scholarly journals 在ＡＩ醫生和病人之間——人工智能診斷技術的內在邏輯及其對病人主體性建構的影響

2019 ◽  
Vol 17 (2) ◽  
pp. 11-36
Author(s):  
Guobin CHENG ◽  
Xiaoxi WU
Keyword(s):  
Medical Diagnosis ◽  
Negative Influence ◽  
Patient Interaction ◽  
Digital Commons ◽  
Way Of Thinking ◽  
Physician Patient ◽  
The Relationship ◽  
Traditional Chinese Medical ◽  
The Way

LANGUAGE NOTE | Document text in Chinese; abstract also in English.近年來，人工智能（ＡＩ）技術在醫療領域中的應用探索十分活躍，ＡＩ診斷又是其中的關注焦點。它可以使診斷更加高效和準確，從而在整體上改善醫療診斷品質，提高醫療資源的供给效率和公平性。不論從ＡＩ診斷發展的技術邏輯還是西方現代醫學診斷思維來看，從智慧助手發展到ＡＩ醫生都具有一定的合理性與必然性。但這一技術具有其内在局限，即使已經發展到理想狀態，ＡＩ醫生也不能完全取代醫生，它能輔助醫生和患者更充分地發揮各自的能動性，卻有可能傷害醫患互動的關鍵内核：意義生成和人格構建。如何在充分利用ＡＩ診斷醫生的效率的同時避免其有可能帶來的負面影響，人們需要對ＡＩ診斷技術發展的底層邏輯提供足夠有力的理論拮抗，而不是停留在技術所限定好的語境中解決那些具體的問題。本文提出，有必要引入中國傳統醫學的診斷思維和儒家“成人”理論，作為針對西方現代醫學觀念和現代主體性哲學發起反思的重要理論資源，並在此基礎上重新審視技術與人文的關係。Applying AI in medical contexts, especially for diagnosis, has become very popular in recent years. AI has the potential to make diagnosis more efficient and accurate, improving the overall quality of medical diagnosis and making medical provisions fairer and more effective. Combining the logic of AI with that of modern Western medical diagnosis, it is to some extent intuitive to imagine AI physicians. However, even in its ideal form, AI technology has intrinsic limitations that will prevent it from completely replacing physicians. Although AI can help physicians and patients to develop their own agency, it may strike at the core of physician–patient interaction: generating meaning and constructing personhood/subjectivity. How can we make best use of the efficiency of AI diagnosis while avoiding its potential negative influence? There needs to be a powerful theoretical rejoinder to the fundamental logic of AI diagnosis. It is not enough to deal with specific issues within the realm already delimited by AI diagnosis technology. This paper highlights the need to incorporate the way of thinking of traditional Chinese medical diagnosis and the Confucian theory of “the way of becoming a person.” Both are important theoretical resources that can be used to counterbalance the way of thinking of modern Western medicine and modern Western philosophy, which emphasize subjectivity. On this basis, the relationship between technology and the humanities can be re-examined.DOWNLOAD HISTORY | This article has been downloaded 65 times in Digital Commons before migrating into this platform.

Physician–patient interaction and medication adherence in lupus nephritis

Lupus ◽  
2020 ◽  
Vol 29 (10) ◽  
pp. 1168-1178
Author(s):  
Sofia Georgopoulou ◽  
Louise Nel ◽  
Shirish R Sangle ◽  
David P D’Cruz
Keyword(s):  
Decision Making ◽  
Medication Adherence ◽  
Lupus Nephritis ◽  
Shared Decision Making ◽  
Interpersonal Trust ◽  
Shared Decision ◽  
Patient Interaction ◽  
Physician Patient ◽  
The Relationship

