新式医患关系的特点分析与对策思考

当前中国式医患关系步入了一个新的阶段，呈现出医患关系模式转型、医患紧张关系的扩大化与医患关系影响因素多样化等新特点，同时，医疗服务的提供方式、医患双方的心理特点、社会舆论导向、诊疗结果的预期与患者知识结构的变化也成为新时期医患关系的影响因素与表现形式。针对新时期中国式医患关系的特点，从改善医疗服务的提供方式、调节医患双方心态、建立医疗机构新闻发言人制度、发展医学人文教育等方面入手，提出构建和谐医患关系的方法与对策。     

关于新时期医患关系体系的逻辑分析

本文研究新时期医患关系体系,着重探讨了医患关系体系的应然逻辑和实然逻辑结构,并通过对这种医患关系体系的应然逻辑的实证分析,探讨了传统的医患关系和现代医患关系.     

医患沟通的实践

医患沟通是医患关系的主题,已经引起了研究人员和医护人员的重视。本文针对新时期诚信危机下的医患沟通展开分析并总结,为促进和谐医患关系提供借鉴。     

新时期医患关系的伦理学思考

新时期的医患关系在科学技术迅猛发展,改革开放观念不断冲击,社会主义市场经济体制逐步建立以及医学知识不断普及和公众健康意识显著增强等诸多因素的相互作用、影响下,出现了一些新的趋势,如:医患关系物化与非人格化趋势,医患关系功利增长趋势,医患关系多元化趋势,病人自主参与与平等意识增强趋势,医患关系人群     

新时期如何构建和谐的医患关系

文章首先分析了新时期医患关系的现状及其原因.基于此,从医务人员、医院、患者等三个层面提出了构建和谐的医患关系的具体对策.     

医患矛盾现状及和谐医患关系建立的探讨

医患关系是医院赖以生存和发展的基础.然而,医患关系矛盾在当前已经是一个世界性问题,近些年来,在我国医疗体系建立和完善,医疗事业不断发展的同时,医患矛盾也变得尤为突出.建设和谐医患关系成为新时期医院工作的重中之重.     

如何构建健康和谐的医患关系

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医疗卫生领域实践活动的开展与良性运转。良好的医患沟通是实现以患者为中心、减轻患者心身痛苦、创造最佳心身状态的需要，是促进奁患问理解与支持、提高治疗效果的需要。本文响应当前提出的建立法治与和谐社会的愿望，认为新时期医院关系也应建立于此之上。     

新时期构建和谐医患关系的思考

本文通过总结分析近年来本市多家大型综合性医院的临床活动中医患关系中的现状和存在的问题,结合我国医疗卫生工作的特点,就目前导致医患关系紧张的社会、经济、人为等因素进行归类和对比,以期发现改善目前医患关系的突破口。本文响应当前提出的建立法治与和谐社会的愿景,认为新时期医患关系也应建立于此之上,并就此问题作一探讨。     

论建立和完善医疗卫生系统思想政治工作机制的新思路

新时期,随着医疗卫生体制不断深入化的改革,随之而来一些严重影响医患关系,损害患者合法权益事情时而发生,而卫生体系更是出现了敬业、奉献、集体主义三种职业精神的淡化的现象。针对新时期医疗卫生系统中出现的新情况,及时改变和完善卫生系统思想政治工作机制将有助于提高医疗服务的整体质量,改善医患关系。     

论我国医患冲突成因及和谐关系构建

目前我国医患之间的矛盾与冲突，实质上是新时期我国社会矛盾在卫生工作中的具体表现，反映了社会群体在经济状况、价值取向、角色意识、道德水平、法律法规等多方面的矛盾与冲突。和谐医患关系应是构建我国和谐社会的内容之一。和谐医患关系的构建需要完善的社会医疗保障体系建立、国家卫生行政管理加大、财政补偿合理投入、医疗服务质量提高、医学知识教育普及与提高、媒体理性传播、社会大众道德控制水平提升，法律法规完善等全方位的努力，有赖于医事主体双方及全社会的关注与通力改善。     

医学生倾听技能的重要性与培养

医学模式的转变使医疗倾听技能的重要性越来越被强调,恰当的使用倾听技术,将有利于提高医患沟通的质量、建立和谐的医患关系。医学生养成倾听的态度和习惯是作为一名行医者首先应强调的。     

