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DID THE BURNOUT LEVELS OF THE NURSES AFFECT THEIR PROFESSIONAL COMMITMENT DURING THE COVID -19 PANDEMIC PROCESS? 护士的职业倦怠程度是否影响了他们在 19 大流行病期间的职业承诺?
Pub Date : 2024-06-02 DOI: 10.33457/ijhsrp.1432179
Fatoş Tozak, Serap Altuntaş
Aims: This descriptive, cross-sectional, and correlational study investigated the effect of burnout on nurses' professional commitment during the COVID-19 pandemic. Background: Nurses have been experiencing high levels of burnout since the onset of the COVID-19 pandemic. However, we know little about how burnout affects their professional commitment. Methods: The study was conducted between March 2021 and April 2021. The sample consisted of 671 nurses. Participation was voluntary. Data were collected online using a personal information form, the Maslach Burnout Inventory (MBI), and the Nursing Professional Commitment Scale (NPCS). The data were analyzed using the Statistical Package for Social Sciences (SPSS) at a significance level of 0.05. Results: Half the participants stated that the pandemic adversely affected their professional commitment (51.4%). More than a quarter of the participants noted that they considered quitting (36.4%). Participants had a mean MBI and NPCS score of 2.43±0.52 (above average) and 2.07±0.76 (average), respectively. Their MBI and NPCS scores were negatively correlated (r= -0.428; p=0.001). Burnout explained 18% of the total variance of professional commitment (p=0.000; R2: 0.182) Conclusion: Nurses experience high levels of emotional exhaustion and depersonalization during the pandemic, resulting in reduced professional commitment. There is also a positive correlation between personal accomplishment and professional commitment.
目的:这项描述性、横断面和相关性研究调查了 COVID-19 大流行期间职业倦怠对护士职业承诺的影响。研究背景:自 COVID-19 大流行以来,护士的职业倦怠程度一直很高。然而,我们对职业倦怠如何影响护士的职业承诺知之甚少。研究方法研究在 2021 年 3 月至 2021 年 4 月期间进行。样本包括 671 名护士。参与是自愿的。使用个人信息表、马斯拉赫职业倦怠量表(Maslach Burnout Inventory,MBI)和护理专业承诺量表(Nursing Professional Commitment Scale,NPCS)在线收集数据。数据使用社会科学统计软件包(SPSS)进行分析,显著性水平为 0.05。结果半数参与者(51.4%)表示大流行病对他们的职业承诺产生了不利影响。超过四分之一的参与者指出他们曾考虑辞职(36.4%)。参与者的 MBI 和 NPCS 平均得分分别为 2.43±0.52(高于平均水平)和 2.07±0.76(平均水平)。他们的 MBI 和 NPCS 分数呈负相关(r= -0.428; p=0.001)。职业倦怠解释了职业承诺总方差的 18%(p=0.000;R2:0.182):在大流行病期间,护士会经历高度的情感衰竭和人格解体,从而导致职业承诺降低。个人成就感与职业承诺之间也存在正相关。
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引用次数: 0
THE HIDDEN IMPACTS OF OCCUPATIONAL STRESS ON PATIENT SAFETY CULTURE 职业压力对患者安全文化的隐性影响
Pub Date : 2024-05-16 DOI: 10.33457/ijhsrp.1357647
Minh Nguyen, Lan Anh Do Thi, An Luong Tran Hong, Long Ly Tieu, Ngan Dang Thi Thien, Nhan Nguyen Thi Thu, Yen Pham Thi Kim, Hue Nguyen Thi Hoang, Ngoc Nguyen Thi Bach, Vu Sam Ha Nhu, Trieu Hoang, Xuan Nguyen Thi Truong
Introduction: Previous studies have shown that over 45% of healthcare workers exhibit symptoms of stress, but the impacts of occupational stress on patient safety culture (PSC) are not well understood. Objectives: This study was to determine the relationship between occupational stress and PSC at Pham Ngoc Thach Hospital in 2022. Methods: A cross-sectional study was conducted on 390 healthcare workers at Pham Ngoc Thach Hospital in November 2022. Data was collected using the Vietnamese version of the HSOPSC 2.0 tool (Cronbach’s alpha 0.68-0.93) and the DASS-21-S. Results: The results showed that 15% of healthcare workers had mild to severe stress. The average PSC score was 3.13 with a standard deviation of 0.36 (5-point Likert scale). Higher occupational stress was associated with lower overall PSC. Specifically, occupational stress negatively impacted three domains of patient safety: teamwork, error communication, and hospital management support for patient safety. Conclusion: This study demonstrates that reducing healthcare worker stress could be an intervention to improve PSC. Hospitals should consider implementing workplace stress relief initiatives as an important factor in promoting PSC in healthcare, which can directly impact patient health and satisfaction.
