Discussion on the Doctor-patient Relationship Model in Psychiatry Based on the Szasz & Hollender’s Model of Doctor-patient Relationship / 中国医学伦理学

Due to the particularity of mental diseases, doctor-patient relationship in psychiatric medicine is a subject that needs to be paid attention to. This paper focused on the discussion of the model of doctor-patient relationship in psychiatric medicine from the perspective of constructing a harmonious doctor-patient relationship. Based on the Szasz & Hollender’s Model of Doctor-patient Relationship and combined with the characteristics of psychiatric medicine, this paper discussed the applicable doctor-patient relationship models, namely, the shared participation model, the guidance-cooperation model, the active-passive model, and the protective-constraint model. The specific application of the shared participation model, the guidance-cooperation model, and the active-passive model in the psychiatric medicine context were introduced in detail, and the reasons and characteristics of the protective-constraint model added on the basis of Szasz & Hollender’s Model of Doctor-patient Relationship were elaborated. Meanwhile, the realization paths of the protective-constraint model in clinical practice were further explored, which included evaluating the behavioral capacity and consciousness state of patients with mental disorders, obtaining informed consent, and standardizing the use of intervention rights and withdrawal mechanisms. The discussion of this model will promote the improvement of doctor-patient relationship and the development of psychiatric medicine.

Hospital Infection among Psychiatric Inpatients in State of Protective Constraint / 中华医院感染学杂志

OBJECTIVE To explore the affection of protective constraint on infection among psychiatric inpatients and it′s preventive methods.METHODS A retrospective study of infection among psychiatric patients was carried by medical records investigation.Inpatients in states of protective constraint and non-constraint in confining units of psychiatric department were divided into study group and control group.Case-control study was carried up on rate of hospital infection and rate of infection of parts of body between groups.RESULTS The infective rate of study group was significantly higher than control one,in which,infective rates of lower respiratory tract,urinary tract,dermatological and mucous parts of study group were significantly higher than control group.CONCLUSIONS Protective constraint for psychiatric patients is one of risk factors of hospital infection,to which should be pay attention,and preventive methods might be taken.