浅谈窗口服务中的人际冲突与冲突管理策略

冲突是两方或多方彼此感觉对立的情况，是人们之间在所要达到的目标或实现目标的方法上存在分歧而发生在人际间的过程。人际冲突问题是一个普遍存在的问题，在社会生活中无法避免。窗口服务中的人际冲突主要是源于工作人员与服务对象双方在服务过程中的地位不当和对双方的期望不能做出适当的反应。人们对这种冲突产生的消极后果有一定的认识，例如导致服务对象产生不信任，难以公开谈出自己的需要或疑虑，继而导致服务对象的不遵从甚至出现被动攻击行为等。其实，冲突带给工作人员与服务对象双方的并非只是破坏性的效应，透彻理解冲突产生的原因，实行有效的冲突管理方式，就能够使人际冲突产生建设性的结果，从而促进良好人际关系的建立，提高窗口服务质量。     

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     

社会安全阀理论视角下的医患冲突

在当前社会中，医患关系紧张，医患冲突不断。医患冲突的不断加剧极大地破坏了正常的医疗秩序和医患关系。造成医患冲突加剧的原因很多，文章以科塞的社会安全阀理论分析医患冲突的原因以及如何通过社会安全阀的构建来控制医患冲突，为缓解医患≯中突、构建和谐医患关系提供新思路。     

医患冲突现象相关研究综述

近年来医患关系已经成为了社会的热点话题,医患冲突—词也频频出现在各大媒体之上,由于医患关系紧张,医患矛盾不断加剧,医患冲突也随之增多。文章首先分析了当前我国医患关系的现状和趋势,然后着重对国内外医患冲突现象的研究进行了归纳,以期对今后的研究提供参考。     

院前急救中常见医患冲突与防范对策

目的探讨院前急救中医患冲突的原因及防范对策。方法由科室质控员负责对医患冲突的原因进行统计归纳和分析讨论。结果 2007年1月～2009年12月医患冲突共28例,严重破坏了院前急救工作的环境,影响了院前急救的质量。结论防范院前急救中医患纠纷已刻不容缓。     

论谈判解决医患冲突

构建和谐社会离不开和谐的医患关系.和谐医患关系的基础是医患双方相互尊重、彼此信任.而今,医患关系却遭遇危机,各地各医院内或大或小的医患冲突屡屡发生,不仅影响了正常医疗秩序,而且也危害到其他患者的合法就医权利.     

医患矛盾微观因素探析

目前，医患关系比较紧张，医患冲突时有发生，这是多种因素共同作用的结果。笔者试图从微观方面探寻影响医患关系的因素，以期推动和谐医患关系的建立和发展。     

当前我国医患冲突的法律思考

目的:从法律制度建设层面剖析造成我国当前医患冲突问题的原因,探究通过法律制度建设纾缓与解决医患冲突问题的思路.方法:通过对医患之间冲突现象的法律分析,客观描述医患之间冲突的表现、影响,揭示医惠之间冲突的主要成因,开展调整、改革法律制度的分析讨论.结果:现行法律制度存在医患权利义务不明晰、医疗纠纷解决机制失灵、缺少医疗风险分担机制等问题.结论:当前解决医患之间冲突问题必须进一步完善法律制度,建立多元化医患纠纷解决机制、医疗风险分担机制、政府干预机制.     

社会冲突理论视角下的医疗纠纷

随着社会经济的发展和人们生活水平的提高，人们的健康需求指数越来越高，法律意识也越来越强。与此同时，由医疗事故等原因导致的医疗纠纷案件正呈逐年上升趋势，这已成为社会舆论关注的热点。有效地解决医疗纠纷，有助于建立和谐的医患关系，而和谐的医患关系在构建和谐社会的过程中又是一个主要的组成部分。在社会学视角下，运用达伦多夫的辩证冲突理论来分析当前的医疗纠纷与冲突的起因、形成，以促进医疗纠纷的解决。     

谈预防医患冲突的语言和行为沟通

当前，医患矛盾呈上升趋势，表现在对医院的投诉增多。究其原因，大多数都是医患沟通不够造成的。因此，要把解决医患冲突问题“前移”，以预防为主，运用语言和行为沟通技巧，变被动为主动，将医疗纠纷消灭在萌芽状态，达到医患关系和谐和稳定就医环境的目的。要实现这一目标，医院管理者要像抓医疗、教学、科研那样，     

The Grim Reaper,Hounds of Hell,and Dr. Death: The Role of Storytelling for Palliative Care in Competing Medical Meaning Systems

Palliative care (PC) is a medical specialty that strives to fulfill the physical, psychosocial, emotional, practical, and spiritual needs of individuals at end of life or in tandem with curative treatment. Although exponentially rising in use and beneficial to patient well-being at end of life, the purpose of PC is often misunderstood and those providing its services frequently report resistance from organizational members. Such resistance can be attributed to tensions between traditional biomedical models of medicine that privilege curative treatment and biosocial models of medicine that holistically care for patients. Thus, this study addresses what tensions PC providers experience in their institutions and what communicative strategies they use at the interpersonal level in managing those tensions. Using structuration theory in tandem with relational dialectics theory, we inductively analyzed semistructured interviews with 24 Circle of Life award-winning PC providers. Findings indicate two dialectics experienced by PC providers in their institutions: the living-dying dialectic and the practicing-advocating dialectic. We conclude that these interpersonal dialectics emerge through interaction in competing medical meaning systems and found that storytelling was a particularly salient form of communication that participants used for management.     

