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PubMed1999

Disentangling dynamics: group sensitivity and supervision.

In order to contextualize Altschul's interest in group dynamics we present a brief history of staff group work approaches in the UK and USA. Using case examples, the work of staff group sensitivity and group supervision is described. The difficulties of working in staff groups are highlighted and the antipathy towards group practice is discussed. It is argued that learning about conflict resolution in staff groups prepares nurses for dealing with conflicts in clinical practice. The case for re-invigorating interest in group theory and practice is presented. In presenting our reflections on staff group work, we hope not only to re-kindle the type of interest in groups that inspired Altschul but also to represent the case that it is ill conceived to attempt the work of mental health nursing without recourse to the supervisory resources of group theory, practice and support. It is through group feedback that mental health nurses and other health professionals can extend their learning about interpersonal relations, achieve quality standardization through peer feedback and reflect on practice in truly collaborative ways (Schon 1983).

Burnout, Professional↗
PubMed2001

The Tidal Model: developing an empowering, person-centred approach to recovery within psychiatric and mental health nursing.

Nursing theories and nursing models have a low profile within psychiatric and mental health nursing in the United Kingdom. This paper describes the philosophical and theoretical background of the Tidal Model, which emerged from a 5-year study of the 'need for psychiatric nursing'. The Tidal Model extends and develops some of the traditional assumptions concerning the centrality of interpersonal relations within nursing practice. The model also integrates discrete processes for re-empowering the person who is disempowered by mental distress or psychiatric services or both. The paper reports briefly on the ongoing evaluation of the model in practice.

Humans↗
PubMed2001

What are the principles and processes of inspiring hope in cognitively impaired older adults within a continuing care environment?

This study focuses on the principles and processes that psychiatric/mental health (P/MH) nurses use to inspire hope in cognitively impaired older adults within a National Health Service (NHS) continuing care environment. Using a grounded theory method, the data were coded and analysed, in an attempt to produce an integrated conceptual framework of hope inspiration. This comprised four core variables: applied humanistic code, pragmatic knowledge, interpersonal relations and nurse as utilizer. The authors postulate a relationship between the function of caring, the activity of helping and the practice of instilling hope, as a basis for suggesting that inspiring hope to clients is one of the primary acts of P/MH nursing. The authors conclude that the four core variables are intertwined and inseparable from one another, and bound up with P/MH nursing practice. From this position, it is suggested that the processes of inspiring and instilling hope cannot be separated from the qualities of being a P/MH nurse. However, a more detailed and complete understanding of the concept of hope can increase the nurse's effectiveness as a carer.

Age Factors↗
PubMed1998

Conceptual bases and methodology for the evaluation of women's and providers' perception of the quality of antenatal care in the WHO Antenatal Care Randomised Controlled Trial.

In this paper, we describe the conceptual bases and methodology used to assess women's and providers' perception of the quality of antenatal care, as part of a large randomised trial in four developing countries. Information has been obtained by applying both qualitative and quantitative methodologies. The focus group discussions and in-depth interviews have contributed useful insights into the cultural milieu in which care is provided, users' and providers' expectations, and their concept of quality. Based on these findings, we developed two standardised questionnaires, one being administered to a representative sample of pregnant women (n = 1600) and the other for all care providers. In this paper we present some of the findings of the focus group discussions and in-depth interviews with women in one country as an example of the kind of information we have obtained. Women expressed their point of view concerning a reduced number of visits, type of provider, information that they get during clinical encounters and interpersonal relations with health professionals. The qualitative information, together with the data we obtain from the surveys, will highlight the aspects that will have be to considered if the new model of care is to be introduced on a routine basis.

Argentina↗
PubMed2002

Patient satisfaction with nursing care in the context of health care: a literature study.

To evaluate and improve the quality of care provided, it is of vital importance to investigate the quality of care in the context of health care. Patient satisfaction is a significant indicator of the quality of care. Consequently, quality work includes investigations that map out patient satisfaction with nursing care. To improve the quality of nursing care, the nurse needs to know what factors influence patient satisfaction. The aim of this literature study was to describe the influences on patient satisfaction with regard to nursing care in the context of health care. In the description of nursing care, we have used Henderson's nursing care model. The results describe eight domains that have an influence on patient satisfaction with nursing care: the socio-demographic background of the patients, patients' expectations regarding nursing care, the physical environment, communication and information, participation and involvement, interpersonal relations between nurse and patient, nurses' medical-technical competence, and the influence of the health care organization on both patients and nurses. The bulk of the literature included in the study came from the UK, Sweden and the USA. This means that the results should be applicable to health care in the western world. An important implication for future research is to continue to elucidate the factors that influence satisfaction with nursing care, as seen from the patient's perspective.

Clinical Competence↗
PubMed2000

Reversible cognitive decline accompanies migraine and cluster headaches.

