Do Student Evaluations of University Reflect Inaccurate Beliefs or Actual Experience? A Relative Rank Model

It was shown that student satisfaction ratings are influenced by context in ways that have important theoretical and practical implications. Using questions from the UK's National Student Survey, the study examined whether and how students' expressed satisfaction with issues such as feedback promptness and instructor enthusiasm depends on the context of comparison (such as possibly inaccurate beliefs about the feedback promptness or enthusiasm experienced at other universities) that is evoked. Experiment 1 found strong effects of experimentally provided comparison context—for example, satisfaction with a given feedback time depended on the time's relative position within a context. Experiment 2 used a novel distribution‐elicitation methodology to determine the prior beliefs of individual students about what happens in universities other than their own. It found that these beliefs vary widely and that students' satisfaction was predicted by how they believed their experience ranked within the distribution of others' experiences. A third study found that relative judgement principles also predicted students' intention to complain. An extended model was developed to show that purely rank‐based principles of judgement can account for findings previously attributed to range effects. It was concluded that satisfaction ratings and quality of provision are different quantities, particularly when the implicit context of comparison includes beliefs about provision at other universities. Quality and satisfaction should be assessed separately, with objective measures (such as actual times to feedback), rather than subjective ratings (such as satisfaction with feedback promptness), being used to measure quality wherever practicable. © 2014 The Authors. Journal of Behavioral Decision Making published by John Wiley & Sons Ltd.     

The impact of job demands,climate, and optimism on well-being and distress at work: What are the mediating effects of basic psychological need satisfaction?

IntroductionPsychological health at work, a multidimensional concept grasped by the absence of negative states and by the presence of positive states, is here approximated in terms of distress and well-being.ObjectiveThis study was aimed at examining the extent to which job demands, individual resources (optimism), and organizational resources (climate) are linked to well-being and distress at work. We looked at whether these links are mediated in satisfaction of the three basic psychological needs posited in self-determination theory (competence, relatedness, and autonomy).MethodThe participants were 298 French elementary, middle, and high school teachers who were asked to answer a questionnaire. The data was analyzed using Hayes and Preacher's method for testing multiple mediations.ResultsSatisfaction of the psychological needs for competence and relatedness fully mediated the links between job climate and psychological health at work (well-being and distress). Optimism turned out to be an important factor of health, not only because it had a strong impact on well-being and distress, but also because its effects were partially mediated by satisfaction of the need for competence.ConclusionThe present results confirm the relevance of the variables used to predict psychological health (particularly optimism). Job demands directly affected well-being and distress levels. The climate — by way of satisfaction of the need for competence and for relatedness — plays a critical role in matters of occupational health.     

The relationship between employment quality and work-related well-being in the European Labor Force

In this article, data from the 2005 European Working Conditions Survey are used to examine the relationship between contemporary employment arrangements and the work-related well-being of European employees. By means of a Latent Class Cluster Analysis, several features of the employment conditions and relations characterizing jobs are combined in a typology of five employment arrangements: SER-like, instrumental, precarious unsustainable, precarious intensive and portfolio jobs. These job types show clear relationships with separate indicators of job satisfaction, perceived safety climate and the ability to stay in employment, as well as with an overall indicator for work-related well-being. The findings from this multifaceted approach towards employment quality raise questions about the long-term sustainability of highly flexible and de-standardized employment arrangements.     

Empirical Priors in Polytomous Computerized Adaptive Tests: Risks and Rewards in Clinical Settings

The use of empirical prior information about participants has been shown to substantially improve the efficiency of computerized adaptive tests (CATs) in educational settings. However, it is unclear how these results translate to clinical settings, where small item banks with highly informative polytomous items often lead to very short CATs. We explored the risks and rewards of using prior information in CAT in two simulation studies, rooted in applied clinical examples. In the first simulation, prior precision and bias in the prior location were manipulated independently. Our results show that a precise personalized prior can meaningfully increase CAT efficiency. However, this reward comes with the potential risk of overconfidence in wrong empirical information (i.e., using a precise severely biased prior), which can lead to unnecessarily long tests, or severely biased estimates. The latter risk can be mitigated by setting a minimum number of items that are to be administered during the CAT, or by setting a less precise prior; be it at the expense of canceling out any efficiency gains. The second simulation, with more realistic bias and precision combinations in the empirical prior, places the prevalence of the potential risks in context. With similar estimation bias, an empirical prior reduced CAT test length, compared to a standard normal prior, in 68% of cases, by a median of 20%; while test length increased in only 3% of cases. The use of prior information in CAT seems to be a feasible and simple method to reduce test burden for patients and clinical practitioners alike.     

