疾病管理国际应用现状的探讨

慢性非传染性疾病已成为我国社区居民的主要健康问题,在慢性病的防治工作中,不可忽视对病人的管理.在阅读分析大量国内外文献的基础上,阐述了疾病管理国际应用现状及所取得的成效,并探讨了疾病管理的模式,以此为我国社区的慢性非传染性疾病管理提供参考和借鉴.     

全科医学是医学科学性与人文性的完美结合

全科医生在社区接触的最多的是常见病、多发病和慢性病.尤其是慢性非传染性疾病,如高血压病、糖尿病、冠心病、脑卒中、慢性阻塞性肺疾病等覆盖了绝大部分门诊慢性病患者. 全科医生不可能像专科医生一样,看相对集中的疾病病种.所以,不可能像专科医生一样就某一疾病将其指南研究透彻,而必须了解、掌握常见病多发病的最新指南指导原则.     

心脑血管疾病防治的社区医疗模式初探

心脑血管疾病是严重危害老年人健康的主要慢性非传染性疾病,简捷、方便、费用低廉的高质量社区医疗服务是提高老年人生活和生命质量的需要,建立科学、规范、有效的社区防治管理模式是减少其发病率、致残致死率的关键措施,同时也是构建“社会主义和谐社会”的有效途径,对于“统筹人与自然、人与社会的和谐发展”具有十分重要的现实意义。     

心脑血管疾病防治的社区医疗模式初探

心脑血管疾病是严重危害老年人健康的主要慢性非传染性疾病,简捷、方便、费用低廉的高质量社区医疗服务是提高老年人生活和生命质量的需要,建立科学、规范、有效的社区防治管理模式是减少其发病率、致残致死率的关键措施,同时也是构建"社会主义和谐社会"的有效途径,对于"统筹人与自然、人与社会的和谐发展"具有十分重要的现实意义.     

疾病模式转变与卫生资源投向的政策思考

世界银行曾提出中国正面临着二次卫生革命的挑战。随着传染性疾病的有效控制,非传染性疾病已形成了人群健康的主要危害。这种疾病模式的变迁及趋势向我国今后卫生资源投向与重点提出挑战。目前政策导向与资源配置取向将决定未来疾病数量及卫生费用增长幅度,应将加强社区、提供成本效益好的预防保健服务作为战略选择。     

现代医学模式疾病谱人类活动时空--人类的活动时空与疾病的关系

1　现代医学模式源于疾病谱的演变 ,疾病谱的演变有赖于人类活动时空的改变医学模式形成源于疾病谱的演变 ,疾病谱的演变有赖于人类活动的时空改变。恰恰是人类活动的时空 ,导致了新的疾病谱 ,同时也导致了现代医学模式的形成。现代医学模式源于疾病谱的演变 ,人类防治疾病的历史 ,是从感染性传染性疾病到非传染性非感染性的历史 ,也是人类活动时空从自然界转到人文社区的历史。笔者在 2 0 0 0年第 8期《医学与哲学》“现代医学模式形成与疾病治疗“一文中 ,曾提出人类延年益寿的历史无非是“三部曲”的历史 :第一部曲是面对“大家伙”——…     

医学的整合与全科医学

大量慢性非传染性疾病的处置涉及许多医学分科,还涉及心理、社会学科.临床医学应重视预防,医学要与人文精神结合.全科医学是整合了生物医学、行为科学和社会学科的医学分科,全科医学不强调分科而强调以人为本.应重视其对医学其他分科的启迪作用.     

综合医院开展临床预防服务的可行性

临床预防服务是预防医学的重要组成部分,也是临床医学的重要内容。鉴于慢性非传染性疾病对社会、家庭及个人的负担越来越重,在各级医院尤其综合医院开展临床预防服务,对预防慢性病的发生、发展,降低死亡率、减轻社会、家庭负担,将起到事半功倍的作用,产生深远影响。     

改变因症就诊的医疗模式搞好慢性呼吸疾病的防控

本文简单介绍了各种慢性呼吸疾病的特点、重要性、病因和发病机理,重点阐述认真搞好三级预防是有效防控慢性呼吸疾病的基础,而目前我国慢性呼吸疾病医疗服务模式是因症就诊,这种医疗服务模式不利于慢性呼吸疾病的管理和控制,必须尽快改变。     

综合医院开展临床预防服务的可行性

临床预防服务是预防医学的重要组成部分,也是临床医学的重要内容.鉴于慢性非传染性疾病对社会、家庭及个人的负担越来越重,在各级医院尤其综合医院开展临床预防服务,对预防慢性病的发生、发展,降低死亡率、减轻社会、家庭负担,将起到事半功倍的作用,产生深远影响.     

