合并精神疾病患者剖宫产术麻醉优化与医患安全保障

合并精神疾病患者接受剖宫产术时,由于此类患者的特殊性,患者以及其家属、医务人员心理表现都有别于普通情况。合理遵守此类患者的如下麻醉方案优化原则：麻醉操作可以实施原则、麻醉效能有效控制原则、避免诱发或加重精神疾病原则、患者无痛和新生儿安全原则、术后镇痛衔接原则、全程心理干预原则和替代麻醉预案制定原则,同时科学制定患者围术期如下管理规章制度：应急程序的及时启动、患者家属及监护人的沟通与知情同意、麻醉前后特定病房或医疗单位的建立和麻醉医疗期间医患合法权益的保障,只有这样医患双方安危和权益才能得到最佳保障。     

The role of disgust in patients with hypochondriasis

Theoretically, disgust sensitivity and disgust proneness could play an important role in hypochondriasis, since disgust is a defensive emotion widely believed to protect the organism from illness. However, empirical evidence to support this hypothesis has so far been based only on nonclinical samples, so that the importance and specificity of disgust for hypochondriasis remains unclear. In the current study, 36 patients with hypochondriasis, 27 with an anxiety disorder, and 29 healthy controls completed several measures which included the assessment of disgust sensitivity (Scale for the Assessment of Disgust Sensitivity) and disgust proneness (Questionnaire for the Assessment of Disgust Proneness). We found that patients with hypochondriasis and those with an anxiety disorder had higher scores than those of the healthy controls for several measures of disgust proneness. Moreover, measures of hypochondriacal characteristics were associated with those of disgust proneness and disgust sensitivity. However, no differences were found between patients with hypochondriasis and those with anxiety disorders, with respect to disgust proneness and disgust sensitivity. Therefore, it can be assumed that disgust proneness and disgust sensitivity seem to be less specific than previously suggested for the development and maintenance of hypochondriasis.     

Living with the unexplained: coping,distress, and depression among women with chronic fatigue syndrome and/or fibromyalgia compared to an autoimmune disorder

Chronic fatigue syndrome (CFS) and fibromyalgia are disabling conditions without objective diagnostic tests, clear-cut treatments, or established etiologies. Those with the disorders are viewed suspiciously, and claims of malingering are common, thus promoting further distress. It was hypothesized in the current study that levels of unsupportive social interactions and the coping styles used among those with CFS/fibromyalgia would be associated with perceived distress and depressive symptoms. Women with CFS/fibromyalgia (n = 39), in fact, reported higher depression scores, greater perceived distress and more frequent unsupportive relationships than healthy women (n = 55), whereas those with a chronic, but medically accepted illness comprising an autoimmune disorder (lupus erythematosus, multiple sclerosis, rheumatoid arthritis; n = 28), displayed intermediate scores. High problem-focused coping was associated with low levels of depression and perceived distress in those with an autoimmune condition. In contrast, although CFS/fibromyalgia was also accompanied by higher depression scores and higher perceived distress, this occurred irrespective of problem-focused coping. It is suggested that because the veracity of ambiguous illnesses is often questioned, this might represent a potent stressor in women with such illnesses, and even coping methods typically thought to be useful in other conditions, are not associated with diminished distress among those with CFS/fibromyalgia.     

More than just child’s play: symbolic expressions of illness and spirit

While spiritual well-being is integral to health, little is known about the spiritual lives of children in the context of illness. Because the spiritual is often a hidden domain of life, exploration of the topic can be challenging, especially when dealing with children. Language is not always sufficient for describing such deeply held experiences, even for adults. Therefore, finding creative ways to elicit experiences of the spiritual is important when attempting to gain a more robust understanding of this phenomenon. Drawing from a larger study that used hermeneutic phenomenology to explore spirituality among ill children, this paper provides an interpretation of ill children’s play experiences and describes how these experiences provide a means of uncovering the spiritual in children’s everyday lives as they cope with life-threatening illness. Findings also provide insight into how play can be used in the promotion of spiritual well-being.     

