Why surgeons behave like surgeons.
Explore the source record for details and available documents.
SEARCH · Search PubMed
Search indexed PubMed citations on genomics, clinical trials, systematic reviews and public health. Explore titles, authors and supplied subject terms, then open the PubMed record.
Quote a phrase for an exact phrase match. Source license links do not imply unrestricted reuse.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
A description of cultural considerations associated with American Indian adolescent coping is presented within a transactional, cognitive-phenomenological framework. Select cultural values and cultural beliefs of American Indians associated with death are discussed in terms of person variables and situational demand characteristics that interplay in the transactional coping process. Three situational demand characteristics (ambiguity of identity, frequency of loss, and pervasiveness of hardships) are then presented to illustrate the reciprocal relationship between environmental contingencies and American Indian individual and community efforts at coping. The dynamic interdependence between person and environmental variables is emphasized and considered essential for inclusion in the design of interventions to prevent suicide. Existing intervention efforts with American Indian adolescent suicide attempters are reviewed and a school-wide cognitive behavioural approach based on the transactional model of coping with suicide is described. It is suggested that on-going cognitive restructuring, social skills training, and peer counselling training activities be culturally adapted and integrated into relevant areas of the school curricula in order that coping be enhanced and suicide ameliorated.
The objective of this exploratory study was to assess the effects of four nurse staffing patterns on the efficiency of patient care delivery in the hospital: registered nurses (RNs) from temporary agencies; part-time career RNs; RN rich skill mix; and organizationally experienced RNs. Using Transaction Cost Analysis, four regression models were specified to consider the effect of these staffing plans on personnel and benefit costs and on non-personnel operating costs. A number of additional variables were also included in the models to control for the effect of other organization and environmental determinants of hospital costs. Use of career part-time RNs and experienced staff reduced both personnel and benefit costs, as well as total non-personnel operating costs, while the use of temporary agencies for RNs increased non-personnel operating costs. An RN rich skill mix was not related to either measure of hospital costs. These findings provide partial support of the theory. Implications of our findings for future research on hospital management are discussed.
This paper presents a severely disturbed self-mutilating person with a chronic substance abuse history. It demonstrates how use of the immediate transactional experience is an analytic model, facilitated treatment. The authentic use of the therapist's self is endorsed as mutative in facilitating personality change in the patient. Fellow professionals are encouraged to respond to this paper in the service of fruitful analytic dialogue, in the service of promoting more effective treatment of this difficult population in equally difficult times.
Although no prospective epidemiological studies have evaluated the relationship between family interactions and the development of borderline personality disorder (BPD), there is considerable evidence for the central role of family interactions in the development of BPD. This paper describes the role of family interactions or processes, especially those that might be regarded as invalidating or conflictual, negative or critical, and the absence of more validating, positive, supportive, empathic interactions, in the development of BPD. Perhaps more importantly, the proposed model considers how these parental and family behaviors transact with the child's own behaviors and emotional vulnerabilities, resulting in a developmental model of BPD that is neither blaming of the family member with BPD nor of her or his parents and caregivers, and has important and specific implications for both prevention and intervention.
Traditional theories regarding the etiology of borderline personality disorder have focused on poor attachment figures and/or traumatic experience. The present review posits an additional pathogenic course for this disorder. Specifically, the proposed mechanism involves a basic disruption of the neural hardware that supports the formation and maintenance of unconscious emotional memory, hardware essential for the formation of early attachments. It is further theorized that this early disruption has ongoing effects on both behavioral and concomitant neural development. Within this model, adolescence is described as a period of intense change that serves as the tipping point for the onset of borderline personality disorder.
Explore the source record for details and available documents.
This study examined the transactional nature of parent-infant interactions over time among alcoholic and nonalcoholic families. The sample consisted of 222 families assessed at 12, 18, and 24 months of child age. Results indicated that infant behavior did not influence parental behavior across time, but parental behavior was longitudinally predictive of infant behavior during play interactions. Higher paternal alcohol consumption at 12 months was longitudinally predictive of negative parental behavior at 24 months. Other significant risk factors included marital conflict, fathers' depression, and fathers' education. Results highlight the nested nature of risk in alcoholic families and the direction of influence from parent to child during interactions and suggest that 1 pathway to risk among these children is through negative parent-infant interactions.
Treatment decision making by women with breast cancer has been recognized to be an inherently stressful process. However, past decisional theory and research has failed to fully elucidate the personal, transactional, and relational nature of choice behaviour. The purpose of this paper is to explore an embedded decisional model of stress and coping that locates key assumptions of Janis & Mann's (1977) conflict-theory model of decision making within Lazarus & Folkman's (1984) transactional framework. Through combining decisional and stress and coping theories, a model is developed that addresses the theoretical limitations of the conflict-theory model and provides greater specificity within decision-making research. The paper examines the complexity of treatment decision making within the context of the constructs of causal antecedents, primary appraisal, secondary appraisal, coping, and adaptational outcomes. Examples specific to women with breast cancer are provided to illustrate the potential application of the embedded model. The implications of this inclusive and comprehensive decisional theory for future knowledge development and research in the area of treatment decision making are also discussed.
Nursing stress: the effects of coping strategies and job satisfaction in a sample of Australian nurses The study reported in this paper examined relationships between nursing work-related stressors and coping strategies, and their impact upon nurses' levels of job satisfaction and mood disturbance. It was proposed that higher levels of perceived work stress and use of avoidance coping would increase mood disturbance, while problem-focused coping would be associated with less mood disturbance. The study also aimed to explore the possible 'buffering effects' of using humour in coping with stress, and the effect of job satisfaction on the stress-mood relationship. The sample consisted of 129 qualified Australian nurses who volunteered to complete standardized questionnaires, including the Nursing Stress Scale, Ways of Coping Questionnaire, the Coping Humour Scale, Job Satisfaction Scale of the Nurse Stress Index, and the shortened version of the Profile of Mood States. Results revealed a significant positive relationship between nursing stress and mood disturbance, and a significant negative relationship between nursing stress and job satisfaction. The use of avoidance coping and the perception of work overload were found to be significant predictors of mood disturbance. No evidence was found to indicate that the use of humour had a moderating effect on the stress-mood relationship but there was support for the influence of job satisfaction upon this relationship. These results provided some support for a transactional model of stress since situational factors were found to influence the nurses' coping and perceptions of stress.
The psychological literature contains little documentation of the therapeutic use of fairy tales. We suggest that fairy tales are uniquely suitable for hypnotherapy and for helping clients reframe existential issues. We propose that the structure of fairy tales allows the meaning of the story to be applied personally and that they also stimulate unconscious search. We examine the way in which hypnosis is achieved when fairy tales are read to children, as well as possible therapeutic uses of this learning set in therapy with both children and adults. We conclude by suggesting that fairy tales need to be given serious consideration as an alternative therapeutic trance procedure.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.
Explore the source record for details and available documents.