Highrise residences with high plot ratio meet housing needs of urban residents, improve living conditions of residents, but also show many unreasonable problems in the design of public communication spaces with a resu...Highrise residences with high plot ratio meet housing needs of urban residents, improve living conditions of residents, but also show many unreasonable problems in the design of public communication spaces with a result of interpersonal indifference and lack of sense of identity. This paper took Xuzhou Hanbang Square for example to explore strategies of improving public communication spaces in highrises from the perspectives of entrance lobby, open-floor ground design, ecological garage, and three-level property management. On the one hand, the paper tries to improve quality of residential environment and service quality of public facilities; on the other hand, to enhance sense of neighborhood and identity of residents, and change the current interpersonal indifference.展开更多
Aim: This research aims to evaluate patient-centeredness and communication skills from the patients’ point of view and that of the physicians’ point of view and compares the two outcomes. Methods: This was a cross-s...Aim: This research aims to evaluate patient-centeredness and communication skills from the patients’ point of view and that of the physicians’ point of view and compares the two outcomes. Methods: This was a cross-sectional study with a convenient sample of 418 patients and 94 residents. Instrument of the study was a structured questionnaire that aimed to evaluate patient centeredness and communication skills of the residents. Results: Residents gave themselves a significantly higher score than the score given to them by patients in most studied aspects such as the extent to which the doctor discussed the patient’s problem, the extent to which the doctor explained the problem, the doctor introduced himself, the doctor greeted the patient properly and others. The only aspect for which patients gave residents higher score than that residents gave themselves was the extent to which the doctor asked the patient about what is expected to be done (ECG, CT scan, giving antibiotics, …). Conclusion: A transformation from doctor centered approach to patient centered approach is needed.展开更多
Objective: This study aimed to determine variables associated (predictors and correlates) with the learning of assessment and supportive skills in the context of a communication skills training for medical residents. ...Objective: This study aimed to determine variables associated (predictors and correlates) with the learning of assessment and supportive skills in the context of a communication skills training for medical residents. Methods: Learning was measured by comparing residents’ communication skills in a simulated consultation before and after a communication skills training. Communication skills were transcribed and tagged with a computer-assisted program. Potential variables associated with learning (residents’ characteristics, contextual characteristics and pre-training communication skills) were measured before the training and entered in regression analysis. Results: Fifty-six residents followed the training between 2002 and 2006. Poor pre-training assessment and supportive skills predicted the respective learning of these skills. Better assessment skills’ learning was predicted by copings (i.e. lower level of emotional coping), lower levels of self-efficacy and depersonalization. Better supportive skills’ learning was predicted by a lower work experience and associated with a higher training attendance rate. Conclusions: Predictors and correlates of assessment and supportive skills learning were different. Trainers needed to detect certain residents’ characteristics (i.e. depersonalization) in order to optimize assessment skills learning. Trainers needed to be aware that supportive skills are difficult to learn and to teach and may need more training hours.展开更多
BACKGROUND: Costs of care are increasingly important in healthcare policy and, more recently, in clinical care in the emergency department(ED). We compare ED resident and patient perspectives surrounding costs in emer...BACKGROUND: Costs of care are increasingly important in healthcare policy and, more recently, in clinical care in the emergency department(ED). We compare ED resident and patient perspectives surrounding costs in emergency care.METHODS: We conducted a mixed methods study using surveys and qualitative interviews at a single, academic ED in the United States. The two study populations were a convenience sample of adult ED patients(>17 years of age) and ED residents training at the same institution. Participants answered open- and closed-ended questions on costs, medical decision making, cost-related compliance, and communication about costs. Closed-ended data were tabulated and described using standard statistics while open-ended responses were analyzed using grounded theory.RESULTS: Thirty ED patients and 24 ED residents participated in the study. Both patients and residents generally did not have knowledge of medical costs. Patients were comfortable discussing costs while residents were less comfortable. Residents agreed that doctors should consider costs when making medical decisions whereas patients somewhat disagreed. Additionally, residents generally took costs into consideration during clinical decision-making, yet nearly all residents agreed that they had too little education on costs.CONCLUSION: There were several notable differences in ED patient and resident perspectives on costs in this U.S. sample. While patients somewhat disagree that cost should factor into decision making, generally they are comfortable discussing costs yet report having insuf? cient knowledge of what care costs. Conversely, ED residents view costs as important and agree that cost should factor into decision making but lack education on what emergency care costs.展开更多
