关注肿瘤患者的心理健康,提高医患沟通质量

心理健康对于肿瘤患者来说非常重要,医生应该在治疗患者身体疾病的同时,关注他们的心理健康状态,注意医患沟通技巧.不仅有利于患者的康复,也能提高医患沟通质量,促进发展良好的医患关系.     

重视医患沟通产生的功效--从成功诊治一例寄生虫病妄想患者说起

良好医患沟通直接影响到医疗活动的正常进行,有效的医患沟通是构建和谐医患关系必要的途径和手段。而医患沟通技能和医患沟通方法是实现良好医患沟通的基础。本文从诊断、治疗一种罕见的精神性疾病---寄生虫病妄想个案过程中,具体应用医患沟通听、说基本活动的技能,融洽与患者交流,构建良好医患关系,成功治愈这一寄生虫病妄想患者。阐明临床医生不仅仅需要仁爱之心、专业的医学知识,还需重视医患沟通,掌握医患沟通技巧。     

医护人员心理健康服务与医患关系相关性调查研究

采用自编的《医护人员心理健康服务行为量表》与《医患关系量表》对664名医护人员进行问卷调查。结果显示,医护人员心理健康服务行为处于中等水平(3.85±0.46),医护人员心理健康服务行为各维度与医患关系的总分及各维度的得分具有一定的相关性,具有统计学意义(r=0.136～0.514,P0.01)。其中,言语耐心、表情亲和、情感支持与沟通主动四个维度均能正向预测医患关系,能够有效解释医患关系36.7%的变异量。因此,加强医护人员的心理健康服务行为,对医护人员进行相关的培训,可以促进医患关系的良好发展。     

患者社会经济地位对医患沟通行为的影响研究

良好的医患沟通是减少医疗纠纷、改善医患关系的有效途径。探讨患者社会经济地位是否影响到医生的沟通方式与患者的沟通偏好,从而提高医患沟通质量,实现医患沟通"零距离"。采用问卷调查法对某市2所三甲公立医院门诊患者进行调查,结果显示患者的社会经济地位与医生语言沟通行为之间无显著性差异,然而与患者参与医疗决策及权利维护行为之间有显著性差异。建议医生坚持"以患者为中心",注重沟通方式与技巧的运用,尊重患者自主权利,增强患者参与医疗决策能力,同时利用医务社会工作者第三方力量的介入,共建平等和谐医患关系。     

多媒体技术在医患沟通中的临床应用实践——以胸外科患者为例

伴随着网络信息技术的飞速发展,医学卫生行业正在跨入信息化时代,本课题采用多媒体技术的多样性、集成性、交互性和实时性的特点,使用自制多媒体术前谈话课件进行医患沟通.通过将胸外科拟手术患者随机分为试验组及对照组,试验组采用多媒体课件进行医患沟通,对照组采用传统方式沟通,分别统计分析两组患者沟通质量满意度,来探讨多媒体技术在胸外科医患沟通中的临床应用.采用多媒体技术进行医患沟通可以显著提高患者满意度,值得在临床工作中进一步推广.     

非医疗事故鉴定案例中医患沟通障碍因素分析

采用自行设计的调查问卷,对某市医学会非医疗事故鉴定案例中存在医患沟通障碍因素的86份案例进行回顾性分析,其中大于60岁和14岁以下患者,初中及以下文化层次患者、中青年医师、外科医师较容易发生医患沟通障碍.医疗机构应提高医务人员的人文素养与沟通技能,合理配置人力资源等方式来加强医患沟通.     

医生的心理健康问题分析

医生的心理健康问题主要是由社会对医德的认同度差等原因造成的。医生要学会自我宣泄和解压;加强自身人文素质的培养;医患双方要相互沟通和理解;政府应为医者创造良好的医者心理健康氛围。     

医患沟通中患者的信息认知

医患沟通在医疗过程中发挥着重要的作用,沟通中的主要内容是信息交流,信息交流的主要目标是达到医患双方的相互理解.论述影响医患沟通中信息认知的几个因素,其中包括信息的形式,情绪因素,沟通行为因素三个方面.通过对这些因素的干预,提高患者对信息的认知能力将使医患沟通更加有效,从而有利于合作式的医患关系的形成.     

