Medical Psychology in Australia

Medical psychology in Australia is heavily influenced by British and American thought. The dominant model for clinical training and practice is the scientist–practitioner model, yet a gulf exists between academic and practice settings. Membership of the professional society requires 6 years of university study in psychology. However, registration requires only 4 years training in psychology. Medical psychologists provide a broad range of services in hospital and community settings, often within multidisciplinary teams. Challenges for the future include bridging the divide between university and health settings, increasing qualifications required for registration, making psychology culturally relevant, and demonstrating to funding managers that psychological interventions are both clinically effective and cost effective.     

Referral Source Differences in Functional Impairment Levels for Children Served in the Comprehensive Community Mental Health Services for Children and Their Families Program

We report one of the first multi-site investigations into referral source variation in functional impairment for children with serious emotional disturbance served in systems of care settings. Baseline data collected as part of the national evaluation for the Comprehensive Community Mental Health Services for Children and Their Families Program was used to assess the comparability of functional status for children referred from traditional mental health versus non-mental health agencies. Results indicate that children referred from child welfare and family groups have significantly lower levels of overall dysfunction than those referred from mental health, while children referred from school and juvenile justice agencies have comparable levels. Clinical and research implications are discussed.     

The Current State of Medical Psychology in Iran

This paper reviews medical psychology in Iran and describes the two major professional associations representing the profession. The unique role of religion in Iran is stressed, and limitations of the current health care system are described. The paper also addresses human resource issues and the educational requirements for the practice of psychology in Iran.     

Psychological Distress in Caregivers of Liver and Lung Transplant Candidates

Although organ transplantation represents a stressful experience for the entire family, surprisingly little research has focused on the adjustment of caregivers. The purpose of this study was to examine what caregivers report to be the greatest benefits and stressors pretransplant, the prevalence of psychological distress and caregiver strain in pretransplant caregivers as compared to normative populations, and the physical, psychological, and demographic variables that predict distress. Fifty-two caregivers of transplant candidates (28 liver and 24 lung) completed a series of questionnaires, including the Psychosocial Adjustment to Illness Scale (PAIS-SR), SF-36 Health Survey, Caregiver Strain Index (CSI), and qualitative questions about benefits and stressors. The most commonly reported benefit of being a caregiver could be categorized as Helping the Patient, and the most common stressors were associated with Uncertainty/Waiting/Fears. Compared to normative samples of caregivers of patients with Alzheimer's disease, caregivers of liver transplant candidates reported more caregiver strain; there were no differences for lung transplant caregivers. Caregiver social functioning was found to be the only significant predictor of caregiver distress, with those caregivers who report greater distress also reporting extreme and frequent interference with normal social activities. Implications of these findings for psychological interventions are discussed.     

A Test and Refinement of the Demand–Control–Support Model in the Construction Industry

This study aims at a test and further refinement of the Demand–Control–Support (DCS) model among construction workers (N = 210). On the basis of theory and empirical evidence, we hypothesized that mental or physical job demands, low job control, and lack of social support at work have direct and synergistic effects on burnout. The model was expanded by hypothesizing that burnout mediates the relationships between these potentially demanding working conditions on the one hand, and health complaints on the other. Results of a series of structural equation analyses partly supported these hypotheses. The proposed model fitted adequately to the data, although some variables in the DCS model did not make a unique contribution to explaining variance in burnout and (indirectly) health complaints. Interestingly, lack of social support was the most important determinant of burnout and health complaints among construction workers. In addition, a significant three-way interaction effect partly confirmed the synergism hypothesis: Physical demands were only related to burnout if participants had poor job control and reported high social support. The implications of these findings for research and practice are discussed.     

Managing Job Stress in the Netherlands

Compared with other countries, in the Netherlands work pressure and sickness absenteeism and work incapacitation rates due to work-related mental health problems are quite high. About a decade ago a new Working Conditions Act (WCA) was introduced that had far-reaching consequences for the way job stress is dealt with in organizations. The WCA emphasizes the central role to be played by commercially operating Occupational Health and Safety Services (OHSSs), and it defines a new kind of professional—the Work & Organizational Expert—who is primarily responsible for the assessment and prevention of job stress. Recently, a number of instruments have been developed for psychosocial risk assessment that are now widely used on a regular basis in a way prescribed by the WCA. Preventive measures are increasingly taken by organizations in order to reduce job stress and sickness absenteeism. Based on the Dutch approach some lessons may be learned. Recommendations pertain to (1) the role of government, (2) legal recognition of psychosocial work factors, (3) the privatization of the occupational health and safety sector, and (4) evaluation of job stress prevention programs.     

Patterns of Natural Language Use: Disclosure, Personality, and Social Integration

When people write about their deepest thoughts and feelings about an emotionally significant event, numerous benefits in many domains (e.g., health, achievement, and well-being) result. As one step in understanding how writing achieves these effects, we have developed a computer program that provides a "fingerprint" of the words people use in writing or in natural settings. Analyses of text samples indicate that particular patterns of word use predict health and also reflect personality styles. We have also discovered that language use in the laboratory writing paradigm is associated with changes in social interactions and language use in the real world. The implications for using computer-based text analysis programs in the development of psychological theory are discussed.     

卫生系统绩效评估及其思考—《2000年世界卫生报告》的启示与思索

世界卫生组织在《2000年世界卫生报告－卫生系统：改进绩效》中,对191个成员国的卫生系统绩效进行了评估和排序。介绍了这一评估的框架和主要结果;提出对卫生系统绩效评估的启示与思考,认为我国应反思卫生改革绩效并客观地作出评价,为在新世纪促进卫生系统更好地发展和调整卫生改革目标作出明智的选择。