精神分裂症心理社会治疗

药物治疗虽然能改善精神分裂症的许多显性症状,而复发、残留症状和功能衰退单靠药物是不能解决的。从现代医学的角度看精神分裂症的预防与康复应该采取整体、多维度、综合性预防和康复措施,在进行生物学治疗的同时给予心理社会治疗,使病人达到最好的疗效。     

Addressing Consent Issues in Donation After Circulatory Determination of Death

Given the widening gap between the number of individuals on transplant waiting lists and the availability of donated organs, as well as the recent plateau in donations based on neurological criteria (i.e., brain death), there has been a growing interest in expanding donation after circulatory determination of death. While the prevalence of this form of organ donation continues to increase, many thorny ethical issues remain, often creating moral distress in both clinicians and families. In this article, we address one of these issues, namely, the challenges surrounding patient and surrogate informed consent for donation after circulatory determination of death. First we discuss several general concerns regarding consent related to this form of organ donation, and then we address additional issues that are unique to three different patient categories: adult patients with medical decision-making capacity or potential capacity, adult patients who lack capacity, and pediatric patients.     

Re-work: a new Japanese support system for reinstatement

Re-work is a new treatment technique that follows the conventional Japanese approach, which includes rest and pharmacotherapy. The aim of re-work is to prevent repeated sick leave by helping individuals reflect on the reasons behind the sick leave and improve stress-related coping skills. Re-work participants prepare in an environment similar to their workplaces at a medical institution or a specialised public facility for several months before returning to work. As re-work is undertaken via group work, this has benefits beyond those which can be achieved by an individual alone. The reinstatement effects of re-work are now starting to be verified. Issues of interest for re-work include its unified concept-based programme, and the need to further verify its clinical efficacy and cost-effectiveness.     

注意缺陷多动障碍儿童教育康复线上模式的构建

注意缺陷多动障碍(简称ADHD)是一种常见的儿童神经发育性障碍。当前用于儿童ADHD的传统(线下)教育康复模式存在缺少学业实效、教师低参与、学校管理经验不足以及遇到特殊情况(如疫情)无法服务等问题。本研究在脑电生物反馈认知训练的基础上, 以解决问题和循证研究为设计思路, 为中国ADHD患儿构建教育康复线上模式并进行初步应用。本研究分为3个子研究：研究1采用访谈法和问卷调查法对中国儿童ADHD教育康复的现状调查并分析患儿及关键相关人(家长和教师)需求; 研究2采用随机对照单盲试验(干预组和对照组各为50人), 评价基于脑电生物反馈认知训练(NCT)的教育康复线上模式的有效性; 研究3采用一个更大被试样本量(每组n = 100)的(家长为中介人干预组/教师为中介人干预组/对照组)×(诊断组/亚诊断组)随机对照研究评价由干预中介人(家长或教师)参与的线上模式的有效性, 以及一个纵向质性研究发现关键相关人对于线上模式的接受情况。研究旨在为中国ADHD患儿提供一个有效且好用的教育康复形式。     

The Body-Machine Interface: A New Perspective on an Old Theme

ABSTRACT

Body-machine interfaces establish a way to interact with a variety of devices, allowing their users to extend the limits of their performance. Recent advances in this field, ranging from computer interfaces to bionic limbs, have had important consequences for people with movement disorders. The authors provide an overview of the basic concepts underlying the body-machine interface with special emphasis on their use for rehabilitation and for operating assistive devices. They outline the steps involved in building such an interface and highlight the critical role of body-machine interfaces in addressing theoretical issues in motor control as well as their utility in movement rehabilitation.     

Self-blame attributions,control appraisals and distress among cardiac rehabilitation patients

This study examined associations between self-blame attributions, control appraisals and distress among cardiovascular disease patients participating in a cardiac rehabilitation (CR) programme. Questionnaire data were collected from 129 patients at the beginning and end of CR. We found little evidence that characterological self-blame (CSB) affects distress symptoms, but behavioural self-blame at the beginning of CR was positively associated with distress symptoms concurrently, and 12 weeks later. Furthermore, diet- and exercise-focused self-blame was only modestly, positively related to control appraisals concurrently, while CSB was negatively associated with control. Prospectively, we found few significant associations between self-blame and control. Results imply that making any type of self-blame attribution during CR does not aid in adjustment or enhanced control appraisals. Our findings suggest that CR staff should encourage patients to recognise their control over reducing risk for recurrence, but should discourage patients from looking backward and ruminating about factors that may have contributed to disease onset.     

