Nature,extent, and causes of bullying among personality‐disordered patients in a high‐secure hospital

The present study explored the perceptions and experiences of the nature, extent and causes of bullying among personality‐disordered patients, with a subsidiary aim of exploring differences in perceptions between staff and patients. The sample was selected from the Personality Disorder Unit of a high secure hospital. The total sample consisted of 60 participants, 30 patients and 30 staff. Participants engaged in a semi‐structured interview based on that developed by Brookes [1993] and modified by Ireland and Archer [1996] and Ireland [2002a]. The interview assessed their perceptions and experiences of patient‐to‐patient bullying. One fifth of patients and staff reported that they had seen a patient being bullied in the previous week. One‐fifth of patients reported that they had been bullied in the previous week and less than one tenth reported that they had bullied others. The most frequent types of bullying reported were theft‐related, verbal abuse, being made to do chores, physical assaults and intimidation. One fifth of the sample reported that sexual abuse took place. Victims were generally perceived to be ‘easy targets’ that were vulnerable, either physically or emotionally. Staff identified a wider range of victim types than patients. The results highlight how patient‐to‐patient bullying does occur and is an important issue worthy of further research. A number of similarities were found between the current findings and those of prison‐based research suggesting that both hospitals and prisons share a number of environmental similarities that help to explain why bullying takes placed in secure forensic settings. Aggr. Behav. 30:229–242, 2004. © 2004 Wiley‐Liss, Inc.     

从医生和医院角度透视医患关系

医患关系一直以来都是临床医学实践的核心问题和基础,受多因素影响,包括患者、医生(医院)和社会.在医患关系不和谐的今天,如何以系统论方法,从医生和医院角度分析制约医患关系健康发展症结,是每个医生和医院管理者需认真思考和对待的问题.而发扬人文主义精神,坚持"以病人为中心"理念,是医生和医院缓解日益加剧的医患矛盾,从根本上改善医患关系的前提.     

从突发公共卫生事件透视医院感染控制

通过突发公共卫生事件来审视目前我国医院感染管理工作中存在的一系列问题并提出了相应对策.     

大型综合性医院手术室统筹及加快周转的措施

科学的统筹规划、紧凑有序的接台管理,能够更好地服务患者,提高医院工作效率。探索大型综合性医院手术室合理有效地安排手术、加快手术周转的措施。讨论如何有效利用手术室的物资和人力资源,进行全盘科学的筹划,抓住关键环节,合理安排工序。进而成功破除制约手术科室的瓶颈,大大提高了手术科室的效率。     

论医院实行单病种限价的伦理学价值

从单病种限价在医院内部管理机制等方面的作用出发,探讨了实施单病种限价的伦理价值基础和伦理学意义。认为单病种限价政策能促使医院形成“以人为本”的管理理念,切实维护患者利益,培养医务人员的医德素质,促使医院重视德源资产和品牌形象的建设,强化医务人员精益求精的科学精神,取信于民并帮助医院树立诚信的道德形象,是医院可持续发展的可取途径。     

大型教学医院应加强肿瘤疾病数据库的建设

建立恶性肿瘤疾病数据库（carcinoma cases database,CCD）来管理肿瘤患者的临床资料是临床医学信息化、现代化的迫切要求和必然趋势。大型教学医院应充分利用资源优势,遵循可行性、实用性原则,加强CCD的建设,以实现对肿瘤病人临床资料规范、系统、便捷的管理,更好地开展临床、教学和科研工作,评估肿瘤疾病的疗效及完善病例的随访追踪。     

医院药师应提供全方位药学服务

药品是一种特殊商品,直接关系到广大人民群众生命健康。近年来,随着我国医疗体制改革的深入进行,人们健康意识和法律意识得到了普遍提高。为了更好地体现以“病人为中心”的服务理念,提高患者用药的安全性和有效性,提高患者的生活质量,需要我们医院药师不断实践与探索,为临床提供全方位的药学服务。     

我国医院法人治理结构改革的探索

从分析我国医院法人治理结构模式入手,深入探索了医院法人治理结构中存在的问题,介绍和探讨我国产权和所有权改革的形式,并对上海和无锡的法人治理结构改革做了较详细的介绍,为探索我国医院建立适应市场经济体制的体制与机制提供借鉴和参考。     

第五讲灵敏度分析在临床决策中的应用

通常情况下,在临床上由于病人病情的复杂性,医生在处理病人时要承受一定的风险,此时医生所做出的决策就是风险性型决策.风险型决策之所以有风险,是因为决策所依据的主要参数中,存在不确定性(即概率性)的参数,如果这些参数发生一点变化,或估计时不够准确,有一点出入又会产生怎样的结果呢?这时决策方案还如以前一样稳定吗?因此,应该对决策方案的稳定性进行分析和估计.这时所作的分析和估计就是灵敏度分析.     

加强医学伦理学教育指导医疗实践

通过对五所医院医务人员和两所医科大学的学生从医学伦理学教育和伦理培训等四方面进行现场调查和分析,提出目前在医科大学,医学伦理学已经逐步被认识和接受;医学伦理在临床实践和医疗科研中已有较大的影响;医学伦理委员会的工作需要进一步加强;医学伦理教育任重道远.