The liberty principle and universal health care

A universal entitlement to health care can be grounded in the liberty principle. A detailed examination of Rawls's discussion of health care in Justice as Fairness shows that Rawls himself recognized that illness is a threat to the basic liberties, yet failed to recognize the implications of this fact for health resource allocation. The problem is that one cannot know how to allocate health care dollars until one knows which basic liberties one seeks to protect, and yet one cannot know which basic liberties to protect until one knows how health care dollars will be allocated. The solution is to design the list of basic liberties and the health care system in tandem so as to fit each other, such that every citizen is guaranteed a set of basic liberties and access to the health services needed to secure them.     

青少年心理健康素质的概念和结构初探

青少年心理健康素质是健康心理学中具有开创性和探索性的研究领域,因此涉及若干理论问题需要探讨。其中青少年心理健康素质的基本概念和基本结构是该研究领域首先应探讨的基本理论问题。     

健康公平--概念、影响因素与政策

长期以来健康不平等和不公平一直是卫生改革与发展所关注的重点,并已经成为了国际卫生政策的主要方向.在国家之间健康不平等和不公平也存在不同的理解.发达国家主要集中在产生疾病和导致死亡率差异的社会经济阶层的形成机制,将健康不平等作为疾病病原学的一个函数,关键措施是加强初级卫生保健;在中低收入国家,人们却趋向于通过提供基本的医疗保健服务来解决这一问题.     

The Unmet Educational Agenda in Integrated Care

One of the reasons integrated care has not become a dominant service delivery model is the unmet training agenda. This article argues that the typical mental health professional is not trained to adequately address the challenges of integrated care. To insure competency both a macro and clinical training agenda are needed. At the macro-level, mental health professionals need to understand healthcare economics and basic business principles as any integrated care service delivery system is embedded and driven by economic forces. Integrated care practitioners also need some basic business skills to understand these forces and to create and manage a financially viable system, given the future flux of the system. Traditional mental health professionals also do not have the clinical skills to implement integrated care. Integrated care is not simply placing a traditionally trained mental health professional and letting them practice specialty mental health in a medical setting. Thus, the special skills needed in integrated care are enumerated and discussed. Finally, a new degree program is described as it is time given the huge need and advantages of integrated care to develop specialty training in integrated care.     

Editorial

This study examined the psychometric properties of the Outcome Questionnaire-30.2 (OQ-30.2; designed to measure patient progress throughout mental health treatment) in a sample of United States Air Force active duty basic military trainees who were evaluated for mental health concerns during the course of basic training. Findings indicate that the OQ-30.2 was internally consistent and Total scores decreased with more contact with mental health professionals. Previously reported 1- and 3-factor structures were not replicated; rather, results suggested the use of a broad 27-item general psychological distress subscale and a separate subscale of 3 critical items assessing substance use concerns. Present findings support the utility of the OQ-30.2 as a tool for repeated monitoring of patient progress in military mental health settings. Recommendations for future directions in the development of alternate calculations of the clinical cut score and reliable change index are discussed.     

Alexithymia, emotional disclosure, and health: a program of research

This article reviews a program of research on alexithymia, emotional disclosure, and health. The article first describes two lines of research and then outlines current work attempting to integrate these lines. The first research line involves basic correlational studies on alexithymia's link to health problems; these studies suggest that alexithymia is a potential risk factor for symptoms and illness behavior, although not necessarily organic disease. The second research line involves experimental studies of the health effects of emotional disclosure via expressive writing or talking; these studies suggest that disclosure improves health on average, but that the effects are not that robust and that various moderators likely are involved. The next section of the article describes recent attempts to integrate the two research lines by examining how baseline levels of alexithymia influence the effects of emotional disclosure; these analyses suggest that alexithymia interferes with or attenuates the health benefits of disclosure. Finally, the article describes initial forays into research on interventions with the alexithymic patients. This evolving program of research demonstrates the value of integrating emotion, personality, and health, and highlights the bidirectional relationship between clinical problems and basic research.     

