姑息止痛治疗在悉尼

对中国北京与澳大利亚悉尼市姑息止痛治疗进行比较,发现并借鉴悉尼市的先进经验,改进国内姑息止痛治疗,减轻患者痛苦.用半年时间考察悉尼市各级医院的姑息治疗情况,重点是止痛治疗.内容包括姑息医学的医疗服务体系、姑息团队、药物止痛治疗、社区服务、家庭访问等,与北京的姑息止痛治疗现状进行比较,发现主要特点.悉尼市已形成健全的姑息医学服务系统,有专业的姑息止痛治疗团队长期从事止痛治疗.改善生活质量贯穿患者止痛治疗的始终,已形成个体化的止痛治疗模式.对生活质量的关注应贯穿姑息治疗的始终,止痛治疗需要个体化.     

姑息医学在大肠癌治疗中的地位和应用策略

大肠癌的治疗应采用一种无缝的连接方式将姑息治疗与抗肿瘤治疗整合在一起。姑息医学的采用应贯穿肿瘤治疗的始终,以期更好地提高生命质量,尊重生命价值,体现医学本质和人文关怀。     

姑息医学在大肠癌治疗中的地位和应用策略

大肠癌的治疗应采用一种无缝的连接方式将姑息治疗与抗肿瘤治疗整合在一起.姑息医学的采用应贯穿肿瘤治疗的始终,以期更好地提高生命质量,尊重生命价值,体现医学本质和人文关怀.     

姑息治疗及其在肿瘤学中的地位

本文对姑息治疗的历史及概念作了详细的介绍,解释了其不同阶段的内涵,作为医学学科之一,姑息治疗的内容主要包括了疾病伴随或治疗所致症状的诊断评估、预防和治疗,心理和非癌性躯体疾病的预防和治疗,姑息治疗的科研、教学和教育以及终末期病人的治疗和护理等,特别纠正了对“安乐死”的看法。在肿瘤学中,经过40多年,它已从治疗中的辅助角色迅速成为肿瘤综合治疗中的主角,且贯穿于始终。它倡导多学科协作,与抗癌治疗完整结合,对无法治愈的晚期癌症患者以缓解症状、改善生活质量为主要目标,在全球范围内,很大一部分晚期肿瘤病人已从姑息治疗中明显获益。它的有力实施,也是我们创建和谐社会的重要反映。     

现代姑息医学内涵在实践中的演化

积极开展姑息医学服务已成肿瘤临床工作者的共同实践,并使其在实践中得到发展。姑息医学在肿瘤整体治疗中的作用和地位已逐渐受到同行的认同,提高了肿瘤工作者对姑息医学实践的参与热情,使业内有识之士从全新的角度对姑息医学的内涵进行审视。本文拟结合姑息医学的发展历程及不同分期肿瘤患者姑息治疗的内容介绍现代姑息医学内涵的演化过程。     

现代姑息医学内涵在实践中的演化

积极开展姑息医学服务已成肿瘤临床工作者的共同实践,并使其在实践中得到发展.姑息医学在肿瘤整体治疗中的作用和地位已逐渐受到同行的认同.提高了肿瘤工作者对姑息医学实践的参与热情.使业内有识之士从全新的角度对姑息医学的内涵进行审视.本文拟结合姑息医学的发展历程及不同分期肿瘤患者姑息治疗的内容介绍现代姑息医学内涵的演化过程.     

肿瘤姑息治疗的全程介入

恶性肿瘤严重威胁人类健康,肿瘤本身以及针对肿瘤的治疗不仅会对患者的生理和心理产生重要影响,同时也会对照顾患者的家人产生各种心理影响。现有医疗条件下短时间内难以提高治愈率,就应更加注重将姑息治疗贯穿于肿瘤治疗的始终,不仅要及早介入,甚至延伸至居丧期。在肿瘤治疗过程中不断对肿瘤患者进行评估和适时调整姑息治疗策略,可有效地提高患者生活质量同时降低医疗成本,最终患者能够在不同阶段和各种治疗手段中获得最大受益。     

脊柱转移瘤个体化综合治疗中的临床决策

脊柱转移是恶性肿瘤最重要的并发症,其个体化综合治疗应遵循循证医学原则,根据患者机体状况、肿瘤病理类型、临床分期和发展趋势等,优化多学科综合治疗手段,努力做到临床决策的科学性,以期最大幅度地提高患者临床疗效及改善患者生活质量。     

中国本土舒缓医学的发展现状和前景

舒缓医学,既往称为姑息治疗,是一种针对终末期患者的缓解性和支持性医疗照护。随着老年人口的激增,各种原因所致接近生命终点的患者数量的快速增长,中国本土的舒缓医学也进入快速发展阶段。与国际水平相比,中国死亡质量非常低,死亡质量指数排名仅位列80个国家中的第71位,舒缓医学水平亟待发展。由于没有相关国家政策的出台,舒缓医学在发展过程中在诸多方面遇到需要解决的问题,如服务团队、培训体制及学科建设、社会认知等。资金支持和完善政策是我国本土舒缓医学事业长足发展的关键。     

论患者个体差异

患者的个体差异现象是医学的显著特征之一。准确揭示个体差异,针对个体的特点进行诊断、治疗和预防,是提高医疗质量的保证。本文论述了个体差异普遍存在的根据;探讨了揭示个体差异的方法;阐发了诊断、治疗、预防个体化观点及其实践意义;说明了患者个体差异与疾病共同特征的辩证关系并强调了注重个体差异在临床实践中的重要性。     

Make New Friends but Keep the Old: The Sisterhood Bonds that Have Shaped Me

The relationships in an Asian American psychologist's life have helped to shape her as a person as well as a professional. Specifically, a review of significant female relationships indicates that they have contributed to the author's therapeutic style. In this article, the author explores some of the relationships with other women in her life and illustrates how they have informed her role as a therapist. She concludes with a case vignette illustrating how some of these concepts were applied to a long-term therapy client.     

