Exploring the transitional process from receiving a diagnosis to living with motor neurone disease

Motor neurone disease (MND) is a rapidly progressing neurodegenerative condition that results in a marked reduction in life expectancy. Currently, little is known about the experiences of people after they have received this diagnosis and the effect of this on their sense of self and identity. In this study, interpretative phenomenological analysis was used to explore both the personal and lived experiences of people with MND. Seven people diagnosed with MND within the previous six months were recruited. The three themes constructed from the participants’ accounts were ‘Then they dropped the bomb shell’; Receiving a diagnosis of MND; ‘Getting on with it’; Learning to live with MND; and ‘A lot of normal life is lost’; Experiencing progressive loss. Participants described receiving a diagnosis as a devastating experience but most participants were able to accept their diagnosis and employ adaptive strategies to cope with increasing levels of functional decline. However, in spite of this, the participants experienced functional changes that affected their identity, social status and social relationships.     

Applying multiple models to predict clinicians’ behavioural intention and objective behaviour when managing children's teeth

This study used multiple theoretical approaches simultaneously to predict an objectively measured clinical behaviour. The six theoretical approaches were: The Theory of Planned Behaviour (TPB), Social Cognitive Theory (SCT), Common Sense Self-Regulation Model (CS-SRM), Operant Learning Theory (OLT), Action Planning (AP) and the Precaution Adoption Process (PAP), with knowledge as an additional predictor. Data on variables from these models were collected by postal survey. Data on the outcome behaviour, the evidence-based practice of placing fissure sealants, was collected from clinical records. Participants were 133 dentists (64% male) in Scotland. Variables found to predict the behaviour were: intention, attitude, perceived behavioural control, risk perception, outcome expectancies, self efficacy, habit, anticipated consequences, experienced consequences and action planning. The TPB, SCT, AP, OLT and PAP significantly predicted behaviour but the CS-SRM did not. A combined (Stepwise) regression model included only intention and action planning. Post hoc analyses showed action planning mediated effect of intention on behaviour. Taking a theory-based approach creates a replicable methodology for identifying factors predictive of clinical behaviour and for the design and choice of interventions to modify practice as new evidence emerges, increasing current options for improving health outcomes through influencing the implementation of best practice.     

Psychological effects of permanently implanted false teeth: A 2-year follow-up and comparison with dentate patients

Abstract

The treatment of patients who have suffered total tooth loss (edentulism) has always posed many problems in dental care, since removable dentures cannot restore function completely and can often result in pain and mouth ulcers. An important recent advance is the development of “osseointegrated implants”. This technique involves the insertion of titanium screws into the jawbone and the denture is then attached to this fixed bridge. A previous controlled study (Kent and Johns, 1991) has shown that in the short term this technique is associated with a reduction in psychological distress and the number of dentally disabling symptoms, but no change in self-esteem. The aims of the current study were to (a) conduct a longer-term follow-up of these patients (the implant group) and (b) compare their adjustment with patients who possess their natural teeth (the dentate group). Twenty implant patients completed the General Health Questionnaire (GHQ), Rosenberg's self-esteem scale (Rosenberg, 1965) and a check-list of disabling symptoms on three occasions: before treatment, six months and 24 months post-treatment. Sixty-one dentate patients from four general dental practices completed the same questionnaires on a single occasion. In the implant group at 24 months, the number of psychological symptoms (GHQ) had returned to the pre-treatment level, even though the reduction in the number of disabling symptoms was maintained. Self-esteem remained unchanged. There was considerable individual variation in changes in GHQ scores, although, on average, the implant group's level of well-being at 24 months was similar to the dentate patients' on all measures.     

A meta-analysis of studies on psychological preparation of children facing medical procedures

Abstract

The results of a meta-analysis of 75 controlled intervention studies between 1953 and 1985 concerning psychological preparation of children facing medical procedures are analyzed. Both the subject matter and methodological characteristics of the studies were subjected to multiple coding procedures. 125 controlled comparisons were carried out in the 75 studies. and 916 individual effect sue scores were calculated. The overall effect size was found to be 0.44. The effectiveness of modeling techniques, which were wed most frequently. was below average. With regard to coping-modeling films, systematic desensitization and cognitive-behavioral packages, the effect of psychological preparation is dependent in large pan on the methodological quality of the control strategy. Very few evaluations have been made of interventions with children considered to be at risk for psychological stress. Preparation r measures can attain higher effect rue scores when they are undertaken in conjunction with major medical operations. series of treatments or children in poor health. With regard to the validity of the studies analyzed, no relationship could be found with the effect size scores. In general, the poor level of documentation of the reported research findings is criticized.     

