Research on the Significance and Path of Standardizing Patients’ Obligations from the Perspective of Building the Community of Doctor-patient / 中国医学伦理学

One of the crux of the problem of doctor-patient relationship is the uneven division of rights and obligations between doctors and patients. Among them, it is significantly essential to emphasize the patient’s obligation as a weak point. The reasons cover many aspects. On the one hand, it is of great significance to standardize patient obligations: the definition of patients’ obligations is better health protection for patients; the emphasis on patients’ obligations is the moral support for doctors’ responsibilities; the fulfillment of patients’ obligations promotes the win-win interests of doctors and patients. On the other hand, the current situation of standardizing patients’ obligations is not optimistic: the provisions of patients’ obligations in existing laws and regulations are not ideal; the current ethical discussion on patient obligations also needs to be deepened. Therefore, in order to standardize patients’ obligations, build harmonious doctor-patient relationship and build a community of doctor-patient, this paper put forward specific suggestions from three aspects: improving laws and regulations, standardizing the management of medical institutions and enhancing patients’ literacy.

Research on the driving mechanism of residents′ willingness to participate in tiered medical care based on harmonious management theory / 中华医院管理杂志

Objective:To construct and validate a theoretical model of residents′ willingness to participate in tiered medical care based on harmonious management theory, providing reference for promoting the tiered medical care system and aiding governmental decision-making.Methods:Based on the harmonious management theory and literature review, a model capturing residents′ propensity to engage in tiered medical care was formulated. Using convenience sampling method, a questionnaire survey was conducted on 2 067 residents from 24 communities in Zhejiang province from April to May 2022. Descriptive statistical analysis was conducted on the survey results, and multilevel linear regression and structural equation modeling were used to analyze the driving mechanism of residents′ willingness to participate in tiered medical care.Results:The willingness rate of residents to participate in tiered medical care was 69.7%, which was at an average level. Regression insights highlighted the positive influence of policy support perception ( β=0.170, P<0.01), awareness of management mechanisms ( β=0.093, P<0.01), cognitive attitudes ( β=0.102, P<0.01), and trust levels ( β=0.244, P<0.01) on residents′ participation willingness. In contrast, resource allocation perceptions lacked a significant effect ( β=0.065, P>0.05). The structural equation model revealed that cognitive attitudes played a mediating role in the " policy system perception → participation willingness" and " management mechanism perception → participation willingness" pathways, with effect sizes of 0.030 and 0.039, respectively. Trust levels also mediated these paths, with effect sizes of 0.039 and 0.045, and entirely mediated the " resource allocation perception → participation willingness" path, registering an effect size of 0.053. Conclusions:The harmonious management theory can be used to explain the formation mechanism of residents′ willingness to participate in tiered medical care. The government and medical institutions urgently need to further improve residents′ awareness of tiered medical care, focus on enhancing residents′ trust, and further improve policies and management measures such as financial investment, medical insurance reimbursement, and referral systems.

Research on the harmonious driving mechanism of doctors′ collaboration willingness and behavior in the tiered diagnosis and treatment system / 中华医院管理杂志

Objective:To explore the driving mechanisms of doctors′ collaborative willingness and behavior in the tiered diagnosis and treatment system, in order to provide reference for promoting the construction of the tiered diagnosis and treatment system.Methods:Based on the harmonious management theory, a theoretical framework for the driving mechanisms of doctors′ collaborative behavior in the tiered diagnosis and treatment system was developed. Through random sampling, a questionnaire survey was conducted among doctors from 40 medical institutions in five prefecture-level cities in Zhejiang province between April and May 2022. The t-test, variance analysis, and non-parametric tests were employed to analyze the differences in collaborative willingness and behavior among doctors based on various demographic characteristics. The structural equation model and stratified linear regression were used to assess the impact of collaborative factors (professional environment and work expectations) and harmonious factors (perception of policy support and perception of management mechanism) on doctors′ collaboration willingness and behavior. Results:A total of 1 959 doctors participated in the survey. Doctors′ collaborative behavior scored 2.13±1.12, indicating a slightly below-average level, whereas their willingness to collaborate scored 3.88±0.79, falling between neutral and somewhat willing. Significant differences in collaborative behavior scores were observed based on the medical institution′s ranking, age, years of experience, monthly average income, and professional titles ( P<0.05). Both collaborative and harmonious factors directly influenced the doctors′ willingness to collaborate, with standardized path coefficients of 0.428 and 0.139, respectively. Similarly, these factors directly impacted their collaborative behavior, with standardized path coefficients of 0.104 and 0.366. The perceptions of policy support and management mechanisms demonstrated a significant positive moderating effect on the relationship between doctors′ collaborative willingness and behavior, with effect values of 0.047 and 0.043 respectively ( P<0.05). Conclusions:The collaborative and harmonious elements serve as positive drivers for collaboration among doctors in the tiered diagnosis and treatment system at both the cognitive and behavioral levels. Enhancing and optimizing policy support and management mechanisms can facilitate the transition from intention to actual collaborative actions among doctors from different levels of medical institutions.