冠心病预防的健康管理模式初探

本文将健康管理中的连续动态理念与现有的社区慢性病管理相结合,构建冠心病预防的健康管理模式。通过冠心病预防策略和策略实施两方面来阐述这一冠心病预防健康管理模式的连续动态性。同时采用SWOT分析法对此模式的应用进行综合评价。希望通过对冠心病预防工作的思考,完善现有的社区慢性病防治工作。     

Family predictors of disease management over one year in Latino and European American patients with type 2 diabetes

Family context is thought to influence chronic disease management but few studies have longitudinally examined these relationships. Research on families and chronic illness has focused almost exclusively on European American families. In this prospective study we tested a multidimensional model of family influence on disease management in type 2 diabetes in a bi-ethnic sample of European Americans and Latinos. Specifically, we tested how baseline family characteristics (structure, world view, and emotion management) predicted change in disease management over one year in 104 European American and 57 Latino patients with type 2 diabetes. We found that emotion management predicted change in disease management in both groups of patients as hypothesized, while family world view predicted change in both ethnic groups but in the predicted direction only for European Americans. Examining family context within ethnic groups is required to elucidate unique cultural patterns. Attending to culturally unique interpretations of constructs and measures is warranted. The import of family emotion management, specifically conflict resolution, in disease management deserves further study to support clinical intervention development. Examining multiple domains of family life and multidimensional health outcomes strengthens our capacity to develop theory about family contexts and individual health.     

Management of multiple sclerosis: the role of coping self-efficacy and self-esteem

Patients with multiple sclerosis (MS) engage in various coping behaviours in order to manage their disease. The aim of this study is to find out if the self-esteem of patients is associated with coping strategies – problem-focused (e.g. making a plan of action when confronted with a problem); emotion focused (e.g. get emotional support from community); and focused on stopping unpleasant emotions and thoughts (e.g. keeping oneself from feeling sad), and if it can enhance or hinder coping efforts in the disease management. We collected data from 155 consecutive MS patients who completed the Coping Self-Efficacy Scale (CSE) and the Rosenberg Self-esteem Scale (RSE). Explained variance for problem-focused coping, emotion-focused coping, and coping focused on stopping unpleasant emotions and thoughts was 33, 24, and 31%, respectively. Self-esteem seems to be associated with coping strategies indicating that feelings of self-worth are linked with the ability to handle difficult life situations and can be helpful in chronic disease management.     

《神农本草经》的道家养生思想与汉画像石中的羽人仙药图

以<神农本草经>中的道家养生思想,结合汉画像石中的羽人仙药图,说明秦汉时期道家养生思想对<神农本草经>的渗透与影响,以及<神农本草经>道家养生思想对后世本草方剂学的重要影响.     

个体心理模式对慢性疾病预后的探讨

21世纪,慢性疾病逐渐成为威胁人类健康的重要原因。然而其预后一直不理想,对慢性疾病患者的心理模式进行了分析,结合工作实际,提出慢性疾病患者如何看待疾病和自身———有意识的或无意识的———在很大程度上决定了疾病的预后。     

Neuropsychological Functioning in Chronic Lyme Disease

Lyme disease is currently the most common vector-borne illness in the United States. The disease is multisystemic, and chronic disease, in particular, may be associated with neuropsychological deficits. However, to date, only a few empirical studies exist, which examine the neuropsychological sequelae associated with chronic Lyme disease. A review of the literature shows that the deficits observed in adults with chronic Lyme disease are generally consistent with the deficits that can be seen in processes with primarily frontal systems involvement. These observations are generally consistent with neuroradiologic findings. The clinical presentation in chronic Lyme disease and the nature of the neuropsychological deficits are discussed, as are several central issues in understanding neuropsychological functioning in chronic Lyme disease, such as the impact of chronic illness, response to treatment, and the relationship between neuropsychological performance and depression, fatigue, and neurological indicators of disease.     

应该发挥医院、医生在慢性病预防中的作用

从必要性分析、可行性分析、预防效果分析及存在的问题等方面探讨在我国必须要发挥医院、医生在慢性病预防中的作用,只有整合医疗资源与疾病预防控制资源,才能更好地预防慢性病。     

Correlates of Maternal and Paternal Adjustment to Chronic Childhood Disease

This study investigated the correlates of psychosocial adjustment in mothers and fathers of children with chronic disease. Participants were 20 mothers and 15 fathers of children with cystic fibrosis, 11 mothers and 9 fathers of children with muscular dystrophy, 18 mothers and 9 fathers of children with asthma, 13 mothers and 8 fathers of children with Type 1 diabetes and 19 mothers and 11 fathers of healthy children. Questionnaires relating to the variables of interest were used. Poorer levels of adjustment were associated with lower levels of social support and family cohesion for mothers and coping by understanding the child’s medical situation, more family life events and lower family cohesion for fathers. These findings suggest that the correlates associated with maternal and paternal psychological adjustment to chronic childhood disease differ. These differences are important to consider when providing care to children with chronic disease and their families.     

盆腔炎性疾病与不孕不育

腔炎性疾病（pelvic inflammatory disease,PID）是常见的妇科疾病,且迁延难愈。同时,盆腔炎（PID）发病率增高与性传播疾病（STD）发病人数增多相平行。这些可以引起一系列临床症状,统称为盆腔炎性疾病后遗症（sequelae of PID）。除了长期慢性疼痛、月经不调、盆腔炎性疾病反复发作外,严重的还会影响女性的生育功能,导致不孕症或异位妊娠。此外,盆腔炎对于IVF—ET的成功率也存在一定的影响。