Clinical communication is a multidimensional concept, which encompasses the core of effective clinical practice. Communication in cancer patients is particularly challenging and yet a less focused area in cancer care....Clinical communication is a multidimensional concept, which encompasses the core of effective clinical practice. Communication in cancer patients is particularly challenging and yet a less focused area in cancer care. Various barriers and challenges in communication may affect the management protocol of cancer patients. Challenges may arise in various dimensions of cancer care including breaking bad news to delivery of complex clinical information, determination of appropriate treatment strategies, dealing with uncertainties, end of life counseling as well as cultural and language barriers affecting the whole communication dynamics. Effective communication is the basic foundation for responsive treatment decisions, positive health outcome, patient driven compliance and overall high quality of care. Thus, there is a need for acknowledging and actively deciphering the challenges and developing and promoting various protocols of effective communication skills in cancer patients.展开更多
目的：探讨社区居民慢性非传染性疾病患病的相关危险因素。方法选择2010年1月～2014年1月大庆市炼化社区和运输社区居民共10045人，对发生慢性病（n=3018，病例组）与非慢性病（n=7027，对照组）的临床资料进行对比分析。单因素分析采...目的：探讨社区居民慢性非传染性疾病患病的相关危险因素。方法选择2010年1月～2014年1月大庆市炼化社区和运输社区居民共10045人，对发生慢性病（n=3018，病例组）与非慢性病（n=7027，对照组）的临床资料进行对比分析。单因素分析采用x2检验，多因素采用非条件 Logistic回归分析。结果10045人中3018人患有慢性病，患病率达30.04％。男性的患病率显著高于女性（35.98％ vs 30.65％， P＜0.05）。病例组的年龄、BMI＞24kg/m2、吸烟史、饮酒史、既往疾病史、家族史比率明显高于对照组（P＜0.05）。年龄＞60岁（OR=8.324）、BMI＞24kg/m2（OR=7.563）、吸烟史（OR=6.427）、饮酒史（OR=4.853）、既往疾病史（OR=5.132）是慢性病发生的危险因素。结论年龄＞60岁、超重、吸烟史、饮酒史、既往疾病史是慢性病发生的危险因素。展开更多
Objectives:Social media has changed methods of communication in the medical profession.As part of a"doctor as communicator"strategy,Chinese medical professionals are actively embracing social media,which may...Objectives:Social media has changed methods of communication in the medical profession.As part of a"doctor as communicator"strategy,Chinese medical professionals are actively embracing social media,which may have an impact on tense physician-patient relationships in China.This paper aims to examine a pattern of Internet access,Internet usage,and trust among Chinese medical professionals and further explores the reasons for these relationships on an individual level.Designs:A web-based questionnaire was designed,based on a media literacy model,and was divided into 3 dimensions:public information,general medical information,and specialty information.After a two-round pilot study,1001 physicians were included.Additionally,4 interviewees were chosen to participate in in-depth interviews and content analysis was performed.Data were analyzed using SPSS 25.0.Results:Findings showed that new media has become a major approach for medical professionals in China to retrieve and get access to various information.However,they still trust traditional media(n=1001,P<0.01)and professional journals more(n=1001,P<0.01).Internet access,usage,and trust were positively correlated(r-0.185-0.344,P<0.01).Regarding usage habits,47.66%of the participating physicians would practice science popularization through their new media accounts and 71.23%would forward approved health information within their professional realm.A validated instrument can be provided for further related studies.Conclusions:Science popularization is a specific usage of new media among Chinese medical professionals,through which they have achieved new authority and empowered communication because of self-media.To some extent,physician-patient relationships in China can be improved because this online interaction is conducive to building harmonious and lasting offline physician-patient relationships.展开更多
文摘Highrise residences with high plot ratio meet housing needs of urban residents, improve living conditions of residents, but also show many unreasonable problems in the design of public communication spaces with a result of interpersonal indifference and lack of sense of identity. This paper took Xuzhou Hanbang Square for example to explore strategies of improving public communication spaces in highrises from the perspectives of entrance lobby, open-floor ground design, ecological garage, and three-level property management. On the one hand, the paper tries to improve quality of residential environment and service quality of public facilities; on the other hand, to enhance sense of neighborhood and identity of residents, and change the current interpersonal indifference.
文摘Aim: This research aims to evaluate patient-centeredness and communication skills from the patients’ point of view and that of the physicians’ point of view and compares the two outcomes. Methods: This was a cross-sectional study with a convenient sample of 418 patients and 94 residents. Instrument of the study was a structured questionnaire that aimed to evaluate patient centeredness and communication skills of the residents. Results: Residents gave themselves a significantly higher score than the score given to them by patients in most studied aspects such as the extent to which the doctor discussed the patient’s problem, the extent to which the doctor explained the problem, the doctor introduced himself, the doctor greeted the patient properly and others. The only aspect for which patients gave residents higher score than that residents gave themselves was the extent to which the doctor asked the patient about what is expected to be done (ECG, CT scan, giving antibiotics, …). Conclusion: A transformation from doctor centered approach to patient centered approach is needed.
