临床护士伦理决策能力研究现状

符合伦理的护理决策能够让护理实践更加充满温度,护士在临床工作中具有做出良好决策的能力是提供高质量护理和确保护理活动合乎道德的关键。从临床伦理决策能力相关评估工具、伦理决策能力的国内外研究现状与影响因素以及有效干预策略三个方面进行综述,通过梳理测量伦理决策能力工具的发展、比较国内外最新的研究情况及其影响因素, 分析各项干预措施,以期让相关科研人员重视这一问题,为我国提升护理伦理决策能力提供更多新的研究思路。

     

中医事业发展路漫漫——纪念《山东省中医条例》颁布15周年

改革开放以来,中医药服务领域不断萎缩,中医药诊疗技术方法使用率低下,办医模式跟从西医院,备受质疑,这些问题的长期存在,表明中医事业发展之路依旧充满曲折,反思其中的原因,既有对《山东省中医条例》认识、落实不到位的问题,也有对中医药的作用、地位的认识脱离客观现实的问题,甚至错把规律当问题。保持中医教育、科研、临床各个环节的高度开放性对促进中医事业的健康发展十分重要。如不能在开放中将特色转化为现实优势,“特色”之路恐将越走越窄。     

On the myth and the reality of the temporal validity degradation of general mental ability test scores

Claims of changes in the validity coefficients associated with general mental ability (GMA) tests due to the passage of time (i.e., temporal validity degradation) have been the focus of an on-going debate in applied psychology. To evaluate whether and, if so, under what conditions this degradation may occur, we integrate evidence from multiple sub-disciplines of psychology. The temporal stability of construct validity is considered in light of the evidence regarding the differential stability of g and the invariance of measurement properties of GMA tests over the adult life-span. The temporal stability of criterion-related validity is considered in light of evidence from long-term predictive validity studies in educational and occupational realms. The evidence gained from this broad-ranging review suggests that temporal degradation of the construct- and criterion-related validity of ability test scores may not be as ubiquitous as some have previously concluded. Rather, it appears that both construct and criterion-related validity coefficients are reasonably robust over time and that any apparent degradation of criterion-related validity coefficients has more to do with changes in the determinants of task performance and changes in the nature of the criterion domain rather temporal degradation per se (i.e., the age of the test scores). A key exception to the conclusion that temporal validity degradation is more myth than reality concerns decision validity. Although the evidence is sparse, it is likely that the utility of a given GMA test score for making diagnostic decisions about an individual deteriorates over time. Importantly, we also note several areas in need of additional and more rigorous research before strong conclusions can be supported.     

Placing inspection time, reaction time, and perceptual speed in the broader context of cognitive ability: The VPR model in the Lothian Birth Cohort 1936

The idea that information processing speed is related to cognitive ability has a long history. Much evidence has been amassed in its support, with respect to both individual differences in general intelligence and developmental trajectories. Two so-called elementary cognitive tasks, reaction time and inspection time, have been used to compile this evidence, but most studies have used either one or the other. Relations between speed and fluid intelligence have tended to be stronger than those between speed and crystallized intelligence, but studies testing this have confounded verbal abilities with crystallized intelligence and spatial/perceptual abilities with fluid intelligence. Questions have also been raised regarding whether speed contributes directly to general intelligence or to more specific cognitive abilities to which general intelligence also contributes. We used 18 ability and speed measures in the Lothian Birth Cohort 1936, assessed at approximately age 70, to construct alternative versions of the Verbal-Perceptual-Image Rotation (Johnson & Bouchard, 2005a) model of cognitive ability to test different hypotheses regarding these issues. Though differences in the extents to which our models fit the data were relatively small, they suggested that reaction and inspection time tasks were comparable indicators of information processing speed with respect to general intelligence, that verbal and spatial abilities were similarly related to information processing speed, and that spatial, verbal, and perceptual speed abilities were more directly related to information processing speed than was general intelligence. We discuss the theoretical implications of these results.     

Cognitive ability, right-wing authoritarianism, and social dominance orientation: A five-year longitudinal study amongst adolescents

We report longitudinal data in which we assessed the relationships between intelligence and support for two constructs that shape ideological frameworks, namely, right-wing authoritarianism (RWA) and social dominance orientation (SDO). Participants (N = 375) were assessed in Grade 7 and again in Grade 12. Verbal and numerical ability were assessed when students entered high school in Grade 7. RWA and SDO were assessed before school graduation in Grade 12. After controlling for the possible confounding effects of personality and religious values in Grade 12, RWA was predicted by low g (β = − .16) and low verbal intelligence (β = − .18). SDO was predicted by low verbal intelligence only (β = − .13). These results are discussed with reference to the role of verbal intelligence in predicting support for such ideological frameworks and some comments are offered regarding the cognitive distinctions between RWA and SDO.     