浅谈医疗机构管理者如何有效运用冲突管理之理论与实践

医疗机构及其从业人员的行业特点和在社会所处的特殊地位,在某种程度上决定了其自身容易受到来自各种冲突的伤害,从而使得医疗机构从业环境产生困难和压力,其从业人员在面对大量冲突的冲击时,会产生焦虑或紧张的情绪,降低工作效率。冲突管理对于医疗机构和医务人员来讲是一种较为新生的事物。善于管理冲突,可以提高工作效率,减少由工作带来的压力,亦可主动创造和谐工作环境,持续提供优质服务。     

Interpersonal continuity of care and patient satisfaction: a critical review

PURPOSE: We wanted to review the medical literature regarding the relationship between interpersonal continuity of care and patient satisfaction and suggest future strategies for research on this topic. METHODS: A search of the MEDLINE database from 1966 through April 2002 was conducted to find articles focusing on interpersonal continuity of patient care. The resulting articles were screened to select those focusing on the relationship between interpersonal continuity in the doctor-patient relationship and patient satisfaction. These articles were systematically reviewed and analyzed for study method, measurement technique, and the quality of evidence. RESULTS: Thirty articles were found that addressed the relationship between interpersonal continuity and patient satisfaction with medical care. Twenty-two of these articles were reports of original research. Nineteen of the 22, including 4 clinical trials, reported significantly higher satisfaction when interpersonal continuity was present. CONCLUSIONS: Although the available literature reflects persistent methodologic problems, a consistent and significant positive relationship exists between interpersonal continuity of care and patient satisfaction. Future research in this area should address whether the same is true for all patients or only for those who seek ongoing relationships with physicians in primary care.     

浅谈医患纠纷成因及防范

医疗问题是近年的社会热点,而医患纠纷已成为影响社会和谐的重要因素。本文从医务人员、医院管理、患者及社会四个方面分析医患纠纷产生的原因,并阐述防范措施。     

浅析医患关系紧张的根源及对策

随着市场经济的发展和群众健康需求的不断增长，医患关系紧张已成为社会热点问题。文章试从医患关系紧张的微观和宏观层面剖析其根源，并从宏观层面提出改善医患关系紧张的可行性建议。     

Ambiguities of chronic illness management and challenges to the medical error paradigm

In recent decades, an interdisciplinary quality assurance (QA) movement has emerged in health care studies, which has included increased attention to medical errors. Implicit in this QA effort is a conflict between (1) external agents encouraging the medical profession to adopt strategies for reducing errors and (2) sociological characteristics of medical practice that systematically inhibit the uptake of these strategies. Using interviews with providers and observations in two diabetes clinics in a large Midwestern city in the USA, we examine how providers understand error in their work, as well as how they think about failures in care and efforts to standardize and impose guidelines in care. We find that the prototypical vocabularies of medical error and QA, which have been largely oriented to acute illness care, are systematically mismatched to ambiguities introduced by chronic illness. These ambiguities create problems for the definition of medical errors, the collection of relevant information, the determination of long-term treatment goals, and the application of standardization efforts. Considered together, these mismatches imply diminishing returns for health policy efforts focused on reducing medical error as part of a larger QA agenda.     

Relationship Personality,Conflict Resolution,and Marital Satisfaction in the First 5 Years of Marriage*

We explore the relationship between couples' stable personality variables associated with interpersonal competencies (referred to here as relationship personality variables) and marital satisfaction with conflict resolution style as the mediating factor. Eighty‐three newlywed couples participated in the study at 6 points over 5 years at 1‐year intervals. The results indicate strong mediational effects across time. In particular, conflict resolution styles appear to form during the 1st year of marriage and are habituated thereafter to a large extent. The relationship personality variables correspond closely with conflict resolution styles, which in turn influence marital satisfaction. The implications for intervention, especially for preventive intervention in early marriage, are presented.     

Exploring Disease Management Programs for Diabetes Mellitus

Diabetes mellitus is a chronic illness that affects the world on an epidemic scale. It requires complex healthcare and considerable economic resources. Diabetes disease management programs use a variety of strategies to improve clinical outcome measures and reduce costs. Studies have demonstrated the effectiveness of these programs on reducing glycosylated hemoglobin levels, improving cardiovascular risks, and reducing utilization of services. However, the most effective components of disease management strategies or combination of strategies remain unknown. This narrative review explores the components, impact, benefits, and barriers of current diabetes disease management models and also presents a novel hybrid model incorporating elements of both on-site and off-site programs.On-site disease management programs include strategies characterized by unique patient identification and evaluation, implementation of intervention methods, on-site health provider team members, and specific environmental resources. Advantages of this model include the face-to-face encounter between patients and providers, the proximity of the healthcare team members to facilitate ease of communication and build independence and trust between patients and providers, and technology resources, such as the electronic medical record. A number of clinical trials have demonstrated the effectiveness and cost effectiveness of on-site diabetes disease management programs. However, because of the methodological limitations of many studies, further studies are needed to confirm such findings. Barriers to the implementation of on-site programs may include patient population characteristics such as complexity of co-morbid illness and social Stressors, including low health literacy, that require adaptation of the disease management model. In comparison, off-site disease management programs utilize administrative resources to identify patients with chronic illnesses. Other key elements include the evaluation of clinical care practices using established guidelines with auditing and feedback to providers based on their performance, and the use of reminders for both patients and providers to influence better processes of care. This process is often independent of the traditional on-site care delivered directly by providers.A hybrid disease management model that incorporates both on-site and off-site disease management components could be the ideal model for optimizing care of patients with chronic illness. The suggested hybrid model incorporates many features of previous models of disease management but gives a new construct that can be customized to different clinic settings, provider practices, and patient populations, including patients with other complex chronic illness. This hybrid model could be applied to a variety of individual or multiple chronic illnesses. This model would engage both on-site healthcare providers and support staff along with off-site administrative staff and electronic medical data to provide patients optimal care while potentially reducing overall costs.