护士对老年人性行为态度的现况调查及影响因素分析

目的探讨护士对老年人性行为的态度现状并分析其影响因素,为开展针对性的老年性知识培训提供依据。方法采取方便抽样法,抽取重庆市渝中区3家综合性三甲医院的325名护士作为研究对象,采用一般资料问卷、中文版老年人性知识和态度量表态度亚量表(ASKAS)对其进行调查。结果 325名护士对老年性态度得分为(117.81±14.27)分,其中82.46%护士对老年人的性行为持较积极的态度,影响因素包括性别、学历、工作年限、科室、和老年亲戚来往密切(P<0.05,P<0.01)。结论护士对老年人性行为的态度趋于正向,但较国外同类研究态度保守。护理管理者应加强对护士的继续教育,提高其学历水平,同时拓展老年性生理、性心理、性道德知识,积极培养护士对老年人性行为的正向态度。     

Reflections on the relational ontology of medical assistance in dying

Canadian nursing practice has been profoundly influenced by the legalization of medical assistance in dying in 2016, requiring that nurses navigate new and sometimes highly challenging experiences. Findings from our longitudinal studies of nurses' experiences suggest that these include deep emotional responses to medical assistance in dying, an urgency in orchestrating the perfect death, and a high degree of relational impact, both professionally and personally. Here we propose a theoretical explanation for these experiences based upon a relational ontology. Drawing upon the work of Wildman, we understand a relational ontology to be one in which relationships are more fundamentally central than the conceptual entities that provide the context to practice. It is in a relationship that conceptual entities, and their affiliated values, are created and recreated. Seen as causal, relationships have ontological status, with important implications for how we consider the concepts of death, suffering, and time in this context. From a conceptual perspective, suffering is primarily self-defined based upon personal histories, time reflects the potential remaining until death, and death is primarily biological and amoral, although social discourses of a good and bad death surround the death trajectory. However, within a relational ontology of medical assistance in dying, these understandings shift. Death becomes primarily social rather than biological, suffering is shared, and time until death is now clearly delimited. Accordingly, nurses assume a profound responsibility for influencing outcomes that are authentically person-centered. These understandings provide important insights into nurses' experiences, enabling us to recognize the causal effects, both intended and unintended, of nurses' relational practices amidst the complexities of assisted death. Drawing on such a perspective, we find implications for how we provide spaces for nurses to reflect on, and have conversations about, their experiences with some of the greatest mysteries of life—death, suffering, and time.     

A Conceptual and Computational Model of Moral Decision Making in Human and Artificial Agents

Recently, there has been a resurgence of interest in general, comprehensive models of human cognition. Such models aim to explain higher‐order cognitive faculties, such as deliberation and planning. Given a computational representation, the validity of these models can be tested in computer simulations such as software agents or embodied robots. The push to implement computational models of this kind has created the field of artificial general intelligence (AGI). Moral decision making is arguably one of the most challenging tasks for computational approaches to higher‐order cognition. The need for increasingly autonomous artificial agents to factor moral considerations into their choices and actions has given rise to another new field of inquiry variously known as Machine Morality, Machine Ethics, Roboethics, or Friendly AI. In this study, we discuss how LIDA, an AGI model of human cognition, can be adapted to model both affective and rational features of moral decision making. Using the LIDA model, we will demonstrate how moral decisions can be made in many domains using the same mechanisms that enable general decision making. Comprehensive models of human cognition typically aim for compatibility with recent research in the cognitive and neural sciences. Global workspace theory, proposed by the neuropsychologist Bernard Baars (1988) , is a highly regarded model of human cognition that is currently being computationally instantiated in several software implementations. LIDA ( Franklin, Baars, Ramamurthy, & Ventura, 2005 ) is one such computational implementation. LIDA is both a set of computational tools and an underlying model of human cognition, which provides mechanisms that are capable of explaining how an agent’s selection of its next action arises from bottom‐up collection of sensory data and top‐down processes for making sense of its current situation. We will describe how the LIDA model helps integrate emotions into the human decision‐making process, and we will elucidate a process whereby an agent can work through an ethical problem to reach a solution that takes account of ethically relevant factors.     

