临床共情的基本路径研究

目的：开展临床共情基本路径研究,调查共情基本路径执行现状,为共情临床实践提供建议。方法：利用自行设计的调查问卷,采用分层随机抽样方法,对江苏省8所公立医院825名临床工作者和在这些医疗机构就诊的807例患者的临床共情基本路径现状进行调查和分析,对医务工作者和患者共情的认知状况进行比较。结果：在临床共情基本路径中的神态、情绪、倾听、微笑环节,医务工作者与患者的认知存在偏差;在耐心、专注、语言、告知、解释环节临床工作者均表现不佳。结论：临床工作者各路径环节表现不佳,需结合临床共情路径的内涵和实施方法,促进临床共情实践的实现和发展。     

基于医疗质量的公立医院绩效体系构建研究

目的：运用德尔菲法构建一套科学、可操作的公立医院绩效评价体系。方法：采用文献法研究国内外绩效评价理论,结合问卷结果形成初始量表。通过德尔菲法对指标进行两轮筛选及优化。结果：初步形成由“社会效益”、“质量安全”、“运行效益与效率”为基本结构的指标体系,包括3个一级指标、13个二级指标和72个三级指标。结论：该指标体系重点关注医院公益性及内涵质量,对公立医院绩效评价具有一定参考意义。     

江苏省综合性医院临床医生对新医改认知研究

为了解江苏省综合性医院临床医生对新医改现状的看法,评价新医改在江苏省内的实施进展和效果,该研究选取了新医改部分重点问题,采用自设计问卷,调查江苏省内7家三级综合性医院和7家二级综合性医院临床医生,运用描述性分析和卡方检验辅助分析研究结果。发现66.5%的医生更希望政府医改经费投入能侧重于医务人员劳动收入;对家庭医生签约服务的认知度及成效评价低于分级诊疗及医联体建设;认为医患关系和看病难、看病贵问题略有改善的医生分别占20.3%、24.9%、27.9%。需正确认识医务人员认知差异及原因;重视医务人员权益、优化薪酬管理制度;加强家庭医生签约服务的宣传和推广;丰富医联体间活动形式;建立及时有效的临床医生反馈机制。     

语料库在医学英语词汇教学中的应用

让语料库说话已经成为了语言学界的一个共识,真实的语料结合理性的分析不仅是语言研究也是英语词汇学习的重要 途径。语料库在医学英语词汇教学中有着巨大的潜力,通过语料库检索软件,引导学生对真实自然的语料进行按部就班的分 析、模仿、学习、应用,可以在很大程度上提升医学英语的词汇学习效率。     

城乡差异、就医惯性与老年人卫生服务利用

现有对城乡老年人卫生服务利用不公平的研究多忽略了长期的城乡差异所导致的隐性的农村老年人就医惯性的存在。本研究在控制了收入、医疗保障和就医可及性等因素的条件下，发现就医惯性的存在；并运用集中指数分解法发现，卫生服务的利用存在不公平，偏向于富人，而就医惯性在两种卫生服务利用中的贡献度分别为12%和5%。这种城乡固定差异造成了农村老年人在身体健康、心理健康和自我照料能力上都显著地低于城市老年人。     

Does Iconicity in Pictographs Matter? The Influence of Iconicity and Numeracy on Information Processing,Decision Making,and Liking in an Eye‐Tracking Study

Researchers recommend the use of pictographs in medical risk communication to improve people's risk comprehension and decision making. However, it is not yet clear whether the iconicity used in pictographs to convey risk information influences individuals’ information processing and comprehension. In an eye‐tracking experiment with participants from the general population (N = 188), we examined whether specific types of pictograph icons influence the processing strategy viewers use to extract numerical information. In addition, we examined the effect of iconicity and numeracy on probability estimation, recall, and icon liking. This experiment used a 2 (iconicity: blocks vs. restroom icons) × 2 (scenario: medical vs. nonmedical) between‐subject design. Numeracy had a significant effect on information processing strategy, but we found no effect of iconicity or scenario. Results indicated that both icon types enabled high and low numerates to use their default way of processing and extracting the gist of the message from the pictorial risk communication format: high numerates counted icons, whereas low numerates used large‐area processing. There was no effect of iconicity in the probability estimation. However, people who saw restroom icons had a higher probability of correctly recalling the exact risk level. Iconicity had no effect on icon liking. Although the effects are small, our findings suggest that person‐like restroom icons in pictographs seem to have some advantages for risk communication. Specifically, in nonpersonalized prevention brochures, person‐like restroom icons may maintain reader motivation for processing the risk information.     

