医院数字化管理在临床决策中的作用

医院数字化建设是管理行为中的重要手段,借助这一工具,医疗决策的制定和执行将更加科学和规范,但同时医院数字化管理在法律和具体操作上对临床决策的管理还有一定的影响。讨论医院数字化在医疗决策中的合法性、安全性及对临床决策基本原则的作用。     

护理观察在临床决策中的作用

在临床护理过程中,护士应充分利用护理工作的独特优势,从护理常规观察入手,使用望闻问切等观察手段,注重多向思维及病人的个性化特征,对病人实施全程观察,适时准确的观察患者细微的重要症状与体征变化,为及时正确的临床诊疗提供充分的、有效的信息,使护理观察能够在临床决策中发挥重要作用。     

护理观察在临床决策中的作用

在临床护理过程中,护士应充分利用护理工作的独特优势,从护理常规观察入手,使用望闻问切等观察手段,注重多向思维及病人的个性化特征,对病人实施全程观察,适时准确的观察患者细微的重要症状与体征变化,为及时正确的临床诊疗提供充分的、有效的信息,使护理观察能够在临床决策中发挥重要作用.     

医院的市场化管理、临床决策与医学人文

医院的市场化管理、人文精神的缺失对临床决策具有重要影响,具体列举并分析了医院市场化管理指标,如分解医疗、限制药费、加速病床周转;价值评价体系,如学位、文章、SCI;政策法规,如精神卫生法;以及领导意志,如官本位、文书多、管理队伍臃肿等对临床决策的影响.此外,人文精神缺失也是导致目前医疗危机的重要原因,影响医生正确的诊疗决策.提出解决矛盾的对策:管理不应以经济作杠杆、不能全盘西化,健全医生的价值评价体系,医院实施全方位的改革.     

论医院伦理委员会在患方决策中的作用

法律的灵魂在于自由、正义之理念,而理念的圆满依靠制度不断的创新与完善。本文旨在创新性地将医院伦理委员会引入患方之决策,使其作为医患之间、医法之间的中间性机构发挥严格审核、代理、咨询等作用,以期达到更好地保护患者、医方和社会之利益;维护人类生存安全与伦理安全;倡导先进人文理念的目的。     

论首发症状的分析在临床决策中的作用

根据不同标准,首发症状可以划分为常见首发症状、可见首发症状、偶见首发症状、特异性首发症状和非特异性首发症状。首发症状在临床决策中的重要作用表现在:提示早期诊断决策信息、疾病内在特征、病灶发生部位、发病病理机制、疾病发展预后和鉴别诊断要点。首发症状的复杂性表现在其无特异性、不典型性、多样性、本系统疾病以外系统疾病为首发症状、躯体性疾病以精神症状为首发症状和首发并发症现象等方面。     

论首发症状的分析在临床决策中的作用

根据不同标准,首发症状可以划分为常见首发症状、可见首发症状、偶见首发症状、特异性首发症状和非特异性首发症状.首发症状在临床决策中的重要作用表现在:提示早期诊断决策信息、疾病内在特征、病灶发生部位、发病病理机制、疾病发展预后和鉴别诊断要点.首发症状的复杂性表现在其无特异性、不典型性、多样性、本系统疾病以外系统疾病为首发症状、躯体性疾病以精神症状为首发症状和首发并发症现象等方面.     

直觉思维在麻醉临床决策中的应用

围手术期麻醉医师面临问题的复杂性、动态性和模糊性,要求其在具备良好逻辑思维能力的同时,还要学会应用直觉思维来进行麻醉危机管理。通过决策判断的双加工理论模型探讨说明直觉思维在临床麻醉决策中的可应用性,并给出麻醉医师直觉思维的培养途径,提高麻醉医师的思考能力,增加应急处理课程和临床训练,重视临床经验的学习,营造良好的教学氛围。为了在围手术期更好地保证患者的安全,麻醉医师应重视直觉思维在临床麻醉决策中的应用。     

数字化医院下的科研管理

医院数字化(Digital Hospital)是国际医院信息学界提出的一个新概念,是我国现代医疗发展的新趋势.根据我院的实践和我们对国内外数字化医院建设的综合分析,我们认为数字化医院的定义可分为"狭义"和"广义"两个层次进行阐述. 所谓"狭义数字化医院",是指利用网络及数字技术,有机整合医院业务信息和管理信息,实现医院所有信息最大限度的采集、传输、存储、利用、共享并且实现医院内部资源最有效的利用和业务流程最大限度的优化的高度完善的医院信息体系,是由数字化医疗设备、计算机网络平台和医院软件体系所组成的三位一体的综合信息系统.我国乃至全球的医院数字化建设总体来讲都还停留在狭义数字化医院的管理水平.     

子宫肌瘤治疗中的临床决策

子宫肌瘤是成年妇女的常见病,其治疗手段越来越多,各种手段都有相应的指征,而每一个患者可同时符合多种手段的指征,根据患者的病情、患者本身的需求,综合考虑多种因素,给每一个子宫肌瘤患者作出最适合的临床决策是每个妇产科医生的责任。     

偶然情绪对决策的影响

情绪在决策领域中的引入曾历经过一个从刻意回避到日益重视的过程, 大量研究表明, 即使与决策本身无关的偶然情绪也会对人类的决策行为具有重要作用。本文通过梳理本领域的最新研究提出未来应注重考察：偶然情绪的影响条件、具体情绪的作用以及偶然情绪与可选项的情感属性对决策的交互影响。最后, 本文在情绪激发方法、情绪的操纵检测和决策任务实测等方面进行了总结并提出一点研究建议。     

