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Objective:To investigate the current status of medical record coders and their resignation tendency, and put forward suggestions for the training and team building of medical record coders.Methods:From April to May 2020, a questionnaire survey was conducted among the medical record coders in 27 DRG payment pilot hospitals in Anyang, Henan. Statistical analysis was conducted on the profile of the medical case department, basic personal information, professional quality, job satisfaction and resignation intention. Kendall coefficient was used to analyze the factors related to the resignation intention.Results:There were 98 coders in the surveyed hospitals, including 43 full-time coders and 55 part-time coders. Eighty-three valid questionnaires were recovered, and the effective recovery rate was 84.7%. Among them, 29(34.9%) had education level of junior college or below, 51(61.4%) had junior title or below, 15(18.1%) had medical information or case management as their major, 29(34.9%) coders had not obtained a coding certificate, 31(37.3%) were dissatisfied with the salary system, and 14(16.9%) had a tendency to leave. The medical record coders with lower professional titles, coding certificates and lower salary satisfaction were more likely to have the intention of resignation.Conclusions:Medical record coders in Anyang were challenged with such problems as shortage of manpower, low percentage of coding certificate holders and low salary satisfaction. Title, code certificate issuance and salary satisfaction were correlated with their resignation intention. Hospital managers should strengthen the importance of medical record coding and coders, and establish a reasonable salary, title evaluation and performance incentive system, so as to improve the attractiveness of coder position.
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RESUMO No texto "Construções em análise", Freud afirma que a tarefa do analista envolve uma atividade de construção, originária da complementação e da integração dos restos conservados da história do analisando. Neste artigo, sustenta-se que, além do modelo de 1937, existem outras formas de construção em análise, concebidas a partir da relação da dupla analista-analisando e decorrentes do vínculo transferencial. Essas construções repercutem na simbolização primária e na elaboração de novas narrativas sobre o vazio psíquico. Propõe-se que, nos casos de vazio psíquico, tédio e apatia, o analista há de se envolver em um trabalho de construção para revitalizar a cena analítica, propiciar uma rota de simbolização do material cindido do analisando e contribuir para que a análise funcione como um espaço potencial para esse fim. Exemplifica-se tal manejo com um caso clínico da chamada síndrome da resignação.
ABSTRACT In the text Constructions in Analysis, Freud (1937/2018) states that the task of the analyst involves a construction activity, originating from the "complementation" and "integration of surviving remains" of the analysand's history. The aim of this article is to argue that, besides this 1937 model, there are also other forms of constructions in analysis, conceived from the relationship between analyst-analysand and resulting from the transference-countertransference link - constructions that generate repercussions on primary symbolization and the elaboration of new narratives about the psychic void. It is proposed that, in cases of psychic emptiness, boredom and apathy, the analyst should engage in a constructive work to revitalize the analytic scene, providing a route of symbolization of the analysand's split material and contributing to the analysis functioning as a potential space for that purpose. Such management is exemplified with a clinical case of the so-called Resignation Syndrome.
RESUMEN En el texto "Construcciones en análisis", Freud afirma que la tarea del analista envuelve una actividad de construcción, que tiene origen en la complementación y la integración de los restos conservados de la historia del analizado. En este artículo, se sostiene que, además del modelo de 1937, existen otras formas de construcción en análisis, concebidas a partir de la relación entre el dúo analista-analizado y decurrentes del vínculo transferencial. Estas construcciones repercuten en el simbolismo primario y en la elaboración de nuevas narrativas sobre el vacío psíquico. Se propone que, en los casos de vacío psíquico, tedio y apatía, el analista se envolverá en un trabajo de construcción para revitalizar la escena analítica, propiciar una ruta de simbolismo del material escindido del analizado y contribuir para que el análisis funcione como un espacio potencial para esa finalidad. Se ejemplifica tal manejo con un caso clínico de la llamada síndrome de la resignación.
RÉSUMÉ Dans le texte Constructions en analyse, Freud (1937/2018) affirme que la tâche de l'analyste implique une activité de construction, qui découle de la «complémentation¼ et de « l'intégration de vestiges conservés ¼ de l'histoire de l'analysant. Dans cet article, on soutient que, outre ce modèle de 1937, il existe aussi d'autres formes de constructions en cours d'analyse, conçues à partir de la relation entre l'analyste et l'analysant et résultant du lien transfert / contre-transfert, constructions qui ont des répercussions sur la symbolisation primaire et l'élaboration de nouveaux récits concernant le vide psychique. Il est proposé que, dans les cas de vide psychique, d'ennui et d'apathie, l'analyste s'engage dans un travail de construction visant à revitaliser la scène analytique, à fournir une voie de symbolisation du matériel scindé de l'analysant et à contribuer au fonctionnement de l'analyse en tant qu'un espace potentiel à cet effet. Une telle gestion est illustrée par la mention d'un cas clinique du syndrome dit de résignation.
