关于生态医学:是补充,不是取代

生态只是影响生命和健康的因素之一,而非全部;生态有其明确的范围,不能无限扩大;生物医学是整个医学的基础;生态医学要成为科学,必须植根于生物医学的基础;生态医学很难成为一种独立的医学模式,只能是生物心理社会医学模式的补充,理想的医学模式应当是生物心理社会生态医学模式;探索生态是如何影响生命与健康,如何应对生态之于生命与健康的影响,如何调整医学理念,是生态医学面临的三项任务。     

临床医学专业人文精神教育误区探析

我国临床医学专业人文精神教育一直存在误区, 误将医学人文知识的多少等同于医学人文精神的高低;重视医学科学教育, 忽视医学人文教育;误将人文精神教育、思想政治教育、文化素质教育等同;过分夸大医学人文与医学科学的对立, 错误定义二者的关系;浮夸的技巧教育掩盖了医学人文教育的实质;传统的封闭式教学扼杀了医学人文精神教育的深入发展。只有正确认知医学人文精神教育的误区才能更好地做好医学人文精神教育, 为医学人文精神教育的发展做出贡献。     

循证医学的认识论探究

循证医学的兴起被认为是医学界重要的现代化运动,其哲学基础却一直倍受质疑。回顾了循证医学概念的发展和基本假设,整理了从认识论视角质疑循证医学的若干观点,着重介绍循证医学倡导者对循证医学认识论的基本看法,包括证据和知识的关系,观察到的、可观察的和不可观察的事实间的关系,正确地进行观察,指出循证医学不是全新的医学证据产生与运用理论,而是对多种科学推理规则的综合运用。循证医学是应客观需要而产生,因争议而不断自我完善,实现其迅速发展。     

瑶医学风病与风药的学术内涵

瑶医药历史悠久,作为民族医药的重要组成部分,为保障瑶族人民的健康发挥了重大作用。经过对瑶医药知识的挖掘和总结,瑶医药已经得到系统化的整理,通过汲取瑶医药理论中的特色养分,有利于加深对瑶医药的认识。瑶医学借鉴中医学理论有关对“风”的论说,结合长期的医疗实践,发展了“百病因风”病因说、“七十二风病说”和“七十二风药说”,对“风”的理解有一定的特色,对其内涵进行总结和解读,有助于促进中医药和瑶医药的交流,为充分发挥民族医药的特色并指导临床提供有价值的参考。     

叙事医学反思性写作对共同决策价值探析

以叙事医学工具反思性写作为切入点,首先从医方、患方及外部环境三个角度分析了当前医患共同决策所面临的临床实践困境,其次在对反思性写作概念、实践特点概述的基础上,提出了叙事能力对临床工作的重要性、叙事医学伦理对决策困境的作用,最后从促使医方自我反思,避免引导式决策及权威主义;弥合医患视阈差异,达成决策共识;阐明并澄清患者偏好及价值观,促进个体化共同决策;提高患者参与决策意愿,调动参与决策积极性;缓和医患关系,实现医患共情,促进共同决策良性互动五个方面阐述了反思性写作对医患共同决策困境的助力作用。

     

科学发展观与生态医学模式

分析了生物医学模式没有转型为生物心理社会医学模式的原因。认为生态危机背景下的医学发展模式研究,应把提高人的生命质量和改善人的生存、生活环境等相关条件,纳入视野之中,这正表现出生态医学模式的价值基础与科学发展观在根本上的一致性。以生态医学模式引领未来医学发展是实践科学发展观的必然要求和具体行动。     

Enhancing the care of children with chronic diseases through the narratives of patient,physician, nurse and carer

We tested the hypothesis that a narrative approach may enhance a bio‐psycho‐social model (BPS) in caring for chronically ill children. Forty‐eight narratives were collected from 12 children with six different medical conditions, their mothers, physicians, and nurses. By a textual analysis, narratives were classified on their predominant focus as disease (biological focus), illness (psychologic focus), or sickness (social focus). Sixty‐one percent of narrative’ text were classified as illness, 28% as disease and 11% as sickness. All narratives had a degree of illness focus. Narratives by patients and physicians on the one hand, and nurses’ and mothers’ on the other were disease focused. Narratives were also evaluated with respect to the type of medical condition: Illness was largely prevalent in all but Crohn’s disease and HIV infection, the latter having a predominance of sickness most probably related to stigma. Narrative exploration proved a valuable tool for understanding and addressing the needs of children with complex conditions. Narrative approaches allow identification of the major needs of different patients according to health conditions and story tellers. In the narratives, we found a greater illness and disease focus and surprisingly a low sickness focus, except with HIV stories. Narrative medicine provides a tool to strengthen the BPS model in health care.     

Self-Compassion and Need Frustration Moderate the Effects of Upward Appearance Comparisons on Body Image Discrepancies

Abstract

Drawing from diverse theoretical frameworks, we examined predictors of discrepancy between current and ideal body image in a sample of 396 Greek adolescents. The participants completed assessments of the frequency of comparing oneself with someone of perceived better appearance, appearance evaluations, frustration of basic psychological needs, and appearance self-compassion. We found that upward appearance comparisons negatively predicted appearance evaluation, which in turn was a negative predictor of body image discrepancy. Moderated mediation analyses showed that appearance self-compassion buffered, whereas psychological need frustration augmented the negative effects of upward comparisons on appearance evaluation. Our findings contribute to the growing literature on body image discrepancies in adolescence by examining moderating factors that amplify or buffer such discrepancies, hence identifying viable intervention pathways.     

A citation network analysis of career mentoring across disciplines: A roadmap for mentoring research in sport

ObjectiveGiven our limited understanding of mentoring in sport, reviewing research from other disciplines has the potential to advance knowledge in this context. Therefore, the purpose of this study was to synthesize and evaluate the mentoring literature across disciplines in order to bridge existing knowledge and to situate the mentoring in sport literature.DesignA citation network analysis.MethodA comprehensive literature search was conducted to locate influential career mentoring articles, books, and book chapters across all disciplines. Subsequently, this body of literature was evaluated using citation network to (a) identify the major career mentoring disciplines, (b) locate the most influential career mentoring texts, (c) evaluate the transfer of knowledge across disciplines, and (d) situate and evaluate the mentoring in sport literature.ResultsThe literature search resulted in a mentoring network of 1,819 texts and 10,951 citation links. Five major mentoring disciplines emerged: academic medicine, industrial and organizational psychology, education, nursing, and psychology. The industrial and organizational psychology and academic medicine disciplines were the most substantial mentoring disciplines. Further, the findings suggest the literature is relatively disconnected within and across disciplines. In regard to sport, the mentoring research represented 1.47% of the full-network (29 texts and 50 citation relations) and is interwoven into the industrial and organizational psychology literature.ConclusionGiven the limited sport texts uncovered in the citation network analysis, sport scholars can stand to benefit from the wealth of existing career mentoring literature in other disciplines. Accordingly, the identification of seminal career mentoring disciplines and texts serves to provide sport mentoring scholars with a roadmap to further promote the advancement and dissemination of mentoring knowledge and research.