临床医学专业学位培养中亟待解决的问题之探索

针对目前临床医学专业学位培养过程中面临的挑战，培养目标和模式上认识的不一、临床能力考核自成体系、职业医师制度与医学专业学位制度的矛盾冲突、临床能力培养与教学资源紧缺、职业背景与多种学位制度及学制并存等问题进行了现状分析，并对构建以综合性医院为主阵地的专业学位研究生质量监控与保证体系进行了剖析与探索。     

通识教育是创造性人才培养的有效途径

知识经济的特点决定了创造性人才应具有新的时代内涵 ,现有的单一的专业教育已不利于创造性人才的培养。通过分析通识教育与创造性人才培养的关系 ,提出注重基础知识、个体的全面发展和人文素养提升的通识教育是创造性人才培养的有效途径 ,并对专业教育与通识教育结合问题提出了自己的看法     

Asthma and mental health among youth in high-risk service settings

Objective: To investigate the prevalence of asthma and mental health problems among representative samples of youth in high-risk service settings and the community, and to examine the relationship between asthma and mental health in these groups. Methods: Data were drawn from the Alternative Service Use Patterns of Youth with Serious Emotional Disturbance Study (SED) (n?=?1181), a combined representative, cross-sectional sample of youth in various clinical settings and the community. Multiple logistic regression analyses were used to examine the association between asthma and mental disorders. Demographic characteristics were investigated as potential confounders. Results: Asthma was common among 15.2% of youth in service settings and 18.8% of youth in the community. The prevalence of mental disorders was extremely high among youth with and without asthma in all service settings, and asthma was associated with increased prevalence of mental disorders among youth in the community, but not among youth in service settings. The relationship between asthma and internalizing disorders among youth in the community does not appear entirely attributable to confounding by demographics. Conclusions: Findings are consistent with and extend previous data by showing that both asthma and mental disorders are disproportionately common among youth in high-risk service settings. Almost half of youth with asthma in service settings meet diagnostic criteria for a mental disorder. Clinicians and policy makers who are responsible for the health care of youth in these high-risk groups should be aware that asthma is common, and that the prevalence of internalizing disorders are especially common among those with asthma.     

“精准医学”理念下康复治疗人才培养的思考与实践

随着精准医学理念不断深入人心和"健康中国"国家战略的深入实施,患者对医疗水平的要求越来越高,康复医疗已向"精准康复"方向发展。作为人才培养的高等医学教育也必须顺应这种新的医学模式。我国康复治疗人才培养起步较晚,目前仍以"综合"康复治疗师培养为主,这种"庞杂"的康复治疗人才培养模式,与国际上专业分化培养的现状不接轨,导致培养的人才不精不专,甚至无法与国际专业组织及人员进行对话。这就要求我们要逐步改革目前康复治疗专业教育模式,构建与国际接轨、符合精准医学理念的人才培养模式。文章立足于国内康复治疗人才培养现状,从专业设置分化、课程体系和教学内容设立、教学师资队伍建设、教育教学模式和教学手段改革、临床实习带教队伍建设等5个方面,阐述了如何开展分方向培养康复治疗人才,培养符合精准医学理念的、满足国际国内需求的高、精、专高水平合格人才,以迎接精准医学教育时代的到来。     

终末期肾病患者对护理专业性社会支持体验及期望的叙事研究

目的了解终末期肾病患者住院期间对护理人员提供社会支持的体验及需求,为护士实施全面有效的社会支持提供依据。方法采用立意抽样法选取14例终末期肾病住院患者为研究对象,采用半结构式访谈提纲进行深入访谈并按三维度叙事分析法进行转录和分析。结果患者住院期间感受到的护理专业性社会支持主要有:护理帮助支持、情感支持、沟通和信息支持;患者期望获得及时的评价支持,更多的情感支持,针对性、多样化的沟通信息支持。结论护理人员为终末期肾病患者提供专业性社会支持时应关注患者的期望,提升护理服务效能。     

Knowledge of the patient as decision‐making power: staff members' perceptions of interprofessional collaboration in challenging situations in psychiatric inpatient care

Challenging situations in psychiatric inpatient settings call for interprofessional collaboration, but the roles and responsibilities held by members of different professions is unclear. The aim of this study was to describe staff members' perceptions of interprofessional collaboration in the context of challenging situations in psychiatric inpatient care. Prior to the study taking place, ethical approval was granted. Focus group interviews were conducted with 26 physicians, ward managers, psychiatric nurses, and nursing assistants. These interviews were then transcribed and analysed using qualitative content analysis. Results described participants' perceptions of shared responsibilities, profession‐specific responsibilities and professional approaches. In this, recognising knowledge of the patient as decision‐making power was understood to be a recurring theme. This is a delimited qualitative study that reflects the specific working conditions of the participants at the time the study was conducted. The findings suggest that nursing assistants are the most influential professionals due to their closeness to and first‐hand knowledge of patients. The results also point to the possibility of other professionals gaining influence by getting closer to patients and utilising their professional knowledge, thus contributing to a more person‐centred care.     

标准化病人教学视频联合PCMC教学模式在感染科的应用

目的探讨标准化病人教学视频联合问题导向临床医学教学模式(PCMC)在感染科护理教学中的应用。方法于2018年9月—2019年1月将学校2017级42~47六个班级共计60名学生作为研究对象,42~44班为观察组(n=30),45~47班为对照组(n=30)。对照组采用标准化病人教学视频教学,观察组在上述教学模式基础上增加使用PCMC教学模式,比较两组最终考核成绩及教学满意度。结果观察组理论知识考核成绩及专业技能考核成绩均高于对照组,差异有统计学意义(P<0.05);观察组教学满意度比对照组高,差异有统计学意义(P<0.05)。结论标准化病人教学视频联合PCMC教学模式可显著提高感染科学生理论知识及专业技能成绩,提升教学满意度。     

Managing depression in patients with vision impairment: A descriptive study of practitioners' beliefs and confidence

Aim: Depression is common in older adults with vision impairment yet it often remains unidentified and untreated. Eye health professionals (EHPs) and rehabilitation workers (RWs) may be able to assist in detecting depression. This study identified EHPs' and RWs' beliefs about depression and confidence in working with patients with vision impairment and depression. Methods: A self‐administered cross‐sectional survey of 94 EHPs and RWs assessed beliefs about the symptoms and treatment for depression, and confidence in working with depressed people with vision impairment. Results: Participants showed awareness of both the symptoms and treatment options for depression. However, some important misconceptions were identified and many symptoms of depression were commonly attributed to vision loss. Participants lacked confidence in communicating about depression with patients and their families. Conclusions: Training programs are needed to enable EHPs and RWs to confidently identify depression and discuss appropriate treatment and referral options with their patients.