整形美容外科的实践认识和选择性治疗的哲学应用

随着我国经济、生活条件的改善,现代整形美容技术飞速发展给广大有身体缺欠者提供了机会,同时也给临床工作者带来了很多问题.因此对整形美容外科实践进行哲学思考,进行选择性治疗,遵守客观规律,既有利于满足医患双方的利益,缓解医患关系,减少医疗纠纷的发生,又有利于提高整形美容外科的整体医疗服务质量.     

整形美容外科实践中若干问题之我见

现代整形美容技术的飞速发展,既给广大有身体缺欠者提供了机会,给整形美容外科的发展和壮大提供了广阔的空间,同时也给整形美容外科工作者提出了很多问题和挑战。对整形美容外科实践进行思考,自觉遵守客观规律,有利于缓解医患关系,减少医疗纠纷的发生,又利于提高整形美容外科的整体服务质量。     

整形美容外科年轻医师的人文修炼

我国整形美容外科在迅速发展的同时还存在许多弊病,为了促进学科整体健康快速发展,整形美容外科的年轻医师除了精进专业技术,还必须进行必要的人文修炼。本文介绍并分析了整形美容外科面临的五个人文困境,指出整形美容外科年轻医师具有进行人文修炼的必要性,并提出人文修炼的三条途径。     

我国整形美容外科及医学美容技术发展的辩证思考

整形美容事业的飞速发展带来了一些问题。回顾历史,整形美容外科及医学美容技术的发展是在实践、认识,再实践、再认识的过程中不断发展的;但发展过快并非好事,作为整形美容外科医生,在工作当中必须坚持一切从实际出发,辩证地认识问题,解决问题,使整形美容外科及医学美容技术保持良好的发展势头,更好地为患者服务。     

知情同意和医生的责任--整形美容外科实践中的几个特殊问题的分析

根据《执业医师法》第 2 6条、第 12 2条规定 ,病人有权利要求医师对其介绍病情 ,医师有义务如实回答 ,并不得隐瞒。随着《执业医师法》颁布 ,由于知情同意权的实施与医生责任之间矛盾解决不妥而引发的医疗纠纷也越来越多。整形美容外科与其他医学专科相比 ,有其自身的特点。因此 ,该专科中的知情同意和医生相应的责任与其他专科也有所不同。1　医患审美观的冲突医生与患者的审美观是一对矛盾 ,二者从出发点和目的来说是一致的 ,都是为了使病人术后更加漂亮 ;但就某一方面的理解来说 ,如对漂亮的理解 ,二者又可能有明显的不同。当医患双方的…     

整形外科医患关系恶化的辩证思考

受多重因素的影响,我国目前的医患关系恶化明显,已成为一个棘手的社会问题.作为医疗行业的一个分支,整形外科领域内的医患关系也不容乐观.笔者利用哲学辩证思维从多个角度对当前整形医学领域内医患关系的恶化进行分析,并探讨构建和谐医患关系的解决途径.     

美容外科的安全性问题与伦理原则

围绕美容外科的安全性进行伦理学分析,认为美容外科的有效性与有伤性的不可分是美容外科的基本特征,因此,美容外科实施过程中必须遵循伦理学的有利无伤、知情同意、解释说明的原则,并且要把美容外科的安全性作为首要原则.     

创伤中心工作特点和医患矛盾的预防

创伤中心患者来源多样,伤情复杂,救治时间紧迫,患者家属急迫的心理需求与医学现实判断和工作制度之间常常产生矛盾,给医患矛盾埋下了伏笔。而资源短缺、风险规避与伦理原则的冲突更让医护人员陷入了两难境地,对医护人员造成了身心伤害。本文从创伤中心的工作特点出发,从心理学和医疗实践中矛盾冲突的角度,分析了可能引起医患矛盾的原因及相应的预防办法,希望这些方法有利于构建和谐的医患关系并改善医务人员身心健康。     

