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1.
试论病人权利及医院管理理念的调整   总被引:4,自引:0,他引:4  
病人的权利是维护病人利益的基本依据,也是未来医患关系的根本立足点.作为医院管理者们更应充分认识到这一点,树立起以病人权利为中心的管理理念.  相似文献   

2.
论病人权利让渡与医生告知义务   总被引:6,自引:0,他引:6  
近年来,我国的医疗卫生事业取得了一定成绩,但不合理的医患利益调节机制和以疾病为中心的服务理念难以适应人民群众对卫生保健服务质与量的要求.当前医患矛盾的加剧正是这一情况的反映.如何改善医患关系,协调利益冲突,减少医患纠纷已成为社会和医疗行业关注的热点.尊重病人权利是建立良好医患关系的基础,但在正常的医疗活动中,病人根据诊疗的需要总是要让渡部分权利,为此,如何正确认识和看待病人权利的让渡,并通过医生承担告知义务以避免对病人权利的侵害就显得尤为重要.  相似文献   

3.
论病人知情同意权的回归及在医患关系中的价值   总被引:24,自引:3,他引:21  
知情同意权是病人最基本的权利。目前医患双方对病人权利的主张和尊重均未触及到权利的核心部分,是造成医患矛盾的症结。随着医疗自主时代的来临,病人知情同意权的回归可以预防和减少医疗纠纷,提高医疗服务品质,同时也是相关法律法规充分履行贯彻的表现。  相似文献   

4.
论病人"知情同意权"的回归及在医患关系中的价值   总被引:8,自引:0,他引:8  
知情同意权是病人最基本的权利,医患双方对病人权利的主张尊重均未触及到权利的核心部分,这是造成医患矛盾的症结。随着医疗自主时代的来临,病人知情同意权的回归可以预防和减少医疗纠纷,提高医疗服务品质,同时也是相关法律法规得以充分履行贯彻的表现。  相似文献   

5.
医学模式的演变,导致医患关系相应改变,对医疗效果也将产生不同的影响.纵观不同医学模式下医患关系的互动,不难发现这样一条主线:患者在医患关系中地位逐渐上升.这实际上反映了"以病人为中心"这一越来越为人们所重视的医疗文化理念.  相似文献   

6.
当前,紧张的医患关系是各级医院所面临的难题,也是影响和谐医院建设进程的重要因素。据一项关于医患关系认知的调查表明,85.3%的医生认为医患关系紧张原因在于沟通太少,58.5%的病人认为缺少沟通[1]。医患不能沟通就无法相互理解,就容易产生对立情绪。  相似文献   

7.
病人权利,义务在医疗实践中的保证   总被引:7,自引:0,他引:7  
论述了病人权利和医疗法律法规中的地位,归纳了病人权利,义务的基本内容。在此基础提出了病人权利,义务在医疗实践中保证的措施,指出:医疗管理人员工作者要学习法律法规,医疗机构要建立必要可行的制度,使病人充分享有权利,履行应尽义务;医务人员要给予就医者足够的医疗信息,使其具有选择医疗方式的权利;在医疗实践中还应尽量满足就医者的特需请求。  相似文献   

8.
从医患双方角度透视当前医患关系   总被引:3,自引:0,他引:3  
许玲  田侃 《卫生软科学》2005,19(4):263-264
医患关系的核心是医患两个人群之间相互关系的问题。面对日益紧张的医患关系,如何从医方和患方的角度进行分析,寻找医患关系的症结,已经成为当务之急。因此,必须坚持“以病人为中心”的理念,增进双方的法律意识,才能缓解日益严峻的医患矛盾,从根本上改善当前紧张的医患关系。  相似文献   

9.
上海市某区域医患矛盾处理方式及病人投诉调查   总被引:1,自引:0,他引:1  
为了分析我国医疗服务供需双方对医患矛盾的处理方式以及病人投诉的原因,探讨减少医患矛盾的有效措施及解决医患矛盾的切入点,促进医疗安全,构建和谐医患关系,现对上海市某一区域的社区居民、病人及医务人员进行问卷调查,报告如下。  相似文献   

10.
试论病人的社会角色   总被引:1,自引:1,他引:1  
1病人的社会特性医学社会学的有关研究已经证实,社会生活中人的各种社会关系失调到一定程度,人的健康就会受到损失成为病人。"在日常生活中的大多数情况下,生病或者健康是不一样的,它牵扯到与周围人的关系,日常生活中的疾病、疲倦和轻微身体不适在种种生活关系中扮演着中间媒介作用,特别是在工作场所或学校里"[1]。对病人的认识和理解应该适应病人的  相似文献   

