护理执行用药医嘱的伦理学思考

护理人员在医疗机构推行临床合理用药的过程中承担着十分重要的任务。加强护理人员的道德教育,提高护理人员的素质,提高药物使用业务知识水平,提高与药物临床使用相关的护理技能,真正体现医疗机构推行的"以人为本"的护理理念,为患者的健康、康复负责。     

Balance between volunteer work and family roles: Testing a theoretical model of work‐family conflict in the volunteer emergency services

Trends indicate overall declines in numbers of volunteer emergency service workers and suggest negative organisational factors impacting adversely on volunteers and organisations. Conflict between emergency service work and family is implicated in falling volunteer numbers, and there is thus a need for research on difficulties experienced in balancing volunteer work and family. The current study tested an adaptation of the work‐family conflict (WFC) model originally proposed by Frone, Russell, and Cooper, in a sample of 102 couples in which one partner was an Australian emergency service volunteer. Results supported a model in which volunteer work‐related antecedents, including time invested in on‐call emergency activities and post‐traumatic stress symptoms, had indirect links with outcomes, including volunteer burnout and their partners' support for the volunteer work role, through the effects of WFC. These results add to research using theoretical models of paid work processes to better understand the problems faced by volunteer workers, and identify specific antecedents and outcomes of WFC in the volunteer emergency services. Implications for future research and organisations reliant on volunteer workers are discussed.     

Statistical manifold as an affine space: A functional equation approach

A statistical manifold M_μ consists of positive functions f such that defines a probability measure. In order to define an atlas on the manifold, it is viewed as an affine space associated with a subspace of the Orlicz space L^Φ. This leads to a functional equation whose solution, after imposing the linearity constrain in line with the vector space assumption, gives rise to a general form of mappings between the affine probability manifold and the vector (Orlicz) space. These results generalize the exponential statistical manifold and clarify some foundational issues in non-parametric information geometry.     

Utilizing structural family therapy and systems theory in the business world

The structure of businesses and the structure of families are very similar, considering the fact that so many businesses are owned or operated by families. Structural family therapists who are knowledgeable in systems theory and have an adequate understanding of the underlying concepts of structural family theory (including hierarchy, boundaries, and coalitions) can translate their knowledge to the structure of businesses and organizations. The purpose of this paper is to illustrate the similarities between the structures of families and businesses. In doing so, an application of structural family theory to the business world (employee assistance programs, business consultation, and family businesses) will be demonstrated.     

学习不良儿童的家庭心理环境,父母教养方式及其与社会性发展的关系

从２３０８名１０—１５岁儿童中选取４２９名被试的研究结果表明．一般儿童的家庭心理环境、父母教养方式大大优于学习不良儿童,这些家庭资源与学习不良儿童的社会交往、自我概念和社会行为等有着密切的联系,说明家庭心理环境、父母教养方式对学习不良儿童社会性发展产生着重要作用。     

Divorce mediation: the impact of mediation on the psychological well‐being of children and parents

This study evaluated levels of psychological distress experienced by children (aged 4–16) and parents at the beginning of and one month after mediation for child‐related disputes. In contrast to previous research, this study employed both child‐ and parent‐reports of child outcome. Mediation was associated with reductions in child‐reported, though not parent‐reported, child psychological distress and with reductions in parent‐reports of their own psychological distress. The negotiation of successful agreements in mediation was not related to improved psychological well‐being of family members. The difficulties encountered (i.e. small numbers, low response rate) render the results tentative. Implications of the findings for future research are discussed. Copyright © 1999 John Wiley & Sons, Ltd.     

“Not with me you don't”: A story of narrative practice and dissociative disorder

This paper discusses issues relating to therapeutic practice based upon the narrative metaphor. A case of someone suffering the effects of Dissociative Identity disorder is used to illustrate the difficulties that clients can experience with the “expert” knowledge conception of therapy. The value of the “respectful” and “non-expert” emphasis of Narrative Practice emerges even when the therapist believes that he or she lacks expertise in the client's apparent “condition.” Three themes emanating from the case form the basis for the discussion: the client's experience of being recruited into accepting the diagnostic label of Dissociative Identity Disorder; the effects of being forced to accept a contract to eliminate self-abusive behaviour; and the therapist's dealing with a gun in the therapy room.     

Art in existential psychotherapy with couples and families

The authors describe and outline how art can be used in existential psychotherapy to help a couple or family uncover, discover, and make use of the meanings and meaning potentials to be found in marital and family life. In existential psychotherapy with couples and families, art can be used to help the members of the relationship notice meaning potentials in the future, honor meaning potentials that have been actualized and deposited in the past, and discover new ways to actualize meaning potentials in the here and now.     

Analysis of long-term stress reactions in emergency room patients: An initial study

The psychological stress reactions of 44 family medicine patients who were treated in the emergency room were examined approximately a year after the event. Patients were assessed on several psychological measures, including one for posttraumatic stress disorder (PTSD), and on their perception of how stressful the event was initially and now. Results show continuing stress reactions related to the emergency room event. Three patients endorsed symptoms indicating full PTSD and 13 appeared to have at least partial PTSD. Age appeared to be a factor in the presence of stress symptoms and in degree of perceived communication with the physician.     

Argumentation and Evidence

This essay explores the role of informal logicand its application in the context of currentdebates regarding evidence-based medicine. This aim is achieved through a discussion ofthe goals and objectives of evidence-basedmedicine and a review of the criticisms raisedagainst evidence-based medicine. Thecontributions to informal logic by StephenToulmin and Douglas Walton are explicated andtheir relevance for evidence-based medicine isdiscussed in relation to a common clinicalscenario: hypertension management. This essayconcludes with a discussion on the relationshipbetween clinical reasoning, rationality, andevidence. It is argued that informal logic hasthe virtue of bringing explicitness to the roleof evidence in clinical reasoning, and bringssensitivity to understanding the role ofdialogical context in the need for evidence inclinical decision making.