特色教学和科研结合创新航空疗养与康复课程

为贯彻新时代教育方针和加强内涵式发展要求,我校航空航天医学系不断创新教学内容,以更好地培养航空医疗和航空医学专业人才.现有的航空航天医学教学体系中针对航空疗养与康复的内容较少,而航空疗养与康复是飞行人员医学保障的重要内容.因此,我们分别在《航空临床医学》、《航空航天医学》和《航空航天医学前沿》三门已有课程中增加了航空疗...     

负性心理暗示对医学与非医学专业大学生身心健康影响的比较研究

目的比较负性心理暗示对医学与非医学专业大学生的影响,为高等学校有针对性地开展大学生心理健康咨询教育提供理论依据。方法采用SCL-90量表对甘肃省3所高校整群抽取的3 000名一年级、二年级及实习学生进行问卷调查。结果症状自评量表(SCL-90)因子得分情况在一年级医学与非医学专业学生之间存在差异,医学专业学生"躯体化症状"(t=2.38)、"焦虑"(t=3.92)、和"精神病性"(t=4.11)的得分高于非医学专业学生,差异有统计学意义(均P0.05);在二年级医学与非医学专业学生之间存在差异,医学专业学生"躯体化症状"(t=5.12)、"人际关系敏感"(t=2.97)和"焦虑"(t=2.54)的得分高于非医学专业学生,差异有统计学意义(均P0.05);在医学与非医学专业实习学生之间存在差异,非医学专业学生"躯体化症状"(t=-3.94)、"抑郁"(t=-3.29)及"精神病性"(t=-2.88)的得分均高于医学专业学生,差异有统计学意义(均P0.05)。结论负性心理暗示对于大学生身心健康的影响在医学生与非医学生之间存在差异,建议高等学校有针对性地提出相应的干预措施,以降低或消除消极情绪带来的负性心理暗示对大学生的影响。     

整合医学在炎症性肠病中的应用

整合医学(holistic integrated medicine)最初只是狭义的临床治疗学概念,指将针灸、气功、心身医学等"非主流医学"整合入以现代西医为代表的"正统医学",以求最佳治疗效果.随着转化医学的提出与兴起,生命科学研究的整合思路被提到一个全新的高度.整合医学就是将医学各领域最先进的知识理论、临床各专科最有效的实践经验分别加以有机整合,并根据社会、环境、心理的现状进行修整、调整,使之成为更加符合、适合人体健康和疾病治疗的医学新体系[1].     

前言——老年安宁疗护的国内外发展现状

正医学的发展与进步,让公众对疾病诊治水平的期望度越来越高,人们生命的终点"越来越长",这让有些人误以为所有疾病都是有办法治疗的。而实际上,"生命的本质是一定走向死亡",医学因自身的局限性,也不可能实现"包治百病"。这就意味着,我们每个人最终都会走到生命的终点。那么,当生命自然地走向终点,面对注定即将到来的死亡,人们应该如何面对?如何让这一过程少一些痛苦与悔恨,多一些从容     

中国医学生对老年医学的执业意愿调查及干预研究

目的 探讨我国医学生对老年人及老年医学的态度以及老年医学教育对其影响.方法 对4所医科大学正在学习诊断学的医学生进行横断面调查,对北京协和医学院选修老年医学课程的非老年医学专业的研究生进行课前和课后调查.通过电子问卷调查,收集一般信息、与老年人接触经验、对老年人态度以及从事老年医学的意愿,并通过40学时的老年医学课程比...     

慢性阻塞性肺疾病患者生命质量及其相关因素研究进展

随着医学模式从单纯的生物-医学模式向生物-心理-社会模式的转变,目前对"健康"的理解已不局限于寿命的延长,提高生命质量更为重要.本文综述了慢性阻塞性肺疾病患者生命质量概念、生命质量测量表及其选择以及生命质量的影响因素.     

