Spirituality and spiritual care – missing concepts from core undergraduate children’s nursing textbooks

Background: Spiritual care is espoused to be fundamental in children’s nursing; however, the extent to which current fundamental children’s nursing textbooks support and advocate spiritual care delivery by children’s nurses and nursing students is unknown. Aim and objectives: To examine whether or not fundamental undergraduate children’s nursing textbooks include spiritual care content. Methods: Five hundred and nineteen books were sampled from the Nursing and Midwifery Core Collection list (UK) using a survey, the Spirituality Textbook Analysis Tool (STAT) to collect data. Analysis and Results: 519 books were included in the study using the STAT and 13 books included content on children’s spirituality. There were a variety of textbooks in the audit of those that made reference to the search terms in the STAT, it was found that content mainly addressed only two areas; religious faiths and the dying child. Recommendations: Children’s nurses require education about children’s spiritual developmental stage and age appropriate spiritual assessment. A lack of detailed information in core children’s nursing textbooks means that this area of nursing practice may be taught as an adjunct to care and not as an element of holistic care which is the gold standard that children’s nurses should strive for.     

Implementation of Cognitive Therapy for PTSD in routine clinical care: Effectiveness and moderators of outcome in a consecutive sample

ObjectiveTrauma-focused psychological treatments are recommended as first-line treatments for Posttraumatic Stress Disorder (PTSD), but clinicians may be concerned that the good outcomes observed in randomized controlled trials (RCTs) may not generalize to the wide range of traumas and presentations seen in clinical practice. This study investigated whether Cognitive Therapy for PTSD (CT-PTSD) can be effectively implemented into a UK National Health Service Outpatient Clinic serving a defined ethnically mixed urban catchment area.MethodA consecutive sample of 330 patients with PTSD (age 17–83) following a wide range of traumas were treated by 34 therapists, who received training and supervision in CT-PTSD. Pre and post treatment data (PTSD symptoms, anxiety, depression) were collected for all patients, including dropouts. Hierarchical linear modeling investigated candidate moderators of outcome and therapist effects.ResultsCT-PTSD was well tolerated and led to very large improvement in PTSD symptoms, depression and anxiety. The majority of patients showed reliable improvement/clinically significant change: intent-to-treat: 78.8%/57.3%; completer: 84.5%/65.1%. Dropouts and unreliable attenders had worse outcome. Statistically reliable symptom exacerbation with treatment was observed in only 1.2% of patients. Treatment gains were maintained during follow-up (M = 280 days, n = 220). Few of the selection criteria used in some RCTs, demographic, diagnostic and trauma characteristics moderated treatment outcome, and only social problems and needing treatment for multiple traumas showed unique moderation effects. There were no random effects of therapist on symptom improvement, but therapists who were inexperienced in CT-PTSD had more dropouts than those with greater experience.ConclusionsThe results support the effectiveness of CT-PTSD and suggest that trauma-focused cognitive behavior therapy can be successfully implemented in routine clinical services treating patients with a wide range of traumas.     

Patterns of paralexia: A psycholinguistic approach

A sample of the literature on acquired dyslexia is reviewed with special reference to the nature of paralexic errors. Linguistic studies of six cases of dyslexia are presented, with appropriate neurological and psychological details; there are two cases of each of three hypothesized types of impairment, visual dyslyxia, surface (grapheme-phoneme) dyslexia, and deep (syntactico-semantic) dyslexia. Finally, a scheme for acquired dyslexia is proposed and related to the error patterns observed in normal adult readers and in children learning to read; our approach to lexical look-up is one that the diagram makers may have found sympathique.This is a revised version of paper presented at the International Neuropsychology Symposium, Engelberg, Switzerland, June 1971.     

Book reviews

Ellis, A. W. (Ed.). Progress in the psychology of language, Vols 1 and 2. London: Erlbaum Associates. 1985. Pp. vii+247 (Vol.1), v+274 (Vol.2). ISBN 0-86377-027-4 (Vol.1), 0-86377-028-2(Vol.2). £19.65. each.

Eysenck, M.W. A hondbook of cognitive psychology. London: Lawrence Erlbaum Associates. 1984. Pp. 417. ISBN 0-86377-016-9. Hardback £26.95; paperback £8.95.

Roy, E. A. (Ed.). Neuropsychological studies of apraxia and related disorders. Amstrdam: North olland. 185 Pp. 414. ISN 0-444-87669-3. $60.00.

Fischer, K. W. and Lazerson, A. Human development frm conception through adolescence. New York: W. H. Freman. 1984. Pp. 747. ISBN 9-7167-1575-9. £24.95.

Sloboda, J. A. The musical mind. Oxford: Clarendon Press, 1985. Pp. vii+291. ISBN 0-19-852114-6 (hardback) £20; ISBN 0-19-852128-6 (paperback) £9.65.

Howell, P., Cross, I. and West, R. Musical structure and cognition. London: Academic Press. Pp. xiv+ 338. ISBN 0-12-357170-7. £44.     

The role of experience in spatial test performance: A meta-analysis

The hypothesis that spatial ability is, in part, experientially determined, and that sex differences in spatial ability can be explained by sex differences in spatial experience, can be studied in a correlational manner by examining the relationship between spatial activity participation and spatial ability test performance for males and females. Alternatively, an experimental training situation, comparing male and female susceptibility to training, has been proposed to test the hypothesis that environment has an impact on spatial skills and sex differences in ability. Both lines of research are reviewed here, through the use of meta-analytic techniques. The first meta-analysis reveals a weak but reliable relationship between spatial activity participation and spatial ability. This relationship appears similar for males and females. The second meta-analysis reveals that spatial ability test performance can be improved by training for both sexes. This improvement does not appear different for males and females, however, contrary to a predominant hypothesis in the literature. Training to asymptote may be a better test of the relevance of differential experience to sex differences. Content and duration of training are also discussed as important factors in the effectiveness of training.This research was supported by Grant No. MH39671 from the National Institute of Mental Health. A version of this paper was presented at the biennial meetings of the Society for Research in Child Development, Baltimore, Maryland, April 1987. We are grateful to Margaret Signorella and Susan Resnick for providing data. We would also like to thank Judith Dubas, Susan Resnick, Ralph Rosnow, Carolyn Spies, Lance Weinmann, and Marsha Weinraub for helpful comments on earlier drafts of this article.     

Neuropsychological Impairment of Face Recognition Units

Despite the absence of “conscious”, overt identification, some patients with face recognition impairments continue covertly to process information regarding face familiarity. The fact that by no means all patients show these covert effects has led to the suggestion that indirect recogntion tasks may help in identifying different types of face recognition impairment. The present report describes a number of experiments with the patient NR, who, after a closed head injury, has been severely impaired at recognizing familiar faces. Investigations mostly failed to show overt or covert face recognition, but NR performed at an above-chance level in selecting the familiar face on a task requiring a forced-choice between a familiar and an unfamiliar face. This discrepancy between a degree of rudimentary overt recognition and absence of covert effects on most indirect tests was addressed using a cross-domaim identity priming paradigm. This examined separately the possibility of preserved recognition for faces that NR consistently chose correctly in a forced-choice familiarity decision and those on which he performed at chance level. Priming effects were apparent only for the faces that were consistently chosen as “familiar” in forced-choice. We suggest that NR's stored representations of familiar faces are degraded, so that face recognition is possible only via a limited set of relatively preserved representations able to support a rudimentary form of overt recognition and to facilitate performance in matching and priming tasks.