家庭功能与青少年消极冒险行为的关系:一个有调节的中介模型

为探讨家庭功能影响青少年消极冒险行为的作用机制及条件,采用青少年冒险行为问卷、家庭功能问卷、自尊问卷、同伴群体特征问卷对山东省日照市940名初高中学生进行调查。结果发现:(1)家庭功能不良不仅可直接预测青少年更多的消极冒险行为,而且也可通过使青少年交往更多不良同伴进而使其冒险行为进一步增多;(2)不良同伴交往对青少年消极冒险行为的预测受到个体自尊的调节。低自尊个体更容易受到不良同伴交往的影响而发生更多的消极冒险行为,表现出两风险因素的叠加效应。研究结果提示,家庭是青少年健康成长的基础,家庭功能不良可使青少年适应不良,塑造良好的同伴环境、培养良好的自我素质或可降低这一风险。     

An experimental test to reveal negative side-effects of high treatability information on preventative health behaviour

Objectives: When the course of a disease can be positively changed by health professionals the disease can be indicated as ‘highly treatable’. This ‘high treatability information’ (HTI) may have negative side-effects on people’s preventative motivation. This study examined the effects of HTI regarding skin cancer on preventative motivation.

Design: This study employed a 2 (high treatability (HTI) versus low treatability (LTI)) × 2 (high versus low susceptibility)?experiment with a hanging control group. (family) History and self-efficacy were assessed as moderators. Participants (N = 309) were randomly assigned to one of the five conditions.

Main outcome measures: The main outcome was intention to engage in preventative actions regarding skin cancer.

Results: HTI significantly lowered the intention compared to LTI, under the condition of high susceptibility in people with low self-efficacy. In addition, in people with a (family) history of skin cancer, HTI significantly lowered the intention compared to the no-information group.

Conclusion: HTI regarding skin cancer can cause a drop in the preventative motivation. The effects can be conceptualised as negative side-effects of HTI. As substantial proportions of the general population have a (family) history of skin cancer or low self-efficacy, the side-effects may be widespread, possibly increasing the incidence of skin cancer.     

Working while studying at university: The relationship between work benefits and demands and engagement and well-being

We tested a role-conflict, depletion, and enrichment model, in which work-based benefits (enabling resources, psychological rewards, and psychological involvement) and work-based demands (time-, strain-, and behaviour-based demands, and hours worked) were antecedents to work–university conflict and work–university facilitation, which, in turn, were antecedent to students' academic engagement (dedication and vigour) and well-being (general and context-specific feelings about university). We also tested whether conflict and facilitation acted as mediators in the relationships between benefits and demands and the outcomes of engagement and well-being. The hypotheses were tested using 185 university students (77% female; mean age = 22.7 years) who were working while studying. Work-based benefits (enabling resources, rewards, and involvement) were associated with higher work–university facilitation; more time demands and fewer psychological rewards were associated with more work–university conflict; facilitation was associated with more engagement (dedication) and general well-being; and conflict was associated with more negative feelings towards the university. There were no mediation effects. Working while studying is related to students' engagement and well-being, although modest effects were explained by role-conflict theory.     

以家庭平衡为目的的辅助生殖技术性别选择问题探讨

对三孩政策下辅助生殖医疗机构患者就诊过程中呼声较高的以家庭平衡为目的的性别选择问题进行探讨,从概念的界定、产生需求的社会背景及可能引发的伦理问题进行论证,从而推动社会层面的深度思考。同时,结合当前辅助生殖技术中存在的社会需求,提出了以家庭平衡为目的的性别选择是曾经实行的“生男即止法”的延伸。但以家庭平衡为目的的性别选择还需要以辅助生殖技术规范应用为前提,应该从法律法规的完善、技术应用的监督及审查体系的加强等方面推动工作,防止相关技术的滥用。

     

家庭癌症告知过程及类型分析

将癌症告知看作一个家庭过程,以患者-家属为分析单位,阐述确诊及病程信息如何在家庭中流动,以及告知过程中患者和家属的角色演变。研究者对12位肺癌患者、7位家庭照护者和2位医生进行半结构访谈,并对访谈数据进行主题分析。家庭癌症告知是一个关乎患癌事实如何在家庭内流动的过程。围绕确诊、治疗和临终安排三个阶段,详细阐述了病患和家人的多种角色的演变,并基于此构建了两种家庭告知的理想类型：病患决策型和家属代理型。患者以往家庭角色、家庭沟通系统和疾病具身性体验是家庭癌症告知过程的重要影响因素。

     

患者和家属参与患者安全的概念演变及临床意义

运用Rodgers演化概念分析法对患者和家属参与患者安全概念的演化、替代术语和相关术语、前因变量、结果、概念属性、定义、典型案例进行分析。概念属性包含过程、行为及环境3个领域,4个重要特征分别为个性化、获取、投入及治疗联盟,其前因变量为患者的疾病、健康信息或护理协调的混乱、新政策号召的尝试。结果包括保障患者安全、减少医疗费用和确定最佳做法。澄清患者和家属参与患者安全的概念有助于提高医护人员对其的重视与了解,为临床的实践和研究提供参考和理论依据。

     

家庭及社会支持对城乡老年人心理健康影响的研究——以河北省城乡老年人调查为例

探究家庭及社会支持对老年人心理健康的影响,选取河北省6 173名60岁及以上城乡老年人,采用社会支持和心理健康症状自评量表进行问卷调查。城乡老年人心理健康评测结果显示,有心理症状者占22.9%;社会支持以低中度水平为主,占77.4%;家庭功能以一般及以下为主,占86.3%;经常与子女交流者占53.7%;得到社区帮助者占84.7%;社会支持、家庭功能、与子女交流情况、得到基层社区卫生服务情况均与城乡老年人的心理健康显著相关。统计结果揭示,我国应加大家庭及社会对老年人的支持力度,改善其心理健康状况。     

国内外预立医疗照护计划社会经济效益的探讨

从卫生经济学视角,探讨预立医疗照护计划的社会经济效益。通过分析预立医疗照护计划的卫生经济政策、经济分析模式及社会经济效益评价研究等发现,预立医疗照护计划具有较明显的社会经济效益。借鉴国外经验和结合我国文化背景提出预立医疗照护计划在我国发展的对策和建议,包括建立相关政策突破发展障碍;构建激励制度,加强人才培养以支撑预立医疗照护计划发展;开展评价预立医疗照护计划经济效益的研究,以价值为导向构建本土化的医疗模式,以期为我国发展预立医疗照护计划的卫生经济学研究领域提供理论依据。