Theoretical exploration and research pathways of the harmonious symbiotic mechanism in the tiered medical treatment system / 中华医院管理杂志

The tiered medical treatment system stands as a cornerstone in the deepening reforms of China′s medical and health sectors, playing a crucial role in building a healthy China. Exploring the harmonious coexistence mechanism of multiple entities on the supply and demand sides of the tiered diagnosis and treatment system, and promoting the formation of a scientific and reasonable tiered diagnosis and treatment order, has become an urgent public proposition that needs to be answered and has significant social impact. Addressing the challenges in China′s tiered medical treatment system, particularly its need for a more systematic, comprehensive, and collaborative approach, this study is informed by a thorough literature review. Based on the harmonious management and symbiosis theories, the authors proposed a theoretical concept and future research path for the formation of a harmonious symbiotic mechanism in the tiered diagnosis and treatment system, in order to pave the way for exploring the harmonious symbiotic mechanism in the tiered diagnosis and treatment system.

Localization Practice and Enlightenment of Medical Social Work in Shanghai / 中国医学伦理学

By reviewing the development context of medical social work in Shanghai, this paper summarized the practical experience in the development process of medical social work in Shanghai, and provided summary and suggestions for the long-term healthy development of medical social work from four aspects that basic path, key guarantee, important boost, and social image. It is suggested to carry out interdisciplinary cooperation and deepen patient service to build harmonious doctor-patient relationships, pay attention to talent training and improve institutional mechanisms to promote the stability of talent team, develop continuing education and meet different needs to upgrade modern service levels, emphasize brand building and carry out cooperation and co-construction to continuously expand social influence.

Pilot study of a brief psychological intervention for reducing emotional exhaustion and secondary traumatic stress among physicians of intensive care units in Mexico / Estudio piloto de una intervención psicológica breve para reducir el agotamiento emocional y el estrés traumático secundario en personal médico de las unidades de cuidados intensivos en México

Abstract Introduction Physicians of Intensive Care Units (ICU) have a potential risk to develop negative outcomes such as emotional exhaustion and secondary traumatic stress (STS). Specifically, job demands in these units (i.e., work stressors and emotional effort) may positively predict these outcomes, whereas personal resources such as harmonious passion and self-compassion may diminish them. Objetive To design a specific intervention for physicians in ICU and provide preliminary evidence of its effectiveness. Method A brief intervention of five weekly sessions (two hour-sessions) was carried out with four physicians in ICU in a hospital in Mexico. Other four physicians were selected as a control group. The intervention was aimed at reducing emotional exhaustion and STS by increasing harmonious passion and self-compassion, and diminishing the emotional effort. Results The intervention group showed a significant reduction in: a) work stressors (2/4 physicians; RCI = .21); emotional effort (1/4 physicians; (RCI = .60); emotional exhaustion (2/4 physicians; RCI = .34); and STS (3/4 physicians; RCI = .26). One physician experienced a significant increase in harmonious passion (RCI = 1.00), but the intervention seems to maintain high levels of this and self-compassion in comparison with the control group. The control group showed a worse result in its outcomes. Discussion and conclusion Despite the limitations, this study provides preliminary evidence for effectively reducing emotional exhaustion and STS. Our findings highlight the individual analysis of the effective tools per physician and address interventions focused on harmonious passion and self-compassion. This study calls for future research concerning intervention proposals in ICU with follow-up measures to diminish the negative consequences in the long-term.

