患者报告结局（PRO）在临床疗效评价体系中的应用与思考

现代医疗模式的转变,使得患者对疾病的直接感受,对疗效的评价,成为临床决策和药物安全性评价的重要指标。而PRO量表的问世,使患者有机会真正参与到医疗过程中来,也为临床疗效评价及药物管理提供了珍贵资料。本文将通过什么是PRO、PRO的价值以及PRO的发展近况来对PRO做一个初步的介绍,以便为后来的研究者提供可能的帮助。     

Factors associated with self-efficacy in persons with chronic illness

Change of lifestyle may be necessary for persons with chronic illnesses in order to manage their health situation and reduce symptom distress. Success in changing lifestyle partly depends on a person's self-efficacy beliefs. This cross-sectional study explores social support, physical activity, and illness perceptions in relation to self-efficacy in a sample with morbid obesity and in a sample with chronic obstructive pulmonary disease (COPD). The linear regression analyses showed that higher physical activity and less emotional response to illness were directly associated with higher self-efficacy among persons with obesity, while more social support; fewer perceived consequences from illness; and more understanding of the illness were directly associated with higher self-efficacy among persons with COPD. The results indicate that obese persons are likely to benefit from increasing physical activity and from receiving emotional support. Persons with COPD may be empowered by being able to utilize cognitive coping strategies and by receiving social support.     

The relationship between implicit and explicit motives, goal pursuit, and autobiographical memory content during a diary study

This online diary study investigated how motives interact with goal pursuit to predict daily autobiographical experiences. Participants (N = 141) completed measures of implicit and explicit achievement, provided daily memories and reports of their goal pursuit during a 3-week diary period. A stronger implicit achievement motive at the onset of the study was associated with more agentic (and fewer communal) autobiographical content. Goal progress was linked with using more agentic words, while goal attainability was related to using more communal words. Interactions between motives and goal pursuit on autobiographical memory suggests a trade-off: Favorable goal pursuit conditions may prompt people not motivated for achievement to shift their focus from agentic to communal themes, while individuals motivated for achievement maintain their priorities.     

The effect of time constraints and personality facets on general cognitive ability (GCA) assessment

General cognitive ability (GCA) is a recognized construct for predicting job performance and capacity to learn. However, it has recently been argued that the time constraints under which GCA is assessed might provoke test anxiety, which negatively biases GCA scores. This can then lead to erroneous rejection of qualified candidates in personnel hiring contexts. This paper aimed to investigate: (1) to what extent candidates’ GCA scores increase when tested without time constraints and the ability of this GCA score to predict job performance; and (2) the personality characteristics that hinder GCA test performance under time constraints. Results from two field studies conducted in an actual personnel selection context partially confirmed the hypotheses. They revealed that, aside from the improvement of all candidates’ GCA scores when time constraint was removed, only GCA assessed without time constraints predicts job performance. Furthermore, while all candidates’ scores were influenced by the time constraint condition, individuals who are anxious, low-impulse, low value-questioning and deliberating are more penalized by the time constraint condition of such testing and, thus, are more likely to be erroneously eliminated in a selection process.     

What's mine is yours: The crossover of day-specific self-esteem

This diary study examines the daily crossover of self-esteem within working couples. By integrating self-esteem research into the crossover framework, we hypothesized that the day-specific self-esteem experienced by one partner after work crosses over to the other partner. Furthermore, we proposed that this daily crossover process is moderated by the other partner's general level of self-esteem and empathic concern. We conducted a diary study over five consecutive working days among 102 working couples. Multilevel analyses using the actor-partner interdependence model supported our hypotheses. Day-specific self-esteem experienced by one partner after work crossed over to the other partner in the evening, particularly when this partner had a generally low level of self-esteem and a generally high level of empathic concern.     

