医护人员对癌症告知态度的调查研究

为了了解医护人员对癌症告知的态度,对634名医护人员进行问卷调查.结果显示,医护人员不十分赞同将真情完全告知患者,其告知意愿在一定程度上取决于患者的知情愿望,他们比较认同家属拥有决策权,且普遍认为患者不是充分知晓病情.因此,医护人员应该增强告知认识,尊重患者告知意愿,引导家属告知观念,努力提高患者知情程度.     

50例晚期肿瘤患者对病情告知需求分析

研究在晚期肿瘤患者及其家属中影响病情告知的相关因素,及病情告知对晚期肿瘤患者的影响和患者及其家属的需求,探讨病情告知在宁养服务中的作用。对50例晚期肿瘤患者及50例晚期肿瘤患者家属分别进行问卷调查,内容包括被问卷者的一般资料、情绪状态及需求。得知病情的患者多数对于生命是积极的、乐观的,少数处于消极状态中,而多数不知道病情的患者因对自身情况的猜疑导致情绪障碍,患者的需求因自身情况的差异而不同,年龄、教育程度及宗教等因素对患者病情告知的需求有不同程度的影响。病情告知在宁养服务中起重要作用,有利于患者生活质量的提高,但仍要根据个体特点并掌握一定技巧。     

癌症患者家属选择是否告知患者真实病情的质性研究

在东方或发展中国家,家庭成员得了癌症后,家属通常反对告知患者真实病情。本研究运用质性研究方法对15例癌症患者家属进行深入访谈,探讨癌症患者家属选择是否告知患者真实病情的原因,以其为临床医护人员正确处理癌症病情告知问题提供指导。     

老年晚期肿瘤患者及家属照顾者死亡态度和病情告知的需求分析

研究老年晚期肿瘤患者及其家属照顾者的死亡态度和病情告知的相关因素,及病情告知对晚期肿瘤患者及其家属照顾者的影响,探讨病情告知在临终关怀中的作用。对60例老年晚期肿瘤患者及60例家属照顾者进行问卷调查,内容包括被调查者背景资料、死亡态度、个人情绪状态及个人需求。多数得知真实病情的老年肿瘤患者的生命态度是积极的,且会因为对个人病情猜疑而引发情绪障碍。患者的死亡态度及真实病情告知在临终关怀中起重要作用,但医护人员及医务社工仍要根据老年晚期肿瘤患者的个体特点行事并掌握相关技巧。     

晚期癌症患者家属的病情告知态度探究

本文采用自行设计的调查问卷,对200例晚期癌症患者家属进行问卷调查,以探讨晚期癌症患者家属对病情告知的态度。结果显示,认为病情应绝对保密者55例（27．5％）;暂时保密者107例（53．5%）;而不保密者38例（19．0％）。晚期癌症患者家属普遍采取“慈悲原则”,对患者病情持保密态度;癌症患者家属普遍缺乏病情告知策略。临床医生在执行知情同意时应该依据患者不同的家庭情况,有针对性地进行告知。     

皮肤科知情告知中的人文哲学思考

在皮肤科的临床工作中应该树立辩证唯物主义的思想方法,重视用普遍联系的观点看待皮肤疾病,分清主要矛盾和次要矛盾.应对患者进行全面、真实,合理的病情知情告知,并在知情告知中充分体现人文关怀的精神.     

医护人员对癌症告知态度的调查研究

为了了解医护人员对癌症告知的态度,对634名医护人员进行问卷调查。结果显示,医护人员不十分赞同将真情完全告知患者,其告知意愿在一定程度上取决于患者的知情愿望,他们比较认同家属拥有决策权,且普遍认为患者不是充分知晓病情。因此,医护人员应该增强告知认识,尊重患者告知意愿,引导家属告知观念,努力提高患者知情程度。     

癌症病情告知技能培训课程对医学院校医患沟通课程的启示

医学院校医患沟通课程的内容设置应符合临床实践对医学人才知识及技能的要求.通过对临床医生进行癌症病情告知技能培训课程的探索,为医学院校医患沟通课程开设癌症病情告知技能相关内容提供参考和依据.     

