白血病患者诊治中的医患矛盾与人文关怀：

白血病患者是一个特殊的群体,承受着巨大的身体痛苦、心理压力和经济负担,本文从三个层面对白血病患者诊治中的医患矛盾加以认识,探讨人文关怀在白血病患者诊治中的体现,注重提高医生的人文素质和沟通技巧,创造和谐的医患关系。     

男科临床工作中的人文关怀

随着现代医学模式的转化和男科学诊治技术的发展,在男科临床工作中应该注重树立人文关怀理念和强化人性化服务意识.实施人文关怀的方法包括:重视心理应激,应用心理疗法;关注患者生活,有效预防疾病;营造人文环境,提供人性化服务;遵循最优化原则,做到适度医疗;关心老年人健康,关注社会特殊群体.在男科临床工作中应提高人文关怀的自觉性.     

以白求恩精神接诊老年口腔疾病患者

老年患者是口腔科门诊接诊患者中的特殊群体,本文从医学伦理学角度入手,从口腔疾病诊治中白求恩精神体现角度出发,对老年患者在进行口腔疾病治疗中的生理、心理状态进行分析,以白求恩“把救死扶伤、给患者解除生理及精神病痛,看作是自己最大的幸福”为指导原则。探讨如何能更有效的诊治老年患者口腔疾病,并更好的为老年口腔疾病患者服务。     

医疗群体的外延思维

本文基于临床观察的具体情况 ,对医患关系的潜在含义进行以下浅析。1　现代医疗群体的特征1 .1　医疗群体的不对称性随着科学技术的发展 ,医学也不断发展 ,逐渐从哲学中分化出来成为独立的学科 ,医患关系的不平等更加明显 ,具体表现在 :其一 ,由于医学知识的普及教育十分薄弱 ,人们的医疗知识普遍匮乏 ,所以 ,具有特殊专业知识技能的医疗者 ,自然处在知情者的优势地位 ,而患者群体则处在不知情的劣势地位。这种专业知识的不对等 ,造成了患者对医护人员 ,一是盲目信任 ,二是缺乏理解。知识的不对等是医疗群体间的特色。其二 ,在医患关系中 ,…     

住宅权视域下特殊需求群体的住宅保障

随着现代公民住宅权理论的产生和发展,特殊需求群体的住房问题日益受到关注.我们必须明确什么是特殊需求群体,这既有助于确定研究的边界,也是与以往的关于低收入群体等社会弱势群体住宅保障研究的区别.我们强调“住有所居”决不能够为满足片瓦遮身的住宅保障形式主义大开方便之门,而是要以公民住宅权的最终实现为目标.而对特殊需求群体实施住宅法律保障,必须严格区分各类人群在住宅权实现中的不同要求,不能粗暴地采取“一刀切”.     

男科临床工作中的人文关怀

随着现代医学模式的转化和男科学诊治技术的发展,在男科临床工作中应该注重树立人文关怀理念和强化人性化服务意识。实施人文关怀的方法包括：重视心理应激,应用心理疗法;关注患者生活,有效预防疾病;营造人文环境,提供人性化服务;遵循最优化原则,做到适度医疗;关心老年人健康,关注社会特殊群体。在男科临床工作中应提高人文关怀的自觉性。     

大学生弱势群体的伦理社会处境分析与思考

随着高校招生规模的不断扩大,大学生中弱势群体的绝对数量也大大增加,成为高校必须正视、重视和关注的特殊群体.从共性角度对这一特殊群体面临的两大伦理困境:挫折感强和社会认同感弱进行了深层解析;从类特性的角度对其他伦理问题进行了有益的探究和思考.     

针对妊娠期生殖道尖锐湿疣患者性传播疾病知识调查的思考

性传播疾病（sexually transmitted disease,STD）在我国正以每年平均16．45％的速度增加。妊娠妇女是STD的易感人群。加强对孕龄期妇女的干预措施,是保证母婴健康的关键,对防治妊娠期尖锐湿疣等STD尤为重要。为此,我们对妊娠期尖锐湿疣患者采取健康教育干预措施如STD知识培训、发放宣传资料、鼓励自购STD科普丛书等,并对其效果进行评价。     

“利润绩效”至上折射医德滑坡的启示

利益驱动是“利润绩效”至上折射从医人员对医德底线失去敬畏的根本因素;漠视患者的利益高于一切的服务根基是从医人员对医德底线失去敬畏的基本因素;“利润绩效”转嫁给患者是从医人员对医德底线失去敬畏的强化因素.“利润绩效”至上的利益机制昭示医学伦理缺陷,折射医德滑坡.     