移动医疗视域下HIV/AIDS患者自我管理体验及需求的质性研究

采用目的抽样选取成都市、绵阳市及西昌市19名HIV/AIDS患者作为研究对象,采用描述性质性研究对研究对象进行半结构式访谈,对访谈结果进行主题分析,共提炼出一级主题5个：（1）患者有基于移动医疗的自我管理需求;（2）基于移动医疗自我管理平台期望载体及形式;（3）基于移动医疗的医疗或行为管理需求;（4）基于移动医疗的角色管理需求;（5）基于移动医疗的情绪管理需求。患者对基于移动医疗的自我管理平台有较高接受度。可设计开发易用性与隐私性强的移动医疗平台,通过提供疾病知识、线上诊疗、疾病监测与心理社会支持等功能,提升患者自我管理能力。

     

患者就医伦理责任认知问卷的编制与信效度检验分析

采用文献分析法,结合专家咨询,对患者就医伦理责任进行概念与范畴界定,拟定问卷条目。采用随机抽样调查法对南通市某三级甲等医院的患者进行问卷调查。问卷可划分为责任范畴认知、责任态度信念两个维度,共计18道条目,累计方差贡献率为82.434%。项目分析中各分析项均呈现出显著性差异（P＜0.05）。问卷总体的Cronbach's α系数为0.979,内容效度为0.910,在结构效度分析中,问卷因子分析KMO值为0.971,聚敛效度和区分效度皆达到标准。本问卷具有良好的信效度,可为日后进一步的研究分析提供科学可靠的依据。

     

重大传染病感染患者的道德创伤隐患研究

重大传染病疫情背景下,病原体的不断变异、疫苗保护效力的不确定性以及诸多后遗症会导致疫情难以控制,并且造成一个数量极其庞大的特殊弱势群体—感染患者。在感染患者从疑似患病到康复的期间,影响他人工作生活、恶化疫情防控形势、感染他人、亲友的抛弃、传染病污名化、医疗资源分配不均以及社会的歧视与排挤等潜在的道德创伤源会对其内心原本的道德体系产生巨大的冲击,甚至改变其原有的道德认知并击溃其积极的道德情感,从而产生道德创伤。在此基础上,感染患者会因此产生一系列社会问题、信任问题、精神问题、生存问题以及诸多消极观念。

     

叙事医学反思性写作对共同决策价值探析

以叙事医学工具反思性写作为切入点,首先从医方、患方及外部环境三个角度分析了当前医患共同决策所面临的临床实践困境,其次在对反思性写作概念、实践特点概述的基础上,提出了叙事能力对临床工作的重要性、叙事医学伦理对决策困境的作用,最后从促使医方自我反思,避免引导式决策及权威主义;弥合医患视阈差异,达成决策共识;阐明并澄清患者偏好及价值观,促进个体化共同决策;提高患者参与决策意愿,调动参与决策积极性;缓和医患关系,实现医患共情,促进共同决策良性互动五个方面阐述了反思性写作对医患共同决策困境的助力作用。

     

医务人员对医患共同决策辅助工具的态度研究

循证医学实践要求在临床决策中整合最佳临床研究证据、医者经验、患者自身价值取向与所处具体临床情境。使用决策辅助工具进行医患共同决策可作为一种实践模式,有必要了解来自临床一线医务人员的态度。采用多阶段分层抽样方法,于国内11省及3个直辖市共32个城市的51所二级和三级医院发放问卷,探究使用决策辅助工具促进共同决策实施的可能性。对1 212份问卷的分析显示,73.2%的医务人员认可患者是高质量临床决策的参与主体;支持患者获知诊疗决策依据、认同患者决策辅助工具的积极效果与高学历等正相关。     

艾滋病防控中获取患者信息的伦理问题刍议

当前艾滋病获取患者信息中,存在公私观念上的摩擦、相关规定与环节存在疏漏、对信息弱势群体关照不足的伦理难题。问题背后包含着患者为了公共健康的伦理目的却又失去伦理关系的风险,“失德”名声带来的耻感与歧视,遵守政策规范却缺少应有的尊重与保护等矛盾。问题的解决需要在文化背景和利益关系下思量个人身心秩序与社会整体秩序间如何权衡,结合历史、理论与现实维度提出路径。“信”的建立是关键所在,包括公共卫生部门公信力的树立和相应制度措施建设,同时在信息活动中需要给“私”以合理地位,并注重艾滋病治疗相关医学信息的宣传。