TRANSFERENCE BEFORE TRANSFERENCE

This paper is predominantly a clinical presentation that describes the transmigration of one patient's transference to another, with the analyst functioning as a sort of transponder. It involves an apparently accidental episode in which there was an unconscious intersection between two patients. The author's aim is to show how transference from one case may affect transference in another, a phenomenon the author calls transference before transference. The author believes that this idea may serve as a tool for understanding the unconscious work that takes place in the clinical situation. In a clinical example, the analyst finds himself caught up in an enactment involving two patients in which he becomes the medium of what happens in session.     

Exploring definitions of bullying among personality disordered patients in a maximum‐secure hospital

The current study explored the perceptions of staff and patients concerning how patient‐to‐patient bullying should be defined and what behaviours it should include. Participants were randomly selected from the Personality Disorder Unit of a maximum secure hospital. A total of sixty interviews were conducted (30 staff and 30 patients). Problems in attempting to utilise definitions of bullying developed for use in other contexts, i.e., schools, were identified. Patients and staff presented with similar views about how it should be defined: both felt that aggression did not have to be repeated or severe in order to be classed as bullying, that bullying could be accidental, that the power imbalance between perpetrator and victim was not always explicit and, finally, that victims could provoke bullies unintentionally. Indirect (i.e. covert) forms of aggression were less likely to be considered bullying than direct (i.e. overt) forms. A number of differences were found between staff and patients regarding how bullying was conceptualised. Staff were more likely than patients to hold the belief that some patients liked being bullied, and appeared to acknowledge a broader definition of bullying than patients, accounting for a wider range of aggressive behaviours. A number of similarities between the current study and previous prison‐based research were found. The implications of these findings for current research and the value in attending to prison‐based research are highlighted. Aggr. Behav. 00:000–000, 2005. © 2005 Wiley‐Liss, Inc.     

医患冲突与诚信的缺失

在新的历史条件下,医患冲突表现出更为复杂的特点,从深层次研究医患冲突的原因,诚信的缺失往往被人们所忽视.多数医疗纠纷源于医患双方缺乏诚信,以自我为中心,过分强调经济利益,缺少人文关怀.必须加强诚信道德教育,建立健全信用法律制度,使诚实守信成为人人自我约束、自觉遵守的行为规范.     

目前形势下临床教学问题的探讨与改革

当前医疗大环境的改变,社会评价的影响及病人的维权、自我保护意识等使临床教学工作发生了很大变化.需要我们采取相应的变革,注重病历的书写,基本功的培训,语言能力的指导和改变查房的方式,以完成培养新一代合格医生的任务.     

当代中国医患关系的合理重构--论我国社会转型期医患利益的调节与平衡

我国社会转型,为当代中国医患关系的合理重构提供了平台,但社会转型期中出现的诸多医患利益冲突也向人们提出了严峻的挑战,亟需对其加以调节和平衡.这种调节与平衡,不能完全甚至不能主要地交由市场这双"看不见的手"去运作,不能完全任凭甚至不能主要地任凭医患双方自由地去博弈;政府必须明确并履行自己的职责,为正确调节与平衡我国社会转型期的医患利益创立一个全方位的合理的框架,使医患之间在有控制的理性的双赢的利益博弈中合理地重构当代中国医患关系的基本格局.     

反思医院泄露病人隐私现象

医院泄露病人隐私现象,是阻碍医患关系的和谐发展的绊脚石,是一种医疗领域人文缺失的表现.作为医院要设身处地的多为患者考虑,把尊重病人隐私当成一种常态,作为病人、家属及探视者,要自觉形成保护他人隐私的公德意识.     

终末期癌症病人诊治中的心理特征与人文关怀

在诊治终末期癌症病人过程中不仅要关心他们的躯体方面,更要关心他们的心理方面,在诊治过程中要根据他们的独特的心理特征来进行人文心理关怀,维持生命质量和保证他们应有的人格尊严.     

Nature,extent, and causes of bullying among personality‐disordered patients in a high‐secure hospital

The present study explored the perceptions and experiences of the nature, extent and causes of bullying among personality‐disordered patients, with a subsidiary aim of exploring differences in perceptions between staff and patients. The sample was selected from the Personality Disorder Unit of a high secure hospital. The total sample consisted of 60 participants, 30 patients and 30 staff. Participants engaged in a semi‐structured interview based on that developed by Brookes [1993] and modified by Ireland and Archer [1996] and Ireland [2002a]. The interview assessed their perceptions and experiences of patient‐to‐patient bullying. One fifth of patients and staff reported that they had seen a patient being bullied in the previous week. One‐fifth of patients reported that they had been bullied in the previous week and less than one tenth reported that they had bullied others. The most frequent types of bullying reported were theft‐related, verbal abuse, being made to do chores, physical assaults and intimidation. One fifth of the sample reported that sexual abuse took place. Victims were generally perceived to be ‘easy targets’ that were vulnerable, either physically or emotionally. Staff identified a wider range of victim types than patients. The results highlight how patient‐to‐patient bullying does occur and is an important issue worthy of further research. A number of similarities were found between the current findings and those of prison‐based research suggesting that both hospitals and prisons share a number of environmental similarities that help to explain why bullying takes placed in secure forensic settings. Aggr. Behav. 30:229–242, 2004. © 2004 Wiley‐Liss, Inc.     

An Investigation of Irrational Beliefs and Death Anxiety as a Function of HIV Status

The present study investigated the relationship of irrational beliefs and death anxiety as a function of human immunodeficiency virus (HIV) status in homosexual and bisexual men. Recruited for this study were 101 HIV-seropositive participants (34 asymptomatic, 30 symptomatic, and 37 symptomatic and diagnosed with AIDS) and a contrast group (40 HIV-seronegative). In the primary analysis, HIV-negative participants in this study could not be differentiated from asymptomatic, symptomatic, and AIDS diagnosed HIV-infected participants on measures of death anxiety and irrational beliefs regardless of the status or severity of illness. In addition, irrational beliefs strongly predicted death anxiety for all participants. Results from post hoc analyses suggested that HIV status produced an interaction effect with level of total irrational beliefs and together predicted death anxiety. Even in these analyses, total irrational beliefs explained more of the variance of death anxiety than HIV status. These results are discussed within the context of the need for expanding cognitive-behavioral treatment options for HIV-infected individuals.     

试论社会人群中医学信息的不对称性

简述了社会人群中产生的医学信息不对称性的根源、特点和社会效应,以及医务人员应如何正确对待这个问题.