Effectiveness of a Creative Arts Summer Camp: Benefits of a Short-Term,Intensive Program on Children’s Social Behaviors and Relationships

This pilot study evaluated whether a creative arts therapy program delivered through a 2-week summer day camp benefited children’s support networks and improved their general wellness. Camp staff completed ratings on the behavior of 11 children. Eleven parents (10 mothers) completed ratings on their children’s behavior. Surveys were utilized; data were analyzed using Wilcoxon t tests. Results demonstrated that camp staff observed the most significant improvements in children’s behaviors and relationships. Results of this study indicate that a social skills therapy program delivered through a creative arts summer camp can be beneficial to young children. Furthermore, these results were found during an intense, yet brief, period of time.     

企业社会责任视角下“制造疾病”现象的成因及对策研究

制药企业除应履行一般企业的社会责任外,因其产品的特殊性还应以“安全、健康”为首要职责,并通过协调自身“福利性”与“盈利性”实现可持续发展。企业参与和影响新的疾病定义和标准制定的主要原因是缺失社会责任意识,盲目追求短期经济利益。此外,制定主体不明确,制定流程不规范;法制体系仍不完备,监督体系不够健全等也是导致“制造疾病”现象发生的潜在原因。因此,应采取加强制药企业社会责任意识建设;规范疾病定义和标准制定主体和流程;完善“制造疾病”法律法规和监督体系等措施减少“制造疾病”现象的发生。

     

制造疾病：工具理性的泛滥

工具理性的泛滥导致医疗的商品化和技术主体化,产生“制造疾病”的现象层出不穷。究其原因概括为：其一,求“效率”过程无意中“制造疾病”;其二,为追求利益最大化有意“制造疾病”,将科学简单地等同于数据,认为科学可以解释一切疾病,无视患者自愈的能力,将“正常”的生命现象视为疾病;其三,视人为物,为社会管理“制造疾病”。医者应将自己的工具理性,约束在为患者谋利的价值理性之下,弘扬医学人文去遏制制造疾病的恶行。

     

医患关系何解？——医者患病经历文献述评

综述医者患病经历相关文献发现,医、患分野和矛盾植根于医学和医学模式本身,是在现代医学发展过程中被建构出来的,解决医患关系问题应着眼于审视和改变医学文化和医学模式内部造成医患矛盾、分歧的根本原因,创造机会打破严格的医、患角色区隔,实现病人得治、医者得安、医患共同。在医者患病经历文献中,能追溯医患同源的起点,能洞悉医患分化和冲突所在,也能看到形成医患共同体的可能性,为实现和谐医患关系指明方向。

     

创造性认知重评在情绪调节中的迁移效应及其神经基础

认知重评在负性情绪调节中发挥着重要的作用。针对传统认知重评重构程度不够高、调节效果不明显的问题, 研究团队在先前的工作中提出了一种使消极情绪“转负为正”的高效情绪调节方法, 即创造性认知重评, 这种调节策略伴随着大脑海马的新颖联结形成和杏仁核的积极情绪唤醒。然而这些工作采用“指导式”的重评更像是对重评解读的“理解”而非主动的情绪调节; 鉴于主动情绪调节的产生难度较大, 造成创造性认知重评在实际应用上的两难困境。基于此, 本项目拟指导受试者进行创造性认知重评的学习, 通过学习将这种策略迁移并且应用到生活中的负性情绪调节事件中。具体研究内容包括：(1)行为学上, 探索创造性认知重评在大学生群体和青少年群体负性情绪调节中的迁移效应; (2)影像学上, 探索创造性认知重评迁移前后在脑认知表征模式上的变化。本项目是对已有工作基础的延伸和拓展, 为验证和推动创造性认知重评成为一种可学、可用、高效的情绪调节策略奠定理论基础。     

创造性人格与员工创造力:一个被调节的中介模型研究

本文基于动机行动和成就动机理论,构建一个被调节的中介模型以检验创造性人格对员工创造力产生的作用机理。以251套来自主管-下属配对的问卷数据为样本,实证分析结果表明:创造性人格可预测员工创造力产生,学习目标导向与绩效证明目标导向在两者之间起部分中介作用;内在动机能够强化个体目标导向对创造力的作用,并显著正向调节创造性人格对员工创造力的间接效应。最后,论文讨论了研究发现对员工创造力产生的理论和实践意义。