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101.
102.
The purpose of the paper is to describe how residents express preferences for end-of-life (EOL) care. For this qualitative study, we conducted semi-structured interviews and completed conventional content analysis to describe how residents’ expressed their preferences for care at the end of life. Sixteen residents from four nursing homes (NH) in southeastern Pennsylvania participated in this study. Residents were on average 88 years old, primarily non White, and widowed. Three key domains emerged from the analyses: Preferences for Today, Anticipating the End of My Life, and Preferences for Final Days. Residents linked their everyday living and EOL preferences by using ‘if and then’ logic to convey anticipation and readiness related to EOL. These findings suggest new strategies to start discussions of EOL care preferences with NH residents. 相似文献
103.
ObjectiveTo systematically evaluate the acceptability of high-technology augmentative and alternative communication (high-tech AAC) among ICU patients who are voiceless guided by the technology acceptance model (TAM).MethodsWe searched the Cochrane Library, EMBASE, PubMed, CINAHL, PsycINFO, Web of Science, SinoMed, China National Knowledge Infrastructure (CNKI), China Science and Technology Journal Database and Wanfang Database from database inception to September 2019. Studies that examined conscious nonverbal ICU patients with high-tech AAC intervention were included. Two reviewers independently collected and evaluated all the studies. The methodological quality was assessed by using the Joanna Briggs Institute critical appraisal tool.ResultsEighteen studies with a total of 914 patients met the inclusion criteria, and the quality of the studies varied from low to moderate. Based on the TAM, ICU voiceless patients perceived that high-tech AAC was useful, was easy to use, decreased communication difficulties, reduced negative emotions, and improved symptom identification and management. Patients maintained a positive attitude and were willing to continue to use high-tech AAC.ConclusionsAlthough the existing evidence is limited, voiceless patients regard high-tech AAC devices as a useful, reliable, and acceptable alternative communication choice in the ICU. Multicenter, large-sample, and high-quality studies are highly recommended in the future. 相似文献
104.
《Journal of the American College of Radiology》2021,18(2):324-333
PurposeWith clinical volumes decreased, radiologists volunteered to participate virtually in daily clinical rounds and provide communication between frontline physicians and patients with coronavirus disease 2019 (COVID-19) and their families affected by restrictive hospital visitation policies. The purpose of this survey-based assessment was to demonstrate the beneficial effects of radiologist engagement during this pandemic and potentially in future crises if needed.MethodsAfter the program’s completion, a survey consisting of 13 multiple-choice and open-ended questions was distributed to the 69 radiologists who volunteered for a minimum of 7 days. The survey focused on how the experience would change future practice, the nature of interaction with medical students, and the motivation for volunteering. The electronic medical record system identified the patients who tested positive for or were suspected of having COVID-19 and the number of notes documenting family communication.ResultsIn all, 69 radiologists signed or cosigned 7,027 notes. Of the 69 radiologists, 60 (87.0%) responded to the survey. All found the experience increased their understanding of COVID-19 and its effect on the health care system. Overall, 59.6% agreed that participation would result in future change in communication with patients and their families. Nearly all (98.1%) who worked with medical students agreed that their experience with medical students was rewarding. A majority (82.7%) chose to participate as a way to provide service to the patient population.ConclusionThis program provided support to frontline inpatient teams while also positively affecting the radiologist participants. If a similar situation arises in the future, this communication tool could be redeployed, especially with the collaboration of medical students. 相似文献
105.
Kimberly M. Kelly Mayank Ajmera Sandipan Bhattacharjee Rini Vohra Gerry Hobbs Lubna Chaudhary Jame Abraham Doreen Agnese 《Patient education and counseling》2013
Objective
Breast cancer is the most common cancer among women worldwide. Given the advances in extending survival, the number of recently diagnosed breast cancer patients and longer-term breast cancer survivors is growing. The goals of this study were to better understand (1) perceptions of provider cancer recurrence risk communication, (2) perceived risk of breast cancer recurrence in cancer patients and survivors, and (3) accuracy of perceived risk.Methods
A survey was conducted on women with a prior breast cancer (n = 141).Results
Approximately 40% of women perceived that providers had not talked about their breast cancer recurrence risk; although only 1 person reported not wanting a physician to talk to her about her risk. Women were largely inaccurate in their assessments of risk. Greater worry, living in a rural area, and longer time since diagnosis were associated with greater inaccuracy. Women tended to think about distal recurrence of cancer as often of local recurrence.Conclusions
Perceived risk of breast cancer recurrence was inaccurate, and patients desired more communication about recurrence risk.Practice implications
Consistent with findings from other studies, greater efforts are needed to improve the communication of cancer recurrence risk to patients. Attention should be paid to those from rural areas and to distal cancer recurrence in women with a previous history of breast cancer. 相似文献106.
