医患智能交流的分类、利弊与优化策略研究

从服务过程、交互工具、应用场景三个视角,阐释不同表现形式下的智能化医患交流。可以看出,相较于传统模式,医患智能交流表现得更加灵活和多样化、更加绿色高效、更加以患者为中心,并能够带动患者共同参与决策。但是,智能技术的应用也凸显出很多弊端,如较弱的共情能力容易让医患关系降温,难以分辨的虚假信息容易破坏医患信任,医学伦理风险增加。针对以上问题,建议从转变临床决策的模式、医患共同营造数字共情、提升医患的数字健康信息素养、保障信息安全四方面来加以完善。

     

Authentic leadership,followership, and psychological capital as antecedents of work engagement

The present study investigated authentic leadership, psychological capital, and followership behaviour influences on work engagement of employees. Respondents were 901 South African employees within the healthcare industry organisation (n = 647) and mining industry (n = 254). The employees completed questionnaires on authentic leadership, psychological capital, and followership behaviour, and work engagement. Results following structural equation modelling and mediation analysis suggest work engagement to be explained by the psychological capital of the employee rather than by authentic leadership qualities. Improving employee psychological capital has the potential to enhance the levels of work engagement of employees.     

患者参与患者安全的国内外研究分析

患者是患者安全的主体和核心,保证患者安全,不仅是医护人员和医疗机构的责任,同时需要患者的参与。自1999年美国医学研究院发表了《孰能无错,构建更为安全的卫生保健体系》报告后,患者安全首次成为学术组织、公众媒体关注的焦点,其相关研究如雨后春笋般涌现,包括患者参与患者安全的研究。     

Interaction effects among multiple job demands: an examination of healthcare workers across different contexts

Background and Objectives: Simultaneous exposure to time, cognitive, and emotional demands is a feature of the work environment for healthcare workers, yet effects of these common stressors in combination are not well established. Design: Survey data were collected from 125 hospital employees (Sample 1, Study 1), 93 ambulance service employees (Sample 2, Study 1), and 380 aged care/disability workers (Study 2). Methods: Hierarchical multiple regressions were conducted. Results: In Sample 1, high cognitive demand exacerbated high emotional demand on psychological strain and job burnout, whereas the negative effect of high emotional demand was not present at low cognitive demand. In Sample 2, a similar pattern between emotional demand and time demand on stress-remedial intentions was observed. In Study 2, emotional demand?×?time demand and time demand?×?cognitive demand interactions again revealed that high levels of two demands were stress-exacerbating and low levels of one demand neutralized the other. A three-way interaction on job satisfaction showed the negative impact of emotional demand was exacerbated when both time and cognitive demands were high, creating a “triple disadvantage” of job demands. Conclusions: The results demonstrate that reducing some job demands helps attenuate the stressful effects of other job demands on different employee outcomes.     

河南省医疗改革的公平性分析

河南省医疗改革突出的难题在于如何实现保健资源的公平公正.影响河南医疗改革公平的因素是产权改制的方向偏差,道德异乡人的利益博弈,资本和技术对医学的剥蚀,医学、医疗自身发展的失衡.实现医疗改革公平的对策建议是显化政府责任伦理,重建医患利益共同体,整合优化卫生资源的配置,推行医学整体化的发展模式.     

Orthodox Christian Healthcare Ministry amidst the Tensions of Ecumenism

The paradoxes of globalization and the efforts toward the establishmentof a consolidated healthcare ministry have caused tensions whileaffording the possibility for true ecumenical dialogue. As today'ssocieties become more pluralistic, Orthodox Christian healthcareministry finds itself amongst these paradoxes and tensions.The content of Orthodox healthcare chaplaincy, which is centeredin its Eucharistic expression, maintains a sense of catholicityand unity. This though differs from a "psychological" understandingof pastoral care, which has developed. Therefore, there is aquestion of the chaplain's identity, a crisis of theology andecclesiology, which must be faced so that true unity can beattained. This article explains the content of Orthodox healthcarechaplaincy and addresses the issues of pastoral identity, theologyand psychology, together with the crisis of ecclesiology. Itis written with a true agony for unity.     

Interactive effects of self-concept and social context on perceived cohesion in intensive care nursing

Group cohesion is critical in the workplace, especially when individual and contextual constraints coexist but high performance is essential. We assess the source of variation in group members' perceptions of cohesion. Using an interactional psychology perspective, and within the context of intensive care, this study examines the interactive effects of nurses' self-concept and the objective social context within which they are embedded. Individual- and unit-level factors are investigated because they jointly shape the degree to which nurses perceive their intensive care units as cohesive. A multisource, multilevel study of approximately 140 nurses employed in 20 units across Denmark demonstrates the role self-concept plays in easing and enhancing the constraints workplaces impose on cohesion. Implications for research on emergent states and interactional psychology are discussed.     

新时期我国农村卫生服务体系的路径选择

解决好占中国人口将近70%的农民的健康问题,是全面建设小康社会中非常重要的问题。如何完善现有的卫生服务体系、构建真正惠及全体农业人口的卫生服务体系又是农村卫生事业发展的重中之重。试从制度经济学的角度出发,探讨新时期我国农村卫生服务体系的路径选择。     

Situating Standards in Practices: Multi Drug-Resistant Tuberculosis Treatment in India

Public health care needs to cope with a basic dilemma between providing standardized care within public programmes across entire and at times resource-constrained countries and adapting this care locally when responding to individual needs. This tension between standardization and local adaptation becomes particularly obvious for the prolonged and complicated treatment of multidrug-resistant tuberculosis (MDR-TB). Situated standardization, as introduced by Zuiderent-Jerak [2007a, 2007b] offers a way out of this dilemma. It helps to focus on how standards need to be situated in practice rather than viewing standardization and local adaptation as mutually exclusive practices. How do actors relate standardization and individual care in their practices of treating MDR-TB? Results from qualitative fieldwork at the first MDR-TB treatment sites of the Indian TB programme show that actors situate standards in a particular way. They assess the role of guidelines in a particular situation and on that basis recognize the core recommendations of guidelines or go beyond the guidelines. This allows actors to negotiate how standards should be situated and reconciles the dilemma between local adaptation and standardization. Having guidelines internalized, as is common for Indian TB control, bears both promises and pitfalls for engaging in standardization processes in a situated manner. The results contribute to science and technology study scholarship on guideline development. They highlight how actors coordinate the situating of standards and how this depends upon cultures of control. This illustrates the potential of qualitative studies on local adaptation for guideline developers by revealing existing practices of relating and negotiating local adaptation and standardization.