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PubMed1999

[Tasks, burdens and borderline situations in old age. General discussion].

In this four-part review article, an update covering the geropsychological research since 1988 in German speaking countries is given as follows: Cognitive development in old age (part I), personality development in old age (part II), social relations in old age (part III), age-related tasks, burdens, and border situations (part IV). In part IV of the update presented in this issue, research contributing to a competence perspective of old age and aging is summarized under four main headings: (1) Independence, everyday life, and everyday competence; (2) aging in spatial, physical, and technical environments; (3) health and coping with illness; (4) coping with death and dying. The article ends with a general discussion considering as well the findings of our survey addressing gerontologists from German speaking countries.

Aged↗

PubMed2003

Achieving acceptable reliability in oral examinations: an analysis of the Royal College of General Practitioners membership examination's oral component.

BACKGROUND: The membership examination of the Royal College of General Practitioners (RCGP) uses structured oral examinations to assess candidates' decision making skills and professional values. AIM: To estimate three indices of reliability for these oral examinations. METHODS: In summer 1998, a revised system was introduced for the oral examinations. Candidates took two 20-minute (five topic) oral examinations with two examiner pairs. Areas for oral topics had been identified. Examiners set their own topics in three competency areas (communication, professional values and personal development) and four contexts (patient, teamwork, personal, society). They worked in two pairs (a quartet) to preplan questions on 10 topics. The results were analysed in detail. Generalisability theory was used to estimate three indices of reliability: (A) intercase (B) pass/fail decision and (C) standard error of measurement (SEM). For each index, a benchmark requirement was preset at (A) 0.8 (B) 0.9 and (C) 0.5. RESULTS: There were 896 candidates in total. Of these, 87 candidates (9.7%) failed. Total score variance was attributed to: 41% candidates, 32% oral content, 27% examiners and general error. Reliability coefficients were: (A) intercase 0.65; (B) pass/fail 0.85. The SEM was 0.52 (i.e. precise enough to distinguish within one unit on the rating scale). Extending testing time to four 20-minute oral examinations, each with two examiners, or five orals, each with one examiner, would improve intercase and pass/fail reliabilities to 0.78 and 0.94, respectively. CONCLUSION: Structured oral examinations can achieve reliabilities appropriate to high stakes examinations if sufficient resources are available.

Clinical Competence↗

PubMed1982

Passive-aggressive personality disorder. Treatment implications of a clinical typology.

Patients with passive-aggressive personality disorder or personality traits represent a very difficult group on which surprisingly little is written. The authors delineate four patterns of passive-aggressive behavior that pose different problems in learning and adaptation. These are the anxiety-inhibited, environmentally inhibited (masochistic), and resentful-vindictive patients and patients inhibited by existential choice. All four types meet the DSM-III criteria for passive-aggressive personality disorder; they may also occur as significant personality traits apart from the fully developed personality disorder. The difficulties that these patients present are the same for clinicians of every theoretical perspective. Using one treatment approach, assertiveness training, the authors offer specific suggestions in the treatment of each type of passive-aggressive patient. These suggestions should aid the clinicians in avoiding premature termination, and fostering both a positive therapeutic alliance and a successful treatment outcome.

Adult↗

PubMed2006

Education needs for integrated care: a literature review.

AIM: This paper reports a systematic review to identify the education needs of the workforce within primary care to promote the effective delivery of integrated health and social care services. BACKGROUND: The need for different professionals to work more closely dominates global health policy. The drive to develop a workforce prepared for the future is crucial to the success of integrated services. However, some have argued that nurses are ill-equipped to meet the challenges of integrated service provision. The ability to work interprofessionally is an important skill which needs to be developed to support integrated working. METHODS: Structured searches were undertaken on organizational websites and the Caredata, CINAHL, Cochrane Library, MEDLINE, Sociofile databases between December 2002 and April 2004 to identify policy documents and primary research studies. The robustness of identified research studies were appraised using recognized appraisal tools. FINDINGS: Six themes were identified which indicate essential elements needed for integrated care. The need for effective communication between professional groups within teams and an emphasis on role awareness are central to the success of integrated services. In addition, education about the importance of partnership working and the need for professionals to develop skills in relation to practice development and leadership through professional and personal development is needed to support integrated working. CONCLUSION: Education which embeds essential attributes to integrated working is needed to advance nursing practice for interprofessional working. Further research exploring this and its impact on integrated provision is essential to ensure that evidence-based services are provided. The reinforcement of partnerships between higher education institutions and health and social care organizations should ensure that the workforce is educated to manage continuous change in service delivery. Innovative ways of teaching and learning which promote inter-professional working need to be explored.