导言:以往的研究表明,超过 45% 的医护人员表现出压力症状,但职业压力对患者安全文化 (PSC) 的影响却不甚了解。研究目的本研究旨在确定 2022 年范玉泽医院职业压力与患者安全文化之间的关系。研究方法2022 年 11 月,对 Pham Ngoc Thach 医院的 390 名医护人员进行了横断面研究。使用越南语版 HSOPSC 2.0 工具(Cronbach's alpha 0.68-0.93)和 DASS-21-S 收集数据。结果显示结果显示,15% 的医护人员存在轻度至重度压力。PSC 平均分为 3.13 分,标准差为 0.36 分(5 点李克特量表)。职业压力越大,PSC 总分越低。具体来说,职业压力对患者安全的三个方面产生了负面影响:团队合作、错误沟通和医院管理层对患者安全的支持。结论这项研究表明,减轻医护人员的压力可以作为改善患者安全中心的一项干预措施。医院应考虑实施工作场所压力缓解措施,将其作为促进医疗保健领域患者安全中心的重要因素,这将直接影响患者的健康和满意度。
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引用次数: 0
AWARENESS AND PARTICIPATION OF UNIVERSITY EMPLOYEES IN CANCER SCREENING PROGRAMS 大学员工对癌症筛查计划的认识和参与情况
Pub Date : 2024-05-15 DOI: 10.33457/ijhsrp.1456101
Gönül Yılmaz Dündar, Büşra Dağcı Günal
The study aimed to investigate the level of awareness and engagement among university employees regarding cancer screening programs. In the descriptive cross-sectional study, 223 university employees were sampled. Data collection involved the utilization of an information form aligned with existing literature to ascertain participants' demographic details, cancer risk assessment, engagement in cancer screening initiatives, and knowledge level regarding these programs. Data analysis employed frequency, percentage, mean, standard deviation, and chi-square test methods. The significance level was set at p
该研究旨在调查大学员工对癌症筛查项目的认识水平和参与程度。在这项描述性横断面研究中,共抽取了 223 名大学员工。数据收集包括使用与现有文献一致的信息表,以确定参与者的人口统计学细节、癌症风险评估、参与癌症筛查计划的情况以及对这些计划的了解程度。数据分析采用了频率、百分比、平均值、标准差和卡方检验方法。显著性水平设定为 p
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引用次数: 0
EFFECTS OF COVID-19 ANXIETY AND COVID-19 QUALITY OF LIFE ON COVID-19 BURNOUT IN PSYCHIATRIC NURSES covid-19焦虑和covid-19生活质量对精神科护士covid-19职业倦怠的影响
Pub Date : 2024-02-28 DOI: 10.33457/ijhsrp.1416559
İbrahim Gün, Nur E Lcin Boyacıoğlu, Semra Engi̇nkaya
Nurses are key professionals in fighting the COVID-19 pandemic and they provide services beyond expectations. Although psychiatric nurses are suffering from anxiety and burnout they need to enhance and protect their quality of life. The major aim of the study was to investigate the effects of COVID-19 anxiety on COVID-19 quality of life and COVID-19 burnout, and the impact of COVID-19 quality of life on COVID-19 burnout on psychiatric nurses. The descriptive-relational design was used. The sample consisted of 159 nurses working in a state psychiatric hospital in İstanbul, determined by convenience sampling method. The data of the study was collected by using the socio-demographic form, COVID-19 Anxiety Scale, COVID-19 Life Quality Scale, and COVID-19 Burnout Scale. Statistically significant relationships were found between COVID-19 anxiety, COVID-19 life quality, and COVID-19 burnout. The increase in the anxiety of psychiatric nurses due to COVID-19 also increases the negative effect on their quality of life. COVID-19 anxiety positively affects burnout related to COVID-19. The increase in the negative effects of COVID-19 on the life quality of nurses causes an increase in burnout levels. The effect of COVID-19 on their life quality and the burnout based on COVID-19 was investigated in the research. Nurses are surpassing traditional boundaries, providing their services without constraints to confront the challenges posed by the COVID-19 pandemic. Their dedication knows no bounds as they work tirelessly to navigate through these difficult times, transcending conventional limits to offer essential care and support. Policymakers can alleviate the increasing physical and psychosocial burden of psychiatric nurses by providing financial and moral support. Additionally, medical, psychosocial, and legal resources should be provided to psychiatric nurses.
