医患和谐需要"双向道德规范"

医患关系的特殊性,决定了协调医患关系需要双向道德规范。而对这一问题的探讨,不仅引发了人们思考特殊领域里人际伦理关系协调的双向性特点。而且也从一般意义上凸显了当前双向伦理规范研究的必要性和迫切性。     

清代医师旅日史钩沉

１８世纪初至１９世纪初的１００年间,１６位中国医师先后随商船旅日,行医授徒,并与日本医师进行学术交流。由于日本当局与清朝皇帝实行锁国政策,他们的活动范围、时间受到了限制。笔者在日本查阅了大量资料,踏寻了几位旅日医师的足迹,理清了这一个多世纪头绪纷繁的人员往来和交流活动,重点介绍了影响较大的朱来章、朱子章、周歧来、赵松阳、李仁山、胡兆新等人的事迹。     

非精神科医生对抑郁认识及相关因素的调查

目的　了解综合医院非精神科医生对抑郁问题的认识，为抑郁的诊治工作及医学再教育提供资料与信息。方法　按医院级别分层选点随机抽样获取样本，用自编抑郁问题调查问卷进行调查。问卷内容包括抑郁一般知识、临床表现以及相关问题三部分。然后就非精神科医生对抑郁的认识及其相关因素进行对照与分析。结果　共完成调查346人。抑郁知识平均得分13.53±2.08，对抑郁知识条目的应答正确率最高的为95.4％，最低的仅为14.5％。抑郁知识得分与医院级别、职称、学历、及对抑郁与非精神科医生关系的认识等因素有关。结论　非精神科医生对抑郁的认识和对抑郁知识的掌握情况急待改善。     

严格医护人员准入设立医护人员职业能力倾向性测试

对吉林省医学会和长春市医学会2家医疗事故鉴定组织，从2004-2007年新的《医疗事故处理条例》实施3年来669例的鉴定案例进行回顾性调查，对引起医患纠纷的医院因素进行分析，包括医疗技术过失、医疗程序瑕疵、服务态度、管理不完善、外来因素介入、技术局限性等方面，并提出通过严格医护人员准入的方式，设立医护人员职业能力倾向性测试。防范医患纠纷，为医院的医疗工作更好地开展提供参考依据。     

中医临床用药思维的干扰因素

近年来，在中医临床用药思维中出现了一些新的变化情况，针对存在的这些问题，本文作者根据临床体会与观察，从三个方面具体分析了中医临床用药中思维干扰的产生原因与需要采取的预防方法，同时论述了用药中正确的思维方式与方法对中医临床辨证论治的重要作用。     

从社区医疗看全科医生培养

从全科医生在社区医疗服务中的角色入手,分析了目前我国社区医疗服务中全科医生的状况,提出了立足岗位培训,加速全科医生培养的途径.并从转变教育观念、课程设置、教材建设、师资队伍建设等方面论述了怎样搞好全科医生的岗位培训工作.     

循证实践:促进医患关系的重要途径

医患关系成为近年来大众关心的热门话题,在当前医疗体制改革、转型的过程中显得更加突出。循证医学的出现顺应了医学模式转变带来的临床医疗实践的变革,将在促进医患关系中起到重要作用,循证实践的推行将有助于缓解医患间的矛盾,促进医疗质量的提高。     

护士在牙槽外科四手操作中的配合

目的:探讨护士在牙槽外科四手操作中的配合作用。方法:患者采用随机分配,分为两组,常规护理组和四手操作组,并设计表格对病例及工作时间进行统计。结果:四手操作组的手术操作时间平均比常规护理组缩短21min,患者满意度达100%。结论:四手操作有效提高了牙槽外科门诊的工作效率,保障医疗安全,提高医、护、患的满意度。     

Doctors also suffer when giving bad news to cancer patients

Giving bad news to patients with cancer may generate stress in doctors, who use distancing tactics. The causes of this anxiety come from social conventions and its consequences affect both doctors and their patients. There is no gold standard by which stress may be overcome during the interview but we offer some suggestions that may help.     

Aggression towards health care staff in a UK general hospital: variation among professions and departments

Background. Aggression towards health care staff is an increasing problem and although many studies have examined psychiatric settings, few have considered general hospitals and in particular, variation among professions and locations. In addition, studies often fail to include all forms of aggression such as threatening behaviour and verbal aggression. Methods. This study extends existing research by evaluating physical assault, threatening behaviour and verbal aggression from patients/visitors towards general hospital staff in the context of different professions and departments. Results and conclusions. The survey of staff showed that aggression is widespread. Within the preceding year, 27% of the respondents were assaulted, 23% experienced threatening behaviour from patients and 15.5% experienced threatening behaviour from visitors. Over 68% reported verbal aggression, 25.7% experiencing it more regularly than monthly. By departments, over 42% of the medical department staff, 36% of the surgical staff and over 30% of the Accident and Emergency staff were assaulted. By profession, staff nurses and enrolled nurses reported the most assaults (43.4%) and doctors, the fewest (13.8%). Other nursing grades and health care professions all reported levels of physical assault in excess of 20%. Correspondingly high levels of threatening behaviour and verbal aggression were also reported although the patterns of victimization differed according to the various professions and departments. Independently, significant levels of assault, threatening behaviour and verbal aggression were reported. When aggregated they demonstrate the higher levels of victimization that general hospital staff experienced on a regular basis. Relevance to clinical practice. Institutional averages actually obscure the much higher levels of aggression experienced by the particular professions in particular departments. This study helps to localize the problem and identify those at most risk, but more research is needed into the aetiology of the aggression and of vulnerability factors associated with victimization.