A self-efficacy enhancing intervention for pulmonary rehabilitation based on motivational interviewing for postoperative lung cancers patients: modeling and randomized exploratory trial

The objective of this study was to evaluate the feasibility and preliminary efficacy of a self-efficacy enhancing intervention designed for pulmonary rehabilitation based on motivational interviewing (MI) for postsurgical non-small cell lung cancer (NSCLC) patients. This study was a 2-arm pilot randomized controlled trial and was conducted in two cardiothoracic surgery departments, a tertiary hospital in Fuzhou, China. 28 postsurgical NSCLC patients were randomized to a 3 month (6 session) self-efficacy enhancing intervention based on MI or usual care (UC). Data were measured at baseline and after intervention. The MI based self-efficacy enhancing intervention group was superior to the UC group for reducing anxiety and depression, improving self-efficacy, quality of life, confrontational coping, social support and functional capacity. However, no statistically significant difference was observed in subjective well-being, posttraumatic growth, body mass index and pulmonary function between the two groups. This pilot study demonstrated the feasibility of MI based self-efficacy enhancing intervention for postsurgical NSCLC patients. A larger randomized trial would demonstrate a more rigorous test of efficacy.     

Is a bad will a weak will? Cognitive dispositions modulate folk attributions of weakness of will

In line with recent efforts to empirically study the folk concept of weakness of will, we examine two issues in this paper: (1) How is weakness of will attribution (WWA) influenced by an agent’s violations of best judgment and/or resolution, and by the moral valence of the agent’s action? (2) Do any of these influences depend on the cognitive dispositions of the judging individual? We implemented a factorial 2?×?2?×?2 between-subjects design with judgment violation, resolution violation, and action valence as independent variables, and measured participants’ cognitive dispositions using Frederick’s Cognitive Reflection Test (CRT). We conclude that intuitive and reflective individuals have two different concepts of weakness of will. The study supports this claim by showing that: (1) the WWA of intuitive subjects is influenced by the action’s (and probably also the commitment’s) moral valence, while the WWA of reflective subjects is not; (2) judgment violation plays a small role in the WWA of intuitive subjects, while reflective subjects treat resolution violation as the only relevant trait. Data were collected among students at two different universities. All subjects (N?=?710) answered the CRT. A three-way ANOVA was first conducted on the whole sample and then on the intuitive and reflective groups separately. This study suggests that differences in cognitive dispositions can significantly impact the folk understanding of philosophical concepts and thus suggests that analysis of folk concepts should take cognitive dispositions into account.     

Effects of belief in luck on the attractiveness of loyalty programmes

The aim of this article is to demonstrate that the perception of belief in luck affects loyalty programmes, causing people making cognitive (affective) choices to feel more (less) attracted. To validate our hypotheses, we conducted 3 related experiments (2 laboratory tests and 1 in the field). We found that the perception of belief in luck (bad or good) affects the relationship between loyalty programmes and attractiveness (Study 1). We study this effect considering the mechanisms of points‐pressure and rewarded behaviour. Thereafter, we established that cognitive (affective) decisions promoted an increase (decrease) in attractiveness when consumers were exposed to continuous loyalty programmes because their belief in luck was lower (Studies 2 and 3). We believe that these changes occur because the consumer's belief in luck masks the uncertainty in the decision‐making process.     

Is regulatory focus related to minimal and maximal standards? Depends on how you ask!

Regulatory focus theory suggests that hopes and aspirations (promotion focus) function like maximal goals, whereas duties and responsibilities (prevention focus) function like minimal goals. However, past research has not always reliably found such a link between regulatory focus and maximal–minimal goals or standards. In the present research, we hypothesised that this inconsistency can be explained, at least in part, by conceptual differences resulting in the use of different, specific wording. In four studies, we compared wording in terms of the relative magnitude of the goals to wording in terms of their absolute versus gradual perception. Results showed that regulatory focus (manipulated or measured) consistently relates to maximal versus minimal standards framed as goals of different magnitudes, but not to the goals framed according to an absolute–gradual perception. Implication of the results for regulatory focus research is discussed.     