本期专栏组稿专家介绍

拓西平，博士，博士生导师，第二军医大学第一附属医院老年病科主任医师、教授。兼任中华医学会老年医学分会副主任委员、全军老年医学专业委员会副主任委员、上海市医学会老年医学专业委员会副主任委员、中华预防医学会循证预防医学专业委员会委员、中华医学会老年医学分会老年内分泌代谢病学组组长、海军第八届医学科学技术委员会保健和老年医学专业委员会顺问、     

课程思政在循环生理课堂中的挖掘和应用

如何在医学专业课上立德树人于无形,在课程中设计“课程思政”内容为医学专业课教学打开了一扇光明之门,不仅可以活跃课堂,增加师生互动,加深学员对专业知识的理解,而且还可以培养学员医学人文精神、高尚的医德医风和军事素养,牢固树立正确的世界观、人生观和价值观。本文就“课程思政”在《大学生理学》循环生理教学中的挖掘和应用进行探讨。     

回首过去,展望未来——《实用老年医学》创刊三十周年

正沐浴着改革开放的春风,1986年10月,江苏省老年医学研究中心(现为江苏省老年医学研究所)创办了《实用老年医学》杂志。三十年耕耘发展、三十年春华秋实。《实用老年医学》始终秉承"以实用为主、面向基层、指导临床、理论联系实际、普及与提高相结合"的办刊宗旨,真诚服务于作者和读者。几代专家学者共同砥砺奋进,铿锵前行,使《实用老年医学》成为了目前国内有影响力的老年医学专业学术期刊。     

第二届中法危重病医学研讨会暨首届上海危重病医学论坛

由中国病理生理学会危重病医学专业委员会及法语系危重病医学会共同主办的"第二届中法危重病医学研讨会暨首届上海危重病医学论坛"将于2009年12月10至12     

北京市在中学生中开展预防AIDS健康教育效果的研究

目的 了解北京市预防艾滋病（AIDS）知识和生活技能教育项目，对中学生在预防AIDS知识、态度和需求方面的健康教育的效果，为在中学普遍开展预防AIDS知识和生活技能教育提供依据。方法 对北京市20所中学学生进行预防AIDS健康教育和生活技能培训，在培训前、后采用整群抽样方法获取样本进行评估。结果 健康教育活动后学生关于AIDS常识、传播途径、预防措施正确回答率有显著提高。活动前后分别有32．26％和32．48％的学生认为课内教育和课外活动相结合是最有效的健康教育方式。结论 成功地对中学生进行了预防AIDS健康教育和生活技能培训，在中学中推广AIDS健康教育和生活技能培训势在必行。     

Faire de la tolérance à l’incertitude une compétence médicale

Uncertainty in inherent to every aspects of medical practice. As the concept of uncertainty in healthcare is still to explore, deciphering the determinants and the roots of this uncertainty would benefit from the insights of various disciplines, such as epistemology, sociology, mathematics, or philosophy. The urgent need to improve physician's ability to cope with uncertainty, has been recently highlighted by the COVID-19 pandemic. Besides, the concept of uncertainty tolerance has been proposed, and could serve as a relevant basis for approaching uncertainty, in medical education. Thus, we propose at first to discuss the uncertainty tolerance framework from Hillen et al. Then, from an educational perspective, we outline some avenues regarding how uncertainty tolerance could be thought, in a competence-based approach, and discuss several educational activities, which have proven efficient in promoting uncertainty tolerance among medical practitioners abroad.     

Ambulante Schulung bei Typ-1-Diabetes

Background

Education for type 1 diabetic patients is an essential part of therapy; however, little is known about the current setting of education in Germany.

Aim

For the first time the PRIMASCOPE study was able to shed light on this topic.

Material and methods

A questionnaire regarding the setting and frequency of education, evaluation of available education programs and appraisal of possible goals and contents of education was sent to diabetologists throughout Germany. Data from 818 diabetologists could be analyzed.

Results

According to diabetologists nearly 25?% of patients with type 1 diabetes never took part in a structured education and 40?% of patients have an elevated need for diabetes education. The most important goals of diabetes education were enhancing self-management, optimizing quality of life and boosting motivation. In general, psychosocial goals and contents were rated as important as medical goals and contents. Furthermore, diabetologists indicated a great need for a follow-up education after 2 years for the topics motivation, physical activity, nutrition and hypoglycemia. Diabetologists were relatively dissatisfied with the best known education program “Treatment and Education Program for Intensified Insulin Therapy”. The best known problem-specific education program “HyPOS” achieved the highest satisfaction.

