ICU医护沟通与协作的现状与思考

许多研究表明ICU医护之间的沟通与协作存在重大问题,特别是在临终决策中存在分歧。护士的作用经常被忽视。加强医护之间的沟通与协作有助于提高医疗质量并改善医护、患者及家庭满意度。许多旨在改善沟通与协作的措施已经证实有效并可应用于临床实践,并应对此进行更深一步的研究。     

围手术期抗菌药物合理使用与药品费用的相关性分析

通过对本地一所三级甲等医院进行的围手术期抗菌药物的干预对照研究,用SPSS软件对470个手术病例的调查资料进行了统计分析,加强抗菌药物的用药管理及进行用药干预,能在对住院时间和手术切口感染率无影响的同时,明显降低手术病例的药品费用,特别是抗茵药品的费用,减轻患者负担。     

探索性因素分析因子抽取方法的比较

探索性因素分析决定因子抽取的方法主要有Bartlett法、K1原则、碎石检验法、Aaker原则、PA、MAP等六种,通过对样本1的395名大学生的学习过程问卷调查获得真实数据,运用这六种方法进行因素分析分别抽取7、4、2、4、3、2个因子;应用样本2的383名大学生的问卷调查数据进行验证性因素分析,结果显示,碎石检验方法与MAP方法抽取的二因素模型更理想。研究表明,因子抽取需兼顾“简约性原则”与“完备性原则”,同时要根据一定的理论建构、专业知识和经验来决定因子数。     

Role of amygdala-prefrontal cortex circuitry in regulating the expression of contextual fear memory

The basolateral amygdala (BLA) and medial prefrontal cortex (mPFC) are inter-connected regions involved in fear memory expression. The reciprocal nature of projections between these areas differs along the rostrocaudal extent of BLA. This study investigated the role of functional interactions between BLA and the prelimbic (PL) subregion of mPFC in mediating contextual fear memory. Freezing served as the measure of conditioned fear. Experiments 1–3 examined the effects of left, right or bilateral infusion of bupivacaine into anterior BLA (aBLA), posterior BLA (pBLA) or PL on fear memory expression. Reversible inactivation of left, right or bilateral aBLA impaired fear memory expression. Bilateral inactivation of pBLA or PL also disrupted the expression of fear memory, although left or right inactivation alone had no significant effects in either region. Experiment 4 examined the effects of functionally disconnecting pBLA and PL on contextual fear memory by infusing bupivacaine unilaterally into pBLA and PL in the ipsilateral or contralateral hemisphere. Fear memory expression was impaired by asymmetric inactivation of pBLA and PL; however, a similar effect was also observed with symmetric inactivation of these regions. Bupivacaine infusion did not affect behavior in the open field, likely ruling out non-specific effects of inactivation on innate fear and locomotor activity. These results demonstrate different roles for rostral and caudal BLA in mediating the expression of contextual fear memory. They also raise the possibility that pBLA–PL circuitry is involved in subserving fear memory expression via complex processing mechanisms, although further research is needed to confirm this preliminary finding.     

Attention during visual secondary tasks in driving: Adaptation to the demands of the driving task

Visual attention in driving with visual secondary task is compared for two visual secondary tasks. N = 40 subjects completed a 1 h test drive in a motion-base driving simulator. During the drive, participants either solved an externally paced, highly demanding visual task or a self paced menu system task. The secondary tasks were offered in defined critical and non-critical driving situations. Eye movement behavior was analyzed and compared for both tasks. Before starting the secondary tasks, eye movement behavior shows a smaller standard deviation of gaze as well as longer fixation durations for both tasks. The comparison between the two tasks indicates that drivers use the possibilities the self paced task offers: during the secondary task, they monitor the driving scene with longer fixations and show a greater standard deviation of gaze position. Furthermore, independently of the type of secondary task, drivers adapt their eye movement behavior to the demands of the situation. In critical driving situations they direct a larger proportion of glance time to the driving task. Last, the relation between glance behavior and collisions is analyzed. Results indicate that collisions go together with an inadequate distribution of attention during distraction. The results are interpreted regarding the attentional processes involved in driving with visual secondary tasks. Based on the similarities and differences between the two secondary tasks, a cognitive approach is developed which assumes that the control of attention during distraction is based on a mental situational model of the driving situation.     

