑兰部分教学医院护士工作绩效影响因素研究
Pub Date : 2019-09-25 DOI: 10.18502/jebhpme.v3i3.1506
Vahid Saberzadeh, Javad Abdollahinia, Pedram NourizadehTehrani, Hadi Asheghi, Khatere Khanjankhani
Background: Undoubtedly, one of the most important objectives of any organization is to provide high quality and desirable goods and services that depends on the performance of human force of the organization. The performance of physicians and nurses is a very important factor in establishing and enhancing the effectiveness of services. Since nurses are the most fundamental medical staff of the hospital, the present study was performed with the aim of investigating the factors affecting the job performance of nurses working in selected teaching hospitals in Tehran in 2018. Methods: The target group of this study included nurses working in inpatient wards of hospitals, of whom 354 individuals were selected by simple random sampling method. The intraorganizational environment questionnaire (Weisbord), five personality traits (NEO personality inventory), and Paterson’s job performance questionnaire were the three data collection tools. The study was conducted in 2018 and the data were analyzed by SPSS 20 software using descriptive statistics and artificial neural networks. Results: In the personality traits questionnaire, neuroticism (40.22 ± 6.66) dimension had the highest and responsibility (23.94 ± 4.91) dimension had the lowest mean scores. Also in the inter-organizational environment questionnaire, communication (14.66 ± 4.52) dimension and rewards (21.33 ± 6.54) dimension had the best and worst status, respectively. Comparison of significance coefficients in neural networks showed that dimensions of agreeability (100 %) and marital status (8 %) had the highest and lowest importance in nurses’ job performance. Conclusion: The results reveal that the dimensions of personality traits and job agreeability dimension have the most effect on the employees’ job performance. Hence, it is possible to improve staff performance by hiring people consistent with their work.
背景:毫无疑问,任何组织最重要的目标之一是提供高质量和理想的商品和服务,这取决于组织人力的表现。医生和护士的表现是建立和提高服务有效性的一个非常重要的因素。鉴于护士是医院最基础的医务人员,本研究旨在调查2018年德黑兰部分教学医院护士工作绩效的影响因素。方法:以医院住院部护士为研究对象,采用简单随机抽样方法抽取354人。组织内环境问卷(Weisbord)、五种人格特质问卷(NEO人格量表)和Paterson工作绩效问卷是三种数据收集工具。该研究于2018年进行,数据采用SPSS 20软件进行描述性统计和人工神经网络分析。结果:人格特质问卷中,神经质(40.22±6.66)维度平均得分最高,责任心(23.94±4.91)维度平均得分最低。在组织间环境问卷中,沟通维度(14.66±4.52)和奖励维度(21.33±6.54)分别为最佳和最差。神经网络显著性系数比较结果显示,对护士工作绩效影响最大的维度是“亲和性”(100%)和“婚姻状况”(8%)。结论:人格特质维度和工作亲和性维度对员工工作绩效的影响最大。因此,有可能通过雇用与其工作相一致的人来提高员工的绩效。
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引用次数: 0
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Evidence Based Health Policy, Management and Economics
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