团体辅导对提高警察院校大学生生命意义感的干预效果

目的探讨团体辅导对促进警察院校大学生生命意义感提升的干预效果。方法采用实验组和对照组前后测试及干预后1个月追踪测试的实验设计,对133名(其中实验组66名,对照组67名)警察院校大学生进行团体辅导实验干预及测评。结果 (1)干预前后测试中,对照组生命意义感得分差异无统计学意义(±s前测=3.591±0.558,±s后测=3.526±0.541,t=0.664,P0.05),干预组生命意义感得分显著提高,差异有统计学意义(±s前测=3.601±0.609,±s后测=3.894±0.602,t=-2.779,P=0.006);(2)实验组和对照组在干预前后生命意义感得分差异有统计学意义(±s实验组=0.297±0.848,±s对照组=-0.098±0.755,t=2.785,P0.01);(3)实验组生命意义感后测试得分和1个月后的追踪测试得分差异无统计学意义(±s后测=3.894±0.602,±s追测=3.826±0.598,t=0.647,P0.05)。结论团体辅导可以有效的提升警察院校大学生的生命意义感,干预效果良好。     

绘画疗法改善肥胖女大学生抑郁的实验研究

目的探讨绘画艺术疗法改善肥胖女大学生抑郁情绪的有效性,为提高肥胖女大学生的学习和生活质量提供依据。方法在大学生中招募志愿者16名随机分为2组:8人为实验组,8人为对照组。实验组参加团体绘画艺术疗法,每周1次,每次2 h,共8次;对照组不采取任何干预。以抑郁自评量表(SDS)、症状自评量表(SCL-90)抑郁项和自尊量表(SES)为测量工具,在团体干预实施前、实施后1周对被试进行测量。结果与对照组相比,实验组被试在干预前后的抑郁自评量表得分显著下降(t=6.75,P<0.01);SCL-90抑郁项均分干预前后比较差异有统计学意义(t=4.32,P<0.05)。实验组被试在干预后的自尊量表得分显著提高(t=5.43,P<0.01)。结论绘画艺术疗法是干预肥胖女大学生抑郁症状的有效途径之一。     

艾滋病患者的抑郁情绪调查分析

目的了解艾滋病患者与正常人群在抑郁情绪方面的差异,以及心理团体辅导活动对艾滋病患者抑郁情绪的影响。方法采用流调中心抑郁量表中文版简版对92名艾滋病患者进行抑郁评分,并比较提供心理团体辅导活动前后的抑郁得分情况。结果艾滋病患者都存在不同程度的负性情绪和不同的行为意志表现,26.4%的艾滋病患者在"我对未来充满希望"选项中选择没有或极少(每周1d以下);在行为意志上,44.6%的艾滋病患者在"我做事缺乏干劲"选项中选择"时常"(每周3~4d);干预前艾滋病患者的抑郁总分均值为11.80±4.61,与筛查临界值(10分)比较,差异有统计学意义(t=3.743,P0.05);干预后艾滋病患者的抑郁总分均值为8.89±4.69,与筛查临界值比较,差异有统计学意义(t=-2.28,P0.05);干预前与干预后的抑郁总分比较,差异具有统计学意义(t=6.185,P0.01),且干预前、后抑郁总分存在相关性(r=0.526,P0.01);干预后,男性艾滋病患者抑郁得分为7.56±4.84,女性艾滋病患者抑郁得分为9.95±4.33,二者相比差异有统计学意义(t=-2.500,P0.05)。结论艾滋病患者的心理健康需要得到重视,心理团体辅导活动能促进艾滋病患者的心理健康。     

