医患关系的文化背景

医患关系是人们道德关系的表现形式，受社会文化的制约和影响，并与其同步发展。医患关系从原始社会末期医巫分离后逐渐形成，几千年的文化积淀成为医患关系的文化背景。社会文化、医院文化对医患关系有着明显和直接的影响。医院文化建设是密切医患关系的重要方面。     

通过完善医患沟通体系杜绝医患纠纷的探讨

文章通过阐述医患纠纷和医患关系的基本定义,以及解决医患纠纷的可行性措施,结合医患纠纷实例,对如何在现代中国社会日趋紧张的医患关系下处理医患纠纷,最大限度实现患者的医疗权利与保障医生的人身安全以及合法权益做出了合理的建议。通过分析产生医患纠纷的原因,探讨如何构建医院思想政治工作,以促进医患关系和谐发展,提出完善的医疗纠纷解决办法与途径。探讨了医院结合当前医患关系实际,建立合理的医患沟通体系的途径与卫生医疗体系优化医患关系处理机制的可能性。     

建构和谐医患关系的哲学思考

建构和谐医患关系是构建社会主义和谐社会的重要组成部分,但医患关系紧张仍是我国当前社会一个十分突出的问题.当代哲学以人性理解为主题的转向,为和谐医患关系指明了方向,使得人对人的理解成为建构和谐医患关系的重要理论基础.     

浅议医患关系及医患冲突

随着人们对医疗服务质量要求的不断提高,医疗卫生改革的不断深化,我国社会主义的医患关系也发生了巨大变化。当前,医患关系紧张,医患冲突不断,那么如何正确看待当前的医患冲突,怎样正确理解医患关系?正确认识和处理当前医患关系及医患冲突,确立社会主义新型医患关系具有重要意义。1 医患关系的特点 在医疗工作实践中,医患关系通常分为3种类型,即主     

加强医患沟通缓解医患关系

在日常的医疗活动中,医患之间对医疗结果不可避免地存在着不同认知,故医患关系的不协调或医患冲突难以避免.近年来医患关系紧张成为了大众关心的热门话题,而医患关系紧张的其中一个重要原因是缺乏沟通,医患之间没有建立融洽、互相信任的关系,这就使加强医患沟通显得十分重要,加强医患沟通不仅是减少医疗纠纷、缓解医患关系的重要手段,同时也是提高医疗质量、提高医院声誉的需要.     

基于文化的中国古代医患关系博弈分析

医患关系自古以来就是医疗服务的本质问题。由于医患信息不对称,容易产生道德风险。中国古代医患关系在文化力的作用下形成了较为和谐的关系。作者通过对文化力在古代医患博弈中作用的模型分析,证明了其相关性,从而为我国当前医患矛盾的解决提供了借鉴。     

医患关系与医患沟通

文章从六个方面分析了医患关系不和谐的产生原因:政府因素、医院因素、患者自身素质差异、社会媒体因素、医学人文精神的缺乏以及医患权利不平等.强调了医患沟通的重要性,总结了医患沟通的几种形式,重点提出医患沟通的努力方向:构建和谐的医患关系,从医学人文精神角度定位医院,从主要以单向沟通为主,向双向互动沟通转变,开展健康专题讲座,推行科室出院随访,注重媒体报道的策略,理性报道医患关系.     

文化冲突分析：构建和谐医患关系的切入点

目前出现的医患关系问题，其实质就是医患文化的冲突。本文阐述了医患文化的概念，分析了出现医患文化冲突的原因，并从认知、情感、伦理、心理四个方面提出了跨越医患文化冲突，构建和谐医患关系的对策。     

缓解医患矛盾 构建和谐医患关系

笔者从社会、医方、患者三个角度,多维度地阐述了医患矛盾产生的原因,以及如何从制度改革、媒体宣传、改进服务、文化建设等多方面着手缓解医患矛盾,构建和谐的医患关系。     

口腔诊疗中的医患沟通问题分析

随着医疗卫生事业的不断发展,传统医疗模式的转变,医患关系已经成为当前卫生医疗机构和社会舆论的焦点。高水平的医疗技术已经不能满足当代患者的诊疗要求,心理、情感的慰藉已经成为广大患者对医生的诊疗需求,从而予以医患关系新的诠释。同样,口腔诊疗中的紧张的医患关系也屡见不鲜。本文从患者、医务人员的角度分析口腔诊疗中医患沟通的现状、原因,提出简单的措施及方案,从而改善紧张的医患关系,减少医疗纠纷的发生,创造和谐的诊疗氛围。     