Objective The quality of physician–patient interaction can have a significant impact on medication adherence. Little is known about this relationship in patients with lupus nephritis. Methods A cross-sectional, quantitative study. Data collected included demographics, current medication, systemic lupus erythematosus disease activity index, medication adherence, beliefs about medicines, shared decision-making, patient–doctor depth of relationship, patient–doctor quality of relationship, interpersonal trust in a physician and illness perceptions. Results Ninety-eight patients with lupus nephritis completed the questionnaires. Logistic regression indicated that medication adherence was significantly predicted by (a) interpersonal trust in a physician (B = 0.85, Wald 3.94, 95% confidence interval (CI) 1.01, 5.44; P = 0.05); (b) timeline cyclical (B = –0.89, Wald 4.95, 95% CI 0.19, 0.90; P < 0.05) and beliefs about the necessity of medicines (B = 0.75, Wald 4.14, 95% CI 1.03, 4.38; P < 0.05). Mediation analysis showed that beliefs about the necessity of medicines significantly mediated the relationship between trust and medication adherence when adjusted for age (B = 0.48, 95% CI 0.06, 1.08; P < 0.01). A further mediation analysis showed that patient–doctor depth of relationship (B = 0.05, 95% CI 0.01, 0.09; P < 0.001), shared decision-making (B = 0.07, 95% CI 0.01, 0.13; P < 0.001) and patient–doctor quality of relationship (B = 0.08, 95% CI 0.01, 0.16; P < 0.001) significantly mediated the relationship between illness coherence and interpersonal trust in a physician. Conclusion The findings highlighted two key elements: (a) the importance of trust in relation to medication adherence; and (b) a good understanding of patients’ illness is linked to a better relationship with their doctor and greater participation in shared decision-making which is associated with increased trust. Tailored psycho-educational interventions could contribute to improving the patient–doctor relationship quality, trust and increased shared decision-making, which, in turn, might improve medication adherence in patients with lupus nephritis.

Mental models, humorous texts and humour evaluation

2018 ◽  
Vol 16 (1) ◽  
pp. 97-127 ◽  
Author(s):  
Henri de Jongste
Keyword(s):  
Mental Models ◽  
Model Theory ◽  
Mental Model ◽  
Model Construction ◽  
Mental Model Theory ◽  
The Relationship ◽  
Manipulation Process ◽  
The Way

Abstract This paper investigates how a mental-model theory of communication can explain differences in humorous texts and how aesthetic criteria to evaluate humour are dependent on the way mental models are exploited. Humour is defined as the deliberate manipulation by speakers of their private mental models of situations in order to create public mental models which contain one or more incongruities. Recipients can re-construct this manipulation process and thereby evaluate its nature and its quality. Humorous texts can be distinguished in terms of ownership of the manipulated mental model, the relationship between the speakers’ private and their public (humorous) mental model, as well as the speed required in the humorous mental model construction. Possible aesthetic criteria are the quality of the mental model manipulation, the pressure under which the humorously manipulated mental models have been constructed and the quality of the presentation of humorous mental models.

Management of Somatic Symptoms

2014 ◽  
Author(s):  
Andreas Schröder ◽  
Joel E Dimsdale
Keyword(s):  
Clinical Presentation ◽  
Health Anxiety ◽  
Management Strategies ◽  
Somatic Symptoms ◽  
Conversion Disorder ◽  
Effective Management ◽  
Patient Interaction ◽  
Step Care ◽  
Physician Patient

Somatic symptoms that cannot be attributed to organic disease account for 15 to 20% of primary care consultations and up to 50% in specialized settings. About 6% of the general population has chronic somatic symptoms that affect functioning and quality of life. This chapter focuses on the recognition and effective management of patients with excessive and disabling somatic symptoms. The clinical presentation of somatic symptoms is categorized into three groups of patients: those with multiple somatic symptoms, those with health anxiety, and those with conversion disorder. The chapter provides information to assist with making a diagnosis and differential diagnosis. Management includes ways to improve the physician–patient interaction that will benefit the patient, a step-care model based on illness severity and complexity, and psychological and pharmacologic treatment. The chapter is enhanced by figures and tables that summarize health anxiety, symptoms, differential diagnoses, and management strategies, as well as by case studies and examples. This review contains  5 highly rendered figures, 10 tables, and 235 references.