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Psychoanalysis , Boredom , Personal Construct Theory , ApathyABSTRACT
Objective@#To explore the statue quo of psychological resilience of breast cancer patients during chemotherapy period and its influencing factors.@*Methods@#From December 12 to May 2018, Totally 165 breast cancer patients during chemotherapy period in Department of Mammary Chemotherapy of Zhejiang Cancer Hospital were investigated by self-designed demographic questionnaire, the Connor-Davidson Resilience Scale and the Medical Coping Modes Questionnaire.@*Results@#The total score of psychological resilience for breast cancer patients during chemotherapy period was (60.26±16.17)points.Multiple regression analysis showed that marital status, transfer, confront and resignation coping style were the influencing factors for psychological resilience(t=-3.048, 3.216, 3.070, -3.044, all P<0.05).@*Conclusion@#The level of psychological resilience of breast cancer patients is poor and multivariate analysis appears that marital status, transfer, confront and resignation coping style are important influencing factors.
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Objective To explore the statue quo of psychological resilience of breast cancer patients during chemotherapy period and its influencing factors.Methods From December 12 to May 2018,Totally 165 breast cancer patients during chemotherapy period in Department of Mammary Chemotherapy of Zhejiang Cancer Hospital were investigated by self－designed demographic questionnaire ,the Connor －Davidson Resilience Scale and the Medical Coping Modes Questionnaire.Results The total score of psychological resilience for breast cancer patients during chemotherapy period was (60.26 ±16.17) points.Multiple regression analysis showed that marital status,transfer, confront and resignation coping style were the influencing factors for psychological resilience ( t＝－3.048,3.216, 3.070,－3.044,all P＜0.05).Conclusion The level of psychological resilience of breast cancer patients is poor and multivariate analysis appears that marital status , transfer, confront and resignation coping style are important influencing factors.
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Objective: According to ERG ( Existence Relatedness Growth) needs theory, analyze factors influencing the resignation probability in Township Health Centers (THC). Methods: Structural equation model was used based on ERG needs theory. The sample consists of 403 stuffs in the THC. Results: The result of model fitting goes well. The satisfaction levels of the needs to survive and the needs of relationship become the major influencing factors of resignation probability in the THC. Conclusion: To reduce the resignation probability in THC, it needs to guarantee their income and benefits, improve working condition and living convenience facilities.
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Según modelos psicopatológicos recientes el desarrollo y mantenimiento de los trastornos de ansiedad (TA) se relacionaría con el uso de estrategias de regulación emocional desadaptativas. El estudio comparó el uso de estrategias de regulación emocional para afrontar emociones displacenteras en un grupo de 62 pacientes con TA y uno integrado por 61 controles (GC). No se hallaron diferencias en el uso de las estrategias de aproximación cognitiva. Comparados con el GC, los pacientes con TA utilizaron en mayor medida estrategias de Evitación Cognitiva, Resignación-Aceptación, Descarga Emocional y Búsqueda de apoyo; a la vez que emplearon en menor medida estrategias de Resolución de Problemas. Para el grupo ansioso, las estrategias de Resignación-Aceptación, Descarga Emocional y Análisis Lógico correlacionaron positivamente con todas las medidas de severidad sintomatológica, mientras que la Revaloración positiva lo hizo negativamente. En vista de los resultados, se discuten sus implicaciones para el desarrollo de nuevos protocolos de tratamiento.
According to current psychopathological models development and maintenance of anxiety disorders (AD) would be related to the use of maladaptive emotion regulation strategies. The study compared the use of emotional regulation strategies to cope with unpleasant emotions in a group of 62 patients with AD and one composed by 61 controls (CG). No di f ferences were found between groups regarding use of cognitive approximation strategies. Compared with control group patients with AD reported a greater tendency to engage in Cognitive Avoidance, Resignation-Acceptance, Emotional discharge and Support Seeking strategies. In turn, AD patients were less prone to use Problem Solving strategies. For AD group Resignation-Acceptance, Emotional discharge and Logical Analysis strategies were positively correlated to all symptomatology measures while Positive Revaluation strategy did negatively. In view of the results their implications for the development of new treatment protocols are discussed.
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O processo de globalização ocorrido nas últimas décadas trouxe repercussões nos modos de produção econômica, científica e cultural. Neste contexto, a noção de cotidiano emergiu, a partir das contribuições teóricas de Henri Lefebvre, Agnes Heller e Michel de Certeau, como um importante instrumento de conhecimento e de análise da realidade social, trazendo visibilidade à dinâmica dos processos de acomodação/mudança social.
In the last decades, the economic, scientific and cultural means of production were affected by the globalization process. In this context, the studies of Henri Lebfevre, Agnes Heller and Michel de Certeau about everyday life revealed that this notion can be an important tool for the knowledge and analysis of the social reality, in particular of the resignation/changing social processes.
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Capitalism , Life Change Events , Social Conditions , Technological DevelopmentABSTRACT
The present study relating to job satisfaction involved 440 registered nurses at Siriraj Hospital; 40.7 percent of those surveyed indicated that they were dissatisfied with their jobs. The causes of job dissatisfaction leading to resignation were having to work on nightshifts and difficult work, low salary, lack of job promotion and “burn-out”. Approaches to solving these problems include providing opportunites for selecting jobs and changing existing job opportunites and appropriate fringe benefits.