Attitude of Health Personnel↗

PubMed1982

Thoughts on the emergence of the sense of self, with particular emphasis on the body self.

In trying to trace the emergence of the sense of self during the first fifteen months of life--in particular the formation of the bodily self--we used, on the one hand, severe dissociations of the integral parts of the body self such as occurs in psychosis, in the Gilles de la Tourette syndrome, and in phantom-limb disturbances and, on the other hand, data from our normative study of the separation-individuation process as inferred from mother-infant interaction in general and the infant's behavior in front of the mirror in particular. The infant's behavior in front of the mirror strongly suggests that feelings about himself only gradually become integrated with perceptual and cognitive awareness of himself. All the data, furthermore, indicate that it is not possible to study the development of the self separate from the development of the object. All inferences contained in our paper about the emergence of the sense of self were made from the point of view of the central organizing, integrating, and synthesizing institution of the mind, that is, the ego. We agree with other authors that the developing self has both experiential and structural aspects. We titled our paper "Thoughts on the Emergence of the Sense of Self" to indicate that this paper is meant to be an initial and quite tentative communication about the vast and elusive area of personality development concerning the emergence of our bodily self, and thus of the core of our personal identity.

Body Image↗

PubMed1979

[Various family problems of early education of early treated children with clefts].

To prevent retardation in personality development of physically and mentally handicapped children and adolescents, more attention should be paid to the qualification of parents, kindergarten teachers and teachers to educate handicapped children, and so those with cleft lips and palates. This is corroborated by findings obtained of 21 mothers of early-treated cleft children who had been involved in the present study. To qualify parents and co-educators to educate and care cleft children, they are needing sympathetic guidance by, and paedagogical advice from, all those who are contributing to rehabilitation.

Child↗

PubMed1977

[Studies on the socio-medical and psychological situation of persons suffering from osteogenesis imperfecta tarda (author's transl)].

A group of 22 patients suffering from osteogenesis imperfecta tarda were evaluated on their school and vocational education, sport activities as well as personality development with the help of follow-up studies, questionnaires or medical records. 21 patients had at least received elementary school education and had been average or good pupils. Five of six patients who had meanwhile reached adulthood had received higher education and vocational training. Owing to their disease five of six patients had to give up their original jobs or occupational plans. There was only one female patient who had received vocational guidance. Of ten children and six adults five and four respectively carried out sports in their leisure time. To improve the patients' situation it is immediately necessary that (1) the parents be informed of the nature of the disease as well as its heridity, and be advised how to handle these children; (2) the patients and their parents receive educational and vocational guidance.

Adult↗

PubMed1991

Continuity and change in personality in old age--evidence from five longitudinal studies: introduction to a special issue.

This short essay introduces some of the current problems in developmental personality theory and comments on the five articles that follow, all of which arise from longitudinal studies of aging in Israel, Sweden, and the United States. Although the study of personality has always been of central interest in psychology, personality development in advanced old age is a very new topic. We hope that this Special Issue will stimulate a lively discussion and will provoke further studies of personality in old age, which is indeed a "special issue."

Aged↗

PubMed1975

Psychotherapy in India: past, present, and future.

If psychotherapy is defined as "interpersonal method of mitigating suffering" then many psychotherapeutic systems have existed in India a long time. Unlike Western systems, these have lacked a clinical bias but have provided a more global framework. The future of psychotherapy in both East and West lies in discovering a conceptual framework with universal validity within which ad hoc therapies--for symptom relief, personality development, or interpersonal adjustment--can be developed.

Buddhism↗

PubMed1984

Developing physical fitness for the elderly through sport and exercise.