基层医疗卫生机构全科医生岗位吸引力的影响因素研究

目的 探讨基层医疗卫生机构全科医生岗位吸引力的影响因素,制定有效策略吸引更多的医学毕业生选择全科岗位,以期稳定并壮大基层医疗卫生机构全科医师队伍。方法 在文献研究和预调查的基础上设计问卷,2020年4月—7月对403名应届医学毕业生进行问卷调查,收回有效问卷394份,有效回收率为97.77%。采用结构方程模型分析工作环境、政策保障、个人发展和人际关系4个方面与基层医疗卫生机构全科医生岗位吸引力之间的关系。结果 在基层医疗卫生机构全科医生岗位吸引力结构模型中,工作环境、政策保障、个人发展和人际关系对岗位吸引力的标准化路径系数分别为0.375、0.145、0.236、0.176,表明工作环境对岗位吸引力的影响作用最大,其他影响因素依次是个人发展、人际关系和政策保障。而政策保障、人际关系、工作环境对个人发展的标准化路径系数是0.255、0.168、-0.116,表明政策保障对个人发展的影响最大,而工作环境对个人发展具有一定的负面影响。结论 轻松的工作环境、稳定的政策保障、和谐的人际关系和良好的个人发展空间有效提升基层医疗卫生机构全科医生岗位吸引力,且稳定的政策保障、和谐的人际关系通过促进个人...     

Medical practice: defendants and prisoners.

It is argued in this paper that a doctor cannot serve two masters. The work of the prison medical officer is examined and it is shown that his dual allegiance to the state and to those individuals who are under his care results in activities which largely favour the former. The World Health Organisation prescribes a system of health ethics which indicates, in qualitative terms, the responsibility of each state for health provisions. In contrast, the World Medical Association acts as both promulgator and guardian of a code of medical ethics which determines the responsibilities of the doctor to his patient. In the historical sense medical practitioners have always emphasized the sanctity of the relationship with their patients and the doctor's role as an expert witness is shown to have centered around this bond. The development of medical services in prisons has focused more on the partnership between doctor and institution. Imprisonment in itself could be seen as prejudicial to health as are disciplinary methods which are more obviously detrimental. The involvement of medical practitioners in such procedures is discussed in the light of their role as the prisoner's personal physician.     

Sources and patterns of referrals of oral cancer: role of general practitioners

Referrals of patients with oral squamous cell carcinomas to an oral medicine clinic were assessed with regard to the sources, delays, and pattern of referrals from general medical practitioners and general dental practitioners. Slightly more patients were referred by dental practitioners than by medical practitioners, but general medical practitioners were far more likely to see advanced tumours and to request an urgent second opinion or suggest a diagnosis of malignant disease. The greatest delay overall was caused by the patients in seeking advice from their practitioner, particularly those who attended a general medical practitioner. Both groups of practitioners requested a hospital opinion within roughly a month--a reasonable interval. Subsequent delays were minimal. Delays occur mainly because the patients are slow in seeking professional advice and, in general, do not appear to have been reduced over the decade since a previous British study on referral patterns was carried out. This study emphasises the importance of educating patients about oral cancer since it is they who appear to be mainly responsible for the delays in diagnosis. The results also help to dispel the myth that general medical practitioners might be less competent at diagnosis and referral of patients with oral cancer than are dental practitioners, though we are aware of misdiagnoses from both groups.     

Legal aspect of medical practice

Practice of medicine does not involve its curative aspect alone only, but also it is concerned with its legal nee medicolegal aspect relating to (a) doctor-patient relationship, (b) doctor-doctor relationship, (c) doctor-state relationship in relation to the duties of a doctor, obligation to his patients apart from legal aspect of medical practice including infamous conduct, medical negligence, malpractices, etc. State medicine envisages proper code of conduct of registered medical practitioners to guide and regulate their professional activities, to protect the community at large from quacks and charlatans against malpractice. Medical jurisprudence connotes legal aspect of medical practice.     

Knowledge and attitudes of Victorian medical practitioners in relation to the acquired immunodeficiency syndrome

A stratified random sample of Victorian medical practitioners was surveyed to determine doctors' knowledge of and attitudes to the acquired immunodeficiency syndrome (AIDS). The results of this survey have shown that the knowledge level of a representative sample of medical practitioners in Victoria about AIDS was satisfactory at the beginning of a continuing educational campaign. The knowledge level varied according to the age of the doctor and the specialty of medicine that was practised. Attitudes towards and management practice of AIDS varied according to the specialty and rarely correlated with the knowledge level of the doctor. The majority of doctors who were surveyed had already received queries about AIDS from their patients, and over 90% of doctors thought that medical practitioners have a role to play in educating and counselling patients about AIDS (including preventive measures). In addition, the majority of doctors were receptive to receiving more information about AIDS.     