护士是抗击 COVID-19 大流行的关键专业人员,她们提供的服务超出了人们的预期。虽然精神科护士饱受焦虑和职业倦怠之苦,但她们需要提高和保护自己的生活质量。本研究的主要目的是调查 COVID-19 焦虑对 COVID-19 生活质量和 COVID-19 职业倦怠的影响,以及 COVID-19 生活质量对 COVID-19 职业倦怠对精神科护士的影响。研究采用了描述性关系设计。样本由 159 名在伊斯坦布尔一家国立精神病院工作的护士组成,采用方便抽样法确定。研究数据通过社会人口学表格、COVID-19 焦虑量表、COVID-19 生活质量量表和 COVID-19 职业倦怠量表收集。研究发现,COVID-19 焦虑量表、COVID-19 生活质量量表和 COVID-19 职业倦怠量表之间存在统计学意义上的重要关系。COVID-19 增加了精神科护士的焦虑感,同时也增加了对其生活质量的负面影响。COVID-19 的焦虑会对与 COVID-19 相关的职业倦怠产生积极影响。COVID-19 对护士生活质量负面影响的增加导致职业倦怠水平的增加。研究调查了 COVID-19 对护士生活质量的影响以及基于 COVID-19 的职业倦怠。护士们正在超越传统界限,无拘无束地提供服务,以应对 COVID-19 大流行带来的挑战。她们的奉献精神是无止境的,她们不辞辛劳地渡过难关,超越传统限制,提供必要的护理和支持。政策制定者可以通过提供财政和精神支持来减轻精神科护士日益加重的身体和心理负担。此外,还应为精神科护士提供医疗、社会心理和法律资源。
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引用次数: 0
NURSE-ON-NURSE VIOLENCE: EXPLORING COLLEAGUE BULLYING IN NURSING 护士对护士的暴力:探讨护理工作中的同事欺凌
Pub Date : 2024-02-28 DOI: 10.33457/ijhsrp.1416325
İrem Uyanik, Ayşe ÇİÇEK KORKMAZ
Colleague violence in nursing, identified as bullying, represents a significant issue. This cross-sectional and descriptive study aims to investigate the prevalence of workplace bullying among nurses and how these perceptions of bullying vary according to their individual-professional characteristics, frequency of support from managers and colleagues, and the bullying situations encountered. The study was conducted on 323 nurses, with data collected through an online survey using a descriptive information form and the Negative Act Questionnaire-Revised (NAQ-R). Descriptive statistics, Mann Whitney U, and Kruskal Wallis H tests were utilized for the analysis in SPSS. The findings indicate that the mean score of nurses on the NAQ-R is 35.61±12.34. Significant differences were found in the scale mean scores based on age, type of institution, unit worked, shift type, frequency of support from managers and colleagues, and the bullying situations encountered (p
护理工作中的同事暴力(即欺凌)是一个重大问题。这项横断面描述性研究旨在调查护士在工作场所遭受欺凌的普遍程度,以及护士对欺凌的看法如何根据其个人职业特点、获得管理人员和同事支持的频率以及所遇到的欺凌情况而有所不同。本研究以 323 名护士为对象,通过在线调查使用描述性信息表和消极行为问卷-修订版(NAQ-R)收集数据。在 SPSS 中使用了描述性统计、Mann Whitney U 和 Kruskal Wallis H 检验进行分析。结果表明,护士在 NAQ-R 上的平均得分为 35.61±12.34。根据年龄、机构类型、工作单位、轮班类型、得到管理人员和同事支持的频率以及所遇到的欺凌情况,量表平均分存在显著差异(P<0.05)。
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引用次数: 0
THE IMPACT OF EMOTIONAL CONTAGION IN NURSES ON MISSED NURSING CARE: A CROSS-SECTIONAL STUDY 护士的情绪感染对护理遗漏的影响:横断面研究
Pub Date : 2024-02-28 DOI: 10.33457/ijhsrp.1421659
Gamze Türedi̇, S. Altuntaş
Nurses encounter various situations in their work that can affect their emotional status, and they can contagion these emotions to others. These emotions experienced by nurses can influence nursing care. The study used a cross-sectional, descriptive, and correlational design to explore the impact of emotional contagion among nurses on unmissed nursing care. The research was conducted with 304 volunteer nurses through an online survey. Data were collected using a survey form consisting of a Demographic Information Form, Emotional Contagion Scale, and Missed Nursing Care Needs Scale. The data were analyzed by the researchers. The study revealed that nurses had a moderate level of emotional contagion. Differences in emotional contagion levels were found based on gender, age, educational level, type of institution, marital status, working hours, institutional experience, unit of work, and voluntary choice of job (p < 0.05). Additionally, the study showed that the level of missed nursing care among nurses was low. "Communication" was identified as the most significant factor causing missed