医患交际的“复调”研究

近几十年来，医患交际日益受到社会学家和语言学家的关注，成为医患关系研究的热点。医患交际是人类对话的一种形式，充满了与疾病有关的各种声音。拟运用巴赫金的复调理论对医患交际中的各种“声音”进行研究，揭示医患交际中，医生的医生声音、教育者声音、同伴声音和患者的叙述病情声音、能力声音、社会交际者声音、发话者声音等在对位对话中并存共生，既各自独立又彼此相关。     

脂肪源性干细胞（ADSCs）在美容整形外科应用的基本概念

近来,干细胞作为一种利用最大自疗能力的治疗方法在医学领域得到了迅速发展。很多文献报道,利用脂肪源性干细胞（ADSCs）进行自体脂肪细胞移植在提高脂肪移植的成活率和持续性方面,取得了良好的效果,并越来越受欢迎。目前,干细胞的功能尚没有完全阐明,后续关于干细胞的研究使其内容随时发生变化的可能性是存在的。但是干细胞和 ADSCs 的基本概念需要每一位整形美容外科医生掌握。本文将主要介绍当前干细胞和脂肪源性干细胞的一些基本概念。     

重视内镜诊治新技术应用中的人文关怀

内镜诊治新技术在临床消化道疾病的广泛应用中,医务人员往往重视“检查”不重视“临床思维”,重视“疾病”不重视“患者”,迷信“高新技术”忽视“医患交流”,过分重视“效益”导致过度诊治等现象带来了人文价值的漠视,故而在内镜诊治新技术中重视与“生物—心理—社会”医学模式相符合的人文关怀,在当前我国卫生系统“看病难,看病贵”的大环境下,具有重大社会意义。     

Counselling and Pain Relief

Health-care staff (e.g. doctors, nurses, physiotherapists, occupational therapists) frequently have to care for patients who suffer from conditions which cause crippling pain. Pain relief is part of such treatment. This article suggests how counselling, as a skill which every health care worker could acquire and use, may reduce the level of pain by helping the sufferer cope more effectively with it. Four principles of pain relief are considered: the therapeutic relationship; other sensory input; rest and relaxation; and the use of imagery. The discussion on pain relief centres on rest and relaxation and the use of imagery, based mainly on the work of Jung and Assagioli's model of psychosynthesis. Patients are encouraged to continue practising these pain-relieving techniques when counselling has ended. By so doing, they will acquire positive ways to escape from the world of nightmare in which sufferers from chronic pain are often held prisoners. An account is included of how a sufferer from trigeminal neuralgia benefited from one session in which imagery was used.     

躯体变形障碍与美容整形术前心理评估

躯体变形障碍是一种并不罕见的精神障碍,其临床表现的特殊性使大多数患者以普通求术者的身份出现在美容整形科医生面前。然而,关容整形手术非但不能解决患者的心理问题,更可能引发复杂的医疗纠纷。基于躯体变形障碍在美容整形科呈高发生率的特点,文章对美容整形术前心理评估的必要性和现状进行分析,并列举了有效的评估工具以提高心理评估的准确性。     

患者拒绝签署紧急手术知情同意书的处理对策

签署手术知情同意书是医方履行告知义务,保障医患双方合法权益的一种重要手段。当患者病情需要紧急手术但患者或其家属拒绝签署手术知情同意书时,医院面临错失抢救时机和巨大的医疗风险,甚至可能因此成为被告。结合我院临床工作中的成功经验,探讨医院如何在尽可能抢救患者生命的情况下,规避相关法律风险。     

Investigation of the Relationship Between Anxiety Levels of Patients Before Plastic Surgery Operation and Worship Practices in Muslims