如何提高临床医学生与患者之间沟通的能力

正常有序的医疗活动应以良好的医患沟通为基础,要从根本上处理好医患关,首先要从培养临床医学生与患者之间的沟通能力入手,多数医学生在进入临床实习时都因紧张而不知道应该如何与患者沟通,因此培养医学生与患者间良好的沟通能力是当前迫切需要解决的问题。     

医患沟通障碍的心理解析:信息交换视角

医患沟通指医生与患者之间信息交换的过程。基于信息交换视角,通过建构医患沟通模型,解读医患沟通障碍研究的被试获取、衡量指标和心理根源。其中,获取医患研究对象的方式包括直接选取医患群体或医学生和非医学生,以及通过启动的范式操纵医患角色;衡量指标指患者的心理反应,包括患者的心理感受、对医嘱的认知、对医嘱的遵从、健康恢复等;心理根源可归为医患个体特征的作用差异和沟通需求的结构不匹配。未来研究需要进一步拓展研究视角,丰富启动方法,补充认知指标,深化心理根源,开发教育模式。     

Suicides in users of mental health care services: treatment characteristics and hindsight reflections

The current study aims to describe the patient and treatment characteristics of a sample of 505 suicides by mental health care patients, and to determine how clinicians view the care provided and what they learned. The results indicate that the quality of mental health care for suicidal patients could be improved by focusing on communication among clinicians, continuity of care, suicide risk assessment procedures, and the involvement of relatives.     

Coparental communication,relational satisfaction,and mental health in stepfamilies

This study tested a series of actor–partner interdependence models of coparental communication, relational satisfaction, and mental health in stepfamilies. Participants included 127 couples (N = 254). Results revealed 2 actor‐oriented models whereby parents' and stepparents' coparental communication quality positively predicted their own (but not their partners') satisfaction and mental health. A final model revealed that parents' relational satisfaction mediated the effect of coparental communication on their own mental health. A similar pattern emerged for stepparents, although coparental communication continued to have a direct, positive effect on stepparents' mental health. Importantly, parents' coparental communication produced an inverse partner effect on stepparents' mental health, highlighting the potential stress stepparents may experience as they are called upon to help raise their spouse's offspring.     

‘Hope givers’? A scoping review of new media and mental health in 27 Australian Christian organisations

This article explains a range of conceptual and methodological innovations in the use of new media for the clinical practice and public communication of mental health. Building on two current contexts – the emerging research area of new media and mental health, and major reform of the mental health system in Australia – this article presents a scoping review of the online communication of Christian organisations that offer mental health care in Australia. This article compares the websites of 27 Australian Christian mental health organisations, analysing these organisations’ configurations of mainstream and religious modalities of mental health care, their discursive and visual communication strategies, as well as their use of social media platforms.     

Collaborative Communication Between Psychologists and Primary Care Providers

Psychologists frequently collaborate in the care of patients managed in primary care. Communication with a patient’s primary care team is important to ensure coordination and continuity of care. The communication is far from seamless. Although The Health Information Privacy and Portability Act (HIPPA) is designed to promote sharing of clinical information while protecting patient confidentiality, unique problems arise when mental health records are included. Mental health records are subject to different regulations to protect the patient’s confidentiality. Thus, what is communicated and how it will be accomplished are challenges. Further, psychologists and primary care providers often view documentation differently, resulting in different styles of documenting that may also impede coordinated care. Increasingly, health care systems are moving toward electronic medical records, creating greater opportunities for an integrated record. Improved communication through the record can keep other providers abreast of the mental health care being provided as well as suggestions they can use to reinforce the mental health care treatment plan.     

青少年异性交往心理问题研究综述

异性交往对青少年的成长与发展具有极其积傲的功能：(1)能够促进自我同一感的发展;(2)有利于增进心理健康;(3)有助于增进友谊．并为日后获得成熟爱情积累经验：同时．青少年异性交往存在不少心理问题。并且．对青少年的异性交往仍存在着教育误区．主要表现为不当的教育观念和教育方式,当前．有关青少年异性交往的研究主要集中在：e3q青a少年异性交往的发展阶段、特点、影响因素和教育构想,缺乏对青少年异性交往心理问题的研究,研究领域较为狭窄;理论研究多．实证研究少;缺乏专门、科学的测量工具。     

Communicating evidence‐based mental health care to service users

There is a significant gap between evidence‐based mental health care and patients, their family members and carers. To inform preventative mental health care among existing and potential service users, this review identifies effective methods for communicating evidence. A systematic review located 14 publications that met search criteria. Several methods can effect behavioural and/or intermediary change among existing and/or potential service users: namely, mass media; health warning labels; policy change; community interventions; school‐based programs; parent programs; and psychoeducation. Robust evidence, however, is lacking. Although effective approaches are likely to be founded on several factors, the review concludes with a discussion of a research agenda, and appropriate methodologies that could strengthen the knowledge base that guides the communication of evidence‐based mental health care to service users. This agenda has important implications for practitioners, policymakers, and researchers, which are also discussed.     

