Methods of teaching - revisited the nominal group process.
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The business philosophy of total quality management is saturating the healthcare arena, and with it brings new meaning to the old concept of team. Nurses are not exempt from this concept, and will be expected to become effective team leaders and team members. The author reviews the literature on teams to define the concept of teams in the context of group process, and discuss effective team characteristics and barriers that often impede the success of teams. Whether the nurse carries the hat of educator, administrator, practitioner, or staff nurse, all will be part of a team within the changing healthcare environment.
Many liaison psychiatrists have advocated staff meetings as a means of enhancing communications on a medical ward. This paper, based on a one year experience as a psychiatric consultant to a medical ward in a major teaching institution, describes the implementation of a weekly group meeting of nursing and social service staff as a component in the structure of an effective liaison service. Case material is presented to document the efficacy of group process as a teaching and therapeutic modality. By encouraging the verbalization of cogent feelings and anxieties in a weekly group meeting, members developed a sense of mutual trust and openness. In an atmosphere conducive to promoting clarification, understanding, and insight, the group members increased their self awareness of the psychological aspects of physical disease and the effect of their own emotions on the interpersonal process of patient care.
Post-myocardial infarction patients participating in a 12-session group therapy program completed self-rating measures ranking group process variables before and after therapy. Learning positive qualities, experimenting with new behavior, receiving advice and guidance, and gaining cognitive insight by learning how their lifestyle plays a role in the development and management of their coronary condition were most valued. Interpersonal learning, catharsis, and testing group acceptance by revealing embarrassing things about oneself were ranked lowest. These results are examined in the context of previous descriptions of coronary patients' behavior in therapy.
The outcome of a 12-week interpersonal process group therapy for women with postraumatic Stress Disorder (PTSD) related to childhood sexual abuse with and without borderline personality disorder (BPD) was assessed by comparing three naturally occurring treatment conditions: groups that did not have any members with borderline personality disorder (BPD-) (n = 18), groups in which at least one member carried the diagnosis (BPD+)(n = 16), and a 12-week waitlist (WL) (n = 15). PTSD, anger, depression, and other symptoms were significantly reduced in the BPD- groups. However, the BPD+ and WL conditions did not show any pre- to posttreatment improvements. Furthermore, the BPD+ condition showed a significant worsening on measures of anger. Analyses within the BPD+ condition indicated that women with and without the diagnosis experienced equal posttreatment increases in anger problems. These latter results suggest the presence of an anger "contagion" effect. That is, women without BPD did well in the BPD- groups but showed increased anger similar to the BPD+ women when treated in groups with them. Implications for client-treatment matching considerations in PTSD group therapy are discussed.
The authors discuss the important and often neglected role of psychosocial factors in guideline development. Such factors can influence the process by which guideline development groups interact, make decisions and achieve consensus, which may have important implications for the validity and reliability of the recommendations they produce. Particular attention is paid to the role of social influence within multidisciplinary groups and the importance of good chairmanship. Recommendations for participants, chairmen and guideline development bodies are given.
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Two simple sociometric techniques for practical use are described which are derived from the data given in the sociogram. Compared with the conventional sociogram, the group rank score we use everyday therapy has the advantage that it can be published. It permits members of the group to better identify the social situations which cause specific psychic impulses. The sociogram is reserved for the therapist. In our opinion the sociodynamogram has certain advantages over both methods because it provides an insight into spheres which are inaccessible in the sociogram and group rank score.
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OBJECTIVE: To investigate the internal consistency, the domain structure and the influence of social desirability with regard to a questionnaire translated and adapted to assess the quality of rehabilitation team conferences in the Netherlands. STUDY DESIGN: A questionnaire to determine group decision-making processes was translated and adapted to rehabilitation and completed by 44 rehabilitation professionals. RESULTS: The internal consistency of the domains Personal participation, Negative socio-emotional behaviour, Result satisfaction and Process satisfaction was found to be satisfactory (Cronbach's alpha ranges from 0.70 to 0.84). The domain structure is confirmed by item-total and item-rest correlations. From the original English questionnaire, one question concerning the domain Personal participation was omitted. The domain Informal leadership has been deleted from the questionnaire, because informal leadership is not an issue in a situation in which the Chairman is already known. Response to the questionnaire did not seem to be biased by social desirability. CONCLUSION: The translated and adapted questionnaire can be used to assess the group processes of rehabilitation team conferences. Results from the literature concerning the original questionnaire suggest that the translated and adapted questionnaire might be able to detect changes in the group process of rehabilitation team conferences.
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