Vascular headaches, including migraine, cluster, and migrainous transformation to chronic daily headaches, are disabling. During and shortly after headache intervals, difficulties are reported in concentration, comprehension, and communication, not accounted for by nausea, photophobia, or sonophobia. These interfere with interpersonal relations and performance at work with economic loss. The hypothesis tested and reported here is that cognitive impairments comprise an important part of vascular headache diatheses. One hundred ninety-six otherwise normative subjects suffering from migraine or cluster, but not tension-type, headaches (136 women, 63 men; mean age, 46 years) participated in an outpatient prospective trial. One hundred thirty-three patients had migraine without aura, 39 migraine with aura, 11 periodic cluster (by IHS criteria), and 13 had migrainous transformation into chronic daily headaches. Neuropsychological testing was compared with and without headaches, by combined Mini-Mental Status Examination (MMSE), Cognitive Capacity Screening Examination (CCSE), and Hamilton Depression Rating Scale (HDRS). During headache intervals, significant decline was measured in both CCSE and MMSE scores (P <. 001) without HDRS change in all types of vascular headache and independent of headache severity, which often improved, or associated physical symptoms. Cognitive decline was promptly relieved by serotonin agonists and sleep. Disorders of cerebral serotoninergic projection systems appear to cause these reversible cognitive impairments.

Adult↗
PubMed2000

[Change in technical aids (AT)--a technology assessment from the viewpoint of rehabilitation-anthropology].

Practical experience in adjusting complex computer-assisted (CAS) communication aids has resulted in a search for prognostic criteria useful in evaluating the efficacy of technical aids. Such evaluation implies a holistic approach as is included in the ICIDH-2. These circumstances are demonstrated by examples ranging from mechanical to computer-assisted (CAS) aids. "Reciprocity" has turned out to be a valid semi-qualitative criterion in describing the dynamic equilibration of the rehabilitative issues involved. Only a dialogical situation with reciprocity will lead to sustainable participation. In case of technical aids, a conjunction of abilities and the qualitative level of activities in disabled people have to be taken into account to provide all dimensions of participation. In this holistic approach, social participation and balance will equally be respected. The differentiation of social systems with unequal consequences for people with disabilities in terms of environmental factors, or e-code of the ICIDH-2, have to be considered for prognostic evaluation with regard to efficacy and possible participation. A comprehensive psycho-socio-functional rating therefore has to include a comparative (socio-structural or morphological) analysis of the environment at hand. This approach will invariably show that technical aids alone are unable to ensure individual independence but, rather, may lead to isolation if there is no regional or local networking based on partnership and close interpersonal relations to be drawn on "technically".

Communication Devices for People with Disabilities↗
PubMed2002

[Quality of life in patients before and after kidney transplantation].

The presented study was carried out to differentially assess the quality of life (QOL) of two patient groups with end-stage renal disease (ESRD) with regard to the replacement therapy (dialysis vs. transplantation) and healthy controls. Successfully transplanted patients (n = 149) and patients treated by dialysis (n = 149) on the waiting list for transplantation at the Transplant Center Essen, Germany were enrolled. Additionally, 149 healthy controls were enrolled by an accumulative process starting from employees of the University Hospital Essen. Members of these three groups were strictly matched by age and gender. Medical data were gained from the patient record, QOL was measured by a global inventory, the Munich Quality of Life Dimension List (MLDL), and two specific inventories, the Brief Symptom Inventory (BSI) and the Questionnaire for Social Support - Short Form (K-22). Transplanted patients and healthy controls reported similar QOL, which was significantly higher than in dialysis patients (p < 0.0001). This was particularly true for the physical and the psychological status, but not for the social situation. Both patient groups reported similar social support, which was significantly lower than in controls (p < 0.006). Both ESRD groups described higher satisfaction with social support than the healthy controls (p < 0.0001). Successful kidney transplantation not only improved distinct aspects of QOL, but even put the patients on par with healthy controls regarding physical, psychological and functional QOL. Lower social support and higher satisfaction with social support in both patient groups should be evaluated further. From a clinical viewpoint, the improvement of QOL due to transplantation is impressive, but more attention should be paid to the interpersonal relations of ESRD patients. International multicenter longitudinal studies to investigate QOL in ESRD patients under different treatment modalities are emphasized.

Activities of Daily Living↗
PubMed2005

The psychosocial aspects of obstructive sleep apnea.

The primary events of obstructed breathing during sleep, snoring and obstruction of the upper airway, cause hypoxemia, sleep fragmentation, and daytime sleepiness. Obstructed breathing during sleep can have negative effects on mental processes, behavior, and interpersonal relations. This article reviews some of the cognitive, emotional, and social aspects of obstructive sleep apnea in adults and children. Apnea is associated with cognitive impairments but these are generally mild. Most studies suggest that these impairments improve with CPAP but evidence suggests that some changes may be permanent. Even mild apnea may worsen depression and quality of life. Apnea may have more profound effects in children but the findings are inconclusive. This may be due to difficulty in recognizing sleep apnea in children, the subtle nature of the disorder, the lack of daytime sleepiness, and the imposition of adult norms on children's sleep studies.

Adult↗
PubMed2003

Social interaction distance and stratification.

