Using Cognitive Mapping to Understand Problems Experienced by Family Caregivers of Persons with Severe Physical Disabilities

Individuals who provide ongoing care for family members who have a chronic disease or disability are likely to encounter a wide array of problems that can compromise their own health and their ability to function effectively in a caregiving role. Structured focus group meetings were conducted to elicit a comprehensive list of the problems that caregivers experienced during their first year of providing care to a person with a severe physical disability. A separate group of caregivers (N = 60) individually sorted problems into piles based on their similarity and assigned relative importance to each problem. The aggregated data were analyzed with multidimensional scaling and hierarchical cluster analysis. Results indicated that caregivers cognitively organize problems along three dimensions: I. Centeredness–caregiver versus patient-oriented; II. Relationship Demands–physical versus emotional; and III. Caregiver Burden–time versus emotional. Additionally, 6 clusters of substantively similar problems were identified and prioritized in terms of personal relevance: Basic Needs (lowest); Perceived Constraints; Caregiver Challenges; Patient Resentment; Patient Withdrawal; and Patient Intrapsychic Adjustment (highest). Further examination of the organization of problems identified by caregivers should provide important insights about the experience of caregivers and how more targeted interventions can be developed to address their specific needs.     

婚检“检”破处女膜映射出的医学伦理问题

近年来婚检或妇检过程中“检”破未婚女性处女膜的现象屡屡发生,给未婚女性的身心带来巨大伤害,既侵犯了未婚女性的合法权益,又严重地损害了医学伦理声誉。医师在检查未婚妇女的生殖器官时除了要遵循普通的疾病诊断特别是体格检查过程中的伦理要求和妇科检查道德规范外,在婚检过程中还应当特别强调遵循自愿检查(知情同意)原则、尊重原则、不伤害(安全性)原则,履行谨慎检查、保护隐私等医学伦理义务,切实遵守婚前体格检查的技术规范,确保被检妇女的权益不受侵害。