南京市浦口区家庭医生签约服务调查

定性与定量研究相结合,对南京市浦口区家庭医生团队成员共287人进行问卷调查,对31位关键知情人进行深入访谈。了解南京市浦口区家庭医生团队成员的基本构成、服务能力、收入情况,并对家庭医生签约服务履责的认知情况进行分析,以期为政府部门制定基层卫生人力规划及全面推进家庭医生签约服务提供建议与对策。结果显示,浦口区各社区卫生服务中心都积极建立了家庭医生团队,但仍存在家庭医生服务能力不足、签约服务人员专业多样性不足、待遇不高等问题;家庭医生中绝大多数人对家庭医生签约服务内容了解,支持团队签约方式;专业技术水平有限、工作量增加是家庭医生履行签约服务中遇到的主要困难。开展多渠道专业培训提高家庭医生服务能力;以专业、均衡、多样“标配”家庭医生团队;提高家庭医生收入;建立团队成员分工协调机制等措施可以完善浦口区家庭医生团队建设,增强家庭医生履责信心和推进家庭医生签约服务的进一步开展。     

孑L子“仁”说与现代医患关系

从传统文化古为今用的立场,探讨现实问题,以孔子“仁”说为理论前提,并赋予其以新的时代意义,指导医学领域中医患关系的实践。首先,概括了孔子“仁”说的历史内涵,简言之,即“爱人”。其次,从两个方面论证了孔子“仁”说对指导现代医患关系的现实可能性。即现代医患关系的矛盾冲突呼唤孔子“仁”说的指导,孔子“仁”说本身所具有的真理性,使其指导现代医患关系也成为可能。最后,联系现代医患关系实践,赋予孔子“仁”说以两个方面的新的时代意义,要求兼顾医患双方的利益,树立“人是目的”的理念。     

我国医师多点执业制度影响因素鱼骨图分析

医师多点执业制度的实施效果受到许多因素的影响,文章采用鱼骨图分析法,分析了影响医师多点执业实施的关键因素,主要包括政策因素、组织因素和个人因素三个方面.建议通过完善法律法规,建立监督体系,修改医师考核体系及增强医师法律意识等措施,稳步推进医师多点执业的实施.     

门诊医患会话打断的语用功能研究

门诊医惠交际中的言语打断是医患双方为了获得话语权而试图与对方争夺话轮的言语行为。基于小型汉语门诊医患会话语料库,对汉语门诊互动中医患会话打断现象进行研究,从打断的类型和语用功能及其在打断过程中的三个功能一向上、向下和向前运行模式进行分析,试图揭示中国门诊医患会话打断的语用策略及其功能。     

论和谐视域下的医患关系建设

在我国建设社会主义和谐社会的进程中,共建和谐医患关系的重要性日益凸显出来。和谐的医患关系建设必须在客观分析当前医患关系存在的问题的基础上,科学判断影响医患关系和谐的相关因素,把加大对医疗卫生事业的改革与发展力度、营造和谐互信的医患文化氛围、依法依规处理医患关系等方面作为着力点,方能取得良好效果。     

Discourse,affect and affliction

While much recent theorizing into affect has challenged the primacy of discourse in understanding social life, this paper is premised on the intertwining of affective experience with discursive meaning. Furthermore, appreciating the entwining of affect and discourse facilitates broader understanding into the illness experience, medical decision‐making and experiences of healing. Today, the biomedical discourse carries particular affective weight that can saturate experiences of affliction. Cultural understandings of disease similarly shape affect that may emerge in affliction. Social meaning, more specifically stereotypes pertaining to identities, interweave with emotion also in the context of medical practice. The doctor‐patient relationship is an affect‐laden encounter where the entwining of affect with social assumptions carries important, yet poorly understood, repercussions for treatment decisions and for the furthering of health inequalities. Both the elusiveness and the power of affect that unfolds in relation to discursive meaning rest on the way in which affect dwells in and resounds through the body.     

论孝道思想对历代医家从医动机之影响

孝道思想是儒家文化中的核心观念,内容广泛深刻,概括起来有孝养父母以敬、宗族繁衍为重、孝为政道基础等方面。我国历代医家大多具有深厚的儒家文化知识背景,儒家孝道观念对医家从医动机的形成影响很大,是儒家知识分子完成由儒入医转变的重要心理动力。     

江苏省农村老年人医疗消费行为研究——以苏北农村地区为例

通过对老龄化程度较高的江苏省的实地调查,利用两部模型法对农村老年人医疗消费行为进行实证分析,结果表明,老年人口特有的生理特征和疾病模式决定了老年人群拥有更大的健康风险和更多的医疗消费需求,老年人的个人和家庭特征、经济状况、健康状况、疾病的严重程度、参加合作医疗的情况和医疗服务的质量等因素对农村老年人口医疗消费起着决定作用.     

中国传统文化何以容纳患者自主

患者自主概念源于生命伦理学的自主原则,它在概念上强调对医患关系的依附和医生对患者自主权利的尊重。传统儒家的仁学在强调人与人之间的关系的同时,没有否定个人的自主,通过对“人”的肯定和对人的“情感自由”的认可来体现自主的力量。传统中国医患关系中,要求医生尊重生命、尊重患者,治病时要了解患者的心理和情感等,表明了中国传统文化能够容纳患者自主。     

What's in a name? named doctor in child protection—interpretation and implementation of the role

Child protection issues are reported in the media with uncomfortable regularity, highlighting that all paediatricians need to be competent in dealing with cases of child abuse. The named doctor in child protection was introduced to improve this, but implementation of the role has varied widely. This paper describes how the role of the named doctor in child protection has been put into practice in Nottingham City Hospital and discusses some of the challenges that can arise. The importance of training and audit in maintaining the quality of service for the trust is emphasized and developments for the future and important avenues for research are suggested. We have shown that with three designated sessions in a large district general hospital (without an accident and emergency department), the named doctor can combine with the named nurse to increase the awareness and effectiveness of child protection in all parts of the hospital. Copyright © 2003 John Wiley & Sons, Ltd.