Resumen Introducción Los médicos de las unidades de Cuidados Intensivos (UCI) presentan un riesgo de desarrollar agotamiento emocional y estrés traumático secundario (ETS). Las demandas laborales en estas unidades (estresores laborales y esfuerzo emocional) pueden predecir positivamente estos resultados, mientras que los recursos personales como la pasión armoniosa y la autocompasión pueden disminuirlos. Objetivo Diseñar una intervención específica para médicos de UCI y proporcionar evidencia preliminar de su efectividad. Método Se realizó una intervención de cinco sesiones semanales (de dos horas de duración cada una) con cuatro médicos de una UCI en un hospital de México. Otros cuatro médicos fueron seleccionados como grupo control. El objetivo fue reducir el agotamiento emocional y el ETS mediante el aumento la pasión armoniosa y la autocompasión; y la disminución del esfuerzo emocional. Resultados En el grupo de intervención se halló una disminución significativa en: a) estresores laborales (2/4 médicos; RCI = .21); esfuerzo emocional (1/4 médicos; RCI = .60); agotamiento emocional (2/4 médicos; RCI = .34); y ETS (3/4 médicos; RCI = .26). Un médico experimentó un aumento significativo en la pasión armoniosa (RCI = 1.00), en tanto que el resto mantuvo altos niveles de ésta y autocompasión en comparación con el grupo control. Discusión y conclusión A pesar de las limitaciones, este estudio proporciona evidencia preliminar para reducir el agotamiento emocional y el ETS. Nuestros hallazgos destacan el análisis individual de las herramientas efectivas y destaca las intervenciones centradas en la pasión armoniosa y la autocompasión. Nuestro estudio recalca la importancia de desarrollar investigaciones futuras sobre intervenciones en UCI con medidas de seguimiento que puedan disminuir las consecuencias negativas a largo plazo.

Analysis of drug consumption in medical service for Dominica and Dominican in Harmonious Mission -2018 / 药学实践杂志

Objective To analyze the drug consumption in medical service for Dominica and Dominican in Harmonious Mission -2018, and provide reference for future drug supply services in similar countries. Methods Data of the drugs used during the medical service of the two countries were extracted from the computer system, which were summarized and analyzed. Results Ranking first in drug consumption in medical service for Dominica and Dominican was external drugs. Chinese traditional medicines were very popular in both two countries. There were great similarities and unique characteristics in the drug consumption during medical service between the two countries, orthopedic drugs, digestive system drugs, ophthalmic drugs and dermatological drugs were frequently used drugs. Conclusion The drug consumption in medical service was closely associated with the national conditions. Therefore, in order to prepare medicines reasonably in future overseas medical service, disease distribution of the country which would be visited and drug consumption in the similar country which had been visited before should be concerned.

Experience of the support of medicine in Harmonious Mission -2018 / 药学实践杂志

Objective Through the statistics of drug consumption in the task of Harmonious Mission -2018, sort out the process of medication supply of overseas medical services, analyze and evaluate the medication supply services. Methods Count the types and quantities of medicines consumed by marine hospitals in the Harmonious Mission-2018, analyze whether the preparation of medicines is sufficient, effective, and economically reasonable, and find way to improve the process of medicine supply in overseas medical services. Results Statistics on the consumption of drugs in the Harmonious Mission-2018 show that the number of drugs consumed accounted for 68.21% of the total kinds of medicine carried, that the total amount of drugs consumed accounted for 40.61% of the total costs of medicine carried, and that the total number of boxes of drugs consumed (the number of the smallest packages) accounted for 21.72% of the total number of boxes of medicine carried. Conclusion The medicine support services in the Harmonious Mission-2018 was sufficient and effective. But, the workflow and the processes of the services still need to be further improved.

