职业精神与弱势病人

医学职业研究所对美国医生的现实行为的调查说明:医生们是相信且赞同职业精神在对待弱势病人方面的关键信条的;增强美国医生的职业精神的努力,也应该包括努力转变医生照顾弱势病人的行为方面。但是,增强职业精神的努力不仅要通过书本上的或理论上的教育,也应该包括致力于制定使医生更容易履行这些义务的实践政策,提供体制上的支持可使医生更容易做他们已经知道其应该做的行为。     

影响住院患者知情因素的调查与分析

为了解影响住院患者知情的因素,采用问卷调查和访谈相结合的方法进行调查,并对各因素进行分析。在患者知情组与家属知情组的一般情况构成比比较与二分变量logistic回归分析的结果中显示,年龄、科室、职业、文化程度、对病情告知态度方面达到显著性差异并被引入回归方程(P<0.01)。从患者方面讲,影响患者知情的主要因素是患者的年龄、疾病性质、文化程度及患者的知情态度。     

老年非小细胞肺癌治疗中存在的问题

肺癌已成为危害人类健康和导致死亡的最主要疾病,其中一半以上发生在老年人,且大部分为确诊时已为晚期,针对这些患者的诊断和治疗还存在很多误区,因多病并发所致的诊断延误、因恐惧所致的逃避、以及因对药物的过度依赖而对患者心理因素的忽视等,致使部分老年肺癌患者不能及时得到合理的治疗,值得引起临床医师的重视。     

论医患言语交际的得体性

以医患言语交际为切入点,主要研究医者一方言语表达的得体性。对医患言语交际的得体性作出定义,分析认为医患言语交际的得体性具有医学伦理学、医学社会学、医学心理学及语义学、语用学等学科基础。进一步描述了医学会话中不得体现象的表现,提出了得体性的实现途径。     

汉语的认知神经心理学研究

认知神经心理学为探讨语言的心理机制开辟了一条新途径,使得人们对心理词典的认识日渐深入。该文着重介绍了汉语方面的认知神经心理学研究成果,其中包括语义系统、语音输出词典、语音输出buffer的信息表征方式,以及汉字的书写机制与阅读机制     

Does quality of sleep mediate the effect of depression on hopelessness?

The objectives of the study were to evaluate the relationship between sleep quality, depression, and hopelessness in advanced cancer patients and whether sleep quality mediated the effect of depression on hopelessness. The final sample consisted of 102 advanced cancer patients under palliative treatment. Patients completed the Greek Pittsburgh Sleep Quality Index, a sleep quality instrument, the Greek Beck Depression Inventory for measuring depression, and finally the Beck Hopelessness Scale. Patients' performance status was assessed by their overall physical functioning, as defined by the Eastern Cooperative Oncology Group. Depression was highly associated with hopelessness (r = .52, p<.001). Statistically significant associations were found between sleep quality with hopelessness (r = .37, p<.001), as well as with depression (r = .36, p<.001). Mediation analyses indicated that depression influenced hopelessness directly as well as indirectly by its effect on sleep quality. About 14.58% of the variation in hopelessness was explained by depression; 4% of the variance in hopelessness explained by depression was accounted for by the mediation pathway indicating that sleep quality mediated the relationship between depression and hopelessness. Similarly, in the reverse mediation analysis, depression mediated the relationship between sleep quality and hopelessness; 43% of the variation in hopelessness was explained by sleep quality. In conclusion, some of the effect of depression on hopelessness was mediated by sleep quality, but depression had a direct effect on hopelessness as well. Additionally, some of the effect of sleep quality on hopelessness was mediated by depression. The current findings are important because improving sleep quality by treating depression may contribute to decreased hopelessness scores and vice versa: Treating depression by improving sleep quality may also contribute to lower hopelessness scores.     

A Holistic Client Functioning Profile Comparison of People With Serious Mental Illness

Among a sample of 196 participants, small differences in holistic client functioning, as measured by standardized Adult Needs and Strengths Assessment (Lyons & Walton, 1999) and symptom severity scores, emerged across 3 diagnostic categories of serious mental illness (SMI; i.e., depression, bipolar disorder, and schizophrenia). However, sizable variations in symptom severity were evident across diagnoses of SMI, despite study participants receiving a similar configuration and intensity of recovery-oriented usual-care services. These results may evidence previous concerns surrounding the transdiagnosis of SMI, overlapping criteria and symptomatology among disorders in the Diagnostic and Statistical Manual of Mental Disorders, and mental health treatment and service practices in the United States. Implications for counselor practice are discussed.     

An evaluation of support groups for patients with long-term chronic pain and complex psychosocial difficulties

There is a significant group of chronic pain patients with complex psychosocial needs who are frequent users of hospital outpatient departments and who do not participate in or benefit from traditional pain management treatments and are convinced there is a medical solution to their problems. They are a particularly challenging group of patients to help, often shunned by medical and psychological professionals. A new type of ten-session psycho-social group for these patients that is less demanding than traditional pain management group programmes is investigated. It is designed to foster the development into community-based self-help groups and reduce the need for professional support and unnecessary medical intervention. Accounts of four groups of patients who participated in support groups and successfully established their own groups is presented. To assess changes in motivation, mood and pain disability standardized questionnaire measures were given before and after group attendance. Findings suggest that patients benefited and took increased responsibility for their pain management but did not demonstrate positive changes on measures of mood or level of pain disability. Patients experienced satisfaction with the groups and established their own self-help community groups. The positive experience of participants and staff suggests further work with support groups would be productive for this group of patients.     

Approaching the religious patient in forensic psychiatry,with special focus on ethnic minority patients

ABSTRACT

Ethnic minority patients are overrepresented in Danish forensic psychiatry and knowledge is needed on how these patients are approached in relation to religious and cultural issues. The aim of this study was to investigate how psychiatrists in Danish forensic psychiatry approach religious ethnic minority patients. The study revealed positive approach towards religious ethnic minority patients. However, unless religion features as part of the illness, the tendency is to not incorporate the patients’ religiosity in treatment. The study finds that the hospital chaplain is regarded by the psychiatrists as an important part of the ward and expressed the desire for a more formal cooperation with religious specialists to be developed. Finally, the study finds that religious practices such as Ramadan, common prayer, and Islamic edicts on food and unlawful touch are areas where more knowledge is needed, especially in relation to anxiety, potential stress, and conflict situations.     

Spirituality and Religion in Antiretroviral Therapy (ART) in Kwazulu-natal,South Africa: A Longitudinal Study

This study assesses the effects of spirituality and religion in health outcomes of patients on ART in KwaZulu-Natal, South Africa. Participants were 735 patients who attended three HIV clinics for ART over a period of 20 months as follows: 519 after 6 months on antiretroviral therapy (ART), 557 after 12 and 499 after 20 months on ART. They completed the Duke Religion Index each visit. Factors associated with spirituality/religiousness included fewer mental health problems (lower depressive symptoms, lower alcohol use), CD4 cell counts, adherence to ART, better certain health related quality of life outcomes (physical, psychological and environmental), social support and internalized HIV/AIDS stigma. Further research could examine the feasibility of including spirituality and religion in the assessment and providing support interventions for HIV patients.