提高医务人员情绪管理能力 构建和谐医患关系

本文分析了医患矛盾中医务人员情绪管理存在的主要问题；从医疗技术服务的特殊性、患者的认知特点、情感特点、个性特点等方面，论述了医务人员提高情绪管理能力的必要性；提示医务人员应通过专业学习、文化艺术修养，在医疗实践中、不断提高情绪管理能力，构建和谐的医患关系。     

以绿色交往构建和谐医患关系

本文总结以开展绿色医院交往活动为载体,以＂注重教育引导、突出重点治理、依靠活动牵引、把握内在规律＂为管理思路,促使医务人员处理好医患关系,自觉抵制各种不正之风的侵蚀和影响,带动和促进医院建设的全面发展。     

“质量、服务、沟通、文化”全方位构建和谐医患关系

大型公立医院医患关系的和谐程度不仅关系到患者对医院的直观评价,更关系到医改的成败和医疗卫生事业的长远发展。大型公立医院在医疗质量、服务水平、主动沟通、多方联动以及医院文化等方面的创新举措与大胆尝试,可以为整个社会的医患和谐发挥引导和示范作用。     

A socioecological discourse of care or an economistic discourse: which fits better with transition?

Objective : To analyse a ‘socioecological’ health promotion discourse and its relationship to orthodox ‘economistic’ discourse in Australia. Method : In research on health promotion addressing equity and environmental sustainability, we identified a socioecological discourse, based on an ethic of care for people and ecosystems. Using Foucault's concept of discourse as a regime that produces and legitimises certain kinds of knowledge, and ecofeminist historical analysis, we analysed this discourse and its relationship to economism. Results : The socioecological discourse takes social and ecological wellbeing as primary values, while economism takes production and trade of goods and services, measured by money, as primary. Following British invasion, property‐owning white men in Australia had the right to control and profit from land, trade, and the work of women and subordinate peoples. A knowledge regime using money as a primary measure reflects this history. In contrast, a First Nations’ primary value expressed in the study was ‘look after the land and the children’. Conclusion and implications for public health : Public health often attempts to express value through economism, using monetary measures. However, socioecological discourse, expressed for example through direct measures of social and ecological wellbeing, appears more fit for purpose in promoting a fair and sustainable society.     

The influence of dominant obesity discourse on child health narratives: a qualitative study

The medicalization of obesity encourages the structural and interpersonal regulation and monitoring of people who appear to be overweight or obese, with particular attention paid to low-income and minority populations; these dynamics serve to perpetuate contemporary social inequalities. The purpose of this study was to gain a better understanding of the perceptions of health and obesity among mostly Black parents and mostly White school personnel at a US elementary school serving low-income Black children, compare these perceptions to the dominant obesity discourse, and explore possible differences in child health narratives and obesity discourse based on race. In-depth qualitative interviews were conducted with 20 parents and 20 school personnel, which were part of a larger ethnographic study. Three main themes around dominant obesity discourse were identified from the in-depth interviews with parents and school personnel: (1) reflections of obesity discourse in child health narratives, (2) identifying ‘deviant others’, and (3) challenging obesity discourse. By engaging in dominant obesity discourse, school community members create an environment where children are taught possibly damaging ways to view their bodies and health. The findings from this study are evidence of the need for health messaging within the school environment that recognizes the complexities of child health.     

A birth centre's encounters with discourses of childbirth: how resistance led to innovation

An ethnographic study of a free-standing birth centre uncovered a site of intense contestation. Two prominent childbirth discourses attempting to inscribe their orthodoxies on staff and women users encountered stern and persistent resistance. Using postmodern theory, this resistance is conceptualised as nomadic activity, as space is made at the margins of discourse for a difference and diversity to manifest. The relationship between discourse and women's agency is layered and non-linear as the presence of dissonant data indicates. The birth centre, however, actualises a number of contrasting ways of 'being' and 'doing' that appear to serve the interests of staff and women well. In particular, 'nomadic' midwifery practice and a 'care as gift' orientation challenges the biomedical model that defines the parameters of normal and the 'vigil of care' discourse that regulates the professional/patient relationship. Birth centres may encourage novel and eclectic ways of providing childbirth care.     

