护士长在处理病人投诉中的策略

目的　正确处理病房病人投诉 ,减少医疗纠纷。方法　查清事因 ,主动应对。结果　改善了护患关系 ,提高了护理服务满意度。结论　护士长首先要重视和正确对待病人投诉 ,力争将矛盾的负面影响降到最低程度。以此为契机 ,完善管理 ,强化服务理念 ,进一步提高护理质量。     

基于科研实践的肖永庆首席研究员学术思想分析

肖永庆首席研究员从事中药科研30余年,将中药化学、中药炮制学的理论和研究经验融汇于中药炮制学科及饮片产业的继承、创新与发展,对中药炮制学继承和发展中存在的问题有着深入的理解和分析,并通过多年的科研实践,构建了基于中药饮片生产经验传承的中药饮片炮制工艺规范化研究模式、基于炮制前后科学内涵变化规律的中药饮片炮制原理研究模式、基于中药饮片炮制原理的具有饮片个性特色的质量评价模式、基于传统与现代相结合的中药饮片分级及质量评价模式。同时,他提出了通过开展中药标准饮片研究,进一步完善中药标准物质体系,稳定中药饮片质量及临床疗效;以大宗中药材产地为核心,构建中药饮片区域性、专业化和智能化生产模式等设想。其创新性的学术思想、前瞻性的科研模式及产业发展策略为中药炮制学科的发展以及中药饮片行业在新环境下重新布局指明了方向,并提供了切实可行的解决方案。本文旨在通过对肖永庆首席研究员主要学术思想和多年科研实践的梳理,为中药炮制学科和中药饮片行业的发展提供有益的参考。     

主诉辨治法与微观辨证及其学科群的和谐发展

主诉辨治法是辨病脉证并治、辨证论治的传承,又是以证统病、专病论治的创新。主诉辨治法抓住主诉,开展有序的望、闻、问、切四诊,结合诊断新技术,来探讨病因、落实病位,阐明病机、分清病性,详悉病势、确定证名,依证立法、按法制方而论治。主诉辨治、微观辨证及其学科群的发展,有利于中医药的创新和发展。      

门急诊患儿家长投诉分析

目的：描述门急诊患儿家长的投诉率、投诉事件分类、被投诉科室和投诉解决结果。方法：对2005年1月-2007年11月某儿童医学中心门急诊就医患儿家长投诉案例进行回顾性分析。主要测量指标包括被投诉科室、投诉事件和投诉解决结果。结果：2005年-2007年间门急诊患儿家长平均投诉率为0．133‰。各种投诉事件中，治疗、沟通、患者权利受损、服务便捷性问题位居前四位，分别占37．4％，29．8％，11．6％和9．9％。73％的投诉通过道歉、解释和对医护人员进行教育得以解决。结论：将投诉率作为质量保证的参考指标，采取干预措施加强医护人员沟通能力教育，加强门急诊的管理，特别是流程的合理化是降低患儿家长投诉率的有效举措。     

基于博弈分析的患者投诉管理策略

新时代背景下,公民的权利意识不断增强,患者投诉屡见不鲜.医患关系的紧张严重影响到社会医疗秩序,患者投诉逐渐成为医院发展关注的重点.作者从静态博弈和动态博弈两个角度分析医生、患者、医院三者之间的行为选择,分析各方在博弈中的策略选择及其得益,并提出规范患者投诉管理的对策.建议规范化管理患者投诉,畅通医院投诉渠道,加强对医生...     

Upper endoscopy after Roux-en-Y gastric bypass: diagnostic yield and factors associated with relevant findings

