临床医生对患者参与临床决策的可行性调查与分析

在临床决策中,决策者将面临包括生物、心理、社会方面的更多信息。同时随着医疗费用的增长、医学科学的不确定性、患者知识的提高、参与意识的增强、因特网的普及等促使临床决策更加困难。为了更好地促进患者参与临床决策,提高医疗服务质量,我们采用自拟问卷调查表随机对273名四川大学华西医院的临床医生进行调查。了解临床医生对患者参与治疗决策的困难与态度,分析影响患者参与临床决策的因素,为促进医患共享临床决策提供循证依据。     

Getting involved: Testing the effectiveness of a volunteering intervention on young adolescents' future intentions

Past research has identified a host of benefits associated with volunteering and community involvement, yet involvement appears to be on the decline in recent years. We tested the effectiveness of an intervention designed to encourage involvement. We provided young adolescents with information about volunteer opportunities, benefits and ways to overcome barriers to involvement. Adolescents who participated in the volunteering intervention reported greater involvement intentions than control participants. In addition, mediation analyses indicated that adolescents in the volunteering intervention based their self‐worth to a greater degree on virtuous behaviour, which in turn predicted their involvement intentions, especially in the helping domain. Copyright © 2008 John Wiley & Sons, Ltd.     

Madness strikes back

This commentary is concerned with the involvement of mental health service users in research. It will argue that research carried out by service users is one way of giving voice to a previously silenced group—the mad. It is one way in which ‘Madness Strikes Back’. The main theoretical model to be used is that of the early Foucault. I will not be concerned with what has become known as ‘Foucauldian discourse analysis’ since nowhere in Foucault's writing is there reference to conversation or talk. I will, however, be concerned with power as mental health service users are amongst the most disempowered of groups in all societies. I will also be concerned with Foucault's claim that, since the Enlightenment, madness has been positioned as the antithesis of reason, as ‘unreason’. This distinction can be argued to persist in the field of research. Copyright © 2008 John Wiley & Sons, Ltd.     

Impact of Tourette’s Disorder on Parent Reported Stress

We examined the relationship between Tourette’s Disorder (TD) and parent reported stress. About 84 parents of children with TD participated by completing questionnaires assessing parental stress, TD symptom severity, co-morbid disorders, services received by the child, and parents’ perception of their child’s academic ability. The results indicate that parent reported stress reached clinically significant levels when a co-morbid disorder was present, but not with a diagnosis of TD alone. Similarly, parents report higher levels of stress when they view their child as performing below other students academically. Finally, the types of services that the child receives were found to have little or no relationship to parent reported stress. Limitations of this study, directions for future research, and implications for intervention are discussed.     

Parental Social Cognitions: Considerations in the Acceptability of and Engagement in Behavioral Parent Training

Behavioral parent training (BPT) is a widely used, evidence-based treatment for externalizing child behaviors. However, the ability of BPT programs to be maximally effective remains limited by relatively low rates of acceptance, attendance, and adherence to treatment. Previous reviews have focused on a variety of demographic and mental health characteristics of parents and children that are predictive of poor outcomes in BPT. This paper focuses instead on consideration of parental social cognitions, and how incorporation of these cognitions may, or may not, be useful in advancing the effectiveness of BPT. We first review evidence suggesting limited incremental effects to incorporating parental cognitions within the context of BPT programs. Then, we examine the role of two particular types of parental social cognitions, attributions and parenting efficacy, in relation to the initial stages of accepting and engaging in BPT. We conclude by noting limitations in available research on the links between parental social cognitions and BPT, and we outline a number of potentially useful directions that may clarify whether or not parental social cognitions should be accorded greater attention either in the initial stages or throughout BPT programs.     

父亲关于自身教养价值的态度对其教养投入行为的影响:一个有中介的调节模型

在基于身份认同理论的母亲守门员效应的框架下,本研究探讨了父亲关于自身教养价值的态度对其教养投入行为的影响机制,通过方便取样的方式在全国27个省市共选取了364对3-7岁儿童的父母,采用父亲教养投入问卷、父亲教养价值态度问卷、协同教养问卷进行测查,结果发现,母亲关于父亲教养价值的态度是父亲教养投入的促进性因子,在父亲关于自身教养价值态度影响其教养投入的过程中具有调节效应;这种调节效应以父亲协同教养的一致性为中介变量。这一研究结果可增强人们对母亲守门员效应的理解,对亲职教育的干预实践也具有一定的启示。     

Personality, risky driving and accident involvement among Norwegian drivers

Despite the large body of studies, the role of personality in risk research still remains debatable and unclear. The objective of this study was to identify determinants of road user behaviour and accident involvement with the aim of developing effective accident countermeasures. Examining relationships between personality, risky driving and involvement in accidents can open up the possibility of early identification of those more likely to be involved in accidents. The aim is not to influence personality as such, but to develop measures constructed for specific groups. The results are based on a self-completion questionnaire survey carried out among a sample of Norwegian drivers in year 2000 and 2001 (n=2605). The Norwegian Directorate of Public Roads financed the study. The questionnaire included measures of risky driving, accident involvement, normlessness, sensation-seeking, locus of control and driver anger. Results showed that those who scored high on sensation seeking, normlessness and driver anger reported more frequent risky driving compared to those who scored low on these variables. They were more often involved in both speeding and ignorance of traffic rules. Respondents involved in risk taking-behaviour experienced near-accidents and crashes leading to both injuries and material damage more often than other drivers.     

Parent-Child Interaction Therapy for Puerto Rican Preschool Children with ADHD and Behavior Problems: A Pilot Efficacy Study

This study evaluates the initial efficacy of the Parent-Child Interaction Therapy (PCIT) for Puerto Rican preschool children aged 4–6 years with a diagnosis of attention-deficit/hyperactivity disorder (ADHD), combined or predominantly hyperactive type, and significant behavior problems. Thirty-two families were randomly assigned to PCIT ( n =20) or a 3.5-month waiting-list condition (WL; n =12). Participants from both groups completed pretreatment and posttreatment assessments. Outcome measures included child's ADHD symptoms and behavior problems, parent or family functioning, and parents' satisfaction with treatment. ANCOVAs with pretreatment measures entered as covariates were significant for all posttreatment outcomes, except mother's depression, and in the expected direction ( p <.01). Mothers reported a highly significant reduction in pretreatment hyperactivity and inattention and less aggressive and oppositional-defiant behaviors, conduct problems assessed as problematic, parenting stress associated with their child's behavior, and an increase in the use of adequate parenting practices. For the WL group, there were no clinically significant changes in any measure. Treatment gains obtained after treatment were maintained at a 3.5-month follow-up assessment. PCIT seems to be an efficacious intervention for Puerto Rican families who have young children with significant behavior problems.     

Parental involvement in children's learning: Comparing parents of children with and without Attention-Deficit/Hyperactivity Disorder (ADHD)

The present study examined involvement in children's learning among parents of 101 children between 8 and 12 years of age (53 parents of children with ADHD, 48 parents of children without ADHD). Compared to parents of children without ADHD, parents of children with ADHD reported lower self-efficacy in their ability to help their children, felt less welcome and supported by their children's schools and teachers, and perceived less time and energy for involvement in their children's academic lives. Mothers of children with and without ADHD reported similar types and levels of involvement behaviors in the home. Fathers of children with ADHD reported being more disengaged from their children's learning and using more coercive and punitive interactions regarding their children's achievement compared to fathers of children without ADHD. These findings underscore the difficulties in parent-supported learning practices and home-school collaboration initiatives faced by parents of children with ADHD and educators alike. Implications for school psychology practice are discussed.