从权利意识的视角看实践患者知情同意的文化障碍

实现知情同意权是对患者自主权利的尊重,但患者知情同意权的实现遇到诸多的文化障碍,从权利意识的视角看,主要来自于中国的一元社会结构、儒家文化和法律文化传统对个人权利诉求的影响,只有培养和提高患者权利意识,增强主体性和自主性,消除文化障碍,才能真正落实知情同意权。     

Career barriers and reading ability as correlates of career aspirations and expectations of parents and their children

Data were obtained from 176 Year 7 children (mean age = 12.2 years) on career status aspirations and expectations, career barriers, academic engagement, academic control beliefs, general ability and literacy; and from parents, mainly mothers, on aspirations, expectations and career barriers. Discrepancy scores between aspirations and expectations were calculated for both children and parents. Children differed from parents on career status aspirations and expectations; boys did not differ from girls, and parents did not differentiate between boys and girls. Parents’ and children’s aspirations were both associated with reading ability, although the association was weak for the children. Children’s expectations were associated with perceptions of career barriers, and a trend towards reading abilities, while parents’ expectations were associated with general ability and reading.     

Ageism in Mental Health and Health Care: A Critical Review

Discussions of aging and mental health widely assume that ageism among mental health providers is an important factor limiting access to mental health services for older adults. Given the widespread citation of ageism as a problem, we critically review the history of the ageism construct, and evidence for its existence in both mental health and medical professionals. There is surprisingly little empirical evidence for age bias among mental health providers. Considerable evidence does suggest differential medical treatment for older adults in such diverse areas as physician–patient interaction, use of screening procedures, and treatment of varied medical problems, although it is unclear whether age bias accounts for these differences. We suggest that innovations in delivery of psychological services, such as collaborative medical/psychological care in primary care settings, may ultimately prove more useful in improving access to mental health services than efforts to combat ageism.     

Caring for Someone with Depression: Attitudes and Clinical Practices of Australian Mental Health Workers

Many people who support a person with depression report struggling with the carer role and being dissatisfied with the inclusivity and lack of support provided by clinicians. However, little is known about what influences the support provided to Australian carers of people with depression. To investigate this, 119 Australian mental health workers completed a self‐report questionnaire to gather information on their attitudes towards, barriers experienced and current clinical practices when working with carers of people with depression. Participants' attitudes towards family members and carers were generally positive. Reported inclusive clinical practices varied. Participants identified a number of barriers to inclusive practice that were predominantly organisational in nature. Participants who perceived more barriers reported providing more clinical interventions. Attitudes and barriers were associated with the inclusive clinical practice of participants who worked with mental health consumers, but not participants who worked with family members and carers. Even among this sample of self‐selecting clinicians, there was room for significant improvement in rates of carer inclusive practice. Further research should explore not only what inhibits but also what enables the participation of family members and carers in the care and treatment process for people with depression.     

Who uses services for homeless people? An investigation amongst people sleeping rough in London

From a sample of 389 homeless people in London, the characteristics of those who used services for homeless people are presented and the implications for service planning and delivery explored. Staff providing services for this client group need knowledge about drug use and the confidence to work effectively with homeless drug users. Copyright © 2002 John Wiley & Sons, Ltd.