Two alternative models of health behaviour and recovery from activity limitations due to acute injury: A prospective study

Cognitions influence recovery from activity limitations. In this study we aimed to independently test, compare and combine the common sense self-regulation model (CS-SRM) and social cognitive theory (SCT) in predicting recovery from activity limitations due to acute injury. Measures were gathered at two time points 5–6 weeks apart. The sample consisted of 146 university students (Mean age: 21.86, SD: 4.83, 62% female) with a heterogeneous range of injuries that limited their participation in physical activity. The dependent variable was recovery from activity limitations (Physical Functioning?–?Short Form-36). The predictor variables were measured using the Brief Illness Perception Questionnaire and SCT items designed according to theoretical recommendations. Time-line (TL) and self-efficacy (SE) were significant predictors of recovery in a multivariate analysis, controlling for reported pain at Time 1. A combined model including the best predictors from both models, TL (β = ?0.25, p < 0.05, R ² change = 0.17, p < 0.01) and SE (β =0.31, p < 0.05, R ² change = 0.05, p < 0.05), accounted for a significant amount of the variance in recovery from activity limitations. A combination of key variables from both models may be particularly useful for understanding the cognitive factors that influence recovery from activity limitations.     

A comparison of pain management outcomes for disability compensation and non-compensation patients

Abstract

In this study, 50 men in an in-patient comprehensive rehabilitation program receiving disability compensation were compared with 25 non-recipients with respect to pre-and post-program measures of personality functioning. physical functioning and reported pain. On the pre-program measures. the only significant difference emerging between the two groups was found on the Mf scale of the MMPI, with the compensation group showing a slightly lower mean score. The two groups responded equally well on virtually all outcome measures. One interesting exception was found on the subjective measure of pain. which showed the compensation group reporting a higher level of subjective pain, and the non-compensation group a lower level than would be predicted on the basis of pre-program scores. Overall. and contrary to popular belief. the results suggest that compensation recipients can derive considerable benefit from pain management interventions despite the ostensible reinforcement provided by disability payments.     

Assessment,Treatment, and Rehabilitation for Interpersonal Violence Victims

Abstract

Psychotherapists who have received minimal training in neuropsychology do not consider cognitive rehabilitation among the treatment options for their clients who have mild traumatic brain injury (mTBI). Historical perspectives on mTBI did not acknowledge brain plasticity and/or rehabilitation, yet rehabilitation might provide a necessary foundation for a client to be able to benefit from traditional feminist psychotherapy. This article provides an overview of two treatment modalities, biofeedback and neuropsychologically-informed feminist psychotherapy, for women with mTBI who sought relief from interstitial cystitis and headaches. Assessment for neuropsychological treatment planning and monitoring is illustrated with employment of the Ackerman-Banks Neuropsychological Rehabilitation Battery. Clinical examples are provided to demonstrate a variety of manifestations of mTBI and responses to treatment.     

Burnout during a long-term rehabilitation: comparing low burnout,high burnout – benefited,and high burnout – not benefited trajectories

Abstract

To focus rehabilitation activities among burnout clients more effectively, it is important to investigate who benefits from burnout interventions. This study (N=85) aimed at identifying burnout trajectories in terms of benefit, that is, subgroups of clients who share similar mean levels and changes in burnout during a one-year rehabilitation intervention (17 days in total) with a six-month follow-up. After identifying the burnout trajectories, the relations of the trajectories with factors describing the clients, antecedents, and consequences of burnout during the one-year intervention were examined. Three burnout trajectories were identified by growth mixture modeling: (a) low burnout (n=39), (b) high burnout – benefited (n=29), and (c) high burnout – not benefited (n=17). Positive changes were detected in antecedents and consequences among the clients in the low burnout and high burnout – benefited trajectories. Recovery from burnout was associated with increased job resources and decreased job demands, as well as with increased job satisfaction and decreased depression. It seems that more precise targeting of rehabilitation is needed since the trajectories revealed not only clients with mild symptoms, but also clients who probably received this treatment too late.