文摘Objective: This study aimed to determine variables associated (predictors and correlates) with the learning of assessment and supportive skills in the context of a communication skills training for medical residents. Methods: Learning was measured by comparing residents’ communication skills in a simulated consultation before and after a communication skills training. Communication skills were transcribed and tagged with a computer-assisted program. Potential variables associated with learning (residents’ characteristics, contextual characteristics and pre-training communication skills) were measured before the training and entered in regression analysis. Results: Fifty-six residents followed the training between 2002 and 2006. Poor pre-training assessment and supportive skills predicted the respective learning of these skills. Better assessment skills’ learning was predicted by copings (i.e. lower level of emotional coping), lower levels of self-efficacy and depersonalization. Better supportive skills’ learning was predicted by a lower work experience and associated with a higher training attendance rate. Conclusions: Predictors and correlates of assessment and supportive skills learning were different. Trainers needed to detect certain residents’ characteristics (i.e. depersonalization) in order to optimize assessment skills learning. Trainers needed to be aware that supportive skills are difficult to learn and to teach and may need more training hours.
文摘BACKGROUND: Costs of care are increasingly important in healthcare policy and, more recently, in clinical care in the emergency department(ED). We compare ED resident and patient perspectives surrounding costs in emergency care.METHODS: We conducted a mixed methods study using surveys and qualitative interviews at a single, academic ED in the United States. The two study populations were a convenience sample of adult ED patients(>17 years of age) and ED residents training at the same institution. Participants answered open- and closed-ended questions on costs, medical decision making, cost-related compliance, and communication about costs. Closed-ended data were tabulated and described using standard statistics while open-ended responses were analyzed using grounded theory.RESULTS: Thirty ED patients and 24 ED residents participated in the study. Both patients and residents generally did not have knowledge of medical costs. Patients were comfortable discussing costs while residents were less comfortable. Residents agreed that doctors should consider costs when making medical decisions whereas patients somewhat disagreed. Additionally, residents generally took costs into consideration during clinical decision-making, yet nearly all residents agreed that they had too little education on costs.CONCLUSION: There were several notable differences in ED patient and resident perspectives on costs in this U.S. sample. While patients somewhat disagree that cost should factor into decision making, generally they are comfortable discussing costs yet report having insuf? cient knowledge of what care costs. Conversely, ED residents view costs as important and agree that cost should factor into decision making but lack education on what emergency care costs.
文摘Clinical communication is a multidimensional concept, which encompasses the core of effective clinical practice. Communication in cancer patients is particularly challenging and yet a less focused area in cancer care. Various barriers and challenges in communication may affect the management protocol of cancer patients. Challenges may arise in various dimensions of cancer care including breaking bad news to delivery of complex clinical information, determination of appropriate treatment strategies, dealing with uncertainties, end of life counseling as well as cultural and language barriers affecting the whole communication dynamics. Effective communication is the basic foundation for responsive treatment decisions, positive health outcome, patient driven compliance and overall high quality of care. Thus, there is a need for acknowledging and actively deciphering the challenges and developing and promoting various protocols of effective communication skills in cancer patients.
文摘目的：探讨社区居民慢性非传染性疾病患病的相关危险因素。方法选择2010年1月～2014年1月大庆市炼化社区和运输社区居民共10045人，对发生慢性病（n=3018，病例组）与非慢性病（n=7027，对照组）的临床资料进行对比分析。单因素分析采用x2检验，多因素采用非条件 Logistic回归分析。结果10045人中3018人患有慢性病，患病率达30.04％。男性的患病率显著高于女性（35.98％ vs 30.65％， P＜0.05）。病例组的年龄、BMI＞24kg/m2、吸烟史、饮酒史、既往疾病史、家族史比率明显高于对照组（P＜0.05）。年龄＞60岁（OR=8.324）、BMI＞24kg/m2（OR=7.563）、吸烟史（OR=6.427）、饮酒史（OR=4.853）、既往疾病史（OR=5.132）是慢性病发生的危险因素。结论年龄＞60岁、超重、吸烟史、饮酒史、既往疾病史是慢性病发生的危险因素。
基金Sanofi and data support from the Dingxiangyuan platform for this study.
文摘Objectives:Social media has changed methods of communication in the medical profession.As part of a"doctor as communicator"strategy,Chinese medical professionals are actively embracing social media,which may have an impact on tense physician-patient relationships in China.This paper aims to examine a pattern of Internet access,Internet usage,and trust among Chinese medical professionals and further explores the reasons for these relationships on an individual level.Designs:A web-based questionnaire was designed,based on a media literacy model,and was divided into 3 dimensions:public information,general medical information,and specialty information.After a two-round pilot study,1001 physicians were included.Additionally,4 interviewees were chosen to participate in in-depth interviews and content analysis was performed.Data were analyzed using SPSS 25.0.Results:Findings showed that new media has become a major approach for medical professionals in China to retrieve and get access to various information.However,they still trust traditional media(n=1001,P<0.01)and professional journals more(n=1001,P<0.01).Internet access,usage,and trust were positively correlated(r-0.185-0.344,P<0.01).Regarding usage habits,47.66%of the participating physicians would practice science popularization through their new media accounts and 71.23%would forward approved health information within their professional realm.A validated instrument can be provided for further related studies.Conclusions:Science popularization is a specific usage of new media among Chinese medical professionals,through which they have achieved new authority and empowered communication because of self-media.To some extent,physician-patient relationships in China can be improved because this online interaction is conducive to building harmonious and lasting offline physician-patient relationships.
