临床共情与护理技术结合：人性化的护理

临床共情是一种能体验患者内心世界的能力,通过患者的言语和非言语表达,觉察和认识患者情感和情绪需求,并对其做出恰当的回应.临床共情具有科学的理论和实践基础,具有缓解患者心理上的痛苦,改善护患关系,促进患者康复等作用.在当今复杂的医疗环境下,务必要重视共情培养,适时运用临床共情.然而,我们强调临床共情的重要作用,并不能忽视护理技术的根本作用,根除躯体上的病变仍有赖于护理技术的有效性.在临床护理实践中,坚持共情与护理技术的有机结合,推进人性化的护理构建.     

Experiences of Adults Who Identify as Primary Caregivers

The role of primary caregiver is unique. Understanding the role of the primary caregiver will better inform those in the counseling profession. The purpose of this qualitative research study was to gain a clearer perspective of the lived experiences of adults who identify as primary caregivers. The authors conducted semistructured interviews with 6 Caucasian female participants and analyzed the data using interpretative phenomenological analysis. The findings include personal perceptions and caregiver experiences pertaining to the caregiver role, caregiver mentality, professional identity, social and emotional responses, and self‐care among caregivers throughout the caregiving process. Implications for counselors and future research are presented.     

Action‐semantic and syntactic deficits in subjects at risk for Huntington's disease

Frontostriatal networks play critical roles in grounding action semantics and syntactic skills. Indeed, their atrophy distinctively disrupts both domains, as observed in patients with Huntington's disease (HD) and Parkinson's disease, even during early disease stages. However, frontostriatal degeneration in these conditions may begin up to 15 years before the onset of clinical symptoms, opening avenues for pre‐clinical detection via sensitive tasks. Such a mission is particularly critical in HD, given that patients’ children have 50% chances of inheriting the disease. Against this background, we assessed whether deficits in the above‐mentioned domains emerge in subjects at risk to develop HD. We administered tasks tapping action semantics, object semantics, and two forms of syntactic processing to 18 patients with HD, 19 asymptomatic first‐degree relatives, and sociodemographically matched controls for each group. The patients evinced significant deficits in all tasks, but only those in the two target domains were independent of overall cognitive state. More crucially, relative to controls, the asymptomatic relatives were selectively impaired in action semantics and in the more complex syntactic task, with both patterns emerging irrespective of the subjects’ overall cognitive state. Our findings highlight the relevance of these dysfunctions as potential prodromal biomarkers of HD. Moreover, they offer theoretical insights into the differential contributions of frontostriatal hubs to both domains while paving the way for innovations in diagnostic procedures.     

Childhood memories of threatening experiences and submissiveness and its relationship to hallucination proneness and ideas of reference: The mediating role of dissociation

Recent studies have emphasized the importance of childhood memories of threatening experiences and submissiveness in a diversity of psychological disorders. The purpose of this work was to study their specific relationship with hallucination proneness and ideas of reference in healthy subjects. The ELES scale for measuring memory of adverse childhood experiences, the DES ‐II scale for measuring dissociation, the LSHS ‐R scale for measuring hallucination proneness, and the REF for ideas of reference were applied to a sample of 472 subjects. A positive association was found between childhood memories of adverse experiences and hallucination proneness and ideas of reference, on one hand, and dissociation on the other. A mediation analysis showed that dissociation was a mediator between the memory of adverse childhood experiences and hallucination proneness on one hand, and ideas of reference on the other. When the role of mediator of the types of dissociative experiences was studied, it was found that absorption and depersonalization mediated between adverse experiences and hallucination proneness. However, this mediating effect was not found between adverse experiences and ideas of reference. The relationship between these last two variables was direct. The results suggest that childhood memories of adverse experiences are a relevant factor in understanding hallucination proneness and ideas of reference. Similarly, dissociation is a specific mediator between adverse childhood experiences and hallucination proneness.     