医患不同角色群体对患者知情同意权的态度研究进展

概述目前国内外关于医患不同角色群体对患者知情同意权的态度的研究状况。现有的研究重点是关于癌症患者和精神分裂症患者的知情同意权问题,研究结果表明,患者、家属、医务人员三个不同角色群体的认知和态度存在明显差异;对普通疾病患者的知情同意权的认知和态度问题,目前国内尚缺乏比较全面系统的研究。     

Making Decisions About Life-Sustaining Medical Treatment in Patients With Dementia

The problem of decision-making capacity in patients with dementia, such as those with early stage Alzheimer's, can be vexing, especially when these patients refuse life-sustaining medical treatments. However, these patients should not be presumed to lack decision-making capacity. Instead, an analysis of the patient's decision-making capacity should be made. Patients who have some degree of decision-making capacity may be able to make a choice about life-sustaining medical treatment and may, in many cases, choose to forgo treatment.     

Association of hypertension-related distress with lack of self-care among hypertensive patients

Research on factors associated with poor adherence to self-care focuses primarily on psychiatric emotional disorders such as depression and anxiety, whereas non-psychiatric chronic-disease-related emotional distress has received little attention in hypertensive patients. The objective of this study was to evaluate the association of hypertension-related distress with the lack of self-care including low adherence to pharmacological treatment, lack of regular physical activity, low intake of fruits and vegetables and frequent intake of high-salt foods. A cross-sectional survey was conducted in 2014 in two family medical units affiliated with the Mexican Institute of Social Security. The study included 487 hypertensive patients >19 years of age. The conceptual framework for the study was based on the Health Promotion Model. The analysis included multiple Poisson regression models. We found that 21.1% of participants had hypertension-related distress. Low adherence to pharmacological treatment was identified in 45.8% of patients, whereas 46.8% lacked regular physical activity, 30.8% reported a low consumption of fruits and vegetables, and 54.6% frequently consumed foods high in salt content. Hypertension-related distress was associated with lack of regular physical activity and low intake of fruits and vegetables. These findings highlight the importance of addressing distress in order to improve self-care of hypertensive patients.     

临床医学新趋势：语言作为一种治疗工具的复兴

在履践生物心理社会医学模式中,语言具有不可替代的重要作用。现代医疗设备和仪器的高度发达使医生逐渐脱离了患者;技术主体化倾向使医生的语言功能逐渐地退化,语言能力的欠缺不仅影响医患关系,也直接影响疾病的治疗效果。因此,履践语言的临床复兴,务必掌握语言的艺术、沟通的技巧,以建立和谐稳固的医疗环境和医患关系,良好的语言是缓解患者痛苦的有效良方,在当今诸多医学及复杂社会因素的影响下,语言作为一种治疗工具必将成为临床医疗的新趋势。     

Multidimensional Family Therapy HIV/STD Risk-Reduction Intervention: An Integrative Family-Based Model for Drug-Involved Juvenile Offenders

Drug and juvenile justice involved youths show remarkably high rates of human immunodeficiency virus (HIV)/sexually transmitted disease (STD) risk behaviors. However, existing interventions aimed at reducing adolescent HIV risk behavior have rarely targeted these vulnerable young adolescents, and many approaches focus on individual-level change without attention to family or contextual influences. We describe a new, family-based HIV/STD prevention model that embeds HIV/STD focused multifamily groups within an adolescent drug abuse and delinquency evidence-based treatment, Multidimensional Family Therapy (MDFT). The approach has been evaluated in a multisite randomized clinical trial with juvenile justice involved youths in the National Institute on Drug Abuse Criminal Justice Drug Abuse Treatment Studies ( http://www.cjdats.org ). Preliminary baseline to 6-month outcomes are promising. We describe research on family risk and protective factors for adolescent problem behaviors, and offer a rationale for family-based approaches to reduce HIV/STD risk in this population. We describe the development and implementation of the Multidimensional Family Therapy HIV/STD risk-reduction intervention (MDFT-HIV/STD) in terms of using multifamily groups and their integration in standard MDFT and also offers a clinical vignette. The potential significance of this empirically based intervention development work is high; MDFT-HIV/STD is the first model to address largely unmet HIV/STD prevention and sexual health needs of substance abusing juvenile offenders within the context of a family-oriented evidence-based intervention.     

