强化规培医师思维能力的方法研究初探

目的探究规培医师思维能力的强化对策,完善院内规培医生的培训对策。方法依据青岛大学附属医院2017年1月—2018年12月所收集的规培医师数据,2017年1月—2017年12月期间未进行思维能力强化培养,设为对照组;2018年1月—2018年12月期间进行思维能力强化培养,设为强化组,两组均为62人。比较两阶段患者就诊满意度和工作评价合格率。结果对照组患者满意度为96.8%,强化组治疗满意度为87.1%,比较两个时间段患者就诊满意度,强化组明显好于对照组,有统计学意义,P<0.05。对照组合格率为74.2%;强化组合格率为91.9%,比较两个时间段医生工作情况,强化组明显好于对照组,有统计学意义,P<0.05。结论规培医生是世界医生行业未来的发展趋势和方向,完善规培医生思维能力的培养对策有利于提升院内的治疗质量和服务质量,定向的、科学的、优质的规培医师思维能力培养有助于提升规培医师的思维能力、改善医患关系、提升治疗效果,应着重强化培养。     

中医思维：中医药文化自信的内在逻辑

中医思维传承中国古代哲学的辩证思维传统,以独特的视角、方式和方法研究人类健康、生命及其疾病现象,表现出中华民族特有的原创思维特征。传承中医思维是坚定中医药文化自信的历史逻辑,创新中医思维是坚定中医药文化自信的理论逻辑,养成中医思维是坚定中医药文化自信的实践逻辑。中医药院校必须改革创新培养路径,培养出具有中医思维自觉的“铁杆”中医人才。     

临床应用大方的思路与方法

探讨临床应用大方的思路和方法。从辨证的模糊性、疾病的复杂性与矛盾性和小方在临证应用中的困惑与不足等方面探讨临床应用大方的必要性,从合方而用、专方及体质辨证基础方等方面论述大方药势的处方学特点。     

Different types of thinking of seven‐year‐old children and their achievements in school

The theoretical basis of the research was the conception of human intelligence of Sternberg. The aims of the study were: ? to determine the level of analytical thinking, creative thinking and practical thinking of seven‐year‐old children;

? to determine the relations between the level of analytical, practical and creative thinking and pupil's success in school;

? to determine the association between the level of different kinds of thinking and their success as students; and

? to explore the impact of teacher's perception of level of children's thinking on their achievements in school.

The research was carried out on a group of 167 seven‐year‐old children selected at random from urban schools and their teachers. This paper discusses how learning programmes foster and promote the development of different forms of thinking.     

Toward a Model for Counseling the Wives of Alcoholics

Earlier literature on the wives of alcoholics confused the causes with the effects of alcoholism. Wives of alcoholics were thought to be highly neurotic contributors to their husbands' illness. Furthermore, sexist biases influenced opinion and research with the result that while wives were blamed for their spouses' illness, husbands of alcoholic wives were considered blameless victims. Despite recent gains in the understanding of alcoholism and its effects on family dynamics, treatment of alcoholic marriages continues to reflect subtle sexist attitudes and values. For example, wives are often viewed as little more than adjuncts to their husbands' treatment. Such approaches undermine reality-centered and effective treatment. A model for counseling wives of alcoholics is proposed which addresses her special and separate concerns.     

中医医案方剂多维相似度算法设计与探索＊

中医医案方剂具有多维度的特性，单独采用一种相似度算法难以展现方剂数据在各维度的相似情况，具有一定的局限性。本研究基于中医医案方剂的多维数据特点，结合中医临床遣方用药的思维过程，设计了中医医案方剂的多维相似度算法，并以七则国医大师医案为示例，详细展示了该算法的计算过程，同时将多维相似度算法计算结果与传统算法计算结果进行了对比分析。通过对比可以看出本算法能够相对全面地反映不同方剂间的相似度，且结果更为合理也更贴合中医临床实际。     

Expectancy-Induced Placebo Analgesia in Children and the Role of Magical Thinking

Expectations and beliefs shape the experience of pain. This is most evident in context-induced, placebo analgesia, which has recently been shown to interact with the trait of magical thinking (MT) in adults. In children, placebo analgesia and the possible roles that MT and gender might play as modulators of placebo analgesia have remained unexplored. Using a paradigm in which heat pain stimuli were applied to both forearms, we investigated whether MT and gender can influence the magnitude of placebo analgesia in children. Participants were 49 right-handed children (aged 6–9 years) who were randomly assigned—stratified for MT and gender—to either an analgesia-expectation or a control-expectation condition. For both conditions, the placebo was a blue-colored hand disinfectant that was applied to the children's forearms. Independent of MT, the placebo treatment significantly increased both heat pain threshold and tolerance. The threshold placebo effect was more pronounced for girls than boys. In addition, independent of the expectation treatment, low-MT boys showed a lower tolerance increase on the left compared to the right side. Finally, MT specifically modulated tolerance on the right forearm side: Low-MT boys showed an increase, whereas high-MT boys showed a decrease in heat pain tolerance. This study documented a substantial expectation-induced placebo analgesia response in children (girls > boys) and demonstrated MT and gender-dependent laterality effects in pain perception. The findings may help improve individualized pain management for children.PerspectiveThe study documents the first experimental evidence for a substantial expectancy-induced placebo analgesia response in healthy children aged 6 to 9 years (girls > boys). Moreover, the effect was substantially higher than the placebo response typically found in adults. The findings may help improve individualized pain management for children.     

基于结构方程模型的护理本科生自主学习能力影响因素研究

目的探讨护理本科生心理自立水平、评判性思维倾向、教育环境认知对其自主学习能力的影响,并建立其作用关系模型。方法采用一般资料问卷、护理学生自主学习能力量表、中文版加利福利亚评判性思维倾向调查表、大学生心理自立问卷和医学教育环境量表对湖南省11所护理院校的885名护理本科生进行调查。结果教育环境、心理自立、评判性思维倾向均可直接正性影响护理本科生自主学习能力,其中心理自立的效应值最大(总效应值为0.295,直接效应值0.180,间接效应值0.115);心理自立还可通过评判性思维的中介作用间接影响自主学习;教育环境5大因素均对自主学习产生直接或间接影响,其中效应值最大的是学习知觉域(总效应值为0.195,且全部为直接效应)和学术知觉域(总效应值为0.256,且全部为直接效应)。结论高等护理教育应注重培养护理本科生心理自立人格和正性评判性思维倾向,同时教育环境改善的重点应在学习知觉域和学术知觉域。