Management of Somatic Symptoms

2018 ◽  
Author(s):  
Andreas Schröder ◽  
Joel E Dimsdale
Keyword(s):  
Clinical Presentation ◽  
Health Anxiety ◽  
Management Strategies ◽  
Somatic Symptoms ◽  
Conversion Disorder ◽  
Effective Management ◽  
Patient Interaction ◽  
Step Care ◽  
Physician Patient

Somatic symptoms that cannot be attributed to organic disease account for 15 to 20% of primary care consultations and up to 50% in specialized settings. About 6% of the general population has chronic somatic symptoms that affect functioning and quality of life. This chapter focuses on the recognition and effective management of patients with excessive and disabling somatic symptoms. The clinical presentation of somatic symptoms is categorized into three groups of patients: those with multiple somatic symptoms, those with health anxiety, and those with conversion disorder. The chapter provides information to assist with making a diagnosis and differential diagnosis. Management includes ways to improve the physician–patient interaction that will benefit the patient, a step-care model based on illness severity and complexity, and psychological and pharmacologic treatment. The chapter is enhanced by figures and tables that summarize health anxiety, symptoms, differential diagnoses, and management strategies, as well as by case studies and examples. This review contains  5 highly rendered figures, 10 tables, and 235 references.

COGNITIVE HABITS LINKED TO RESILIENCE: SURPRISING COMMONALITIES ACROSS THE UNITED STATES

2020 ◽  
pp. 1-14
Keyword(s):  
Quality Of Life ◽  
United States ◽  
Socioeconomic Status ◽  
Regional Differences ◽  
The United States ◽  
Postal Code ◽  
Improvement Plan ◽  
The Relationship ◽  
The Way

Abstract Background: Research has documented many geographic inequities in health. Research has also documented that the way one thinks about health and quality of life (QOL) affects one’s experience of health, treatment, and one’s ability to cope with health problems. Purpose: We examined United-States (US) regional differences in QOL appraisal (i.e., the way one thinks about health and QOL), and whether resilience-appraisal relationships varied by region. Methods: Secondary analysis of 3,955 chronic-disease patients and caregivers assessed QOL appraisal via the QOL Appraisal Profile-v2 and resilience via the Centers for Disease Control Healthy Days Core Module. Covariates included individual-level and aggregate-level socioeconomic status (SES) characteristics. Zone improvement plan (ZIP) code was linked to publicly available indicators of income inequality, poverty, wealth, population density, and rurality. Multivariate and hierarchical residual modeling tested study hypotheses that there are regional differences in QOL appraisal and in the relationship between resilience and appraisal. Results: After sociodemographic adjustment, QOL appraisal patterns and the appraisal-resilience connection were virtually the same across regions. For resilience, sociodemographic variables explained 26 % of the variance; appraisal processes, an additional 17 %; and region and its interaction terms, just an additional 0.1 %. Conclusion: The study findings underscore a geographic universality across the contiguous US in how people think about QOL, and in the relationship between appraisal and resilience. Despite the recent prominence of divisive rhetoric suggesting vast regional differences in values, priorities, and experiences, our findings support the commonality of ways of thinking and responding to life challenges. These findings support the wide applicability of cognitive-based interventions to boost resilience. Keywords: appraisal; resilience; cognitive; quality of life; societal; geographic Abbreviations: MANOVA = Multivariate Analysis of Variance; PCA = principal components analysis; QOL = quality of life; SES = socioeconomic status; US = United States; ZIP = Zone Improvement Plan (postal code)

Construct Validity and Reliability of the Questionnaire on the Quality of Physician–Patient Interaction in Adults With Hypertension

2017 ◽  
Vol 25 (1) ◽  
pp. 17E-30E
Author(s):  
Ronald L. Hickman ◽  
John M. Clochesy ◽  
Breanna Hetland ◽  
Marym Alaamri
Keyword(s):  
Construct Validity ◽  
Community Dwelling ◽  
Self Management ◽  
Validity And Reliability ◽  
Reliable Measure ◽  
Convenience Sample ◽  
Patient Interaction ◽  
Test Retest Reliability ◽  
Physician Patient

Background and Purpose: There are limited reliable and valid measures of the patient– provider interaction among adults with hypertension. Therefore, the purpose of this report is to describe the construct validity and reliability of the Questionnaire on the Quality of Physician–Patient Interaction (QQPPI), in community-dwelling adults with hypertension. Methods: A convenience sample of 109 participants with hypertension was recruited and administered the QQPPI at baseline and 8 weeks later. Results: The exploratory factor analysis established a 12-item, 2-factor structure for the QQPPI was valid in this sample. The modified QQPPI proved to have sufficient internal consistency and test– retest reliability. Conclusions: The modified QQPPI is a valid and reliable measure of the provider–patient interaction, a construct posited to impact self-management, in adults with hypertension.