Positive psychotherapy: A strength-based approach

Positive psychotherapy (PPT) is a therapeutic approach broadly based on the principles of positive psychology. Rooted in Chris Peterson’s groundbreaking work on character strengths, PPT integrates symptoms with strengths, resources with risks, weaknesses with values, and hopes with regrets in order to understand the inherent complexities of human experiences in a way that is more balanced than the traditional deficit-oriented approach to psychotherapy. This paper makes the case of an alternative approach to psychotherapy that pays equal attention and effort to negatives and positives. It discusses PPT’s assumptions and describes in detail how PPT exercises work in clinical settings. The paper summarizes results of pilot studies using this approach, discusses caveats in conducting PPT, and suggests potential directions.     

Experience of Parental Marital Dissolution Earlier in Life and the Disposition to Forgive Among Older Violent and Non-Violent Prisoners

The purpose of this study was to examine differences in self-reported dispositional forgiveness types among older male prison inmates who experienced parental separation/divorce earlier in life. Participants included a sample of N = 261 incarcerated men, aged 45 and older, residing in state-managed prisons in Oklahoma. IBM/SPSS 22.0 was used to examine mean differences across forgiveness of self, situation, and others. Significant mean differences were evident only for forgiveness of situation. In particular, significant differences emerged relative to depressive affect F (1, 192) = 19.90, p < .001, and social support F (1, 192) = 18.64, p < .001. After controlling for age, race, religiosity, depression, social support, perceived health, crime type, and parental separation/divorce, one significant interaction (crime type X parental separation/divorce) emerged, F (1, 192) = 4.42, p < .05. It appears that the disposition to forgive the situation among older prison inmates depends on criminal offender type as well as whether the older inmate experienced parental dissolution earlier in life. Implications for pastoral counseling programing and forgiveness therapy treatment for older male prison inmates who experienced parental separation/divorce earlier in life are discussed.     

Expressions of vernacular psychoanalysis

The present paper examines the clinical integration of theory and experience from the perspective of clinicians’ subjective shaping of inquiry. The author suggests that the historical, conceptual development of clinical psychoanalysis parallels the progressive articulations of consensual understanding within the clinical hour. He suggests that the clinician's utilization of vernacular elements, derivative of direct experience as well as of reference to the wider range of psychoanalytic thinking, addresses gaps and disconnections within the abstract understanding of the clinical psychoanalytic process. Providing examples from psychoanalytic history, he concludes with a contemporary example of psychoanalytic papers, reflecting vernacular elements that are of use to practicing clinicians.     

Ethics in Supervision: Consideration of the Supervisory Alliance and Countertransference Management of Psychology Doctoral Students

Clinical supervision provides the foundation for cultivating ethical practice and professionalism for mental health trainees. Exploration and management of a supervisee’s personal reactivity or countertransference (CT) is a critical component of supervision and has clear ethical implications for clinical management and the development of clinical competence. This article discusses supervision practice and presents the results of a study that investigated the influence of supervisor–supervisee relationship on clinical and counseling doctoral students’ CT disclosures. Respondents completed the Working Alliance Inventory–Supervisee form and the Personal Reaction Disclosure Questionnaire, which assessed respondents’ comfort and likelihood of reporting CT reactions to hypothetical clinical interactions. Results of this analogue study demonstrated positive associations between supervisory alliance and reported comfort and likelihood of CT disclosures, highlighting the importance of the alliance and drawing attention to supervisors their responsibility to particularly attend to the bond dimension of the relationship.     

Paranoia predicts out-group prejudice: preliminary experimental data

This article examines the relationships between exposure to terrorism news and state social paranoia, death anxiety and Islamophobia. In two experiments we show that, contrary to previous research in this area, the terrorism news condition did not significantly increase state social paranoia, death anxiety and prejudice towards Muslims, but that paranoid thinking was the sole predictor of Islamophobia. Trait paranoia is associated with both poor well-being and with negative perceptions of Muslim competitive players – a form of inter-relational prejudice. Results indicated that the frequency of paranoid thoughts mediates the relationship between death anxiety and anti-Muslim prejudice and trait paranoia is the main predictor of the negative perceptions of a Muslim competing player. This study elucidates new pathways to understanding terror management theory, by including paranoia as a type of thinking that predisposes individuals to be suspicious of salient out-groups.