医生职业倦怠及社会、组织影响因素的探讨

医生是职业倦怠研究最早关注的职业之一,通过回顾国内外相关研究,分析了医生职业倦怠的现状,并认为我国现阶段医生的职业倦怠与医疗政策、法制层面存在缺憾、经济和心理回报不够、价值观冲突、缺乏控制、角色冲突等有关。呼吁从社会、组织层面深入研究我国医生的职业倦怠。     

医生职业倦怠研究

职业倦怠是指在职业环境中,对长期的情绪紧张源和人际关系紧张源的应激反应而表现出的一系列心理、生理综合症。用经过信效度分析后的职业倦怠问卷(MBI)对253名医生的调查发现,医生的职业倦怠感整体上比较严重;工龄16～20年是医生职业倦怠最严重的阶段;不同科室、职称的医生职业倦怠程度不同,中级职称和精神科医生职业倦怠较严重。     

广州部分三甲医院急诊科医护人员职业倦怠调查

探讨三级甲等医院急诊科医护人员职业倦怠现状及相关影响因素.采用Maslach职业倦怠量表对广州三甲医院急诊科医护人员进行调查.医护人员平均情感耗竭处于中度,平均得分为27.93分;不同性别、工作类别与婚姻状况在去人格化和低个人成就的得分比较无统计学意义(P＞0.05);但不同的性别,工作类别、婚姻状况、年龄大小与职称等级在情感耗竭和职业倦怠上的得分比较差异均有统计学意义(P＜0.05),其中男性、医生、未婚、年纪轻和职称低人员的情绪耗竭和职业倦怠高于其他类别的医护人员.三甲医院急诊科医护人员职业倦怠现象较为普遍,程度处于中度,性别、工作类别、婚姻状况、年龄大小与职称等级影响着医护人员的职业倦怠;男性、医生、未婚、年纪轻和职称低人员的情绪耗竭和职业倦怠较为显著.     

医生职业倦怠与医患关系认知的相关性研究

采用问卷调查和量表评分方法,对265名医生进行职业倦怠程度调查、医患关系紧张度认知量化评分及二者相关性分析,对782名上述医生主管的住院患者行医患关系紧张度认知量化评分并与医生认知进行比较分析。结果显示,医生的职业倦怠程度较高,且对医患关系紧张度的认知明显差于患者认知(P0.01),医生的职业倦怠程度与对医患关系紧张度的认知明显相关(P0.01)。提示医生职业倦怠较重,与其对医患关系紧张度的认知互为影响,据此提出医生职业倦怠应及时发现、早期干预并提高医生对医患关系认知度等相关建议。     

医生执业特点引发的心理变化对医患关系的影响

近年来医患关系紧张成了一个社会热点问题.医生在执业过程中,可能受到一些内在心理因素的影响.通过对医生的执业特点及其引发的心理变化进行分析,包括工作压力、职业倦怠、风险、收入、伦理、信心等,试图寻找引起医患关系紧张的医生内在思想问题.通过这些问题的解决以期达到改善医患关系,增进卫生事业发展的目的.     

“多点执业”政策对医生职业心理和行为的影响研究

探讨"多点执业"政策对医生的职业心理和行为的影响,从"人与环境匹配"的视角解释医生行为和政策落实的关键点。理论推导和案例研究相结合,通过对10个在职医生关于"多点执业"政策和职业倦怠情况的深度访谈,分析医生对政策的态度及其背后的原因。当医生与组织相似性不匹配时,医生易倦怠易离职甚至弃医,当职业环境为组织需要个人时,医生最易自发产生"多点执业"的动机,而当医生与组织相似性匹配时,医生不易离职且更易接受政策。"多点执业"这种"模糊性政策"的落实,主要视政策是否满足其职业发展阶段的需要,多点执业能提高医生的心理和经济回报,甚至寻找到更匹配的组织,是职业环境的再选择,有利于减轻医生职业倦怠。     

南京地区妇产科医务人员职业倦怠的实证研究

妇产科医务人员是职业倦怠的高发人群,具有较多的人际压力源存在,加上长期的精力耗损,导致其工作绩效和医疗服务质量下降.本研究旨在对妇产科医务人员职业倦怠状况进行实证研究,采用比较研究法和问卷调查法进行调研,分析妇产科医务人员职业倦怠的影响因素,采取有效的应对措施,缓解其职业倦怠状况.     

中学教师职业倦怠状况及影响因素的研究

职业倦怠是职业压力的一种,指在职业环境中,对长期的情绪紧张源和人际关系紧张源的应激反应而表现出的一系列心理、生理综合征.教师是职业倦怠感的高发人群.教师身上表现出的职业倦怠感对学生的成长和发展有巨大的消极影响.以中学教师为被试,采用问卷调查的方法考察教师的职业倦怠状况和影响因素.研究发现中学教师的职业倦怠整体上并不严重;教龄6-10年是教师职业倦怠最严重的阶段;职称是影响教师职业倦怠的重要因素;性别、所在学校是否重点以及是否班主任对教师职业倦怠没有显著影响.     

