Research on the Localization Development Path of Narrative Medicine / 中国医学伦理学

After more than ten years of preliminary exploration, the localization development of narrative medicine has made some achievements in theoretical research, medical education and clinical practice, but its development direction and pathway still need to be further confirmed. From the five perspectives of policy system, management mechanism, cultural background, medical education and social development trends, this paper discussed systematically and macroscopically the localization development of narrative medicine, and advocated that improving the top-level design and local policies, constructing management systems at all levels, taking root in Chinese culture, carrying out systematic narrative education and closely integrating with the development trend, so as to inspire the theoretical construction of the development path of narrative medicine in China.

Exploration of the Narrative Medical Education from the Perspective of Anthropology: Based on the KAP Survey Report of 2,353 Medical Students / 中国医学伦理学

【Objective:】 To understand the development of narrative medicine in medical schools and the cognitive level of narrative medicine among medical students. 【Methods:】 Taking 2,353 medical students nationwide as the research subjects, Knowledge, Attitude/Belief, Practice (KAP) questionnaire was distributed online to conduct a survey. The survey results were analyzed from the perspectives of general knowledge, ways to understand narrative medicine, and cognitive level of parallel medical records. 【Results:】 44.50% of the survey respondents had never learned about narrative medicine, and 50.79% of them had never heard of parallel medical records. 26.80% of the survey respondents had participated in the training of narrative medicine courses, while most medical students learned about narrative medicine through other ways. 【Conclusion:】 This paper showed that the majority of the survey respondents are not familiar with the key concepts of narrative medicine. By introducing the concept of big culture in anthropology into medical college education or exploring the perspective of doctor-patient interaction, integrating communication models to improve doctor-patient relationships. The current popularization level of parallel medical records and narrative types among medical students is not good, and the cultivation of cultural sensitivity and reflective ability may help promote the teaching and application of parallel medical records. Multiple learning pathways lay the foundation for further teaching, and build a diversified teaching system to enrich the course content, which should be the focus of promoting narrative medicine education in the future.

Analysis of the medical complaint data in a district of Beijing during the COVID-19 epidemic / 中华医院管理杂志

Objective:To analyze the complaint data of medical institutions in a district of Beijing in 2021, discuss the patients′ demands for medical services under the background of epidemic normalizaed prevention and control, for reference to improve the service quality and quality management level of medical institutions.Methods:The data was from all patient complaints received by the Beijing Hospital Management Center in 2021 from medical institutions in a district of Beijing, and the information of confirmed cases of COVID-19 in Beijing in 2021 from Wind database. The time of complaint, the complained organization, the object of complaint, the content and reason, and the time distribution of epidemic related complaints and COVID-19 cases were analyzed. All data were analyzed by descriptive analysis.Results:A total of 2 408 valid complaints were included. The tertiary hospitals(1 175, 48.8%) and secondary hospitals(724, 30.1%) received more complaints; The complaints against to hospital managers were the most(1 470, 61.0%), followed by complaints against doctors(590, 24.5%); The number of complaints related to hospital management were the largest(776, 32.2%), followed by complaints related to diagnosis and treatment effects(623, 25.9%) and epidemic situation(431, 17.9%). The time distribution of epidemic related complaints was similar to the change trend of the number of confirmed COVID-19 cases in Beijing during the same period.Conclusions:Under the background of epidemic normalizaed prevention and control, the problems of hospital management in medical complaints were the most prominent, and epidemic related complaints accounted for a large proportion. Medical institutions should closely combine patients′ demands, optimize diagnosis and treatment procedures, unblock doctor-patient communication channels, promote hierarchical diagnosis and treatment, optimize resource allocation, and explore high-quality hospital operation and management mode.

Research on Medical Humanistic Spirit Construction Based on Narrative Medicine Education: Based on KAP Survey Report of 2 145 Medical Staff / 中国医学伦理学

【Objective:】 To understand the current situation of narrative medical education for medical staff in China, and to explore the construction of the practice mode of medical humanistic spirit in the new era. 【Methods:】 The cross-sectional study and convenience sampling method were used to conduct an online questionnaire survey on the knowledge, attitude and behavior of 2,145 medical staff about narrative medicine in China. 【Results:】 The knowledge of the surveyed medical staff about narrative medicine was at a lower moderate level. Nearly 70% of the medical staff had a positive attitude toward learning and using narrative medicine, with a high degree of recognition, but 30% of medical staff still had a negative attitude toward narrative medicine practices such as parallel medical records. The frequency of related behaviors among medical staff was low, and the proportion of people who evaluated the questions as positive accounted for about 40%, especially about 30% of the people evaluated as positive in narrative medicine practice projects. 【Conclusion:】 Narrative medical education in China is at the primary stage and is facing many tests such as the effectiveness of the transformation of theoretical results. The healthy and sustainable development of narrative medical education must be combined with the practical experience of medical humanities education at home and abroad to explore narrative programs with Chinese characteristics. Narrative medical education focuses on the three links of "narrative medical knowledge, attitude and behavior" and closely links its humanistic connotation, which is of great significance to enrich and innovate the medical humanistic education model.

