Self-Report Versus Performance-Based Activities of Daily Living Capacity Among Heart Transplant Candidates and Their Caregivers

Transplant candidates completed the Every Day Problems test (EPT), a performance-based measure of instrumental activities of daily living (IADL), and the Katz self-report scale of IADL functioning. Caregivers estimated the candidate's IADL capacity using the Katz scale. A healthy community group and patients with cardiac disease not undergoing transplant evaluation and their caregivers served as controls. Discrepancies between the EPT and Katz scales were generated. Results showed that the total number of discrepancies was significantly higher among the two patient groups as compared to controls. Three or more discrepancies (a total of 7 IADL domains were assessed) occurred in 40–52% of the participants and their caregivers in the two patient groups. Similarly, the total number of discrepancies between the Katz scale of the participant and their caregiver was significantly higher among the two patient groups as compared to controls, with only 33–44% showing perfect agreement in the patient groups as compared to 97% among controls. Despite a high prevalence of discrepancies in both patient groups, results did not support the hypothesis that transplant candidates tend systematically to overestimate their ability level on self-report IADL measures.     

The Cleveland Scale for Activities of Daily Living (CSADL): Its Reliability and Validity

This study evaluated the reliability and validity of the Cleveland Scale for Activities of Daily Living (CSADL), a scale designed to measure in detail specific activities of daily living in individuals with dementia. Administered to knowledgeable informants by trained examiners, the CSADL demonstrated good reliability in terms of interrater agreement and internal consistency. The validity of CSADL total scores was shown by its sensitivity to degree of cognitive impairment: All comparisons between means of the healthy elderly group and three groups of AD patients differing in severity were statistically significant. The CSADL was highly correlated with the Blessed–Roth Dementia Scale (DS-ADL) and more highly correlated with Mini-Mental State Exam scores than was the DS-ADL.     

Relationships Between Dysfunctional Beliefs and Positive and Negative Indices of Well-Being: A Critical Evaluation of the Common Beliefs Survey-III

The Common Beliefs Survey-III is a factored measure of dysfunctional beliefs and has generally shown satisfactory convergent validity and test–retest reliability [(2001) Journal of Rational-Emotive and Cognitive-Behavior Therapy, 19(2), 89–103). We sought to further establish the utility of the measure by examining the extent the dysfunctional belief subscales related to a wide variety of positive and negative indices of well-being, after controlling for a potential confound, namely, social desirability. Four hundred and fifty-seven university students completed questionnaires that assessed six dimensions of dysfunctional belief, seven negative indices of well-being (depression, anxiety, stress, guilt, hostility, hopelessness, suicidal thinking), three positive indices of well-being (life satisfaction, joviality, state self-assurance), and social desirability. Analyses revealed that lower well-being was associated with (1) beliefs that self-worth is dependent on success, (2) beliefs that self-worth is dependent on approval, (3) demanding beliefs that reflect unrealistically high expectations for events and individuals. Belief variables predicted 14% of the variance in the negative indices but only 7.3% in the positive indices. Stepwise regression revealed that the optimal set of belief predictors depended on the type of well-being predicted. These findings have implications for both theory and practice.     

"活得好"与"做得好":亚里士多德幸福概念的两重含义

在这篇文章中,我将证明,亚里士多德伦理学里的eudaimonia概念是"在两种意义上说的",而非只具有一种意思.它既是"活得好"也是"做得好".这一区分构成了亚氏伦理学主要论证的基础.它是一条贯穿许多主要论争的单一线索.对于这两种用法的区分将能够提供对这些争辩的一种统一性的解决.尤为重要的是,它将使我们得以用一种不十分费劲的方式去阅读那荆棘丛生的<尼各马可伦理学>第十卷的第六到第八章.幸福是"活得好"还是"做得好"这一问题是一个比涵盖论-理智论的论争更为基本的问题.在很大程度上,涵盖论-理智论的论争之所以会发生,正是由于争论双方都没能在作为"活得好"的幸福与作为"做得好"的幸福之间进行区分.他们共同地设定幸福的意思在于"活得好",然后开始争论它到底是各种善的复合、还是专注于思辨.本文将首先表明对于活动的讨论在亚里士多德幸福论之中有着何种位置;然后,我将论述"做得好"和"活得好",并将讨论下面一些争论主题:(a)幸福的两种标准;(b)思辨生活的非实用性;(c)首要幸福与第二等级幸福这一层级的性质,以及(d)道德与思辨的关系.     

LAW培养模式在医学教育中的建立

LAW模式的建立是要改变被动的、填鸭式学习方式为积极、主动及高效的学习,培养有能力、高素质、有知识的人才.LAW模式给出学习的目标、学习方式及自我检查的标准,基本特点:多层次、多角度学习潜力的调动;启发式、以问题为导向、以学生为中心的互动学习方法;逻辑性、批判性及创造性思维的培养与应用;重点与相关学科内容的整合方式;观察、思考、信息与实践的有机结合.     

