国内城市社区健康教育和健康促进研究

分析了我国城市化加速发展过程中出现的城市社区健康问题及其影响因素。在对社区健康教育与健康促进的作用和意义进行探讨的基础上,提出解决这些城市健康问题的根本途径是城市社区健康教育与健康促进策略,并针对我国城市社区健康教育与健康促进的研究和发展现状提出对策建议。     

发挥健康促进志愿者在社区健康管理中的作用

在我国,开展社区健康管理具有重要意义.针对目前医学的社会化趋势以及社区卫生人力资源不足问题,通过概述健康促进志愿者活动在我国各地的实施进展与效果,指出发挥健康促进志愿者在社区健康管理中的作用的必要性和可行性,并对怎样充分发挥健康促进志愿者在社区健康管理中的作用进行探讨.     

城中村人群健康:城市化进程中不可忽视的问题

城中村现象是中国城市化进程中出现的新的普遍性现象,它既区别于现代城市,又不同于传统的村落,引发了不同于其他社区人群的健康问题.论述了城中村的特殊性质,分析了当前城中村人群健康问题,并据此提出开展健康教育,保障人群健康建议.     

城中村人群健康：城市化进程中不可忽视的问题

城中村现象是中国城市化进程中出现的新的普遍性现象,它既区别于现代城市,又不同于传统的村落,引发了不同于其他社区人群的健康问题。论述了城中村的特殊性质,分析了当前城中村人群健康问题,并据此提出开展健康教育,保障人群健康建议。     

健康城市建设中环境因素对健康的影响与分析

城市化进程加快导致环境对健康的影响日益突出.针对生活环境质量问题,应尽快出台环境与健康管理法规及条例,强化对生态环境保护的政策支持.通过开展健康城市建设项目,倡导环境保护,有效控制环境污染,坚持生态立市,加强环境质量监督管理及污染防治,提升人类生活质量和促进社会全面发展.     

中国健康城市建设的进展及理论思考

中国健康城市的建设走过了探索和实质性发展两个阶段.它以健康促进的理念为指导,以"健康社会、健康环境、健康人群"为主线,成为了当前开展健康促进的典范.健康城市能呈现实质且快速发展的势头,政府主导是其重要的特点.它既符合中国社会文化背景和现状,也是以"上游策略"来解决全人群健康问题创新性举措.中国健康城市推行的深远意义在于,它为当前公共卫生体系建设赋予了先进的内涵,与世界卫生组织倡导的"健康促进曼谷宪章"的核心精神是完全相符的,成为了引领中国公共卫生汇入国际现代公共卫生运动的领头兵.但是,它的茁壮成长仍需要有远见的政治家的呵护和支持.     

健康城市建设的新理念及其导向

健康城市的理论与实践的发展以及人类对健康及其决定因素认知的深入使健康城市的内涵和理念不断扩充,吸纳了健康的社会模式及健康决定因素的理念,为健康城市建设注入了新的机制,并成为健康城市建设发展的新导向.我国建设健康城市的实践,从基线评估、规划制定到建设推进,已着力体现国际上健康城市的新理念和导向.     

初探健康管理与我国糖尿病的预防与控制

近年来,我国糖尿病发展的势头迅速,成为糖尿病患病率增长最快的国家之一,给社会和经济带来了巨大的负担.文章针对我国的糖尿病的流行现状及其带来的经济负担,分析了实施糖尿病健康管理的现实意义,并借鉴美国健康管理的经验,构思了我国社区的促进糖尿病防制的健康管理模式.     

健康城市--发展历程、建设方法和评估机制

健康城市的研究、监督和评价,必须建立在科学的方法和方法论基础上.调查既往导致健康不公平的因素,收集社会人口数据及编辑相关资料,总结市政当局直接或间接处理公平性问题的政策及程序,选择上述政策可产生影响和不能影响的政策进行比较,评价影响参与健康城市项目的各个因素,评价主观与客观的效益,寻求促进健康公平性的措施,这就是健康城市的评价与建设要回答的问题.     

健康城市建设的新理念及其导向

健康城市的理论与实践的发展以及人类对健康及其决定因素认知的深入使健康城市的内涵和理念不断扩充,吸纳了健康的社会模式及健康决定因素的理念,为健康城市建设注入了新的机制,并成为健康城市建设发展的新导向。我国建设健康城市的实践,从基线评估、规划制定到建设推进,已着力体现国际上健康城市的新理念和导向。     

年轻医生如何搞好临床科研

面对目前年轻医生对科研束手无策的状况,提出了科研的重要性.从科研选题要紧密结合临床实际、医学科研选题强调创新与实用的原则、医学科研需要的科研素质、培养独立从事临床科学研究的能力、充分利用优势科研资源,加强科研合作能力的培养五方面进行阐述如何进行临床科研工作,以便更好地促进临床医学事业的发展.     

Meeting Survivors Where They Are: The Vital Role of Trauma-Informed and Competent Clinicians in Primary Care

For adult survivors of adverse childhood experiences, primary care is the entryway to treatment of post-traumatic stress disorder (PTSD). It is estimated 25% of adult primary care patients have PTSD, and they present to their provider more often with pain and non-specific physical symptoms rather than mental health issues. Physicians, even those somewhat knowledgeable about trauma and PTSD, are unlikely to assess for it in order to avoid issues they may not have the time and/or skills to sufficiently address. This is due to PTSD treatment not being a core training competency in graduate-level education and professional training being timely and expensive. Usual care for PTSD consists of medication to manage symptoms and a referral to a mental health clinician. However, substantial disparities and patient, provider, and delivery system-level barriers means survivors are unlikely to follow-through with referrals nor receive adequate treatment when they do. In this theoretical article, we review the trials and tribulations experienced by research teams and argue what is lacking is trauma-informed care. None of the trials reviewed mentioned trauma-informed care as a component of their intervention nor as a recommendation for future studies. We also outline a host of recommendations for best practice protocols that benefit patients and the collaborative care teams meeting them where they are. Trauma-informed care deepens the focus on relational, physiological, and physical safety. Attention to soothing physiological arousal through the physician-patient-clinician triad creates more positive associations toward moving forward in treatment for survivors and providers.     

