诚信是改善医患关系的根本

随着经济社会的发展,人们的法律意识的增强,作为社会关系的重要组成部分,医患关系正越来越成为人们关注的焦点.面对目前有史以来医患关系的最低点,怎样才能搞好医院管理、提高服务质量、有效地防范医疗纠纷、促进医院科学发展呢?构建和谐医忘关系、改善医患沟通、提高医疗质量、加强医德医风教育,是医疗纠纷防范的根奉;医患双方只有携手向前,共同为医患关系的改善注入希望和动力.患者是医生的"衣食父母",医生是帮助患者恢复健康的使者,医患关系应该成为社会上最和谐的人际关系.     

加强有效沟通促进医患关系和谐健康发展

通过探讨影响医惠沟通的因素,从而完善沟通渠道,达到密切医患关系,促进医忘关系和谐健康发展的目的,减少医疗纠纷的发生.     

改善医患矛盾和谐医患关系

医患矛盾日益激化的今天,如何缓解医患矛盾已经是目前医院,乃至整个社会都亟需解决的同题,医患沟通是良好医患关系的开始,但也必须承认和了解现在医患之间矛盾的存在和发展,改善医忘关系还是要从医生和患者做起,需要整个社会的共同努力,让医生关系更加和谐.     

增强沟通、和谐医患关系

医患关系的实质是“利益共同体”.医患纠纷的最主要起因是沟通不足.因此,建立健康和谐的医患关系应该从医患沟通开始,医患沟通是基础.如何搭建和谐的医患关系是每个医务工作者都需要面临的问题,尊重、信任、沟通是和谐医患关系搭建的关键,医患之间的沟通不仅为诊断所需,也是治疗中不可缺少的方面.     

医患沟通在非技术因素所致医疗纠纷防范中的应用

在医疗纠纷中,纯技术原因引起的不到20%,非技术因素所致的纠纷占主要部分。而良好的医患沟通,可以使患者对相关诊疗具有客观的理解,避免该类医疗纠纷的发生[1]。     

剖析医患矛盾改善医患关系

医院和患者是形成医疗行为的两在要素.随着医疗制度改革的进一步深入开展,医患矛盾经常见诸报端.那么分析原因,笔者认为:不平等医患关系的理念是造成医患矛盾的根本.患者从踏进医院门坎起就处于卑贱状态,医生俨然以救世主身份对待患者,自然形成了主动与被动、施恩与受恩的医患关系.因此,建立良好的医患关系刻不容缓.笔者认为:首先,要建立良好的医患沟通;其次要规范各项医疗活动行为、创新服务举措;再别要进一步加强制度建设才能有效的改善医患矛盾.     

社区健康服务中心构建和谐医患关系的看法

医患关系是医疗实践活动中最基本的人际关系,这一关系的协调与否直接影响着整个社区健康服务中心医疗卫生工作的展开与良性运转.根据社区健康服务中心的工作特点,以病人为中心,加强医患沟通,提高医疗服务质量,减轻病人心身痛苦,促进医患间理解与支持,对构建和谐医患关系效果有很大的帮助.     

手外科医患间的沟通技巧

目的探讨手外科医患沟通技巧、方式,促进医患和谐。方法对2011年1月-2012年1月我院手外科患者全程（接诊、术前、术中、术后、出院）医患沟通进行总结分析。结果患者对医患关系满意度稳步上升了10个百分点。结论加强医患沟通,采取合理沟通方式,有利于医患关系发展,并促进患者身心健康的恢复。     

信息员在医患沟通中的作用

目的探讨应用信息员减少医患纠纷。提高患者满意度的方法和效果。方法在全院各临床科室，设置1名具备爱心、耐心、细心、责任心、有较强人际交往能力及丰富临床经验的高年资护士为信息员，脱离常规护理工作，按信息员职责要求专门负责医患间的交流沟通。结果使用信息员前患者满意率为92．84％、医患纠纷发生率为0．16‰；使用信息员后患者满意率为94．81％、医患纠纷发生率为0．07‰，两者比较，χ^2=310．41、10．67，均P〈0．01。结论信息员制度有利于构建和谐的医患关系，减少医疗纠纷和提高患者满意度。     

人文精神与医患和谐

目前,医疗纠纷已经成为社会关注的热点问题之一,也成为社会不安定的隐患.构建一种和谐的医患关系,使医患双方共达双赢已迫在眉睫.笔者认为如果医院从自身做起,注重人文精神及人文关怀的培育,提高医护人员人文素质,必将有助于进一步改善和缓解医患矛盾.     