‘You don’t know what’s going on in there’: a discursive analysis of midwifery hospital consultations

In contemporary Western society, the concept of risk is mostly linked related to negative or undesirable outcomes and used to explain unusual or abnormal events that have harmful consequences. Working in a poststructuralist framework, in this article we examine how risk shapes interactions between midwives and pregnant women in the context of public hospitals in Australia. We draw on data from an observational study of clinical encounters in three Australian hospitals between October 2014 and July 2015. The research teams recorded 83 health encounters and in this paper we draw on data from the recordings of 10 clinical consultations between 8 midwives and 10 pregnant women at various stages of gestation. We used these data to explore how a discourse of risk was mobilised through rhetorical strategies and practices of ‘hunting’ for the abnormal and attempts to control the body. Our findings demonstrate how a discourse of pregnancy and birth as risky operates within public hospital midwifery consultations. We found that in the midwifery consultations we recorded, pregnancy was constructed as a period of vulnerability and unpredictability. It was normalised through discursive practices of hunting for the abnormal and rhetorical strategies of attempting to control the body. Within this discourse, midwives occupied conflicting positions. They asserted that women, with the right support, were capable of spontaneous and intervention-free (pregnancy and) birth. Yet, they acted to enable medical professionals to assess a woman’s ability to give birth (un)assisted, or the potential for an adverse event. The women, while positioned as passive within the public health system, were positioned as active in surveilling themselves and responsible for taking steps to mitigate against adverse events.     

学术期刊话语影响力相关指标的特征及其关系研究——以中国英文学术期刊为例

【目的】 探讨学术期刊话语影响力相关指标的特征及关系,为更清晰地认识我国英文期刊话语影响力的现状与差距提供参考 【方法】 融合多源异构数据,采用文献调研、比较分析、描述性统计分析和多元逐步回归分析等方法,从宏观、中观和微观视角对中国英文学术期刊话语影响力评价指标特征与关系进行研究。【结果】 从宏观层面来看,目前中国英文学术期刊数量少、规模小、实力不强,且与中国快速增强的科研竞争力不相匹配。从中观层面来看,我国英文学术期刊数量在学科领域的分布上呈现不均衡特点;12个指标的分布规律和分布特征存在较明显差异;无论是在国内还是在国际上,我国英文学术期刊个体的话语影响力差距较大。从微观层面,由建立的多元线性回归模型发现,总被引频次、CiteScore、国内他引频次、SJR、国际合作率和OA论文数占比对h5指数的影响或贡献度依次减弱,而SNIP、发文量和参考文献数3个指标虽与h5指数呈正相关关系,但对h5指数不存在显著影响。 【结论】 我国英文学术期刊应发挥中国学术话语的重要代言人这一优势,为中国学术成果走出去和提升我国国际学术话语影响力贡献力量。     

Mediatised risk culture: News coverage of risk technologies

In this article, we examine if and how a particular risk culture emerges as mediated and mediatised for a number of diverse technological risks. Modern news reporting is increasingly preoccupied with representing risk events in order to show how technological lifestyles affect our human and natural environments. In this article, we draw on data from project which used a comparative research design to investigate media coverage of four contemporary risks, in order to show how public risk communication contributes to the establishment of a broader mediatised risk culture. The project combined a quantitative content analysis with a qualitative study of a sample (n = 344) of news items across three different Danish media platform. We found that risk reporting varied substantially depending on dominant news themes, cultural resonance and media platform. However, within these variations we also found common elements such as the discursive representations of risk as contested and/or manageable. Based on the aggregate picture of the four risk studied, we argue that the media risk discourse takes a particular form that is different to risk discourse in other social arenas. Media risk discourse, therefore, tends to share certain cultural traits which results in the representation of risks as either (un-)manageable or (un-)controllable according to the level of public or elite disagreement in public debate.     

The (dis)appearance of the dying patient in generalist hospital and care home nurses' talk about the patient

Abstract This article explores interview data from a study of 50 Norwegian generalist nurses' focus group accounts of caring for dying patients in the hospital and care home. An eclectic discourse analytic approach was applied to nurses' accounts of the patient and three discursive contexts of reference to the patient were identified: the ‘taken as read’ patient, the patient paired with particular characteristics and the patient as psychologically present. Talk about the patient falls mainly into the first two contexts, which position the patient in relation to three closely related discursive processes: individualization, anonymization and objectification. The third context presents the patient as a person with a particular identity. The analysis is discussed in a broader philosophical and sociological context in which we return to some of the theoretical work on death and dying of the 1990s and the topic of sequestration. We suggest that nurses' talk about the patient can be heard to participate in a continuing sequestration of the dying patient in healthcare institutions focused on ‘result‐oriented’ care.