儿童抑郁症的综合治疗

儿童抑郁症的比例近年来有逐渐上升趋势,但是却未受到充分的重视,解决方式也容易陷入误区。儿童抑郁症,临床表现为生理、行为、情绪、认知等多个方面,病因则涉及到生理遗传、家庭环境、学校教育、社会变迁等因素。因而,其治疗手段也应是整体性的,包括家庭、心理、药物、行为等方面。     

在家庭自由游戏和智力任务游戏中母亲对孩子的态度特征

采用家庭观察的方法,考察了61名3—4岁儿童在家庭环境中的两个情境——自由游戏和带有智力任务倾向的拼图游戏中,其母亲对他们的态度和行为的特征,结果发现：(1)母亲在2种类型的游戏中对待孩子的态度和行为可以从母亲对孩子的控制性(高控、低控)、温暖性(接受和拒绝)、言语交流和参与性4个维度做出评价。(2)当儿童的游戏从自由游戏转为带有智力任务倾向的游戏时,母亲对待孩子的态度和行为方式发生明显变化,直接要求、提问等高控行为增多,互相商量等低控行为减少;对孩子的拒绝行为和态度增强,而肯定、爱抚、积极情绪等接受行为减少;与孩子的言语交流和参与行为减少。(3)在上述2种游戏情境中,母亲对待孩子的态度表现出个别差异,在自由游戏情境中,42．6％的母亲为宽松型,32．8％的母亲为温暖型,24．6％的母亲为交流型。在带有智力任务倾向的游戏中,54％的母亲为宽松型,23％的母亲为低控型,23％的母亲为高控型。     

Does it matter where you work? A comparison of how three work venues (traditional office, virtual office, and home office) influence aspects of work and personal/family life

Millions use electronic tools to do their jobs away from the traditional office. Some labor in a “virtual office” with flexibility to work wherever it makes sense and others telecommute primarily from home. This IBM study compares how three work venues (traditional office, n=4316, virtual office, n=767, and home office, n=441) may influence aspects of work (job performance, job motivation, job retention, workload success, and career opportunity) and personal/family life (work/life balance and personal/family success). Perceptions, direct comparisons, and multivariate analyses suggest that the influence of the virtual office is mostly positive on aspects of work but somewhat negative on aspects of personal/family life. The influence of the home office appears to be mostly positive and the influence of traditional office mostly negative on aspects of both work and personal/life. Implications of these findings are discussed.     

Children's Cooperation at School: The Comparative Influences of Teacher Responsiveness and the Children's Home-Based Behavior

Examined the school social interactions of 33 child-teacher dyads who volunteered to participate in a 1-hr classroom observation. Observers coded child compliance, aggregate measures of the children's responsiveness and negativity, and the teachers' responsiveness to the children. In addition, observers coded the same three child behaviors in 1-hr observation sessions in the children's homes. Based on a state-trait model of social behavior, correlational analyses were used to predict the children's school behavior using measures of the children's home behavior and teacher responsiveness. Results showed that teachers' responsiveness covaried with children's responsiveness and negativity, and the children's home behavior also accounted for significant variance in their school behavior. When these home and school predictors were compared, teachers' responsiveness accounted for most of the variance in the children's classroom negativity, but children's home responsiveness was the better predictor of their responsiveness in the classroom. The findings were discussed within a state-trait model of children's social behavior.     

论护理学是医学中人文精神的主要承载者

医学是"以人为本"的科学,对病人的关怀照顾是医学中人文关怀的主要体现,护理学作为医学的分支科学,是以女天赋的母性慈爱为基础,以对病人的关怀照顾为目的的学问,所以,护理学是医学中人文精神的主要承载者.     

危机管理在急诊护理管理中的应用

本文概述了急诊护理危机管理的含义,分析了当前急诊科护理危机的隐患因素,并进一步探讨危机管理在急诊护理管理中应用时的具体措施。阐述了强化危机管理在现代急诊护理管理中的重要作用,提出应最大限度防范与控制急诊护理危机,全面提高急诊科护理管理水平。     

护理健康教育与治疗性沟通的比较与思考

根据近年来有关护理健康教育和治疗性沟通的研究,从护理健康教育和治疗性沟通的概念、适用范畴、实施的模式、实施的程序、实施的主客体等角度对两者进行比较和思考,以解决目前临床对两者的困惑。提出治疗性沟通和规范护理健康教育协同进步才是护理学发展之未来。     

Integrating Care for Persons, Not Only Diseases

Integrated care is geared toward enhancing usual care and decision-making for common combinations of medical and mental health conditions, including the behavioral health and behavioral change aspects. Yet even with comprehensive and well-integrated care for health conditions and well-coordinated teamwork in place, some patients do not engage or respond to care in the way clinicians would like or predict. This troubles patients and clinicians alike and may be chalked up informally to things like medical complexity (multiple co-existing conditions), mental health conditions (that complicate care), or simply the case being considered complex or difficult. It also raises the question of how to address person-specific factors that interfere with care of whatever conditions the patient may have, and invites behavioral health clinicians in medical settings to look beyond care of conditions to the care of persons, and to look beyond disease-specific care management protocols to master generic practices of care management across whatever conditions the person may have. This person-centered emphasis is intrinsic to the concept of the “patient-centered medical home” which has burst into animated discussion and demonstration among providers, health plans, government plans, employer purchasers, and professional associations across public and private entities. This represents an opportunity for collaborative care clinicians to help shape the national state of the art in medical home and includes a range of person-oriented (rather than disease-oriented) practices for care management, including working systematically with complex patients and difficult patient–clinician relationships.     

HOLDING ONE ANOTHER (WELL, WRONGLY, CLUMSILY) IN A TIME OF DEMENTIA

Abstract: This essay takes a close look at a species of care that is particularly needed by people with progressive dementias but that has not been much discussed in the bioethics literature: the activity of holding the person in her or his identity. It presses the claim that close family members have a special responsibility to hold on to the demented person's identity for her or him, and offers some criteria for doing this morally well or badly. Finally, it considers how even those with dementia can hold others in their identities, and suggests that this kind of holding too can have great moral worth.     

Rationale for Individualizing Interventions to Promote Adjustment to the Nursing Home

This study was designed to determine whether certain variables were predictors of nursing home residents' membership in groups representing qualitative categories of nursing home adjustment. Responses of 186 residents to an open-ended question about how they handled the change to nursing home life were coded as very good, fair, or poor; an adjustment variable was created on the basis of this classification. Analysis of variance of random samples from each adjustment group showed that affect and social support varied significantly with adjustment. However, when discriminant analysis was applied, the three groups could not be differentiated using measure of affect, life satisfaction, social support, participation in the decisions leading to admission, nursing home satisfaction, or health. Based on the conclusion that adjustment to the nursing home is a unique experience for each individual, strategies were proposed for individualizing interventions to enable adjustment.