A self-efficacy enhancing intervention for pulmonary rehabilitation based on motivational interviewing for postoperative lung cancers patients: modeling and randomized exploratory trial

The objective of this study was to evaluate the feasibility and preliminary efficacy of a self-efficacy enhancing intervention designed for pulmonary rehabilitation based on motivational interviewing (MI) for postsurgical non-small cell lung cancer (NSCLC) patients. This study was a 2-arm pilot randomized controlled trial and was conducted in two cardiothoracic surgery departments, a tertiary hospital in Fuzhou, China. 28 postsurgical NSCLC patients were randomized to a 3 month (6 session) self-efficacy enhancing intervention based on MI or usual care (UC). Data were measured at baseline and after intervention. The MI based self-efficacy enhancing intervention group was superior to the UC group for reducing anxiety and depression, improving self-efficacy, quality of life, confrontational coping, social support and functional capacity. However, no statistically significant difference was observed in subjective well-being, posttraumatic growth, body mass index and pulmonary function between the two groups. This pilot study demonstrated the feasibility of MI based self-efficacy enhancing intervention for postsurgical NSCLC patients. A larger randomized trial would demonstrate a more rigorous test of efficacy.     

Improving Fitness to Drive: The Case for Hazard Perception Training

On one hand, individuals who are unfit to drive should not be allowed behind the wheel. On the other hand, being unable to drive can have significant negative consequences for some individuals, including an increased mortality risk. One potential solution to this dilemma is to use training interventions to improve fitness‐to‐drive. The problem is that, in general, post‐licensing driver training and education has a disappointing track record in terms of improving road safety. However, one type of intervention that may have the potential to buck this trend is hazard perception training. Hazard perception, which is the driver's ability to anticipate dangerous situations on the road ahead, has been found to predict both crash risk and on‐road driving performance, and can account for variance in both of these criteria that other key fitness‐to‐drive measures cannot. Crucially, there is evidence that hazard perception competence can be improved by brief computer‐based interventions, even for driver groups who are more likely to face fitness‐to‐drive challenges, such as individuals aged over 65 years or adults with attention deficit hyperactivity disorder. This article puts the case for potentially using such interventions to help individuals with fitness‐to‐drive difficulties.     

Can Video Self-Modeling Improve Affected Limb Reach and Grasp Ability in Stroke Patients?

The authors examined whether feedforward video self-modeling (FF VSM) would improve control over the affected limb, movement self-confidence, movement self-consciousness, and well-being in 18 stroke survivors. Participants completed a cup transport task and 2 questionnaires related to psychological processes pre- and postintervention. Pretest video footage of the unaffected limb performing the task was edited to create a best-of or mirror-reversed training DVD, creating the illusion that patients were performing proficiently with the affected limb. The training yielded significant improvements for the forward movement of the affected limb compared to the unaffected limb. Significant improvements were also seen in movement self-confidence, movement self-consciousness, and well-being. FF VSM appears to be a viable way to improve motor ability in populations with movement disorders.     

Behavioral Interventions and Families: A Medical Rehabilitation Perspective

Behavioral interventions are pertinent to many issues faced by medical rehabilitation patients and their families in late adulthood. Despite their utility in managing chronic illnesses and reducing problematic behaviors related to cognitive impairment, behavioral interventions can be difficult to implement and maintain in a family setting. Problems resulting from countercontrol, caregiver fatigue, conflicting priorities, and impact on family relationships must be anticipated and addressed. These issues are illustrated through references to pertinent research and case examples. Recommendations are offered to reduce caregiver stress and to minimize shifts in relationships when family caregivers act to alter a member's behavior.     

疾病治疗与康复的自我效能模式及其意义

自我效能是指个体对其在特定情境中成功地完成某种活动的能力预期。患者的自我效能预期能以直接或间接的方式影响其行为表现和生理机能,从而影响到疾病治疗与康复效果。患者自我效能的形成与发展既受各种效能信息的影响,也受个体认知加工方式的影响。根据患者自我效能的形成与作用模式,可以采取不同的措施来提高患者的自我效能预期,发挥它在疾病治疗与康复中的作用。     

中世纪的修道院医学对近代西医体制化的影响

中世纪的修道院医学使超自然疾病观死灰复燃,从而严重阻碍了对疾病生理机制的探讨.但从医学社会体制的视角看,它孕育了近代医院与医学院的雏形,打破了古代医疗活动以家庭为中心的传统,促成了古代个体医学向近代群体医学的过渡.     

深层失读及其认知神经心理康复

以语义性错读为特征的深层失读症是一类特殊的阅读障碍类型,它的存在提示了人类在口语阅读过程中需要经过语义性通路。深层失读在拼音文字使用者中并不多见,但在汉语使用者中却多有发现,这种差别提示了汉字阅读与拼音文字阅读之间可能存在某种重要区别。该文概要介绍了深层失读的表现,比较了汉语深层失读与拼音文字深层失读的差异,阐述了深层失读的机制,同时介绍了深层失读病人的神经心理康复手段和方法     

认知损伤的评估

该文介绍了作为认知损伤临床评估最优方法的必要条件。评估的一个重要目的是将关于功能区域的优势和劣势的假设公式化,并据此设定适当的康复目标,评价康复的结果。为了达到这一目的,评估应该开始于康复之前,贯穿于康复过程,并持续到康复结束以后。文中比较了两种评估方法：量表法和假设检验法。为了考察认知损伤及其引起的障碍的变化,测验应该具有信度、敏感性和效度。量表法通常不具备这三个必要条件,而假设检验法在这方面更好。该文以一例获得性失语症的词语产出损伤评估为例,介绍了假设检验法的应用