术前人文关怀对肺癌手术患者全麻诱导心理和生理的影响

为探讨术前进行人文关怀式沟通和健康教育对肺癌手术患者全麻诱导后心理和生理的影响,将83例非同期别的肺癌手术患者（均采用全身麻醉,双腔管气管插管辅助通气）分成两组。观察组进行人文关怀式沟通,对照组采用普通沟通。判定方法采用焦虑自评量表（SAS）,根据焦虑评分反映两组患者入院即刻及手术前的心理变化情况,监测全麻诱导即刻与全麻诱导气管插管后5min患者平均动脉压（MBP）的波动、心率（HR）的变化,用两个时间段两个变量的差值来反映两组患者全麻诱导期发生心理和生理反应的情况。结果显示,两组患者入院即刻焦虑差异无统计学意义（P〉0．05）;手术前SAS评分两组患者较入院即刻降低（P〈0．05）,并且观察组与对照组相比下降更明显（P〈0．01）;观察组患者MBP波动无统计学意义（P〉0．05）、HR波动有统计学意义（P〈0．05）。因此,证实人文关怀式沟通和健康教育能够减轻肺癌患者在心理和生理两个方面对麻醉和手术产生的不良反应。     

Using doctor-patient communication to affect patients' lifestyles. theoretical and practical implications

Abstract

Physicians very often do not perceive themselves as being efficient in affecting patients' life style. The aim of this article is to elucidate theoretical constructs and models in health education and their practical implications for individual health counselling in daily work as a guidance for physicians. The current most commonly used strategies are giving information and exhorting people, which have a limited ability to change peoples' behaviour. Derived from current behavioural constructs and models in health education - such as the health belief model, social learning theory, health beliefs, self-efficacy, self-determination theory - principles for successful strategies are described: to use patient-centredness instead of directing, to encourage patients to reflect and decide on their behavior, to find out the patient's readiness to change, to present knowledge as neutral facts instead of valuations, to focus on the actual behaviour instead of information-giving, to highlight patients' health beliefs and to discuss the advantages and disadvantages which the patients experience with their life style. The article concludes with a comprehensive model for individual health counselling in consecutive steps.     

FALSIFIABILITY AND TRACTION IN THEORIES OF DIVINE ACTION

One of the most focused research programs in the science‐religion dialogue that has taken place up to the present is the series of volumes published jointly by the Vatican Observatory and the Center for Theology and the Natural Sciences. Originating with the encouragement of Pope John Paul II, this series has produced seven volumes focusing on how divine action can be understood in light of contemporary science. A retrospective volume published in 2008, Scientific Perspectives on Divine Action: Twenty Years of Challenge and Progress, contains articles reviewing the series as a whole. In this article I analyze the series as a whole as well as some of the pivotal problems discussed throughout the series, such as the zero‐sum game, scientific “traction,” falsifiability in theories of divine action, and locating special divine action in the physical world.     

Reliability and Validity of a Short Version of the General Functioning Subscale of the McMaster Family Assessment Device

The General Functioning 12‐item subscale (GF12) of The McMaster Family Assessment Device (FAD) has been validated as a single index measure to assess family functioning. This study reports on the reliability and validity of using only the six positive items from the General Functioning subscale (GF6+). Existing data from two Western Australian studies, the Raine Study (RS) and the Western Australian Child Health Survey (WACHS), was used to analyze the psychometric properties of the GF6+ subscale. The results demonstrated that the GF6+ subscale had virtually equivalent psychometric properties and was able to identify almost all of the same families who had healthy or unhealthy levels of functioning as the full GF12 subscale. In consideration of the constraints faced by large‐scale population‐based surveys, the findings of this study support the use of a GF6+ subscale from the FAD, as a quick and effective tool to assess the overall functioning of families.     

Interacción persona x situación en la predicción de la personalidad: algunas especificaciones del factor personal

RESUMEN

Este trabajo intenta determinar si la multidimensionalidad de la Ansiedad-rasgo (A-trait), medida por el S-R GTA (Inventario E-R del Rasgo General de Ansiedad) está referida a diferentes perfiles de personalidad. Los resultados del análisis de regresión lineal múltiple usando la escala de “Locus of Control” interno-externo, el Inventario Psicológico de California, la Escala de Confianza interpersonal, como medidas predictivas, confirmaron la existencia de diversos perfiles de personalidad para una de las cuatro facetas de la Ansiedad-rasgo. Estos hallazgos atestiguan la multidimensionalidad del Inventario E-R del Rasgo General Ansiedad y la importancia de especificar la situación en la medida de la Ansiedad.     

Individual Ambidexterity: Exploring and Exploiting in Dynamic Contexts

The objective of this study is to analyze the mediating role of intrinsic and extrinsic job satisfaction in the relationship between the 2 dimensions of work–family conflict—family interfering with work (FIW) and work interfering with family (WIF)—and general job satisfaction. Step-by-step hierarchical regression analyses were carried out on a sample of 151 men and women from a Spanish public organization. The results confirmed the mediating role of intrinsic job satisfaction in the case of FIW. This highlights the importance of taking into account the level of satisfaction with the intrinsic facets of one's job as a measure for understanding why FIW has a negative impact on general job satisfaction.     

小学数学教师职业知识的结构与内在关系

本研究以小学数学分数起始教学为媒介,通过自编的小学数学教师职业知识测验,考察了162名小学数学教师在学科知识、一般教育学知识和教育实践知识等三类知识上的表现,并据此探讨了这三类职业知识间的相互关系。研究结果表明,自编的小学数学职业知识测验具有良好的信度和结构效度,教师的学科知识和一般教育学知识能显著地预测其教育实践知识。     

发展性阅读障碍的理论及眼动研究

关于发展性阅读障碍,国外研究者,基于认知和生物因素,先后提出了语音缺陷论、小脑缺陷论、一般性大细胞功能障碍论等对发展性阅读障碍进行解释,并考察了患者的眼动特征,提出了有效的诊治方法。目前,汉语发展性阅读障碍研究主要局限在语音和正字法领域,也涉及局部脑区的功能缺陷,但还未从多角度测查其成因,如眼动。这里,在理论梳理的基础上,系统探讨了发展性阅读障碍者的眼动特征,如注视时间、注视次数、眼跳、回视等,及视觉加工的眼动机制