基于医景网(Medscape)数据的美国医生生活方式、倦怠发生趋势及应对研究

为分析美国医生倦怠的总体发生趋势、科室、性别、年龄、原因和后果,探讨了美国医生和医院的应对方式及其问题,并对我国医生倦怠管理提出了建议。采用对现有调研结果二次分析的方法,翻译、总结和提炼医景网(Medscape)2016年～2018年发布的美国医生生活方式大数据调查结果。结果,得到了倦怠发生率持续上升,倦怠科室稳中有变,女性倦怠发生率持续高于男性,倦怠随年龄先升后降等9个分析结果。总结了美国医生职业倦怠仍处于高位,女性医生和家庭医生倦怠形势严峻,收入并非决定因素,医生倦怠的专业干预及生活方式指导亟待开展等9个结论。     

中学教师应对方式、教学效能感与职业倦怠关系研究

目的:探讨中学教师应对方式、教学效能感与职业倦怠的关系.方法:运用应对方式问卷、教学效能感量表和教师职业倦怠问卷(MBI)对河南省724名中学教师进行调查.结果:1.中学教师职业倦怠现象不严重,女教师情感枯竭水平高于男教师,差异极其显著(p<0.01);2.中学教师的应对方式、教学效能感和职业倦怠有显著的相关;3.应对方式、教学效能感与职业倦怠维度存在显著的线性关系(p<0.01).结论:中学教师职业倦怠现象并不严重,成就感较高,女教师情感枯竭水平高于男教师;应对方式和教学效能感对职业倦怠有很好的预测作用.     

Seeing and hearing and space and space and time

A previous experiment had shown spatial location to be judged in terms of the framework provided by the modality in which stimuli were presented. In the present study, digits were either auditorally or visually presented, and in either form the three digits appeared successivly to the left, in the center, and to the right of the S. The digit which occurred temporally in the middle of the sequence was never central from the spatial viewpoint. The S was asked to indicate which digit was the middle one. Ss were blind, deaf, or normal. The deaf and two control groups saw visual displays, and the blind and their controls heard auditory displays. The former groups predominantly chose the spatially middle digit and the latter groups the temporally middle. It was concluded that modality of presentation was the trigger which switched in the coding dimension of time or space.     

Bob and Carol and Tess and Ali

Conflicting religious experiences in different traditions do not necessarily defeat the rationality of conflicting beliefs sustained by those experiences in those traditions. The circularity that protects religious beliefs from such mutual defeat is not vicious. Moreover, the lack of ‘epistemological humility’ exhibited by such believers poses no threat to world peace. In fact, a campaign for compulsory humility would itself constitute a much greater threat.     

Law and Gospel,and Youth and Family Ministry

Abstract : If “faith comes through hearing” the word of God comprised in law and gospel, how do the imperatives that characterize ‘Youth and Family Ministry’ make such hearing possible? Here, literature delineating ‘Youth and Family Ministry’ is analyzed in light of its biblical foundations. The primary lens implemented in this analysis is the law/gospel hermeneutic advocated by Martin Luther and other reformers.     

Extremes of self-esteem and narcissism and the experience and expression of anger and aggression

This study examined the level of self-esteem and narcissism as personality variables involved in the disposition to experience and express anger. Three hundred thirty-eight subjects were sampled across two higher education centres and one student teaching programme in the United Kingdom. It was reasoned that individuals with both high self-esteem and narcissism would report especially high tendencies to experience and express anger and aggression and that those with high self-esteem and low narcissism would report the lowest. These predictions were influenced by theories that emphasise the role of threats to high self-esteem in the production of aggression and violence. Results indicate that groups defined by their extreme scores on self-esteem and narcissism scales produced levels of anger expression in the predicted direction. The importance of considering extreme levels of self-esteem and narcissism (in conjunction with other factors) in an analysis of anger is discussed with reference to currently influential theories in the field. Aggr. Behav. 24:421–438, 1998. © 1998 Wiley-Liss, Inc.     

Dance and psychotherapy--possibilities and limits

From a starting point of therapeutic and prophylactic components identifiable in the dance, the authors regard the dance as deserving of greater attention than was hitherto the case in programs of physiotherapy, psychotherapy, and sociotherapy. From the existing essays at a therapy basing on body and motion, they infer basic common points, and to promote discussion, they state their attitudes in respect of the potential and rank of the dance in the concept of complex multimodal psychotherapy.     

