社会资本理论及其在卫生领域的应用

在文献复习的基础上,首先介绍了社会资本的基本理论一定义、类型和研究层次,然后总结分析了国内外卫生领域就社会资本与健康、卫生服务利用以及卫生筹资的关系所开展的研究,最后指出在卫生领域应用社会资本理论时应明确界定社会资本的概念,科学完整地测量它,并科学看待它对健康和卫生服务的影响。     

How to enhance service quality through organizational facilitators,collective work engagement,and relational service competence

This study aims to test how collective work engagement and relational service competence, as affective and cognitive-competent collective states, mediate the relationship between organizational facilitators and customers' perceptions of service quality. In all, 107 service-oriented units were aggregated from 615 service workers and 2165 customers. Structural equation modelling confirmed that organizational facilitators are related to collective work engagement andrelational service competence, which play a mediating role between organizational facilitators and service quality. Whereas collective work engagement plays a partially mediating role between organizational facilitators and relational service competence, relational service competence plays a fully mediating role between collective work engagement and service quality. A discussion and limitations are also provided.     

Envisioning human service organizations free of microaggressions

Microaggressions refer to verbal or non-verbal communications that invalidate those with non-dominant group identities across all dimensions of human diversity. Within human service organizations (HSOs), microaggressions may lower therapeutic alliance, reduce retention, and result in negative outcomes. While understanding the type, frequency, and damaging impact of microaggressions are useful and well established in research, less is known about the organizational policies, practices, behaviors, and values needed to reduce or eradicate microaggressions within human service contexts. Utilizing three focus groups and four individual interviews with adults who received services from HSOs, this qualitative study explored: What would HSOs need to learn, practice, and believe in order to be free of microaggressions? Sixteen participants reported on the provider's knowledge and behaviors, organizational environment, and institutional characteristics needed to create an organization free of microaggressions. Limitations of existing approaches and implications to develop more equitable practices within HSOs are discussed.     

Visioning Family-Centered Care in Genetics: What Parents and Providers Have to Say

The purpose of this multisite exploratory research study involving focus groups of consumers and service providers was to generate stakeholder input for a statewide strategic plan for genetic services in the southwestern region of the United States. This article describes the qualitative methods by which the data were collected and summarizes major themes in participants’ perceptions about genetic services. It also describes processes related to obtaining genetic services and characteristics of an ideal service delivery system for children affected by genetic disorders and the families that care for them. Implications for practice and policy are also reviewed.     

Variations in Figurative Language Use as a Function of Mode of Communication

Various studies have demonstrated that the mode by which people communicate affects the content of their messages. The present study examines the ways in which one aspect of language use, namely figurative language, differs as a function of mode of communication. Subjects worked together in pairs to build a small household appliance, with an expert directing a novice in the construction. Subjects communicated in one of four modes: full copresence, separated by a screen, through an intercom system, or through e-mail. Differences between modes were found on a number of measures of figurative language types, including what the author has described as interrogative analogies. These differences are discussed in terms of costs, constraints, and affordances associated with different media, and the role figurative language plays in communication.     

Defining Location in the Mental Health System: A Case Study of a Consumer-Run Agency

In this ethnographic study of a mental health service agency staffed by “consumers,” or fellow “recipients” of services for serious mental illness, the concept of community narrative provides the framework for examining how such an agency preserves its consumer identity while providing services dictated by the established service system. Locating the agency's narrative in its “origins tale,” analysis revealed five principles comprising the agency's identity: a normalizing view of mental illness, a commitment to helping, a dual-valued understanding of the mental health system, and beliefs in recovery and in the significance of employment as a criterion for recovery. Predicted consequences of narrative functioning emerged in social climate and staff expressions of cohesion and commitment. The local meaning of these narrative themes reveals the agency's view of the consumer element in its work and its solution to the dilemma of being both inside and outside of the mental health system.     

The Role of Psychological Factors in Medical Presentations

Research shows that a large number of medical presentations do not result in a medical diagnosis but rather are related to behavioral health problems. Factors such as age, lower education and economic status, health beliefs, and medical and psychological factors are linked to high medical service utilization. Research consistently shows that patients with psychological problems use more services than those without diagnosable psychological problems. The purpose of this paper is to provide a more detailed analysis of the roles of psychological factors in medical presentations. We present three kinds of pathways by which psychological factors lead to medical presentations. These include the (1) primary or direct medical presentation of a clinical problem, (2) secondary presentation or the impact of the clinical problem on patients general physical, psychological, or psychosocial health, and (3) the complex presentation or the impact of multiple diagnoses on the presentation of the clinical problem. Examples of each of these pathways are presented for each axis of the DSM-IV.     

Service Needs of Foster Families with Children who have Disabilities

We examined the service needs of foster families with children who have disabilities. Foster parents in a large Canadian city were asked “What services or supports would be helpful to you?” The responses to this question were edited for clarity and to eliminate redundancies, and sorted into piles of like statements by a group of 15 foster care professionals. Two types of statistical analysis were applied to the sorting of the statements to describe the relationship between statements and their groupings. The major concepts were identified according to the contents of the cluster and a map was constructed to provide a graphic representation of the conceptualization process. The major services and supports identified in this study were: support in the community, financial support, accommodating school system, good relationships with social workers, responsive professionals, information, comprehensive medical care, services for aboriginal children and families, transitional services, and respite.     

Electrophysiological correlates of dispositional mindfulness: A quantitative and complexity EEG study

While growing evidence supports that dispositional mindfulness relates to psychological health and cognitive enhancement, to date there have been only a few attempts to characterize its neural underpinnings. In the present study, we aimed at exploring the electrophysiological (EEG) signature of dispositional mindfulness using quantitative and complexity measures of EEG during resting state and while performing a learning task. Hundred twenty participants were assessed with the Five Facet Mindfulness Questionnaire and underwent 5 min eyes-closed resting state and 5 min at task EEG recording. We hypothesized that high mindfulness individuals would show patterns of brain activity related to (a) lower involvement of the default mode network (DMN) at rest (reduced frontal gamma power) and (b) a state of ‘task readiness’ reflected in a more similar pattern from rest to task (reduced overall q-EEG power at rest but not at task), as compared to their low mindfulness counterparts. Dispositional mindfulness was significantly linked to reduced frontal gamma power at rest and lower overall power during rest but not at task. In addition, we found a trend towards higher entropy during task performance in mindful individuals, which has recently been reported during mindfulness meditation. Altogether, our results add to those from expert meditators to show that high (dispositional) mindfulness seems to have a specific electrophysiological pattern characteristic of less involvement of the DMN and mind-wandering processes.