"Without being in psychoanalysis I would never have dared to become pregnant": psychoanalytical observations in a multidisciplinary study concerning a woman undergoing prenatal diagnostics

As is well known, Freud described the clinical practice of psychoanalysis as the 'loam' of his cultural-theoretical work, an assessment which is shared by many psychoanalysts up to the present, including the authors of this paper. The complex interplay between unconscious phantasies on the one hand, and the real experiences arising from the new possibilities opened up by prenatal diagnostics on the other, is described with reference to a report of an intensive, long psychoanalysis with an analysand from a family burdened with a genetically transmitted illness (haemophilia). The holding and containing function of the analyst enabled this analysand, despite traumatic experiences with the miscarriage of a healthy child triggered by a prenatal diagnosis and the later abortion of a haemophiliac baby, nevertheless to have the courage to go through another pregnancy and give birth to a healthy girl. The intensive clinical investigation of the unconscious phantasies, conflicts and traumas around the prenatal diagnostics proved to be not only therapeutically fruitful for the analysand, Ms F. It also facilitated insights into those individual chances and risks which appear to be an integral part of the opportunities presented by todays prenatal diagnostics and, through them, it lead to a cultural-critical look at the ambivalence of medical-technical progress. These insights, which are only attainable through psychoanalysis, can represent a distinctive contribution of psychoanalysis to a multi-disciplinary dialogue with medical practitioners, geneticists, ethicists and health policy-makers. By referring to a large EU study on 'Ethical Dilemmas due to Prenatal and Genetic Diagnostics', this paper gives a practical example of such a discussion. Ms F. was psychoanalytically interviewed as part of this study, 16 years after the conclusion of her analysis. The summary of these interviews, which is set against the account of the treatment, offers an impressive insight not only into the long-term effects of a psychoanalysis under very particular personal circumstances, but also into the lasting consequences of decisions made in the context of prenatal diagnostics. Finally, the results of the individual case study are brought together with the clinical outcomes of the EU study, and some considerations are formulated concerning the protective and risk factors facing women during and after prenatal diagnostics. The paper is an appeal to psychoanalysts, with their specific competence in dealing with unconscious phantasies and conflicts and their high level of professionalism in dealing with traumatised patients, to get involved in fresh dialogue with prenatal diagnosticians and their patients.     

The Relationship of Parental Attachment and Psychological Separation to the Psychological Functioning of Young Adults

Abstract

The authors explored the interrelations between attachment patterns and psychological separation from parents as well as the contribution of these variables to adaptive psychological functioning. Among 153 university students in Greece, there was a positive association between security of attachment and freedom from guilt, anxiety, and resentment toward one's parents (conflictual independence); in contrast, there was an inverse relation between security of attachment and independence from parents in relation to emotional, functional, and attitudinal independence. Compared with the insecurely attached students, the securely attached students also scored higher on measures of self-esteem and lower on measures of anxiety and loneliness.     

Friendship, perceived mattering and happiness: a study of American and Turkish college students

Although it is well established that friendship is a consistent correlate of happiness, less is known about how friendship experiences might promote happiness. The current investigation addressed this gap by testing a mediational model proposing that perceived mattering explains the association of friendship quality with happiness among college students in Turkey and the United States. An alternative model suggesting friendship quality as the mediator was also tested to enhance confidence in the proposed model. SEM analyses revealed that perceived mattering mediated the association of friendship with happiness only in the American sample. In the Turkish sample, friendship quality mediated the association between mattering and happiness. Findings highlight the importance of cross-cultural research and suggest that the underlying processes and psychological mechanisms related to the friendship-happiness link might be different in different cultures.     

The Myth of Individualism-Collectivism: A Critical Review

Abstract

The authors critically assess the dimension of individualism-collectivism (I-C) and its various uses in cross-cultural psychology. They argue that I-C research is characterized largely by insufficient conceptual clarity and a lack of systematic data. As a result, they call into question the utility of I-C as an explanatory tool for cultural variation in behavior, suggest alternative dimensions for cross-cultural research, and interpret the weaknesses of research on I-C as illustrative of a general trend in social psychology.     

从自尊的文化差异说起

在不同的文化背景中,自尊既有相似性,也有差异性。在东西方文化中,自尊在其根源性、包容性及表达性等方面均存在差异。树立文化差异性与普遍性的意识,加强对自尊文化差异的研究对于科学地认识社会心理现象和学科建设都具有重要意义。未来可以从自尊的内涵、自尊研究的内容及研究方法等方面开展自尊的中国化研究。