BackgroundAfter laparoscopic Roux-en-Y gastric bypass many patients present with complaints for which an upper endoscopy is performed. However, often no abnormalities are found.ObjectivesTo investigate the incidence of relevant findings at upper endoscopy and identify patient characteristics associated with a relevant finding.SettingA high-volume bariatric center.MethodsA retrospective cohort study was performed. All patients presenting with complaints after laparoscopic Roux-en-Y gastric bypass who consequently underwent a diagnostic upper endoscopy were identified from a prospective endoscopic database. Primary outcomes were the number and type of relevant findings at upper endoscopy and its association with patient characteristics. Relevant findings were defined as abnormalities requiring treatment.ResultsNinety-eight (39.2%) of 250 patients had a relevant finding at upper endoscopy, mostly marginal ulcer and stomal stenosis. Male sex (odds ratio [OR] 3.47 [1.12–10.76]), alcohol consumption (OR 7.27 [1.58–33.36]), dysphagia or suspicion of bleeding as referral reason (OR 3.62 [1.54–8.52] and 39.93 [4.96–321.47], respectively, compared with abdominal pain), an abnormal upper gastrointestinal series (OR 6.81 [2.06–22.48]), and no abdominal ultrasound (OR 7.41 [1.48–37.08] compared with a normal ultrasound) were significantly associated with a relevant finding at upper endoscopy.ConclusionsIn this study sex, alcohol consumption, referral reason, and prior imaging studies were associated with a relevant finding at upper endoscopy after laparoscopic Roux-en-Y gastric bypass.     

精神分裂症开放式护理管理的应用效果

目的了解精神分裂症开放式护理管理的应用效果。方法将本院2017年2月-2018年12月的68例精神分裂症患者,随机分组,对照组给予传统护理,开放式护理管理组开展开放式护理管理。比较两组满意度;患者对精神分裂症疾病知识的掌握水平、患者的遵医行为水平;护理前后阳性症状和阴性症状的相关评分以及总分、病理分值;家属护理投诉率。结果开放式护理管理组满意度、阳性症状和阴性症状的相关评分以及总分、病理分值、患者对精神分裂症疾病知识的掌握水平、患者的遵医行为水平、家属护理投诉率对比对照组有优势,P <0.05。结论精神分裂症患者实施开放式护理管理效果确切,可有效提高患者的满意度和改善病情。     

Motoric cognitive risk syndrome and cardiovascular diseases and risk factors in the Canadian population: Results from the baseline assessment of the Canadian longitudinal study on aging

BackgroundMotoric Cognitive Risk Syndrome (MCR) is a pre-dementia syndrome. The aim of this study was to examine whether there is: 1) an association between MCR and cardiovascular diseases and risk factors (CVDRF) in the Canadian population, and 2) a specific MCR-related CVDRF profile (i.e., cardiovascular diseases (CVD) versus cardiovascular risk factors (CVRF) versus both) when comparing different age groups.MethodsA total of 29,569 participants free of dementia were recruited in the Canadian Longitudinal Study on Aging. Participants were categorized into groups by their age and MCR status (with MCR versus without MCR). Overweight/obese, smoking, waist to hip circumference ratio (WHCR), systolic blood pressure and diastolic blood pressure levels were CVRF. Diabetes type I and II, hypertension, heart disease and attack, peripheral vascular disease, angina, stroke and rhythmic disease were CVD.ResultsA higher prevalence of CVRF in MCR was shown in the youngest age groups (i.e., 45–54 and 55–64) compared to the other age groups. MCR was positively associated with CVDRF, except in the oldest age group (i.e., ≥75). In this group, the only significant association with CVRF was with diastolic blood pressure, which was negatively associated with MCR. Diabetes and hypertension were not associated with MCR.ConclusionsMCR is associated with CVDRF in both younger and older individuals. A stronger association was present for CVRF factors in younger adults and for CVD in older adults.     

Memory complaint in attenders at a self-referral memory clinic: The role of cognitive factors,affective symptoms and personality

Memory complaint has been shown to be poorly correlated with objective memory performance in non-demented elderly people. A previous study indicated the possible importance of depression and personality in the presentation of memory complaint in people with mild memory impairment. The present study overcomes some previous methodological limitations and describes memory complaint, cognitive, affective and personality variables in subjects with mild cognitive impairment self-referring to a memory clinic, with non-presenting age- and sex-matched community controls. Self-referrers had a higher original IQ, but no evidence of greater decline in memory despite having more memory complaint. Personality factors were demonstrated to be important alongside affective symptoms in the presentation of memory complaint in these subjects.