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PubMed2005

A literature review of the progress of the psychiatric nurse-patient relationship as described by Peplau.

Knowledge is limited with regard to the progress of the nurse and patient through the phases of the psychiatric nurse-patient relationship (PNPR). Relationship progress is indicative of patient progress in the healing and recovery process. Hildegard Peplau described the phases of the therapeutic relationship in her Interpersonal Relations Theory (IRT). This review of literature describes the state of nursing science using IRT as the theoretical framework. Research conducted on the progress of the PNPR has generated evidence of the relevance of IRT to clinical practice, the importance of the PNPR to the patients themselves, and the importance of nursing knowledge regarding the progress of the orientation phase of the PNPR to patient care. However, all studies were done in Canada, and additional studies are needed. Knowledge of the relationship established between psychiatric nurses and patients is essential to the nursing process in psychiatric mental health settings.

Clinical Nursing Research↗
PubMed2006

Social and psychological factors associated with willingness to test for HIV infection among young people in Botswana.

In spite of extensive campaigns to promote voluntary counselling and testing through the radio, television, newspapers and mass rallies, testing for HIV remains a challenge in Botswana. Using a representative sample of 1,294 students from secondary schools and tertiary institutions, the study investigates the effects of socio-demographic background variables, family coherence, interpersonal relations, sexual experience and knowledge about sexual health, on willingness to test for HIV infection. The results show that willingness to test for HIV infection was negatively associated with being sexually active and having a number of partners. Indicators of family, coherence, psychological bonding and personal adjustment such as common residence among parents, emotional support from the family attachment to parents, happiness with life in general and satisfaction with life as a student were associated with willingness to test. The importance of sexual activity, number of partners, happiness with life in general, level of attachment to father and physical fights with other children were identified as the social and psychological predictors of willingness to test for HIV using multiple logistic regression. The study highlights the importance of continued education about voluntary counselling and testing among sexually active young people, especially those from poorer backgrounds in rural areas.

Adolescent↗
PubMed1999

'In an important way, I did die': uncertainty and revival in persons living with HIV or AIDS.

This study reports the revival experiences of persons who once were reconciled to their death from HIV/AIDS but who, as a result of dramatic treatment responses, now believe they may survive (popularly known as the Lazarus Syndrome). A purposive sample of men and women living with HIV infection or AIDS were interviewed in six focus groups. As part of a larger study of uncertainty in HIV illness, participants described their uncertainty accompanying renewed health and a return to the joys and problems of continued life. While new discoveries about the disease and exciting antiretroviral therapies hold the promise of improved survival, ambiguity about the durability of treatment response and ultimate survival contribute to the level of uncertainty with which a patient must cope. The experience of uncertainty in the narratives about revival involved renegotiation. Participants described physical renewal as an unexpected new stressor forcing them to renegotiate: (a) feelings of hope and future orientation, (b) social roles and identities, (c) interpersonal relations, and (d) the quality of their lives. Implications for prevention, practice, research and theory are presented and suggestions for education and assistance are offered.

Acquired Immunodeficiency Syndrome↗
PubMed2004

Parent/child transactional processes predictive of resilience or vulnerability to "substance abuse disorders".

This article discusses implications of a theoretical model of resilience--the Resilience Framework, including the impact of parent/child transactional processes in moderating or mediating a child's biological or environmental risks and later substance misuse. Research is presented on behavioral and emotional precursors of substance abuse disorders in children of substance users. Detrimental processes within dysfunctional family environments are presented followed by a listing of strategies for increasing resilience in youth by improving family dynamics. The value in elucidating these interactive processes is to increase our understanding of ways to reduce the impact of risk factors. Prevention providers should use these strategies as benchmarks for selecting or developing effective family-focused prevention programs. Resources are presented for finding effective family interventions as well as an example of a family intervention based on resilience principles, namely the Strengthening Families Program. Recommendations are made for future research and better dissemination of evidence-based family interventions.