Conclusion

The results demonstrate that many type 1 diabetic patients are in need of a structured diabetes education. In addition, diabetes education is a complex intervention which should cover not only medical but also psychosocial goals. The current dissatisfaction with basic education programs suggests that a comprehensive education concept which covers both medical and psychosocial issues is lacking.     

Learning by Living: Life-Altering Medical Education Through Nursing Home-Based Experiential Learning

The University of New England College of Osteopathic Medicine Learning by Living Project (referred to as Learning by Living) was piloted in 2006 as an experiential medical education learning model. Since its inception, medical and other health professions students have been “admitted” into nursing homes to live the life of an older adult nursing home resident for approximately 2 weeks—24 hours a day/7 days a week—complete with a medical diagnosis and “standard” procedures of care. The Learning by Living Project applies qualitative ethnographic/autobiographic research methods to collect students' perspectives and experiences about life lived as an older adult with functional challenges in a residential setting. To date, all students have completed their extended stay successfully and felt that this experiential learning project provided life-altering medical education. Longitudinal data reveals that students' maintain patient-centered attitudes and skills such as the use of eye contact, touch, body position, and voice cadence. Barriers to working with older adults are decreased; understanding is gained by “wheeling a mile in an older person's wheelchair.”     

Reinventing specialty training of physicians? Principles and challenges

In a world undergoing constant change, in the era of globalisation, the training of medical professionals should be under constant review so that it can be tailored to meet the needs of this society in transition. This is all the more true at times of economic uncertainty, such as the current conditions, which have a direct impact on health services. Professionals need new Competencies for new times. Over the last decade initiatives have emerged in various Anglo-Saxon countries which have defined a framework of basic Competencies that all medical specialists should demonstrate in their professional practice. In addition to this, we must respond to the creation of the European Higher Education Area which has implications for specialised training. In Spain, training for medical specialists was in need of an overhaul and the recently passed law (Real Decreto 183/2008) will allow us to move forward and implement, in medical education, initiatives and innovations required in our medical centres, to respond to the new society and bring us in line with international professional education and practice. The way forward is a Competency-based model for medical education with assessment of these Competencies using simple instruments, validated and accepted by all the stakeholders. The institutions involved (hospitals, medical centres and other health care services) should trial different approaches within the general framework established by the current legislation and be conscious of the duty they have to society as accredited training organisations. Accordingly, they should consolidate their teaching and learning structures and the various different educational roles (Director of Studies, Tutors, and other teaching positions), showing the leadership necessary to allow proper implementation of their training programmes. For this, the Spanish Autonomous Regions must develop their own legislation regulating Medical Specialty Training. So, medical professionals should receive training, based on ethical values, behaviours and attitudes that considers humanistic, scientific and technical factors, developing an understanding of the scientific method; ability to put it into practice; skills to manage complexity and uncertainty; a command of scientific, technical and IT terminology to facilitate independent learning; and a capacity for initiative and teamwork, as well as skills for dealing with people and for making an effective, democratic contribution both within health organisations and in the wider society.     

Evaluation of an Educational Program for Asthma Control in Adults

We have developed a 6-month educational plan associated with outpatient follow-up and special clinical care for asthmatic patients in a deprived population, with serious socioeconomic problems and a very low level of education. The objective was to determine the effects of the program on clinical asthma outcomes, lung function, and quality of life. Forty patients were enrolled in the program with a regular schedule of outpatient visits, and 31 finished the 6-month intervention, which included information about asthma, instruction in appropriate use of medication, training in metered-dose inhaler technique, how to identify and control asthma triggers, how to use symptom diary cards, and how to recognize early signs of deterioration. Patients included 8 males and 23 females, 47.8 ± 16.5 years old, with 77.4% elementary school education and 22.6% illiterate, and an average monthly income of around $450. After the 6-month program there was a significant change in asthma control with a reduction in asthma emergency visits and hospitalizations, reduction of score symptoms, and improvement in quality of life. Based on the results, educational programs are recommended and should be adapted to the socioeconomic and cultural characteristics of the target population.     

The effect of education on quality of life in patients under interferon therapy

Background and Aims

The main purpose of treating and caring for patients with chronic viral hepatitis is to promote life satisfaction and a feeling of well-being in patients suffering from this disease. The aim of this study was to evaluate the effect of education on quality of life in patients with chronic hepatitis who were treated with Interferon alpha.

