关于重大医疗纠纷行政干预认识的调查分析

为了解医患双方对重大医疗纠纷的基本认识,对上海市徐汇区35家医疗机构医患双方进行问卷调查.就医患双方对重大医疗纠纷的产生原因、救济途径、行政干预作用等方面的认知情况展开分析,从而得出为了有效解决重大医疗纠纷,需发挥行政干预作用、健全纠纷解决机制以及正确引导舆论导向的结论.     

Decisional Capacity Among Minors With HIV: A Model for Balancing Autonomy Rights With the Need for Protection

The purpose of this article is threefold: (a) to describe the relevant ethical and legal issues associated with decisional capacity among minors and to discuss the importance of these concepts for children and adolescents living with HIV, (b) to provide a framework for assessing the decisional capacity of children and adolescents with HIV, and (c) to present a model for thinking about how to use this assessment data to guide action along the protection-autonomy continuum.     

The Efficiency of the Group Rorschach Test in the Psychiatric Screening of Marine Corps Recruits

In a study to extend the theory of cognitive dissonance into the area of person perception, 108 male freshmen dormitory students were led to believe that they either would or would not be sharing a room in the future with a negative other. They were also informed that they were either low, moderate, or high in similarity to this negative other. The major response measure was the extent to which the negative first impression changed in a more positive direction. A 2 × 3 ANOVA showed that both the proximity and similarity manipulations had the predicted effect. However, the trend in similarity was not linear, as hypothesized. Similarity was also found to be a more salient source of dissonance than proximity.     

Animal-Assisted Therapy with Farm Animals for Persons with Psychiatric Disorders: Effects on Anxiety and Depression,a Randomized Controlled Trial

This study examined the effects of Animal-Assisted Therapy with farm animals during a 12 weeks' intervention on anxiety and depression among psychiatric patients by using a randomized controlled trial with a follow-up investigation at 6 months. Ninety adult patients were included, with 41 completers in the treatment group and 28 in the control group. Anxiety measured using Spielberger State Anxiety Inventory did not decrease significantly during the intervention for the treatment group but was significantly lower at follow-up compared with baseline (p = 0.002) and with the end of the intervention (p = 0.004). There was no significant change for the control group. Depression measured using Beck Depression Inventory was significantly lower at follow-up compared with baseline for both groups, but there were no significant differences between the groups.     

Cases to cases: A study of psychotherapy

The background to the study was a research project on psychotherapy (279 subjects) in the context of the Finnish Student Health Service. Patients were divided into three groups by duration of treatment. For each group, a hypothetical case was constructed. The hypothetical case in relation to short-term treatment (less than six months) is someone whose temporarily disturbed mental balance is supported by the therapist. The hypothetical case in relation to medium-term treatment (one to two years) exhibits recovery through release from self-objects. The hypothetical case in relation to long-term treatment (two to five years) was marked by the partial working through of object relationships.     

Autobiographical memory specificity and the persistence of depressive symptoms in HIV-positive patients: Rumination and social problem-solving skills as mediators

Individuals infected with human immunodeficiency virus (HIV) are at elevated risk for depressive conditions, which in turn can negatively impact health-related behaviours and the course of illness. The present study tested the role of autobiographical memory specificity and its interaction with perceived stress in the persistence of depressive symptoms among dysphoric HIV-positive individuals. Additionally, we examined whether rumination and social problem solving mediated these effects. Results indicated that memory specificity moderated the impact of perceived stress, such that perceived stress was more strongly associated with follow-up depressive symptoms among those with greater memory specificity. Rumination, but not social problem solving, mediated this effect. Implications of these findings are discussed.     

Pervasive traumatic loss from AIDS in the life of a 4-year-old African boy

It is estimated that, by the end of this century, over five million children under the age of 10 will have lost their mothers as a result of HIV infection. The psychological implications for the children who survive are extensive. These children suffer not only from bereavements and disruption to family life, they also suffer from prevailing anxieties about their own health and the health of their carers. It is the pervasive threat of death which constitutes chronic trauma for child survivors of HIV infection. Confusions abound in fact and in phantasy of where responsibility lies for the tragedies which surround them. Psychotherapeutic treatment for the survivors concentrates on both the cognitive and the emotional aspects of the traumas to enable the child to grieve and to feel appropriate anger for the tragedy in their life. This paper presents a detailed case history of a 4-year-old African boy of refugee parents who were victims of war as well as AIDS. Using a psychoanalytic framework, the child's distorted perceptions of his world are described and his attempts to make sense of his world and keep hope alive in spite of the continual threat of abandonment is demonstrated.     

Adolescent beliefs about AIDS prevention

Abstract

Four hundred and ten school children, aged between 13 and 16 years, were administered a questionnaire to investigate (a) their perceptions of AIDS and implications of the disease for the victim; (b) beliefs about how best to prevent the spread of disease; (c) sources of information and (d) AIDS relevant topics they would like to learn in school. The results suggested that there were few differences in knowledge or attitude as a function of age, but some significant differences due to sex. Boys were more likely to derogate the AIDS victim compared with girls. In terms of different strategies for prevention, boys were more in favour of “scare” approaches, and girls of information-giving. The success of any AIDS education package may be at least partly determined by individual beliefs about the disease, and preferences for different educational strategies.     

The effect of chronic caffeine consumption on urinary incontinence in psychogeriatric inpatients

Abstract

Urinary incontinence is a common problem in psychiatric settings, particularly among psychogeriatric patients. In view of the known diuretic action of caffeine, the present study assessed the effect of tea and coffee consumption on level of incontinence in selected psychogeriatric inpatients. A total of 14 patients participated in the study which employed a combined “withdrawal” and “multiple-baseline across subjects” design to examine the effect of alternating phases of caffeine exposure and abstinence on frequency of daytime and nighttime incontinence. Incontinence levels were significantly reduced during periods of caffeine abstinence relative to periods of chronic caffeine exposure. The hypothesis that observed reductions in incontinence may have been due to accompanying reductions in fluid intake was examined but not supported.     

Shock tactics to counter AIDS: The australian experience

Abstract

The use of shock tactics to motivate people to learn more about AIDS and to take appropriate protective action characterised the approach adopted by the national health authorities in Australia during 1987. The rationale underlying this approach is critically examined, particularly in the light of results obtained from surveys of community concern and knowledge about AIDS in the state of South Australia before the campaign and after it had been in progress for some five months. Contrary to expectations no significant increases in either personal or social concern were found; in fact, among older respondents personal concern had decreased significantly. Levels of knowledge about AIDS, in general, remained unchanged, apart from an increase in acceptance of the safety of blood transfusions from a very low to a somewhat higher level. Among a minority of respondents (29%) who approved of the campaign and also believed they had been influenced by it, personal and social concern about AIDS, but not knowledge, was significantly greater than among others. The view that fear-inducing techniques can be used to bring about increases in knowledge about AIDS was not supported, although some positive effects on the social attitudes of respondents most affected by the campaign are suggested.