nursing care. The level of missed nursing care varied according to gender, age, educational status, type of institution, professional and institutional experience, marital status, working hours, unit of work, and duration of employment (p < 0.05). Emotional contagion had a negative impact on the need for missed nursing care (β = -0.150, t = -2.636, R2 = 0.022, p < 0.05), its causes (β = -0.193, t = -3.411, R2 = 0.037, p < 0.05), especially workforce resources (β = -0.249, t = -4.470, R2 = 0.062, p < 0.05), and material resources (β = -0.271, t = -4.898, R2 = 0.074, p < 0.05). To reduce the level of missed nursing care, fostering positive emotions among nurses and promoting their transmission can be utilized as a strategy.
护士在工作中会遇到各种情况,这些情况会影响她们的情绪状态,她们的情绪也会传染给其他人。护士经历的这些情绪会影响护理工作。本研究采用横断面、描述性和相关性设计,探讨护士情绪传染对未被忽视的护理工作的影响。研究通过在线调查对 304 名志愿护士进行了研究。数据收集使用的调查表包括人口信息表、情绪传染量表和护理需求缺失量表。研究人员对数据进行了分析。研究结果显示,护士的情绪传染程度适中。研究发现,不同性别、年龄、教育程度、机构类型、婚姻状况、工作时间、机构经验、工作单位和自愿选择工作的护士在情绪感染水平上存在差异(P < 0.05)。此外,研究还显示,护士的护理遗漏率较低。"沟通 "被认为是造成护理遗漏的最重要因素。不同性别、年龄、教育状况、机构类型、专业和机构经验、婚姻状况、工作时间、工作单位和工作时间长短的护士的护理误时程度不同(P < 0.05)。情绪感染对错过护理时间的需求(β = -0.150,t = -2.636,R2 = 0.022,p < 0.05)、其原因(β = -0.193,t = -3.411,R2 = 0.037,P<0.05),尤其是劳动力资源(β=-0.249,t=-4.470,R2=0.062,P<0.05)和物质资源(β=-0.271,t=-4.898,R2=0.074,P<0.05)。为了减少护理遗漏,可以将培养护士的积极情绪并促进其传播作为一种策略。
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引用次数: 0
THE RELATIONSHIP BETWEEN FEAR OF DEATH AND MEANING OF LIFE IN NURSING STUDENTS AND NURSES CARING FOR TERMINAL PATIENTS 护理专业学生和护理临终病人的护士对死亡的恐惧与生命意义之间的关系
Pub Date : 2024-02-27 DOI: 10.33457/ijhsrp.1416706
Merve Akarslan, Funda Gümüş, Fidan Karadeni̇z
IThis study aims to determine the relationship between fear of death and the meaning of life in nursing students and nurses caring for terminally ill patients. The study was conducted in a cross-sectional and relationship-seeking research design. The research was conducted between March 15 and June 30, 2023. 123 nurses and 139 nursing students working with terminal-stage patients at a university hospital participated in the study. The study was conducted with a total of 262 participants. The Personal Information Form was collected using the Fear of Death Scale (DAS) and the Meaning of Life Scale (MLQ). The relationship between fear of death and the meaning of life in nursing students and nurses caring for terminally ill patients was determined to be 31.74 (7.13) years old on average for the nurses participating in the study and 22.71 (1.66) years for the nursing students. 61% of nurses and 66.2% of nursing students were women. It was determined that 56.1% of the nurses had undergraduate degrees and 77.7% of the students were third-year students. According to the Student t-test analysis, a significant difference was detected between the groups in terms of the total score of the DAS, and the DAS scores of the nursing students were statistically significantly higher. According to the Pearson correlation analysis, a weak negative relationship was detected between the total scores of the nurses' DAS and MLQ, while no significant difference was found between the scale scores of the nursing students. In this study, the Cronbach's alpha coefficient of the Death Anxiety Scale (DAS) was found to be 0.96 and the Meaning of Life Scale (MLQ) was 0.68. It can be said that there is no relationship between the fear of death and the meaning of life in nursing students who care for terminal patients, but there is a relationship between the fear of death and the meaning of life in nurses.
