社区卫生服务在医疗体制改革中的作用和地位—英国的经验与教训

社区卫生服务通过六位一体的服务可以合理疏导医疗服务需求,解决医疗服务的公平性和合理控制医疗费用增长过快,在医疗体制改革中扮演着制约医院服务的重要角色。没有社区卫生服务组织和全科医生的积极参与和强有力的制约,医疗市场很难形成有效的竞争,医疗体制改革的初衷就很难实现。英国在该方面的经验与教训,足以引起起我们的关注与警惕,结合中国国情来借鉴,渴望我国在该方面的发展更趋稳定和合理。     

Evaluating the effectiveness of counselling in primary care: Taking a fresh look

One criticism voiced by counsellors and psychotherapists is that research does not reflect either the culture or values of therapy. Researchers, on the other hand, accuse practitioners of not attending to their findings, and the implication is made that the latter engage in treatment processes that are ill‐informed. These polarised understandings give rise to the situation where the client — and his or her development — fall into the practice‐research gap. In more recent studies of counselling in primary care, an attempt has been made to offer new perspectives for interpreting and understanding findings, and the relative value — and limitations — of different research questions and methods. They provide just a few examples of how practitioner‐researchers in the future may ask more precise questions, yet reflect on their findings from a broader set of viewpoints.     

Behavior Problems, Academic Skill Delays and School Failure Among School-Aged Children in Foster Care: Their Relationship to Placement Characteristics

We describe the level of behavior problems, academic skill delays, and school failure among school-aged children in foster care. We also examine how behavior problems are associated with academic problems, and explore how these outcomes are related to children's placement characteristics. Foster parent and child home interviews, as well as teacher telephone interviews were conducted from a randomly selected sample of 302 children aged 6 through 12 years living in out-of-home placement. Interviews included standardized screening measures. Results showed that 27% of the children scored in the clinical range for a behavior problem, and 34% were rated as having at least one behavior problem in the classroom. Twenty-three percent of the children had severe delays in reading or math, 13% had repeated a grade, and 14% had a history of school suspension and/or expulsion. Behavior problems by foster parent report were related to child suspension and/or expulsion from school, but were not associated with severe academic delays or grade retention. Placement characteristics were only sometimes related to these outcomes. Future studies examining the mental health and educational needs of this population should take into account the child's sociodemographic and placement characteristics.     

We are not a Healthcare Business: Our Inadvertent Vow of Poverty

Psychology has been fractionated from mainstream healthcare delivery and this schism has resulted in huge costs to psychologists and our intended customers. Psychology has also been naïve economically. The authors suggest three revolutions: (1) for clinical psychology to be better integrated into the healthcare delivery system; (2) for psychologists to better understand healthcare economics and business; and (3) for psychologists to become more entrepreneurial, i.e., see needs in healthcare (such as those of the elderly, obesity, improved access and value through ehealth) and systematically fill these. We note high quality businesses help many individuals (customers, family members, employees) not typically recognized by anti-business psychologists.     

Models of Psychotherapy: Implications for Pastoral Care Practice

Pastoral care givers are called to provide care and counseling to parishioners that are suffering in many ways. A core question is what does a pastor rely on to provide this care? Pastors usually call on models of psychotherapy to inform their care giving. A framework of theological anthropology, cosmology, soteriology and harmatiology is developed for analyzing the worldviews inherent in models of psychotherapy. The specific models of Adler’s Individual Psychology, Narrative therapy, Horney’s personality theory, and Intersubjective theory are used to demonstrate the application of this framework. Several pastoral care implications are developed following the application of the framework.     

宫腔镜对不典型滋养细胞肿瘤辅助诊断的哲学观

滋养细胞肿瘤恶性程度高,破坏力极强,但是对化疗高度敏感,所以早期诊断和及时化疗是治疗成功的关键。本文初步探讨了宫腔镜作为一种对不典型滋养细胞肿瘤的辅助检查手段,有助于早期明确诊断,提示我们在运用宫腔镜的过程中应该遵循个体化原则,在循证医学的指导下,充分体现对病患的人文关怀。     

医院药学服务与人文关怀

医院药学服务是医院医疗服务中的重要组成部分,药师在医院人文服务中起着重要作用。本文阐述了人文关怀在医院药学服务中的实施,指出药师在日常工作中的每个环节都要为患者提供充满人文关怀的服务,并指出了现在医院药学服务的人文关怀中存在的困难及解决办法。     

宫颈癌普查与人文关怀

随着不育症患者的不断增多,不育症治疗技术的迅速发展及医学模式的转化,在不育症临床诊疗中应树立人文关怀的理念,强化人性化服务的意识。在工作中应遵循患者第一的原则并恪守心身统一原则、保密原则、最优化原则、知情同意等原则。在治疗过程对患者同情、鼓励以及进行心理治疗,体现人文关怀,构建和谐的诊疗气氛。     

抑郁症的概念及分类研究历史

宫颈癌的发病率居女性恶性肿瘤的第二位,只要做到早发现、早诊断、早治疗,宫颈癌是一种可以预防和治愈的疾病。认真地做好宫颈癌的普查和随诊,能够降低宫颈癌的发病率和病死率。因为宫颈液基细胞学设备简单,方法便利,阳性检出率高,目前已成为基层医疗单位开展宫颈癌普查的重要手段。提倡宫颈癌的普查是对全社会育龄妇女健康的关怀,是医学人文精神的具体体现。全社会的妇女都应享有这种人文关怀。     

谈谈我国肿瘤治疗中的人文关怀

目前,人类对肿瘤的治疗其实仍然在黑暗中摸索,国内医疗系统存在着过度治疗和无效治疗、对终末期患者的漠视、放弃和治疗不足等弊端,对肿瘤患者缺乏足够的人文关怀.针对这种现状,笔者从人文角度提出了一些看法和建议,以期更加尊重生命价值,体现医学的本质.