11.
Emergence and preservation of a chronically sick building   总被引:2,自引:0,他引:2  
STUDY OBJECTIVE: To investigate the merits of case studies as complementary methodological approaches in the study of the sick building syndrome. SETTING AND PARTICIPANTS: A Swedish office building with longstanding health problems, and its inhabitants. DESIGN: This paper is a case study based both on historical and present, quantitative as well as qualitative, documentary material, produced over the years by distinct parties, and on semi-structured interviews. RESULTS: Long drawn conflictive processes within the building were identified. It was revealed that the organisation for dealing with environmental problems was split, and ineffective with poor patterns of communication. It was suggested that this generated a situation of chronic stress leading to the persistence of symptoms. CONCLUSIONS: By their capacity to identify internal processes within building contexts, case study methodology can contribute to a better understanding and management of sick building syndrome. The results of this study suggest that psychosocial factors, among them organisational structures and communication patterns, should be given close attention.  相似文献   

12.

Background

Patient work resumption after sickness absence varies even among patients with similar pathologies and characteristics. Explanations remain uncertain. One newly investigated field is “information asymmetry”, a situation in which critical information is not appropriately exchanged between stakeholders in disability management. It is hypothesised that information asymmetry between social insurance physicians and occupational physicians prolongs sickness absence.

Objectives

To assess the influence of enhanced information exchange between these physicians on patient outcome.

Methods

Non‐randomised controlled intervention study. The setting was the work inability assessment consultation of social insurance physicians in Belgium. Inclusion criteria were: employee, age 18–50, and subacute (more than one month) sickness absence. The intervention was a structured information exchange (through the use of a communication form) between the patient''s social insurance physician and occupational physician. The intervention started when the patient''s sickness absence reached the subacute stage, and ended when the sickness absence benefit was ceased or the duration exceeded one year. The primary outcome measure was the sickness absence benefit status of the patient assessed one year after benefit onset.

Results

Of the 1883 patients asked to enrol in the study, 1564 (84%) participated; 505 (32%) of 1564 patients were assigned to the intervention group and 1059 (68%) to the control group; 1553 (99%) of 1564 patients completed the study. In the intervention group, 86% received no sickness absence benefit at the end of the study, versus 84% in the control group (95% CI 0.91–1.15). No significant differences in other outcome parameters were obtained.

Conclusions

Information exchange between physicians may not be enough to influence work resumption among patients on sickness absence. Further research on stakeholders'' information asymmetry and its effect on the outcome of patients are necessary. The complexity of information asymmetry in disability management cannot be underestimated.  相似文献   

13.
Abstract

In a prospective study of the association between self-reported diabetes mellitus and sick leave from work, 21,149 men and women, aged 35-59 years, participated. Prevalence of diabetes was obtained by questionnaire. Sick leave was prospectively obtained from departments of human resources in the year after the baseline survey. Outcome variables related to duration of sick leave, repetitive absences, and long absences of at least seven consecutive days. In gender-specific multivariate analyses the relation between diabetes and sick leave was studied independent of age, body mass index, physical activity, alcohol intake, education, job title, and smoking habit. Prevalence rates of self reported diabetes were 2.8% and 2.2% in men and women, respectively. For each outcome variable a significant association between diabetes and sick leave was observed. Significant associations were found between diabetes and duration of sick leave and repetitive absences in men. In women a similar trend was observed for duration, and a significant association was found for repetitive absences.  相似文献   

14.
文章总结了儿科患者及家属的心理问题,并根据其存在的心理问题提出了相应的护理策略,认为儿科患者的心理护理实际上是对家长的心理支持,家长的心理状态对儿科患者有着直接的影响,做好心理护理是进行有效治疗的前提。对于小儿科的护士,应该更深入地了解患儿及患儿家属的心理需求,认真及时地做好和家属之间的沟通和交流,建立良好的护患关系。  相似文献   

15.
Utilizing the Current Population Survey, the study identifies that absences due to sickness decline following the legalization of medical marijuana. The effect is stronger in states with ‘lax’ medical marijuana regulations, for full‐time workers, and for middle‐aged males, which is the group most likely to hold medical marijuana cards. Copyright © 2016 John Wiley & Sons, Ltd.  相似文献   

