冠脉介入治疗合理临床应用的思维基础

冠心病的发病率逐年升高,死亡率居高不下,成为威胁人类健康的重要疾病。人们为了攻克这一难题进行了不懈的工作,溶栓、监护及介入治疗的出现挽救了众多生命。随着冠状动脉介入治疗方法的不断完善和广泛开展,冠状动脉介入治疗越来越成为冠心病治疗的主要临床手段。但随之而来的手术并发症、支架在狭窄等问题成为不得不考虑的问题。治疗策略的选...     

情绪领导力：概念、测量、发展与模型建构

情绪领导力是指领导者基于自身情绪能力, 通过情绪传染和策略运用来有效管理组织成员的正性和负性情绪, 充分发挥不同情绪的有利效价, 营造应景的组织情绪氛围, 带领组织成员为实现组织共同目标而奋斗。目前, 情绪领导力的测量主要是借用情绪智力量表, 缺乏标准化工具。情绪领导力的研究发展经历3个阶段：以领导情绪能力为中心、以领导情绪传染为中心和以情绪领导力为中心。基于各阶段研究梳理, 建构整合模型：遗传基因、人格和情绪特质对情绪领导力起预测作用, 大脑活动(右侧额叶)与情绪领导力互为因果关系。情绪领导力通过直接和间接两条路径对个体和组织层面的领导效能产生显著影响。未来研究应加强对概念、测量、调节机制、生物基础、组织层面议题和跨文化对比等方面进行探讨。     

患者决策能力与风险相关标准

患者决策能力对于患者享有临床知情同意权具有重要意义。风险相关标准主张决策所需的能力水平应该根据决策的结果来调整,单一的决策能力标准是不够的。决策结果带来的风险越大,能力水平要求越高,反之则可以要求较低的能力水平。该主张的伦理本质是不合理家长主义,并且,它意味着对同一决策任务,个体可能只有同意的能力而没有拒绝的能力,因而在经验上也站不住脚。患者决策能力标准仅应根据决策本身的复杂性和难易程度视该决策特性来决定,而独立于患者实际决策结果。     

生命健康视野下的叙事闭锁

从弗里曼的叙事闭锁理论出发,将“叙事闭锁”重新定义为“将自己禁锢在停滞的故事空间里,无法吸纳推动叙事进程向前发展的生命状态”,并将其进一步分为职业型、创伤型、疑虑型和老年型四种类型。叙事闭锁不仅在老年人群中高发,在其他年龄阶段人群中也不少见,以至于人生故事提前进入结束状态或者处于无法更新的停滞状态。对叙事闭锁者开展叙事介入可以帮助他们提升叙事素养,重启再次体验和阐释人生的按钮,赋予他们由内而外突破闭锁的能量。当人处于一种叙事稳定性和叙事开放性的平衡状态之中时,主体经历的就是一种健康和谐的生命进程。     

Therapeutic factors in interactional inpatient groups: Results from a Turkish sample

Therapeutic factors in an inpatient group from Turkey are presented. A total of 40 patients were seen over a period of 2 years and each patient was given Yalom's (1983) 60-item therapeutic factor list on discharge. The first four most valued therapeutic factor groups were Catharsis, Existential Factors, Cohesiveness and Hope. There were significant differences in the highly valued factors in different diagnostic groups. Patients with diagnoses of anxiety/somatization and borderline/identity problem preferred factors resembling those in many out-patient studies. The results are discussed in the light of relevant literature.     

上海地区青少年道德判断能力测验的编制及常模制定

上海地区青少年道德判断能力测验量表共有四个道德行为故事,分别反映自由与自律、公与私、义与利、平等与公正四对道德冲突中的一对矛盾。常模样本系随机选取上海市区、郊区四所完全中学,每校从初一至高三年级各一个班共1324名学生。常模形式包括总分常模、P分常模和道德判断能力水平等级划分三种。其信度和效度均令人满意。本量表适用于12－17岁青少年学生。     

Social support and psychosocial competence: Explaining the adaptation to college of ethnically diverse students

Examined relationships among social support, psychosocial competence, and adaptation to college in a sample of 357 African American, Asian American, Latino, and white college students. Social support and active coping were significant predictors of adaptation to college, whereas locus of control was not. However, there was an interaction between ethnicity and locus of control indicating that although internal African American, Latino, and white students had higher adaptation-to-college scores than external students, the opposite was true for Asian Americans. The relationships among social support, internality, and active coping were also explored. Satisfaction with social support and internality were positively related to active coping, but locus of control and social support were unrelated. Active coping and internality were significantly related to each other for all groups except for African Americans. Although most relationships were the same across groups, these findings call attention to the role of ethnicity as a moderator of college adjustment processes.     

Don't get stuck in the mother: regression in analysis

This paper was part of an afternoon workshop on regression. It re views the author's recollections of her own analysis and clinical work with the purpose of discovering the sources of her own ideas on regression. Two specific forms of regression are then delineated – negative therapeutic reaction as described by Rosenfeld and 'umbilical transference' as a possible future development.