Research on Harmonious Doctor-patient Relationship from the Perspective of Harmonious Management Organization Theory / 中国医学伦理学

Through the analysis of current situation of the tension relationship between doctor and patient,this paper expounded that the harmonious management organization theory took the cooperation order as the core of the development of the group organization,and emphasized the running-in process of the internal staffs in the collective group.And it pointed out that the internal cooperation between doctor and patient had the certain cooperation order,and also had obstacles that might cause conflict in cooperation from the perspective of the harmonious management organization theory.This paper analyzed and understood the process of doctor-patient coordination at the group level of harmonious management organization theory,explored and analyzed the obstacles that might cause the conflict during the cooperation process and the reasons in the view of innovation,explored and concluded relevant measures to ease the tension of the doctor-patient relationship,and finally achieved the outcome of maximization of common interests and optimization of treatment effect.

Discussion on the "Five Points" in the Construction of Harmonious Mediation Mechanism / 中国医学伦理学

After several in -depth investigations on the third party mediation mechanism of "Guangdong mode" in Guangdong Harmony Medical Dispute Mediation Committee and combined with the analysis of the domes-tic and foreign medical dispute disposal experience , this paper summed up five points that successful construction of harmonious mediation mechanism should grasp .The five points include the fairness of harmonious mediation thoughts , the feasibility of harmonious mediation paths , the justice of harmonious mediation mechanism , the suita-bility of harmonious mediation environment and the success of harmonious mediation results .Only when grasp these five points, couldit create a gradually harmonious doctor -patient relationship .

Discussion on the "Five Points" in the Construction of Harmonious Mediation Mechanism / 中国医学伦理学

After several in -depth investigations on the third party mediation mechanism of "Guangdong mode" in Guangdong Harmony Medical Dispute Mediation Committee and combined with the analysis of the domes-tic and foreign medical dispute disposal experience , this paper summed up five points that successful construction of harmonious mediation mechanism should grasp .The five points include the fairness of harmonious mediation thoughts , the feasibility of harmonious mediation paths , the justice of harmonious mediation mechanism , the suita-bility of harmonious mediation environment and the success of harmonious mediation results .Only when grasp these five points, couldit create a gradually harmonious doctor -patient relationship .

Review of Current Status and Countermeasures of School Violence / 中国医学伦理学

School violence is a hot and difficult issue around the world.The frequem school violence imposes a great threat on the campus security.School violence not only severely affects the physical and mental health of juvenile students,but also disturbs the harmony and stability of the whole society.Firstly,this paper reviewed the concept of school violence.Then,it summarized the research progress in domestic and overseas area,and expounded a new trend of school violence.Finally,this paper showcases the prevention strategies from school violence,in order to provide a new perspective to promoting the research and effective governance on school violence in our country.

"Discussion on the idea of""He""of Chinese medicine in the palliative care" / 国际中医中药杂志

The palliative care has become an important part of social civilization. Its treatment of advanced patients with no response to the treatment of patients with positive and comprehensive care, paying attention to the people-oriented conforms to the Chinese nationHeperfectly. In palliative care practice,Heconcept penetrates in the happening of the disease and development, treatment and special and complex and changeful in interpersonal relationship. The ultimate goal of He is also a palliative care. The concept of reconciliation will promote the development of palliative care.

Combinations in Fangji of Chinese medicine: holistic view / 中国中药杂志

The modernization research on Fangji is not only an important approach to the improvement on the clinical effects of Chinese medicine, but also a representative field on the inheritance and innovation of Chinese medicine in this new historical period. For the rule of the combintions in Fangji, we proposed a hypothesis of "the holistic harmonious pharmacological effect", which is defined as the different efficacies of different combinations in Fangji deriving from the harmoniousness on the diversity of pharmacological effects like antagonism, complementarity, regulation, etc. In our paper, by analyzing the different pharmacological mechanisms in the differential genes and pathways for the additive effect on the combinations of gardenoside and baicalin as well as the synergy effect on the combinations of gardenoside and cholic acid, we introduced a developed analytical technique for the principle of comprehensive pharmacological effects, pointed out the encountered dilemma in the researches on the combinations in Fangji and at last proposed three transformations to the further researches in this fields.

