European General Practice Research Network meeting: Vilnius,Lithuania, September 2007

ABSTRACT

After decades of developing family medicine, one can see that it has been successful in defining its principles and in proving the importance of its contribution using quantitative measures of quality that are prevailing today. But if family medicine needs to make a real contribution to society, it needs not to forget that using only rationalistic approach is not enough to define its quality and that caring for a fellow being is as important as science.

Our contribution to changing the world for the better should be in constantly reminding that personal care is essential for every doctor regardless the speciality. This largely neglected feature of medicine can be best taught and researched in the context of family medicine, because it represents the very essence of the discipline.

This implies that we must often take a different path from other disciplines when we address the issues of policy, research and education and use every opportunity to stress the importance of personal care.     

加强妇产科住院医师医学人文观培养

<正>住院医师规范化培训是医学生毕业后医学教育的重要组成部分,现在更成为国家层面调控的重大项目之一,但必须承认的是,无论是在培训内容、培训方式还是考核内容等方面,对住院医师医学人文观念的培养仍有很大欠缺~([1-2])。而妇产科又由于其本身的特殊性,对医师的人文素养要求更高。     

A humanism for nursing?

Humanism has appeared intermittently in the nursing literature as a concept that can be used in understanding nursing. I return to the concept in response to noticing the term appearing in the context of health humanities, where it is loosely associated both with humanities and being humane. I review the usage and critiques of humanism in both nursing and medical literature and then re‐evaluate what the idea of humanism might hold for nursing, trying to avoid the traps of an over‐determination of the human subject, or dichotomizing nursing as art or science, technology or caring. I draw on writings on humanism primarily from Emmanuel Levinas and Edward Said to emphasize strands in humanism of obligation towards others and of critical discernment within history and culture directed towards democratic practices. I discuss in passing the strong association in the UK particularly between humanism and scientism as a note of caution about the plurality of the term humanism. I conclude that humanism is a tradition that does offer productive ways of thinking about nursing with the proviso that it ought to be treated carefully as a problematic tradition and not as a new essence for nursing.     

Combining the Creative Arts and the House Call to Teach Medical Students About Chronic Illness Care

As the number of people living with chronic illness in the United States rises, it is imperative that medical school prepare physicians who are capable of caring for these patients. This article outlines a creative educational intervention to teach third‐ and fourth‐year medical students about caring for chronically ill people. All students at Weill Medical College, Cornell University, make home visits to homebound older adults with an interdisciplinary team as part of a mandatory Primary Care Clerkship. Under their guidance, students observe the myriad challenges facing homebound older adults. Afterward, students create a project, using original or found art, to express their reactions and thoughts. Students present projects to peers in a small group, with multidisciplinary faculty mentors framing the discussion. To evaluate the intervention, students responded to a nine‐item questionnaire and a series of open‐ended questions. Quantitative and qualitative analyses show consistently strong positive responses to the experience. Most students (95.0%) felt that they learned about the complexities of chronic illness care from their home visits. The opportunity to express reactions through a creative project received positive responses with 97.0% of students responding favorably. Ninety‐seven percent felt that the discussions with colleagues and faculty increased knowledge of chronic illness care. Nearly all (97.0%) felt they had a better understanding of team and that attitudes toward the chronically ill were positively affected. The coupling of the creative arts with home visits is an effective tool for teaching about chronic illness and may be a useful model for medical schools interested in expanding their chronic illness curriculum.     

浅谈《黄帝内经》的人体观

通过对《内经》中"天人合一"、"形神一体"的整体人体观的分析,探讨了《内经》所体现的医学人文精神。医学人文精神推崇的是由人的多重属性和多重关系而展现出来的"人的世界",而《内经》中的身体,是和自然环境、社会环境融为一体的存在,体现了以生态的自然人为本,重视病患精神状态的人文精神。     

中国首个大型医院品牌营销研究

通过对全国11个中心城市的20家大型三甲医院的3924名病人及1815名员工进行随机抽样调查及对406名医务工作者进行一对一深度访谈,对中国大型医院品牌营销现状进行研究探讨,得出如下初步结论,供医院管理者参考:医院以技术品牌为主;员工品牌意识薄弱,服务品牌有待加强;医院品牌区域性强,外地病人多为自费;病人支付能力参差不齐;医院品牌营销尚在起步阶段.     

In the name of Husserl: nursing in pursuit of the things-in-themselves

A perceived contradiction between the tenets of humanism and positivism secures phenomenology's endorsement in nursing as an alternative methodology to the natural sciences. Nursing's humanistic doctrine of valuing the individual is aligned with phenomenology in the belief that both projects investigate the subjective experiences of others. However, the belief that phenomenology opposes objectifying methods does not account for the different understandings of subjectivity that underpin various philosophic positions, such as humanism, phenomenology, hermeneutics and positivism. What is not recognised in nursing inquiry is that the same characteristics which belong to humanism and are subsequently attributed as belonging to phenomenology are grounded, philosophically, in a view that separates the person from her world. But rather than examining the premises on which phenomenology and humanism are based, nurse-phenomenologists have simply yoked them together in a mutual alliance against a common enemy--Cartesian dualism. This paper focuses on Husserl and argues that the conceptual link between nursing as a humanistic discipline and Husserlian phenomenology cannot be sustained on philosophic and methodologic grounds. Far from being mutual allies, the philosophic underpinnings of humanism and Husserlian phenomenology offer two incommensurable views on the nature of subjectivity.