Emotional differences based on comments on doctor-patient disputes with varying levels of severity

BACKGROUND The risks associated with negative doctor-patient relationships have seriously hindered the healthy development of medical and healthcare and aroused wide-spread concern in society.The number of public comments on doctor-patient relationship risk events reflects the degree to which the public pays attention to such events.Thirty incidents of doctor-patient disputes were collected from Weibo and TikTok,and 3655 related comments were extracted.The number of comment sentiment words was extracted,and the comment sentiment value was calculated.The Kruskal-Wallis H test was used to compare differences between each variable group at different levels of incidence.Spearman’s correlation analysis was used to examine associations between variables.Regression analysis was used to explore factors influencing scores of comments on incidents.RESULTS The study results showed that public comments on media reports of doctor-patient disputes at all levels are mainly dominated by“good”and“disgust”emotional states.There was a significant difference in the comment scores and the number of partial emotion words between comments on varying levels of severity of doctor-patient disputes.The comment score was positively correlated with the number of emotion words related to positive,good,and happy)and negatively correlated with the number of emotion words related to negative,anger,disgust,fear,and sadness.CONCLUSION The number of emotion words related to negative,anger,disgust,fear,and sadness directly influences comment scores,and the severity of the incident level indirectly influences comment scores.

Study on the Relationship between Psychological Stress and Doctor-Patient Relationship of Cancer Patients and Their Families

Objective: To research the relationship between psychological stress and doctor-patient relationship of cancer patients and their families. Methods: The patients were randomly divided into the intervention group and the control group, and PDRQ-15, pcl-c, SAS and SDS scales were selected as evaluation indexes, and the levels of norepinephrine and dopamine were compared between the patients diagnosed with PTSD cancer and those without PTSD. Results: 1) The total score of PCL-C, SAS, SDS, PDRQ-15 scale of the cancer patients and their families after the intervention of clinical psychological care was significantly lower than that of before intervention and the control group. 2) The correlation coefficients between PCL-C, SAS, SDS and PDRQ-15 of cancer patients and their relatives were 0.971, 0.952 and 0.939 respectively. The significant test P value was less than 0.05 and the difference was statistically significant. 3) The plasma levels of dopamine and norepinephrine in cancer patients under stress were significantly higher than those in cancer patients without stress (P Conclusion: After psychological Intervention of cancer patients and their families, post-traumatic stress disorder, anxiety, depression and doctor-patient relationship were all improved.

Spiritual Anamnesis and Doctor-Patient Relationship： Review and Reconstruction of a Daily Routine Instrument

Introduction： spiritual anamnesis is fundamental to familiarity with patient’s beliefs. It enables health professionals to： investigate how patients face the treatment, understand the role and importance of religion in the life of this individual, how much spirituality may interfere in the health-disease process and in the disease experience. It also helps detect spiritual needs and mobilize resources to promote the biopsychosocial and spiritual wellness of the individual. Objective： identify spiritual questionnaires in literature. Methods： This article is a bibliographic review. Researching was on books and electronically based from August to December 2014. PUBMED and SCIELO databases were used in English and Portuguese. Inclusion factors： short, brief and easy to memorize questions to know if the patient’s beliefs interfere in medical treatments and to what extent. Exclusion factors： not try to convert or to interfere with the patient’s rights, not try to influence their beliefs or to make anamnesis on emergency situations or acute medical consultations. Results： based on the questions of seven samples of spiritual questionnaires found in literature, health professionals identified the patient’s spiritual needs and the beliefs likely to interfere in the doctor-patient relationship and in the therapeutic conduct as such. The anamnesis models found converge in some points, but differ mainly as to time excess some questionnaires demand （due to the large number of questions） when compared to others （shorter） and/or when going deeper into a particular aspect of beliefs, leaving some important points out. Conclusion： the anamnesis found are as follows： FICA Questionnaire; HOPE Questionnaire, Kunh’s Spiritual Inventory, CSI-MEMO, ACP Spiritual History, Matthews Spiritual History, Maugans Spiritual History. The main points found in these seven questionnaires are： resources mobilization to meet the patients’ spiritual demands; to what extent spirituality may interfere both in adherence to the treatment and in the clinical treatment and in strengthening the doctor-patient relationship.

