医病关系以及医疗商议.pptVIP

良好的壓力因應者 良好的自我控制能力 充分投入工作 良好的時間管理 宏觀的視野 均衡的飲食及運動 善用週遭的社會支持網絡 REM Sleep Awake Stage 1 Stage 2 Stage 3 Stage 4 Hours of Sleep REM Latency Structure of Sleep The communal life of human beings had, therefore, a two-fold foundation: the compulsion to work, which was created by external necessity, and the power of love... . Freud S: Civilization and Its Discontents,1930, S.E. XXI.101. Thank you for your attention * 醫病關係以及醫療溝通 廖士程 醫師 臺大醫院精神醫學部心身醫學科 醫學院要如何挽回大眾對醫業的信任？其根本之道在於：篩選並培育出一群醫療專業人員，他們視醫療為社會建構的一環，並知道如何傾聽與回饋，在他們自我許諾的特殊專業領域中，能清晰而誠摯地回應與溝通。 Wallace AG: Educating tomorrow’s doctors:the thing that really matters is that we care. Acad Med 1997;72:253-8. Pain Pain + Warm Warm Sawamato et al., J Neurosci 2000;20:7438-7445 Vastag B: Scientists find connections in the brain between physical and emotional pain. JAMA 2003 290:2389-90. Danger Frustration Loss Stress Anxiety Anger Depression SOM = somatic complaints; OBS = obsessive-compulsive symptoms; SEN = interpersonal sensitivity; DEP = depressive symptoms; ANX = anxiety symptoms; HOS = hostility; PHO = phobic-anxiety; PAR = paranoid tendency; ADD = additional symptoms. The adjusted T score was determined from data obtained from 4600 participants of regular health examination in the same medical center. After adjustment, a T score of 50 was considered identical to the mean of the reference group and the standard deviation (SD) was set at 10. Managed Care and Physician Patient Relationship Choice Competence Communication Compassion Continuity Conflict of Interest Emanuel EJ et al., JAMA 1995;273:323-329. Consumerism Basic right of consumer (J.F. Kennedy 1962 ) The right to informed The right to safety The right to choose The right to heard Basic assumption of consumers and their behaviors Reversed or blurred obligation and right Otto von Bismarck 1815－1898 俾斯麥是19世紀最卓越的政治家之一 任普魯士首相期間通過一系列成功的戰爭統一了德國，並成為德意志帝國第一任總理 他通過立法建立了世界上最早的工人養老金、健康和醫療保險制度，或社會保險。 醫病溝通實例 病人篇 醫生啊！你以前有看過像我這樣的病情嗎？ 醫生啊！我和某某立法委員很熟喔！ 醫生啊！拜託你不要問這麼多了，你們決定就