健康素养促进型组织的概念内涵、测量工具及其影响因素

通过对健康素养促进型组织的概念内涵、测评工具以及影响因素进行综述,以期引起国内学者和实践者的关注,为我国健康素养促进型组织研究提供参考。综述结果表明,健康素养促进型组织概念内涵发展逐渐趋同;测量工具多以10项特征为基础结合各机构实际状况进行构建,分为医疗机构、服务人群以及综合视角三大类;影响因素方面主要涉及组织文化、人力资源、患者参与和组织支持等。建议将构建健康素养促进型组织作为落实健康中国战略的重要措施,积极开展适应中国情境的健康素养促进型组织理论研究,加快推进我国医疗机构的健康素养促进型组织建设。

     

英国的健康促进与个人自由

从英国的3种自由观——消极自由、积极自由和赋权自由出发,论述了健康促进和个人自由的关系。通过比较不同自由观的特征以及其对健康促进的影响,得出结论:当今英国政府主张的赋权自由,尊重和维护了公众的个人选择,提高了公众在健康教育过程中的参与性,有助于健康促进的开展。     

青少年健康促进行为的调查研究

本研究采用青少年健康促进量表(Adolescent Health Promotion scale,AHP)以长沙市450名中学生为对象,对青少年的健康促进行为水平及其在不同性别、年龄和学校类型上的差异进行了调查和分析。研究结果表明,青少年在人际支持行为上得分最高,而在运动行为上得分最低;经分析,运动行为及人际支持行为上存在明显的性别差异;AHP的六个因子在不同年龄段和学校类型上均呈现显著差异。     

健康促进志愿者的运行机制研究

新的社区卫生规划中,社区卫生服务内容越发广泛,伴随着新医改的深入,社区卫生服务人力资源缺乏,服务盲点多而分散,医患衔接不畅等问题日益突出.以重庆市江北区的健康促进志愿者为例,分析志愿服务对于社区卫生的影响,并对建立健全志愿服务的机制做一定的分析.     

民办非营利性医疗机构监管:中美的比较与启示

近年来,我国民办非营利医疗机构监管体系的发展明显滞后于机构自身的发展,如何完善新时期民办非营利医疗机构的监管体系迫在眉睫。本文运用文献分析法和实地调研法,对比分析了中美民办非营利医疗机构在监管主体、监管内容、法律法规等方面的差异,归纳了美国民办非营利医疗机构监管体系的可借鉴之处,提出构建多元化、多层次监管体系的政策建议,以期为我国民办非营利医疗机构的健康发展提供理论支撑和决策参考。     

国际健康城市计划的理论与实践

健康城市计划由世界卫生组织欧洲区在1987年发起, 其理论基础是人人享有卫生保健和《渥太华健康促进宪章》, 以健康承诺、制定公共卫生政策、开展多部门合作、加强社区参与、注重创新和健康的公共政策为特征。健康城市计划的开展分为启动阶段、组织计划阶段和行动阶段, 指标体系包括健康指标、健康服务指标、环境指标和社会经济指标等四个方面。目前, 世界卫生组织六个区域均已开展健康城市计划, 我国北京、上海、苏州、杭州、长春等地的健康城市计划开展良好。     

从健康价值体现对健康管理概念与目标的思考

在经济社会中人的健康价值体现于健康的有效付出.在健康价值体现过程中,心理健康在一定程度内能弥补身体健康问题导致的能力减弱.却不能被身体健康所代替.狭义健康管理对健康价值的体现尚有局限性,宏现健康管理则更具实际意义.调整个体健康与社会之间的关系,使个体健康价值最大化,是健康管理的目标.     

促进型和抑制型建言的差异

本文系统地回顾了促进型和抑制型建言在前因与后果上的差异。这些差异的理论基础包括计划行为理论、调节焦点理论、目标导向理论、社会期望理论、资源保存理论、归因理论、自我损耗理论、认知评价理论以及情感事件理论。与理论相对应, 两类建言前因的差异体现在建言者特质(如人格、动机)、领导风格与行为、领导成员交换和组织层面的因素(如组织政治、组织公平)等方面; 后果的差异体现在建言者工作态度与行为(如绩效、工作满意度)、领导建言采纳和团队绩效等方面。未来可能的研究方向包括:探讨两类建言在团队中的共存、两类建言的文化差异等。     

健康的边际价值变化特征与长期健康投资不足

有效预防控制慢性病是我国公共卫生面临的重大挑战.健康是具有特殊特征的资产,并且其边际价值变化是不连续的,存在拐点,超过拐点的健康状态的价值没有得到充分体现,是影响人们采取预防措施的重要原因之一.给予超过拐点的健康以适当的补偿是有效应对慢性病的方式之一.     

健康的边际价值变化特征与长期健康投资不足

有效预防控制慢性病是我国公共卫生面临的重大挑战。健康是具有特殊特征的资产,并且其边际价值变化是不连续的,存在拐点,超过拐点的健康状态的价值没有得到充分体现,是影响人们采取预防措施的重要原因之一。给予超过拐点的健康以适当的补偿是有效应对慢性病的方式之一。     

论医疗卫生保健服务体系的合理结构——兼评医疗联合体

公共卫生、医院和初级卫生保健的三重结构,是当代医疗卫生服务系统结构的合理选择。三重服务体系相互配合,各司其职,为广大公众提供疫情管控、患病人群的诊治、居民健康管理与健康促进全方位的服务;初级卫生保健和其他各方面一起,担负着从源头上控制慢性病的发生与发展,实现健康国家、健康城市、健康社区的重任,处于基础和核心地位,也是从根本上解决看病难和看病贵的关键。医联体必须从健康中国和医疗卫生服务体系基本部署的大局出发做根本性的调整,强化初级卫生保健的基础和核心地位,不仅重视提升初级卫生保健的医疗功能,更要重视健康促进和健康管理的功能,将医联体建设成为防治并重、预防优先的医疗卫生保健联合体。     

