西医——中医挥之不去的他者

中西医的论证是医学哲学与医学史研究的热点问题。后现代哲学可以为理解两种医学之间的关系提供一个新的视角。本文运用后现代哲学中的“他者”观念回顾了中西医之间张力的演变,指出在整个过程中“中医”未能摆脱“西医”作为“他者”的注视。并从后现代医学的角度对这种张力的未来进行展望。     

论地域传统文化与西部民族地区艾滋病防控

地域传统文化与疾病防控的关系密切,地域传统文化不仅是一种重要的文化资源,对地方的疾病防控也有着极大的促进作用,但有时还会阻碍疾病防控的进一步实施。由于西部少数民族地区艾滋病已蔓延到了非常严峻的时期。预防和控制艾滋病传播迫在眉睫,眼下首先应学习先进文化,急待转变和更新观念,消除地域传统文化摩擦;其次,高度重视教育,提高其人口素质,消除传统文化摩擦。     

Mind, Body, and Spirit: Family Physicians’ Beliefs, Attitudes, and Practices Regarding the Integration of Patient Spirituality into Medical Care

This study used a qualitative approach to explore family physicians’ beliefs, attitudes, and practices regarding the integration of patient spirituality into clinical care. Participants included family medicine residents completing training in the Southwest USA. The qualitative approach drew upon phenomenology and elements of grounded-theory. In-depth interviews were conducted with each participant. Interviews were recorded, transcribed and coded using grounded-theory techniques. Four main themes regarding physicians’ attitudes, beliefs, and practices were apparent from the analyses; (1) nature of spiritual assessment in practice, (2) experience connecting spirituality and medicine, (3) personal barriers to clinical practice, and (4) reflected strengths of an integrated approach. There was an almost unanimous conviction among respondents that openness to discussing spirituality contributes to better health and physician–patient relationships and addressing spiritual issues requires sensitivity, patience, tolerance for ambiguity, dealing with time constraints, and sensitivity to ones “own spiritual place.” The residents’ voices in this study reflect an awareness of religious diversity, a sensitivity to the degree to which their beliefs differ from those of their patients, and a deep respect for the individual beliefs of their patients. Implications for practice and education are discussed.Michael M. Olson, Ph.D., is a member of the Department of Family Medicine, University of Texas Medical Branch in Galveston.M. Kay Sandor, Ph.D., R.N., is in the School of Nursing.Victor Sierpina, M.D., is in the Department of Family Medicine.Harold Vanderpool, Ph.D., Th.M., represents the Institute for Medical Humanities at the university and Patricia Dayao, M.A., is a graduate student there.Funding for this study provided in part by the John G. and Marie Stella Kenedy Foundation and the George Washington Institute for Spirituality and Health/John Templeton Foundation. Correspondence to Michael M. Olson, mmolson@utmb.edu.     

The Development and Validation of the Health Proneness Questionnaire

This series of studies describes the development, validation and potential use of the Health Proneness Questionnaire (HPQ). Recent health, wellness and illness studies focus upon the dynamic interaction between psychological and physical well-being. This newly developed scale allows practitioners to quickly screen psychological characteristics related to health and a patient's perception of their quality of life. Participants were patients in university research clinics for vision problems. Through exploratory factor analysis three factors evolved related to the hypothesized psychological characteristics involved in health related quality of life: adaptability, self-efficacy and subjective well-being. In a confirmatory factor analysis, the best fit model yielded a higher-order health-proneness factor with the original three categories as sub-factors. Further criterion-related validity comparisons and discriminant and convergent validity studies indicated a psychometrically sound short survey for examining psychological characteristics of patients with mild chronic health conditions.     

Three sources of wisdom of Chinese traditional virtue and a contemporary examination

There are three explanations of the sources of virtue in the history of Chinese traditional ethical thoughts. The first source is tian Dao (the Dao of Heaven) (natural), the second is xing Dao (the Dao of nature) (mind-nature), and the third is ren Dao (the Dao of human) (social). These explanations not only demonstrate the unique wisdom of ancient Chinese thinkers in constructing mortality, but also have special revelations for us to comprehend more accurately the Chinese traditional morality, to clear up the wrong ideas about morality that have formed since modern times, to make virtue ‘present’ instead of ‘latent’, and to construct a moral society. __________ Translated from Fujian Luntan 福建论坛 (Fujian Forum) (Humanities and Social Sciences Edition), 2005 (2) by Xi Liuqin & Peng Hua     

口腔种植诊疗实践中的思考

口腔种植现已经出现在人们的视线里,它具有一定的特殊性和优越性,能够解决常规修复手段不能解决的问题,然而在临床应用中,需要考虑和处理的问题往往很复杂。因此有必要在临床实践中运用辩证思维及循证医学的思想,在诊断中全面考虑、周密计划;在治疗中处理问题、解决难点;在随访中发现问题,促进发展。     

症状性颅内动脉狭窄研究热点透视

颅内动脉狭窄是缺血性脑卒中的重要原因之一,其病因及诊治尚存在争议。本文简要介绍该病的发病机制、治疗选择,重点对药物治疗和血管内治疗的现状进行探讨。     

循证医学与人文关怀

本文从循证医学发展和应用过程的角度分析了循证医学所包涵的人文精神和人文关怀。文章介绍了循证医学的人文底蕴,针对医学实践中人文关怀的缺失,着重探讨了循证医学的发展对医学人文关怀内涵的丰富和发展。文章最后就怎样在循证医学的实践中更好地实现人文关怀提出几点建议。     

临床路径制定过程中应用循证医学探讨

临床路径作为一种新的质量效益型管理模式将病种医疗服务标准化。本文通过概述循证医学在临床路径服务项目和内容以及住院时间制定过程中的应用方法以及循证实践步骤,为进一步制定科学合理的临床路径提供了循证来源,从而促进我国医院循证管理得到更好的实践。     

循证医学指导下的真菌性角膜溃疡个体化综合治疗

真菌性角膜溃疡的诊治是眼科界的一大难题,在总结既往有效经验的基础上不断创新是FCU诊治取得突破的必然途径。本文通过综合分析循证医学与个体化综合治疗在FCU治疗中的不同作用,提出了FCU的诊治应是循证医学与个体化综合治疗辩证统一的观点。