There is an increasing interest in the effects of preoperative anxiety on the course and outcomes of surgical treatments and also in the studies about the anxiety-decreasing interventions. The present study aims to identify the relationship between the preoperative anxiety level of the individuals prior to aesthetic surgery operations such as nose, ear, eyelid, and mammoplasty and religious rituals such as performing prayers, fasting, and going to pilgrimage. The frequency of performing the religious rituals was identified through a questionnaire. The questionnaire included questions about the religious rituals such as performing prayers, going to a pilgrimage, and fasting as well as questions about sociodemographic features such as gender, age, and education level of the patients. Preoperative anxiety level was measured using the “Anxiety Specific to Surgery Questionnaire.” The nonparametric Mann–Whitney U test was used for the scale score comparisons of the two independent groups. The scale score comparisons of more than two groups were performed using the Kruskal–Wallis test. The relationships between age and scale scores were analyzed using the Spearman’s correlation coefficient. The study involved 117 patients who were planned to undergo an aesthetic surgery operation. The scale scores were significantly different according to the pilgrimage groups (p = 0.004). The scale scores were significantly different according to the level of fasting (p = 0.022). No significant differences were found between the scales scores of the groups who reported the frequency of performing prayer as never, sometimes or five times (p = 0.515). In conclusion, the present study found that Muslim people who performed religious rituals more often experienced less preoperative anxiety levels in plastic surgeries, which indicates that the belief level is an effective factor in preoperative anxiety levels. The findings of the present study indicate that patients’ beliefs and worship practices should be taken into consideration by doctors, operating room personnel, and even all health workers in order to decrease the anxiety levels of patients who will undergo surgery.

     

Stress and family support as predictors of distress and rejection in people who care for a relative with schizophrenia

Relatives (N=121) of adult schizophrenia patients were interviewed to investigate predictors of their level of psychological distress and of rejecting attitudes toward the sufferer. The relatives' total stress, particularly that associated with poor communication skills in the sufferer, predicted several measures of their psychological distress, and the same variables plus turbulence of sufferer behavior (i.e., violence and disruptiveness) predicted rejection of the sufferer by the relative. In each case, adequacy of family support moderated the influence of the stressors, although this effect was more marked for distress outcomes than for rejection. The results have important implications for the sorts of professional and peer support which relatives may need to encourage their performance of this potentially burdensome role. In addition, the results fit a classic stress management model and provide a feasible alternative to the Expressed Emotion Model of the relationship between relatives' rejection and patients' illness severity.     

The Effect of Religious Beliefs on the Attitude of Aesthetic Surgery Operation in Islam

This study aims to investigate the relationship between individuals’ attitudes about acceptance of aesthetic surgery (e.g. rhinoplasty, autoplasty, blepharoplasty, and mammaplasty) and some of the worship practices in Islamic religion such as performing prayer, fasting, and going to pilgrimage. Although many people think that aesthetic surgery is inappropriate in Islamic religion, no studies in the literature were found to have investigated this issue. This study collected data through a questionnaire administered to 96 patients who applied to our Plastic Surgery Clinic and underwent various surgical operations and 96 patients who were recommended plastic surgery but rejected to have one; the questionnaire aimed to identify the participants’ frequency of religious worship practices and appropriateness of aesthetic surgery to their beliefs. The participants responded on the frequency of religious worship levels according to the options in the questionnaire. The “Acceptance of Cosmetic Surgery Scale” was utilized in order to identify their attitudes towards aesthetic surgery. Levels of performing prayers, fasting, and going to pilgrimage in the groups that accepted surgery and in the groups that rejected surgery were significantly different (p < 0.001, p = 0.008, p < 0.001). In two different groups, the Acceptance of Aesthetic Surgery Scale scores were significantly different within the prayer groups and fasting groups (p < 0.001, p < 0.001, p = 0.001, p < 0.001). While the group that accepted surgery indicated no significant differences between those who thought about going to pilgrimage and who did not (p = 0.650), there was a significant difference in the group that rejected surgery (p < 0.001). While 14.6% of the participants in the group that accepted surgery considered aesthetic surgery a sin, this proportion was 56.3% in the group that rejected surgery, and this difference was significant (p < 0.001). In both surgery groups, there were differences in the scale scores of those who considered aesthetic surgery a sin and those who did not (p < 0.001, p < 0.001). There was a significant relationship between worship practices, one of the biggest indicators of the level of belief in Islamic religion, and aesthetic surgery attitudes. However, despite the fact that belief levels affect the decision of having an operation in plastic surgery, in case of serious health problems, the decision of having an operation becomes more important religious beliefs.