美国、英国和加拿大健康战略的比较分析

美国、英国和加拿大三国均为发达国家,也是世界上最早开展健康战略研究的几个国家。通过比较美国、英国和加拿大三国的基本卫生状况、健康战略的内容和发展过程,在此基础上,分析了三个国家在制定和实施健康战略过程中的做法与经验,为制定和完善“健康中国2020”战略提出了相关的建议。     

医生在英国健康保障制度体系建立中的影响

英国健康保障制度体系包括健康保险制度、医疗救济制度和国民保健制度。医生促使了英国医疗救济制度的出现,并使其在20世纪初成为健康保险制度的补充,改变了英国健康保险制度的内容及其管理体制。医生推动了英国国民保健制度的出现,而且对其服务内容、管理体制及其实施进程产生直接影响。     

加拿大健康战略及其启示

介绍了加拿大健康战略出台的背号、战略愿景、目标、优先发展领域和具体的行动计划,在此基础上总结了加拿大健康战略实施过程的基本特点与经验,并结合我国的实际情况,提出了我国制定和实施“健康中国2020”战略的相关政策建议。     

美国健康战略及启示

介绍了美国健康战略出台的背景,并重点介绍了美国“健康公民2010”战略的目标、优先领域、主要健康指标以及相应的行动计划,比较了美国“健康公民2000”和“健康公民2010”的异同,在此基础上总结了美国健康战略发展的基本特点与经验,并提出了对我国制定和实施“健康中国2020”战略的启示。     

“健康国家”战略发展的过程与国际经验

基于健康价值概念,居民健康所面临的挑战,以及医疗卫生服务发展趋势,系统描述了“健康国家”战略的发展过程与国际社会实施“健康国家”战略的基本情况,并提出了可借鉴与学习的经验。     

公立医院在全民健康中的战略定位与实现路径

从重大疾病的严峻挑战及其对医院管理的影响分析出发,阐述宏观医院管理的政策环境和全民健康的理念战略。提出公立医院要实施应对大健康背景、以维护和促进全民健康为目标、注重社会效益和健康权益的医院发展战略,将健康管理置于优先发展战略中,在理念、战略、实践环节上有所作为,不仅要治病,更要参与预防,积极开展健康促进、健康教育和健康管理。总结教学研究型医院、三级医院、县级医院等不同层级公立医院在全民健康中的功能定位和战略实现路径,筛选在健康管理上做出表率的几家医院代表及其典型模式。     

澳大利亚“国家电子医疗战略”对我国的启示

电子医疗对于推动医疗信息互联互通、创新医疗模式、提升卫生服务水平具有重要意义。澳大利亚"国家电子医疗战略"确立了加强基础设施建设、利益相关者参与等7项实施原则,并围绕电子医疗消费者、提供者和管理者三个利益群体确定了较为详细的战略实施目标。战略实施分为短期、中期和长期三个阶段,每个阶段都规定了较为详细的具体内容。目前澳大利亚已经初步取得了较为理想的实施效果,形成了政府服务国民健康体系的核心基础。澳大利亚的相关政策措施对我国的医疗改革及"电子医疗"建设具有一定的启示意义。     

从对抗到合作--马来亚非殖民化研究

英属马来亚是英帝国重要的经济与战略基地，马来亚的非殖民化在英帝国非殖民化史上占有重要地位。马来亚的非殖民化是追求国家独立的马来亚民族主义、英国的合作主义政策和有利于非殖民化的国际环境这三种历史合力综合作用的结果，其实质是英国在新的历史条件下，试图通过与民族主义合作，继续维持其在马来亚的经济与战略利益。但随着英国在前殖民地世界影响的衰落，英国在马来亚的经济、战略利益也逐渐丧失，英国的“新殖民主义”美梦终于破灭。     

英国心理咨询的专业化发展及其问题

由于英国咨询与治疗协会及其前身英国咨询协会的不懈努力,英国心理咨询业的专业化发展取得长足进步。表现在：在培训方面,统一课程要求;注重受训者的业务发展;培训对象、时间及费用上有灵活性。在督导方面,实施终身督导;尊重各种流派;坚持授权式和发展式督导,保证督导人员独立行使职责。在资格鉴定或注册方面,严格控制条件和标准。在伦理和投诉方面,出台了内容丰富、独具特色的关于咨询和治疗的伦理规范框架。英国心理咨询所面临的主要问题在于：学校心理咨询的不景气;咨询专业化要求与咨询实际不相吻合;在经济上面临挑战;资格鉴定注册及投诉上存有争议。了解他山之石,对于促进我国心理咨询专业化的健康发展不无裨益。     

居民健康指标体系研究

健康指标体系是居民健康状况和卫生服务系统能力建设的评价工具,也是制定健康战略与卫生规划的基本指南。基于国内外健康指标体系研究的基本情况,系统回顾和分析了健康相关指标体系的发展与应用状况,并总结了主要启示,以期为我国制定健康发展战略提供决策依据。     