Trait reappraisal is associated with resilience to acute psychological stress

Life is full of stressful events. However, while some individuals are negatively affected by stress, others are more resilient to its effects. The factors that contribute to variability in stress resilience are not fully understood. Here, we tested the hypothesis that trait reappraisal would be associated with greater stress resilience to a first-time tandem skydive. Specifically, we expected measures of “anxiety” to be lower and measures of “euphoria” to be higher in high trait reappraising individuals. Our findings that trait reappraisal is negatively correlated with stress reactivity as measured by cortisol, heart rate, and self-report state anxiety, but positively correlated with self-report state euphoria suggest that individuals high in trait reappraisal are more stress resilient.     

Modern Regression Methods that can Substantially Increase Power and Provide a more Accurate Understanding of Associations

During the last half century, hundreds of papers published in statistical journals have documented general conditions where reliance on least squares regression and Pearson's correlation can result in missing even strong associations between variables. Moreover, highly misleading conclusions can be made, even when the sample size is large. There are, in fact, several fundamental concerns related to non‐normality, outliers, heteroscedasticity, and curvature that can result in missing a strong association. Simultaneously, a vast array of new methods has been derived for effectively dealing with these concerns. The paper (i) reviews why least squares regression and classic inferential methods can fail, (ii) provides an overview of the many modern strategies for dealing with known problems, including some recent advances, and (iii) illustrates that modern robust methods can make a practical difference in our understanding of data. Included are some general recommendations regarding how modern methods might be used. Copyright © 2011 John Wiley & Sons, Ltd.     

Motivation as a Mediator of Social Disparities in Academic Achievement

The present study aimed at contributing to the understanding of social disparities in relation to students' academic achievement in the science, technology, engineering and mathematics domains. A sample of n = 321 German 11th graders completed measures of their family socio‐economic status (SES), general intelligence, domain‐specific ability self‐concepts and subjective scholastic values in math, physics and chemistry. Students' grades in these subjects received four months after testing served as criteria. Significant mediation effects were found for all motivational variables between fathers' SES and students' achievement, whereas for mothers' SES, only children's academic self‐concept in chemistry was a significant mediator. These results also held when students' general intelligence was controlled. Additionally, we controlled for students' grades before testing to investigate which variables mediated the influence of SES on change in school performance. Motivational variables significantly mediated the influence of fathers' SES on change in school performance in math but not in chemistry and physics. Intelligence significantly mediated the influence of fathers' SES on change in school performance in physics and chemistry but not in mathematics. The impact of mothers' SES on change in grades in chemistry was mediated by intelligence. Among others, the reasons potentially accounting for the differential influences of fathers' and mothers' SES are discussed. Copyright © 2011 John Wiley & Sons, Ltd.     

Investigating the Impact of Noneffortful Responses on Individual-Level Scores: Can the Effort-Moderated IRT Model Serve as a Solution?

Suboptimal effort is a major threat to valid score-based inferences. While the effects of such behavior have been frequently examined in the context of mean group comparisons, minimal research has considered its effects on individual score use (e.g., identifying students for remediation). Focusing on the latter context, this study addressed two related questions via simulation and applied analyses. First, we investigated how much including noneffortful responses in scoring using a three-parameter logistic (3PL) model affects person parameter recovery and classification accuracy for noneffortful responders. Second, we explored whether improvements in these individual-level inferences were observed when employing the Effort Moderated IRT (EM-IRT) model under conditions in which its assumptions were met and violated. Results demonstrated that including 10% noneffortful responses in scoring led to average bias in ability estimates and misclassification rates by as much as 0.15 SDs and 7%, respectively. These results were mitigated when employing the EM-IRT model, particularly when model assumptions were met. However, once model assumptions were violated, the EM-IRT model’s performance deteriorated, though still outperforming the 3PL model. Thus, findings from this study show that (a) including noneffortful responses when using individual scores can lead to potential unfounded inferences and potential score misuse, and (b) the negative impact that noneffortful responding has on person ability estimates and classification accuracy can be mitigated by employing the EM-IRT model, particularly when its assumptions are met.