For maintaining and developing motor mobility in old age motor activity is essential. We can take from the phylogenesis and ontogenesis of the human being how important physical activity is for personality development and for maintaining physical fitness in old age. Many phenomena, which have so far been thought to be due to natural consequences of the ageing process, can now be traced back to lack of physical activity. These findings are illustrated by examples referring to the most important subsystems of our organism (such as the central nervous system, the cardiovascular system, etc.). To keep these subsystems and with them our organism as a whole functioning as well as possible, we must improve their specific adaptability through sports and exercise. Sports and exercise for the elderly as well as gymnastics for senior citizens should therefore adequately improve co-ordinative skills, the ability of the muscles to relax, joint flexibility, muscle strength, endurance, vegetative adaptability, stress tolerance, controlling body-weight, and resistance to infections.

Adult↗

PubMed2003

The values profile of nursing undergraduate students: implications for education and professional development.

This study examined the values profile of 152 nursing undergraduate students, as measured by the 20 life and work values from the Values Scale, and compared their profiles to those from a comparable sample of 111 management undergraduate students. Results showed that Personal Development and Altruism are the most important values for this sample of nursing students. There also were several significant age effects related to six of the values. The results of the t tests showed that the nursing sample had a significantly higher mean on the Altruism value and lower means on the Life Style, Advancement, Autonomy, Authority, Creativity, Economic, and Risk values, compared to the management sample. Recommendations are offered for nurse educators and managers. Inevitably, values compel individuals to be and to act, both personally and professionally.

Adolescent↗

PubMed1991

Cytomegalovirus retinopathy as the initial manifestation of the acquired immunodeficiency syndrome.

Of 100 consecutive patients with human immunodeficiency virus infection and cytomegalovirus retinopathy, 15 did not have a previous diagnosis of the acquired immunodeficiency syndrome before the ocular infection. All had other HIV-related disorders that would place them in Group IV of the Centers for Disease Control hierarchical classification system for HIV infections. In nine patients, cytomegalovirus retinopathy was the only disorder that fulfilled the Centers for Disease Control criteria for diagnosis of AIDS. In the other six, examination disclosed additional preexistent or concurrent nonocular disorders that were also diagnostic of AIDS. No demographic, medical, or ophthalmic characteristics distinguished the nine patients for whom cytomegalovirus retinopathy was initially the only manifestation of AIDS. On the basis of published figures for the prevalence of cytomegalovirus retinopathy in patients with AIDS, and the incidence with which HIV-infected persons develop AIDS, it is estimated that approximately 1.8% of patients with AIDS have cytomegalovirus retinopathy as the first manifestation and that less than 1% of HIV-infected persons will develop cytomegalovirus retinopathy as the initial manifestation of AIDS during the first seven years after infection with HIV.

Acquired Immunodeficiency Syndrome↗

PubMed1992

Self-perceived stress and the risk of peptic ulcer disease. A longitudinal study of US adults.

BACKGROUND: Although many physicians and laypersons believe that stress plays a role in the occurrence of peptic ulcer disease, the importance of stress in the pathogenesis of peptic ulcers remains controversial. METHODS: To investigate the relationship between perceived stress and peptic ulcer disease we used data from the National Health and Nutrition Examination Survey Epidemiologic Follow-up Study--a nationally representative cohort study of US adults. This analysis included 4511 persons who had not previously been diagnosed with peptic ulcer disease. RESULTS: At baseline, 68% of the cohort perceived themselves as stressed. During 13 years of follow-up, 208 persons developed ulcers; the cumulative incidence of ulcers was 7.2% for persons who were stressed and 4.0% for persons who were not. After we adjusted for age, sex, education, smoking status, and regular aspirin use, persons who perceived themselves as stressed were 1.8 times more likely to develop ulcers than those who did not (95% confidence interval, 1.3 to 2.5). We also found a graded relationship between the perceived amount of stress and the incidence of peptic ulcers; relative to nonstressed persons, the relative risk of developing an ulcer was 1.4, 1.9, 2.3, 2.4, and 2.9 at five increasing levels of stress. CONCLUSIONS: These findings suggest that persons who perceive their lives as stressful may be at increased risk for the development of peptic ulcer disease.

Adult↗

PubMed2004

A longitudinal study of the relationships between conscientiousness and the social-environmental factors and substance-use behaviors that influence health.

