患者的诊治期望值与医患矛盾的关系研究

从患者视角来探索医患矛盾发生的原因,寻找一种有效的医患沟通方法。研究认为医患矛盾的核心问题是患者对诊治期望值的不满意,通过构建以患者诊治期望值为主体的医患沟通方法,发现医生和患者之间对诊治期望值存在明显差异。医生通过对医患之间存在的差异性诊治期望值进行充分沟通,形成医患诊治期望值差异下的共识,建立互信合作的关系,最终实现医患互惠共赢。以患者诊治期望值为主体的医患沟通方法,为避免医患矛盾发生,促进和谐医患关系提供一种新的思路。

     

适宜技术与诊疗最优化的可行性研究

在案例分析的基础上,作出了医生是临床诊疗中适宜技术的主要选择者的判断;论证了运用适宜技术实现诊疗最优化的可行性;认为适宜技术难以选择和实施的主要原因是利益关系、责任心不强和管理措施不到位;提出了必须着力培育适合于适宜技术生长的土壤的对策,即:实行政策引导与资金支持、进一步加大监管力度、营造良好的氛围、高度重视并加强医生道德素质的培养。     

创新促进烧伤医学的发展

勇于探索和创新,则事业有成;因循守旧,则停滞不前。持续50余年的烧伤治疗创新大潮极大地推进了中国与欧美等国的烧伤医学向前发展。     

医生健康素养认知调查及内涵探析

调查医生对健康素养概念及内涵、健康教育方式、存在问题等方面的认知情况。调查显示,一半以上的医生对健康素养了解程度一般,96.3%的医生认为病人的健康素养一般或差,96.7%的医生认为其有责任对病人进行健康教育,同时86.2%的医生认为医生健康素养与病人有区别。基于调查,提出医生健康素养应该具有双重属性,第一重属性为医生作为个体应该具备维持和促进自身健康的知识和能力;第二重属性为作为医生应该具备的本科室常见病相关健康教育知识、运用健康知识,针对病人健康问题进行有效沟通,提高病人健康素养水平的能力。

     

公立医院“医疗联合体”改革探析

公立医院“医疗联合体”改革模式为解决“看病难”问题提供了新思路, 其目的是促使优质医疗资源通过医疗联合体纵向下沉, 从而达到医疗资源最大化利用和居民就诊的合理分流。为了推进我国“医疗联合体”改革模式的发展, 首先分析了医疗联合体的作用和面临的障碍, 然后介绍我国上海、北京、湖北、重庆的“医疗联合体”改革实践模式, 在此基础上对我国“医疗联合体”改革发展提出相关建议, 期望对我国这种改革模式的实施推进提供一定的参考价值。     

Evaluating the method of levels

An investigation of the method of levels (MOL) was undertaken. Based on the principles of perceptual control theory (PCT), MOL is a way of helping people to reduce psychological distress. MOL assumes that psychological distress results when people are unable to control experiences that are important to them. The approach was implemented over six months in a large urban GP practice. Patients attended for between one and six sessions. Patients who attended for more than one session demonstrated significant reductions in scores of symptomatology on a standardized questionnaire. Effect sizes of these differences were relatively large. There appeared to be no relationship between the number of sessions a patient attended and the amount of reduction in symptomatology that was recorded. Similarly, there was no relationship between the number of sessions a patient attended and their recorded level of symptomatology at their first appointment. Although the study has important limitations we suggest that these findings might offer new directions for future research and might provide a way of unifying the specific and common factors as well as understanding the Dodo Bird effect.     

Emotion Regulation in Youth with Emotional Disorders: Implications for a Unified Treatment Approach

Given the relationship between internalizing disorders and deficits in emotion regulation in youth, the emotion science literature has suggested several avenues for increasing the efficacy of interventions for youth presenting with anxiety and depression. These possibilities include the identification and addition of emotion-regulation skills to existing treatment packages and broadening the scope of those emotions addressed in cognitive-behavioral treatments. Current emotion-focused interventions designed to meet one or both of these goals are discussed, and the developmental influences relevant to the selection of emotion-focused treatment goals are explored using the framework of a modal model of emotion regulation. These various lines of evidence are woven together to support the utility of a novel emotion-focused, cognitive-behavioral intervention, the Unified Protocol for the Treatment of Emotional Disorders in Youth, a transdiagnostic treatment protocol that aims to treat the range of emotional disorders (i.e., anxiety and depression) simultaneously. Avenues for future directions in treatment outcome and assessment of emotion regulation are also discussed.     

Assessing Counseling Students' Attitudes Regarding Substance Abuse and Treatment

Undergraduate counselors‐in‐training completed the Substance Abuse Attitude Survey, which measures treatment intervention, treatment optimism, and nonstereotypical attitudes. Treatment optimism was positively correlated with nonstereotypical attitudes and treatment intervention. Results indicated that treatment intervention and nonstereotypical attitudes must be addressed in addiction counseling courses.     

Time-Varying Treatments in Observational Studies: Marginal Structural Models of the Effects of Early Grade Retention on Math Achievement

One of the main objectives of many empirical studies in the social and behavioral sciences is to assess the causal effect of a treatment or intervention on the occurrence of a certain event. The randomized controlled trial is generally considered the gold standard to evaluate such causal effects. However, for ethical or practical reasons, social scientists are often bound to the use of nonexperimental, observational designs. When the treatment and control group are different with regard to variables that are related to the outcome, this may induce the problem of confounding. A variety of statistical techniques, such as regression, matching, and subclassification, is now available and routinely used to adjust for confounding due to measured variables. However, these techniques are not appropriate for dealing with time-varying confounding, which arises in situations where the treatment or intervention can be received at multiple timepoints. In this article, we explain the use of marginal structural models and inverse probability weighting to control for time-varying confounding in observational studies. We illustrate the approach with an empirical example of grade retention effects on mathematics development throughout primary school.