本研究旨在确定护理专业学生和护理临终病人的护士对死亡的恐惧与生命意义之间的关系。本研究采用横断面和寻求关系的研究设计。研究时间为 2023 年 3 月 15 日至 6 月 30 日。一家大学医院的 123 名护士和 139 名护理专业学生参加了研究。本研究共有 262 名参与者。个人信息表采用死亡恐惧量表(DAS)和生命意义量表(MLQ)进行收集。参与研究的护士平均年龄为 31.74 (7.13)岁,护理专业学生平均年龄为 22.71 (1.66)岁。61%的护士和 66.2%的护理专业学生为女性。56.1%的护士拥有本科学历,77.7%的学生为三年级学生。根据学生 t 检验分析,两组间 DAS 总分存在显著差异,护理专业学生的 DAS 得分明显更高。根据皮尔逊相关分析,护士的 DAS 总分与 MLQ 之间存在微弱的负相关关系,而护生的量表得分之间没有发现明显差异。本研究发现,死亡焦虑量表(DAS)的克朗巴赫α系数为 0.96,生命意义量表(MLQ)的克朗巴赫α系数为 0.68。可以说,护理临终病人的护生对死亡的恐惧与生命意义之间没有关系,但护士对死亡的恐惧与生命意义之间有关系。
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引用次数: 0
THE RELATIONSHIP BETWEEN NURSING STUDENTS' HEALTH PERCEPTIONS AND HEALTH-SEEKING BEHAVIORS 护理专业学生的健康观念与寻求健康行为之间的关系
Pub Date : 2024-02-27 DOI: 10.33457/ijhsrp.1415947
Esra ANUŞ TOPDEMİR, Meltem Sungur, Şerife Köleoğlu, Zeliha BÜYÜKBAYRAM GENÇ
Examine the effect of health perception on the health-seeking behaviors of nursing students. This descriptive-correlational study was made with a sample of 314 undergraduate nursing students. The Personal Introduction Form, Health Perception Scale, and Health-Seeking Behavior Scale were used to gather data. Kolmogorov Smirnov normality testing and Q-Q graphs were used to evaluate the data's normal distribution. Descriptive statistics, independent group t-tests, one-way variance (ANOVA), Kruskal-Wallis, and Pearson Correlation analysis were used. Additionally, the Dunn-Bonferroni and Tukey tests were used. According to the students' overall health status, between the mean Accuracy sub-dimension scores, a significant difference was found (p
研究健康认知对护理专业学生寻求健康行为的影响。本研究以 314 名护理专业本科生为样本,进行了描述性-相关性研究。研究采用个人介绍表、健康认知量表和寻求健康行为量表收集数据。采用 Kolmogorov Smirnov 正态性检验和 Q-Q 图来评估数据的正态分布。使用了描述性统计、独立组 t 检验、单因素方差分析(ANOVA)、Kruskal-Wallis 和 Pearson 相关分析。此外,还使用了 Dunn-Bonferroni 和 Tukey 检验。根据学生的总体健康状况,准确性子维度平均分之间存在显著差异(p
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引用次数: 0
FEAR OF PREGNANCY AND BIRTH 孕产恐惧
Pub Date : 2024-02-27 DOI: 10.33457/ijhsrp.1416310
Saadet Boybay Koyuncu, İpek Turan
This study aimed to examine the relationship between internet use and fear of childbirth in pregnant women. This descriptive cross-sectional study was conducted with a total of 385 pregnant women who were referred to a hospital in Turkey. Data were collected using a personal information form and the Women Childbirth Fear – Prior to Pregnancy Scale (WCF-PPS). The WCF-PPS total mean score of the pregnant women was 38.04±10.49 (17-60) and there was a weakly significant positive correlation between their WCF-PPS total score and duration of daily internet use. In addition, there was a statistically significant relationship between their WCF-PPS total mean score, the issues searched on the Internet about pregnancy/childbirth, the status of believing in the accuracy of the information they obtained on the Internet, the status of confirming this information by health professionals, and the status of having concerns about this information (p