积极心理团体辅导对大学生抑郁症状的干预效果评价

探讨以积极心理学理论为导向的团体心理辅导对大学生抑郁症状的影响,为高校开展健康心理辅导和干预工作提供参考.方法 在江西省某高校1 870名大学生中筛查出56名可能有抑郁症状的大学生,以团体辅导的形式对其进行干预,采用实验组和对照组前后测试及追踪测试的实验设计,以综合幸福问卷(MHQ)、抑郁症自评量表(SDS)、心理韧性量表(CD-RISC)为评估工具,最终完成所有实验内容的大学生为45名.结果 团体辅导干预后,实验组综合幸福感得分生活满意因子提升了0.22,正性情感提升了3.86,自我价值提升了0.40,友好关系提升了1.59,幸福体验提升了1.34.抑郁水平由前测的(59.91±2.35)分降至后测的(53.36±2.84)分,心理韧性水平由前测的(57.22±2.59)分提升到后测的(59.50±2.42)分,差异均有统计学意义(t值分别为8.44,-3.05,P值均<0.05);追踪评估结果显示团体辅导结束3个月后,效果依然存在.结论 积极心理团体辅导对抑郁倾向大学生心理健康状况有一定程度的改善作用,可以提高心理韧性和幸福感指数.     

大学生抑郁心理干预效果分析

了解大学生的抑郁状态,探讨心理干预技术对大学生抑郁情绪的效果,为提高大学生心理健康水平提供依据.方法 选取哈尔滨6所高校各专业大学生5 240名,用贝克抑郁量表筛选出有抑郁情绪的大学生355名,随机分为干预组(180名)和对照组(175名),对干预组大学生进行12周个体咨询与团体辅导相结合的心理干预,对照组大学生只进行阶段性的电话随访.结果 干预前、后大学生抑郁评分的重复测量方差分析显示,时间效应(F=301.357,P<0.01)、时间与组别的交互作用(F=10.713,P<0.01)均有统计学意义,组别效应无统计学意义(F=0.043,P>0.05).干预组与对照组干预前抑郁得分分别为(15.96±7.84) (14.66±7.39)分,干预后降低为(7.02±5.85) (8.55±5.75)分(F值分别为215.90,97.838,P值均<0.01);干预组抑郁得分低于对照组抑郁得分(F=6.24,P<0.01).结论 心理干预技术能够有效降低大学生的抑郁水平.     

不同强度羽毛球训练对维吾尔族焦虑症大学生干预效果评价

比较不同运动强度羽毛球训练对维吾尔族焦虑症大学生的干预效果,为提高维吾尔族大学生心理健康水平提供参考.方法 采用大、中、小强度的羽毛球训练分别对从新疆农业大学大一、大二年级整群筛选出的72名(分为3组)具有焦虑倾向的维吾尔族在校大学生进行羽毛球训练干预,干预前后分别采用SCL-90焦虑因子、显性焦虑量表(MAS)和焦虑自评量表(SAS)进行测试,并对结果进行比较.结果 羽毛球训练小强度组干预前焦虑维吾尔族大学生的MAS得分为(32.68±3.47)分,干预后得分为(26.96±3.51)分,干预前后比较差异有统计学意义(t=5.677,P<0.05);SCL-90焦虑因子干预前后得分相比较差异也有统计学意义(t=2.004,P<0.05);SAS干预前后得分相比较差异无统计学意义(t=1.871,P>0.05);中等强度组和大强度组维吾尔族大学生干预前后MAS、SCL-90焦虑、SAS得分差异均有统计学意义(P值均<0.05).干预后,对3个不同强度组组间多重比较显示,大强度组的MAS、SCL-90焦虑、SAS得分与中强度组得分相比较较低,差异均有统计学意义(P值均<0.05);大强度组与小强度组得分相比较也较低,差异均有统计学意义(P值均<0.05).结论 羽毛球训练对维吾尔族大学生的焦虑水平起到较好的改善效果,其中大强度干预训练效果最显著.     