Ageism in Mental Health and Health Care: A Critical Review

Discussions of aging and mental health widely assume that ageism among mental health providers is an important factor limiting access to mental health services for older adults. Given the widespread citation of ageism as a problem, we critically review the history of the ageism construct, and evidence for its existence in both mental health and medical professionals. There is surprisingly little empirical evidence for age bias among mental health providers. Considerable evidence does suggest differential medical treatment for older adults in such diverse areas as physician–patient interaction, use of screening procedures, and treatment of varied medical problems, although it is unclear whether age bias accounts for these differences. We suggest that innovations in delivery of psychological services, such as collaborative medical/psychological care in primary care settings, may ultimately prove more useful in improving access to mental health services than efforts to combat ageism.     

美国医疗系统的中流砥柱:非营利性私立医院

系统介绍了美国医疗系统的主流——非营利性私立医院的起源、性质、运行情况以及在医疗服务中的地位 ,并将之与营利性医院进行对比 ,以揭示限制医疗市场化的重要意义。     

人文关怀视野中的医院发展

医院人文关怀表现为作为医疗主体的医生必须具备广博的人文素养;医院应当遵循"救死扶伤,实行革命人道主义"的医疗原则;实行人文关怀的目的在于"以患者为上帝".由于受现代性的后果--抽象性和市场经济的影响,医院人文关怀缺失和被疏漏.人文关怀视野中的医院发展要求,医院硬件建设要以"以人为本"为指导思想;内涵发展要以医疗技术与人文关怀有机统一为关键;制度建设要以"以患者为中心"为宗旨.     

Adolescent Health Care Training in Predoctoral Psychology Internship Programs: A Model of Interdisciplinary Training Needs in Health Care

This needs assessment of predoctoral psychology programs in a large southeastern state reveals that although many programs include adolescent health issues and often involve the psychiatry discipline in their curricula, many trainees do not have exposure to medicine, nutrition, or nursing disciplines. Opportunities for greater interdisciplinary adolescent health care training exist in psychology training programs in this southeastern state. Integrating such training into psychology programs may enhance psychology's ability to function as a vital component of adolescent health care teams within academic medical centers across the country.     

Integrating Mental Health and Primary Care Services in the Department of Veterans Affairs Health Care System

Integrating mental health care in the primary care setting has been identified in the literature as a model for increasing access to mental health services and has been associated with enhanced clinical and functional patient outcomes and higher patient satisfaction. The Department of Veterans Affairs (VA), which operates the nation’s largest integrated health care system, has taken a leadership role in creating a health care system in which mental health care is provided in the primary care setting. This article examines VA’s efforts and progress to date in implementing evidence-based models of integrated mental health services nationally in community based outpatient clinics, home based primary care, and outpatient primary clinics at medical facilities. Psychology plays an important role in this progress, as part of an overall interdisciplinary effort, in which all professions are crucially important and work together to promote the overall well-being of patients. This article is based in part on a presentation by the first author at the 3rd National Conference of the Association of Psychologists in Academic Health Centers (APAHC) in May of 2007 in Minneapolis, Minnesota.     

医院和医疗保险的经济学分析

随着医疗卫生体制改革的深入,应对老龄化危机,降低不断提高的医疗服务费用,提高医疗服务质量,提高医疗服务可及性和公平性,是我们面对的切实问题。医院是提供医疗卫生服务的场所,也是提供医疗卫生服务的主体单位,了解医院的经济学特性和组织特点,有利于我们对市场经济环境下的医院行为有所了解,为卫生体制改革和医疗保险改革提供理论依据。     

精准医疗的理念及其技术体系

精准医疗模式本着患者的最大获益和社会医疗投入的高效配置为宗旨,结合现代流行病学和预防医学、临床诊断学和治疗学、分子医学、医学信息学技术以及卫生经济学和医学社会学,使传统的医疗模式走向整合化,为每一个人提供量体裁衣般的疾病预防、筛查、诊断、治疗和康复计划,以最小资源投入获取最大健康保障,从而提高整体人群的健康水平。     

Vertical integration in medical settings: A brief introduction to its potential effects on professional psychology

Vertical integration in medical settings typically involves the merging of independent physicians, physician groups, and hospitals to render an organized health care network. Such systems are considered to be vertical, as they may allow for a seamless continuation of services throughout the range of needs a patient may require. Mergers often result in the redefining of professional services offered in the acquired facility or across the network. As such, mergers have the potential of adversely impacting psychological practices. Professional psychology needs to take a proactive stance in this changing health care landscape. Research regarding empirically validated treatments and effects of psychological interventions on overall health-care costs needs to be properly disseminated to health care administrators to assure their knowledge of the utility of psychological services in the medical setting. Training psychologists to assume leadership positions in health-care institutions, gaining representation on hospital staff boards, and linking psychologists and physicians through collaborative training, to provide improved care, may allow for psychology to influence health care delivery.     

医院的社会责任:伦理学视角

讨论了评价医院管理行动的伦理框架,严峻的卫生形势,医院的社会责任,其中着重讨论参与全面建设小康社会;向社会提供公平的卫生保健服务;重建医患信托关系以及调整与企业关系防止利益冲突.