医师数字专业精神的研究热点与启示——基于CiteSpace的可视化分析

为深入了解医师数字专业精神的研究现状、热点及发展趋势,运用CiteSpace软件对 Web of Science核心合集数据库建库至2023年3月所收录的386篇相关文献进行可视化分析。结果显示,美国、英国、澳大利亚是该领域影响力最大的国家,高等院校是目前的主要研究机构。当下的研究热点主要包括医师数字专业精神的内涵、现状和影响,以及医师数字专业精神的培育。未来的研究应纳入患者、家属、公众等更多人群的观点,关注医师数字专业精神内涵的动态演变,完善医师数字专业精神的评价体系,并通过在校教育、继续教育等多种途径加强医师数字专业精神的培养。

     

电子健康素养研究热点及发展趋势的可视化分析

通过检索中国知网、万方、维普、中国生物医学文献服务系统和Web of Science核心合集数据库建库至2023年12月发表的电子健康素养的相关文献,应用CiteSpace 6.2.R4软件进行关键词共现、聚类和突现分析。发文量总体呈持续上升趋势,但国内发文量较国外有较大差距。研究热点和趋势集中在移动医疗、慢性病患者电子健康素养、中青年学生群体电子健康素养、公共卫生事件等方面。我国可借助国际研究热点及前沿拓展研究思路,加大对该领域的关注,促进我国电子健康素养领域的不断创新和发展,提升全民电子健康素养。     

运气平等主义与吸烟者的健康责任

作为一种以责任为导向的分配正义理论,运气平等主义主张吸烟者应自行承担自愿选择吸烟而造成的医疗成本责任,否则会对其他人不公平。吸烟者健康责任论虽然在道德直觉上极具吸引力,但却面临实践上的困难。以前瞻性责任为依据的事前投保或征税方案,可能遭遇道德风险或不能精准锁定目标人群等问题。以追溯性责任为依据的“罚当其责”方案,可能面临认识论或医学伦理等问题。从次优角度来看,以激励和预防为主的前瞻性责任比以指责和惩罚为主的追溯性责任更能产生促进健康的效果。     

医学伦理落实临床实践的理论进路思考——一次学术会议中学者们的声音

医学伦理学理论付诸实践时,面临诸多深层次伦理问题,这些问题影响医学伦理学理论的落实与落地。2024年7月6日,在山西晋中召开“医学伦理学实践中的前沿问题”学术会议,与会学者们认为,关注个人伦理向整体伦理研究范式的转变、关注“伦理决策”中的情与境、重视伦理效应和责任伦理研究转向、探索医疗实践中伦理冲突的解决之道、克服医学伦理学教学与实践的脱离问题五大议题是当前医学伦理学研究应关注的重点问题,对医学伦理学理论研究进路的深度思考有助于切实解决临床实践问题,拓宽道德主义立场解决问题的视域,促进医学伦理落地临床。     

医联体背景下分级诊疗的难点与对策

自主选择的就医模式使得大多数患者选择三级医院首诊,三甲医院承担了不应该的轻症、常见病诊治。我国医联体服务模式探索较早,也是分级诊疗制度的重要载体。分析医联体与分级诊疗的关系,结合本单位在医联体建设中的遇到的实际问题,分析认为目前分级诊疗中存在办医主体利益难协调、下转动力不足、基层能力不足、转诊系统信息化建设不完善的问题,提出紧密合作、完善流程、加强引导、发挥基层特色,提高分级诊疗制度的实施力度。

     

Stressors, Quality of the Child–Caregiver Relationship, and Children's Mental Health Problems After Parental Death: The Mediating Role of Self-System Beliefs

Investigated whether three self-system beliefs, fear of abandonment, coping efficacy, and self-esteem, mediated the relations of stressors and caregiver–child relationship quality with concurrent and prospective internalizing and externalizing problems in a sample of children who had experienced parental death in the previous 2.5 years. The cross-sectional sample consisted of 340 children ages 7–16 and their surviving parent/current caregiver; the longitudinal analyses employed a subset of this sample that consisted of 100 children and their parents/caregivers who were assessed at three time points. A multirater, multimethod measure of caregiver–child relationship quality and a multirater measure of children's mental health problems were used. The cross-sectional model supported a mediational relation for fear of abandonment, coping efficacy, and self-esteem. The three-wave longitudinal model showed that fear of abandonment at Time 2 mediated the relation between stressors at Time 1 and internalizing and externalizing problems at Time 3. Implications of these findings for understanding the development of mental health problems in parentally bereaved children and designing interventions for this at-risk group are discussed.

On being mindful,emotionally aware,and more resilient: Longitudinal pilot study of police recruits

Police officers are at particular risk of stress when compared to people in other occupational groups. A compounding factor is that police are prone to the use of avoidant coping strategies when attempting to deal with this stress. Evidence suggests that “anti‐avoidance” strategies, of acceptance, mindfulness and emotional awareness, are more effective ways of coping, and are linked to both mental health and personal effectiveness. This study followed 60 trainee police officers from the recruit phase into the workplace to determine if these processes predicted more positive mental health and wellbeing in police recruits after 1 year of service. Mindfulness predicted depression at follow‐up, while emotion identification skill predicted general mental health. These results suggest that police officers and police organisations may benefit from interventions aimed at developing and promoting mindfulness and emotion identification.     

Underlying correlation structures of parental stress, general health and anxiety

A partial least square regression (PLSR) was performed on the Swedish Parenthood Stress Questionnaire (SPSQ) sum score and subscales on incompetence, role restriction, social isolation, spouse relationship and health problems, using 42 items from the General Health Questionnaire (GHQ) and 20 items from the State Anxiety Inventory (STAI-X1). The dataset contained 227 fathers and 301 mothers of children aged 1.0-6.6 years from a population-based study on parental psychological distress in the general Norwegian population, and all items correlated positively with SPSQ. Subscales on spouse relationship, incompetence, social isolation and role restriction related to items on state anxiety and depression. The SPSQ subscale on health problems related to GHQ items on somatic symptoms and social dysfunction. The STAI-X1 item "not feeling rested" had a particularly important effect on parental stress. Underlying correlation structures between parental stress and items from STAI-X1 and GHQ were explored, but only the SPSQ sum score could be acceptably predicted. PLSR as a statistical methodology was found useful for health and psychometric data.     

大学生对心理健康必备能力的认知

本研究以200名大学生为被试,以访谈及问卷的方式对大学生心理健康必备能力的认知进行了调查研究,并建立了大学生心理健康必备能力认知结构模型,结果表明:大学生所认知的自己心理健康必备能力由自我调控、社会应对、学习和人际交往这四个方面的能力组成,它们彼此独立,但又相互关联。