大学生网络道德行为状况问卷调查与分析

采用社会学的统计调查方法，对北京、广州、合肥3城市的10所高校大学生的网络道德行为状况进行了问卷调查，对回收答卷的网络谎言、黑客行为、网络色情、网络游戏、上网目的、最关心问题6项内容用SPSS统计软件进行数据分析，得出8个数据表格。结果显示大学生的网络道德意识淡薄，网络道德判断力普遍较弱，不规范行为较多。     

关于建构医院医德医风微观调控模型的研究

医院管理与医德医风建设关系密切,依法治医是医德建设健康发展的前提和保障.构建医德医风微观调控模型有助于加强医德医风的经常性建设,有助于克服医德医风建设中诸多不落实、不到位、不管用的因素,丰富医德医风建设的内涵,完善医院管理的职能.     

Health, morality, and infant feeding: British mothers' experiences of formula milk use in the early weeks

The way mothers feed their babies is, internationally, the subject of research, health policy initiatives, and popular discussion, which commonly affirm the mantra 'breast is best'. On one level, this mantra reflects scientific evidence about nutrition and maternal and infant health. From a socio-cultural perspective, the pro-breastfeeding message has, however, been considered an aspect of morality, which influences maternal identity in important ways. This article explores this idea. It does so primarily by reporting and discussing some findings from a study about British mothers' experiences of using formula milk for infant feeding. The paper begins by contextualising this discussion by briefly outlining some aspects of the construction of infant feeding as a social problem in Britain, focusing in particular on the influence of 'the new paradigm of health'.     

A critical review of the arguments debating the role of the nurse advocate

AIMS OF THE PAPER: This paper critically reviews the arguments for and against undertaking the role of nurse advocate. BACKGROUND: Advocacy has become a popular concept in nursing literature over the past two decades. By addressing issues of power and accountability, conclusions are drawn about the risks facing nurses who would practice patient advocacy. METHODS: Review and analysis of theoretical debate. RESULTS: Empirical evidence is sparse and philosophical arguments predominate in the field of patient advocacy. Humanistic arguments that promote advocacy as a moral imperative are compelling. However, in reality nurses appear to lack the power base to comply except by covert means. Informed consent with a knowledge of the consequences of undertaking such an intervention is as relevant to the nurse as it is to the patient. CONCLUSION: Nurses need to be empowered first, if they are to empower their patients. There may however, be more suitable candidates for the role of patient advocate and nurses should recognize that they do not have a monopoly on ethical decision making.     

论医德建设的目标模式与医德构建

医学活动中各种不良现象的滋生和蔓延，与经济转轨和社会转型过程中医德价值观念的混乱、医德规范的失准、医德秩序的失衡无序密切相关。这种混乱无序的状况，对于医学科学和医疗卫生事业的发展是十分有害的。必须及早构建和确立与社会主义市场经济相适应的医德建设目标模式，重构医德规范和价值体系，力促医德秩序走向有序。     

医德养成教育和医学理性精神对医德建设的启示

系统性和实践性的医德养成教育应该使从医人员和医学生清醒而明确地认识和把握医德对人类社会健康生活产生的社会作用、医德的基本要求、医学目的内涵和始终坚持慎独,加强医德修养,树立医学理性精神等问题.明晰医学理性精神的基本要素、惰性因素和医学应当与医学理性精神的统一性是一个现实命题.     

关于新形势下中青年医务人员道德前景的若干思考

当前,大部分中青年医务人员有着较高的职业素养和道德操守,但也有少部分人的道德现状不容乐观?文章对当前医务人员的道德现状进行了大致归纳,简要进行了原由分析,并从理念信仰?制度体系?行为科学?医院文化?团队建设等方面对加强医务人员的职业道德建设进行了思考和探索?