基层医院年轻医生临床素质现状分析及培养对策

本文对基层医院年轻医生临床素质的现状进行分析,指出了文化层次、福利待遇、带教培养、质控意识、科研热情、人文修养和医疗环境等方面存在的缺陷和不足是导致基层医院年轻医生临床素质低的重要原因。同时呼吁政府加大投入和确保医疗环境安全,加强年轻医生政治思想教育,树立正确的人生观和良好的医德医风,具备良好的心理素质、较好的人文修养和过硬的沟通能力,强化质控意识,引导和培养年轻医生加强临床知识积累,掌握科学的思维方法,从而促进科研水平的提高。     

Conséquences d’une catastrophe naturelle touchant le lieu de travail sur l’épuisement professionnel : Le cas du personnel d’un hôpital gériatrique

The Hautmont tornado has occurred on august 03, 2008, in the North of France. It was caused major destructions in this town and particularly in this city hospital. A tornado is a major natural phenomenon that causes destructions and disasters. In the literature, natural disaster and their destructive consequences are associated with psycho-traumatic disorders, among which is posttraumatic stress. The purpose of this research was to study the psychological impact of this tornado on a particularly vulnerable population: employees of a hospital. Thirty eight employees were interviewed one year after the Tornado. The results of this study showed that this disaster had many psychological repercussions. Many cases of posttraumatic stress disorders and cases of burnout were present independently of job strain level.     

Mental Health Interventions in a General Hospital Following Terrorist Attacks

Abstract

Over three years of repeated terrorist attacks in Israel have shown that the victims suffering from acute stress syndromes constitute the bulk of the casualties. The large number of psychological victims presents an immediate problem of hospital surge capacity. The need for alleviating acute suffering and preventing chronic, disabling posttraumatic syndromes requires organizational and clinical skills. The article reviews deployment and intervention protocols for the treatment of victims and affected staff members in a general hospital setting.     

Coping through prayer: an empirical study in implicit religion concerning prayers for children in hospital

This study links two fields of empirical research. The first field (grounded in empirical theology) is concerned with ordinary prayer and that aspect of implicit religion discernable within explicit religious expressions. The second field (grounded in the psychology of religion) is concerned with private prayer as a significant method of coping in health-related contexts. Few previous studies, however, have focussed on the specific components comprising the content of such prayers and their concern for health issues relating to others, such as family and friends. The present study addresses this gap by employing the analytical framework for health and well-being devised previously in a content analysis of 583 prayers left in the chapel of a children's hospital in England. The conceptual and practical applications of the new research findings are discussed.     

努力避免肿瘤的过度化疗

化疗是肿瘤治疗的主要手段之一,在临床实践中发挥着十分重要的作用,但是其有明显的毒副作用,避免过度化疗是医疗的基本要求。临床过度化疗的原因与现行医疗管理与流程、医生的诊疗水平有关。近年来,人们对肿瘤生物学行为规律认识不断深入,更加注重个体化治疗,肿瘤治疗领域快速更新,因此对医疗决策水平也提出更高的要求。需要通过规范肿瘤诊疗流程、更新知识、积累经验、临床试验并结合我国国情,权衡利弊,使患者接受恰当治疗。     

Perceptions of health care social workers in Ontario: challenges and facilitators to reflective practice

Background: Reflective practice in health care social work ensures that social workers provide effective and efficient services to clients as well as maintaining their mental and physical health. In this study, we aim to determine how health care social workers engage in and describe reflective practice and challenges related to their reflective practice in their work in the health care system.

Methods: We used the Reflective Dialogue Rating Scale (RDRS) developed by Marion Bogo et al. to structure qualitative face-to-face interviews with 23 health care social workers employed in a hospital in a large urban area in Ontario, Canada.

Results: Findings illustrated that all participants regularly engaged in reflective practice in order to carry out everyday social work activities, promote ethical practice, and to enhance the provision of services to their clients. The social worker participants consistently agreed that as a profession they faced challenges maintaining their knowledge of current research due to few opportunities for professional development, workload competing with educational opportunities, and a work climate that is not conducive to gaining professional development, thereby challenging reflective practice. Supportive working environments include: peer supervision, safe and private spaces to talk to colleagues, a supportive supervisor, and an overall positive organizational culture.

Discussion and conclusion: Reflective practice is a key component in health care social work. All 23 social workers stated that they used reflective techniques (such as peer supervision and debriefing) to deal with their own reactions and operated in a purposeful and intentional manner to form therapeutic relationships with clients. As such, participants stated that lifelong learning was paramount in providing quality care to clients.     

Chronic Patients’ Autonomy in Iranian Hospitals: A Qualitative Study

The autonomy of chronic patients in Iranian hospitals is challenged by impaired functioning resulting from chronic illness, a negative image in society, and effects related to hospitalization. Comprehensive interviews and observations of 34 patients, nurses, and physicians were performed to assess the autonomy of chronic patients in Iran. Conceptualization, constant comparison, and the combination of data resulted in the identification of 5 main categories related to autonomy: welcoming paternalism, self-expression, self-proof, shared decision making, and self-determination. Authority scrambling was a central category describing chronic patients’ perceptions of their autonomy during hospitalization. These patients sought to maintain their independence despite serious threats to their autonomy.     

综合医院精神医学问题的认识

综合医院精神医学问题涉及面较广,主要是指除精神病外的各种心理障碍与心理应激相关疾病。患者就诊主诉多样化,就诊医院或专科繁多。提高对综合医院精神医学问题的识别能力对临床各科医务人员非常重要。本文对综合医院常见器质性和功能性精神疾病的临床特点、识别处理作一概述。     

L’équipe paramédicale à l’hôpital psychiatrique : Retentissement actuel d’une évolution de deux décennies Analyse d’un entretien de supervision

At the advent of the reform of nursing education in France, this study attempts to give an overview of changes in the work practices of nurses and the employment of nurse’s aides in psychiatric wards of hospitals. Based on the assumption that interaction acts as an interface between the individual on one side and collective systems on the other, the authors approach this issue by analyzing a supervisory meeting of a caregiving team in a psychiatric hospital.     

公立医院管理体制改革的经济学视角

在社会主义市场经济体制下,传统公立医院管理体制存在很多问题.探讨了公立医院管理体制改革所涉及的产权、政府举办的非营利医院之间的关系和处理方法、政府在医疗服务体系中的职责以及政府管理公立医院的形式等问题,提出了深化公立医院管理体制改革的方向和政策建议.