如何改善医患关系

医患关系是新时期全社会关注的热点问题，应该说，目前的医患关系不是理想的医患关系，其中有许多不和谐的音符。理想和谐的医患关系应该充满人性化、道德化，即真正以病人为中心，全心全意为病人的健康服务。如何改善医患关系，如何与病人沟通，现浅析如下：     

重视"信任度"的作用促进医患关系改善

医患关系的建立是以医疗保健服务为戴体的,由于医疗保健活动需要医患双方的共同参与,因此,医患关系实际为医患之间在医疗保健服务过程中的协作关系.信任度是指医患双方相互信任的程度,它反映出医患之间理解和包容度的高低,是医患之间协作与配合默契程度的基础.医患关系制约着医疗卫生行业整体形象的改善和整体效益的实现,因此,有必要对信任度在医患关系调节中的作用和地位进行深入剖析,以引起应有的关心和重视.     

关于现代医患关系模式的探讨

医患关系是医学社会学中重要的课题之一。医患关系的含义比较宽泛,现代医学认为：医者系为患者诊治服务的整个群体,患者不仅仅是指病人本身,还包括患者的亲属、单位、组织等。因此,广义的医患关系是医疗卫生服务群体与服务对象及相关群体的相互关系。１医患关系模式医...     

应注重提高医务人员的人文素质

医患关系是以医务人员为中心的医疗服务的供给方，与以患者为中心的医疗服务的需求方，在医疗服务过程中形成的相互影响、相互制约的关系。近年来，个别医疗机构的医疗纠纷增多，医患矛盾“日益突出”，已经成为不争的事实。如何建立和谐的医患关系，成为业内普遍关注的一个问题。笔者就提高医务人员的人文素质，缓解“医患关系紧张”的问题谈点看法。     

探讨构建和谐医患关系对策探讨

目的探讨构建和谐医患关系的对策。方法利用中国医院数字图书馆检索1994.01～2011.12关键词为＂医患关系＂的论文共2708篇,按其发表时间及内容等方面进行统计分析。结果 2006～2011年医患关系论文量迅速增长。与医患关系相关的法律问题最受关注,与医患关系相关的医学教育受关注相对较少,医院文化建设等内容受关注程度最低。结论应建立健全符合国情的医患关系法律法规;加强医德医风建设;提高医患有效沟通;注重医学教育中的人文素质教育;重视医院文化建设。     

把握病人心理融洽医患关系

医患关系是社会人际关系的重要组成部分。医患关系是患者、家属与医生、护生及医院各级各类人员之间的关系。在工作质量调查中 ,认为医患关系紧张或比较紧张的比率较大 ,实际工作中 ,医患之间产生的矛盾时有发生 ,有医疗技术方面的 ,有服务态度方面的 ,有收费虚高的等等。据统计资料表明 ,有 90 %的医疗纠纷是患者不满意医护人员的服务态度而引发的。小到医患关系发生争执 ,大到医患纷争上公堂 ,甚至失去理性大打出手都是医患关系紧张的集中反映。建立良好的医患关系 ,对提高医疗质量、改进医疗服务、稳定医疗秩序、促进医学发展、维护社会…     

浅谈临床教学新模式与医患关系

随着医患关系矛盾的尖锐化,传统医学教育模式难以适应新型医患关系的变化,本文旨在总结及探讨临床教学新模式,提高临床教学整体水平,构建和谐的医患关系,确保临床实践教学正常运行。     

以人为本科学管理建立和谐医患关系

医院承担着救死扶伤、治病救人的崇高使命,医疗服务的过程是一个医学科学实践的过程。从某种意义上说,医患关系伴随着医疗服务而诞生,自从有了医疗服务活动,便产生了医患关系。随着社会的发展和医学模式的转变,医患关系的内涵也发生变化。就当前社会对医疗服务的关注、患者寻医需求的变化、政府对医院的调控管理、媒体的宣传导向作用以及医学科学发展的现况而言,良好的医患关系对构建和谐社会起到了重要作用。因此,运用科学管理、现代人文观念,针对新形势下医患关系的特点,建立和谐的新型医患关系,以更好地发挥医院在完善社会保障事业,构建和谐社会方面的重要作用。     

从医患关系入手加强医学学生人文教育

日益增多的医患纠纷对医学学生的人文教育具有重要的启示。本文从现阶段医患关系的特点入手,指出高等医学院校是人文教育的源头,就如何提高医学学生的人文教育提出相应的对策,以达到从根本上回归人性化、和谐医患关系的目的。     

