The relationship between acculturation and problem behavior proneness in a Hispanic youth sample: a longitudinal mediation model

This study, using secondary data analysis, examined prospectively a mediation model of the relationship between acculturation and problem behavior proneness among 330 Hispanic children and adolescents from an urban school district in the southwest region of the United States. Acculturation was predicted to have an indirect, but positive, relationship to problem behavior proneness through parental involvement and self-esteem. The results partially supported the model and indicated that parental involvement, but not self-esteem, played a significant mediational role in children's problem behavior proneness. The individual indicators of problem behavior proneness among Hispanic youth were significantly interrelated, which is consistent with problem behavior theory as conceptualized by R. Jessor (1984) and R. Jessor and S. L. Jessor (1977). Findings from this study provide implications for future research and intervention designs.     

"以病人为中心"医疗服务模式的理念与发展

纵观20世纪医疗服务的发展历程,医疗服务的发展经历了“以疾病为中心”的传统医疗服务模式到“以病人为中心”的新的医疗服务模式的转变;目前,以“以病人为中心”的医疗服务模式已经成为我国现代医院改革与发展的主题。因此,在阐述医疗服务模式变革与发展的基础上,系统论述了“以病人为中心”的医疗服务模式的内涵与特点,新的理念、新的认识,也带来了新的希望,新的医疗服务模式将不断地改善与提高人们的健康状况与生活质量。     

Caring,Social Policy,and Homelessness

Care theory offers a way to overcome a weaknessof liberalism – its reluctance to intervene inthe private lives of adults. In caring for thehomeless, we must sometimes use a limited formof coercion, but our intervention is alwaysinteractive, and the process of finding asolution is one of negotiation between theneeds expressed by the homeless and the needswe infer for them.     

The Role of Families and Care Givers as Risk and Protective Factors in Preventing Youth Violence

This paper reviews research which discusses the risk and protective functions that families and other caregivers provide in influencing the development of aggressive behavior in youth. Currently, there is an emphasis on providing violence prevention programs in the school environment, typically with little parental or caregiver involvement. By enhancing the role of families and caregivers in youth violence prevention programs, we assert that an unique opportunity exists to both address specific risk factors for violence while enhancing the protective features of the family. Relatedly, the risk literature on youth violence indicates that the most influential risk factors (i.e., the family, community, and peers) have their principle impact on youth aggression outside the school. We suggest a shift in the focus of violence prevention programming that is more inclusive of families as both a risk and protective agent. In support of this position, relevant theory and reviews of exemplary family-involved programs are offered. Challenges to involving youth caregivers are identified and recommendations for overcoming those challenges suggested. Last, recommendations for future research and public policy in the prevention of youth violence are offered.     

Health Focused Psychotherapy In Treating a Dual Diagnosed Patient

Health-focused psychotherapy offers a contemporary model used in assessment, treatment planning and evaluation in addressing patients with both medical and psychiatric diagnoses. Clinicians in the health and mental health disciplines must know and understand the importance of standards of care and models of intervention and evaluation in clinical practice for this type of patient. Examined is the use of a specific model providing a tailored orientation to patient education, along with the development and use of a clinical algorithm and care pathway for clinical practice. Provided is a case study for applying the development and use of a clinical algorithm and care pathway for a dual diagnosed patient receiving health-focused psychotherapy.     

Concordant Spiritual Orientations as a Factor in Physician--Patient Spiritual Discussions: A Qualitative Study

Objectives: To understand the impact of physicians and patients religious/spiritual orientation on discussions of spiritual issues. Methods: We performed semi-structured interviews of 10 Missouri family physicians and 10 patients of these physicians, selecting subjects nonrandomly to represent a range of demographic factors, practice types, and chronic or terminal illness. We coded and evaluated transcribed interviews for themes. Results: Respondents expressed that similar belief systems facilitate patient–physician spiritual interactions and bring confidence to their relationships. Those holding dissimilar faiths noted limited ability to address spiritual questions directly. They cited significant barriers to spiritual interaction but considered that ecumenism, use of patient-centered care, and negotiation skills lessen these barriers. Conclusions: Our respondents view spirituality similarly to other aspects of the physician–patient relationship involving differing viewpoints. Where discordance exists, cross-cultural, patient-centered, diplomatic approaches facilitate spiritual discussions.     

Stewardship Models of Pastoral Care,Counselling and Supervision: The Commonians Meet Ricoeur at Worship

The common factors debate in psychology and, more recently, marriage and family therapy is slow to erupt in pastoral care and counselling. This article introduces the common factors debate into pastoral science by proposing the Stewardship Models of Pastoral Ministry and Supervision. The model integrates common factors research and pastoral practice using Ricoeur’s “economy of the gift” ethic. The model’s focus is pastoral care, counselling and supervision in congregations, a unique community context in search of an adequate pastoral praxis.     

A Review of the Children’s Inventory of Anger (ChIA): A Needed Measure

A review and critique of the Children’s Inventory of Anger (ChIA) is presented. The ChIA is a 39-item measure that operationalizes anger according to the conceptualization set forth by Ellis in Rational Emotive Behavior Therapy. The ChIA consists of four subscales (Frustration, Physical Aggression, Peer Relationships, and Authority Relations) which provide information regarding situations that are commonly associated with the experience of anger. Preliminary validity studies demonstrate that the ChIA has excellent reliability and high face validity. The forms are user friendly and easily scored, with norms tables conveniently located within the form. A computer-scoring program is available which significantly reduces clerical errors. The application of the instrument in practice is discussed. Due to the fact that the ChIA attempts to link assessment and intervention it should be useful in advancing the field in regard to treatment evaluation and substantiation of treatment validity. It is also expected to have considerable research utility.     

Care of the Self and Patient Participation in Genetic Discourse: A Foucauldian Reading of the Surgeon General's “My Family Health Portrait” Program

Critics of genetic discourse are concerned that deterministic and discriminatory views of genetics are increasingly becoming adopted. These views argue that current genetic discourse becomes a source of power whereby powerful institutions harm people with so-called “bad” genes. This essay argues that current analyses of the power of genetics discourse are grounded in an improper reading that disempowers patients. Deploying Michel Foucault's concept “care of the self,” this essay claims that genetics discourse is better understood as a way that patients take on power through rhetoric rather than a force that has power over patients. Through a close reading of the “My Family Health Portrait” program, this paper argues that patients experience a process of “subjection” wherein they become agents of and objects of genetics discourse both. This alternative mode of analyzing the power of genetics discourse has implications for our collective understanding of the operations of the care of the self and the uses of genetic information that we propose.