新医科战略下医学人才培养的法治教育重要性解析

健康中国战略对医学人才的培养提出新的要求,新医科模式下的医学人才培养需要对其内蕴的复合型的法治要素进行有效回应.新医科战略实施过程中,面对医疗风险范围的拓宽、患者权利意识的觉醒以及医学教育的惯性逻辑,医学教育应该在早期注入法治元素,培育医者具备相适应的法律素养,以规则思维、平等思维和底线思维分析问题和解决问题,从而对医...     

紧密型医联体模式下全科医学科建设探索

目的 探讨紧密型医连体模式下全科医学科的定位。 方法 通过对比分析国内全科医学科的发展和深圳市5家区属医院全科医学科的实际运行情况，探索紧密型医联体模式下全科医学科在组织架构、功能定位和学科发展方面的建设。 结果 我国全科医学科的发展主要依赖学科联盟，通过教学师资输出与师资培养在临床基地和实践基地间建立联系。紧密医联体模式下全科医学科发展可借用行政手段强力推进，有利于分级诊疗。2016年深圳市社康机构基本医疗服务人次占全市公立医疗机构门急诊总诊疗量的42.66%。选择在社区首诊的医保参保人数量863万，占全市参保人总数的70%。深圳市区属医院全科医学科在组织架构上多采用双重管理模式，即在业务上归属医务科等职能部门管理，行政上归属社区健康管理中心管理。全科医学科在功能定位上侧重于全科教学，着重于全科医学人才培养，为基层输送合格的全科医生。全科门诊是全科医生的主要带教场所，全科住院部适合收治多病共存、未分化疾病和教学患者，有利于全科医生对典型患者的系统学习。 结论 紧密型医联体模式有利于分级诊疗推进，该模式下全科医学科组织架构可采用双重管理，其功能定位为全科教学，其学科发展方向为多病共存患者照顾。      

The relationship between chief complaints, psychological distress, and suicidal ideation in 15-24-year-old patients presenting to general practitioners.

OBJECTIVES: To determine the prevalence of psychological distress and suicidal ideation among patients aged 15-24 years presenting to general practitioners, and the relationship between these variables and patients' chief complaints. DESIGN AND SETTING: Questionnaire survey of young people presenting to Australian general practitioners between 1996 and 1998. PARTICIPANTS: 247 general practitioners who volunteered to participate in a nationwide project aimed at teaching general practitioners to identify and treat suicidal youth; 3242 consecutive 15-24-year-old patients presenting to participating general practitioners during a specified six-week period. MAIN OUTCOME MEASURES: Patients completed three self-administered questionnaires: the General Health Questionnaire-12, the Center for Epidemiological Studies Depression Scale, and the Depressive Symptom Inventory-Suicidality Subscale. Patients' chief complaints were obtained from summary sheets completed by their general practitioners. RESULTS: While only 12% of patients presented with psychological complaints, about 50% percent had clinically significant levels of psychological distress and 22% had clinically significant levels of suicidal ideation. CONCLUSIONS: Despite presenting with primarily medical complaints, almost half of young people presenting to primary care physicians had high levels of psychological distress and almost a quarter had high levels of suicidal ideation.     

全科医生在我国医疗卫生服务体系中的作用研究

我国当前正进行新一轮的医药卫生体制改革，全科医生在此次医改中扮演着重要的角色，探讨全科医生在医疗卫生服务体系内的价值，有助于激励各方参与者共同采取措施，促进全科医生服务的发展。本文从基本医疗卫生服务覆盖范围、医疗资源使用情况、就医格局、应对慢性病挑战的局限性、卫生费用流向、医患关系等方面分析了目前我国医疗卫生服务体系面临的挑战，认为全科医生具有以下6个方面作用：有助于我国“人人享有卫生保健”目标的实现；平衡医患间医疗信息的不对称，降低医疗卫生服务体系内过度医疗；有助于形成合理的就医格局，高效使用卫生资源；使医疗服务具有连续性、主动性、互动性，应对慢性病的挑战；注重“疾病预防”，使卫生费用的投入得到较好的产出；提升医患关系的和谐度。同时，本文基于上述分析，对我国如何更好地发挥全科医生的作用提出了相应的对策建议。