行为决策中出现的分离效应

分离效应（the disjunction effect）是指：当决策者知道事件E会发生,他会采取行动A;当知道事件E不会发生,他仍会采取行动A;而当不知道事件E是否会发生的情况下,他会拒绝行动A。这一现象违背了理性决策理论的确定事件原则（sure-thing principle）。对分离效应的解释主要有基于理由的假设、思维惰性假设和齐当别模型。分离效应是否真的存在以及应该采用何种实验设计来进行研究都还有待进一步探讨。2005年诺贝尔经济学奖获得者Aumann对事件分离情境和事件非分离情境的区分,为进一步研究分离效应指明了新的方向。理解分离效应及其成因有利于人们做出“理性”的决策     

多维视野下的临床决策

临床决策是临床实践的重要组成部分之一,随着时代和科学技术的发展,临床决策的内涵和方法也发生了深刻的变化。有许多的因素影响或决定临床决策的质量,如何正确处理好循证医学证据与经验、传统方法和现代技术、创新与人文主义精神、技术与费用等关系是一个十分复杂的课题,需要从临床、经济、社会和法律等多方面加以研究和探索。     

多维视野下的临床决策

临床决策是临床实践的重要组成部分之一,随着时代和科学技术的发展,临床决策的内涵和方法也发生了深刻的变化.有许多的因素影响或决定临床决策的质量,如何正确处理好循证医学证据与经验、传统方法和现代技术、创新与人文主义精神、技术与费用等关系是一个十分复杂的课题,需要从临床、经济、社会和法律等多方面加以研究和探索.     

系统性红斑狼疮的临床决策

系统性红斑狼疮是临床上表现最复杂多变的疾病之一,其诊断、评价、患者教育、治疗及随访工作中既要遵循临床决策的共同法则,又有其特殊之处。减少误诊漏诊、正确看待和应用各种临床指南和病情评价方法以及提高诊疗水平的关键,是应用临床决策学的方法进行综合分析、评价、再分析和再评价,并且要贯穿患者的终生。     

系统性红斑狼疮的临床决策

系统性红斑狼疮是临床上表现最复杂多变的疾病之一,其诊断、评价、患者教育、治疗及随访工作中既要遵循临床决策的共同法则,又有其特殊之处.减少误诊漏诊、正确看待和应用各种临床指南和病情评价方法以及提高诊疗水平的关键,是应用临床决策学的方法进行综合分析、评价、再分析和再评价,并且要贯穿患者的终生.     

The Rank-Order Effect in Group Decision Making

Many studies indicate that group discussion candisproportionately reflect information known by all group members,at the expense of information known to only one group member, andthis is associated with suboptimal group decisions (Stasser &Titus, 1985). The present study examined the impact of threeprocedural factors on information sharing and quality of groupdecision: (a) group decision procedure (an instruction to "rankorder the alternatives" vs "choose the best alternative"), (b)information access during group discussion (reliance on memory vscomplete access), and (c) communication technology (computer vsface to face). Three-person groups worked on an investment decisionthat was structured as a hidden-profile task where criticalinformation was distributed unevenly prior to group discussion. Thedata provided support for a rank-order effect: Groups instructedto rank order the alternatives, compared to groups instructed tochoose the best alternative, were more likely to fully consider allof the alternatives, exchange information about unpopularalternatives, and make the best decision. But these effects onlyoccurred in face-to-face groups. In computer-mediated groups, therewas general information suppression and no effect of group decisionprocedure. Access to information during group discussion increaseddiscussion of both unique and common information, in theface-to-face conditions, but had no effect on group decisionquality. Taken together, the data suggest that procedural aspectsof group discussion may help overcome the impact of prediscussionpreferences on information processes and group decision.     

The Effect of Emotion on Visual Attention to Information and Decision Making in the Context of Informed Consent Process for Clinical Trials

The aim of this study was to examine the influence of emotion on visual information processing and decision making in the context of informed consent. Researchers are ethically obligated to ensure informed consent in clinical trials; however, many volunteers have unrealistic expectations about the value of an experimental therapy. Moreover, suboptimal participation rates for clinical trials may be partially attributable to perceptions that ethical obligations to volunteers are not met. This study examines whether discrete negative emotions (fear, anger, and sadness) differentially influence information processing, visual attention, and decisions in the context of clinical trial informed consent. Community participants completed a standard emotion induction (or control) and then read an actual consent form from a clinical trial while eye movements were tracked. Fear and anger produced the most prominently different patterns of systematic processing and visual attention, such that fear induced longer fixations to information presented, whereas anger induced shorter fixations. Moreover, among women only, fear increased decisions to participate, compared with anger and neutral emotion. Examinations of associations between eye‐tracking variables and self‐reported outcomes indicated that for angry participants only, less systematic processing was associated with greater decisions to participate. Negative emotions of any kind decreased accurate perceptions of trial benefit. These patterns suggest a complex interplay among emotion, processing style, and decision making. Future research is necessary to further probe these effects among potential clinical trial volunteers. Published 2016. This article is a U.S Government work and is in the public domain in the USA.     

Information Integration in Juror Decision Making

Research applying information integration theory to jury decision making has long assumed that people average informational scale values when making legal judgments. Although often consistent with research results, this hypothesis has never been tested in a legal context against a more general additive rule. The present paper describes two studies conducted as a critical test between these two models. Incriminating evidence and eyewitness confidence were varied in a full-factorial, within-subjects design involving a total of 131 subjects acting as mock jurors. Subject responses included eyewitness accuracy and defendant-guilt probability estimates, as well as final verdict decisions. Results strongly support an averaging model of legal decision making. Additional results concerning the influence of initial attitudes and the interrelationships between the variables considered are reported and their implications are discussed.