Clinical supervision in cognitive behavioural psychotherapy: development of a model for mental health nursing through grounded theory

This study focuses on the development of a cognitive behavioural model of supervision for mental health nurses. The study utilized a grounded theory approach with cognitive behavioural psychotherapy training course directors. The aim was to more fully understand cognitive behavioural supervision from the perspective of expert supervisors, and develop a model of supervision for mental health nurses who are also cognitive behavioural psychotherapists. For this purpose, 16 course directors were interviewed in-depth, with data analysis taking place after each interview. Through a process of inductive reasoning, core categories were identified from the participants themselves. The relationships between the categories are described. The findings are discussed in terms of a new model that can be used to underpin cognitive behavioural psychotherapy supervision in mental health nursing.     

Clinical supervision as a model for clinical leadership

Clinical leadership and clinical supervision are topical areas of nursing development. A project was established to facilitate the growth of leadership ability with a group of ward sisters through individual clinical supervision. The work revealed that ward managers struggled to fulfil their leadership roles largely because of embodied ways of relating within a prevailing organizational culture that constrained them. The paper also reflects on the impact of supervision to develop leadership practice.     

Application of a context-oriented model for the planning of psychotherapy

Since clinical experience has shown that creating a therapeutic setting with borderline or psychotic patients is extremely difficult the Department of Psychoanalysis and Psychotherapy at Vienna University Hospital has developed a method of treatment designed to increase the possibilities to work with this group of patients. This procedure is conceptualised as "context oriented model exploration in psychotherapy planning" COMEPP. Initially the context is explored in which the psychotherapeutic model should be implemented which has so far failed for different reasons. Following this a setting is created in which the therapeutic team and the patient(s) can constructively and creatively reflect on alternative therapeutic models. A clinical case illustrates the problems and the basic structure of COMEPP in a schematic and condensed form.     

Nursing students in clinical practice--developing a model for clinical supervision

The aim of this study was to develop a model for clinical supervision to promote the clinical practice of nursing students. The study was implemented in Finland and it was carried out in three phases. Firstly, data were collected by means of a literature review and focus group interviews. Secondly, the data were analysed and described in expert groups, and finally the model itself was evaluated by 23 nursing experts. The data of literature review and focus group interviews consisted of 27 studies and four groups from three organisations: nurses (n = 7), managers (n = 6), teachers (n = 8) and students (n = 6). The data were analysed by qualitative content analysis. The model devolved from the study includes the concepts describing prerequisites, content and influence of clinical supervision. The prerequisites are nursing skills, a holistic view of the nursing curriculum, pedagogical, organisational, development, cooperation and interaction competence and decision-making skills. The content of clinical supervision includes support of professional development, pedagogical competence, research and development activities and collaborative working. Clinical supervision has influence on students’ professional and personal development and conception of the future of nursing profession, students’ preparedness for career planning and the teacher’s and preceptor’s professional development. The model could unify the notions of all parties concerned of the prerequisites, content and influence of clinical supervision. Furthermore, the entire supervision process and its control could be clarified. The model may be utilised in selecting and educating preceptors and evaluating the quality of clinical supervision.     

Fieldwork education: a shared supervision model

This paper describes how McMaster University, Department of Occupational Therapy implemented a shared supervision model during an adult physical health block clinical placement, in two fieldwork settings in Hamilton. Five students were assigned to each of the clinical facilities and spent time with the group supervisors and clinical preceptors to meet their learning needs. The objectives, implementation process, training and orientation process, learning and evaluation process, and outcome of this project are discussed. The shared supervision model appears to be a viable alternative supervision model in fieldwork education.     

Biopsychosocial elements of empathy: a multidimensional model

Empathy is a topic of growing concern in a variety of disciplines. Although considerable empathy research is reported, often single dimensions of a multidimensional and multiphasic construct are actually being studied. Empathy is a unitary construct involving biopsychosocial components and is particularly well suited for nursing study because of its theoretical congruence with nursing philosophy and concerns. Empathy's importance goes beyond the usual emphasis on helper empathy. Although commonly associated with prosocial behavior, empathy involves underlying processes which may be used for either positive or negative social purposes. Recent technological improvements in research methodology, concerns regarding social violence, and conceptual shifts have led to greatly increased interest in the phenomenon of empathy and an expanded research thrust. One major recent change in empathy research is the tendency to view the phenomenon as multidimensional and consequently to include a variety of measures to capture different elements of the construct. This paper reviews the major approaches to measurement of empathy and classifies these approaches according to the dimensions of empathy that they measure. Physiological change in association with empathy is less frequently measured, but because empathy is commonly assumed to include an emotional response to another, concomitant physiological changes should accompany the emotional aspect of empathy and indicators of physiological response may be appropriate measures to include in nursing studies of empathy. A conceptualization of empathy is presented that considers empathy to be a multidimensional phenomenon, with emotional, cognitive, communicative, and relational components. Because empirical approaches can only examine the most easily measured aspects of empathy, phenomenological approaches are also needed to begin to capture the total construct.     