接纳承诺疗法和音乐治疗结合团体辅导对贫困大学生自尊干预效果评价

探讨接纳承诺疗法(acceptance and commitment therapy,ACT)和音乐治疗结合的团体辅导对提升贫困大学生自尊的效果.方法 经过宣传、招募、面谈、筛选,将筛选的重庆医科大学48名贫困大学生随机分为实验组(n=24)和对照组(n=24).对实验组进行ACT和音乐治疗结合的团体心理辅导,对照组不作处理,等待下学期进行干预.采用自尊量表、自我和谐量表、领悟社会支持量表、简易应对方式量表对两组被试进行前测和后测.结果 经过8次的团体辅导,实验组在自尊量表、自我和谐量表、社会支持领悟量表的后测得分(35.29±4.29,102.13±8.30,67.54±6.81)高于前测(28.76±3.98,92.34±6.35,56.00±8.59)(t值分别为9.31,5.21,7.15,P值均<0.05),对照组以上量表前后测得分差异均无统计学意义(t值分别为1.15,0.07,1.59,1.12,P值均>0.05).结论 接纳承诺疗法和音乐治疗结合可以作为一种有效的团体辅导形式,显著提升贫困大学生的自尊、自我和谐度及领悟社会支持.     

某专科学校贫困生心理复原力团体训练效果分析

探索积极心理训练对贫困生心理复原力的影响,为有针对性开展高校心理健康教育提供参考.方法 根据自愿接受的原则,从某专科学校2012级贫困生中选取187名,随机分为实验组(86名)和对照组(101名).采用积极心理团体训练法对实验组大学生进行训练,运用复原力量表和总体幸福感量表对两组研究对象进行干预前、后调查.结果 实验组干预后心理复原力得分(3.83±0.51)较干预前(3.46±0.43)提高(t=3.982,P<0.01);干预后实验组(3.83±0.51)与对照组(3.54±0.56)心理复原力得分差异有统计学意义(t=2.523,P<0.05).实验组干预后比干预前复原力弱型人员减少,复原力强型人数增加.干预后实验组复原力中间型和复原力弱型的复原力水平较干预前有明显提高(t值分别为3.451,4.236,P值均<0.01).干预后实验组总体幸福感得分(114.52±10.32)较干预前(106.23±9.62)有显著提高(t=2.287,P<0.01).结论 积极心理训练对复原力强型贫困生的复原力水平作用不明显,对复原力弱型和中间型的贫困生复原力水平作用明显.     

知信行模式下正念减压训练对有精神神经症状的围绝经期综合征女性负性情绪 应对方式及性激素代谢的影响

目的 探讨知信行模式下正念减压训练对有精神神经症状的围绝经期综合征女性负性情绪、应对方式及性激素代谢的影响。方法 选取2019年1月—2020年6月在金华市第二医院和金华市中心医院就诊的有精神神经症状的围绝经期综合征女性80例为研究对象,随机分为对照组与观察组,每组各40例,对照组患者采用常规健康教育干预,观察组患者采用知信行模式下正念减压训练干预。比较两组患者干预前后负性情绪、应对方式及性激素水平变化情况。结果 干预前,两组患者焦虑自评量表(SAS)和抑郁自评量表(SDS)评分比较,差异均无统计学意义(均P>0.05);干预后,两组患者SAS[观察组(46.08±7.31)分,对照组(50.85±7.45)分]和SDS[观察组(48.72±7.46)分,对照组(53.14±7.34)分]评分均较干预前[观察组(55.48±8.52)分、(58.96±9.57)分,对照组(55.42±8.49)分、(58.90±9.66)分]下降,差异均有统计学意义(观察组t=2.587、5.337,对照组t=2.559、3.003,均P<0.05);且观察组患者均低于对照组,差异均有统计学意义(t=2.890、2.671,均P<0.05)。干预前,两组患者医学应对方式问卷中文版(MCMQ)中面对、回避及屈服得分比较,差异均无统计学意义(均P>0.05);干预后,两组患者面对得分均较干预前升高,且观察组患者高于对照组;回避和屈服得分均较干预前下降,且观察组患者均低于对照组,差异均有统计学意义(均P<0.05)。干预前,两组患者血清雌二醇(E_(2))、孕酮(P)及卵泡刺激素(FSH)水平比较,差异均无统计学意义(均P>0.05);干预后,两组患者E_(2)、P水平均较干预前升高,且观察组患者均高于对照组,FSH水平均较干预前下降,且观察组患者低于对照组,差异均有统计学意义(均P<0.05)。结论 有精神神经症状的围绝经期综合征女性采用知信行模式下正念减压训练干预有助于缓解患者负性情绪,改变患者对疾病的应对方式,调节性激素的代谢,帮助患者度过围绝经期。     