Survey on Knowledge, Attitude, and Behavior Regarding Narrative Medicine Based on 2 145 Medical Personnel / 中国医学伦理学

【Objective:】 To understand the knowledge, attitude and behavior of Chinese medical personnel on narrative medicine. 【Methods:】 2 145 domestic medical staff were investigated through online questionnaire by convenient sampling. 【Results:】 The scoring rates of knowledge, attitude and behavior of narrative medicine among medical personnel were 49.62%, 47.18%, and 41.43% respectively. 【Conclusion:】 From the cognitive perspective, although most of the participants were familiar with the big framework of narrative medicine, they knew little about the specific methods and tools. As for attitude, medical staff can still further learn the attitude and identity of narrative medicine related theories. But the overall attitude was positive, which laid a foundation for further promoting narrative medicine. From the behavioral perspective, medical personnel’s reading and writing frequency of disease narrative stories was relatively low. In the future, relevant skills training and habit cultivation should be strengthened.

Analysis of the Current Situation and Influencing Factors of Doctor - patient Trust from Different Perspectives of Doctors and Patients:Based on the Investigation of Six Medical Institutions in Beijing / 中国医学伦理学

From two perspectives of doctors and patients, we selected two microscopic angles of the hospital level and communication mode to carry out a parallel research and analyzed the effect of different levels of hospitals and doctor - patient communication mode on the trust between doctor and patient. The study found that both doctors and patients tended to trust each other, and in the process of medical treatment, the trust degree of patients that medical staffs believed was lower than that of the doctors that patients believed; both doctors and patients tended to consider that the hospital levels had great influence on doctor - patient trust, and their evaluation to doctor - patient trust in different levels of hospitals was discrepant; and both the doctors and patients tended to consider that the communication mode had great influence on the doctor - patient trust, in which the patients thought that doctors' appearance, detailed asking about disease and communication channels existed differences of effect in different lev-els of hospital.

Analysis of the Cognitive Factors of Medical Professionalism Affecting Doctor-patient Trust:Based on Investigations of Six Medical Institutions in Beijing / 中国医学伦理学

This paper analyzed the three basic principles of medical professionalism established in the Medical Professionalism in the New Millennium:Physician Declaration and influencing factors of a series of clear professional responsibilities from the medical technology , medical ethics , medical professional responsibility and medical equity four levels .The study found that the proportions of doctors and patients ' identification with the elements of medical professionalism were relatively high , of which the proportion of doctors was higher than patients .It indicated that the basic principles and professional responsibility advocated by medical professionalism had been recognized and accepted by medical staff and the public .

Analysis of the Cognitive Factors of Medical Professionalism Affecting Doctor-patient Trust:Based on Investigations of Six Medical Institutions in Beijing / 中国医学伦理学

This paper analyzed the three basic principles of medical professionalism established in the Medical Professionalism in the New Millennium:Physician Declaration and influencing factors of a series of clear professional responsibilities from the medical technology , medical ethics , medical professional responsibility and medical equity four levels .The study found that the proportions of doctors and patients ' identification with the elements of medical professionalism were relatively high , of which the proportion of doctors was higher than patients .It indicated that the basic principles and professional responsibility advocated by medical professionalism had been recognized and accepted by medical staff and the public .

Analysis of the Social and Cultural Factors of the Difference between Knowing and Doing in Medical Professionalism:Based on Investigations of Six Medical Institutions in Beijing / 中国医学伦理学

Through the analysis of social and culture factors influencing that medical staff's cognition and practice of medical professionalism can bot be unified,which included that social trust crisis in the period of social transformation led to the serious challenge of the trust between doctors and patients;the defects in the medical reform system design and distortions of incentive mechanism triggered conflicts of interests between doctors and patients;" the relativity of public and private groups" under the pattern of difference sequence led to difficult realization of health equity;and medical staff and patients had different cognitions and understandings to diseases,this paper pointed out that although the medical staffs' cognition degree of medical professionalism was relatively high,the current tense situation of doctor-patient relationship still had not been very good relief.

Ethical Strategies for Improving the Construction and Development of Health Personnel in Villages / 中国医学伦理学

This paper summed up the medical professionalism as taking patients'interests first , reshaping the medical good faith , improving business ability and promoting social justice .Also proposed that in order to have rea-sonable human resource allocation , ensure the construction of rural health personnel team and stability , the follow-ings are necessary:medical staff at villages and towns setting up the medical ethics , strengthening the altruism spir-it;changing the traditional model of the doctor -patient relationship , adhering to the principle of patient autonomy;cultivating professional sense of responsibility , building moral education;intensive training and striving to improve the level of medical technology;increasing the doctor -patient communication , restoring patients'interests first , re-shaping medical doctor -patient trust integrity , improving business ability and promoting social justice as well as fully exerting the social , moral and cultural supporting factors etc .