Adaptation, Psychological↗
PubMed2002

Ethical codes and values in a virtual world.

Some members of the so-called virtual world deny that technology such as the virtual environment (VE) is value-laden. But there are a variety of complex issues which arise in VE that make it necessary to think about ethics and values in VE applications. Using VE in therapy and psychotherapy research or diagnostics leads to several ethical concerns. VE can impoverish those aspects of life that are essential to social development, interpersonal relations, and emotional growth. This paper will focus on the concept called "virtual world," a question of metaphysics. After reviewing general ethical principles, ethics in applied sciences will be described. Ethical decision-making, code of conduct, and specific issues in VE will be discussed. The VE community is challenged to set guidelines around VE, and its ethics and values. A set of measurement tools around ethical codes and values in a virtual world ought to be discursively gained in this virtual world and in real society as a whole.

Bioethics↗
PubMed2002

Unsubscribe, pleeezz!!!: management and training of media competence in computer-mediated communication.

Computer-mediated communication (CMC) has created a new communication divide. Mostly, this division is due to technical and access problems. Overlooked is yet another divide in terms of user communication competence. This contribution focuses on media competence based on theories about communication competence and theories about CMC. Two field studies are presented: an analysis of a virtual seminar chat communication (22 participants, 3 weeks' duration) and an analysis of unsubscribe-failures within 2 years of a German mailing list (average of 1,000 subscriptions). Data from both studies reveal that help-seeking CMC users with low media-specific competence experience setbacks in terms of interpersonal relations and information gathering. There is a spiral of neutral to negative reactions and an increase in stress and aggression-related language in the reaction of the addressed peers. From the perspective of external raters, we found a contraintuitive result: The style, content, and wording of the message of the respondent is considered as an indicator for a less competent and socially attractive person behind the follow-up message than those of the initial message. On the one hand, media experts are needed and appreciated as technical problem-solvers; on the other hand, they might be perceived as socially narrow-minded freaks who are less interested in the task itself than in CMC-based task completion. This leads to the question of how sensibility for the social context, task orientation, and media competence can be combined (and trained for) in one person. Two competence trainings for text-based synchronous and asynchronous communication are introduced as interventions.

Communications Media↗
PubMed2004

Planning for effective interaction with FDA.

Manufacturers of diabetes devices can facilitate the formal regulatory approval process through early interaction with the U.S. Food and Drug Administration (FDA). Effective planning can help manage commonly perceived risks of interaction with the Agency, introduce new technologies to regulatory reviewers, and inform the manufacturer's product development strategy. This article reviews key aspects of the FDA evaluation process and suggests strategies that may facilitate effective communication with the Agency. Integrating early communication with FDA into broader product commercialization planning can streamline regulatory review and lead to early product launch into reimbursed markets.

Aged↗
PubMed2006

Alcohol use among entrants to a Hong Kong University.

AIM: This study of first year entrants to one of the major universities in Hong Kong describes the pattern of their alcohol consumption, their binge drinking, alcohol abuse, and dependence. METHODS: A retrospective cross-sectional study was conducted. A representative sample of year 1 students 2630/2968 (89%) newly admitted to the Chinese University of Hong Kong in 2003 were recruited to participate in a structured self-administered questionnaire. RESULTS: First year university students in Hong Kong have low rates of ever drinking alcohol (62%), and the rates of binge drinking and alcohol-related problems were 7 and 0.8%, respectively. The pattern of binge drinking is more common than weekly drinking (2.3%). Binge drinkers are more likely to have experienced alcohol-related interpersonal problems or (95% CI) = 6.5 (1.7-24.5). Males were more likely to drink, to binge drink, and to drink frequently. CONCLUSIONS: In contrast with students in the west, the majority of first year university students in Hong Kong are not binge or regular drinkers. However, there is a subgroup who smoke, drink more, and use alcohol as a means of coping with stress. This group may be particularly in need of a brief intervention, such as providing counseling and referral services.