足球训练对河南大学学生自我效能感的干预效果评价

了解足球训练对河南大学学生身体自我效能感的影响,为高校大学生身心健康成长提供理论支持.方法 在河南大学所有班级中随机选取10个教学班级,班级内全体大学生346名作为研究对象,将其随机平均分为对照组和干预组(各173名).干预组进行16周的足球公选课教学训练,实验前后采用身体自我效能量表(PSE)进行测试,并对结果进行比较分析.结果 干预前,干预组与对照组学生身体自我效能感各因子得分差异均无统计学意义(P值均>0.05).16周的足球公选课教学干预后,干预组身体自我效能感各因子得分均高于干预前,差异均有统计学意义(P值均<0.01).干预组自我感受到的身体能力均分干预后比干预前高11.99分,身体自我表现信心均分干预后比干预前高10.01分.干预后,干预组自我感受到的身体能力自我效能均分为(175.12±0.71)分,对照组为(163.13±0.55)分,差异有统计学意义(t=175.595,P<0.01);身体自我表现信心自我效能均分干预后干预组得分为(174.12±0.62)分,对照组为(164.14±0.52)分,差异也有统计学意义(t=162.218,P<0.01),其他各因子干预后干预组与对照组得分比较差异也均有统计学意义(P值均<0.01).对照组干预前后各因子得分差异均无统计学意义(P值均>0.05).结论 足球教学训练干预对提高河南某高校大学生身体自我效能感具有较好的效果.     

The effect of three commercial coaching courses on Step One USMLE performance

BACKGROUND: A substantial industry exists to provide formal review courses for Step 1 of the United States Medical Licensing Examination (USMLE). There are limited data on the usefulness of these courses. AIM: To determine whether or not student participation in a commercial coaching course improves performance on Step 1 of the USMLE. METHODS: Scores achieved by 468 students on the National Board of Medical Examiners (NBME) Comprehensive Basic Science Examination (CBSE) were used to predict a score on Step 1 of the USMLE. The NBME is the organisation that prepares and administers the USMLE. Predicted USMLE scores were then regressed against the actual scores achieved by the students on Step 1. The students were divided into 2 groups: those who took a 3-4-week live commercial coaching course and those who studied on their own. RESULTS: The regression lines for the 369 students who studied on their own and the 99 students who took a commercial coaching course were statistically indistinguishable. The analysis was powerful enough to have picked up a difference of 1% on average (P = 0.05) or 2 questions out of the 350 constituting Step 1 of the USMLE. Neither the students who performed above average nor those who performed below average on the CBSE improved their performance on Step 1 as a result of the coaching courses. CONCLUSIONS: Students who take a live, 3-4-week commercial coaching course to improve performance on Step 1 of the USMLE do not achieve higher scores than students who study on their own. Students should strongly consider whether or not a substantial investment in time and money for a commercial coaching course is justified in the light of such meagre returns.     

A School Based Community Partnership for Promoting Healthy Habits for Life

Childhood obesity rates continue to increase and there is a need for innovative obesity prevention programs. Our objectives were to (1) create a community partnership, and (2) test an obesity prevention intervention that involved curriculum delivered in the classroom with 1:1 coaching delivered by nursing students on health parameters among 4th and 5th grade school children. Our primary hypothesis was that the intervention would result in significant increases in physical activity levels. 99 children from two schools participated in the program. Classrooms were assigned as intervention or control. All classrooms received standardized content on health habits by the public health nurse and children assigned to the intervention classrooms also received 1:1 coaching by nursing students, with fewer total visits at School A. Baseline and end-of-year data were collected for health parameters and physical activity. For School A, there were no significant differences between intervention and control children between baseline and end-of-year for all health outcomes. Due to a limited control group at School B, control and intervention groups at both schools were consolidated for analysis. BMI and BMI percentile increased at School A, but daily minutes of TV and servings of fruit juice decreased. At School B, there were decreases in BMI percentile and servings of soda/punch, plus increases in servings of fruits/vegetables and daily steps (baseline mean ± SEM = 10,494 ± 419 daily steps; end-of-year = 15,466 ± 585 daily steps). A multi-partner, community approach to obesity intervention shows potential for improving health in elementary school children.     

