A Video Life-world Approach to Consultation Practice: The Relevance of a Socio-Phenomenological Approach

This article discusses the [development and] use of a video life-world schema to explore alternative orientations to the shared health consultation. It is anticipated that this schema can be used by practitioners and consumers alike to understand the dynamics of videoed health consultations, the role of the participants within it and the potential to consciously alter the outcome by altering behaviour during the process of interaction. The study examines health consultation participation and develops an interpretative method of analysis that includes image elicitation (via videos), phenomenology (to identify the components of the analytic framework), narrative (to depict the stories of interactions) and a reflexive mode (to develop shared meaning through a conceptual framework for analysis). The analytic framework is derived from a life-world conception of human mutual shared interaction which is presented here as a novel approach to understanding patient-centred care. The video materials used in this study were derived from consultations in a Walk-in Centre (WiC) in East London. The conceptual framework produced through the process of video analysis is comprised of different combinations of movement, knowledge and emotional conversations that are used to classify objective or engaged WiC health care interactions. The videoed interactions organise along an active or passive, facilitative or directive typical situation continuum illustrating different kinds of textual approaches to practice that are in tension or harmony. The schema demonstrates how practitioners and consumers interact to produce these outcomes and indicates the potential for both consumers and practitioners to be educated to develop practice dynamics that support patient-centred care and impact on health outcomes.     

‘A baptism of fire’: A qualitative investigation of a trainee counsellor's experience at the start of training

Background: Belief in the effectiveness of professional counselling and psychotherapy training is widespread and generally unquestioned. Few studies have attempted to understand the changes experienced by trainees, or identified which aspects of professional training programmes assist them in the process of becoming therapists. Aims: to investigate how a trainee counsellor changes at the start of training, and to identify which aspects of a professional counsellor training programme were helpful in instigating and supporting change. Method: the experience of one trainee counsellor, Margaret, was captured through three semi-structured interviews conducted at the beginning, middle and end of her first term. The data were subjected to systematic qualitative analysis. Findings: Margaret experienced significant change during her first term. Each interview revealed a different phase of her development. The core categories were: becoming something new (week 3); growth in therapeutic confidence (week 6); surviving ‘stressful involvement’ through supervision (week 11). Experiential learning, in particular group supervision, was helpful throughout. The presence of real clients was identified as the main driver for change. Conclusion: The findings were found to be consistent with a number of other studies, which suggest that training is potentially painful because of the emotional demands it places on trainees, particularly at the start of practice. Consequently trainees require opportunities for experiential learning, peer support and supportive supervision to assist them in their development, but most importantly, given that supportive supervision can only minimise the harm of stressful involvement (Orlinsky & Ronnestad, 2005), they need early positive experiences with clients.     

State of Multicultural Neuropsychological Assessment in Children: Current Research Issues

Scientific attention to cultural considerations in child neuropsychological assessment has not developed parallel to the focus these issues have received in adult and elderly neuropsychological assessment. There are limited data on the presence, magnitude, etiology, and implications of culture-related differences in cognitive test performance among children. This preliminary report reviews the available empirical literature on the current state of multicultural neuropsychological assessment in children. The review identified articles by searching PubMed and PsycINFO databases, and the tables of contents of Developmental Neuropsychology and Child Neuropsychology from 2003-2008. Of the 1,834 abstracts reviewed, ten papers met inclusion criteria for the review. Five studies were completed in America; four of these compared performance between ethnic groups while the fifth examined neighborhood level poverty indicators exclusively within African-American children. Of the five international studies, all established local normative data and/or were exploratory investigations of neuropsychological functions in specific cultural groups, including Taiwanese infants, South African youth, and bilingual British children. Taken together, the results yield important clinical and research data that begin to inform many of the complex and fascinating mechanisms by which ethnic identity and culture impact cognitive development and the neuropsychological assessment of children. A critique of the existing literature and directions for future research are provided.     

"If You're Frail You've Had It": A Theory of Planned Behavior Study of Student Nurses' Attitudes Towards Working with Older Patients

Background: The developed world's population is aging but care of older patients is unpopular in nursing.
Objectives: To determine student nurses' attitudes towards working with older patients and analyze underlying factors.
Method: 172 UK student nurses were surveyed using the theory of planned behavior.
Results: Positive intentions were related to attitudes ( p <0.01) and subjective norms ( p <0.05). Three underlying factors, intolerance ( p <0.01), humanism ( p <0.05), and concern about aging ( p <0.01) differentiated more and less positive participants.
Discussion: Results are only partly consistent with previous findings. Future attitudinal research in this area must be more tightly specified to be relevant to health care and should measure actual behavior and employed nurses' views. Nursing curricula should refer to the three relevant factors.     

Locus of control, self-control, and family income as predictors of young children's mathematics and science scores

Locus of control, self-control, and family income were investigated as possible predictors of 138 young children's mathematics and science scores. The children, 60 boys and 78 girls, ranging from 4 to 8 years of age (M = 5.4, SD = 1.3) were administered the Stephens-Delys Reinforcement Contingency Interview Scale, the Self-control Rating Scale, the Comprehensive Mathematics Inventory, and a science test based on the work of D. K. Dickinson. Analysis showed mathematics scores were positively related to income, locus of control, and science scores. Mathematics and science scores were negatively related to lack of self-control. Also, science scores were positively related to locus of control. Multiple regression analysis with mathematics as the dependent variable indicated income had the greatest predictive value followed by self-control and locus of control. The multiple regression model of science was also significant, with locus of control having the greatest influence followed by self-control.     

Feminist Challenges to Conceptions of God: Exploring Divine Ideals

This paper presents a feminist intervention into debates concerning the relation between human subjects and a divine ideal. I turn to what Irigarayan feminists challenge as a masculine conception of ‘the God’s eye view’ of reality. This ideal functions not only in philosophy of religion, but in ethics, politics, epistemology and philosophy of science: it is given various names from ‘the competent judge’ to the ‘the ideal observer’ (IO) whose view is either from nowhere or everywhere. The question is whether, as Taliaferro contends, my own philosophical argument inevitably appeals to the impartiality and omni-attributes of the IO. This paper was delivered during the APA Pacific 2007 Mini-Conference on Models of God.     

Re-visioning clinical research: gender and the ethics of experimental design

Since modern medicine is based substantially in clinical medical research, the flaws and ethical problems that arise in this research as it is conceived and practiced in the United States are likely to be reflected to some extent in current medicine and its practice. This paper explores some of the ways in which clinical research has suffered from an androcentric focus in its choice and definition of problems studied, approaches and methods used in design and interpretation of experiments, and theories and conclusions drawn from the research. Some examples of re-visioned research hint at solutions to the ethical dilemmas created by this biased focus; an increased number of feminists involved in clinical research may provide avenues for additional changes that would lead to improved health care for all.