Economic Impact of Third-Wave Cognitive Behavioral Therapies: A Systematic Review and Quality Assessment of Economic Evaluations in Randomized Controlled Trials

The term third-wave cognitive behavioral therapy (CBT) encompasses new forms of CBT that both extend and innovate within CBT. Most third-wave therapies have been subject to randomized controlled trials (RCTs) focused on clinical effectiveness; however, the number and quality of economic evaluations in these RCTs has been unknown and may be few. Evidence about efficiency of these therapies may help support decisions on efficient allocation of resources in health policies. The main aim of this study was to systematically review the economic impact of third-wave therapies in the treatment of patients with physical or mental conditions. We conducted a systematic literature search in PubMed, PsycINFO, EMBASE, and CINALH to identify economic evaluations of third-wave therapies. Quality and Risk of Bias (RoB) assessment of economic evaluations was also made using the Drummond 35-item checklist and the Cochrane Collaboration’s tool for assessing risk of bias, respectively. Eleven RCTs were included in this systematic review. Mindfulness-Based Cognitive Therapy (MBCT), Mindfulness-Based Stress Reduction (MBSR), Acceptance and Commitment Therapy (ACT), Dialectical Behavior Therapy (DBT), and extended Behaviour Activation (eBA) showed acceptable cost-effectiveness and cost-utility ratios. No study employed a time horizon of more than 3 years. Quality and RoB assessments highlight some limitations that temper the findings. There is some evidence that MBCT, MBSR, ACT, DBT, and eBA are efficient from a societal or a third-party payer perspective. No economic analysis was found for many third-wave therapies. Therefore, more economic evaluations with high methodological quality are needed.     

家庭功能对青少年疏离感的影响: 有调节的中介效应

采用问卷法调查了608名初一至高二城市青少年, 通过结构方程模型探讨了青少年疏离感与家庭社会经济地位、家庭功能和同伴接纳的关系。结果发现: (1) 青少年疏离感年龄段差异显著, 高中生的疏离感显著高于初中生; (2) 青少年疏离感的三个维度之间存在显著差异。其中环境疏离感最高, 其次是社会疏离感, 人际疏离感最低; (3) 家庭功能在家庭社会经济地位与青少年疏离感之间起完全中介作用, 这一中介作用的实现受到同伴接纳的调节, 即家庭功能对青少年疏离感的影响是有调节的中介效应。     

循证医学指导医疗实践

循证医学的发展强调医疗决策物制定应将个人的临床经验与现有的最可信的临床研究证据进行完善结合。促进了医学模式的转化,对医疗实践起指导作用。现就循证医学对心血管病临床实践的指导作用的必要性和可能性及其内容作一简述。     

A study of minorities as victims

This article presents the idea that during the 1990s an important change took place in relation between minorities and majorities: the emergence of minorities as victims alongside the formerly predominant active, militant minorities. A hypothesis is raised that these two types of minorities differ in their agenda as well as in the nature of the influence they exert. Active minorities trigger an external conflict with majority and induce conversion (latent rather than overt influence); minorities as victims create an internal conflict, a sense of guilt, within the majority, while they exert an exclusively overt influence. We report two experiments confirming our hypothesis. We discuss the novelty of this phenomenon and its relevance. Copyright © 2006 John Wiley & Sons, Ltd.     

不同情景下小学儿童对说谎与说真话的道德评价

研究探讨了小学7、9、11岁儿童在对说谎与说真话进行道德评价时不同情景间的差异.研究结果发现,小学儿童对于具有积极意义的说谎/真话的评价显著地好于消极性的说谎/真话.但在对具有积极意义的说谎以及具有消极意义的真话进行评价时,具有显著的情景间差异.总的来说,在个体情景下,对谦虚谎及做好事说真话的评价具有年龄的效应,且谦虚谎的评价比白谎更为积极,而白谎的评价比集体情景下的说谎与伤害性说谎更为积极;而儿童对于交往情景下直率真话的评价在所有的年龄都趋于中性,有别于其他情景.     

患者亲属——医疗决策的重要主体

在医患关系中,患者亲属起着重要作用,是医疗行为及后果生理和心理的承担者,患者的疾病本身和康复情况会直接对家庭生活产生影响。患者亲属也是患者医疗费用的主要承担者。由于医疗决策会涉及到患者的家庭利益,患者患病会对其决定能力产生不利的影响,在法律上确立患者亲属在医患关系中的主体地位,甚至在必要时赋予亲属医疗决定权是必要的和现实的。