Decision-making styles and mental health—A person-oriented approach through clustering

Previous research examining the associations between decision-making styles and mental health has neglected to look at the configurations of styles. The study identifies mutually exclusive groups of people according to their combination of the five decision-making styles and examines the differences between them in mental health-related variables in two studies. In Study 1, decision-making styles, mental health indicators (well-being, depression, stress) and socio-psychological protective factors (resilience, optimism, social support) were examined in university students in two rounds 1 year apart. A cluster analysis revealed three distinct decision profiles—independent/nonintuitive, avoidant/spontaneous and rational/nonavoidant. The best values of mental health-related variables were found in the rational/nonavoidant profile and the most negative values in the avoidant/spontaneous profile. The decision-making styles were stable after 1 year although they were not able to explain changes in mental health-related variables. Study 2 identified three similar clusters in a more general sample—spontaneous/irrational, dependent/avoidant and rational/nonavoidant—with the lowest level of psychological distress symptoms in the rational/nonavoidant cluster. The study highlights the usefulness of combinations of decision-making styles with regard to mental health as well as noting their specificity according to sample characteristics.     

Medical Decision-Making: An Argument for Narrative and Metaphor

This study examines the processes ofdecision-making used by intensive care(critical care) specialists. Ninety-ninespecialists completed a questionnaire involvingthree clinical cases, using a novel methodologyinvestigating the role of uncertainty andtemporal-related factors, and exploring a rangeof ethical issues. Validation and triangulationof the results was done via a comparison studywith a medically lay, but highly informed groupof 37 law students. For both study groups,constructing reasons for a decision was largelyan interpretative and imaginative exercise thatwent beyond the data (as presented), commonlyresulting in different reasons supporting thesame conclusions and similar reasons supportingopposite conclusions. The skills of ethicalimagination and interpretation were related toan individual's prior lived experience,construed in the broadest sense. Application ofthese skills of ethical imagination andinterpretation always occurred, to some degree,in a state of uncertainty and almost alwaysinvolved temporal relationships.Using these results, a theory of ethicaldecision-making is proffered. Three levels ortypes of reasoning processes may be present.Type I decision-making involves the applicationof rules, usually in a deductive fashion. TypeII decision-making is characterised by aprocess where a plurality of reasons arebalanced, weighed and sifted with each other.Type III decision-making is intimately linkedwith respondents lived experiences and `crafts'the content of type I and II reasoningprocesses, via the application of ethicalimagination and interpretation. Relationshipsbetween these three types of reasoningprocesses, and with narrative ethics, are alsodiscussed.     

医疗保险实施中的新课题：构建合理的利益格局

大连市实施医疗保险制度6年来,在医疗保险制度改革中医保机构、医疗机构、医药行业及参职工在利益格局调整中,出现了一些问题。从有利于医疗保险制度改革和公平、公正、客观的角度,用辩证的方法分析了医疗保险制度改革过程中的几个主要矛盾,进而从改变利益观、完善政策、加快配套改革等方面提出了相应的建议。     

Phenomenological Argumentative Structure

The nontechnical ability to identify or match argumentative structure seems to be an important reasoning skill. Instruments that have questions designed to measure this skill include major standardized tests for graduate school admission, for example, the United States-Canadian Law School Admission Test (LSAT), the Graduate Record Examinations (GRE), and the Graduate Management Admission Test (GMAT). Writers and reviewers of such tests need an appropriate foundation for developing such questions – they need a proper representation of phenomenological argumentative structure – for legitimacy, and because these tests affect people's lives. This paper attempts to construct an adequate and appropriate representation of such structure, that is, the logical structure that an argument is perceived to have by mature reasoners, albeit ones who are untrained in logic.     

大学生同一性与职业探索、职业决策困难的关系

采用问卷法对439名大学生的同一性与职业探索、职业决策困难的关系进行了研究.研究结果表明:(1)不同同一性地位类型的大学生在职业探索上存在显著差异,环境探索和自我探索两个维度的得分都呈现出达成型>延缓型>早闭型>混乱型的趋势,同一性地位越高,职业探索得分越高.(2)不同同一性地位类型的大学生在职业决策困难上存在显著差异,职业决策困难各维度得分及各维度平均分上大致呈现出同一性地位越高,职业决策困难得分越低的趋势.     

结直肠癌诊断模式的若干思考

结直肠癌是常见的消化道恶性肿瘤,然而在临床上得到诊断时大多已经到了中晚期,错过了最佳的治疗时机。近年来,随着基因相关技术及生物信息技术的迅猛发展,结直肠癌诊断方法得到不断改进,但早期诊断仍不尽如人意。因此现有的诊断模式值得我们去深思,从哲学意义上探索更为完善的诊断模式。     

实施子宫切除手术中的人文关怀

子宫切除术是妇科手术中的一种常见术式,随临床技术的发展,目前已有许多可供选择的不同方式。实施子宫切除手术中,临床医生应采用哲学的辩证思维方法并尊重患者的自主选择,全面客观地评估患者的情况;更多从人文关怀的角度出发,做出符合患者个体术式的决策,力争达到最佳的治疗效果。     

用现代医学模式看心血管疾病合并抑郁症的诊疗

随着社会进步,生活节奏日益加快,抑郁症及抑郁情绪已经悄无声息地蔓延开来,心血管疾病已成为城乡居民的第一位死因,分别为心理、生理疾病,从传统医学模式的角度看两者互不相干,但从生理-心理-社会的现代医学模式理解以及各种研究表明它们其实有着密切的联系。     

What do Patients Prefer: Informed Consent Models for Genetic Carrier Testing

The recent increased number of conditions for which patients can undergo genetic carrier testing raises the question of how best to obtain pre-test informed consent. Clinical approaches vary from a minimalist model to a model where patients are given detailed information about all conditions to be screened for. Few data exist as to patient preferences, or how information impacts decision-making. Eight high-literacy focus groups were conducted to assess the knowledge and preferences of pregnant patients and their male partners. Most groups indicated that some balance between details and brevity was optimal, recognizing that anxiety can occur when patients are provided with too much information and that the wide range of tests offered during pregnancy often led to confusion. Critical areas for the informed consent process included (1) details about the conditions and risk of being a carrier, (2) logistics of testing, (3) next steps if the test is positive, and (4) prognosis, options and resources if the child were to be affected with a disorder. It will be useful to develop model consent programs and prospectively assess their impact on informed consent and patient satisfaction, both when positive and negative results are received.     

决策与推理的双系统——启发式系统和分析系统

近来,在决策与推理的研究中,研究者提出了双系统作用模型：基于直觉的启发式系统和基于理性的分析系统。启发式系统加工速度较快,不占用或占用很少的心理资源,容易受背景相似性、刻板印象的影响;分析系统加工速度慢,占用较多的心理资源,遵从逻辑和规则,而且两个系统有不同进化历史和神经基础。该文根据已有的相关研究,综述了双系统在决策与推理中可能的作用机制、相互关系、个体差异,同时指出了目前研究存在的不足