如何做好甲状腺手术的术前沟通

近些年来,我国居民健康无病意识和社会维权意识不断增强,对自身疾病的诊治也提出了更高的要求。尽管医生尽最大的努力满足患者的要求,一旦出现了难以避免的并发症,患者及其家属不仅诉诸于法律,还要诉诸于武力。身处当今医疗环境之下,应尽量避免医疗纠纷的发生,而其关键不仅仅在于医生自身专业知识的积累和技术水平的提高,还在于医患沟通的技巧。笔者结合甲状腺疾病和手术特点及相关法律法规、相关案例和临床经验等对如何做好甲状腺手术术前沟通做了总结和归纳,希望有助于增加医患信任,缓解当今紧张的医患关系。     

Ökonomische Implikationen fehlerhafter Kommunikation am Krankenbett

Good communication can contribute significantly to avoiding expert disputes. An open and honest relationship in dealing with errors allows people to learn from them and avoid them in the future. This benefits both doctors and patients.     

医护人员共情能力及影响因素调查分析

目的探讨医护人员共情能力现状及其影响因素,为医患关系和谐发展和针对性管理提供参考。方法对356名医护人员运用中文版杰弗逊共情量表和自编问卷进行调查分析。结果共情能力总分,护士为114.68±13.81,医生为110.70±19.15,其中观点采择维度护士得分显著高于医生(P0.05);医院等级、工作满意度是护士共情能力的主要影响因素(调整R2=0.125)。结论医护人员共情能力处于中等水平,基层医院及对工作满意度较低的护士共情能力受影响;管理者应结合具体情况对护士进行合理干预,提升护士的共情能力,促进护患关系和谐发展。     

E-mail and oncology: a survey of radiation oncology patients and their attitudes to a new generation of health communication

Electronic mail (e-mail) is a powerful tool that can greatly enhance communication and has numerous potential applications within the medical profession. Physician-patient e-mail communication volume is increasing, but little research has addressed patient interests and concerns about this now commonplace technology. The goals of this study were to review the available literature regarding physician-patient e-mail practices, evaluate patient interest, assess patient perspectives about how e-mail communication might facilitate medical treatment and advice, and determine areas of patient concern regarding e-mail communication with their physicians. To this end, a population of cancer patients was sent a written survey designed to assess their access to e-mail and attitudes about physician-patient e-mail communication. We found that patients favored e-mail for increased convenience, efficiency, and timeliness about general health problems, while it was not favored for urgent matters.     

医疗美容的法律纠纷及其防范

随着我国经济的发展，医疗美容的需求呈现不断增加的趋势，而由于医疗美容行业的特殊性及 相关法律法规尚未完善、健全等原因，有关医美方面的法律纠纷也呈现逐年增多的迹象。法律纠纷的增多 不仅对患者及医生个人的工作及生活产生一定影响，频繁的医疗纠纷同时也会对医疗美容行业及相关学科 的发展产生不良影响，因此本文着重介绍医疗美容的相关法律法规，以期对规避及处理医疗美容法律纠纷 提出建议。     

Communication and informed consent in elderly people

Physician-patient relationship is the key-point for an optimal management of any medical procedure. Before performing any diagnostic or therapeutic procedure, clinical communication with patients is necessary. It should regard the nature and purpose of a proposed procedure including potential risks and benefits. During physician-patient communication, alternatives, as well as the risks and benefits of not receiving or undergoing a procedure should also be disclosed. Thus, a complete physician-patient clinical communication is the basis of "shared decision-making" and plays a clinical-therapeutic role in the informed consent process in order to improve patient care. Informed consent is a delicate process of communication between a patient and physician necessary for patient authorization for any medical intervention. The success of achieving good informed consent procedure depends on the strength of the relationship between the doctor and the patient. For this reason, the traditional paternalistic relationship, in which decisions were made by the doctor, is no longer appropriate. Therefore, the use of a model which allows for a greater patient involvement in the decision making process is fundamental. This approach allows for a clearer impact on patient values. The aspects of the procedure related to these values, combined with the technical and scientific considerations of the doctor, are the basis of a shared decision making process, in which the patient is actively involved. Therefore, an informed consent is not simply the acquisition of the patient's signature, but a real process based on the dialogue between doctor and patient. This dialogue is particularly delicate in some circumstances, such as geriatric medicine and anesthesiology. Seeking consent is part of a respectful relationship with an older person. Adults are almost always considered capable of making personal healthcare decisions. Older adults should also be considered capable of handling their own healthcare where the idea that old age or frailty may inhibit ones' decisional capacity. It is essential to provide appropriate and accessible information for each individual case in order to confirm patient comprehension, especially in the presence of possible coexisting disabilities (i.e., cognitive impairment, presbyacusia, visual disturbances, etc.). The informed consent process should therefore be adapted to patient understanding linked to level of education, and personality. Cognitive impairment may limit the ability to actively participate in the process. In this context, physicians deal with three different situations on a daily basis: 1) patients with good cognitive functioning; 2) patients with various degrees of cognitive impairment; 3) patients with a legal guardian. The aim of this review was to discuss patterns of an accurate, empathetic and effective communication process that may be used during the informed consent process with a particular attention to the emerging problems in the practice of anesthesia in the elderly.     

