特需医疗服务发展意向研究概述

我国特需医疗服务发展已近20年,尽管其在满足较高层次的医疗保健需求方面确实起到了积极的作用,但同时在特需医疗服务的内涵、服务内容和承担主体等问题上却始终存在着较大争议。本研究从剖析各位学者对上述问题的不同观点入手,对特需医疗服务的供需双方进行意向调查,在此基础上探讨我国特需医疗服务发展的基本思路,为促进我国特需医疗服务的良性发展提供决策的参考依据。     

脓毒症研究进展及启示

脓毒症(sepsis)是是当前外科ICU所面临的棘手难题.对感染和脓毒症的研究已成为外科学十分活跃的领域之一,所取得的进展已使人们从本质上更深刻、更准确地了解感染与脓毒症,从而为解决这一棘手问题开辟新的途径.脓毒症的研究揭示了人类科学发现和科学认识的普遍规律.     

An exploratory study about Koreans’ attitudes towards counselling services

This mixed-method design research is an exploratory study of Korean college students’ perceptions of seeking counselling. The quantitative part of the study is a series of factor analyses of the Attitudes Toward Seeking Professional Psychological Help Scale (ATSPPH) to extract culturally valid items and constructs. The qualitative part of the study is a content analysis of the written responses to an open-ended question. The factor analyses of the ATSPPH resulted in selecting 15 items and extracting three constructs: Conditional Usefulness, Fear of Judgment, and Lack of Necessity. The content analysis of the written responses derived three additional constructs, including Utilities of Counselling, Provider and Environment of Counselling, and Socio-Cultural and Practical Issues. The meaning of the findings, implications, limitations, and strengths of this study were discussed.     

描述性规范提升义务献血的意愿而非行为

描述性规范指大多数人的做法对他人态度和行为的影响。本研究试图利用描述性规范改变公众的义务献血意愿和行为。研究由两个相似实验组成。实验1发现描述性规范促进了被试义务献血的意愿, 但并没有影响实际献血行为; 实验2在实验1的基础上试图通过增加短信提醒来促进义务献血行为, 但是结果同样显示描述性规范促进了被试的献血意愿而非行为。本文对此原因进行了讨论。     

“The Thing Happened as He Wished”: Recovering an American Indian Cultural Psychology

One of the chief questions confronting mental health professionals who serve American Indian communities is how best to offer genuinely helpful services that do not simultaneously and surreptitiously reproduce colonial power relations. To ensure that counselors and therapists do not engage in psy‐colonization, it is crucial to recognize the sometimes divergent cultural foundations of mental distress, disorder, and well‐being in “Indian Country.” In this article, I will consider four excerpts from a research interview undertaken among my own people, the Aaniiih Gros Ventres of north‐central Montana. At a superficial level, these excerpts seem to reinforce reigning sensibilities that are readily familiar within the mental health professions. And yet, closer analysis of these interview excerpts reveals several tantalizing facets of an indigenous cultural psychology that may well continue to shape life and experience among tribal members in this setting. I recover this distinctive cultural psychology through archival representations of cultural and community life, including analysis of an important tribal myth. This analysis makes possible an alterNative interpretation of these interview excerpts, grounded in an aboriginal cosmology, that yields important implications for conceiving a more inclusive knowledge base for psychology that only robust community engagement can reveal.     

Fundamental Dilemmas in Contemporary Psychodynamic and Insight-Oriented Psychotherapy

Contemporary psychotherapists are being called on to provide treatment with increased degrees of brevity and efficacy. To meet these demands, the practice of brief psychodynamic psychotherapy has turned to (a) the increased emphasis upon a specific psychodynamic focus for treatment versus the more comprehensive goals of longer-term treatment, and (b) the augmented use of confrontation of psychological defenses versus the enhanced use of emotional support as in more nondirective psychotherapy. Other approaches to insight-oriented psychotherapy that have been influenced by this trend include: client-centered psychotherapy with its focus upon the therapeutic relationship; existential psychotherapy with its focus upon death anxiety; and, the revitalization of interpersonal psychotherapy from its original Sullivanian conceptualization. The clinical dilemmas that limitations of time and restricted therapeutic focus place upon each of these methods of treatment are the central issues of this discussion.     

Mental Health in the Schools

Progress is being made in the area of delivering mental health services in the schools through collaborative programs that involve combinations of schools, communities, and research-based programs. The goal of extending collaborative efforts to initiatives that prevent emotional and behavioral problems from developing or escalating is a cross-cutting theme of the National Agenda for Achieving Better Results for Children and Youth with Serious Emotional Disturbance. I discuss examples of collaborative efforts to prevent emotional behavioral problems in school children and ways by which this effort can be enhanced in schools and communities.     

Where Have All the Children Gone? Movement from Child to Adult Mental Health Systems

The mental health histories of the 448 children 15 and 16 years of age who were admitted to state-operated children's psychiatric inpatient services in New York during 1982 were reviewed for the 11 year period through April 1993, Thirty-three percent were served as adults (after age 18) in the state-operated adult civil mental health system; 42% of these individuals were still receiving services at the end of the period. 113 of the 146 individuals served as adults were served only in the civil system. Thirteen percent of the cohort received some of their mental health services as adults in the state-operated adult forensic mental health system due to criminal law involvement. This includes nine percent who received mental health services while they were inmates in state prisons. Twenty four of the 57 forensic clients received services as adults only in the forensic system. Diagnostic, demographic, and service history characteristics of the groups were compared to foster an early understanding of policy and programmatic issues related to movement from the child mental health system to the adult system. Baseline (1982) information was used to identify predictors of later service utilization.     

The challenge of “Healthy People 2000”

The federal Office of Disease Prevention and Health Promotion (U.S. Public Health Service) has again prepared a compilation of goals and objectives for the health of the Nation's people, applicable to anticipated achievements within the decade ending in the year 2000. This effort involved work groups from numerous federal agencies, testimony in regional hearings from 800 citizens, and enrollment of a consortium of 300 national organizations. The final product, Healthy People 2000, was released in September 1990, and contains 298 measurable objectives. Content regarding children, genetic disorders, developmental disabilities, and disabilities in general is less featured and less specific than was hoped for. Ten objectives of relatively direct concern to geneticists are discussed, plus 23 others of interest in the maternal and child health field. On balance, it is suggested that the Healthy People 2000 objectives can be useful and stimulating for workers in genetics, child health care, and disabilities' services. Regrettably, there was no simultaneous proposal of legislation that would provide new federal programs, funding, or assistance to states.