从平等与责任谈医患共同体何以可能

研究对“医患共同体”这一颇具可能性的命题进行分析,指出其成立的基础之一是对医患双方“分裂”处境的认知与承认,通过以对医患平等的探讨为起点,提出应将医、患双方知识/权力上的优劣转化为差异的能动性,在促进共同责任的基础上,建立在理论及实践的医患共同体。目前可能的临床实践包括鼓励医护讲述成为患者的真实体验,鼓励包括叙事医学在内的促进平等共情的实践以及赋能患者、使其具备更强能力参与医疗共同决策的实践等。

     

论西方主流伦理理论的前提错误——兼论道德无力症与冷漠症对医疗的影响

从“畏死的恐惧”出发重塑扎根生命的道德基础,即道德行为和“生-生”式的道德关系是人的本真需要,道德权威性的根据是人类生命共同体这一“内在永恒大我”和人的本真存在方式的需要。这拯救了道德相对主义,也使个体作为潜在的人类生命共同体而能以“与永恒相关的生命意义”推开恐惧。进而,道德行为是出于内在自由而达于实在的自由的。道德主体应具备的道德实践能力包括独立能力、通达能力和勇气。生存性境况中的原子式个体不具备道德实践能力,生命境况中的“超个体的个体”才有此能力。由此,人类道德无力症和道德冷漠症的根源是西方主流伦理理论的前提错误,即以原子式个体充任道德主体。它是医疗纠纷和暴力频发的原因。     

困境与希望：新冠肺炎疫情下的医学叙事

数月以来,新冠肺炎疫情之下的中国医务人员及患者在这场抗疫之战中形成了许多独具特色的医学叙事,其中的文本意义既具有深刻的社会属性,亦具有极强的个人属性。采用参与式观察法,收集、记录自然条件下不同的患者在疫情期间前来医院就诊的疾病故事,共计29个案例,并根据患者就诊中的不同心态将这些案例分为恐慌、无奈和乐观三类,最后尝试以医者的视角,通过三个医务人员的平行病历对疫情之下这三类不同的患者心态进行解读,借此重新审视特殊时代背景之下医者的责任和医学的意义,旨在为后疫情时期的医患关系研究提供一些理论基础和思考空间。     

论当前我国医疗市场对医患关系的影响

解读目前紧张的医患关系是一个迫切的社会课题。医疗服务是一种商品 ,医疗市场是客观存在的 ,它是导致医患关系紧张的深层次原因。     

技术创新对提高医疗服务质量驱动力的探析

技术创新在人类发展史上起着里程碑式的作用,同样推动现代医学快速进展和持续进步。医疗技术是医疗质量的核心,技术创新能够全方位提升医疗服务质量。结合国内外医疗相关技术创新的现况和医院实践,剖析了技术创新在提升医疗服务质量中的驱动作用,结合自身实践,从医疗设备技术创新、医学信息技术创新、医学技术创新思维和理念这三个方面,对技术创新促进医疗服务质量提升的实现途径进行探讨,为持续改进和不断完善医疗服务质量提供新的思路和手段。     

Longitudinal Changes of Planned Happenstance Skills by Gender,Community Types,and Employment Status in a Sample of College Students in School‐to‐Work Transition

This study examined the characteristics of college students who are transitioning from school to work by measuring their mean differences on planned happenstance skills subscales at 3 separate time points. The results indicated that the mean of planned happenstance skills changed across the 3 time points and are somewhat different through demographic factors, such as gender, community types, and employment status. In addition, 2‐way and 3‐way multivariate analysis of variance results showed that the interaction effects of 3 demographic variables on 5 planned happenstance skills were not significant. Practical implications for career counselors are discussed.     

Consider the Children

Summary

In this article, we consider interventions for children exposed to family violence in light of the research on children's problems associated with witnessing family violence. Next, we review risk and protective factors related to these children's adjustment with the view that all children are not similarly affected by exposure to family violence. Against this background, we then move to consider directions for interventions from a systemic perspective. We take into account not only the exposure to interactions between their mother and father, but also children's relationships with their mother, father, and siblings, as well as within broader systems such as the peer group, the school, and the community. We consider the critical challenges within each of these important systems for children exposed to family violence, and we propose some potential interventions to address the problems. Finally, we summarize an evaluation of an intervention that incorporates some of the elements identified by a systemic perspective. The evaluation revealed a significant improvement in children's self-reports of depression and anxiety over the course of the program. Mothers rated their children as significantly improved in emotional and hyperactive behaviour problems. There was no relation between mothers' involvement in counselling and children's improvement. Overall, the results suggest that the Peer Group Counselling Program effectively provided support to children exposed to family violence. Finally, we discuss the steps necessary to support children and families in moving toward violence-free lives.     

Why Clinical Psychology Needs to Engage in Community‐Based Approaches to Mental Health

The aim of this article is to advocate for clinical psychology to engage with community‐based approaches to mental health. This engagement will be challenging given community work is antithetical to the individualism that defines much of clinical psychology. It would also result in a direct challenge to the core tenets of our profession, including an emphasis on individualism, psychopathology, and expert‐driven intervention. We need clinical psychology, however, to decolonise itself to respond to the needs of Aboriginal communities and those from non‐Western collectivist cultures. We also need clinical psychology to consider the sociopolitics of human distress and lend itself to social action for complex problems. Specific examples of community‐based practices will be provided, focusing specifically on those that relate to mental health. Implication for the reform of research methodologies and classroom pedagogies will also be discussed.     

Raising the bar on the body beautiful: An analysis of the body image concerns of homosexual men

Research suggests that gay men are at particular risk for body image dissatisfaction. This study seeks to extend research on gay men's body image concerns. A survey assessed the nature and correlates of body image dissatisfaction among 64 gay men. The survey included assessments related to involvement in and perceived acceptance within the gay community, social comparison tendencies, body image satisfaction, self-esteem, and depression. The results indicate that most participants were concerned with muscularity rather than weight. Greater social comparison tendencies and higher body mass index (BMI) were associated with greater body dissatisfaction. Although involvement and perceived acceptance in the gay community did not independently predict general body image dissatisfaction, there is evidence to suggest that the association between body image and self-esteem may be moderated by integration into the gay community, defined as involvement and perceived acceptance. Implications for the further study of gay men's body image are discussed.