Towards emotional containment for staff and patients: developing a Work Discussion group for play specialists in a paediatric ward

This paper describes the evolution of a staff Work Discussion group run by a child psychotherapist in a teaching hospital for more than 15 years. It offers insight into the emotional experience of both NHS staff and patients as seen through the lens of the discussion of the staff’s work. The author identifies three main stages in the evolution of this group, as trust and the feeling of a safe space gradually developed. The first stage was identifying and understanding the emotional experience of patients, through the use of observational skills and psychoanalytic concepts; the second emerged as staff began to include their own emotional experience in the narrative; the last stage saw a qualitative shift in the staff’s capacity to share the pain generated by the work, knowing about it through holding it in the group’s mind and being able to reflect on it, allowing them to process experience in a way that made the work more bearable – akin to Bion’s concept of ‘containment’. This evolution is illustrated with relevant vignettes in the light of some theoretical and historical considerations. The paper demonstrates the value of Work Discussion groups in terms of indirectly supporting hospitalised patients, as well as promoting staff’s resilience and professional capacities in difficult contexts.     

Elderly offenders in a maximum security mental hospital

Elderly offenders aged 60 and above constitute less than 8% of the population in a maximum security mental hospital. These offenders fall into 2 groups: 1) first admission at or after the age of 50 and 2) first admission before 50. Fewer first time offenders committed homicide in the first group than those in the second group. Neuropsychiatric disturbance and sex offending was common among male first time offenders in the first group; in contrast, schizophrenia and violent offending against persons was found more often in the second group. It is argued that elderly first time offenders should be given adequate neuropsychiatric assessment. © 1995 Wiley-Liss, Inc.     

对医院伦理委员会建设的几点认识

对20年来我国医院伦理委员会建设步伐不够大进行了反思,分析了存在的主要原因;阐述了对生物医学技术的实施进行伦理审查评价的必要性;对我国医院伦理委员会的建设提出展望,对医院伦理委员会工作发表了自己的认识。     

综合医院惊恐障碍高误诊率引发的思考

惊恐障碍是一种急性焦虑障碍,属精神医学研究范畴。但惊恐障碍患者却反复在综合性医院就诊。目前国内综合医院尤其是基层综合医院普遍未设置精神科,非专科医生对惊恐障碍的识别率又非常低,误诊率甚至高达100%。作者就综合医院惊恐障碍高误诊率的原因、对策、展望与期待、较为理想的就医途径和治疗方法做一探讨。     

中国传统伦理对医院道德管理之贡献

随着经济的腾飞,儒家管理思想在文化、伦理道德层面上给予医院经营管理以深刻影响。在医院道德管理的建设中,中国传统儒家伦理起着重要的作用,“仁”是医院经营发展的中心,“义”是医院经营立足的根本,“礼”是医院经营成功的保证,“智”是医院经营腾飞的关键,“信”是医院经营兴旺的标志。     

大医院过度扩张与医疗行业的社会使命

大医院过度扩张已是不争的事实,加速了医疗资源的不合理分配,是造成看病贵的重要原因。医院自身有责任,主管部门与权威媒体实际上在鼓励大医院过度扩张。是医院社会使命重要,还是过度扩张重要,这是培育职业精神、践行社会使命必须做出的艰难抉择。     

医药收费政策调整对医院经济的影响及对策

通过分析医疗服务项目价格调整和药品价格调整对医院经济的影响,指出了新医疗收费政策在降低患者看病费用负担方面起到了一定作用,是值得肯定的。并探讨了在新收费政策下,医院该如何通过对医院管理和经营策略的调整来应对调价带来的不利影响,提高医院的经济效益。     

Abortion and Health Care Chaplaincy in Australia

This paper summarizes the results gained from quantitative and qualitative research involving 327 Australian health care chaplains with regard to their involvement in abortion issues within the health care context. The findings indicate that approximately 20% of surveyed chaplains had provided some form of pastoral intervention to patients and/or their families dealing with issues of abortion and that approximately 10% of chaplains had assisted clinical staff with issues concerning abortion. There was found to be no-statistically significant difference with regard to the number of catholic chaplains compared with protestant chaplains or staff chaplains compared with volunteer chaplains involved in abortion issues. Analysis using the WHO Pastoral Intervention codings highlighted a variety of issues encountered by chaplains and the non-judgmental pastoral care used by chaplains when assisting those dealing with abortion. Some implications of this study with respect to patient and clinical staff support are suggested. Dr. Lindsay Carey, M.App.Sc., Ph.D.: National Research Fellow, Australian Health & Welfare Chaplains Association & Faculty Associate, Palliative Care, School of Public Health, La Trobe University, Melbourne, Australia. Dr. Christopher Newell, AM, Ph.D.: Associate Professor, School of Medicine, University of Tasmania, Hobart, Australia.     

非识字高龄患者住院中的需求对策相关性研究

探讨患者的需求与对策。应用会谈法收集资料,教育患者认知所患疾病相关知识、帮助患者和家属适应住院环境、支持家属对患者的生活护理、缓解患者心理紧张情绪、协助患者遵从医疗护理服务行为、照顾患者口服用药过程、满足患者治疗过程中的需求、加强护理操作周边作业的督导,进而提出了满足需求对策的依据。