Dominance and gender in the physician-patient interaction

The goal of this review is to show that physician-patient interactions differ in the degree of dominance asymmetry between the physician and the patient, that physician's dominance behavior is related to negative patient outcomes, and that physician gender affects how physician dominance is perceived by patients. The article provides (1) an overview of existing findings on dominance in the physician-patient interaction, (2) a summary of gender differences in dominance with an emphasis on the physician-patient interaction, and (3) an explanation on why it might be more important for women doctors than for men doctors to adhere to a non-dominant interaction style.     

Physician-patient communication: a lost art?

In the face of rapid advances in technology, there has been a progressive deterioration of effective physician-patient communication. The American Academy of Orthopaedic Surgeons has identified that patients rate the orthopaedic profession as high in technical and low in communication skills. Poor communication, especially patient-interviewing skills, has been identified in medical students as well as in practicing physicians. Effective communication is associated with improved patient and physician satisfaction, better patient compliance, improved health outcomes, better-informed medical decisions, and reduced malpractice suits, and it likely contributes to reduced costs of care. Recognition of the importance of communication has influenced medical schools to revise curricula and to teach communication skills in residency training and continuing medical education programs. National certifying examinations also are being designed to incorporate these skills. Although written material is useful in increasing awareness of the importance of good physician-patient communication, behavioral change is more likely to occur in a workshop environment. The American Academy of Orthopaedic Surgeons is taking leadership in designing and implementing such an approach for its membership.     

E-mail consultation: clinical, financial, legal, and ethical implications

BACKGROUND: Communication via e-mail has become widespread. Nearly every practicing neurosurgeon is confronted with numerous unsolicited e-mail requests for medical advice, guidance, or information. Neurosurgeons need to be aware of the clinical, financial, legal, and ethical implications of providing medical consultation via e-mail. METHODS: A literature review of the penetration of e-mail consultation in medical practice was performed. The data on the potential for reimbursement for provision of these services is presented. Precedents for legal liability are discussed, and issues of compliance with HIPAA regulations are reviewed. RESULTS: Communication between patients and physicians via e-mail is increasing in prevalence, and a substantial number of physicians are providing medical information via e-mail consultation. Billing for online consultation has been approved by the American Medical Association, and several medical insurance carriers are evaluating the economic consequences of reimbursement for e-mail consultation. E-mail consultation raises potential medico-legal concerns, including establishment of the physician-patient relationship, malpractice liability, and HIPAA compliance. CONCLUSIONS: The increasing prevalence of e-mail consultation raises new concerns for neurosurgeons. Some of these concerns have yet to be addressed by regulatory commissions or in the courts. If used appropriately, e-mail communication can facilitate physician-patient interactions, improve access to care, save time for each interaction, and possibly reduce costs of care.     

医护人员对医患关系认知差异性的调查分析

目的探讨临床医师和护理人员对医患关系认识的差异,以寻求促进改善医患关系的最佳途径。方法采取整群随机抽样方法,对浙江省某市4家医院的临床医师和护理人员采用自行设计的医护人员对医患关系认知调查表进行问卷调查。结果医护人员对医患关系的发展趋势以及解决医患冲突的主要手段等问题的认知比较,差异有显著性意义(P<0.01,P<0.05),对引起医患冲突的责任主体和法律适用、部分诱因(收费、患者过高要求、社会因素)认知上差异无显著性意义(均P>0.05)。结论医护人员对医患关系认知的一致性存在差异,提出医护人员对医患关系认知的一致性会极大地增强单方面措施的效果,而彼此相互沟通、尊重和理解是建立和谐医患关系的根本措施。