Using quality of life measurement to enhance interdisciplinary collaboration

The use of quality of life (QOL) measurement in the End-Stage Renal Disease (ESRD) setting can be useful to measure the impact of interventions on outcomes. Using QOL results can also increase patient participation in care planning and, thus, increase patient satisfaction with care. Clinical indicators can be developed to trigger further assessment of various patient needs.     

建立有效医患沟通 构建和谐医患关系

随着现代医学的发展,医患关系的协调日益重要。同时,也是当前十分敏感的一个社会问题,受到全社会的关注。很多医疗纠纷都是由于医患关系的不协调引起的。而医患关系处理失当的主要原因,就是医患之间缺乏沟通引起的信任危机,进而导致医疗纠纷的出现。因此,本研究就如何建立有效的医患沟通进行探讨,为构建和谐的医患关系提出建议。     

医患沟通技能对阻生智齿冠周炎患者治疗依从性的影响

目的：探讨医患沟通技能对阻生智齿冠周炎患者治疗依从性的影响。方法：收集2011年4月～2012年10月在武汉科技大学附属汉阳医院口腔科门诊中就诊的阻生智齿冠周炎患者132例,分成A、B两组各66例。A组采用传统诊疗方式,B组注重医患沟通技能的体现,对患者进行依从性教育,以炎症控制后1个月内患牙拔除率为依从性评价指标。结果：B组患者依从性明显优于A组,差异有统计学意义（P〈0．01）。结论：应用医患沟通技能可以提高阻生智齿冠周炎患者治疗的依从性。     

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.     

Ethics in practice. Terminating the physician-patient relationship

A.G. is a thirty-six-year-old reading teacher who presented to an orthopaedic surgeon with patellofemoral pain. After an appropriate evaluation, the physician suggested a course of physical therapy and anti-inflammatory medication. The patient asked for and received time off from her work, stating that her job required her to climb stairs. At multiple follow-up visits, A.G. was found to be poorly compliant with physical therapy and home-exercise programs. Her only interest appeared to be in securing the doctor's letter of support for an extended medical leave. At each visit, she demanded that the physician write a letter stating that she was unable to work as a reading teacher due to knee pain. At one point, she became belligerent with the medical office staff when the letter was not prepared. When her physician tried to elicit information about whether there were any unaddressed obstacles to rehabilitation treatment, A.G. did not answer the questions. Instead, she explained that her job required her to climb stairs and that she was unable to return to work because of the continued knee pain. The physician explained that, on the basis of his examination and assessment, he expected that her pain would improve if she complied with the treatment plan. After multiple visits, the orthopaedic surgeon counseled the patient that he did not see that his attempts to help her were providing any benefit and that perhaps it would be best for her to seek help from another physician. A.G. replied that she did not want to start going to another doctor. She stated emphatically that he was her doctor, that she was paying him, and that she wanted a letter saying that she should be granted an extended medical leave from work because of her inability to climb stairs. After this encounter, the surgeon thought it best to terminate the professional relationship.     

Techniques to enhance the ileal conduit

There is a need for operations by which the complications of ileal conduits can be prevented or corrected. The author details techniques to ensure the formation of a short conduit, to shorten a conduit through a peristomal incision, and to correct ileocutaneous stomal stenosis.