在新医改《意见》指引下 进一步构建和谐的医患关系

构建健康和谐的医患关系是建设社会主义和谐社会的一项重要内容。当务之急是要紧紧抓住全社会都在认真落实新医改《意见》和《实施方案》的有利时机，进一步做好这项工作。1新形式下医患关系的现状 新医改《意见》和《实施方案》的贯彻执行，为千家万户带来了福音，为医药卫生事业发展及健康和谐医患关系的构建带来了蓬勃生机，     

新时期新型医患关系现状的多维思考

本文针对新时期新型医患关系的现状、成因及所给启示，依据社会学和心理学的理论，从社会政治、经济、文化、心理、法律多维层面进行了思考。认为医患关系恶化的现状是令人担忧的；其形成原因是多元的；其改善途径应是全方位的；努力应是社会的；历程是漫长的；人性化的医疗服务是必要的。     

Reflections on the development of health care and patients' rights in Croatia

Nowadays, in the world of markets and market economy, not only health care but medicine and medical practice in general, are looked upon more and more through the eyes of profit-making and financial interests. At the same time, there is an increasing number of initiatives intended to emphasise that human medicine should be at the service of society and that this fact should have priority over any market and financial interests of individuals even in "the market oriented world". The experience of the Croatian non-governmental organization to which the authors belong and which deals with patients' rights and helps in the development of partnership relations between patients and other subjects in the health care system, can be of a wider interest. This short review is the result of eight years' experience of the Croatian Association for Patients' Rights (CAPR), and its possible effects on the health care system in the future from the authors' points of view.     

颌间固定与坚固内固定治疗颌骨骨折疗效比较

目的分析坚固内固定技术在颌骨骨折治疗中的临床应用效果。方法将我院收治的40例颌骨骨折患者,按上、下颌骨折和具体的骨折部位分为两组,一组采用传统的颌间固定技术治疗即颌间固定组,另一组采用坚固内固定技术治疗。分别记录上、下颌骨折患者治疗所需的固定周数、有无口臭和咬合错乱。并对应用坚固内固定技术的治疗的接骨材料进行调查,了解不同接骨材料医生和患者的评价。结果上、下颌骨骨折患者采用颌间固定治疗和坚固内固定治疗均可治愈,但坚固内固定技术所需固定的平均周数,治疗过程中患者发生口臭的例数,咬合错乱的例数均低于颌间固定。结论坚固内固定技术具有重要的理论基础,可以更高效,人性化的治疗颌骨骨折,但医生应注意适应症和接骨板材料的选择,及在术中正确安放的接骨板位置。坚固内固定可作为颌骨骨折的首选治疗方法。     

成人慢性乙型肝炎患者焦虑抑郁症状调查

目的了解成人慢性乙型肝炎患者的焦虑抑郁症状.方法 随机抽取2006年1月～12月期间我院慢性乙型肝炎住院患者70例作为研究组,另随机抽取同期在本院健康体检正常者70例作为对照组,采用BECK焦虑量表和抑郁量表调查,比较两组焦虑和抑郁症状的发生率有无区别,并采用描述性相关性研究法分析抑郁症相关影响因素.结果与对照组相比,研究组抑郁症的发生率较高(P＜0.05),而焦虑的发生率在两组间无统计学差异(P＞0.05).焦虑抑郁水平与病情、年龄、性别、文化程度、病程等因素相关.结论 慢性乙型肝炎患者的抑郁发生率较正常人群高,而且与病情、年龄、性别、文化程度、病程等因素有关.因此,有必要对乙肝患者进行心理支持治疗.     

人性化理念在我院健康体检的创新

随着社会经济的发展,生活水平的不断提高,人们的生活方式和行为都有了新的变化,健康状况也日益受到个人和单位的重视。健康体检已成为人类健康的潮流,因此医院的职能和任务已超出了传统意义上的"治病救人",我院在新形势下开办了体检病房,满足不同人群的需要,打破了门诊体检的单一模式,在市场竞争日益激烈的情况下,更新服务理念,提高了体检服务质量和内涵。     

