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.     

The relationship between ADHD symptoms and driving behavior in college students: The mediating effects of negative emotions and emotion control

Previous research has shown a relationship between attention deficit-hyperactivity disorder (ADHD) symptoms and driving anger and adverse driving outcomes. Moreover, adults with ADHD symptoms express their emotions in more aggressive ways, indicating a lack of emotion control. The present study surveyed 246 college students to examine the relationship among ADHD symptoms, negative emotions, emotion control, and driving anger and safe driving behavior. Mediating effects of negative emotions and emotional control on the relationship between ADHD symptoms and self-reported driving anger and safe driving behavior were also examined. Both negative emotions and emotion control were significant mediators of the relationship between ADHD symptoms and driving anger, but not safe driving behavior. Mediation was stronger for ADHD-Hyperactive/Impulsive symptoms than for ADHD-Inattention symptoms. These results may provide some insight on how to design training programs for individuals with ADHD symptoms to increase driving safety.     

Defining greed

Although greed is both hailed as the motor of economic growth and blamed as the cause of economic crises, very little is known about its psychological underpinnings. Five studies explored lay conceptualizations of greed among US and Dutch participants using a prototype analysis. Study 1 identified features related to greed. Study 2 determined the importance of these features; the most important features were classified as central (e.g., self‐interested, never satisfied), whereas less important features were classified as peripheral (e.g., ambition, addiction). Subsequently, we found that, compared to peripheral features, participants recalled central features better (Study 3), faster (Study 4), and these central features were more present in real‐life episodes of greed (Study 5). These findings provide a better understanding of the elements that make up the experience of greed and provide insights into how greed can be manipulated and measured in future research.     

叙事医学反思性写作对共同决策价值探析

以叙事医学工具反思性写作为切入点,首先从医方、患方及外部环境三个角度分析了当前医患共同决策所面临的临床实践困境,其次在对反思性写作概念、实践特点概述的基础上,提出了叙事能力对临床工作的重要性、叙事医学伦理对决策困境的作用,最后从促使医方自我反思,避免引导式决策及权威主义;弥合医患视阈差异,达成决策共识;阐明并澄清患者偏好及价值观,促进个体化共同决策;提高患者参与决策意愿,调动参与决策积极性;缓和医患关系,实现医患共情,促进共同决策良性互动五个方面阐述了反思性写作对医患共同决策困境的助力作用。

     

医患共享决策的价值意蕴、影响因素及辅助工具

当今社会,受消费行为和人权意识的影响,患者愈发渴望参与到医疗决策的过程之中。医患共享决策体现了对患者自主权的尊重,并有助于提高医疗服务品质。然而我国的医患共享决策起步较晚,面对的困难复杂且多样,需要克服来自患方、医方,以及医疗决策过程本身等方面的因素。患者与医生的有效沟通,是提高患者的就医体验,真正实现以患者为中心的使然。在其他国家的实践经验中,决策辅助工具为实现共享决策提供了有益的参考,但现有的决策辅助工具尚不完善,尤其缺乏适合我国国情的决策工具。     

共享决策在慢性病治疗中的应用进展——以糖尿病为例

综述了共享决策的来源及特征,共享决策实施的支持方式以及在糖尿病患者中的实施步骤和影响因素。归纳分析了共享决策在糖尿病患者中的应用效果,包括提高患者对疾病的认知、改善患者的风险感知、帮助患者控制血糖、提高患者满意度,改善决策质量。共享决策与传统的诊疗决策不同,不再是医师主导型,主要强调患者的个人偏好和价值观念在医疗决策中的作用。并探讨其存在的不足和未来发展趋向,旨在为我国糖尿病患者共享决策的开展提供理论支撑和方法借鉴。     

直觉思维在麻醉临床决策中的应用

围手术期麻醉医师面临问题的复杂性、动态性和模糊性,要求其在具备良好逻辑思维能力的同时,还要学会应用直觉思维来进行麻醉危机管理。通过决策判断的双加工理论模型探讨说明直觉思维在临床麻醉决策中的可应用性,并给出麻醉医师直觉思维的培养途径,提高麻醉医师的思考能力,增加应急处理课程和临床训练,重视临床经验的学习,营造良好的教学氛围。为了在围手术期更好地保证患者的安全,麻醉医师应重视直觉思维在临床麻醉决策中的应用。     

病人临终决策中的自主问题辨析

自主在医学伦理学中是一个重要的概念。在临终决策中,必须对病人自主从主体自主和行为自主两个维度加以区分,并强调缺乏内外部约束的重要性,尽管内部约束对病人自主影响巨大,但它并不会破坏临终决策的行为自主。在回顾两种反对将行为自主作为理解临终决策手段的意见基础上,应当实现行为自主的标准从完全自主向充分自主的转变,充分自主的优势在于它对各种医疗环境和背景条件所表现出的适应性。根据这一标准,诸如临终病人的死亡选择并不需要完全自主,充分自主即可。

     

“为癌症患者心理赋能”的临床干预路径

“为患者心理赋能”是近年来医疗健康领域出现的一种新的积极医疗照护理念,其关注点是个体的能力而非缺陷,它强调医疗实践应该为改善健康和生活质量建立患者激励结构。首先梳理了赋能的概念发展与心理结构,随后引证多个实证研究总结出为癌症患者心理赋能的四条临床干预路径,指出医患共同决策、同伴支持、赋能教育以及认知行为压力管理的赋能价值。最后结合已有成果和研究中发现的问题,提出癌症心理赋能干预发展建议,有利于进一步开展临床研究和实践探索。

     

患者决策能力与风险相关标准

患者决策能力对于患者享有临床知情同意权具有重要意义。风险相关标准主张决策所需的能力水平应该根据决策的结果来调整,单一的决策能力标准是不够的。决策结果带来的风险越大,能力水平要求越高,反之则可以要求较低的能力水平。该主张的伦理本质是不合理家长主义,并且,它意味着对同一决策任务,个体可能只有同意的能力而没有拒绝的能力,因而在经验上也站不住脚。患者决策能力标准仅应根据决策本身的复杂性和难易程度视该决策特性来决定,而独立于患者实际决策结果。