A metacognitive model of problem drinking

Previous research has demonstrated significant relationships between metacognition and problem drinking. In this study, we aimed to investigate further these relationships by testing the fit of a metacognitive model of problem drinking in a sample of 174 problem drinkers from a university student population. In the model presented, it is proposed that positive metacognitive beliefs about alcohol use and negative affect lead to alcohol use as a means of affect regulation. Positive metacognitive beliefs about alcohol use are also associated with a reduction in metacognitive monitoring which further contributes to alcohol use. Once alcohol use is initiated it brings a disruption in metacognitive monitoring leading to a continuation in drinking. Following a drinking episode, alcohol use is appraised as both uncontrollable and dangerous, which in turn strengthens negative metacognitive beliefs about alcohol use. These beliefs are associated with an escalation of negative affect, which acts as a trigger for further drinking. The specified relationships among these variables were examined by testing the fit of a path model. Results of this analysis indicated a good model fit consistent with predictions. The conceptual and clinical implications of these data are discussed. Copyright © 2009 John Wiley & Sons, Ltd. Key Practitioner Message: ? A cognitive‐attentional model that may aid assessment, conceptualization and treatment for moderate or at risk problem drinkers.     

静脉留置针留置时间影响因素调查及相关性研究

目的:探讨静脉留置针留置时间影响因素及其影响程度。方法:对335例患者留置静脉针使用情况进行调查,分析影响留置时间因素及其影响程度。结果:肝素封管、加强固定、选择手背血管、血管充盈、输注等渗(含钾或不含钾)液体、一次穿刺、依从性高较盐水封管、一般固定、选择其他部位血管、血管不充盈、输注高渗液体、多次穿刺、依从性低的患者留置针留置时间长。多元逐步回归分析显示留置时间达到3天与封管液选择、固定方法、血管部位、输注液体种类、穿刺次数、依从性6个条目有关。结论:留置时间达到3天的影响因素有封管液选择、固定方法、血管部位、输注液体种类、穿刺次数、依从性等。     

影响基层医院健康教育效果的因素与对策

目的分析影响住院病人健康教育效果的因素,提高基层医院健康教育效果。方法通过自行设计问卷,对住院部护士、患者共130人进行问卷调查。结果影响住院病人健康教育效果的因素包括护士的语言沟通能力、工作量、宣教时机和患者的年龄、健康状况以及对护士的信任度。结论医院应加强对护理人员沟通技巧及人文知识的培训,护理人员应努力提高自身综合素质和扩宽知识面,在实施健康教育之前准确评估患者的健康状况和心理状态,选择合适的时机施教,以达到最佳效果;同时,医院应完善后勤支持,确保护士有更多的时间进行健康教育。     

Testing whether barriers to a hypothetical screening test affect unrelated perceived benefits and vice versa: A randomised,experimental study

ObjectiveDetermine whether (fictitious) health screening test benefits affect perceptions of (unrelated) barriers, and barriers affect perceptions of benefits.MethodsUK adults were recruited via an online survey panel and randomised to receive a vignette describing a hypothetical screening test with either high or low benefits (higher vs. lower mortality reduction) and high or low barriers (severe vs. mild side-effects; a 2 × 2 factorial design). ANOVAs compared mean perceived benefits and barriers scores. Screening ‘intentions’ were compared using Pearson’s χ² test.ResultsBenefits were rated less favourably when barriers were high (mean: 27.4, standard deviation: 5.3) than when they were low (M: 28.5, SD: 4.8; p = 0.010, partial η² = 0.031). Barriers were rated more negatively when benefits were low (M: 17.1, SD: 7.6) than when they were high (M: 15.7, SD: 7.3; p = 0.023, partial η² = 0.024). Most intended to have the test in all conditions (73–81%); except for the low benefit-high barrier condition (37%; p < 0.0005; N = 218).ConclusionsPerceptions of test attributes may be influenced by unrelated characteristics.Practice implicationsReducing screening test barriers alone may have suboptimal effects on perceptions of barriers if benefits remain low; increasing screening benefits may not improve perceptions of benefits if barriers remain high.     

The Breathing Boundary

All psychotherapy is dependent on a frame, a structure. We require boundaries in order to feel and provide containment. However, when working with patient groups who have been excluded from mainstream risk‐averse treatment we learn more about the nature of professional boundaries. A boundary needs to be nurtured and thought about. It needs to breathe and to come from thought. A rigid boundary is a different matter. Where is the humble concept of not knowing? What makes flexible guidelines become rigidified into inflexible codes and barriers? In interrogating techniques that do not work with people with intellectual disabilities we learn more about shared areas of social disability. This paper focuses on questions of analytic neutrality, affect, anger, transparency, and disability psychotherapy in the external as well as internal world.     

The Emotion Word Fluency Test (EWFT): Initial psychometric,validation, and physiological evidence in young adults

Introduction: The clinical assessment of affective functioning has been slow to incorporate findings from affective neuroscience. Of particular interest in the current study is the assessment of affective word production. Method: In a series of four studies, we examined test–retest and interrater reliability for the Emotion Word Fluency Test (EWFT), basic construct validity with existing verbal fluency measures, physiological responses across verbal fluency tasks, and a novel scoring method to examine qualitative aspects of participant response sets. Results: Results demonstrated interrater and test–retest reliability values that were comparable to those of other commonly used verbal fluency tests. Construct validity was demonstrated by relations between the EWFT and other verbal fluency tests as well as through physiological evidence that performance on the EWFT is related to greater sympathetic activity than traditional verbal fluency tasks. Lastly, some of the novel scoring metrics related to two self-report measures of emotional functioning. Conclusions: Taken together, our findings provide initial support for the use of the EWFT as a measure of emotion word generation ability in young adults. This measure may prove to be useful in the assessment of affective language production in patient populations.     

Academic time during college: Associations with mood,tiredness, and binge drinking across days and semesters

The current study examined the amount of time American college students spent on academics and explored whether functioning indicators (i.e., positive affect, negative affect, tiredness, and binge drinking) rose and fell with academic time across days and semesters. College students (N = 735) were followed longitudinally and completed 14 daily diaries within each of 7 semesters (N = 56,699 days). The results revealed that academic time decreased slightly during the middle semesters and then increased in later semesters. Furthermore, on days when students spent more time on academics, they reported less positive affect, more tiredness, and less binge drinking; however, the strength and direction of associations depended on the analysis level and whether it was a weekend. Positive affect, for instance, was inversely associated with academics across days, but the reverse was true across semesters. These results emphasize the importance of considering the temporal context in research on adolescent and young adult time use.