Biotechnology entrepreneurship and ethics: principles, paradigms, and products

Biotechnology, whether in the context of new drugs derived from DNA and genetic technology, genetically modified food, or biologics making use of living cells, raises ethical concerns at a variety of different levels. At the research level, there is concern that the very nature of research is being subverted, rather than enhanced, by entrepreneurship. This area of ethical concern has intensified in the United States as a result of the conflicts of interests resulting from the growing alliance between University academia and private industry in the research enterprise. As we travel down the research path into development of a drug or technology, ethical questions arise with respect to protecting human subjects and society from danger and exploitation by researchers. As development gives way to marketing and dissemination of a new product, government regulators are pressed to get drugs and biologics through the regulatory pipeline into the market faster, walking an ethical tightrope between speed and safety. As new biotechnology products enter the market place, doctors and patients traverse yet another tightrope, that between unknown risk and the promise of benefit. And finally, patent protection is increasingly viewed as a unethical culprit in keeping prices high and depriving the global poor from lifesaving drugs and biologics. Bioethics has, to date, been largely a creation of Western research and medicine. As such it is wholly inadequate to respond to the cascade of ethical issues that flow from a vibrant biotechnology industry. And if biotechnology is in its infancy, as most believe, it is crucial that scientists, entrepreneurs and governments engage in dialogue about the ethical and societal questions raised on the road of scientific progress.     

Patient autonomy and relatives' right to know genetic information

One of the most difficult issues doctors face is a conflict between their professional duties. Such a conflict may arise when doctors know that information has implications not only for patients but also for family members but their duty of confidentiality prevents them from disclosing it. A comparative analysis of English and Israeli medical law reveals that the doctors' duty is based on two principles: a liberal perception of patient autonomy and an overriding utilitarian principle of prevention of harm. However, socio-medical research indicates that these principles do not entirely reflect the views of patients and doctors and are too narrow to deal with the complex situations in practice. Thus, it is argued that the doctor's legal duty of confidentiality should be reconsidered and qualified when it concerns the family. It is suggested that if medical law seeks to recognize the various interests family members have in genetic information then we should consider a different approach, founded on a relational interpretation of autonomy and communitarian notions of solidarity and moral responsibility. This approach perceives confidentiality and privacy as embracing the family unit, based on the view that close relatives are not entirely outside the private sphere of the individual but rather are integral to his or her identity. Thus, to the utilitarian mechanism available in medical law this approach adds a social criterion: The effect any decision (to disclose or not to disclose) will have on the familial relationship and on the dynamics of the particular family. This will provide a more flexible and workable alternative for doctors to resolve familial tensions over access to genetic information.     

Cost-effectiveness of identifying aortoiliac and femoropopliteal arterial disease with angiography or duplex scanning

OBJECTIVES: Cost-effectiveness analysis of three diagnostic imaging strategies for the assessment of aortoiliac and femoropopliteal arteries in patients with peripheral arterial occlusive disease. The strategies were: angiography as the reference strategy, duplex scanning (DS) plus supplementary angiography (S1) and DS plus confirmative angiography (S2). DESIGN, MATERIALS AND METHODS: A decision model was built with sensitivity and specificity data from literature, supplemented with prospective hospital cost data in Euro (euro). The probability of correctly identifying the status of a lesion was taken as the primary outcome. We compared strategies by assessing the extra costs per additional correctly identified case. RESULTS: Assuming no false positive or false negative results, angiography is the most effective strategy if the prevalence of significant obstructive lesions in the aortoiliac and femoropopliteal tract exceeds 70%, or if the sensitivity of duplex scanning is lower than 83%. In case of lower prevalence, strategy S1 becomes equally or even more effective than angiography. At a prevalence of 75%, performing angiography costs euro 8443 per extra correctly identified case compared with strategy S1. CONCLUSIONS: In most situations angiography is more effective than diagnostic strategy S1. However, if society is unwilling to pay more than euro 8443 for knowing a patient's disease status, diagnostic strategy S1 is a cost-effective alternative to angiography, especially at lower prevalence values.     

医院门急诊灾后重建中的问题及对策

目的 探讨医院门急诊在灾后重建中存在的问题和应对策略.方法 以调研、检查、走访、坐谈和问卷等形式,对2008年6月～2009年6月的就诊患者2万人次、社会各界人士800人次、医护人员1600人次进行调查,集成地震后医院门急诊重建中存在的问题,针对问题实施改进措施,对比整改措施实施前后的效果.结果 灾后重建中门急诊面临大...     

Organization and management of urgent imaging

Urgent imaging accounts for more than 50% of the overall activity in diagnostic imaging departments. The enormous impact of this workload makes the appropriate organization and management of urgent imaging essential. Providing urgent imaging services aims to meet the needs of urgent and critical patients from both within the hospital (wards) and outside it (emergency department). To achieve these aims, all hospitals should have a specific unit for urgent imaging. This unit should be large enough to deal with the volume of activity and it should be provided with the human, technological, structural, and organizational resources necessary to fulfill this mission.