An Investigation of Medical Students’ Cognition on the Doctor-Patient Relationship and Their Career Choice

Objective:To investigate medical students’cognition on the doctor-patient relationship and its influence on their career choice as well as to provide reference for medical education and communication education.Methods:A self-compiled questionnaire survey was carried out at a medical university in W city,and descriptive statistics as well as chi-square tests were conducted.Results:There were significant differences in medical students’cognition of doctor-patient relationship among different genders,registered residence,only-child status,whose parents are working in the medical field,and their own evaluation of the major(p<0.05);the different cognitions of doctor-patient relationship have a significant influence on medical students’career choice.Conclusion:Medical students’vocational cognition and educational guidance should be strengthened,hospital information should be open and transparent,media reporting of medical events should be standardized,and a doctor-patient conflict regulation mechanism should be established.

门脉高压性胃病患者中医证型分布特点及其与胃镜下黏膜病变的相关性

目的:明确门脉高压性胃病(portal hypertension gastropathy,PHG)患者中医证型分布特点,探究PHG中医证型与胃镜下黏膜病变特点之间的相关性。方法:采用临床调查方式对符合标准的180例PHG患者中医证型、胃黏膜病变特点等资料进行统计学分析。结果:PHG患者中医证型主要为湿热蕴结证、瘀血阻络证;胃黏膜糜烂、充血、水肿、出血以湿热蕴结证患者多见,瘀血阻络证以PHG重度患者多见;肝气郁结证及瘀血阻络证与肝肾阴虚证、水湿内阻证及脾肾阳虚证相比,食管静脉曲张发病率差异有统计学意义(P<0.05)。结论:PHG中医证型与胃黏膜病变相关,湿热、瘀血是其主要病理因素。

腹膜透析患者血清klotho蛋白水平与中医证候的相关性研究

目的:探讨腹膜透析患者血清klotho蛋白水平与中医证候的相关性。方法:选取180例规律腹膜透析患者作为研究对象,均进行中医辨证,分为主证和兼证两类;并根据患者肾小球滤过率(GFR)和血清分泌型klotho蛋白水平的四分位数,分为4组,统计各组中医主证、兼证分布情况。结果:180例腹膜透析患者主证占比,脾肾气虚证>气阴两虚证>肝肾阴虚证>脾肾阳虚证>阴阳两虚证;兼证占比,瘀血证>湿热证>湿浊证;不同主证的GFR和klotho蛋白水平存在显著性差异(P<0.05),GFR、klotho蛋白水平比较,肝肾阴虚证<阴阳两虚证<气阴两虚证<脾肾阳虚证<脾肾气虚证,且GFR与血清klotho蛋白水平呈正相关。不同兼证患者GFR和klotho蛋白水平比较无统计学意义(P>0.05)。按照血清分泌型klotho蛋白水平分布范围分组,发现在klotho蛋白水平较低的患者中,肝肾阴虚证和阴阳两虚证的占比较高;相反,在klotho蛋白水平较高的患者中,脾肾气虚证和脾肾阳虚证的占比较高,各组中医主证比率比较有统计学意义(P<0.05),而兼证比率比较无统计学意义(P>0.05)。结论:腹膜透析患者血清klotho蛋白水平与中医主证呈显著相关性,且肝肾阴虚证、阴阳两虚证者klotho蛋白降低尤其明显,主要与肾精不足或衰退相关。