归因疗法——一种重要的心理治疗方法

归因疗法是心理治疗的重要方法之一。迄今为止 ,人们已经发展了运用归因理论于治疗实践的两种一般模式 :“真归因疗法”引导患者用准确的归因代替错误的归因 ,“误归因疗法”引导患者用不准确而有益的归因代替准确而有害的归因。归因疗法受到了其他心理治疗理论的怀疑和批评。     

An Integration of Feminism into Experiential Psychotherapy

Abstract

Feminist therapy altered how marriage and family therapists conceptualized their clients’ realities and psychopathology. Upon an extensive search of the literature, there is a sparse amount of literature regarding the integration of feminist therapy with experiential therapy. The authors discuss feminist and experiential therapy models, propose a model of feminist-experiential therapy, and highlight the need and fit of these theories. A discussion on giving space to silenced voices, establishing an egalitarian relationship, expanding the definition of deviance, and exploring the importance of language will be done to aid the experiential therapist in their work and expand their client’s experience.     

The Process of Systemic Change in Filial Therapy: A Phenomenological Study of Parent Experience

This phenomenological study represents the first qualitative exploration of parents’ experiences of the process of filial therapy from a systemic lens. Filial therapy is a treatment approach that teaches parents how to conduct weekly thirty minute play times with their target child at home in an effort to improve the parent–child relationship. Previous research has focused almost exclusively on the impact of this model on this relationship; however, the results from this focus group study (n = 8) indicate several relational shifts that occur within the greater family and societal contexts and suggest potential reasons for treatment gain maintenance over time.     

Three Contributions of Personal History

SUMMARY

Who we are becomes manifest as we conduct therapy. Much of the flavor and strength of our therapeutic style, as well as our errors, can be traced to our personal history. This history provides us a storehouse of memories which enrich our sessions. It also helps determine our chosen therapeutic stances. One of the dilemmas for all therapists is the extent to which we will use transparency and self revelation as an ingredient in our work. The final section of this paper explores the pros and cons of sharing our life stories with our clients.     

What Are the Main Differences Between Behavioral and Systems Therapy with Couples? A Critical Account

This paper describes the main differences between behavioral and systems therapy with couples. To improve clinical decision making for a given case, the theoretical assumptions of the chosen treatment approach need to be clearly understood. Contrasting the two approaches will assist couple therapists in providing clinical services that better reflect the chosen theoretical framework. This paper reviews the common elements that can be found across models. A case example is presented to demonstrate the use of the therapy's theories and techniques.     

David and Judith

SUMMARY

This paper begins with a discussion of Dialogicai Psychotherapy-that “healing through meeting” which comes when the relation between therapist and patient is central-and explores inclusion, making present, confirmation, and the “normative limitation of mutuality.” Secondly, it discusses a Dialogicai Psychotherapy particularly important for couples therapy-Ivan Bos-zormenyi-Nagy's Contextual (intergenerational family) Therapy with its emphases on multidirected partiality, trustbuilding, rejunction, and the intergeneration merit ledger. The third part of the paper applies Dialogicai and Contextual therapy to the case of David and Judith, a couple who show clearly the importance of families of origin.     

Continued Evolution of Family Therapy: The Last Twenty Years

There have been numerous accounts of the history and major trends and issues in family therapy during the field's first three decades in the literature (see for example: Broderick & Shrader, 1981; Framo, 1972; Guerin, 1976; Kaslow, 1973, 1977, 1980; Nichols, 1986, 1999 for some varied depictions, written from each respective author's unique lens). Viewed as a set, packaged with different, yet interrelated contents, they offer a multihued portrait of the emerging field during its infancy, childhood, and adolescence. Now it is time to move on and look at the adulthood era as it has unfolded.     

Differences in Dropout Rates Among Individual, Couple, and Family Therapy Clients

The premature dropout of clients from therapy is an inefficient expenditure of mental health resources. This study examined differences in dropout rates among individual, couple, and family therapy clients. Data came from archived records at a marriage and family therapy clinic at a university in the United States. Results indicated that there were no significant differences in dropout rates, despite the use of multiple measures of dropout. Thus, from a mental health services perspective, administrators and clinicians can expect that dropout rates will remain fairly consistent across treatment modalities.     

A Cognitive-Behavioral Approach to Family Therapy

Although cognitive behavioral spectrum approaches with individual children are plentiful and demonstrate effectiveness, cognitive behaviorally oriented clinicians are frequently left to their own devices when it comes to treating families. Cognitive behavioral family therapy is a relatively recent development and there are precious few reports of its clinical use. This article presents a conceptual foundation and clinical rubrics for the practice of cognitive behavioral family therapy. Basic theoretical background information is presented and places the therapeutic processes and procedures in a proper context. Session structure in cognitive behavioral therapy is illustrated and the way it propels therapeutic momentum and adds focus to each session is explained. Rudimentary processes of self-monitoring, self-instruction, rational analysis, and behavioral enactment are described and augmented with case material. Finally, the conclusion offers directions for further theory building, research, and clinical practice.