Learning in a clinical education programme in primary care: the Maastricht Adoption Programme

INTRODUCTION: At Maastricht University, the integration of knowledge, skills and attitudes in preclinical medical education is promoted by an 'Adoption Programme', where students carry out assignments in a general practice setting. The assignments are explained and discussed in practical medical coaching groups. The aim of this study was to examine the relationships between the elements that affect learning in the programme. METHOD: Data from the evaluation questionnaires of 188 medical students were used to test a causal model of learning in the programme. A distinction was made between 'action' and 'reflection on action'. We examined the relationships between perceived instructiveness (the programme's value as a learning experience) and the following variables: comprehensibility; feasibility and execution of the assignments; time spent on the assignments, and the direct and indirect influences of the hosting general practitioner (GP) and the practical medical coaching group. RESULTS: Performing the assignments had little effect on perceived instructiveness. Coaching by the hosting GP influenced the execution of assignments mainly by its effect on feasibility. Coaching by the GP and in the practical medical coaching groups barely affected perceived instructiveness. DISCUSSION AND CONCLUSION: The model gives insight into the contribution of aspects of the Adoption Programme to student learning. The results are probably negatively influenced by the insufficient priority given to the Adoption Programme in the practical medical coaching groups and by inadequate instruction given to the GPs for the purposes of their coaching role. More careful planning of patient-related assignments is recommended. Reflection on assignments and feedback on procedures are needed to lift practical experience onto a higher educational level.     

Preparing researchers for patient and public involvement in scientific research: Development of a hands‐on learning approach through action research

Background

Acquiring the theoretical and practical knowhow of conducting patient and public involvement (PPI) in research is not part of the traditional curriculum of researchers. Zuyd University of Applied Sciences and Huis voor de Zorg, a regional umbrella patient organization, therefore started a 1.5‐year coaching programme.

Objective

To establish a community of practice by developing a PPI coaching programme for senior and junior health services researchers of Zuyd University. The context consisted of research projects conducted by the participants.

Methods

A participatory action research methodology. Data were collected from reports of thematic group meetings and individual sessions with participants, field notes and regular reflection meetings with the project team. Data were analysed by reflexive deliberation.

Findings

The programme comprised a kick‐off meeting (52 attendees), followed by 7 group meetings with 11 junior and 9 senior researchers. The project team constructed a serious game based on the concept of the participation ladder. Questions and concerns differed for junior and senior researchers, and separate tailored meetings were organized for both groups. Between group meetings, participants received individual assignments. Group meetings were accompanied by individual coaching sessions to provide tailor‐made feedback. The programme concluded with a combined meeting with all stakeholders.

Conclusion

Building a community of PPI practice through action research facilitates the development of a coaching programme that fosters social learning, empowerment and the development of a shared identity concerning PPI. The role and responsibilities of senior researchers should be distinguished from those of junior researchers.     

同伴互助式案例教学法在《临床康复学》中的应用研究

目的:探讨教学方法,提升教学质量。方法:以南京卫生学校2009级高职康复治疗技术专业37人为观察组,2008级高职康复治疗技术专业30人为对照组,两组学生选用教材、授课教师及学时均相同,分别采用同伴互助式案例教学法与传统教学法,分别评价两组学习效果。结果:观察组理论成绩及综合表现明显优于对照组。结论:同伴互助式案例教学法效果良好,能够提高学习成绩,增强学生临床思维能力。     

Parallel Processes: Using Motivational Interviewing as an Implementation Coaching Strategy