五运六气与干燥综合征发病特点及中医证候的相关性研究

目的:探讨原发性干燥综合征(pSS)患者出生时的五运六气等相关信息与pSS发病所累及的系统损害及中医证候的相关性。方法:采用回顾性研究方法,从门诊及住院部收集2020年1月—2021年12月就诊的pSS患者,收集其出生时的运气学相关信息资料,统计运、气因素出现的频次,分析其与pSS发病所累及的系统损害及中医证候相关的运气因素,并运用中医理论进行分析、总结、探讨。结果:岁运因素中“土不及”是pSS患者的易患禀赋因素;岁运因素中“土不及”、六气因素中的“太阴司天、太阳在泉”及“厥阴司天、少阳在泉”是pSS气阴两虚证的易患禀赋因素;岁运因素中“土不及”“木太过”“金太过”“水太过”“水不及”,六气因素中“少阴司天、阳明在泉”及“少阳司天、厥阴在泉”为阴虚津亏证pSS的易患禀赋因素;岁运因素中“火太过”,六气因素中“太阴司天、太阳在泉”“少阴司天、阳明在泉”是阴虚热毒证pSS的易患禀赋因素;岁运因素中“木太过”“金不及”“木不及”,六气因素中“厥阴司天、少阳在泉”为阴虚血瘀证pSS的易患禀赋因素;岁运因素中“土不及”“金不及”,六气因素中“太阴司天、太阳在泉”为pSS患者关节受累的易患禀赋因素;岁运因素中“土不及”“金不及”为pSS患者肺受累的易患禀赋因素;岁运因素中“火太过”“土太过”“土不及”,六气因素中“厥阴司天、少阳在泉”为pSS患者血液系统受累的易患禀赋因素。结论:原发性干燥综合征的发病特点及其中医证候与五运六气具有一定的相关性。

基于实体-联系模型的中医药标准关系模型构建研究

体量日趋庞大的中医药标准为制修订工作和综合管理带来严峻挑战,利用数字技术为标准赋能具有重要战略意义。本研究通过对中医药标准名称信息的深度挖掘和解读,提出基于实体-联系模型的标准间关系建模方法,构建包含7种关系模式的关系模型,并以标准检索为例展示模型的应用场景,为机器读取和使用标准、提高中医药标准检索效率、掌握目标标准相关资源、推动中医药标准数字化转型提供支撑。

Analysis and improving countermeasures of medical disputes from the perspective of legal changes

Under the background of medical disputes growing in number,scale and intensity,tracing back legal changes in medical field as a breakthrough point,this paper took a legal perspective to illustrate changes in medical dispute settlements from legislative orientation to legal system improvement.In view of the fact that early legislation in medical field was biased towards identification and punishment of doctors’responsibility,and later intensive legislation in balancing increasing"medical trouble"phenomenon with limited effects and difficulties to abide by the law,this paper proposed to improve doctor-patient dispute settlements system in China referencing from foreign law experience,to reduce investigation of doctors at the judicial level,and to establish a settlement mechanism on doctors’apology at the legislative level,so as to promote a healthy development of doctor-patient relationship.

宁夏15家二级及以上医疗机构中药饮片处方用量分析

目的促进宁夏医疗机构对中药饮片的合理使用。方法按随机简单抽样原则,通过医院信息系统抽取宁夏回族自治区不同区域15家二级及以上医疗机构门诊2019年中医处方3032张。处方均由各医疗机构具有相关资质的中级及以上职称医师开具。统计各中药饮片使用频率、用量及与2020年版《中国药典(一部)》(简称药典)规定的相符情况。结果共涉及中药615味,平均每剂处方15~19味。非药食同源及药食同源中药饮片的临床常用量分别集中在4~10 g、11~15 g、16~20 g和0~10 g、11~20 g、21~30 g;使用频次排名前3的分别为川芎(765次、25.23%),北柴胡(734次、24.21%),麸炒白术(723次、23.85%)和茯苓(1275次、42.05%),当归(972次、32.06%),甘草片(923次、30.44%)。使用频次排名前30的非药食同源及药食同源中药饮片临床常用量与药典相符率分别为60.03%和70.35%;15家医疗机构有毒、小毒中药饮片用量与药典相符率分别为44.61%和45.60%。结论宁夏二级及以上医疗机构中药饮片处方使用总体较规范。为确保药典的权威性和科学性,建议药典进行再版时,加大中药饮片临床用药剂量与临床疗效的研究力度,修正部分药物的用量范围,区分药食同源和非药食同源中药饮片,以更符合临床实际,保证用药安全。