老子道法自然的心理保健观初探

文章结合心理保健,对老子《道德经》的精髓＂道法自然＂进行现代阐释,探索符合当代国人的道法自然的心理保健观。文章主要探索了道法自然心理保健观的原则,方法及研究意义。道法自然的心理保健观的基本原则是＂无为＂、＂不争＂、＂守弱＂,由此延伸出道法自然心理保健观的基本方法＂致虚守静＂,＂抱一＂。道法自然心理保健观的研究意义在于它不仅适合中国人内道外儒的民族性格,还能使个体有效应对当前复杂多变的环境。     

Psychosoziales Gesundheitsmanagement im Betrieb

After presenting basic prevention concepts, preventive and rehabilitative tasks and initiatives in work places will be presented. It is pointed out that especially the promotion of psychosocial resources both at individual and organizational levels is a central issue in prevention. As the next step the basic principles of health management are described and relevant psychosocial topics and procedures are outlined. The different elements of a systematic process of health management and the implementation and evaluation of procedures are shown. It is demonstrated that such developments can only have a chance in an enterprise if they have quality assurance and are supported by all important protagonists of the organization. This is especially true concerning the management, because without their acceptance of such measures it is not possible to implement them.     

监狱民警心理健康状况及影响因素研究

采用症状自评量表 (SCL -90 )及艾森克人格问卷 (EPQ) ,对 2 89名监狱民警作测量。结果显示 ,至少 7 2 7%的监狱警察存在心理健康问题。一线工作的监狱警察与科室工作的监狱警察相比 ,心理健康状况存在显著差异 ,且前者严重。男性监狱警察相对于女性监狱警察心理健康问题更突出。SCL-90与EPQ得分的相关分析表明 ,情绪越不稳定或精神质越明显者 ,倾向于出现更多的心理健康问题 ,性格越内向心理健康问题越突出。     

基于自我决定理论的工作动机研究脉络及未来走向

对2018年5月为止基于自我决定理论的工作动机研究英文文献的系统检索得到了97篇实证研究样本。基于自我决定理论的核心假设, 运用“环境-基本心理需要-工作动机-结果”的理论模型对工作动机前因和结果的研究脉络进行了仔细地分析和归纳, 结果表明员工基本心理需要满足和自主性工作动机作为中介变量可解释自主性支持的工作环境和员工个体特征对工作行为、态度和心理健康的积极影响。将来的主要研究议题：一是对控制性工作环境具体因素对员工基本心理需要阻滞、控制性动机和去动机以及员工工作行为、态度和心理健康影响的研究; 二是不同动机类型对员工业绩、行为和态度影响的过程以及情境因素的研究; 三是外部奖励(包括薪酬、基于业绩的奖励等)对员工工作动机、基本心理需要、工作业绩和心理健康的影响及边界条件的深入研究。     

论健康伦理学及其基本理论架构——“九大理论”视野中的健康伦理

当代医学道德发展的走向理应是健康道德,后医学伦理学时代理应是健康伦理学。建设健康伦理学需要搭成一个基本理论架构。其组成至少应该有“九大理论”,即生命神圣论、生命质量论、生命价值论,医学人本论、医学功利论、医学公正论,医者美德论、医者义务(患者权利)论、医患和谐论。其间,按顺序由每三论构成一个“统一论”,将第一个“统一论”作为立论前提,将第二个“统一论”作为直接依据,将第三个“统一论”作为应用指南,如此,才能由三个“统一论”共同地更好地阐释全部健康伦理学问题。     

组织健康：概念、特征及维度

组织面临空前激烈的挑战和压力,长期以来被忽视的组织健康正在受到国内外学者和企业界人士的关注和重视。作者对国内外已有研究成果进行了梳理,结合时代背景界定了组织健康的概念,总结了组织健康具有环境适应性、自我调节性、学习创新性、持续成长性和组织、员工与社会健康并存性等特征,并列举了现有研究的维度划分类型。目前学界对组织健康的研究尚处于探索阶段,组织健康的内涵、维度及其测量等基础性问题的解决是进一步开展组织健康前因后果研究的前提,在此基础上,才能为促进组织健康提供可靠有效的管理建     

21世纪医疗保障制度改革与发展趋势管窥

21世纪的医疗保障制度改革与发展主要表现为:在理论上,强调医疗保障是人权的基本内容;在保障的对象上强调全民性和公平性;在保障的内容上更加重视预防保健;在医疗保障的运行机制上,强调政府主导与市场机制相结合;在服务模式方面,积极构建多层次网络化的社区卫生服务体系,推行医疗适宜技术;在筹资模式上,更注意建立以政府投入为主导的多元化筹资机制。     

