医学生实习与患者就医间矛盾调和

患者就医希望得到经验丰富的医生诊治,而经验丰富的医师往往由无经验的实习医师通过以牺牲患者利益为代价成长起来的.随着医师法的实施和病人要求的提高,实习医师与患者间的利益冲突构成的这一矛盾更加突出.为化解矛盾,通过提高实习医师业务素质和道德素质,增强临床老师责任心等一系列措施,提高病人对医院满意程度,使实习医师圆满完成实习任务.     

实习护生眼中的有效沟通

护患间的沟通至关重要,一句话可以“治病”也可以“致病”,这就取决于沟通的有效性.实习护生由于对工作的不熟悉、对技术的不熟练等原因,发送的信息常常不被患者所理解和信任,导致无效沟通.为此,我们以实习护生在临床经验的沟通感受为题材,运用质性研究内容分析的方法,构建了一个由26个二级要素组成的实习护生有效沟通的概念框架.以为未来的实习护生提供经验性的模板,也为护理教育者提供教育培养的第一手资料.     

医学伦理审查实践中存在的主要问题与对策

医学伦理审查对规范医学研究和医疗实践,保护受试者或患者权益有重要意义.通过总结医院医学伦理审查实践经验,指出医学伦理审查存在职能交叉、独立性不强、管理不完善、协同性不够、受试者损害补偿机制不明确等问题,提出从健全组织机构、建立指导原则、加强伦理培训、规操作流程、完善补偿机制等方面予以改进.     

中美教学医院门诊病历管理对比研究

通过文献检索、走访调研并结合笔者时美国教学医院门诊病历管理的实地考察,本文对中美两国教学医院人员对门诊病历管理的认识理念、门诊病历管理的方式、病历的规范设计以及门诊病历的质量控制等方面进行了对比研究.显示我国教学医院在门诊病历管理方面与发达国家存在着差距.从提高临床医疗和医学教学质量、有利于患者疾病的诊治和培养当代优秀医务工作者,促进医学科学技术发展出发,教学医院管理者和临床指导医生应高度重视和规范门诊病历管理.     

内科临床实习医师的带教思考

针对新形势下教学医院内科实习医生的特点,从教学方法、医学模式转变、能力培养、实习管理、医惠关系和医德教育以及就业指导等6个方面进行了分别阐述,强调了教学实习的新特点、新任务,主张教师的角色转换,真正实行弹性化管理,从而达到最佳的实习效果。     

与医学院实习生谈医患关系

阐述实习医师医患沟通的必要性,培养实习生正确的临床思维程序,规范操作技能。注意医患沟通技巧、言语和体语,建立良好医患关系。加深患者对医生的信任感,杜绝临床实习过程中各种医疗隐患。因而迫切需要解决的问题是如何加强实习医师沟通能力的培养,也是高等医学教育改革的重要课题。     

与医学院实习生谈医患关系

阐述实习医师医患沟通的必要性,培养实习生正确的临床思维程序,规范操作技能。注意医患沟通技巧、言语和体语,建立良好医患关系。加深患者对医生的信任感,杜绝临床实习过程中各种医疗隐患。因而迫切需要解决的问题是如何加强实习医师沟通能力的培养,也是高等医学教育改革的重要课题。     

伦理审查委员会文件归档规范化的探讨

我国伦理审查委员会文件归档的规范化管理尚处于起步阶段.在对伦理审查委员会文件归档内涵界定的基础上,阐述了文件归档不规范的弊端和规范化管理的意义,探讨了文件归档的范围和规范化管理过程中存在的问题.最后从强化规范化归档意识、完善操作规程体系、采用现代化管理手段等方面提出完善建议.     

从病历书写论实习、试用期医务人员的监管成效

为了了解上海市卫生局卫生监督所对医疗机构实习、试用期医务人员书写病历监督检查的成效,通过分层抽样的方法对纠纷高发科室运行病历的检查,就实习、试用期医务人员病历书写情况进行分析.结果显示,实习试用期医务人员书写病历及出具医嘱未经上级医务人员审阅修改签名的缺陷情况获得明显改善.说明各级医疗机构和医务人员已逐步树立了依法执业的理念,卫生监督部门监管工作切实有效.     

护理本科生对临床实习中学习关爱的看法——一项焦点小组访谈研究

对12名护理本科生进行焦点小组访谈,探索其对临床实习中学习关爱的看法.护生认为关爱的学习由关爱或不关爱事件诱发,临床实习中学习关爱的困惑源于临床工作繁重导致关爱病人时间不足.护理教育者要关注学生临床实习期间心理变化,给予积极诱导,让临床实习发挥其在关爱教育中的重要角色和功能.     

Together – apart: in touch in a time of separation

This paper explores the experience of working as a Jungian analyst through the various phases of the global COVID-19 pandemic, examining the importance of the physical containing space alongside the analyst’s internal mind and how technology can both help and hinder understanding. A number of clinical vignettes illustrate the challenge of communicating over a distance, paying particular attention to the way countertransference phenomena can become re-attuned. Reference is made to mythology and symbols of hope, and consideration given to the meaning and purpose of the pandemic.     