中医药院校学生志愿者与社区养老的嵌入关系研究:逻辑框架与现实情境

在健康老龄化的背景下,解决居家养老的老年群体健康服务问题成为一项重点任务。中医药作为我国传统医学和特有的医疗健康资源,在为老年群体提供健康养生服务中起着不可忽视的作用。中医药院校的学生志愿者作为重要的补充性力量参与社区医养结合服务能在一定程度上缓解当前中医药医养模式的社会压力和供需矛盾,但这一模式处于起步阶段,想要实现常态化和长效化仍面临诸多现实挑战与实践困境。依托嵌入性理论的研究视角,能够对中医药院校的学生志愿者参与社区养老服务的过程,现状和困境等实然状态有一个更全面的认识,从而帮助我们进一步研究其嵌入的实现路径。

Time to rebuild the doctor-patient relationship in China

In China,the doctor-patient relationship(DPR)has been tense in recent years and continues to deteriorate.From 2009 to 2018,295 severe medical violence events were reported on social media,in which 362 doctors were injured and 24 lost their lives(1).According to a survey conducted in 2018 by the national Chinese Medical Doctor Association(CMDA),62% of doctors had experienced varying degrees of medical disputes and 66% had experienced varying degrees of doctor-patient conflict,dominated by verbal violence(accounting for 51%of cases).

E-mail Could Enhance Doctor-Patient Relationship

病人和医生之间的传统关系是本文所说的normal clinie basedconsultation。然而,这种沿袭了许多年的关系正在被打破！ E-mail,正在成为病人和医生之间联系的重要桥梁。 本文有几个重要信息: …nearly 40％ of American patients say they have used e-mail to contact ahealth professional(专家)in the past. …by the year 2000 nearly every library will offer(Internet and E-mail)services in the United States,allowing even low-income patients some means ofe-mail access. Web experts now estimate more than 10,000 health-oriented websites (站点)already exist. 这两个信息让我们感到:美国在这方面又领先世界一步！ 值得一提的是,病人有通过e-mail和医生联系的积极性,而医生却缺乏这方面的积极性。原因是: …for fear of increasing workload(工作量)and uncertainty about paymentror the time involved. 当然,病人方面也并非100％地欢迎这个新生事物: …patients may worry that sensitive medical information might be read byothers.然而,以上这些“阻力”终将被克服！

Humanistic Spirit Contained in Traditional Chinese Medicine should Be Valued

Medicine is a science studying human's health and diseases as well as the regularity between them. Its research subject is human, who possess natural attribute, psychological attribute and social attribute. Therefore, medicine is bound to possess humanistic attribute. Rooted in Chinese traditional culture, Traditional Chinese Medicine contains abundant humanistic thoughts, for instance, pursuing the unity of human and nature, advocating the vital importance of life, sticking to the virtue of "medicine being humane art", abiding by the principle of "Benevolence prior to interest", complying with the medical rule of "Respecting peers". These are the very concrete reflections of medical humanistic spirit. In this article we aim to explore the humanistic thoughts contained in Traditional Chinese Medicine, and try to inherit and carry forward the spirit to better relieve the tensions between doctors and patients and improve the quality of medical services.