Methods

This quasi-experimental study was conducted on 60 patients with viral hepatitis. The intervention included teaching them the method of self injection of Interferon alpha 2 b, giving them educational pamphlets and then following their continuing treatment with interferon. Patients were randomly assigned to two 30-patient groups. The data- gathering tool was a demographic characteristics questionnaire and the Quality of Life Questionnaire for Patients with Chronic Liver Disease (CLDQ). The educational program was done in four 45- minute sessions for the case group and their relatives. The follow-up period was 12 weeks. Quality of life in patients with chronic hepatitis was measured before initiating interferon therapy, and after the educational period. Quality of life in the two groups was compared.

Results

The total quality of life score in the two groups before therapy did not show any significant difference (P = 0.351); while 12 weeks after education there was a significant difference between the two groups (P < 0.001) in three items including abdominal symptoms (P = 0.01), worry (P < 0.001) and emotional factors (P < 0.001). The other three items did not show a significant difference between the two groups. The total quality of life score in the case group was significantly different before and after education (P < 0.001), and improved after education. The total quality of life score in the control group did not differ significantly after 12 weeks (P = 0.143).

Conclusions

Planning short and simple educational programs has a significant effect on the patient’s control of his/her disease and its side effects; and can improve quality of life, life satisfaction, and mechanisms of coping with treatment in patients with viral hepatitis.     

Quality Assurance in Hospital Medicine: A Report

Abstract: The Austin Division of Medicine Quality Assurance Programme evaluates the quality of care through reviews of admissions, discharges, deaths, and of outpatient attendances, and through special topic surveys and reviews prepared by providers of care from inside and outside the Division. The main focus of the programme is on the technical quality of medical services although the personal dimension is also discussed. The evaluation of quality of care creates pressures for improvement, primarily through continuing education and by increased administrative awareness of clinical priorities .     

Therapeutic education of diabetic patients

Therapeutic patient education is a patient-centred approach, focussed on patients' needs, resources, values and strategies. It allows patients to improve their knowledge and skills not only concerning their illness but also their treatment. It brings a better quality of life, a greater therapeutic compliance and a reduction in complications. The most difficult part of therapeutic patient education occurs when patients must change their behaviour. Motivational interviewing and cognitive-behavioural approaches contribute greatly here and allow both the preparation and support of patients during progressive 'step by step' change. The work on resistance to change is fundamental, and ambivalence when faced with the choice of a new way of life must be measured, discussed and negotiated. Patients become partners and we become 'coaches'. The negotiation of objectives must allow patients to choose their own strategies, which normally should cost them the least possible, psychologically, and bring them the maximum benefit.The efficiency of therapeutic patient education no longer needs to be proved: 80% less amputations over 10 years in diabetic patients; 50% maintenance of weight loss over 5 years, etc.In conclusion, therapeutic education is part of a humanistic medical approach centred on patients; it allows them to be active participants in their own treatment with the aim of improving their quality of life and therapeutic compliance, as well as reducing potential complications. Thus, health care professionals teach, inform, train, negotiate with, motivate and accompany patients in the long-term follow-up of their illness.     

早期康复护理对急性心肌梗死患者生活质量和对医护满意度的影响

目的：探讨早期康复护理对急性心肌梗死（AMI）患者的生活质量和医护满意度的影响。方法：选择我院2012年9月至2013年10月接诊的100例 AMI 患者为研究对象,按数字表法随机分为常规护理组（50例）,早期康复护理组（50例,在常规护理的基础上实施早期康复护理）,采用中国心血管病人生活质量评定问卷（CQQC）评定生活质量,比较两组患者的护理效果。结果：实施3周护理后,早期康复组患者对医护态度、医护水平、健康宣教及心理干预等满意度均明显高于常规护理组患者（分别为98.0％比78.0％、100％比76.0％、96.0％比80.0％、100％比82.0％）,差异具有统计学意义（P ＜0.05～＜0.01）,早期康复组患者的 CQQC 各项评分均明显优于常规护理组患者,组间差异具有统计学意义（P 均＜0.01）。结论：早期康复护理对急性心肌梗死患者有利于病情改善,可大大提高患者的生活质量及对医护工作的满意度,值得临床推广。