医患信任是医患和谐的"黏合剂",探究医患信任的内涵特征与作用机制对于重塑医患和谐与修复医患关系的裂痕具有重要的理论及实际意义.通过对国内外医患信任的概念内涵、测评工具、影响因素的文献回顾和述评,发现已有医患信任测评研究,缺乏结合具有中国特色的社会文化情境来构建医患信任,有待进一步探索医患制度信任、群际信任的形成机制与信任修复策略,从多元协同治理的视角提出新时代建设良性医患信任的本土化治理路径与策略.

目的:分析浙江省DRG改革对大型医院住院服务绩效的影响.方法:以浙江省某省级公立医院为例,从服务能力、住院费用、服务效率、服务质量4个维度,比较DRG改革前后的变化.结果:DRG改革后,大型医院CMI指数上升,次均住院费用下降,费用构成趋于合理,平均住院日缩短,低风险组死亡率下降.结论:DRG改革有利于实现大型医院的高质量发展,但仍需加强院内管理,减少组内变异,完善支付配套政策.

目的:设计开发现代化医院手术室高值耗材使用、计费关联管理系统,实现手术室高值耗材使用时不同信息系统间的实时计费,提高手术室高值耗材管理一体化、协同化能力.方法:通过分析现有医疗高值耗材手术室应用的模式,设计贯穿于医保交易、财务收费、手术室耗材使用计费中的一体化闭环信息系统,使得每个耗材使用计费都可以全流程追溯.结果 及结论:通过应用此系统,减少了护士、财务、医保等多方面医务工作人员工作压力,基本杜绝了手术室高值耗材计费过程中漏费、错费、溢库等情况,提高了医务人员记费效率和正确性.

Objective:To investigate the current status of disability acceptance and alexithymia among patients with permanent colostomy, and to explore the effect of alexithymia on disability acceptance. Methods:Totally 222 patients with permanent colostomy were recruited and investigated by the Acceptance of Disability Scale and the Toronto alexithymia Scale. Results:The mean scores of disability acceptance and alexithymia were (180.45±33.25) and (2.99±0.79), respectively. The affective disorder of recognition, affective disorder of description, extroverted thinking and the total score of alexithymia were signiifcantly negatively correlated with the each dimension and total score of disability acceptance (P<0.05). Hierarchical regression analysis showed that the affective disorder of recognition, affective disorder of description and extroverted thinking were the inlfuencing factors of the disability acceptance among patients with permanent colostomy (P<0.05). Conclusions:The level of disability acceptance was in the medium level among permanent colostomy patients and alexithymia was its inlfuencing factor. The nursing staff could take effective measures to intervene exithymia and to improve the level of disability acceptance among permanent colostomy patients.

我科对心衰病人微泵补钾取得满意效果,现将结果报道如下. 1 资料与方法 1.1 一般情况:观察对象为我科近期收治的心衰病人,共88例,其中男51例,女37例;年龄在35～87岁之间.临床表现除心衰症状外,还有倦怠、乏力、腹胀等低钾症状,血电解质报告血清钾在2.12～3.49mmol/L.