77例前列腺癌中医证型特点与临床相关因素分析

目的探讨前列腺癌中医证型与临床相关因素的关系。方法前列腺癌77例,分为肺热失宣、湿热蕴结、气滞血瘀、痰瘀闭阻、气血亏虚5种证型。分析年龄、血清前列腺特异抗原(PSA)、血清前列腺特异抗原游离部分(fPSA)、血清游离前列腺特异抗原百分率(FPSAR)、前列腺特异抗原密度(PSAD)、前列腺重量(W)、最大尿流率(Omax)与证型的关系。结果痰瘀闭阻、气滞血瘀、湿热蕴结为常见证型,气血亏虚及肺热失宣证型各1例。各证型之间PSA、PSAD、fPSA、FPSAR、Qmax、W,均有统计学差异,而各证型之间年龄上无明显不同。结论气滞、血瘀、痰凝为前列腺癌常见致病因素。中药治疗前列腺癌应注重行气活血、祛痰利湿。

中药复方量效关系剂量阈研究方法探讨

中药复方量效关系研究起步较晚，其理论、方法尚未建立。当病、证、方、药确定后，其方药的“量”是决定“效”的关键因素，并有其最佳的剂量范围。作用复杂的中药复方的量效关系参数可以用剂量阈表述，包括半饱和剂量，或中位剂量（[D]0.5），最佳剂量阈范围（[D]0.8～[D]0.2），剂量阈（[D]0.2）。当病、证、方、药确定后，中药复方药的效仍然是个复杂性问题。中药复方效应有整体效、器官效、分子效等，并有其相应的剂量阈。

脑梗死中医证型与心理因素的关系分析

目的探讨脑梗死中医证型与心理因素的相关性。方法纳入佛山市中医院收治的162例脑梗死恢复期患者,运用症状自评量表(SCL-90)、焦虑自评量表(SAS)及抑郁自评量表(SDS)进行心理测量,分析各中医证型与心理因素的相关性。结果脑梗死患者常常出现明显心理障碍(P <0.05),其中风痰瘀阻证躯体化、强迫症状、抑郁、焦虑因子评分明显高于气虚络瘀证和肝肾亏虚证(P <0.05),气虚络瘀证躯体化、强迫症状、偏执因子评分明显高于肝肾亏虚证(P <0.05),肝肾亏虚证敌对、恐怖因子明显高于风痰瘀阻证和气虚络瘀证(P <0.05)。结论脑梗死病患者常常合并心理障碍,且与中医证型具有一定的相关性,据此进行中医情志疗法,以提高患者的身心健康。

中医临床术语系统v2.0“中药饮片”类概念及关系设定研究

目的从临床实用角度对中医临床术语系统(TCMCTS)v2.0"中药饮片"类概念及关系设定进行整理,为后续研究及应用提供参考。方法基于系统总的修订原则,参照《中药编码规则及编码》、2015年版《中华人民共和国药典》、《中华本草》、《中药大辞典》、《中药学》及TCMCTSv1.0"中药"类概念和TCMCTSv2.0"中成药"类概念,对TCMCTSv2.0中药饮片类概念选取原则、方法及关系设定进行探讨研究,阐述中药饮片的描述性定义、逻辑性定义及以中药饮片类概念为源概念发出的主要关系设定等问题。结果 TCMCTSv2.0目前筛选出中药饮片类正式概念2078个,相关术语8082个,设定主要关系类型7个,共形成具体语义关系31 370条。结论本研究筛选的TCMCTSv2.0中药饮片类概念根据权威标准规范处理,关系设定基于SNOMED逻辑定义思路,可为后续研究及应用提供参考。

中医温病诊疗知识模型初探

目的建立温病诊疗知识模型,梳理温病文献知识,辅助中医温病临床决策。方法从中医温病学入手,以本体论为基础,采用合理的知识表示方式,以OWL2本体语言为建模工具,进行模型构建的探索研究。结果通过梳理温病诊疗概念关系,建立等价类和父子关系的联系方式,初步建立层次较清楚、结构较为合理的中医温病诊疗知识模型;通过机器学习和推理机,实现模型学习推理的功能,为临床医生提供文献参考。结论本研究初步建立了中医温病诊疗知识模型,并实现辅助中医温病临床决策,为中医文献支持中医临床决策提供了一种有效的知识组织方式。

方药量效关系研究的关键问题与思考

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