1例晚期肿瘤患者宁养服务浅谈

通过提供居家宁养护理指导和心理疏导的方法,为晚期癌症患者提供身、心、灵全方位的照顾,从而提高晚期癌症患者的生活质量。通过对1例晚期肿瘤患者进行症状控制、护理指导、心理疏导、灵性沟通,该晚期肿瘤患者及家属的自身照顾能力提高,晚期肿瘤患者在生命末期的生活质量有所提高,最终达到善终。身心灵的照顾在宁养服务中起重要作用,有利于患者生活质量的提高,但仍要根据患者的个体特点并掌握一定技巧。     

知情权与新生儿重症监护病房(NICU)患儿父母的信息交流技巧

在新生儿重症监护病房(neonatal intensive care unit,NICU)中接受治疗的危重新生儿约90%结果良好,而这些患儿的父母100%都在此过程中遭受不同程度的心理创伤.患儿父母及其家人应被充分告知患儿的病情、治疗方案及可能的预后,这是他们拥有的知情权.在临床工作中,怎样运用良好的信息交流技巧让患儿父母充分理解病情、配合治疗又不过分紧张这对患儿的康复比对患儿实施具体的诊疗方案更重要.从患儿父母、医护人员、人文关怀的角度探讨NICU医护人员与患儿父母之间信息交流的技巧.     

Patient-provider care goal concordance: implications for palliative care decisions

Objective: Goal-concordant care is an important feature of high quality medical treatment. Patients’ care goals may focus on curative and/or palliative outcomes. Patients rarely communicate their care goals, and providers’ predictions of patient goals are often inaccurate, corresponding most closely to their own treatment goals. This projection of own goals onto patients introduces the potential for bias, leading to goal-discordant care.

Design and Main Outcomes: We examined goal discordance using data from a U.S. sample of healthcare providers (N?=?492) recruited online in 2017 using GfK Knowledge Panel. Providers reported their perceptions of their patients’ care goals (curative relative to palliative), their own care goals if they were to become ill, and their willingness to deliver palliative care.

Results: For 28% of providers, their own care goals differed from their patients’. Providers were more likely to prioritise palliative care (relative to curative) in their own goals than in their predictions about patients’ goals. Providers were more willing to deliver palliative care when their own goals prioritised more palliative relative to curative care, but their perceptions of patient goals were unassociated with willingness to provide it.

Conclusions: Efforts to improve goal communication and reduce projection biases among providers may facilitate goal-concordant care.     

Collaborative Communication Between Psychologists and Primary Care Providers

Psychologists frequently collaborate in the care of patients managed in primary care. Communication with a patient’s primary care team is important to ensure coordination and continuity of care. The communication is far from seamless. Although The Health Information Privacy and Portability Act (HIPPA) is designed to promote sharing of clinical information while protecting patient confidentiality, unique problems arise when mental health records are included. Mental health records are subject to different regulations to protect the patient’s confidentiality. Thus, what is communicated and how it will be accomplished are challenges. Further, psychologists and primary care providers often view documentation differently, resulting in different styles of documenting that may also impede coordinated care. Increasingly, health care systems are moving toward electronic medical records, creating greater opportunities for an integrated record. Improved communication through the record can keep other providers abreast of the mental health care being provided as well as suggestions they can use to reinforce the mental health care treatment plan.     

应用MDCT检查与诊断大肠癌中的人文关怀

MDCT诊断大肠癌的价值较高。随着医学的发展,医学模式的转变,越来越要求医生在诊断及治疗疾病的同时,从患者心理及社会角度体现人文关怀。完成整个大肠癌的检查及诊断过程需要医生及患者与家属的共同努力,医生在此过程中,不仅要对患者的疾病关注,而且还要体现对患者的心理健康与生命的关怀,社会角色的理解。     

前景理论在重症医学临床决策中的应用

临床决策是每一个医生每天面临的工作,正确的临床决策不仅可以带给患者较好的结果,同时也可以让医生与患者及家属沟通更加良好。本文首先论述了重症医学的临床决策特点,每一个救治方案的收益与损失的权衡不仅仅是取决于患者病情,而且与决策者的风险偏好有明显关系。为了更好地解决这个问题,把诺贝尔奖获奖者丹尼尔的前景理论引入到重症患者的...     

HOW PATIENTS COMMUNICATE ABOUT THEIR ILLNESS

This article presents two empirical investigations of how patients communicate about their illness. A review of the literature on provider-patient communication is offered. From this review, we conclude that we know intuitively more about the interaction between health care providers and their patients than the research literature has revealed. A series of research questions are advanced concerning the patient's communicative contributions to the provider-patient relationship. The first study offers evidence of distinct patient-communication typologies. How patients communicate about their illness is also closely related to how they utilize the health care system. The second study uses independent raters to validate patient self-reports about their communication behavior. The findings suggest that how patients communicate to health care providers is a factor worthy of further study. Several specific avenues for future research are discussed in light of these findings.