癌症病情告知的家庭主义模式

癌症病情告知涉及到的是一个不同于癌症患者知情同意权的问题。中国癌症病情的告知具有不同于西方的特点,形成了一种不同于西方的家庭主义模式。家庭主义模式的确立,可以从患者的脆弱性和文化传统的影响两个方面进行辩护。在新的时代背景下,癌症病情告知的家庭主义模式面临个体权利意识觉醒和家庭社会结构变迁带来的挑战。有必要确立一种程序性的家庭主义模式,在尊重癌症患者知情权的基础上,按照家庭主义模式设计患者行使知情权的具体程序,在保障患者知情权和发挥家庭照护作用之间求得平衡。     

恶性肿瘤患者治疗的知情权

肿瘤微创治疗在本世纪得到飞速发展,有着不可替代的优势.调查结果却显示目前患者及家属对这种治疗方法不太了解.笔者认为医务人员有义务告知恶性肿瘤患者其病情和先进的治疗方法,这有利于患者树立战胜疾病的信心,配合治疗,合理安排自己的生活.     

Illness in the doctor: implications for the psychoanalytic process

The meaning and impact of serious illness in the therapist is described as it affects the doctor's intrapsychic analytic space, the analyzing field, and the fantasy life of patients. The brief literature on this topic is reviewed with particular reference to what patients should be told about one's illness. The author's experience of serious illness is described as it related to his reaction to his work with patients. Patient material is presented that demonstrates the utility of an abstinent stance even when encountering real and disturbing events. Freud's experience with long-term disability is recalled and the special circumstances posed by major illness for the analytic relationship are discussed. The unparalleled experience provided the patient by one's delicate neutrality at such times reveals to him the true depth of unconscious fantasy and its lasting influence on adult functioning.     

Wittgenstein and the Real Numbers

When it comes to Wittgenstein's philosophy of mathematics, even sympathetic admirers are cowed into submission by the many criticisms of influential authors in that field. They say something to the effect that Wittgenstein does not know enough about or have enough respect for mathematics, to take him as a serious philosopher of mathematics. They claim to catch Wittgenstein pooh-poohing the modern set-theoretic extensional conception of a real number. This article, however, will show that Wittgenstein's criticism is well grounded. A real number, as an ‘extension’, is a homeless fiction; ‘homeless’ in that it neither is supported by anything nor supports anything. The picture of a real number as an ‘extension’ is not supported by actual practice in calculus; calculus has nothing to do with ‘extensions’. The extensional, set-theoretic conception of a real number does not give a foundation for real analysis, either. The so-called complete theory of real numbers, which is essentially an extensional approach, does not define (in any sense of the word) the set of real numbers so as to justify their completeness, despite the common belief to the contrary. The only correct foundation of real analysis consists in its being ‘existential axiomatics’. And in real analysis, as existential axiomatics, a point on the real line need not be an ‘extension’.     

Mirror image arm used in monocular, binocular, and blindfolded pointing

Observers were instructed to point with their right arm to a mirror image of their left shoulder. Instead of pointing to the target with their real arm, they occluded the target with their mirror-imaged finger, and their real finger pointed off to the left side of the target, facts that came as a surprise to them in debriefing. The occlusion by a mirror image finger was not done to avoid double images, since it occurred in monocular conditions. That it is due to planning before pointing can be inferred from the fact that it occurred in blindfolded conditions.     

