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871.
现代社会中医患沟通视野下的医学涵义   总被引:2,自引:0,他引:2  
现代社会派生出许多新生事物,对医学与医疗影响深远。其中,医患沟通作为当今中国医学界高度重视的新概念与新行为,与现代医学模式相吻合,引发出医患双方的共同目标——健康生存,进而推导出现代医学内涵及定义。  相似文献   
872.
The paper outlines an approach to the formal representation of signalling conventions, emphasising the prominent role played therein by a particular type of normative modality. It is then argued that, in terms of inferencing related to this modality, a solution can be given to the task J.L. Austin set but failed to resolve: finding a criterion for distinguishing between what Austin called constatives and performatives. The remainder of the paper indicates the importance of the normative modality in understanding a closely related issue: reasoning about trust in communication scenarios; this, in turn, facilitates a clear formal articulation of the role of a Trusted Third Party in trade communication.  相似文献   
873.
As an individual’s understanding of their genetic risk may influence risk management decisions, it is important to understand the ways in which risk is constructed and interpreted. We systematically reviewed the literature, undertaking a narrative synthesis of 59 studies presenting data on the ways in which individuals perceive, construct and interpret their risk, and the subsequent effects. While most studies assessed perceived risk quantitatively, the combined evidence suggests individuals find risk difficult to accurately quantify, with a tendency to overestimate. Rather than being a stand-alone concept, risk is something lived and experienced and the process of constructing risk is complex and influenced by many factors. While evidence of the effects of perceived risk is limited and inconsistent, there is some evidence to suggest high risk estimations may adversely affect health and lead to inappropriate uptake of medical surveillance and preventative measures by some individuals. A more focused approach to research is needed with greater exploration of the ways in which risk is constructed, along with the development of stronger theoretical models, to facilitate effective and patient-centered counseling strategies.  相似文献   
874.
Using language appropriately and effectively in social contexts requires pragmatic language competencies (PLCs). Increasingly, deficits in PLCs are linked to child and adolescent disorders, including autism spectrum, externalizing, and internalizing disorders. As the role of PLCs expands in diagnosis and treatment of developmental psychopathology, psychologists and educators will need to appraise and select clinical and research PLC instruments for use in assessments and/or studies. To assist in this appraisal, 24 PLC instruments, containing 1,082 items, are assessed by addressing four questions: (1) Can PLC domains targeted by assessment items be reliably identified?, (2) What are the core PLC domains that emerge across the 24 instruments?, (3) Do PLC questionnaires and tests assess similar PLC domains?, and (4) Do the instruments achieve content, structural, diagnostic, and ecological validity? Results indicate that test and questionnaire items can be reliably categorized into PLC domains, that PLC domains featured in questionnaires and tests significantly differ, and that PLC instruments need empirical confirmation of their dimensional structure, content validity across all developmental age bands, and ecological validity. Progress in building a better evidence base for PLC assessments should be a priority in future research.  相似文献   
875.
与医学院实习生谈医患关系   总被引:1,自引:0,他引:1  
阐述实习医师医患沟通的必要性,培养实习生正确的临床思维程序,规范操作技能。注意医患沟通技巧、言语和体语,建立良好医患关系。加深患者对医生的信任感,杜绝临床实习过程中各种医疗隐患。因而迫切需要解决的问题是如何加强实习医师沟通能力的培养,也是高等医学教育改革的重要课题。  相似文献   
876.
实习医生在医院里扮演着特殊角色,既要作为学生在临床实践中学习医学知识,又要作为医生在患者面前从事医疗工作。因此,培养医学生医患沟通能力,引导其建立和谐的医患关系,成为临床带教老师面临的一项严峻而又刻不容缓的任务。本研究针对内科实习医生在医院沟通中的典型案例进行了调查,从而了解实习医生在医患沟通中的经历,以及他们对原因的分析、处理方法及对自身的影响,进而了解实习医生对沟通技能培训的需求。  相似文献   
877.
本研究旨在考察上下级沟通对工作应激源-心理及生理应激的调节作用。研究结果表明:上下级沟通的两个维度及时告知和指导、积极表达对应激源-应激有不稳定的、不强烈的调节作用,既表现为及时告知与指导对工作-家庭冲突与心理应激、对工作负荷-生理应激有缓冲作用(负向作用),也表现为积极表达对工作-家庭冲突-生理应激、及时告知和指导对攻击行为-心理应激有增强作用(正向作用)。  相似文献   
878.
    
Signals during delays to reinforcement may lessen reductions in responding that typically occur when there is a delay between a response and its reinforcer. Sparse applied research has been devoted to understanding the conditions under which responding may be maintained when delays to reinforcement are introduced. We evaluated the extent to which providing signals during delay fading affected responding in the context of differential reinforcement of communication responses. Three individuals were exposed to gradually increasing signaled and unsignaled reinforcement delays in multiple‐schedule and/or withdrawal designs. Results for 2 of 3 participants suggested that (a) the presence of signals facilitated response maintenance under delayed reinforcement and (b) coordinated basic and applied research may advance both conceptual understanding and clinical outcomes of delayed reinforcement.  相似文献   
879.
    
There is consistent evidence that health care professionals (hcps) are not addressing the sexual information and support needs of people with cancer. Thirty-eight Australian hcps across a range of professions working in cancer care were interviewed, to examine constructions of sexuality post-cancer, the subject positions adopted in relation to sexual communication, and the ways in which discourses and subject positions shape information provision and communication about sexuality. Participants constructed sexual changes post-cancer in physical, psychological and relational terms, and positioned such changes as having the potential to significantly impact on patient and partner well-being. This was associated with widespread adoption of a discourse of psychosocial support, which legitimated discussion of sexual changes within a clinical consultation, to alleviate distress, dispel myths and facilitate renegotiation of sexual practices. However, this did not necessarily translate into patient-centred practice outcomes, with the majority of participants positioning personal, patient-centred and situational factors as barriers to the discussion of sex within many clinical consultations. This included: absence of knowledge, confidence and comfort; positioning sex as irrelevant or inappropriate for some people; and limitations of the clinical context. In contrast, those who did routinely discuss sexuality adopted a subject position of agency, responsibility and confidence.  相似文献   
880.
    
Abstract

This study examines the communication that occurs during routine genetic counselling sessions. It involves the qualitative analysis of nine consultations with one member of a clinical genetics team.

The consultations were characterised by a contrast between the sense of certainty apparent in how the clinician talked about the power and promise of the new genetics and the uncertainty communicated regarding the actual information produced by genetic tests and their limitations in solving people's problems. There was also a contrast between how the clinician seemed to control the format and agenda of the consultation and the apparently uncontrollable personal and social implications of the topics discussed. We speculate that this may be explained in terms of the clinician giving some order and certainty in an area of inherent uncertainty, and where great promises are as yet unrealised.  相似文献   
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