The physiotherapist-patient relationship: applying a psychotherapy model

The aim of this article is to elaborate the concept of the physiotherapist-patient relationship, taking counselling and psychotherapeutic encounters as the model. The relationship is described as consisting of three components: the working alliance, the transference configuration, and the real relationship. The model of interactions between the therapist and the patient during physiotherapeutic treatment is developed. According to this, the process and the outcome of a treatment are influenced by two factors: (1) the degree of insight-seeking orientation, and (2) the interplay of the three components of the relationship. The application of the model in physiotherapeutic practice is illustrated by means of three case studies.     

Expert views on clinical supervision: a study based on interviews

Clinical supervision is a didactic process of the purpose of human development and maturity. The aim of this study is to analyse views on clinical supervision held by a number of experts, and to reflect on the effects and value of clinical supervision in relation to public health. Data were collected by interviews and analysed in accordance with the grounded theory construction model. The results showed that clinical supervision is an integration process guiding a person from novice to expert' by establising a relationship of trust between supervisor and supervisee. This study indicates that implementation of systematic clinical supervision may positively affect quality of care, and patients' recovery, create improved feeling of confidence in one's work, and prevent burnout among staff. The negative aspects, as reported, were the possibility of high opportunity costs', e.g. the time loss for patient care by those participating in organized systematic supervision. On the other hand, clinical supervision contributes towards more efficient use of resources and hence avoids unnecessary costs. However, neither of these aspects were further elaborated on by the experts but clearly indicate an important field for further research.     

Toward a comprehensive model of death anxiety

An integrative, comprehensive model of death anxiety is presented. The model postulates three immediate antecedents of death anxiety: past-related regret, future-related regret, and meaningfulness of death. Past-related regret refers to a person's unfulfilled aspirations that should have been achieved but were not. Future-related regret refers to the anticipation that, as a result of premature death, one cannot achieve important goals in the future. Meaningfulness of death refers to one's concept of death and ability to make sense of it. These three antecedents are related to death salience in a complex way, mediated by coping mechanisms and their effects on one's beliefs about self and the world. The coping mechanisms include (but are not necessarily limited to) life review, life planning, identification with culture, and self-transcending processes. The model's developmental and practical applications are explored.     

Toward a pharmacoeconomic model of neuropathic pain

BACKGROUND: Pharmacoeconomic analysis is increasingly being used to assist decision makers in getting the biggest "bang for the buck" within cost-constrained health care budgets. The tools and techniques of this science, however, have scarcely been applied to neuropathic pain. OBJECTIVE: To describe the basic principles of pharmacoeconomic analysis and set forth a preliminary pharmacoeconomic model of neuropathic pain. KEY FINDINGS: Applying the tools and techniques of pharmacoeconomic analysis to neuropathic pain yields several insights. First, because pain treatment predominantly benefits quality of life, the results of a pharmacoeconomic analysis of neuropathic pain treatment should be expressed in terms of the cost per quality-adjusted life-year (QALY)-gained metric. Second, because pain can fluctuate, a state-transition modeling approach should be used in constructing the pharmacoeconomic model to account for changes in pain status over time, particularly as relates to the effects of treatment. Finally, assessment of typical practice patterns in neuropathic pain suggests that the pharmacoeconomic model should account for multiple rounds of treatment (i.e., first-line therapy, second-line therapy, and so on), primary care to specialty care referral patterns, and differences in costs and outcomes between primary care physicians and pain specialists. CONCLUSIONS: Pharmacoeconomic analysis of neuropathic pain treatments can play an influential role in formulary committee deliberations, treatment algorithms, and decision making in the clinical setting. By describing the fundamental concepts and key challenges in this field, it is hoped that this article will represent a useful first step toward a pharmacoeconomic model of neuropathic pain.     

Toward a nursing theory of self-transcendence: deductive reformulation using developmental theories

The purpose of this article is to explicate the development of an emerging middle-range nursing theory of self-transcendence. The process of developing the theory was based largely on the method of "deductive reformulation." Using this strategy, theoretic knowledge derived from life span developmental psychology was reformulated based on Rogers' conceptual system. Clinical experience and empirical investigations were also important in the theory development process. The theory of self-transcendence is potentially useful for application in various nursing settings where clients' well-being may be compromised by end-of-life issues.     

基于信息化的化疗相关性恶心呕吐多维管理模式的构建

目的 构建基于信息化的化疗相关性恶心呕吐的多维管理模式。方法 通过查阅文献、质性访谈、专家会议法开发化疗相关性恶心呕吐症状管理微信公众号,构建基于信息化的医护患共同参与的多维管理模式。结果 建立了化疗相关性恶心呕吐的症状管理平台,包括：患者端微信公众号和医护电脑端,明确了使用方法、医护职责,确定了以症状管理平台为媒介的化疗相关性恶心呕吐的多维管理模式。结论 基于信息化的化疗相关性恶心呕吐的多维管理模式具有较强的科学性和实用性,满足了患者和医护症状管理的需求,及时发现患者有无发生化疗相关性恶心呕吐,给予对应的预防和干预措施,提高患者生活质量,保证化疗顺利进行。