膀胱过度活动症诊治的思考

随着老年人口的增多,膀胱过度活动症的发病率也会逐年升高,但其确切病因不清楚,临床症状不典型,很多患者对这种疾病认识不够,严重影响着患者的生活质量,给患者带来了极大的生理和心理上的困扰。因此,临床工作中应注意发现膀胱过度活动症相关的临床症状,结合完整全面的病史,进行体格检查和相关的辅助检查,及早诊断并给予合理的治疗,提高患者的生活质量。     

Against faith schools: a philosophical argument for children’s rights

In spite of the fact that the Universal Declaration of Human Rights grants parents the right to an education in conformity with their own religious convictions, this paper argues that parents should have no such rights. It also tries to demonstrate that religious and cultural minorities have no rights to establish faith schools and that it is a child’s right in trust, to autonomous well‐being, which trumps any such claims. Faith schools, it is argued, represent a real and serious threat to children’s autonomy, especially their emotional autonomy. As such, they are incompatible with the aims of education required by a liberal democracy.     

Understanding of the current police caution (England and Wales)

The Criminal Justice and Public Order Act 1994 (England and Wales) modified suspects' right to silence during police questioning and required a new police caution. The current 37-word caution was introduced after it was found that a proposed 60-word draft version was too complex. The results of the present study show that, although more succinct, the current caution is no easier to explain. Even under optimal conditions, when the participants could focus on each sentence in turn, only 1 in 10 of the general population (n=15), 6 in 10 of A-level students preparing for university (n=72) and 9 in 10 police officers (n=21) demonstrated their understanding by explaining all three sentences correctly. For all groups, the difficulties were more marked when the caution was presented in its entirety, as would happen in real life. The complexity of the caution has serious implications for suspects in police detention. © 1998 John Wiley & Sons, Ltd.     

The meaning of observed violence: Real vs. fictional violence and consequent effects on aggression and emotional arousal

Sixty male subjects were either attacked or treated neutrally by a confederate, after which each saw a videotape of two men fighting. Subjects were informed that fight was either real or fictitious or were given no explanation of it. Subjects who had previously been attacked and had observed the fight under a set to perceive it as real were subsequently more punitive in their treatment of the confederate than subjects in all other conditions. The combination of prior attack and observation of real violence also sustained blood pressure (BP) at near the level produced by the attack, whereas BP of attacked subjects in the other conditions declined during the time the fight was observed. Palmar sweat measures revealed that observation of real violence was more arousing than observation of fictitious fighting. The results are discussed in terms of the effects that the reality of observed violence has on emotional arousal.     

Children's conceptions of the relationship between pictures and their referents

In five investigations we examined 3- and 4-year-olds' conceptions of the relationship between pictures and their referents. In the first two studies, we confirmed that some children judge wrongly that a picture has a feature of the real object it represents, although that feature was added to the real referent after the picture was drawn. Children also judged that a picture that was changed would reacquire its original features, thereby keeping in match with its real referent. In the third, fourth, and fifth studies we included a more difficult no change condition in which the picture slightly mismatched the real referent from the outset. Even children who answered correctly under the previous change conditions wrongly attributed to the picture a visual feature which was present only on the real referent. Such confusions did not occur when children agreed the mismatching picture was not of the real object. We conclude that preschool children have difficulty holding in mind the distinct properties of picture and real referent, just as they tend to confuse the literal and intended meanings of utterances.     

Approximation,Idealization, and Laws of Nature

Traditional theories construe approximate truth or truthlikeness as a measure of closeness to facts, singular facts, and idealization as an act of either assuming zero of otherwise very small differences from facts or imagining ideal conditions under which scientific laws are either approximately true or will be so when the conditions are relaxed. I first explain the serious but not insurmountable difficulties for the theories of approximation, and then argue that more serious and perhaps insurmountable difficulties for the theory of idealization force us to sever its close tie to approximation. This leads to an appreciation of lawlikeness as a measure of closeness to laws, which I argue is the real measure of idealization whose main purpose is to carve nature at its joints. This revised version was published online in June 2006 with corrections to the Cover Date.     

Confucius in the middle of the new cultural revolution today

There is some ground for saying that the real Confucius cannot be the object of recent critiques in the PRC. Both the critiques and critics are of questionable authenticity and they seem to be ‘pulling their punches’. What is clear is that these ideological pursuits mask some very serious political events over the recent past in the PRC.