The present study tested the relationships among conscientiousness-related traits, social-environmental factors that affect health, and substance-use behaviors across a 30-year period from age 21 to age 52 in the Mills Longitudinal study of women (N=99). Results showed that the trait of social responsibility (a facet of conscientiousness) assessed at age 21 predicted family, work, and substance use outcomes at midlife (age 43 and age 52). In turn, marital quality, duration of marriage, divorce, participating in paid work, status level of work, and marijuana consumption were associated with changes in social responsibility. The implications for personality, health, and personality development are discussed.

Adult↗

PubMed1985

Backgrounds of higher suicide rates among "name university" students: a retrospective study of the past 25 years.

Cases from the past 25 years of 143 students who committed suicide at Kyoto University, a "name university" in Japan since 1956, were investigated retrospectively. Then the total trends of the suicide rate were reexamined in comparison with a control group, and the recent trends after the student strife (1970) were confirmed in comparison with the 15-year period before the strife. Thus, using a longer time span, the total pattern of suicide could be reidentified as the "performance type" within an "achievement-oriented culture." Seemingly healthy students from normal homes have suddenly committed suicide in this recent "pupa within a cocoon" syndrome, resulting from "unbalanced personality development" in the context of modern mass higher education.

Achievement↗

PubMed1986

The psychological effects of Apartheid psychoanalysis: social, moral and political influences.

The notorious governmental policy of Apartheid affects the people of that country psychologically, as well as politically, socially, economically and medically. It does so in a variety of ways, including: the humiliating effects on blacks and arrogance inducing effects on whites; the disruption of family-life by the enforced migrant labor system; the stunted brain-development and behavioral effects that result from the inexcusably widespread childhood malnutrition in that wealthy country, (the world's 6th-largest food-exporter); the distortions and alienations in personality development, on racial lines; the mental breakdowns and suicides that result from the physical and mental torture that unchanged security-police detainees are subjected to while under interrogation. In addition, when mental health services are required they are grossly inferior for blacks, especially in the rural areas and particularly in out-patient care. The white-doctor: black-patient relationship, perforce the rule, is distinctly problematic in this socio-political climate. The World Medical Association and the World Psychiatric Association have been supportive to the South African government and silent, respectively, in the face of all the documented information on this hazardous public health situation. The United Nations and its agencies, the World Health Organization and the Centre Against Apartheid, should be commended for their work and unequivocal stands on this issue and should be heeded in their calls for a principled response by more of the world's psychiatric, psychological and medical communities.

Black or African American↗

PubMed1992

Shared experiences and the similarity of personalities: a longitudinal study of married couples.

Do spouses become more similar over time? What processes contribute to enduring similarities between them? Using the 20-year Kelly Longitudinal Study of couples, no support for the hypothesis that couples increasingly resemble each other with time was found. Rather, couples maintain the same degree of similarity across 20 years. Structural equation analyses suggest that the shared environmental experiences of couples play a significant role in maintaining these similarities over time. We distinguish the shared marital environment from the shared rearing environment and consider developmental and dynamic-relational factors that moderate the relative importance of nonshared and shared environmental experiences in life-span personality development. Whereas nonshared influences in one's family of origin contribute to development in childhood and adolescence, shared influences in one's family of destination may contribute a great deal to development in adulthood.

Adult↗

PubMed1998

The key to quality nursing care: towards a model of personal and professional development.

Quality of nursing cannot be assessed in terms of performance referenced criteria, but only in terms of the personal qualities displayed in the performance. The key to improvement in practice may be the improvement of emotional and motivational tendencies. In essence, professional development implies personal development. Harré makes a distinction between 'powers to do' and 'powers to be' (a state of being). The former are the capacities that individuals acquire to perform their tasks and roles. Professional development therefore involves, first, the acquisition of the capacities necessary for the successful completion of a set of professional tasks (the powers to do). Secondly, it involves the acquisition of the appropriate emotions and motivations, and the theories about human nature and the conduct that underpins them (the powers to be). Therefore, these capacities cannot be derived from analysis of tasks, since what are defined as tasks in the first place are determined by the exercise of such powers. The acquisition of attitudes constitutes a source of competent practice. Harré's model of 'personal identity' provides a conceptual framework for thinking about the process of the acquisition of nursing competence and its relationship to differing views of nursing. Considerations relating to different priorities within Harré's model make it possible to raise questions about the objectives of competence at different stages.

Clinical Competence↗