Adolescent↗
PubMed1996

Sources of support and interpersonal stress in the networks of married caregiving daughters: findings from a 2-year longitudinal study.

This research uses data collected on 57 married daughters and 1,069 members of their social networks to examine patterns of social support and interpersonal stress across the first two years of caring for parents with dementia. Reports by the caregivers indicated that friends were the most prominent source of emotional support, while siblings were the greatest source of instrumental support and interpersonal stress, both shortly after the parent's diagnosis and two years later. Multivariate analyses demonstrated that associates who had cared for family members themselves were more likely to have been sources of instrumental support both shortly after diagnosis and two years later. Caregiving similarity was also the most important factor in explaining both emotional support and interpersonal stress at T1; however, its effect diminished across the subsequent two years. These findings suggest that experiential similarity may become less important in explaining some dimensions of interpersonal relations as individuals move further from status transitions.

Adult↗
PubMed1998

Religious activity and depression among community-dwelling elderly persons with cancer: the moderating effect of race.

OBJECTIVES: Research has been oriented toward elucidating the links between religion and mental health. The purpose of this article is to further our knowledge in this area by examining the effect of religious activity on depressive symptomatology among community-dwelling elderly persons with cancer. We also test whether these effects differ between Blacks and Whites. METHODS: We use two waves of data collected from a community-dwelling sample of elderly persons living in North Carolina. Depressive symptomatology is measured using four subscales from the CES-D 20 scale: somatic-retarded activity, depressed affect, positive affect, and interpersonal relations. Measures of religious activity include service attendance, religious devotion, and watching or listening to religious programs. RESULTS: The findings indicate that among Blacks with cancer, religious activity is related to lower levels of depressive symptomatology; no such relationship is found for respondent with other illnesses or no illness. Further, the effects of religious activity are stronger among Blacks than Whites. DISCUSSION: The analyses lend support to the hypothesis that religious activity is a strong predictor of depression in elderly adults with cancer. This finding, however, is not as strong as we had anticipated.

Adaptation, Psychological↗
PubMed1994

Middle generation roles and the well-being of men and women.

Sociological literature on gender, work, and families has focused on both conflict and benefits created by combining the spouse, parent, and paid worker roles, whereas research by family gerontologists has focused on stress experienced by those who provide care to frail elderly parents as well as other roles associated with being in the "middle generation." We examine consequences of adding middle generation roles to other major life roles during the middle years. We find that giving help to parents increases men's distress, while giving help to adult children enhances women's well-being. When help to biological parents is examined separately, it is found to increase both men's and women's distress. Women are unaffected by the multiplicity of roles while, for men, there is evidence of both role buffering and strain from conflicting demands. We discuss further directions for research on consequences of roles for well-being.

Adult↗
PubMed2002

Intergenerational partnerships in adult day centers: importance of age-appropriate environments and behaviors.

PURPOSE: This research identified the potential for infantilization of clients in centers that offer an occasional program of combined adult and child day care. DESIGN AND METHODS: The study used a comparative ethnographic approach, which analyzed observation and interview data collected from two adult day centers that offered intergenerational activities. Special attention was paid to the environment, behaviors, and clients' interaction patterns. RESULTS: The adult day center cultures varied widely in age appropriateness, opportunities for autonomy, privacy regulation, choice, and adult interaction, especially as children were introduced into the setting. Infantilization occurred in the intergenerational program when the adults and children were treated as status equals, and the activities and environments were only child oriented. Older persons perceived a need for an "escape option" if contact with children was overstimulating or age inappropriate. Positive intergenerational experiences involved adults in a mentoring role, voluntary participation, and client-initiated contact with children. IMPLICATIONS: This study explores the influence of intergenerational programming in adult day centers, and bridges the gap between theory and practice with implications for other aging services.

Age Factors↗
PubMed1985

Clinical-subjective evaluation of high-risk children: integration and discussion.