Unhealthy weight control behaviours in adolescent girls: a process model based on self-determination theory

This study used self-determination theory (Deci, E.L., & Ryan, R.M. (2000). The ‘what’ and ‘why’ of goal pursuits: Human needs and the self-determination of behavior. Psychological Inquiry, 11, 227–268.) to examine predictors of body image concerns and unhealthy weight control behaviours in a sample of 350 Greek adolescent girls. A process model was tested which proposed that perceptions of parental autonomy support and two life goals (health and image) would predict adolescents’ degree of satisfaction of their basic psychological needs. In turn, psychological need satisfaction was hypothesised to negatively predict body image concerns (i.e. drive for thinness and body dissatisfaction) and, indirectly, unhealthy weight control behaviours. The predictions of the model were largely supported indicating that parental autonomy support and adaptive life goals can indirectly impact upon the extent to which female adolescents engage in unhealthy weight control behaviours via facilitating the latter's psychological need satisfaction.     

The adaptive effect of personal control when facing breast cancer: Cognitive and behavioural mediators

This prospective study examines the cognitive and behavioural mediators of the relation between personal control and the initial response to a breast cancer diagnosis as well as subsequent psychological adjustment. A total of 143 patients participated immediately after diagnosis (T1), after surgery (T2) and 2 months after the end of treatment (T3), of whom 92 also completed a questionnaire pre-diagnosis (T0). The buffering effect of personal control on psychological distress shortly after diagnosis was mediated by cancer-specific cognitions, i.e. threat appraisal and coping self-efficacy. Moreover, a strong sense of personal control predicted lower levels of anxiety 2 months after the end of treatment, but was unrelated to distress at T3. The adaptive effect on anxiety was mediated by threat appraisal and active engagement in social life after surgery, but not by active patient participation or coping self-efficacy. These results confirm and explain the adaptive effect of control. Apparently, women with a low sense of control appraise cancer and their personal coping skills more negatively, which makes them vulnerable to distress in response to diagnosis. Furthermore, women with a strong sense of control might regulate anxiety by remaining engaged in social life.     

The wonderful adventures of Nils: or Taking leave of childhood

The relationship between neuroscience and psychoanalysis is studied by taking “the new mechanism of neuroscience” under scrutiny. That new trend stresses that neuroscientific explanations are mechanistic explanations in particular. Since the issue of psychological mechanisms lies at the core of psychoanalysis, it is crucial to study the relationship between neural and psychological mechanisms. The authors argue that neuroscience cannot verify psychoanalytic theories. However, by combining neuroscientific and psychoanalytic (psychological) viewpoints, it will be possible to approach a more holistic picture of psychological phenomena, here suggested by a new conception of defense mechanisms.     

Adolescent stress: Evaluation of the factor structure of the Adolescent Stress Questionnaire (ASQ‐N)

Moksnes, U. K., Byrne, D. G., Mazanov, J. & Espnes, G. A. (2010). Adolescent stress: Evaluation of the factor structure of the Adolescent Stress Questionnaire (ASQ‐N). Scandinavian Journal of Psychology, 51, 203–209. The present study reports an evaluation of the factor structure of the Norwegian version of the Adolescent Stress Questionnaire (ASQ‐N) among 723 students. Principal components analysis (PCA) revealed nine internally consistent dimensions of adolescent stress. Scales constructed from this PCA correlated positively with measures of depression and anxiety and negatively with self‐esteem. Girls reported higher stress levels than boys in seven of the nine scales and age was also positively correlated with the scale scores of adolescent stress. The results revealed that the instrument has potential for measuring adolescent stress. The stability of the ASQ‐N needs to be tested repeatedly, across cohorts and over time, to establish the adequacy for use in Norwegian adolescent studies.     

新生儿重症监护室患儿家属焦虑和心理需求的调查研究

了解NICU家属的焦虑和心理需求,分析原因和对策。采用SAI和CCFNI量表来测定200名家属的焦虑及心理需求。结果家属SAI得分明显高于常模,且女性高于男性;家属的各项心理需求中最需求的是患儿的病情保证,而自身有关的需求相对不重要。结论认为NICU患儿家属有焦虑和心理需求,医护人员要有的放矢地满足这些需求,以减轻焦虑。     

领导—成员关系、组织支持感、心理授权与情感承诺的关系研究

领导在组织中发挥着至关重要的作用。本研究探讨LMX对员工组织情感承诺的影响。引入心理授权作为中介变量,组织支持感作为调节变量。对于四个企业的423名员工进行问卷调查,运用相关、回归等统计方法对数据进行分析。结果显示:心理授权对于LMX影响情感承诺的中介作用显著,POS对于LMX影响情感承诺的调节作用不显著。领导作为组织与员工的纽带,对于增加员工对组织的情感依赖有着重要的作用。