The Longitudinal Impact of a Family-Based Communication Intervention on Observational and Self-Reports of Sexual Communication

Parents can play a vital role in shaping teenagers’ sexual attitudes, behavior, and contraceptive use through communication, however, less is known about how to modify parent–adolescent communication among youth with mental health problems. The impact of a family-based sexual risk prevention intervention on both observational and self-report of parent–adolescent sexual communication was examined at 12 months among adolescents with mental health problems. Of the 721 parent–adolescent dyads recruited for the study, 167 videotapes of sexual discussions between parents and adolescent were coded for the family-based intervention and 191 videotapes for the active comparison. Longitudinal analyses examined differences between conditions (family-based vs. comparison) in self-reported and observed parent–adolescent sexual discussions and also examined the impact of gender on intervention response. More parent I-statements, healthier parent body language, and fewer adolescent Negative Vocalizations were detected for family-based intervention participants 12 months after participating in the brief intervention (11?h of total intervention time) relative to those in the comparison condition. Parents in the family-based intervention also self-reported better sexual communication at 12 months. The current study provides supporting evidence that a relatively brief family-based intervention was successful at addressing parent–adolescent sexual communication among a mental health sample.     

Attachment, Acculturation and GHQ-30 of Chinese Students in Japan

This study examines how attachment and acculturation are associated with the general mental health of Chinese students in Japan. The participants were 194 Chinese students living in Japan, who were asked to complete a set of self-reported measures. The results showed that attachment anxiety predicted all subscales of general mental health, and attachment avoidance and acculturation predicted some aspects of general mental health. In addition, the number of years of residence in Japan was also found to be associated with the general mental health. The findings help improving intercultural communication between Asian countries as well as to facilitate clinical intervention and prevention.     

Infant communication and the mother–infant relationship: The importance of level of risk and construct measurement

Infants' emerging communication skills are understood to be associated with the maternal relationship, particularly for children experiencing high levels of social risk. This study attempts to determine the extent to which this association is influenced by (a) the mental health risk of the dyad and (b) different operational definitions and measurement of both the dyadic relationship and the construct of “communication.” Ninety‐six infants (10–30 months) and their mothers were recruited: A total of 46 were at‐risk dyads referred to a mental health clinic for relationship‐based emotional and/or behavioral difficulties, and 50 were nonrisk dyads not seeking mental health services and served as a normative reference or comparison group. Several factors were assessed: (a) developmental competence, (b) maternal psychopathology, (c) quality of mother–infant interaction during play, (d) attachment security classification, (e) prelinguistic and social‐affective communication, and (f) linguistic communication. In all infants studied, the quality of mother–infant interaction during play, rather than the attachment security classification, was associated with infants' prelinguistic and social‐affective communication abilities, but not with linguistic communication. Different aspects of mother–infant interaction predicted prelinguistic communication for clinic and comparison infants whereas only infant age predicted linguistic communication. All infants displayed communication abilities in the normal range, but the statistically poorer performance demonstrated by clinic‐referred infants could become clinically meaningful in later childhood. Best practices should include communication screening of infants presenting with attachment problems and screening for relational difficulties in infants presenting with communication delays. ©2004 Michigan Association for Infant Mental Health.     

Cost-effective use of Rational Emotive Behavior Therapy in a public mental health service

With the advanced deinstitutionalization of the treatment of the mentally ill, the public mental health services in many parts of Australia are facing serious difficulties in providing adequate community-based treatment to the large numbers of individuals in need. Overreliance on medication and a diminishing supply of suitably trained therapists may result in an increasing proportion of patients being denied the benefit of optimal treatment and care which should include evidence-based psychological and behavioral approaches. In this communication we describe a day program, designed and implemented in Perth, Western Australia, which combines individual and group therapy provision, and is closely integrated with both primary care and the specialist mental health services. The program provides an alternative to in-patient admission and is cost-effective by reducing the demand for acute hospital beds. It is acceptable to patients and produces measurable improvements in symptoms, functioning and subjective well-being. Address correspondence to Anthony Mander, ENHANCE, Inner City Mental Health Service, Royal Perth Hospital, Box X2213, Perth 6000, Western Australia.