全文获取类型
收费全文 | 914篇 |
免费 | 129篇 |
国内免费 | 18篇 |
专业分类
1061篇 |
出版年
2024年 | 9篇 |
2023年 | 11篇 |
2022年 | 3篇 |
2021年 | 18篇 |
2020年 | 68篇 |
2019年 | 51篇 |
2018年 | 69篇 |
2017年 | 76篇 |
2016年 | 49篇 |
2015年 | 87篇 |
2014年 | 34篇 |
2013年 | 116篇 |
2012年 | 32篇 |
2011年 | 11篇 |
2010年 | 11篇 |
2009年 | 11篇 |
2008年 | 31篇 |
2007年 | 46篇 |
2006年 | 47篇 |
2005年 | 40篇 |
2004年 | 14篇 |
2003年 | 32篇 |
2002年 | 21篇 |
2001年 | 24篇 |
2000年 | 24篇 |
1999年 | 19篇 |
1998年 | 22篇 |
1997年 | 15篇 |
1996年 | 11篇 |
1995年 | 7篇 |
1994年 | 13篇 |
1993年 | 13篇 |
1992年 | 10篇 |
1991年 | 1篇 |
1989年 | 10篇 |
1988年 | 1篇 |
1987年 | 1篇 |
1982年 | 1篇 |
1980年 | 2篇 |
排序方式: 共有1061条查询结果,搜索用时 15 毫秒
61.
Doctor's Expertise and Managing Discrepant Information from Other Sources in Genetic Counseling: A Conversation Analytic Perspective 总被引:1,自引:0,他引:1
The study examines a recurrent interactional pattern in genetic counseling. It describes clinical geneticists' responses in
situations in which clients have presented information from other sources that is potentially discrepant with information
given by the doctor. The data consists of 12 video-recorded sessions of genetic counseling in Finland, and the method is conversation
analysis. There are two primary ways the doctors respond: either they accept the client's information as such, but show that
it is not discrepant with the doctor's information, or they reject the client's information. In the latter case they mitigate
the ‘wrongness’ of the client's information. The clinical geneticists seem to be working with a dilemma: they need to find
a balance between ensuring correct understanding of the information and showing respect for the expertise of others. A particularly
complex case is also analyzed and reflected on. 相似文献
62.
Claes E Evers-Kiebooms G Denayer L Decruyenaere M Boogaerts A Philippe K Legius E 《Journal of genetic counseling》2005,14(5):349-363
This prospective study evaluates emotional functioning and illness representations in 68 unaffected women (34 carriers/34
noncarriers) 1 year after predictive testing for BRCA1/2 mutations when offered within a multidisciplinary approach. Carriers had higher subjective risk perception of breast cancer
than noncarriers. Carriers who did not have prophylactic oophorectomy had the highest risk perception of ovarian cancer. No
differences were found between carriers and noncarriers regarding perceived seriousness and perceived control of breast and
ovarian cancer. Mean levels of distress were within normal ranges. Only few women showed an overall pattern of clinically
elevated distress. Cancer-specific distress and state-anxiety significantly decreased in noncarriers from pre- to posttest
while general distress remained about the same. There were no significant changes in distress in the group of carriers except
for ovarian cancer distress which significantly decreased from pre- to posttest. Our study did not reveal adverse effects
of predictive testing when offered in the context of a multidisciplinary approach. 相似文献
63.
Differences in Individual Approaches: Communication in the Familial Breast Cancer Consultation and the Effect on Patient Outcomes 总被引:1,自引:0,他引:1
This multicenter study aimed to assess (i) whether individual clinical geneticists and genetic counselors vary in their communication skills and (ii) whether this variation in communication impacts on patient outcomes, such as anxiety, depression, genetics knowledge, and satisfaction. One hundred and fifty women from high-risk breast cancer families attending their first genetic counseling consultation completed pre and post-consultation self-report questionnaires. The consultations were audiotaped and transcribed verbatim. Univariate analyses showed highly significant differences between individual clinical geneticists and genetic counselors in: facilitating understanding (p 0.001); facilitating active involvement (p 0.001); facilitating partnership building (p = 0.003); addressing emotional concerns (p 0.001); and discussing prophylactic mastectomy (p = 0.017). Multivariate linear regressions showed that this variation in communication resulted in a greater change in patients depression 4 weeks after the counseling session (p = 0.017). These findings suggest clinical geneticists and genetic counselors have achieved some standardization in communicating information, but showed diversity in their facilitation skills. Communication skills may be a useful area to explore further in this field. 相似文献
64.
