肿瘤患者心理困扰管理研究现状及本土化思考

心理困扰存在于肿瘤发生、发展的各阶段,是最常见的问题之一,在国外研究日益聚焦的同时,我们从心理困扰起源出发,回顾肿瘤患者心理困扰管理概况、观察性及实验性研究现状,分析心理困扰管理概念内涵、筛查工具、分类标准、干预模式及最佳管理途径等本土化问题,旨在找出困扰管理与我国国情的契合点,探求肿瘤患者心理困扰管理模式的合理化途径。     

妊娠期糖尿病管理策略

妊娠期糖尿病(gestational diabetes mellitus,GDM)是指妊娠期发生或首次发现的不同程度的糖代谢异常。未加控制的妊娠期高血糖可对母子产生极大的围产期和远期危害。妊娠后糖代谢发生明显变化妊娠期血糖的管理和控制与非孕期不同。GDM一经确诊,应及时干预,加强母儿监测,控制妊娠期血糖,以降低母儿并发症,改善围生儿结局;产后对母儿严密随访,异常者给予相应处理,以减少或延缓产妇在产后发展为成为2型糖尿病的可能及预防子代发生肥胖、高血压、糖尿病等代谢综合征的发生。     

恐惧管理研究:新热点、质疑与争论

恐惧管理理论(Terror Management Theory,简称TMT)认为,死亡恐惧为人类发展提出了新的适应性问题,多重机制因此进化而来以维护心理平衡。大量的实证研究验证了TMT的基本假设,但在解释死亡突显效应背后的动机上还存在争议。该文首先介绍了由文化世界观、自尊及亲密关系组成的三重防御系统,之后重点评述了批评者从认知闭合、意义维持、联结动机以及控制等视角对死亡突显效应背后真实动机做出的新的阐释,最后指出未来研究应当尝试将死亡觉知的必然性与不确定性所引发的不同效应分离开来。     

Internet-based contingency management to improve adherence with blood glucose testing recommendations for teens with type 1 diabetes

The current study used Internet-based contingency management (CM) to increase adherence with blood glucose testing to at least 4 times daily. Four teens diagnosed with Type 1 diabetes earned vouchers for submitting blood glucose testing videos over a Web site. Participants submitted a mean of 1.7 and 3.1 blood glucose tests per day during the 2 baseline conditions, respectively, compared to 5.7 tests per day during the intervention. Participants and their guardians rated the program favorably on a number of dimensions. The results suggest that Internet-based CM is feasible, acceptable, and effective to increase self-monitoring of blood glucose in teens.     

Effects of escalating and descending schedules of incentives on cigarette smoking in smokers without plans to quit

Contingent incentives can reduce substance abuse. Escalating payment schedules, which begin with a small incentive magnitude and progressively increase with meeting the contingency, increase smoking abstinence. Likewise, descending payment schedules can increase cocaine abstinence. The current experiment enrolled smokers without plans to quit in the next 6 months and compared escalating and descending payments schedules over 15 visits. In the larger incentive condition (LI, n = 39), the largest possible incentive was $100, and in the smaller incentive condition (SI, n = 18), the largest possible incentive was $32. In both conditions, more participants in the descending groups initiated abstinence. A higher proportion of participants in both the escalating and descending groups initiated abstinence in the LI than in the SI. Although participants in the descending groups had more abstinent visits during the first five contingent visits than those in the escalating groups, these differences were not maintained.     

When the death makes you smoke: A terror management perspective on the effectiveness of cigarette on-pack warnings

One of the principal vehicles for informing tobacco consumers about the risks of smoking is the warning message on each cigarette package. Based on terror management theory, the present study investigates the impact of mortality-salient warnings on cigarette packages compared to warnings with no mortality threat. Results suggest that to the degree that smoking is a source of self-esteem, later attitudes towards smoking become more positive if the warning message is mortality-salient. On the contrary, if the warning is terrifying but not mortality-salient and relates to the source of self-esteem, smoking attitudes become more negative with higher smoking-based self-esteem. Thus, mortality-salient warnings may increase the tendency to favor smoking under certain circumstances. This fatal ironic effect highlights the importance of a risk communication that matches the self-esteem contingencies of the recipients, and it has urgent implications for health care policy.     