医学人文教育与高等中医药人才培养

高等中医药人才培养必须坚持医学科学精神与医学人文精神的统一,实现医学人才医学技术与人文关怀的协调发展。中医人文教育既是医学模式发展的根本要求,也是增进医患互信、构建和谐医患关系的需要。中医人文教育必须以培养高等中医人才为核心,遵循中医人才成长规律,体现人文教育与政治教育、人文精神与科学精神、文化传承与借鉴创新的高度统一,全面提升中医大学生的人文素养。     

医疗执业法制环境研究的路径与方法

法制环境建设对于我国医疗行业健康发展和医师权益保障有着深刻的影响。本文基于对我国医师执业环境研究文献的考察和评析,突出强调医疗法制研究的重要意义,重点探讨医疗法制环境研究可以采用的建构性和评价性两个基本路径,进一步阐明法律规范分析和社会实证分析两种基本研究方法。     

从“反”传统到“返”传统——以五四文人的“弃医从文"现象为例

五四的知识分子的经历大都有弃医从文的现象，以此为切入点来探讨这批知识分子在面对现代文明与传统文化时的复杂态度．并试图通过还原历史语境的方式来阐释出他们从反传统到返传统的逻辑理路。     

新农合对四川藏区的减贫效应分析

The New Rural Cooperative Medi-cal System ( hereafter NRCMS) in Tibetan areas of Sichuan was started in Wenchuan in 2005 , and by 2008 covered all of the province’s Tibetan areas. This paper studies the effects of the NRCMS on im-proving the health of and alleviating poverty for farmers and herdsmen in Tibetan area of Sichuan. Most parts of the Tibetan areas of Sichuan are located in high altitude districts. Thirty two coun-ties of these areas are classified as “National Pov-erty Counties”. Poverty and disease go hand in hand in these regions. Kashin-Beck disease and hydatid disease are the major endemics in the pas-toral and agro-pastoral areas of Sichuan. Endemic, infectious and chronic diseases are widespread in Sichuan’s Tibetan areas. More than 70% of pa-tients are workers from 20 to 60 years old. Disea-ses are more prevalent in women than in men. Kashin-Beck disease and hydatid disease are cur-rently incurable. Patients suffer from health prob-lems, which leads to a decrease in their income and the heavy burden of medical expenses. The new rural cooperative medical system alleviates the negative effects of farmers’ falling into, or back in-to poverty due to disease. However, the existing medical compensation mechanism is not sufficient to solve the problem. The greatest impact of NRCMS on the farmers and herdsmen in Sichuan’s Tibetan areas is that the system has gradually changed local people’s medi-cal behavior, as well as their underlying ideas a-bout medicine: they begin to believe in hospitals. In particular, more pregnant women are choosing to give birth in hospitals, which reduces the rate of infant mortality and postpartum diseases, and im-proves the health of women. Since the full coverage of the NRCMS in 2008 , the number of people participating in the system has reached the overall average level of Si-chuan province. By analyzing the data before and after the implementation of this system, and meas-uring the impact of the system on people’s health, it can be found that the NRCMS’s role in serving the vulnerable population, such as the elderly and infant children, is more marked. Since the implementation of the NRCMS, all administrative villages in Sichuan Tibetan areas have established village clinics, which solved the problem of a shortage of medicines and doctors in those areas. Farmers and herdsmen have conven-ient access to medical treatment, enhancing the ac-cessibility of medical service. After the implemen-tation of the NRCMS, the health of the elderly population in rural areas has improved. Infant mor-tality rates have dramatically fallen. The implementation of the NRCMS improved the medical service capacity of township hospitals and village clinics. And the NRCMS has brought the township hospitals and village clinics into its scope of compensation, which greatly promotes the utilization of primary medical services in Tibetan areas. The poverty reduction effect of the NRCMS can be analyzed from two aspects:Firstly, the im-
provement in health leads to increased income, be-cause good health can promote labor productivity. Meanwhile, the increase in income will in turn im-prove the overall level of health. Secondly, the in-patient and outpatient compensation rate is raised year by year, which reduces the medical fees of farmers, and prevents them from falling back into poverty.