围手术期患者的抗栓治疗

抗栓治疗的患者接受外科手术时面临栓塞和出血双重风险,本文就临床常用抗栓药物的药理特性、围手术期患者抗栓治疗需要注意的问题以及解决方案作一概述。     

口腔正畸治疗中的医患交流初探

口腔正畸治疗时间长,患者依从性难以保证,这时医患交流对于治疗就尤为重要。正畸治疗各阶段良好的医患交流可以统一医患双方对矫治目标的理解差异,增进患者的信任感,争取患者最大程度的积极配合,防止错袷复发,减少医疗纠纷,取得令医患双方更加满意的矫治效果。     

癌症化疗患者护患沟通环节流程化模式初探

在癌症化疗患者的整体护理中,护患沟通较之躯体护理更具挑战性,表现为沟通难做、效果难评、学生难带、绩效难考。作者尝试一种模式,把护患沟通的各环节工作流程化、任务表格化,即首先按精心设计的流程及内容完成针对性调查,找出影响与患者沟通的有关因素及患者最为关注的问题,针对性地运用各种沟通技巧逐一沟通,实现护患沟通的个体化和差异化,同时使护患沟通环节工作有模式、效果有评价、教学有路径、考核有标准。     

患者隐私杈的法学思考

结合法学理论、医疗实践和目前患者隐私权的法律保护现状,就侵权行为、民事责任的认定以及隐私权的限制等问题予以理论阐释,并提出了切实可行的保护措施,如建立健全相关法律法规、医务人员要增强法律保护意识等,以期为患者隐私权的保护提供有益的参考。     

Computerised cognitive‐behaviour therapy (cCBT) and older people: A pilot study to determine factors that influence willingness to engage with cCBT

Objective: The aim of this study was to explore whether older people with depression and/or anxiety were potentially willing to engage with computerised cognitive‐behaviour therapy (cCBT). Method: A short questionnaire was sent to 60 service users aged 65+ who were identified as having anxiety and/or depression. Results: There was a 63.3% response rate for the questionnaire. Almost half of the respondents said they would be interested in using cCBT, and would be willing to learn the necessary computer skills. Conclusions: This pilot study suggests that older people with anxiety and/or depression may be willing to engage with cCBT. However, a number of important factors are highlighted that would need to be considered in deciding whether to develop access to cCBT for older people.     

误诊误治病例所致医疗纠纷分析——附3例报告

当前医疗科技发展的相对性、疾病规律本身的复杂多变性、医生医疗知识的局限性等,导致了临床误诊误治的不可避免性,而医院发生的医疗纠纷事件中,大多是由于误诊误治所致。通过对3例误诊病例及所致医疗纠纷的分析,指出临床误诊误治的客观性、主观性及不可避免性。同时提示临床医师在疾病诊治过程中,随时更新医疗知识,注意疾病的鉴别诊断,及时完善相关的辅助检查,积极治疗,减少对疾病的延误诊治,减轻病人痛苦,改善医患关系,从而减少医疗纠纷。     

"仁"——医德的元德

医德是医学道德的简称,具言之,它是指医务人员在医疗卫生服务的职业活动中应该具备的仁爱、救死扶伤等的品德,是道德德目在医务人员身上的内化,也是对医务人员必须具备的最起码的要求.我们评价一个医生,首先是直面他的医德,医德是医生形象的体现,没有医德的医生即使技艺再高超,也算不上一个完整意义上的医生,"无德不成医".事实上一个医德低下的医生,他的技艺也不会高超的.     

未成年患者的同意能力研究

众所周知,医疗机构必须在取得成年患者的有效同意后才能实施医疗行为。而当患者是未成年人时,这种对医疗行为的同意是否有效呢?对此,国内外法学均未形成统一的定论。通过比较国外医事法学领域相对成熟的同意能力理论,初步建立我国未成年患者的同意能力理论体系,其中评估方法是关键。     

Sectioned offenders presenting with enduring mental illness: a study exploring behaviors indicative of bullying

Logit and logistic regression analyses were employed to explore the nature, extent and predictors of behaviors indicative of "being bullied" and of "bullying others" in a sample of 125 adult male offender-patients sectioned for enduring mental illness and detained within a high-secure psychiatric hospital. The study addresses the lack of research into this specialized population to date, with a subsidiary aim of comparing the results directly with a previous study conducted with a population of adult male personality-disordered offender-patients (n = 53). Participants were required to complete a self-report behavioral checklist (Direct and Indirect Patient behavior Checklist-Hospital version Revised). The prediction that indirect (subtle) aggression would be reported more frequently than direct aggression was supported in relation to perpetration estimates, with evidence such aggression was also more prevalent among personality-disordered than mentally ill offender-patients. As predicted verbal aggression was the most commonly reported direct behavior. Although it was predicted that those perpetrating aggression would present with increased experience with secure settings this was only supported with regard to bully-victims. Contrary to the prediction made, those victimized did not present with less experience of secure settings. Consistent with the hypothesis, bully/victims were predicted by increased negative behavior toward staff and hospital rules. The results are discussed in relation to the environment in which the aggression is taking place with the implications for practice and future research outlined.