Understanding the Lived Experience of Formerly Homeless Adults as They Transition to Supportive Housing

The researchers conducted in-depth interviews with formerly homeless adults who had moved to supportive housing to understand their perceived occupational needs and the factors that affected their transition. A qualitative research design with four participants who had a history of substance abuse and mental illness was used. Participant interviews that addressed categories of daily living and personal satisfaction produced data that were coded for analysis using conventional content analysis. Mega themes emerged that related to factors shaping the housing transition and maintenance experience. Occupational therapists can use these findings to create informed interventions to enhance this population's occupational performance.     

The Relationship Between Health and Human Services and the Personal Goal-Directed Activities of Persons Living with AIDS

This study evaluates the relationship between the social climate from different services and the personal goal-directed activities of 224 individuals with AIDS. The study's results supported the main hypothesis that recipient and participatory service involvement uniquely influence personal goal-directed activities, even after considering individuals with AIDS' physical symptoms, psychological distress, income, and recruitment site. Income and involvement with participatory services were both positively related to the amount of personal goal-directed activity. Longitudinal analyses suggest that personal initiative contributes to the subsequent amount of personal goal-directed activities a person pursues. These results suggest further examination of factors contributing to the selection of different service types and of the processes underlying the relationship between participatory services and positive outcomes for clients with AIDS.     

Sensitive performance-based assessment of everyday action in older and younger adults

Everyday function is compromised by mild cognitive changes in aging. These changes predict risk for future decline and dementia but remain poorly characterized, largely due to a scarcity of sensitive, objective measures.Twenty-seven younger adults and 25 non-demented older adults completed the Naturalistic Action Test (NAT), a performance-based measure of everyday action involving simple and complex tasks. Performance was coded for overt errors and subtle inefficiencies. Participants also completed self-report functional measures and cognitive tests. Mixed ANOVAs revealed that older adults made more subtle NAT errors with high task demands; groups did not differ in overt errors. Correlations did not reveal significant relations between self-report and NAT errors, but NAT performance was correlated with learning and recall.The NAT provides a promising tool for detecting subtle age-related changes and examining decline across levels of impairment. Self-report may lack sensitivity to subtle changes, and episodic memory changes underlie early functional disruption.     

情绪调节策略对日常生活事件与情绪体验关系影响的多层分析

运用经验抽样法对154名大学生的日常情绪体验、生活事件进行为期14天的追踪调查,通过多层线性模型（HLM）探讨日常生活事件与情绪体验的关系及情绪调节策略对二者关系的影响。结果表明：大学生积极情绪体验多于消极情绪体验。在个体内和个体间水平,消极事件都对积极情绪有显著的负向预测作用,对消极情绪有显著的正向预测作用;积极事件对积极情绪有显著的正向预测作用。积极事件对消极情绪的负向预测作用只在个体间水平显著。表达抑制这种情绪调节策略能够增强消极生活事件与消极情绪体验的关系。     

社区老年人的生活质量与心理健康:SEM研究

在Lawton理论框架以及先前研究基础上,进一步对上海社区老年人生活质量与心理健康进行研究。采用结构方程建模的方法对老年人健康生活质量(QHL)、客观生活环境质量(QOE)与心理健康(PWB)的理论构念及其相互关系的理论模型予以实证研究。结果表明,该模型与社区老人测评数据(N=262)的拟合度良好,证明QHL对PWB具有显著正面影响,QOE与QHL显著相关且直接或间接地正面影响PWB。研究表明良好身体健康状况、行为调适能力以及家庭一社区养老环境对促进老人心理健康具有重要意义。     

生前预嘱、预立医疗指示和预立医疗照护计划的概念关系辨析

通过回顾文献对生前预嘱、预立医疗指示、预立医疗照护计划三个概念产生的背景、定义、内容组成和法律实践等问题进行梳理与澄清,进一步指出概念之间的关系。生前预嘱与预立医疗指示属于归属关系。预立医疗照护计划是继预立医疗指示产生和应用后,为促进其签署而提出的概念,二者在内容、实施的侧重点及实施效果方面存在差异。通过概念辨析,旨在减少医务人员和公众对以上概念的混淆和误解,为后续研究和临床实践开展提供借鉴。     

农村留守儿童的抑郁和反社会行为:日常积极事件的保护作用

以来自河南省农村的410名农村留守儿童(双亲外出和单亲外出)和非留守儿童为被试,考察了日常烦恼这一危险因素与儿童抑郁、反社会行为的关系,并探讨了日常积极事件在其中的保护作用。结果表明,儿童经历的日常烦恼越多,其抑郁和反社会行为水平越高。日常积极事件表现出了对儿童抑郁和反社会行为的改善效应,但是因儿童留守类别的不同而不同:日常积极事件对单亲外出儿童和非留守儿童抑郁的改善效应较强,对双亲外出儿童反社会行为的改善效应较强。此外,日常积极事件还可以有效抵抗日常烦恼对儿童反社会行为的不利影响。     