Manualized Treatment of Panic Disorder in a Medical Setting: Two Illustrative Case Studies

People who experience panic attacks (PAs) typically present to medical settings, concerned that their symptoms signify a life-threatening condition. Despite the efficacy of cognitive-behavioral therapy (CBT) for panic disorder (PD), medical practitioners seldom provide this type of treatment. Physicians may lack the time or expertise to impart such behavioral medicine interventions, while patients may find group or individual CBT too costly even when available. Researchers have begun investigating manualized CBT as a cost-effective alternative when traditional forms of this intervention are prohibited. This article describes two case studies in which women presenting to a medical clinic with PD were treated with 6 weeks of manualized CBT after pharmacotherapy was unsuccessful or unpalatable. Both patients exhibited reductions in panic and depressive symptomatology over baseline levels, along with increases in self-efficacy regarding their ability to manage future PAs. Improvements were maintained over 12 months, supporting continued use of manualized CBT as a supplement or alternative to pharmacological methods of treating PD in the medical setting.     

我国肢体残疾病人矫形治疗的现状分析

我国肢体残疾病人的发病率、病种分类、病情特点、医疗需求的实际情况如何?矫形外科医生队伍的建设与学术研究现状怎样?众多的肢体残疾者是否得到正确的矫形外科治疗?骨科学术界缺乏这样的分析。作者实施了2万多例各种肢体残疾的矫形手术,对其中16678例病人进行了统计分析,结果发现,近10余年来我国大医院进入以市场为主导的发展阶段,外科治疗下肢畸形与残疾的矫形外科专业,由于缺乏强大的市场推动、治疗过程较复杂等原因,而被忽视。我国矫形外科医师严重缺乏,某些下肢残缺的矫形手术治疗甚至人才断档。从而出现数以百万计的各种肢体残疾病人,因为缺少经济能力和矫形外科医师,没有得到正确的矫形外科治疗。作者分析了我国肢体残疾病人的发生率、病种、病情特点、年龄分布、经济状况和医疗需求,提出了解决这一问题的对策和建议     

Emotions and cognitions in consumer health behaviors: insights from chronically ill patients into the effects of hope and control perceptions

The lack of compliance to medical advice is a widely recognized healthcare concern with important implications to consumer well‐being. Through an in‐depth examination of the narratives provided by chronically ill patients, this study contributes to transformative consumer research by offering a better understanding of patients' compliance or lack of compliance with medical advice. The narratives are examined with a focus on two potential antecedents: hope and perceptions of control over health outcomes. Findings suggest that although control perceptions play a crucial role in compliance, chronically ill patients often feel that they have no control over their health outcomes. The narratives reveal that the positive emotion of hope is a motivator for positive health behaviors. Additionally, the lived experiences accounts suggest a possible relationship between hope and control perceptions: patients' belief in their ability to manage their chronic illness facilitates hope but might not be essential to it. The importance of healthcare providers' role in cultivating hope and customizing their interactions with patients is discussed. The implications also indicate that health initiatives aimed at increasing treatment compliance should consider alternatives to messages calling for patients to take control of their health. Instead, future research on health behavior should look beyond social cognition models of health behavior and focus on the role of positive emotions such as hope. Copyright © 2015 John Wiley & Sons, Ltd.     

冠心病介入治疗过度应用的分析和对策

介入治疗是冠心病治疗的重要进展和手段之一,可以改善急性心肌梗死患者的生存率.但目前也出现了过度使用的问题.冠心病本身的特点、医生对冠心病治疗认识不全面和现行医疗制度的不合理部分是其产生原因;建立正确的冠心病诊治策略,深入改革医疗体制,加强医师职业道德培养,同时注意辩证分析过度医疗才能科学合理的应用介入治疗造福冠心病患者.     

Third-party payers and the cost of biomedical research

Four principal arguments have been offered in support of requiring public and private third-party payers to help fund medical research: (1) many of the costs associated with clinical trial participation are for routine care that would be reimbursed if delivered outside of a trial; (2) there is a need to promote scientific research and medical progress and lack of coverage is an impediment to enrollment; (3) to cover the costs of trials expands health care and treatment options for the sick; and (4) it is beneficial for private insurers to cover the costs associated with cancer clinical trials because doing so makes such companies more attractive to consumers. Although many see third-party-payer coverage as a victory for patients and for the future of research, requiring coverage of services provided in a trial beyond those that would be provided to a comparable patient outside the research context raises a number of concerns.     

Pharmacological treatment of affective disorders: A review and guide for the non-medical practitioner

Mental health professionals who lack medical training may also lack knowledge and understanding of the potential utility of medications in the treatment of emotional disturbance. They may also lack information regarding the effects and side-effects of medications which their clients may already be taking, or be uncertain when the nature of their client's situation suggests a psychiatric assessment regarding drug therapy. This paper offers an educational review in one such area: the pharmacological treatment of depression. It includes a brief review of theories regarding the aetiology of affective disorder, examines the methodes, mechanisms and efficacy of anti-depressants, and draws conclusions regarding the appropriate use of pharmacological treatment.