Yin and Yang,and the Hot and the Cold

Yin and Yang are important concepts in ancient Chinese philosophy.Western scholars have become more familiar with these two concepts recently,but for a long time almost no one considered comparing them with their own tradition such as the ancient Greek philosophy,and especially with the ideas of the Hot and the Cold in Presocratic philosophy.In this paper,I make an attempt to do exactly that,and especially make a detailed comparison between the thoughts of two ancient thinkers:Laozi and Anaximander.I discuss the thought of Yin and Yang in Laozi-who was the earliest philosopher making use of the concepts Yin and Yang-to express his cosmological thought in ancient Chinese philosophy.Comparatively,I discuss the ideas of the Hot and the Cold in Anaximander,the earlier among Presocratic philosophers referring to the Hot and the Cold as fundamental concepts used to establish his cosmological system.Through this comparison,I indicate that the similarity between ancient Chinese and Western traditions is far more significant than what people are used to imagining.     

Perversion and infancy and adolescence

Abstract

Studying the works of Freud and Lacan, the authors carried out research on perversion in childhood. Their work covered the perverse polymorphism of infantile sexuality and the perception of the anatomic difference between the sexes that leads the child to create sexual theories and fantasies. The phallic mother and the fetish are viewed as imaginary solutions directly related to the Oedipus and castration complexes. In perversion, a particular position is taken in relation to the Oedipus complex: a serious flaw occurs in the symbolization of the law, and the mechanisms of denial and disavowal take form. Sexuality requires a second “logical time,” separated from infancy by the latency period, in order to confirm (in action) that a fixed position of jouissance (enjoyment) has actually been established. This can only happen in a period after adolescent enhancement. The distinction between perverse traces and a perverse structure is made, taking into account the fact that, in the case of child analysis, the analyst should free the child from the family fantasy and help him/her to build his/her own fantasy.

Campos Santoro V. et al. Perversion und Kindheit und Adoleszenz.

Im Studium der Arbeiten von Freud und Lacan haben die Autoren Forschung über Perversion in der Kindheit gemacht. Die Studien behandeln den perversen Polymorphismus der infantilen Sexualität und die Wahrnehmung des anatomischen Unterschiedes zwischen den Geschlechtern, welche das Kind dazu führt, Sexual-Theorien und Phatasien zu schaffen.

Die phallische Mutter und der Fetisch werden als imaginäre Lösungen angesehen, die sich direkt auf den Ödipus- und Kastrations-Komplex beziehen. Bei der Perversion wird eine besondere Position in Bezug auf den Ödipus angenommen; ein ernsthafter Mangel tritt bei der Symbolisierung des Rechts auf; die Mechanismen der Verneinung und der Verleugnung bilden sich. Sexualität erfordert eine zweite “logische Zeit”, von der Kindheit durch die Latenz Periode getrennt, um (in der Handlung) zu bestätigen, daß eine fixierte Position der jouissance (Vergnügung) sich tatsächlich etabliert hat. Das kann sich nur in einer Periode nach der adoleszenten Verstärkung ereignen.

Es wird die Unterscheidung zwischen perversen Spuren und einer perversen Struktur gemacht, in Rechnung stellend, daß im Fall der Kinder-Analyse der Analytiker das Kind von der Familien-Phantasie befreien sollte und ihm/ihr helfen sollte, seine/ihre Phantasie auszubilden.

Campos Santoro V. Perversión e infancia y adolescencia.

Estudiando los trabajos de Freud y Lacan, los autores han investigado la perversión en la niñez. Los estudios cubren la sexualidad infantil perversa polimorfa y la percepción de la diferencia anatómica entre los sexos, que llevan al niño a crear teorías sexuales y fantasías.

La madre fálica y el fetiche son vistos como soluciones imaginarias relacionadas directamente con el complejo de Edipo y de castración. La perversión, toma una posición particular en relación al Edipo; un fallo importante tiene lugar en la simbolización de la ley; los mecanismos de negación y repudio toman forma. La sexualidad requiere un segundo “tiempo lógico” separado de la infancia por el periodo de latencia, para confirmar (en acto) que una posición fija de jouissance (goce) se ha establecido. Esto solo puede ocurrir en un periodo posterior a la intensificación adolescente.

La distinción entre las huellas perversas y la estructura perversa se ha hecho, teniendo en cuenta que, en el caso del análisis de niños, el analista debe librar al niño de la fantasía familiar y ayudar a el/ella a construir su propia fantasía.     

神圣、凡俗与净明、忠孝

本文结合有关宗教学理论,对宋元净明道所推崇的"净明"、"忠孝"概念进行了解析.作者以为:宋元净明道视世俗性的道德实践为"神圣"的宗教修炼,实与宗教学中的凡俗可以"转换"为神圣之理论相合;而净明道徒的这种"转换",则多与其个体的"宗教体验"有关.至于元代净明道借"无极"概念来释"净明",以"净明"为回复宇宙根源之境界,则合于宗教人经验到与万物的根源、终极的本体或神圣的世界契合之感.换言之,宋元净明道的"净明"、"忠孝"说,实与各种宗教的本质有着相通之处.