The Affective Consequences of Minority Stress Among Bisexual,Pansexual, and Queer (Bi+) Adults: A Daily Diary Study

Bisexual, pansexual, and queer (bi+) individuals are at increased risk for depression and anxiety. These disparities are hypothesized to be due to the unique, minority-specific stressors that they experience. Prior research supports that bi+ stressors are associated with depression and anxiety, but nearly all studies have been cross-sectional, limiting our understanding of how experiencing bi+ stress influences individuals’ levels of depression and anxiety as they occur in their day-to-day lives. To address this gap, we examined the daily associations between bi+ stressors (discrimination, internalized stigma, rejection sensitivity, and identity concealment) and depressed/anxious mood in a 28-day diary study. Participants were 208 bi+ individuals who completed daily measures of bi+ stressors and depressed/anxious mood. We tested unlagged (same-day) and lagged (next-day) associations, and we also tested whether internalized stigma, rejection sensitivity, and identity concealment functioned as mechanisms underlying the daily associations between discrimination and depressed/anxious mood. Participants reported higher depressed/anxious mood on days when they reported higher discrimination, internalized stigma, rejection sensitivity, and identity concealment. There were significant unlagged indirect effects of discrimination on depressed and anxious mood via internalized stigma and rejection sensitivity, and there was also a significant unlagged indirect effect of discrimination on anxiety via identity concealment. However, none of the lagged associations were significant. Results suggest that bi+ stress is related to same-day, but not next-day, depressed/anxious mood. The nonsignificant lagged associations could reflect that bi+ individuals are using adaptive coping skills in response to bi+ stress, or that other experiences throughout the day have stronger influences on next-day mood.     

武汉市老年护理医院出院患者疾病构成帕累托图分析

为了解武汉市老年护理医院患者主要病种、多发病种构成情况,以武汉市5家老年护理医院的病案统计数据为资料,运用帕累托图分析法对1236例出院患者的情况进行分析。武汉市老年护理医院患者中病种以心血管病、脑血管病、脑卒中后遗症、慢性支气管炎、糖尿病、肺气肿、骨折等疾病为主,其构成占到老年护理医院出院病例疾病构成的90％以上。     

Relationships Between Locus of Control, Coping Strategies and Emotional Well-Being in Persons with Spinal Cord Lesion

Relations between locus of control, coping strategies and emotional well-being in persons with traumatically acquired spinal cord lesion (SCL) were examined. The sample included 132 community-residing adults. Structural equation modelling, including confirmatory factor analysis, was used. A model was hypothesized based on the transactional theory of stress and coping where coping strategies mediated the relation between locus of control and emotional well-being. The model showed acceptable fit to the data and was compared with five alternative models. The alternative models fitted the data less well or were difficult to interpret. In the preferred model, persons indicating internal control reported more coping strategies (Acceptance, Fighting spirit) related to increased well-being, whereas persons indicating external control reported a coping strategy (Social reliance) related to poorer well-being. The findings support the stress and coping framework in medical rehabilitation and illustrate why some persons need coping effectiveness training to enhance emotional adjustment.     

Functional Status, Receipt of Help, and Perceived Health

We model the effects of disability, functional limitation, and receipt of help on perceived health. This analysis specifies a model with two dimensions of disability and three dimensions of functional limitation, including upper body disability, lower body disability, basic activities of daily living (ADLs), household ADLs, and advanced ADLs. The latent variables of receiving help are modeled for each of the ADLs as intervening between limitations and perceived health. The results show that instrumental social support in the form of receiving help for ADLs has no substantive independent effect on perceived health. In addition, receiving instrumental social support shows a pattern of task-specific responses to individual measures of need. Implications for both caregiver and care recipient are discussed.     

Apathy and Depression as Predictors of Activities of Daily Living Following Stroke and Traumatic Brain Injuries in Adults: A Meta-Analysis

Neuropsychology Review - Apathy and depression are common sequelae of acquired brain injury (ABI). Apathy is a syndrome characterized by diminished motivation and purposeful behaviours. Depression...     

主观社会经济地位与心理幸福感的关系：创造力的中介和安全感的调节作用

为探讨主观社会经济地位对心理幸福感的影响,以及创造力的中介作用和安全感的调节作用,采用问卷法调查了556名18～60岁城市成年人的主观社会经济地位、安全感、创造力和心理幸福感。结果发现：(1)主观社会经济地位正向预测心理幸福感;(2)性格优势之创造力是主观社会经济地位与心理幸福感的中介变量;(3)安全感调节了中介过程的前半路径。只有当个体的安全感较高时,主观社会经济地位对创造力才存在显著的正向预测作用。结果表明,提升社会经济地位的同时,还需要提升个体的安全感,这样才能更好地促进创造力的发展,并进一步增加个体的心理幸福感。