Testing Measurement Invariance of the Dark Triad Dirty Dozen in a Belgian Adult Sample

The Dirty Dozen (Jonason & Webster, 2010) is a frequently used concise version of the Dark Triad to measure three socially aversive personality traits: Machiavellianism, psychopathy and, narcissism. The present study has examined measurement invariance in a sample of Belgian adults. The present study aims to assess measurement invariance of the Dutch version of the Dirty Dozen measure across gender in a large city-based representative adult sample in Belgium (N = 1587). Multi-group first-order confirmatory factor analysis for categorical indicators was utilized. In addition, unique associations between Dirty Dozen traits, trait self-control and, acceptance of illegitimate norms were examined in a series of structural equation models. Results indicated that the internal consistency of the Dirty Dozen subscales was good for Machiavellianism (α = 0.80) and narcissism (α = 0.80), but modest for psychopathy (α = 0.64). The hypothesized three correlated factors model with separate factors for Machiavellianism, psychopathy and, narcissism provided a poor fit for men and women. Invariance testing across gender showed evidence for weak invariance only, indicating that the underlying latent factors are measured the same way with the same metric in the two populations. However, we were not able to establish strong measurement invariance. Observed group differences should be interpreted with caution. Furthermore, Machiavellianism and psychopathy were strongly associated with trait self-control in both men and women. Strong correlations were found between acceptance of illegitimate norms and Dirty Dozen traits, Machiavellianism and, psychopathy, but not with narcissism.     

构建病人自主择医的现代医学伦理观

“病人选择医生”这一重大改革举措可以得到病人自主择医权和改革实践的有力辩护与支持,同时,为使其形成有序合理格局,并进入可持续发展的正常轨道,也亟需以解决现实重大问题为基础,着力的构建病人自主择医权的现代医学伦理观。这个医学伦理观应由现代的伦理理念框架1管理伦理框架、程序伦理框架构筑成主体框架。     

医疗纠纷非诉讼解决机制与和谐医患关系

医疗纠纷的急剧攀升与解决医疗纠纷的方式和途径较为单一、过分倚重诉讼有直接的关系。要改变医疗纠纷的现状,构建和谐医患关系,必须克服法治等于诉讼的误区,建立以法律规范为指导,以预防机制为基础,以非诉讼解决机制为主要方式,以法律诉讼为最终途径的多元化的医疗纠纷解决机制。     

变性术后患者心理状况的影响因素分析及对策

变性术后的患者是个特殊的弱势群体,心理问题非常突出,它是生理、个人、家庭、社会等多种因素交互影响的结果;因此,通过社会、家庭及个体的共同努力,帮助其建立良好的个体心理模式,稳定其心理状态,可促进其心理的健康发展,这对于变性手术的成功和帮助变性后患者重新走向社会有重要意义。     

Doctors' decision-making on giving information to cancer patients

Abstract

A major focus in the literature about doctor-patient communication is information-giving. In the case of cancer patients, one significant issue is which factors determine whether and how, general practitioners and oncologists give information to their patients. Whatever may be the content of information, the most important choice for the doctor is to give information or not. Our research group at the Department of Health Psychology has conducted investigations in order to identify the significant determinants of decisions concerning giving information to cancer patients. A sample of 60 doctors from Alicante province in Spain were asked their criteria for giving information about a cancer diagnosis. Results showed that perceived intelligence and emotional control in the patients were the best predicotrs of the decision by doctors to give information. Age and socio-economic status were also significantly associated with the doctors' information-giving practices. These data suggest that the criteria for giving information to cancer patients are subjective and show a strong cultural influence.     

腰-硬联合麻醉在高海拔高龄患者髋关节置换术中的应用

探讨腰-硬联合麻醉及全身麻醉用于高海拔高龄低氧患者行人工髋关节置换的临床优势。分析2010年1月～2013年11月来我院进行人工髋关节置换术的高龄（年龄＞69岁）低氧患者86例,其中全麻31例,腰-硬联合麻醉55例,记录麻醉后5min、15min、30min及术毕血压、心率,术中低血压发生率,术后转ICU比例等指标。与全麻相比,腰-硬联合麻醉组血流动力学稳定、术中低血压发生率降低（P＜0．05）、入住ICU几率显著降低（P＜0．05）。在高海拔高龄低氧患者行人工髋关节置换术中采用腰-硬联合麻醉可以使患者麻醉效果突出,血流动力学平稳,安全有效,比全麻更有临床应用优势。     

NARCISSISTIC DEFENSES IN THE DISTORTION OF FREE ASSOCIATION AND THEIR UNDERLYING ANXIETIES

This paper examines particular distortions in the process of free association characteristics of patients with narcissistic personality disorders. The author proposes that the dominant narcissistic transference developments typical of the early and middle phases of the analytic treatment of these patients are reflected in these distortions of free association. This paper gathers the various patterns that these defensive distortions present, along with technical interventions geared to deal with them.     

论医学人文精神的历史走向

医学人文精神和医学科学精神的整合交融,是医学走向成熟的标志,对生命的终极关怀,是医学人文精神的基本内涵;对医患关系的理解和介入方式,是医学人文精神切入实践的关键;医学人文品格是医学人文精神的良性载体和职业表征。是医生理想的职业人格。这四个问题从不同角度,不同层面凸现了医学人文精神的实质,反映了在新医学模式背景下医学人文精神的历史走向。     

Exploring correlations between positive psychological resources and symptoms of psychological distress among hematological cancer patients: a cross-sectional study

Hematological cancer patients experience high levels of psychological distress during diagnoses and intensive treatments. The aim of the present study is to explore the effects of positive psychological resources on depressive and anxiety symptoms in hematological cancer patients. This survey was conducted in a hospital during the period from July 2013 to April 2014. A total of 300 inpatients were recruited and finally 227 of them completed the questionnaires. Questionnaires included demographic and clinical variables, the Center for Epidemiologic Studies Depression Scale, the Self-Rating Anxiety Scale, the Life Orientation Scale-Revised, the General Perceived Self-Efficacy Scale, and the Resilience Scale-14. Results showed that the prevalence of depressive and anxiety symptoms was 66.1 and 45.8%, respectively. Both optimism (β = ?.479, p < .001) and resilience (β = ?.174, p < .05) were negatively associated with depressive symptoms, and optimism (β = ?.393, p < .001) was negatively associated with anxiety symptoms. However, resilience (β = ?.133, p > .05) was not significantly associated with anxiety symptoms, and self-efficacy was not significantly associated with depressive (β = ?.032, p > .05) or anxiety symptoms (β = ?.055, p > .05). The results suggest that hematological cancer patients who possess high levels of positive psychological resources may have fewer symptoms of psychological distress. The findings indicate that enhancing positive psychological resources can be considered in developing intervention strategies for decreasing depressive and anxiety symptoms.     

Patient and Family Descriptions of Ethical Concerns

Abstract

Ethically challenging situations routinely arise in the course of illness and healthcare. However, very few studies have surveyed patients and family members about their experiences with ethically challenging situations. To address this gap in the literature, we surveyed patients and family members at three hospitals. We conducted a content analysis of their responses to open-ended questions about their most memorable experience with an ethical concern for them or their family member. Participants (N?=?196) described 219 unique ethical experiences that spanned many of the prevailing themes of bioethics, including the patient-physician relationship, end-of-life care, decision-making capacity, healthcare costs, and genetic testing. Participants focused on relational issues in the course of experiencing illness and receiving medical care and concerns regarding the patient-physician encounters. Many concerns arose outside of a healthcare setting. These data indicate areas for improvement for healthcare providers but some concerns may be better addressed outside of the traditional healthcare setting.