The Teaching Alliance Inventory: Evaluating the student-instructor relationship in clinical and counselling psychology training

The Teaching Alliance Inventory (TAI) was developed to measure the quality of the student-instructor relationship in graduate clinical and counselling psychology classrooms. Based on Bordin's (1983) original concept of the alliance as fundamental to the change process in psychotherapy, we developed the TAI to measure aspects of the classroom relationship that may be fundamental to learning essential skills of counselling and clinical psychology. Factor analysis revealed six subscales, four representing interpersonal variables not evaluated in traditional teaching effectiveness measures. We demonstrated internal consistency and split-half reliability with a large sample of graduate students and described evidence for the scale's face validity and content validity. Construct validity was supported by significant correlations between the TAI and its subscales with an established measure of teaching effectives and its logically related subscales (SEEQ; Marsh, 1987 Marsh, HW. 1987. Students’ evaluations of university teaching: Research findings, methodological issues, and directions for future research. International Journal of Educational Research, 11(Whole Issue 3): 253–288.  [Google Scholar]). The TAI may supplement traditional assessments of instructor quality by providing feedback regarding interpersonal impact in the classroom.     

Categories and Facets in Integrative Levels

Facets and general categories used in bibliographic classification have been based on a disciplinary organization of knowledge. However, facets and categories of phenomena independent from disciplines can be identified similarly. Phenomena can be classified according to a series of integrative levels (layers), which in turn can be grouped into the major strata of form, matter, life, mind, society and culture, agreeing with Nicolai Hartmann’s ontology. Unlike a layer, a stratum is not constituted of elements of the lower ones; rather, it represents the formal pattern of the lower ones, like the horse hoof represents the shape of the steppe. Bibliographic categories can now be seen in the light of level theory: some categories are truly general, while others only appear at a given level, being the realization of a general category in the specific context of the level: these are the facets of that level. In the notation of the Integrative Level Classification project, categories and facets are represented by digits, and displayed in a Web interface with the help of colours.     

患者医疗高付费的社会文化背景断想

“看病贵”的原因之一即病患者主观方面的医疗高付费的表现形式及文化背景包括在趋祈“神灵”的求医心理支配下崇尚名医名院;受“药须贵,医须贿”观念的影响,在医疗活动中以高付费求取感情踏实;富有阶层追求高于一般社会水平的生活享受和精神享受;至爱亲朋在病人重病期间或弥留之际以高额费用寄托伦理亲情。     

Environmental Contributions to Adolescent Delinquency: A Fresh Look at the Shared Environment

Few genetically-informative studies have attempted to explicitly identify the shared environmental (i.e., those environmental influences that contribute to sibling similarity) factors now known to contribute to adolescent delinquency. The current study therefore examined whether the parent-child relationship served as one source of these shared environmental influences. Participants were 610 adoptive and biological families from the Sibling Interaction and Behavior Study (SIBS). Parents and adolescents reported on their parent-child conflict and parental involvement with child, and adolescents reported on their own delinquent behaviors. We employed structural equation modeling and supplementary multilevel modeling, finding consistent evidence that the association between delinquency and the parent-child relationship is at least partially shared environmental in origin. Such findings provide an important extension of previous twin studies, as they suggest that passive genotype-environment correlations do not explain earlier findings of shared environmental influences on this association.     

Work Stress and Marriage: A Theoretical Model Examining the Relationship Between Workaholism and Marital Cohesion

Using structural equation modeling the relationship of work stress and marital cohesion was empirically investigated. It was hypothesized that work stress would have an inverse relationship with marital cohesion. Participants were a random sample of 326 adult females who were members of the American Counseling Association. The results of the data-model fit analyses support the hypothesized relationship. The coefficient of determination for the structural equation was 0.60 indicating a substantial degree of explanation for the relationship tested. Implications of these findings for future research are presented.     

儿童社交回避行为：成因、测量方式及适应功能

社会退缩行为是指儿童在社会情境中抑制自己参与同伴互动并表现出独处的行为。根据不同的社交动机,社会退缩行为包含多种亚类型,其中社交回避行为这一亚类型指儿童总是表现出主动避免各种社交场合的行为。总体而言,社交回避是目前研究最少的一种,其形成的主要原因可能是由于儿童本身较高的抑郁感所致,而研究者已开始尝试以间接和直接的方式测量其水平。来自以变量为中心和以个体为中心的研究分别表明,社交回避儿童面临着最高的适应风险。鉴于这一研究领域的广泛前景,未来的研究亟需关注社交回避影响儿童适应的过程机制及其年龄发展特点,测量工具的进一步开发,直接的跨文化比较以及社交回避的干预方案开发。     

亲子关系对贫困儿童问题行为的影响

以247名贫困儿童为被试进行问卷调查,构建家庭社会经济地位和亲子关系对贫困儿童问题行为的多重中介模型,得到抑郁、自我控制的中介作用。结果显示,亲子关系和社会经济地位分别通过中介路径影响贫困儿童问题行为,与亲子关系有关的中介路径为91.25%,与抑郁有关的中介效应为57.60%,与自我控制有关的中介效应为57.15%. 结论：良好的亲子关系或成为贫困儿童的保护因子;应关注贫困儿童心理健康,增加有效心理疏导机制;注重培养贫困儿童的自我控制能力。     

急诊医学医患共同决策中的博弈分析

通过急诊医学的实践,借助博弈论方法分析了急诊医学中实施医患共同决策（shared decision making,SDM）的现状,为急诊医学中实施SDM提供参考意见。分析发现,在急诊医疗决策中存在“公地悲剧”“蜈蚣博弈”“博傻理论”等博弈现象。急诊医学中的信息技术滞后、医患对SDM的认知不足、医患信任等因素是影响SDM在急诊医学中实施的重要博弈因素。通过推动急诊医学的信息化建设、SDM理念的普及和技能培训,借助博弈论的方法和相关法律制度的完善,提升互联网作为健康宣传和健康教育的工具作用,有利于SDM在急诊医学的应用推广,从而促进急诊医学和谐医患关系的构建。     

关怀伦理的介入：医患关系重构的新视角

梳理有关学者的关怀伦理理论观点,并基于关怀伦理的相关思想对疾病状态下患者的特性（脆弱性、自主性和依赖性）进行分析,在此基础上,讨论目前医疗机构中主流医患关系模式理论（包括律法关系、家长制关系和自主决策关系）的局限性与不足,并将这类主流医患关系说纳入到基于关怀的医患关系之中,以重构适用于当前医疗行为模式和医疗行业现状、体现己他两利关怀思想的医患关系模式,最后阐述了基于关怀的医患关系中的“关怀”实践路径,包括引导性双向叙事、同情与移情以及关怀美德。     

社区护理病房中长期慢性病患者的照料服务机制——基于质性研究的方法

现有社区护理病房照料服务存在不能充分满足患者的深层需求、生活质量不佳的问题。访谈材料显示出由于照料者缺乏对“善终”概念的认知,患者、家属以及医护人员的三方关系中,患者处于权力的弱势地位,主体之间在讨论死亡相关问题上存在严重的脱节。患者的意愿从表达、传递、实施等环节中都存在阻碍,患者“善终”的需求无法实现。“以患者为中心”的照料理念应在现有照料服务中加以推广,通过提升社区照料质量来满足医学关系、家庭关系和患者自身利益的既定政策目标。