The Possibility of Meaning in Human Evolution

Science undermines the certitude of non-naturalistic answers to the question of whether human life has meaning. I explore whether evolution can provide a naturalistic basis for existential meaning. Using the work of philosopher Daniel Dennett and scientist Ursula Goodenough, I argue that evolution is the locus of the possibility of meaning because it has produced intentionality, the matrix of consciousness. I conclude that the question of the meaning of human life is an existentialist one: existential meaning is a product of the individual and collective tasks human beings undertake.     

Phenotypic plasticity and archetype: a response to common objections to the biological theory of archetype and instinct

Since Jung’s death in 1961, scholars have attempted to integrate growing biological science data into Jungian concepts such as the collective unconscious, instincts and the archetypes. This enterprise has been challenging due to persistent false dichotomies of gene and environment occasionally arising. Recent works by Roesler (2022a, 2022b) for example, have raised objections to the biological theory of archetypes, but the objections are plagued by such dichotomies. The concept of phenotypic plasticity, however, helps to both avoid this problem as well as bridge the gap between competing theories into a more integrated model with solid biological foundations.     

When is it time to stop? When good enough becomes bad enough

This article draws on Winnicott’s concept of the good enough mother to discuss how to know whether a therapeutic situation is good enough to continue or bad enough to end. This dilemma is explored in terms of clinical syndromes, such as anorexia and pathological gambling, but focuses mainly on analyst-initiated endings, which are termed the ‘Casablanca dilemma’, based on an amplification of the ending of the film Casablanca. The author goes on to discuss such one-sided endings, drawing on interviews with 40 analysts and therapists about their clinical experience. A typology of bad enough endings is presented. The psychological differences between a good enough analysis as opposed to a bad enough one are explored through the ideas of Winnicott and Neumann.     

Kann Es Ein Argument Für Den Skeptizismus Geben? Das Epistemische Problem Der Irrtumsmöglichkeit

Summary  Is there any argument for scepticism? The epistemic problem of the possibility of error. Arguments for scepticism rest on the assumption that knowledge claims are fallible. For this reason the concept of knowledge appears to be questionable. Since it is necessary to distinguish doubts from possible doubts, the arguments for scepticism appear to be unconvincing. If we take it into account that we know something that is immune to doubt, we should draw the conclusion that, contrary to scepticism, knowledge claims have to be compatible with being fallible. Thus any knowledge claim is capable of being doubted.     

The transcendent function in Spitteler’s Prometheus and Epimetheus

In August 2020, John Beebe and Steve Myers met via Zoom to discuss their differing interpretations of psychological typology and the different sources within Jung’s writings that influenced their books: Integrity in Depth: Energies and Patterns in Psychological Type (Beebe), and Myers-Briggs Typology vs Jungian Individuation (Myers). The discussion centred on Spitteler’s epic poem Prometheus und Epimetheus, which forms the basis of chapter V of Psychological Types. This is both the largest chapter and one of two chapters that Jung highlighted in the Argentine foreword as containing the essence of the book. Jung’s book is primarily about the transformation of personality rather than the categorization of people. Although it contains a critical psychology that deconstructs the nature of consciousness, that is only one half of the book and a stepping-stone to the other half, which is the reconciliation of opposites with particular emphasis on the relation of consciousness and the unconscious. Jung assumed that readers were already familiar with Prometheus und Epimetheus, an understanding of which sheds light on the nature of the transformation that Jung described – the development of a new attitude towards attitude itself.     

Chapter 6: Biblical Foundations for a Practical Theology of Aging

SUMMARY

This article reviews Biblical sources pertaining to the elderly, particularly the frail elderly. Founded on these sources, implications for elderly with Alzheimer's Disease and other forms of dementia are addressed through a personal perspective informed by writings of Christian mystics.     

Seeing in the Dark: A View into Dissociation and Healing

In this paper, I will explore the role of art-making, the experience of trauma and dissociation, and the process of working with self-states from an analytic and creative frame. Relevant literature on dissociation, trauma, and the use of art will be discussed. A case involving my work with an adolescent girl who had experienced sexual abuse from a family member will be shared, with an emphasis on the meaningful role images played during the therapeutic process. Both Jungian and psychoanalytic models of conceptualizing and working with dissociation are included, following Donald Kalsched’s (2013) recommendation for a “binocular stance” to treatment, including both a focus on the inner, intrapsychic world and the interpersonal, relational realm, and how art images both illuminated and expressed these realms. Within the therapeutic process, art images allowed the therapist a view into the client’s unconscious process, and created a meeting ground for dissociative barriers to be gradually seen, felt and known, by both therapist and client. The experience of dissociation, in images and in session, provided a reference point for myself and my client, Taylor, to develop a shared understanding and a framework for growth.