16.
Doctor and patient meet in a circle of feelings determined by suffering. Sensitivity to the suffering is an axis determining the nature of the doctor and patient relationship. The patient's experience of an illness is individual, private, and very often difficult to describe. But the possibility to understand the suffering of another person comes from the fact that suffering is a universal feeling. We propose to enter the world of patient's experience by writing a letter to a doctor, which would reflect their experiences and expectations towards him. This was the task required for 120 students of the second year of medicine and dentistry education. This revised version was published online in July 2006 with corrections to the Cover Date.  相似文献   

17.
In social insurance systems that grant workers paid sick leave, physicians act as gatekeepers, supposedly granting sickness certificates to the sick and not to shirkers. Previous research has emphasized the physician's superior ability to judge patients' need of treatment and potential collusion with the patient vis‐á‐vis an insurer. What is less well understood is the role of patients' private information. We explore the case where patients have private information about the presence of nonverifiable symptoms. Anyone can then claim to experience such symptoms, reducing physicians' ability to distinguish between sick patients and shirkers. Doubting a patients' reported symptoms may prevent good medical treatment of the truly sick. We show that for all parameter values, the Bayesian Nash equilibrium is that some physicians trust all claims of nonverifiable symptoms, sicklisting shirkers as well as sick; for many values, every physician is trusting. In particular, if physician strategies are observable by patients, extremely strong gatekeeping preferences are required to make physicians mistrust. To limit unwarranted sicklisting, policies reducing the benefits of shirking for healthy workers may be better suited than attempts to convince physicians to be strict.  相似文献   

18.
Objective:It was shown that an indicated prevention strategy (IPS), based on screening and early intervention, can considerably decrease future risk of long-term sickness absence (LTSA>28 days) over one year. Given the nature of the interventions, the potential of an effect extending beyond the original one year of follow-up might be present. This study aims to determine the efficacy of this IPS on LTSA and termination of employment contract over five years by extended follow up of IPS trials.Methods:Company records on sickness absence and termination of employment contract over five years were used from two randomized controlled trials (RCT) on the efficacy of the IPS (RCT I employees at high-risk for LTSA: intervention: N=263; RCT II high-risk employees with concurrent mild depressive complaints: intervention: N=139). Survival analysis was used to model time until the first LTSA episode and termination of employment contract.Results:RCT I showed a decrease of 43.2 days of sickness absence (P=0.05) and a lower 5-year risk of LTSA in the intervention, as compared to the control group [hazard ratio (HR) 0.61, 95% confidence interval (CI) 0.41–0.90], however no considerable impact on employment contract (HR 0.85, 95% CI 0.54–1.35) (intention-to-treat, ITT). For RCT II, we found no large difference in days of SA and no difference in LTSA risk over five years (HR 1.31, 95% CI 0.70–2.47), whereas the risk of termination of the employment contract was lower (HR 0.62, 95% CI 0.39–0.99) (ITT).Conclusion:Effects of the IPS were observed over five years, albeit differential between the two approaches. A combination of elements of both interventions might lead to optimal results but needs further study.  相似文献   

19.
This study, carried out in a work rehabilitation unit in Sweden, investigated how clients perceived their work experiences after a one-year follow up. A semi-structured interview was administered to 14 former clients and a content analysis was applied. Seven categories were derived from the results: 'Expectations of the rehabilitation process'; 'Social relationships'; 'Client influences on the rehabilitation process'; 'Occupations engaged in during the rehabilitation programme'; 'Perceived outcome'; 'Current occupations'; and 'Future aspirations'. The dominating expectations were to find a job, with an overall desire for change. The social relationships with the staff and other clients were of great importance. The positive outcome of the rehabilitation was described as feeling better or having new skills. The perceived negative outcome was that the rehabilitation programme had not turned out as the client expected. The clients reported varying daily occupations after the rehabilitation experience and a majority were contented and optimistic about their future. The main conclusions of the study are that when planning a work rehabilitation programme, efforts have to be made to examine clients' interests and skills, and to develop a dialogue between clients and staff. Further research is needed to evaluate the work rehabilitation experience from the clients' perspective.  相似文献   

20.
I analyze how general practitioners (GPs) indirectly affect their patients' employment outcomes by deciding the length of sick leaves. I use an instrumental variables framework where spell durations are identified through supply‐side certification measures. I find that a day of sick leave certified only because the worker's GP has a high propensity to certify sick leaves decreases the employment probability persistently by 0.45–0.69 percentage points, but increases the risk of becoming unemployed by 0.28–0.44 percentage points. These effects are mostly driven by workers with low job tenure. Several robustness checks show that endogenous matching between patients and GPs does not impair identification. My results bear important implications for doctors: Whenever medically justifiable, certifying shorter sick leaves to protect the employment status of the patient may be beneficial.  相似文献   

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