腰椎间盘突出症患者MED术前心理状态调查与分析

为了研究腰椎间盘突出症患者行MED微创治疗前的心理状况,对442例行MED手术治疗的患者应用焦虑自评量表（SAS）、抑郁自评量表（SDS）进行术前心理评估。结果显示MED微创治疗前患者SAS、SDS测量分明显高于常模组。患者性别、年龄、婚姻状况、文化程度、病程长短等都与心理状况的改变相关。有34.9%的患者SAS得分和36.7%的患者SDS得分显示阳性。因此,临床骨科医师应重视心理因素的作用,在MED术前应对患者进行心理状况评估,并对心理状况较差的患者进行术前干预,才能取得更好的临床疗效。     

高师生心理健康教育实验研究

本文采用自然教学实验的研究方法,探讨心理健康教育对高师生健康信念、健康行为和健康水平的影响,以高师９５级大学三年级学生１２６个为实验组,进行５４个课时的心理健康课程教学,并以同校同级学生１０９个对照组。采用健康信念和健康行为调查表和Ｃａｗｔｅ健康量表,对实验组和控制组被试进行调查和测试。结果表明,心理健康教育不仅明显改善了高师生的健康信念和健康行为,而且提高了他们的身心健康水平。     

Preventive behaviour and health status among the elderly

Abstract

The research describes the range of preventive health behaviours undertaken by the elderly, investigates the dimensionality of preventive health behaviour, and explores the relationship between preventive health behaviour, self-assessed and medically assessed health status. Previous research has relied mainly on self-reports of health status. Data from medical examinations and interviews with 115 elderly individuals (aged 65–75) indicated that most elderly persons performed some intentional preventive health practices, as well as a broad range of normative preventive health practices. Particular clusters of preventive health behaviour emerged when the data were subjected to cluster analysis. A short index consisting of five personal preventive health behaviours found in other studies to have a protective effect on long-term health was found to have a low to moderate correlation with the medical and self-assessments of health status employed in the study. These findings indicate particular types of preventive health behaviour of importance for health promotion programmes with the elderly.     

Exploring families’ experiences of health: contributions to a model of family health

Child health and developmental outcomes are influenced by the health of the family and the context created. Research suggests symptoms of poor family health (e.g. suboptimal family interactions, parenting stress) yet there is limited understanding of the factors which contribute to robust family health which may unveil opportunities for targeted intervention and family health promotion. The present study examined families’ experiences of family health and factors contributing to family health. We performed a qualitative study using constructivist grounded theory methods to guide our understanding of family health for families with typically developing children aged 5–18. Interviews were conducted in family homes and all members were invited to participate. Data from interviews were transcribed, coded, thematically analyzed, and verified with select families. Ten families, including 10 mothers, 8 fathers, and 15 children participated in the study. Participants described family health as a process of balance, living purposefully, and sharing experiences together in alignment with family identity. Mediating family health were processes of awareness and reflection, and adapting, adjusting, and changing in response to family life including external stress factors. Results highlight the possibility for healthcare practitioners to facilitate families’ self-reflection and awareness about their health in order to mediate family health development.     

Primary health care for women: What is it and who provides it?

Recent federal policy has highlighted historically underrecognized women's health issues. Women comprise the majority of the population, especially the elderly. Women's health care needs, utilization patterns, and outcomes vary from those of men, and often among each other. Primary health care services for women are multidisciplinary and emphasize prevention, education, and early intervention as well as treatment. Psychologists and other primary health care providers can collaborate to provide their services in a cost-effective manner that optimizes quality of care and comprehensive health care.     

中西方关于心理健康标准问题的探讨及对我们的启示

分析了国内外学者在制定心理健康标准时所作的探讨,提出了适应与发展应是心理健康考察的基本对象,对心理健康的评估应是对心理机能的评估,我国在制定心理健康标准时应借鉴西方的有关理论和经验。     

墨西哥的医疗保险制度

墨西哥卫生改革之前,卫生系统存在严重的问题。为了应对这些问题,墨西哥卫生改革实行了新的医疗保险制度,以全民医保为主要目标。通过分析墨西哥实施新的医疗保险制度的背景,介绍新的医疗保险计划———大众医疗保险制度及所取得成果,从中得到对我们有益的启示。     

深化卫生事业改革应关注卫生经济伦理学研究

卫生经济伦理学是应用伦理学的一个分支,相对于经济学和卫生经济学的发展,卫生经济伦理学的建立和发展滞后,导致卫生经济体制改革的经济效果与社会效果的一定程度的偏离。卫生经济伦理学的理论前提是社会结构变迁要求各个相对独立社会领域的规则整合,其研究任务是为社会经济主体的行为提供一个规范性的评判,实现社会的和谐发展。     

Health behavior, knowledge and attitudes among Swedish university students

A range of health behaviors was related to beliefs concerning health practices and health knowledge. A questionnaire dealing with health-related practices, health beliefs and knowledge of health risk factors was answered by 166 male and 179 female students aged 18–30 years at Stockholm University. Female students reported engaging in better health behavior than males. Beliefs about the importance of health behaviors were closely related to their frequency of occurrence. There was only a weak relationship between health behaviors and knowledge of specific health matters. It is concluded that health attitudes rather than health knowledge determine health behavior.     

让公众走近现代健康理念——从陈晓旭剃度出家及英年早逝说起

现代健康观是文明进步的产物。让公众走近现代健康观,是追寻人类理想,建设和谐社会,管好国家核心资源,全面提高人民群众健康水平的需要。按照现代健康观的基本精神开展健康教育,是当今社会的重要课题。