When animals attack: The effects of mortality salience, infrahumanization of violence, and authoritarianism on support for war

Terror management theory (TMT) suggests that people are motivated to elevate themselves above other animals as a way of denying their creatureliness and mortality. Based on this reasoning, the present study assessed whether infrahumanizing violence by emphasizing its similarities to animal aggression would lead to reduced support for war, especially when mortality is salient. This hypothesis was supported among participants high in right-wing authoritarianism (RWA), who are especially prone to infrahumanize outgroup members and are generally more supportive of military action against outgroups. RWA was associated with greater support for war against Iran, except when primed with thoughts of death and violence as an infrahuman behavior. These data suggest that by portraying violence as something instinctual and creaturely, it may be possible to reduce inter-group hostility and aggression among individuals who tend to be more dispositionally aggressive, particularly in the context of the death awareness that often exacerbates inter-group conflict.     

Using a Compromise Programming Framework to Integrating Spatially Specific Preference Information for Forest Management Problems

The development of forest management plans is a multi‐criteria problem that usually involves multiple stakeholders. In forested recreational areas or natural parks, stakeholders could include government officials, forest companies and visitors to the area. With the progress of mobile phone technology, preference information (including aesthetic values) can be conveniently obtained from stakeholders while they are in the forest. This paper develops a methodological approach that incorporates place‐specific opinion preference into the development of alternative forest management plans. Through the use of a modified Compromise Programming approach, prospective alternatives are developed, which optimize the opinions of stakeholders and the quantity of timber over time depending on specified parameters. The analysis is based on a small simulated forest holding and place‐specific simulated opinion data. To allow for a comparison between potential stakeholder groups, the opinion data was generated by a method that produced three separate groups. The results indicate the practical use of place‐specific preferences and provide a means to incorporate the information to generate possible alternative plans. In addition, the analysis highlights that by segregating the preference information into groups, the planning of more specific courses of actions can be made. Copyright © 2015 John Wiley & Sons, Ltd.     

TRAINING RESIDENTIAL SUPERVISORS TO PROVIDE FEEDBACK FOR MAINTAINING STAFF TEACHING SKILLS WITH PEOPLE WHO HAVE SEVERE DISABILITIES

We evaluated procedures for training supervisors in a residential setting to provide feedback for maintaining direct-service staff members' teaching skills with people who have severe disabilities. Using classroom-based instruction and on-the-job observation and feedback, 10 supervisors were initially trained to implement teaching programs themselves. The training improved supervisors' teaching skills but was insufficient to improve the quality of feedback they provided to direct-service staff regarding the staff members' teaching skills. Subsequently, classroom-based instruction and on-the-job observation and feedback that targeted supervisors' feedback skills were provided. Following training in provision of feedback, all supervisors met criterion for providing feedback to their staff. Results also indicated that maintenance of teaching skills was greater for direct-service staff whose supervisors had received training in providing feedback relative to staff whose supervisors had not received such training. The need for analysis of other variables that affect maintenance of staff performance, as well as variables that affect other important areas of supervisor performance, is discussed.     

Evaluating the Performance Diagnostic Checklist‐Human Services to assess incorrect error‐correction procedures by preschool paraprofessionals

The Performance Diagnostic Checklist‐Human Services (PDC‐HS) has been used to assess variables contributing to undesirable staff performance. In this study, three preschool teachers completed the PDC‐HS to identify the factors contributing to four paraprofessionals' inaccurate implementation of error‐correction procedures during discrete trial training sessions. The PDC‐HS indicated insufficient training as a contributing factor. We then implemented a nonindicated intervention (posting reminders), followed by an indicated intervention (behavioral skills training). The nonindicated intervention failed to produce desired performance improvements; however, the PDC‐HS indicated intervention resulted in improvements for all paraprofessionals.