放弃治疗后，以护理为主导的医学服务和人文关怀

剖析放弃治疗后死亡病案508例,分析放弃治疗的原因、疾病和形式,放弃治疗后护理工作存在的问题。提出在放弃治疗后,临床护理决策：对于护理工作发生的变化,应该提高认识,培养护理人员人文素质和法律意识,应该加强护理管理和规范,放弃治疗后,护理应该承担医学服务和人文关怀的主导作用。     

广州市14种常见疾病门诊就诊时间定量分析

为了确定常见疾病的合理就诊时间,本文对广州市区县级医院和社区机构的门诊就诊时间进行了调查,结果分别是9.46分钟和5.92分钟,并进一步分析发现门诊就诊时间的长短与机构级别和病种有关,且前者的影响显著高于后者。医院管理者应科学合理地确定门诊就诊时间。     

“疑难杂症”与医学模式

那些长期困扰患者和医生、查不出病因又久治不愈的病症,被称为“疑难杂症”;然而部分“疑难杂症”并非真正的疑难杂症,而是在诊治疾病的过程中所用医学模式出现了问题,医生往往局限于生物医学模式,忽略患者的心理、社会因素。因此,医学模式应该从实际工作中进行转变,而不能仅仅局限于理论上。笔者就临床常见的“怪”现象、医疗对象的复杂性...     

肿瘤临终关怀医疗对医疗资源需求和医患关系影响的初步研究

为了研究肿瘤患者临终的医疗需求和对医患关系的影响,我们收集肿瘤死亡病例,研究临终表现、治疗、住院时间及费用。乏力、纳差、咳嗽、疼痛是最痛苦的症状;末次住院平均天数为25．7日;末次住院人均医疗费用12946．428元。结果表明,临终患者治疗的重点是症状的改善,这能减轻患者的痛苦、营造和谐的医患关系。     

Fruits of Health; Roots of Despair: William James, Medical Materialism and the Evaluation of Religious Experience

In The Varieties of Religious Experience, William James introduces the term “medical materialism” to describe the fallacious attempt by some scientists to argue against the value of spiritual ideas. Two literary case studies will be considered for purposes of better understanding James’ idea. What’s more, it will be shown that, in addition to James’ three criteria for the appropriate evaluation of religious experience, there is another factor not made explicit, namely that of hopefulness. This factor serves to distinguish ordinary from pathological morbid-mindedness, the latter of which has no religious significance.Tadd Ruetenik teaches philosophy at Penn State Altoona. He received his Ph.D. from the English and Philosophy program at Purdue University. Correspondence to Tadd Ruetenik, tlr18@psu.edu.     

Dr. Mom? Conversational Play and the Submergence of Professional Status in Childbirth

Through a close analysis of various moments within two hours of video-taped interaction, we investigate properties of the setting that the participants cannot ignore even as they transform them in various ways. These properties are not under local control. What is under control is revealed in the participants' “play” with the properties, including dangerous, “deep” play. In this process, some properties of the participants are rarely mentioned (e.g., that the laboring woman is an MD), others are repeatedly emphasized (e.g. the strength of contractions). And others appear in ways that have not been dealt with adequately in current theoretical frameworks. To deal with life-threatening lies, and jokes about lies, we must move away from theories of hegemonic particularity that rely on a habitus. Rather we must acknowledge the practical understandings revealed in the collective submergence of that which may be actively noted as potentially relevant and then set aside so that other tasks can be foregrounded and achieved.     

病史采集和体格检查医学行为的人文思考

医务人员的言行都体现了一种职业精神,其医学行为在病患眼里是希望、责任、义务、信任、公正和平等以及等等。病史采集和体格检查是医生的基本功,而正是这项基本技能却随着临床检查仪器和设备的不断更新,正被越来越多的医生所轻视,“望、闻、问、切”正逐渐成为医学历史的痕迹。病史采集和体格检查既体现了一位医生的医疗技能,也蕴含着丰富的人文哲理,是医患相互信任、配合的出发点和归宿,是医生与患者交流和沟通的极其重要行之有效的手段,也是疾病诊治的基本条件和必备元素。     

干细胞移植技术离临床治疗应用到底还有多远

骨髓细胞移植是一种早期的干细胞移植性治疗方式.干细胞分离纯化技术的革命,尤其是干细胞移植在各种临床疾病治疗中近期疗效的不断报道促成了干细胞移植技术的推广迅猛发展.胚胎干细胞或成体干细胞如何分化形成指定的有恰当功能的组织器官一直是发育生物学家和干细胞移植科学家们关注的重大研究课题.实际上,干细胞移植治疗既存在理论性困惑,又存在技术性问题,因此干细胞移植技术的实际应用前途是光明的,但道路是曲折的.     

研究生临床技能测试制度与临床决策能力培养

医学研究生的生源不同、学制不同和培养方式等的差异,导致医学研究生毕业时的临床技能和临床决策能力参差不齐。建立医学毕业研究生临床技能测试制度,合理地评价医学研究生毕业时的实际临床能力,从而制定针对个体的临床技能培养方案,为快速培养和提高青年研究生的临床决策能力提供有力的措施。     

临床麻醉中知情同意的思考

临床麻醉工作中,尊重患者自主权是知情同意的基础,知情同意反映了患者自主权与医学干涉主义之间的相互妥协。在信任基础上的知情同意,是患者自主权的最佳体现,也是对医学干涉主义的尊重,从而为患者的利益提供服务。