本研究旨在探讨孕妇使用互联网与分娩恐惧之间的关系。这项描述性横断面研究的对象是土耳其一家医院的 385 名转诊孕妇。数据收集采用了个人信息表和妇女分娩恐惧--孕前量表(WCF-PPS)。孕妇的 WCF-PPS 总平均分为 38.04±10.49(17-60)分,WCF-PPS 总分与每天使用互联网的时间长短呈弱显著正相关。此外,她们的 WCF-PPS 总平均分、在互联网上搜索到的有关怀孕/分娩的问题、相信在互联网上获得的信息的准确性的情况、通过医疗专业人员确认这些信息的情况以及对这些信息有顾虑的情况之间也存在统计学意义上的显著关系(P<0.05)。
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引用次数: 0
THE EFFECT OF SOCIAL MEDIA USE LEVEL AND SLEEP QUALITY ON WORK PERFORMANCE AMONG UNIVERSITY EMPLOYEES 社交媒体使用水平和睡眠质量对大学生工作表现的影响
Pub Date : 2024-02-24 DOI: 10.33457/ijhsrp.1405091
Berkhan Topaktas, Neşe Yakşi
It is important to determine the level of social media addiction in the working population and to determine its relationship with sleep quality, and how both variables affect the work performance of the employees. In this study, it was aimed to determine the effects of social media addiction levels and sleep quality of employees at Amasya University on their work performance. The population of the cross-sectional study consisted of staff in all employment types at Amasya University. Sociodemographic data form, Social Media Addiction Scale-Adult Form (SMAS-AF), Pittsburgh Sleep Quality Index (PSQI), and Work Role Functioning Questionnaire (WRFQ) were applied by face-to-face survey method between August 15 and October 15, 2022. A total of 148 individuals participated in the study. The total score on the SMAS-AF was 40.0 (20-84), the PSQI total score was 6.0 (1-15) and the WRFQ total score was 92.5 (6-100). The WRFQ was found to be lower in individuals with associate degree or higher education, females, and academic staff (p=0.042; p=0.010 and p=0.008 respectively). The WRFQ total score indicated low, moderate, and negative significant correlations with the SMAS-AF and PSQI total scores (r= -0.333 and -0.344, respectively, p< 0.001). It was found that as the level of social media addiction increased and sleep quality deteriorated, work role functionality was negatively affected. A holistic approach, including behavioral problems, should be exhibited in the evaluation of work performance.
确定工作人群的社交媒体成瘾程度,确定其与睡眠质量的关系,以及这两个变量如何影响员工的工作表现,这些都非常重要。本研究旨在确定阿马西亚大学员工的社交媒体成瘾水平和睡眠质量对其工作表现的影响。横断面研究的研究对象包括阿马西亚大学所有就业类型的员工。在2022年8月15日至10月15日期间,研究人员采用面对面调查的方式收集了社会人口学数据表、社交媒体成瘾量表-成人表(SMAS-AF)、匹兹堡睡眠质量指数(PSQI)和工作角色功能问卷(WRFQ)。共有 148 人参与了研究。SMAS-AF总分为40.0分(20-84分),PSQI总分为6.0分(1-15分),WRFQ总分为92.5分(6-100分)。研究发现,拥有副学士学位或更高学历的人、女性和学术人员的 WRFQ 分数较低(分别为 p=0.042;p=0.010 和 p=0.008)。WRFQ 总分与 SMAS-AF 和 PSQI 总分呈低、中和负相关(r=-0.333 和-0.344,p< 0.001)。研究发现,随着社交媒体成瘾程度的增加和睡眠质量的下降,工作角色功能也会受到负面影响。在评估工作绩效时,应采取包括行为问题在内的综合方法。
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引用次数: 0
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International Journal of Health Services Research and Policy
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