Clinical evaluations of index and control children from the point of view of the clinical interview, observations of the subjects during testing, the subjects' parents, and their teachers were compared. There was general agreement that index children showed more psychopathological symptoms, poorer ego development, poorer interpersonal relations, and poorer use of leisure time than their controls. By contrast, behaviors related to aggression, phobias, shame, sleep pathology, eating disorders, frustration tolerance, sexual behavior, and verbal communication skills failed to show consistent group differences. Index boys showed greater anxiety than their controls, while there were no such differences among the girls. Rearing environment exerted no apparent effect on the psychosocial functioning of the children. Factor analysis disclosed that a general factor, accounting for 32.6 percent of the variance, discriminated between index and control children, while several special factors, which represented rarely seen traits, did not discriminate. Group differences, therefore, appeared to stem from global impairment of psychosocial functioning rather than from several distinct patterns of deficit. The present results are in general agreement with previously reported evaluations of children at risk for schizophrenia.

Adaptation, Psychological↗
PubMed2006

FAMILY CAREGIVERS: caring for older adults, working with their families.

As the U.S. population ages and health care costs soar, family and friends are called upon increasingly to provide care. While the typical caregiver is a 46-year-old woman with at least some college education, anyone in the infirm person's circle may be called upon to provide care. The kind of care provided varies greatly--from managing treatment and medication regimens to driving in from out of town to help with shopping--as does each caregiver's reaction to providing such care. While some find caregiving terribly stressful, others find it rewarding. Nurses need to know how to identify the primary caregiver, discern the level of strain caused by caregiving, and create a partnership with the caregiver to help ease the burden. Accompanying text explores one caregiver's experience.

Adaptation, Psychological↗
PubMed2001

Cleft palate in a patient with Williams' syndrome.

Cleft lip or palate has not been reported in the medical literature as a part of Williams' syndrome. We present a patient who had cleft palate among other congenital manifestations. This patient's immediate postnatal period clinically seemed to have a Pierre Robin sequence. With the development of the craniofacial complex, microgenia and micrognathia with glossoptosis gradually became apparent. On further assessment, the patient showed other clinical findings that suggested a syndromic association. This required a complete evaluation to discard other conditions that present with low psychomotor development and distinctive facies, such as Kabuki syndrome or fetal alcohol syndrome. The diagnosis for Williams' syndrome was established based on the clinical features and supported by the fluorescent in situ hybridization test. Williams' syndrome has been described as a rare, congenital disorder characterized by physical and developmental problems. Common features include characteristic "elfin-like" facies, supravalvular aortic stenosis, hypercalcemia, low birth weight, slow weight gain, feeding problems, impulsive and outgoing personality, limited spatial skills and motor control, and intellectual disability. Although individuals with Williams' syndrome may show competence in areas such as language, music, and interpersonal relations, their IQs are usually low and they are considered moderately to mildly retarded.

Child, Preschool↗
PubMed1978

Personality changes and compatibility in the psychiatric resident--supervisor relationship.

Seventy-one psychiatric resident-supervisor dyads were studied in terms of Schutz's interpersonal theory of compatibility. Personality changes during the second year of psychiatric residency were also measured by means of Schutz's Fundamental Interpersonal Relations Orientation Scale. Predictions relating compatibility to satisfaction with the dyad and to ratings of competence were not confirmed. Personality changes were found, with residents showing a significant decrease in needs for wanting to be included and for expressing affection. Situational factors are proposed for the personality changes, and personality factors are suggested as influencing the selection of psychiatry as a medical specialization.

California↗
PubMed1983

Penetrating the information maze.

Advances in library science have led to efficient and expedient methodologies for the acquisition of medical/basic scientific information. These advances provide an opportunity for physicians and librarians to strengthen their bonds of communality so that ultimately technology will serve to link them ever more firmly. This opportunity will be realized only if physicians and librarians continue to maintain open communication channels. In this technological age, social scientists are promulgating the message that, in this era of accelerated changes, the beneficiaries of technology are well advised to emphasize interpersonal relations to the utmost.

Academic Medical Centers↗