Affektive Interaktion zwischen Patienten und Therapeuten

Zusammenfassung Eine positive therapeutische Beziehung wird therapieschulenübergreifend als wichtige Voraussetzung für den Therapieerfolg angesehen. Meist wird jedoch in Studien lediglich die schriftliche Patienteneinschätzung erfasst. Nonverbale Aspekte der Interaktion zwischen Patienten und Therapeuten werden kaum untersucht. Aus einer Studie zur Vorhersage des Erfolgs stationärer Fokaltherapie werden affektive Interaktionsprozesse im Erstinterview exemplarisch zwischen einer erfolgreichen und einer nicht erfolgreichen Behandlung mit mikroanalytischen Verfahren (facial action coding system, FACS) verglichen. In der nicht erfolgreichen Therapie waren die mimischen Affektäußerungen reziprok; Therapeutin und Patientin zeigten ähnliche vorherrschende (sog. Leit-)Affekte. Erfolgreicher waren die Behandlungen, wenn die Therapeuten komplementäre Affektmuster zeigten. Implikationen für Behandlungstechnik, Supervision und Weiterbildung werden diskutiert.     

A formal framework for modelling the developmental course of competence and performance in the distance,speed, and time domain

The developmental course in the distance–speed–time domain is still a matter of debate. Traditional stage models are contested by theories of continuous development and adaptive thinking. In the present work, we introduce a formal framework for modelling the developmental course in this domain, grounding on Competence-based Knowledge Space Theory. This framework, as a more general case, widely includes assumptions and facets of previous models and covers empirical findings collected based on different experimental paradigms. By a distinction of latent competences and observable performance, model validation is not bound to a certain experimental paradigm and no one-to-one correspondence between competences and tasks is required. Therefore, the framework has the potential to bridge the gap between stage models and models of continuous development. The approach also precisely defines misconceptions, for example overgeneralization, and empirically investigates their occurrence. In the present work, we established a prototypical model for the development of understanding the distance–speed–time system. We extended this model with definitions based on different perspectives of overgeneralization. The assumptions of the model and its extensions were examined on the basis of the results of two empirical investigations using six judgment task types. The results yielded a reasonably good fit of model and data. No evidence was found for the occurrence of overgeneralization in this domain. The theoretical model and empirical results are discussed with respect to their relationship to other developmental models and theories.     

专科医生应注重整体性和系统思维训练——由一例甲亢患者门诊长期误诊引发的哲学思考

临床医学专科的发展对促进医学科学的进步起到了重要的推动作用,尽管它可能缺乏整体性、系统性临床思维,但在可预见的将来,它仍是综合性医院医疗实践的主旋律,医学界应对此有较为清醒的认识。本文从哲学的角度分析了造成误诊的原因,然后指出防止或减少误诊的途径是培养科学的临床思维,并提出了在临床过程中培养整体思维和系统性科学思维的一些方法。     

Analysis of the elements of attention: A neuropsychological approach

A model for conceptualizing the components or elements of attention is presented. The model substitutes for the diffuse and global concept of attention a group of four processes and links them to a putative system of cerebral structures. Data in support of the model are presented; they are derived from neuropsychological test scores obtained from two samples, the first consisting of 203 adult neuropsychiatric patients and normal control subjects, and the second, an epidemiologically-based sample of 435 elementary school children. Principal components analyses of test scores from these two populations yielded similar results: a set of independent elements of attention that are assayed by different tests. This work presents a heuristic for clinical research in which the measurement of attention is essential.     

基层医院口腔科如何构建和谐医患关系

基层医院口腔科容易引起医患纠纷,本文从基层医院口腔科以及口腔医生的角度谈谈如何构建和谐的医患关系。基层医院口腔医生要掌握扎实的专业理论知识和操作技能以及加强自身修养,并进行良好的医患沟通;基层医院口腔科要营造舒适的就医环境,合理收费,严格的消毒灭菌。构建和谐医患关系在口腔治疗中的起重要作用。     

制度伦理与我国社会转型期医患关系

我国社会转型期中出现的诸多医患利益冲突向人们提出了严峻挑战,亟需对其加以调节和平衡.这种调节与平衡,不能完全甚至不能主要地交由市场去运作,不能完全任凭医患双方自由地去博弈;政府必须明确并履行自己的职责,为正确调节与平衡社会转型期的医患利益创立一个全方位的合理的框架.     

我国人体器官移植的社会支持系统研究

供体来源不足严重制约了我国器官移植事业的发展。有鉴于此,建立一个非技术的人体器官移植的社会支持系统对促进我国器官移植事业的发展将具有重要意义。通过对该系统各组成部分如法律法规系统、组织管理系统、宣传教育系统、补偿系统的研究,旨在对我国器官移植事业的发展有所裨益。     

案例教学与医学伦理学教育

案例教学已经成为普遍的方法在我国各医学院校的医学伦理学教学中广泛使用,案例教学作为一种方法,如何客观地看待它,需结合医学伦理学教育的目的和内容。案例教学具有增加互动、加深理解和提高分析能力等优点,但如果驾驭不好,也会暴露一些弱点,而起到反作用。试图还案例教学法于医学伦理学教育的本来位置。     

中国古代医德教育对现代医学生医德教育的启示

医德医风已成为全社会普遍关注的焦点,特殊职业要求医务工作者应具有高尚的医德,而高尚医德的培养应从医学生教育阶段开始,努力提高医学生的医德素养。我国传统的医德教育方法,如医学生人品的选拔,老师言传身教,徒弟满师传统等等对于培养现代医学生关爱病人、救死扶伤的医德风范仍具有积极的借鉴意义。     

东西方医学伦理思维之共通性

从中国古代医者的行医事迹、著作来探寻中国的医者是否在行医过程当中勤守医者的本份,也即类似原则思维的表现。虽然中国古代并没有"医学伦理"这个名词,但从历代具有代表性之医者身上发现,其实在中国古代医者的行医事迹当中,就表现出类似的医学伦理情操。因之,医学伦理原则是俱普世价值的,也即世界上有所谓的共同道德存在。