166-EVALUATION OF A QUESTIONNAIRE TO ASSESS THE QUALITY OF PHYSICIAN-PATIENT INTERACTION

2004 ◽  
Vol 56 (6) ◽  
pp. 655-656
Author(s):  
KG Müller ◽  
C Bieber ◽  
K Blumenstiel ◽  
A Richter ◽  
D Eisenbeiß ◽  
...  
Keyword(s):  
Patient Interaction ◽  
Physician Patient

scholarly journals People with Disabilities, Self-Determination and Very Personal Acts

Teisė ◽  
2020 ◽  
Vol 114 ◽  
pp. 122-131
Author(s):  
Gaetano Di Martino
Keyword(s):  
Social Protection ◽  
People With Disabilities ◽  
Self Determination ◽  
Active Part ◽  
Persons With Disabilities ◽  
Way Of Thinking ◽  
The Relationship ◽  
The Way

The evolution of medical, social and economic sciences and, more generally, the way of thinking has profoundly changed the relationship between Society and people with disabilities: these persons, from the recipients of social protection and care, have become an active part of Society. Therefore, this publication analyzes the basis and limits of the powers of persons with disabilities in the context of ethical, political, religious and legal values.

scholarly journals Hubungan Gangguan Fungsi Kognitif dengan Kejadian Depresi pada Lansia di Posyandu Lansia Ikur Koto Wilayah Kerja Puskesmas Ikur Koto Kota Padang

2019 ◽  
Vol 1 (1) ◽  
pp. 30-37
Author(s):  
Indri Zaliavani ◽  
Mutiara Anissa ◽  
Fidiariani Sjaaf
Keyword(s):  
Cognitive Function ◽  
The Elderly ◽  
Negative Influence ◽  
Bivariate Analysis ◽  
Cross Sectional ◽  
A Value ◽  
Relationship Of ◽  
Spearman Test ◽  
The Relationship

In the elderly, environmental stress and decreased cognitive function often cause depression. Depression that is not treated properly can cause an increase in the use of health facilities, a negative influence on the quality of life elderly, and can even cause death. Purpose of this research to know the relationship of cognitive function disorders with depression in the elderly at Posyandu Lansia Ikur Koto working area of the Puskesmas Ikur Koto, Padang. This type of research is correlative analytic with cross-sectional approach. Research has been conducted at posyandu lansia Ikur Koto in February 2019. The samples in this research was elderly who were recorded at the posyandu lansia Ikur Koto there were 51 elderly. Data analysis univariate presented in the form of a frequency distribution table and bivariate analysis using the spearman test using the SPSS program. Result of the 51 respondents, the majority of age was 60-74 years old (70,6%), the highest sex were women (94,1%), the highest education was elementary school (56,9%) ), the most marital status was married (52,9%), the highest health status (58,8%) did not suffer chronic diseases and most medical history does not use drugs (98%),most (72,5%) did not experiencing depression, most (37,3%) had mild cognitive function disorders and there were relationship between cognitive function disorders and depression in the elderly with a value p=0,007<0,05 and r=-0,373. Conclusion is there were significant relationship between cognitive function disorders and depression in the elderly at Posyandu Lansia Ikur Koto working area of the Puskesmas Ikur Koto, Padang.

scholarly journals I, tutor - a monologue of a reflective teacher, or how to properly understand his role

2018 ◽  
Vol 2 (1) ◽  
pp. 67-69
Author(s):  
Patryk Krzemiński
Keyword(s):  
Way Of Life ◽  
Educational Work ◽  
Theoretical Assumptions ◽  
Reflective Teacher ◽  
The Relationship ◽  
Practical Dimension ◽  
The Way

Abstract Tutoring is not only theoretical assumptions, but also the practical dimension of the relationship between the tutor and the student. The final result depends on the quality of this process, if a student who not only possessed knowledge but also took over the tutor’s attitude towards many issues, including the way of life. The study will show reflections on the practical use of the tutorial with general conclusions resulting from the tutorial educational work.

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