浅谈医患有效沟通与和谐医患关系

探讨有效医患沟通的方式,建立医患之间相互信任、相互了解的关系,从而减少医疗纠纷的发生.探讨医患关系紧张原因,探索语言沟通的技巧.希望通过有效沟通,帮助病人了解、认识、配合医生的治疗.良好的医患沟通,有助于建立良好的医患关系,有利于开展高质量的医疗护理工作,全方位地为患者服务.     

Physician-assisted suicide: reflections on Oregon's first case

The authors analyze Oregon's first reported assisted suicide of Mrs. A as a real life application of the Oregon Death with Dignity Act. They critique the effectiveness of the Act's safeguards as illustrated by the case of Mrs. A. They point out that the Act does not require that physicians be adequately trained in palliative care in order to participate in assisted suicide. Most physicians do not have such training. Without it, they are not able to effectively present alternatives to patients requesting assisted suicide. Most physicians also lack the expertise to assess patients' decision-making capacity. Nor does the Act ensure that physicians will be in a position to assess coercion of patients' decisions. The Act requires physicians to report only minimal information about their cases, and there are no enforcement provisions to see that even this is done. Under the Act, a good faith standard rather than the more usual negligence standard immunizes physicians from civil or criminal liability even when they act negligently. The authors demonstrate that the Act protects physicians more than patients, and encourages secrecy. The authors conclude that secrecy will need to be replaced by openness to permit the kind of examination the practice of assisted suicide warrants.     

Observing the other: reflections on anthropological fieldwork

Aspects of anthropological fieldwork are examined from a psychoanalytic viewpoint using two sources: (1) Malinowski's A Diary in the Strict Sense of the Term, a fieldwork journal he kept in New Guinea and the Trobriand Islands "as a means of self-analysis"; (2) the analysis of an anthropologist both before and after she returned from the field. Malinowski's Diary, written in a virtually free-associative form, illustrates how fieldwork stimulates derivatives of significant early infantile conflicts. The patient's analysis revealed the unconscious meaning of, and motivation for, fieldwork for this particular individual. Based on these data, it is postulated that during fieldwork a new, emotionally charged object relationship, with its concomitant transference responses, may be unconsciously established by the anthropologist with the alien society being studied.     

Phenomenology and nursing: reflections

The project is about phenomenology and its elements. It points out the essential ideas of existential phenomenology interpreted by Maurice Merleau-Ponty's ideas and tries to connect this philosophy to nursing world.     

Emotional inhibition in essential hypertension: Obstacle to communication during medical visits?

Studied 542 patient–physician interviews to see if 203 patients with essential hypertension (EH) were less likely to exhibit negative emotions than 339 normotensive Ss as rated by their physicians and independent observers. EH Ss did not differ from others on self-rated emotional or physical health. However, physicians rated EH Ss as exhibiting fewer signs of distress during the visit than normotensive Ss. Independent observers also judged the EH Ss as less distressed than normotensives. Content analysis disclosed that physicians paid less attention to psychosocial concerns and concentrated on biomedical matters to a greater degree with EH Ss than with normotensive Ss. EH Ss appear to have patterns of self-presentation that could present an obstacle to effective communication. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Health promotion and empowerment: reflections on professional practice

Recent reformulations of health promotion focus on empowerment as both a means and an end in health promotion practice. Both concepts, however, are rarely examined for their assumptions about social change processes or the potential of community groups, professionals, and institutions to create healthier living situations. This article attends to some of these assumptions, expressing ideas generated during 6 years of professional training workshops with over 2,500 community health practitioners in Canada, New Zealand, and Australia. The article first argues that health promotion is not a social movement but a professional and bureaucratic response to the new knowledge challenges of social movements. As such, it has both empowering and disempowering aspects. The article analyzes empowerment as a dialectical relation in which power is simultaneously given and taken, and illustrates this in the context of health promotion programs. A model of an empowering professional (institutional) health promotion practice is presented, in which linkages among personal services, small group supports, community organizing, coalition advocacy, and political action are made explicit. Practice examples are provided to illustrate each level of the empowering relation, and the article concludes with a brief discussion of the model's educational and organizational utility.     

Comments on Renner: Some reflections from an administrator.

Professor Renner's paper (see record 2007-09069-001) on the current crisis in Canadian universities posits an internal solution in response to a plethora of problems with a multitude of causes. There are many points in this analysis that prompt an administrator to nod encouragingly, but the breadth of the context of his argument leads to a final assessment of his proposal as inadequately developed and overly one-sided. It is, nevertheless, provocative and timely. While I am unable to comment upon the psychological elements of the proposal with any theoretical or disciplinary expertise, I can comment on the fact that Renner's paper evokes areas of concern that are daily on the administrative agenda. But it is not just the psychology of change that university administrators are trying to plumb; it is also the psychology of choice with which we are trying to contend successfully. And it is not just governments that are a source of concern; faculty, staff, and the public and private sectors all inform our analysis and planning. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Presidential reflections

Two direct methods for the diagnosis of trichinellosis were compared: trichinoscopy and artificial digestion. Muscles from 17 wistar rats, orally infected with 500 Trichinella spiralis encysted larvae were examined. From each of the following muscles: diaphragm, tongue, masseters, intercostals, triceps brachialis and cuadriceps femoralis, 648,440 larvae from 1 g samples were recovered. The linear correlation between trichinoscopy and artificial digestion was very high and significant (r = 0.94, p < 0.0001), showing that both methods for the detection of muscular larvae did not differ significantly. In both methods, significant differences were found in the distribution of larvae per gramme of muscle.