Liesbeth van Vliet Anneke Francke Samanta Tomson Nicole Plum Elsken van der Wall Jozien Bensing 《Patient education and counseling》2013
Objective
To investigate how oncologists can balance explicit with general and realistic with hopeful information when discussing various topics at the transition from curative to palliative care in breast cancer.Methods
Qualitative analysis of focus groups consisting of female breast cancer survivors and healthy women.Results
Perceptions of survivors and healthy women largely overlapped. Participants thought that oncologists can help patients regain a future perspective during this consultation. To achieve this, four themes seemed important: honest medical information, availability of continued support, hope has many faces, and space to choose. Moreover, participants stressed they would need time to let the message sink in before any further information was provided.Conclusion
Participants thought that when confronted with this type of consultation they would need – more or less explicit – medical information and information regarding support. In order to maintain hope, knowledge about (treatment) possibilities is important, but also the certainty not to be abandoned by the hospital at a later stage of the disease and the confidence to remain able to make one's own decisions.Practice implications
A life-limiting diagnosis may shatter patients’ future perspective; however, this study provides suggestions for oncologists to create a new perspective. 相似文献107.
Glyn Elwyn Amy Lloyd Natalie Joseph-Williams Emma Cording Richard Thomson Marie-Anne Durand Adrian Edwards 《Patient education and counseling》2013
Objective
To describe the exploratory use of short decision support tools for patients, called Option Grids. Option Grids are summary tables, using one side of paper to enable rapid comparisons of options, using questions that patients frequently ask (FAQs) and designed for face-to-face clinical encounters. To date, most evidence about ‘patient decision aids’ has been based on tools with high content levels, designed for patients to use independently, either before or after visits.Methods
We studied the use of Option Grids in a quality improvement project, collecting field notes and conducting interviews with clinical teams.Results
In the ‘Making Good Decisions in Collaboration’ (MAGIC) program, clinicians found that using Option Grids made it easier to explain the existence of options and reported a ‘handover’ effect, where patient involvement in decision making was enhanced.Conclusion
Option Grids made options more visible and clinicians found it easier to undertake shared decision making when these tools were available. Used in a collaborative way, they enhance patients’ confidence and voice, increasing their involvement in collaborative dialogs.Practice implications
Further work to confirm these preliminary findings is required, to measure processes and to assess whether these tools have similar impact in other clinical settings. 相似文献108.
Gloria R. Grice Nicole M. Gattas Jill Sailors Julie A. Murphy Amy Tiemeier Peter Hurd Theresa Prosser Tricia Berry Wendy Duncan 《Patient education and counseling》2013
Objective
To assess whether student pharmacists’ communication skills improved using the Four Habits Model (FHM) at the St. Louis College of Pharmacy.Methods
During the Fall of 2009 and 2010, student pharmacists in the third professional year learned and practiced the FHM. They were given feedback by faculty on three of the four Habits, used the FHM for self and peer assessment, and were formally evaluated on all four Habits during a standardized patient encounter.Results
Student pharmacist performance significantly improved from baseline during both Fall 2009 and Fall 2010 in the majority of the Habits assessed.Conclusion
Use of the FHM in pharmacy education can improve a student pharmacists’ ability to display the four Habits of communicating and developing relationships with patients. Tailoring of the FHM to pharmacy encounters will further enhance the utility of this communication framework.Practice implications
Use of the FHM enhances the measurement and assessment of the relational aspects of student pharmacist–patient communication skills. Consistent use of the FHM over time is likely necessary to fully develop and retain communication skills. The overall goal is to improve patient's health literacy and appropriate medication use by improving communication and the pharmacist–patient relationship. 相似文献109.
Shannon L. Arntfield Kristen Slesar Jennifer Dickson Rita Charon 《Patient education and counseling》2013
Objective
This study sought to explore the perceived influence of narrative medicine training on clinical skill development of fourth-year medical students, focusing on competencies mandated by ACGME and the RCPSC in areas of communication, collaboration, and professionalism.Methods
Using grounded-theory, three methods of data collection were used to query twelve medical students participating in a one-month narrative medicine elective regarding the process of training and the influence on clinical skills. Iterative thematic analysis and data triangulation occurred.Results
Response rate was 91% (survey), 50% (focus group) and 25% (follow-up). Five major findings emerged. Students perceive that they: develop and improve specific communication skills; enhance their capacity to collaborate, empathize, and be patient-centered; develop personally and professionally through reflection. They report that the pedagogical approach used in narrative training is critical to its dividends but misunderstood and perceived as counter-culture.Conclusion/Practice implications
Participating medical students reported that they perceived narrative medicine to be an important, effective, but counter-culture means of enhancing communication, collaboration, and professional development. The authors contend that these skills are integral to medical practice, consistent with core competencies mandated by the ACGME/RCPSC, and difficult to teach. Future research must explore sequelae of training on actual clinical performance. 相似文献110.
Phyllis N. Butow Ming Sze Maurice Eisenbruch Melaine L. Bell Lynley J. Aldridge Sarah Abdo Michelle Tanious Skye Dong Rick Iedema Janette Vardy Rina Hui Francis Boyle Winston Liauw David Goldstein 《Patient education and counseling》2013