推行职工基本医疗保险制度的现实问题、法律对策与思考

从医疗保险的理论入手,提出了改革是否成功的三条标准,进而推演到 我国城镇基本医疗保险制度的成效和优势。又从实践的角度,概括地列举了推行职工医疗保险制度改革中7个方面的现实问题。并着重论述了社会主义市场经济条件下解决上述问题的对策,其关键在于立法,在于建立健全相应的法律法规体系。从立法的角度阐述了立法规则、 立法监督、立法宣传和咨询,以及保险管理从业人员的专业化问题。对当前正在进行的医疗保险制度的改革有一定的借鉴意义。     

Health of Organisms and Health of Persons: An Embedded Instrumentalist Approach

In a time when we as a society are in the process of deciding what our basic rights to health care are, it is critically important for us to have a full and complete understanding of what constitutes health. We argue for an analysis of health according to which certain states are healthy not in themselves but because they allow an individual to reach actual goals. Recognizing that the goals of an individual considered from the point of view of biology and the goals of the same individual considered as an agent in the world might be different, we introduce a distinction between the health of an individual qua organism and the health of an individual qua person. We then argue that this distinction characterizes the evaluations made by patients and healthcare providers better than the widely discussed distinction between disease and illness.     

Smoking research: basic research, intervention, prevention, and new trends

Smoking is a behavior that is influenced by a variety of factors that cut across methodologies, disciplines, and content areas within health psychology. The present article is designed to show the diversity and richness of smoking research by examining smoking from four perspective: basic laboratory research, intervention, prevention and deterrence, and new directions in smoking research. Methodologies that were derived from such varied sources as psychopharmacology, behavioral pharmacology, behavior therapy, clinical psychology, public health and health promotion, and social and developmental psychology have been used to study the smoking problem. The subject populations in these investigations ranged from animal models, to the individual smoker attempting to quit, to communities involved in health promotion and public health approaches. Future research should seek to provide new and improved examples of interdisciplinary research within the field of health psychology to multidisciplinary approaches from the basic and applied sciences.     

基本需要在导师排斥感知与研究生心理健康的关系中的作用

为探讨导师排斥感知对研究生心理健康的影响及作用机制,本研究采用导师排斥感知问卷、基本需要问卷、生活满意度量表、简版流调中心抑郁量表及攻击问卷,对北京市六所本科院校的864名在校硕士和博士研究生进行问卷调查。结果发现：（1）导师排斥感知正向预测研究生的抑郁和攻击性,负向预测其生活满意度;（2）基本需要在导师排斥感知与研究生的生活满意度、抑郁之间起着完全中介作用,在导师排斥感知与攻击性之间起部分中介作用。结果表明,研究生导师排斥感知越强,基本需要的满足水平越低,进而导致研究生的抑郁水平越高、攻击性越强、生活满意度越低。即研究生感知的导师排斥感越强,其心理健康水平越低。     

农村卫生改革面临的深层次的矛盾和问题

对健康缺失阻碍农村经济发展没有清楚的认识,是制约农村卫生发展的重要因素.农村卫生纯属公共品范畴,理所当然是政府实现公共服务目标的基本职责.我国财政整体分配格局不合理,是农村卫生投入不足的基本原因.农村卫生保健制度一个非常突出的问题,是基本模式的选择,忽视关键制度的设计与调整.卫生院是医疗服务的提供者,是合作医疗保障制度的利益主体,同时又是合作医疗的组织者与管理者,不符合医疗保障制度的要求,同时也难以形成纠错的机制.     

The cultural moral right to a basic minimum of accessible health care

(1) The conception of a cultural moral right is useful in capturing the social-moral realities that underlie debate about universal health care. In asserting such rights, individuals make claims above and beyond their legal rights, but those claims are based on the society's existing commitments and moral culture. In the United States such a right to accessible basic health care is generated by various empirical social facts, primarily the conjunction of the legal requirement of access to emergency care with widely held principles about unfair free riding and just sharing of costs between well and ill. The right can get expressed in social policy through either single-payer or mandated insurance. (2) The same elements that generate this right provide modest assistance in determining its content, the structure and scope of a basic minimum of care. They justify limits on patient cost sharing, require comparative effectiveness, and make cost considerations relevant. They shed light on the status of expensive, marginally life extending, last-chance therapies, as well as life support for PVS patients. They are of less assistance in settling contentious debates about screening for breast and prostate cancer and treatments for infertility and erectile dysfunction, but even there they establish a useful framework for discussion. Scarcity of resources need not be a leading conceptual consideration in discerning a basic minimum. More important are the societal elements that generate the cultural moral right to a basic minimum.