Promote Enterprise Culture Construction Based on Social Responsibility:Taking Food Enterprises as Example / 中国医学伦理学

Enterprise has the responsibility for economic , to promote the construction of material culture , legal responsibility , to promote the construction of institutional culture , ethical responsibility , can promote behavior cul-tural construction , charity responsibility , to promote the construction of spiritual culture .Chinese enterprises must rely on the power of the enterprise culture , under the background of building a harmonious society and the current market environment , corporate social responsibility into the cultural construction .Is a connection between fully un-derstand and use , based on corporate social responsibility , corporate culture , comprehensive and efficient develop-ment achieve the long-term development of the enterprise .

DOCTOR -PATIENT COMMUNICATION BY UNDERSTANDING, RESPECTING AND CARING / 现代医院

The author excludes many social factors , focuse on building a harmonious relationship between doctors and patients from the perspective of hospital manager .Medical staff must pay attention to the doctor -patient communication skills and methods from their own , play an important role in good doctor -patient communication by understanding, respecting and caring.

CONTINUOUS IMPROVEMENT OF SCIENCE OF TCM--COMBINED WITH THE USE AND QUALITY OF SERVICE PERCEIVED GAP ANALYSIS MODEL / 现代医院

This paper takes the Traditional Chinese Medicine health population science as a social service . From the theoretical perspective .There's a clue that using the models of Perceived Service Quality , Determinants of Quality of Service , 5 Gaps Mode to find out the invisible zone of the continuous improvement of TCM populational sci -ence services.With the further analysis , this zone refers to the 5 gaps of the recognition differential .By minimizing the recognition differential , we form up a strategic program package for TCM populational science , which makes it dif-ferent.Besides, the real case of Guangdong Provincial hospital of TCM has verified that the good TCM populational Science service had demonstrated a positive influence to the Harmonious Relationship of doctor -patient.

Ethical Measures for Hospital Party Committee in Constructing Harmonious Doctor-patient Relationship / 中国医学伦理学

From ethics angle analysis of the characteristics of the doctor -patient contradiction in the new peri-od, clear the hospital party committee in the political core position in the construction of a harmonious doctor -pa-tient relationship , and puts forward play the ethical function of the hospital party committee in building a harmoni -ous doctor-patient relationship , finally summarize the hospital party committee in rebuilding the harmonious doctor-patient relationship specific ethical measures , including: strengthening the ethical and moral education , in -depth professional moral education; Hospital ethics committee , and actively promote ethical operation system; To improve medical environment , mobilize the enthusiasm of the party branch;And improve the mechanism of doctor-patient communication , to protect patients′right to know and privacy;The treatment medicine , commercial brib-ery letter-inquiring-and-accusing work mechanism .

On Value Pursuit of Harmonious Medical Ethics View / 中国医学伦理学

The development and innovation of medical ethics is the pilot to promote the harmonious relation-ship between doctors and patients, and to construct good medical ethics.To accommodate the building of a harmo-nious society and the new requirements of the new medical reform, we put forward the new concept and basic con-tent of the harmonious view of medical ethics.We focuses on value pursuit of the harmonious view of medical ethics, namely the value goal of unified health value, medical value and social value, the value leading of patients interests first and the fundamental standards of its value pursuit.

A Treatment Module in Orthodontics: Cephalometric Polygon Norms as a Guide towards a Harmonious Individual Craniofacial Pattern among Keralites.

The objective of the study was to identify a polygon with limited number of cephalometric parameters in region near to teeth; to find values for linear, angular and area measurements for the polygon in the ideal, Class II and III groups and to define correlations and male female differences observed in the study variables. In this crosssectional study, cephalograms of young adults satisfying the inclusion criteria, were evaluated for the specific parameters. Linear, angular and area measures of polygons in the ideal, Class II and Class III malocclusions were measured from tracings of cephalograms and statistically analysed. Mean±SD of the angular, linear and area measurements for the different study groups, and the Correlations observed between the angular, linear and area measurements in the different study groups; The mean ±SD of the angular, linear and area measurements for males and females in the different study groups; and the Norms for the ideal polygon is identified in the results. A polygon with a limited number of cephalometric parameters was successfully identified; the mean values, correlations and male female differences observed in measurements for the ideal, class II and Class III malocclusions groups are defined.