One measure of the impact of genetic counseling and testing (GCT) is the extent to which it fosters behavioral change that is consistent with mutation status. We describe and illustrate how two different signal detection methods, receiver operating characteristic (ROC) analysis and recursive partitioning, can be used in this context to evaluate the impact of GCT. We analyzed real screening behavior data obtained in the 12 months following GCT for Hereditary Nonpolyposis Colon Cancer (HNPCC) using these two different signal detection approaches. Each approach demonstrated that GCT had an impact on behavioral outcomes, and was effective in fostering behavioral outcomes appropriate to mutation status. The ROC approach demonstrated that GCT was effective because mutation positive and mutation negative individuals could be distinguished on the basis of the number of recommended screening behaviors. The recursive partitioning approach demonstrated that GCT was effective because there were generally high rates of adherence to screening guidelines among subjects. The recursive partitioning technique also identified four subgroups of subjects, each with distinct characteristics, for which tailored interventions could be developed to increase rates of adherence to screening guidelines. Signal detection methods are easily implemented and are useful techniques for evaluating the impact of GCT. 相似文献
65.
Evaluating Genetic Counseling: Client Expectations,Psychological Adjustment and Satisfaction with Service 总被引:1,自引:0,他引:1
Periodic evaluations of genetic counseling services are useful for determining the effectiveness of counseling in meetings its psycho-educational aims, as well as identifying where improvements to the service may be made. This study aimed to evaluate the genetic counseling services provided by Genetic Services of Western Australia (GSWA) to determine the impact of counseling on client expectations, satisfaction with the service, and psychological adjustment, defined as wellbeing and perceived personal control (PPC). A total of 122 clients participated in a self-administered survey conducted pre- and post-counseling. Client expectations of the service as a means of providing information were met, and opportunities for counselors to meet client’s expectations of psychological support were identified. Furthermore, counseling was found to maintain and enhance psychological wellbeing of clients. The role of counseling in facilitating the development of PPC was a key contributor to a high sense of satisfaction in clients. 相似文献
66.
To explore the influence of client characteristics in premarital counseling, a five factor model is presented that includes the social context, family-of-origin influences, individual characteristics, couple interactional processes, and motivation for attending premarital counseling. The findings demonstrate that providers believe that many client characteristics influence the degree to which couples benefit from premarital counseling. Providers rated the influence of the client characteristic factors in the following order (from most to least influential): couple interactional processes, family-of-origin influences, individual characteristics, motivation for premarital counseling, and the social context. Recommendations for future theory development, practice, and research are discussed.The findings presented in this article were part of the authors doctoral dissertation at the University of Florida. 相似文献
67.
Underemployment in America: Measurement and Evidence 总被引:4,自引:0,他引:4
An important way in which employment hardship has come to be conceptualized and measured is as underemployment. Underemployment goes beyond mere unemployment (being out of a job and looking for work), to include those who have given up looking for work, part-time workers whose employer(s) cannot give them full-time work, and the working poor. To provide needed background for the other articles in this special issue, we trace the history of the concept of underemployment, review existing empirical literature, offer a critique of the measurement of underemployment as conventionally operationalized, and provide up-to-date evidence on the trends and correlates of underemployment in the United States. 相似文献
68.
Unemployment, Underemployment, and Mental Health: Conceptualizing Employment Status as a Continuum 总被引:1,自引:0,他引:1
Dooley D 《American journal of community psychology》2003,32(1-2):9-20
The economy is one of the most important social environments that affect well-being, and community psychologists have long studied the social costs of one key economic stressor—job loss. But economically inadequate employment has received much less research attention than unemployment in regard to mental health effects. This paper contrasts these two literatures and considers factors that might account for their differential growth including actual rates of unemployment and underemployment. Recent panel studies offer no support for another possible basis for this differential growth—the assumption that inadequate employment is more like adequate employment than unemployment. Implications of a paradigm shift from a dichotomous perspective (employment vs. unemployment) to a continuum perspective with variations of both unemployment and employment are discussed for research and prevention. Another implication is the need to expand standard labor force statistics to reflect better the degree of underemployment. 相似文献
69.
Dagmar Diekmann-Tapon 《Journal of genetic counseling》1999,8(4):235-246
Object relations family therapy (ORFT) is a psychoanalytically based approach for the treatment of couples and families which stresses the importance of past relationships. The therapist assumes a parentlike role and provides a holding environment in which clients can explore unconscious motivations. This paper will discuss the applicability of this method to genetic counseling. The case of a couple seen for recurrent trisomies will be presented and used as an example to discuss how ORFT might serve as a framework in a genetic counseling session. 相似文献
70.
Abby Lippman 《Journal of genetic counseling》1999,8(5):255-274
Open-ended, qualitative interviews with women to whom amniocentesis was offered were analyzed to understand how women made sense of these tests. We found that women, whether tested or not, negotiated with biomedical information. They transformed it through identifiable processes, then wove it with their own instincts and beliefs and with their personal experiences, thereby creating embodied knowledge on which their decisions were based. Women who were and were not tested may have differed from each other when categorized on the basis of a final, binary choice, but they were more alike than unalike in reaching this point. The apparent importance of embodied knowledge suggests the critical role of the listening activities of the genetic counselor and of awareness of the validity and importance of women's complementary ways of knowing and doing in understanding the uses and meanings of prenatal genetic testing. 相似文献