In addition to its clinical efficacy as a communication style for strengthening motivation and commitment to change, motivational interviewing (MI) has been hypothesized to be a potential tool for facilitating evidence-based practice adoption decisions. This paper reports on the rationale and content of MI-based implementation coaching Webinars that, as part of a larger active dissemination strategy, were found to be more effective than passive dissemination strategies at promoting adoption decisions among behavioral health and health providers and administrators. The Motivational Interviewing Treatment Integrity scale (MITI 3.1.1) was used to rate coaching Webinars from 17 community behavioral health organizations and 17 community health centers. The MITI coding system was found to be applicable to the coaching Webinars, and raters achieved high levels of agreement on global and behavior count measurements of fidelity to MI. Results revealed that implementation coaches maintained fidelity to the MI model, exceeding competency benchmarks for almost all measures. Findings suggest that it is feasible to implement MI as a coaching tool.     

Multidisciplinary perspectives: Application of the Consolidated Framework for Implementation Research to evaluate a health coaching initiative

Long‐term conditions are a leading cause of mortality and morbidity. Their management is founded on a combination of approaches involving government policy, better integration between health and care systems, and individual responsibility for self‐care. Health coaching has emerged as an approach to encouraging individual responsibility and enhancing the self‐management of long‐term conditions. This paper focuses on the evaluation of a workforce initiative in a diverse and socially deprived community. The initiative sought both to improve integration between health and care services for people with long‐term conditions, and equip practitioners with health coaching skills. The aim of the study was to contribute an empirical understanding of what practitioners perceive to be the contextual factors that impact on the adoption of health coaching in community settings. These factors were conceptualised using the Consolidated Framework for Implementation Research (CFIR). A stratified purposive sample of 22 health and care practitioners took part in semi‐structured telephone interviews. Data were analysed using the CFIR as an analytical framework. The perceptions of trainees mapped onto the major domains of the CFIR: characteristics of the intervention, outer setting, inner setting, characteristics of individuals involved and process of implementation. Individual patient expectations, comorbidities and social context were central to the extent to which practitioners and patients engaged with health coaching. Structural constraints within provider services and the wider NHS were also reported as discouraging initiatives that focused on long‐term rewards rather than short‐term wins. The authors recommend further research is undertaken both to understand the role of health coaching in disadvantaged communities and ensure the service user voice is heard.     

Coaching process outcomes of a family visit nutrition and physical activity intervention.

The purpose of this article is to report the process outcomes of a coaching methodology used in a study designed to increase fruit and vegetable consumption and physical activity in families. Eighty-eight families with second graders were recruited from a rural, biethnic community in Colorado and randomized to intervention and delayed intervention conditions. This article reports on the 27 families in the delayed intervention group. Families received up to 10 home visits over 10 months from a family advisor and completed activities to improve their dietary and physical activity behaviors. Coaching conversations took place during each home visit. Coaching process outcomes were evaluated by analysis of visit documentation, participant survey, and qualitative interviews. Results indicated that coaching, in conjunction with family activities, engaged families in the process of change and facilitated movement toward the achievement of their weekly nutrition or physical activity goals. Coaching methodology may be particularly useful for participatory research.     

Randomized controlled trial of the effectiveness of an intervention to implement evidence-based patient decision support in a nursing call centre

We evaluated the effect of an intervention on call centre nurses' knowledge of decision support and skills in coaching callers facing value-sensitive health decisions. Forty-one registered nurses at a health call centre were randomly assigned to an intervention or control group. The intervention was a coaching protocol, online tutorial, skills building workshop and performance feedback. The main outcome measures were: knowledge test; blinded quality assessment of coaching skills during simulated calls and call duration. Compared with controls, nurses in the intervention group had better knowledge (74 versus 60%, P = 0.007) and decision coaching skills (81 versus 44%, P < 0.001), particularly in assessing decisional needs (information, values clarity, support, stage and timing of decision) and addressing support issues. Call duration did not differ (18.5 versus 16.7 min, P = 0.73). The coaching protocol was rated as compatible with nurses' views on decision-making and more advantageous compared with their usual practices. The intervention improved the quality of nurses' decision coaching without affecting call duration.