前景理论在重症医学临床决策中的应用

临床决策是每一个医生每天面临的工作,正确的临床决策不仅可以带给患者较好的结果,同时也可以让医生与患者及家属沟通更加良好。本文首先论述了重症医学的临床决策特点,每一个救治方案的收益与损失的权衡不仅仅是取决于患者病情,而且与决策者的风险偏好有明显关系。为了更好地解决这个问题,把诺贝尔奖获奖者丹尼尔的前景理论引入到重症患者的...     

癌症患者对医疗风险的感知及对临床决策的影响

由于医学的复杂性和癌症疾病的不确定性,癌症的临床决策存在着一定的风险性。癌症患者对医疗风险的感知也因人而异,继而影响着临床决策。本研究应用癌症患者医疗风险感知问卷对唐山市4家三级综合医院内住院治疗的320名癌症患者进行调查,调查结果显示,癌症患者对于经济风险（67．5％）的感知和社会心理风险（40．3％）的感知均高于对身体功能风险的感知（21．6％）,患者的性别、家庭月收入和年龄影响患者对医疗风险的感知,患者对经济风险和社会风险的感知影响患者对临床决策的意愿。临床医护人员应注重评估癌症患者对医疗风险感知的特点,帮助患者制定适宜的临床决策。     

医学科研与医学科学的发展——高校附属医院SCI热的利弊分析

针对当前我国各大医院普遍出现的《科学引文索引》(science citation index,SCI)热,对高等医学院校附属医院进行调查研究,从医学科研与医学科学的发展、医院SCI热的利弊,及未来规划三个方面进行详细分析.客观说明对科研工作者的科研成绩进行公正、合理的评价,反对单纯以发表论文数量评价个人学术水平和贡献的做法.只有这样才可以充分调动科研工作者的科学探索兴趣和热情,还科学研究以本来的面目,促进科研管理水平再上新台阶.     

医生服务态度的实证研究

医生的服务态度是医学人文关怀的具体形态.采用自行设计的调查问卷,在江苏省某大型综合性三甲医院对医生服务态度的耐心、专注、语言、神态、情绪、倾听、告知、解释、微笑、共情十个方面进行双向调查.通过统计分析发现,医生的服务态度是影响医患关系的重要制约因素,且医患双方对于医生服务态度表现的评估有显著性差异.服务态度管理是医院管理的重要内容,对服务态度的考核应进入考核体系.服务态度的改善必将有利于医院人文形象的构建,有利于和谐医患关系的构建,有利于医疗质量的提高.     

新疆农村医疗救助制度实施效果评价

为评价新疆农村医疗救助制度实施效果,利用2008年和2012年两次横断面调查资料,分析医疗救助对象和非医疗救助对象的卫生服务需要、利用及费用变化.救助对象的两周患病率由2008年的181.34‰下降到2012年的87.81‰,2008年两周患病率救助对象高于非救助对象.救助对象两周就诊率由2008年的110.92‰下降至2012年的46.93‰,2012年两周就诊率救助对象高于非救助对象.年住院率救助对象均高于非救助对象.新疆农村医疗救助制度提高了贫困人口对卫生服务的利用,应将医疗救助制度与新农合紧密结合,持续资助贫困家庭参合.     

从《夷坚志》看宋代旴江医家为医处世之道

吁江,古称吁水,流经江西16个县市.其流域自古人文荟萃,不仅有名闻天下的文人学士,更不乏学验俱丰的医药学家.南宋洪迈所著笔记小说集《夷坚志》中记载了王、李两位吁江医家的小故事.从这则诊疗故事可以窥见古代吁江医家的生存状态,认为古代吁江医家不仅有着高超的治疗技术,更秉承传统医学一贯的医德思想,对病人细心体贴、对同行互敬互帮.更为难得的是,在金钱利益面前能做到重义轻利,表现出了谦虚谨慎的为医态度与谦和有礼的处世智慧.     

A Defense of Unqualified Medical Confidentiality

It is broadly held that confidentiality may be breached when doing so can avert grave harm to a third party. This essay challenges the conventional wisdom. Neither legal duties, personal morality nor personal values are sufficient to ground professional obligations. A methodology is developed drawing on core professional values, the nature of professions, and the justification for distinct professional obligations. Though doctors have a professional obligation to prevent public peril, they do not honor it by breaching confidentiality. It is shown how the protective purpose to be furthered by reporting is defeated by the practice of reporting. Hence there is no conflict between confidentiality and the professional responsibility to protect endangered third parties.     

Doping: Just Do It?

This paper provides a new philosophical argument against the lifting of the ban on doping in sports. It makes several assumptions for the sake of argument, one of which is, ironically, the moral justification of the lifting of the ban on sports doping. It is, then, a reductio ad absurdum against the claim that said ban should be lifted. Following this is a preliminary discussion concerning how doping athletes ought to be punished given that there ought to be a ban on doping due to the implausibility of the position to lift said ban. Considerations from responsibility and punishment theories are brought to bear in order to discern which punishments are most fitting for those athletes caught doping in designated clean sports competitions.     

The Benefits of Interprofessional Collaboration for a Pharmacist and Family Therapist

Abstract

Medical family therapists (MedFTs) and pharmacists in the context of interdisciplinary collaboration will be discussed. In an effort to build and reflect on their own professional experiences, recognizing the need to address wellbeing from a multitude of perspectives, and with the goals of improving access to care by identifying potential partnership opportunities between the two professions, the authors synthesized findings from pertinent articles using Medline and PsycInfo. This paper will illuminate the precise roles of MedFTs and pharmacists, how they fit into the interdisciplinary healthcare team, and anticipated facilitators and barriers in this undertaking to enhance patient care.     

Applicability of systems philosophy to the futuristic science of education: Dissident vistas

This dissertation is a futuristic exploration into “dissident vistas” in pedagogical science and, in fact, in human sciences in general. The scope of educational research is often narrowed and distorted by the sociopolitical needs of the established academic elite. The mainstream of the present tradition of pedagogical theory and research has failed to focus on the phenomenon of education as a whole in order to open new perspectives for its beneficial influence on the society. There has been, for decades now, a growing need for education to become a change agent —a strategic tool for serious search after goals and models relevant to the future progress of the human society. Proper new scientific attempts are necessary if education is to be seriously considered as such a change agent. It is the firm conviction of the author that any attitude of today's educationalists towards their work, other than that of serious obligation towards the future of mankind, would be ethically unsound. Certain ambiguity has always surrounded the concept of education: is education a whole system or is it a vague set of very different things (human aspirations, social conditions, intentional input, contextual circumstances, natural processes etc.)? This ambiguity must be reduced, if any explicit discussion of the role of education is sought. In pedagogical science, and indeed in most human sciences, there are very few ontological premises, and certainly no axioms, that the majority of scientists would generally agree on. Systematic ontological and epistemological study of the phenomenon of education is almost nonexistent. It is to this end that this research is hoped to contribute.