There have been calls from several sources recently for a renewal of class analysis that would encompass social and cultural, as well as economic elements. This paper explores a tradition in stratification that is founded on this idea: relational or social distance approaches to mapping hierarchy and inequality which theorize stratification as a social space. The idea of 'social space' is not treated as a metaphor of hierarchy nor is the nature of the structure determined a priori. Rather, the space is identified by mapping social interactions. Exploring the nature of social space involves mapping the network of social interaction--patterns of friendship, partnership and cultural similarity--which gives rise to relations of social closeness and distance. Differential association has long been seen as the basis of hierarchy, but the usual approach is first to define a structure composed of a set of groups and then to investigate social interaction between them. Social distance approaches reverse this, using patterns of interaction to determine the nature of the structure. Differential association can be seen as a way of defining proximity within a social space, from the distances between social groups, or between social groups and social objects (such as lifestyle items). The paper demonstrates how the very different starting point of social distance approaches also leads to strikingly different theoretical conclusions about the nature of stratification and inequality.

Hierarchy, Social↗
PubMed1992

Administrators and patients: using the personal touch.

Although rarely discussed in management training, taking the time for a handshake or gentle touch on a patient's arm can yield multiple benefits for the administrator. The patient's confidence in the facility is increased, and the administrator is reminded that the patient is the true bottom line of the hospital. Moreover, both are reassured that, at the other end of the chain of service, there is another human being.

Hospital Administrators↗
PubMed1996

Group treatment for adult women who experienced childhood sexual trauma: is telling the story enough?

Long-term process-oriented psychotherapy groups for adult survivors of childhood sexual abuse allow an in-depth exploration of both the individual meaning of traumatic experiences and the subsequent effects on current adult life functioning. It may not be curative just to tell the traumatic story. Therapists must also pay careful attention to unconscious reenactments by examining the process of interpersonal relating between and among group members and their therapists. Rather than avoidances, these reenactments are better viewed as a necessary form of remembering and can contribute to the understanding of the past trauma and recognition of current, previously unconscious manifestations in maladaptive behaviour. Such therapeutic benefit began to be evident in some members within 6 months in the group; for others, more time was necessary, often a year or more. Additional study and understanding of the role of reenactments in trauma treatment may lead to more effective intervention strategies that can further elucidate the complexity of this form of memory.

Adult↗
PubMed1978

Contrasting personality profiles of male and female medical students.

The Millon-Illinois Self-Report Inventory Form P, the State-Trait Anxiety Inventory, and the Personal Orientation Inventory were administered to 155 male and 37 female students across the four years of medical school to assess the personality differences between male and female medical students. Differences in mean scores were found between males and females on eight scales from the tests. The results indicated that female medical students' style of interpersonal relating is characterized by less emotional indifference and uninvolvement, less competitiveness and self-centeredness, less constriction and authoritarianism, and more impulsivity and negativism than that of their male colleagues. Further, compared to male students, the females were more likely to endorse items reflecting anxiety, emotional difficulties, and a value orientation that stresses being sensitive to one's own needs and feelings. The results were compared to those of previous research with male and female medical students.

Adult↗
PubMed1977

Dream content and its relation to self-reported interpersonal behavior.

THE NATURE of the relationship between those psychological processes which influence waking behavior and cognition, and those which influence the content of nocturnal dreams, is a question both interesting and unresolved. Is a person's approach to life similar in both the dream and the waking state? If someone was experiencing conflict in his life, might we expect to find conflictual situations in his dreams? And if, on the contrary, a person's waking expectations and experiences were harmonious, might we expect him to manifest conflict-free dreams? These are the questions to which we addressed ourselves in the present study.

Aggression↗
PubMed1977

A comparison of the scaling of Afro-Americans' life-change events.

Research using the Recent Life Change Questionnaire is being conducted with various ethnic, economic, and cultural groups. The findings of studies using comparable forms have indicated that economic conditions and cultural differences have a minimal effect upon the overall concordant rankings of most groups. In this paper, cultural and economic variables which influence the rankings of poverty-level Afro-Americans are compared with data from a previous study. The significant items related to employment, health, and family problems were found to influence the subject's life conditions, and those related to interpersonal relationships were found to be based on cultural values. The author discusses the importance of recognizing economic and cultural variables which are salient to the measure of life changes by selecting a scoring system which allows for the influence of these variables.

Adult↗
PubMed2004

An intergenerational group benefits both emotionally disturbed youth and older adults.

This qualitative descriptive study examined the perceived benefits of an intergenerational program for low-income older adults residing in subsidized housing and youth who were part of a support group for emotionally disturbed youth. The intergenerational group met bimonthly for 11 months at the independent living facility for the elderly. Activities consisted of group discussions, games, talent expressions, trips, picnics, and crafts. Frequently a teen was paired with an older adult to complete a craft project. Bonding between each pair occurred over time, as the older adults became role models for the youth. The perceived benefits of including emotionally disturbed youth and vulnerable but well older adults in an intergenerational program were determined by a structured interview and then through categorization of the participants' responses to a series of emotional, attitudinal, and behavioral questions using Yalom's (1985)Therapeutic Factors. The results indicated that both of the age groups' attitudes toward each other and relationships with each other changed positively. Behavioral changes among the youth included improved social skills observed by the co-facilitators of the group.

Adolescent↗