"以病人为中心"医疗服务模式的理念与发展

纵观20世纪医疗服务的发展历程,医疗服务的发展经历了“以疾病为中心”的传统医疗服务模式到“以病人为中心”的新的医疗服务模式的转变;目前,以“以病人为中心”的医疗服务模式已经成为我国现代医院改革与发展的主题。因此,在阐述医疗服务模式变革与发展的基础上,系统论述了“以病人为中心”的医疗服务模式的内涵与特点,新的理念、新的认识,也带来了新的希望,新的医疗服务模式将不断地改善与提高人们的健康状况与生活质量。     

When religion may be an ethical issue

Though Americans are a religious people, there are times when religion or religious views may confound the ethical process. This article claims that religious values may be expressed as either principles or narratives, then seeks to establish a case for dealing with religious claims as principled narratives. Methods of evaluation are explored and then seven guidelines are offered for dealing with religion in ethics consultations.     

Speaking for Ourselves: Feminist Methods and Community Psychology

Although feminist and community psychology share a number of epistemological and methodological perspectives that guide their respective theories and research practices, it has been argued that community psychology has not fully integrated a feminist perspective into the discipline. This paper examines how community psychology and feminist research methods might combine to help us better understand women's experiences without essentializing or universalizing those experiences. The authors offer a series of suggested directions for feminist research that may also prove promising for community psychology. Particular attention is paid to feminist social constructionist approaches insofar as they address the complex relationship between epistemology and methodology.     

The Client Is the Most Important Common Factor: Clients' Self-Healing Capacities and Psychotherapy

I first briefly review the dodo bird verdict and suggest that we should be responding to it by looking for a new way to conceptualize how therapy works. Then I describe the dominant medical or treatment model of psychotherapy and how it puts the client in the position of a dependent variable who is operated on by supposedly potent therapeutic techniques. Next I argue that the data do not fit with this model. An alternative model is that the client is the most important common factor and that it is clients' self-healing capacities which make therapy work. I then argue that therapy has two phases—the involvement phase and the learning phase—and that the involvement phase is the most important. I next review the five learning opportunities provided by therapy. Finally, I argue that a relational model of therapy focused on consultation, collaboration, and dialogue is better than a treatment model.     

社会因素对剖宫产率的影响

近二三十年来,剖宫产率在世界范围内不断升高。究其原因,除了医学因素外,社会因素起着重要作用,从社会经济发展,社会科学文化水平、社会习俗观念、法律、医疗道德、国家计划生育政策、医学教育等多个角度分析了社会因素对剖宫产率的影响,并就如何发挥社会因素的积极作用,消除和避免其消极作用,使剖部率维持在合理的范围内进行了讨论。     

The Meaning vs. The Medical Model in the Empirically Supported Treatment Program: A Consideration of The Empirical Evidence

A review of the debate on the Empirically Supported Treatment Program is presented. It is argued that underlying the specifics of the debate are fundamentally incompatible paradigms: a meaning vs. a medical model. The findings from two gold standard multi-site studies are reviewed to conclude that the control condition meets requirements for an empirically supported treatment. The empirical finding of the failure of clinical training to improve treatment outcomes is explained by the focus on rational factors in training. It is recommended that training of therapists focus on enhancing experiential capacity rather than mastery of manualized treatment approaches.     

Community Science: Creating an Alternative Place to Stand?

This article comments on two emerging views of community psychologys approaches to the use of research for responding to social problems in contemporary community contexts – (a) the formation of a new field of community science, or (b) the updating of community psychology research traditions. If community science is to become established as a field related to community psychology, its proponents will need to agree upon conventions of epistemology, foci of interest, methods, and standards by which its work can be judged so that it can be distinguished from other human sciences. These articles provide early sketches for what community science might be. However, as noted in this commentary, we need to heed signs of concern about community psychologys continued relevance in public discourse regarding the analysis of and responses to social problems. While this special issue offers some promising responses to the concern of what the field can contribute, the field would be well served if we broaden our dialogue about a renewal of community psychologys commitment to social justice and the need for its perspectives in the practice of research that seeks to address community-based issues in the early 21st century.