流畅体验、内/外动机、数学焦虑及数学成绩的路径分析

目的：研究旨在考察数学学习中的流畅体验,探讨流畅体验、内/外动机、数学焦虑及数学成绩的关系。方法：招募296名高中生,在数学月考后完成自编考试流畅体验量表、学习动机量表、数学焦虑量表。结果：路径分析表明,存在四条显著路径,即内部动机→流畅状态→数学成绩;数学焦虑→流畅状态→数学成绩;外部动机→流畅状态→数学成绩;外部动机→数学成绩。结论：只有通过考试过程中的流畅体验,内部动机和数学焦虑才能影响考试成绩。     

青少年日常情绪调节问卷的编制

旨在编制青少年日常情绪调节问卷,通过增添对日常情绪诱发情境的描述,增强关于对青少年日常情绪调节测量的生态效度,获得更具有现实意义且真实的结果。根据访谈(n=30)获得诱发青少年日常情绪的典型情境,编制了问卷的项目;根据探索性因素分析(n=268)确定的正性情绪调节问卷项目为15个,负性情绪调节问卷项目为20个,皆抽取了四个因素分别命名为"认知重评"、"认知沉浸"、"表达抑制"、"表达宣泄"。经验证性因素分析(n=269)以及信度检验,问卷的各个心理测量学指标均符合要求,表明该结果具有良好的结构效度和内部一致性,可用作青少年日常情绪调节的测量工具。     

交互分析理论对改善人际交往困惑的应用

在心理咨询中,会遇到很多"老好人"来访者,这些老好人因不会拒绝别人而有苦难言。为更好地解决"老好人"式来访者的心理困惑,作者在交互分析理论的"人间游戏"基础上,发展并诠释了一个新的游戏——"老好人游戏"。通过对这一游戏模式的剖析,帮助咨询师充分了解"老好人"的行为模式及其背后的内心状态,对症咨询,真正实现心理咨询"助人自助"的目的。     

An exploratory path analysis of the factors contributing to life satisfaction in fathers

The purpose of this study was to present and test a model to examine those factors contributing to life satisfaction in fathers. A total of 268 fathers participated in this study. Path analysis was used to examine the direct and indirect influences of independent variables on life satisfaction in fathers. Results indicated that income and perceived family cohesiveness were the strongest variables in the model. Family cohesiveness mediated the effects of income, male role norms, conflict, and father involvement on life satisfaction. Income had the greatest total effect on life satisfaction. Perceived family cohesiveness and fathers’ education level followed income as the second and third most influential effects on life satisfaction. Results are discussed in light of the existing literature on family resilience, male role norms, and life satisfaction.     

The development of the Awe Experience Scale (AWE-S): A multifactorial measure for a complex emotion

ABSTRACT

Awe is a complex emotion composed of an appraisal of vastness and a need for accommodation. The purpose of this study was to develop a robust state measure of awe, the Awe Experience Scale (AWE-S), based on the extant experimental literature. In study 1, participants (N = 501) wrote about an intense moment of awe that they had experienced and then completed a survey about their experience. Exploratory factor analysis revealed a 6-factor structure, including: altered time perception (F1); self-diminishment (F2); connectedness (F3); perceived vastness (F4); physical sensations (F5); need for accommodation (F6). Internal consistency was strong for each factor (α ≥ .80). Study 2 confirmed the 6-factor structure (N = 636) using fit indices (CFI = .905; RMSEA = .054). Each factor of the AWE-S is significantly correlated with the awe items of the modified Differential Emotions Scale (mDES) and Dispositional Positive Emotion Scale (D-PES). Triggers, valence, and themes associated with awe experiences are reported.