A comparison of the background, needs, and expectations of patients seeking genetic counseling services

Patient background, needs, and expectations (BNE) can be important predictors and modifiers of the process and outcomes of genetic counseling. We describe the assessment of BNE of 216 genetic counseling clients using the BNE Scale. Twenty-five percent sought reproductive genetic counseling (RGC), 57% sought adult-pediatric genetic counseling (APGC), and 18% sought cancer genetic counseling (CaGC). Analyses of the BNE of these patient groups identified significant differences in general unsureness/uncertainty about their condition (df = 2, F = 3.96, Significance =0.02), beliefs about treatment for the condition (d f= 2, F = 3.352, Significance = 0.04), and interest in support group involvement (df = 2, F =4.6, Significance = 0.01). Respondents who had not had genetic counseling more readily endorsed the desire to address educational issues than those who had previously had genetic counseling (Previous GC: Mean = 4.03, SD = 0.67; No Previous GC: Mean = 4.29, SD = 0.61; t-value; -2.86; P < 0.01). These results suggest that there are significant differences in the BNE of groups of patients seeking genetic counseling. These data support differential genetic counseling goal setting based on practice subspecialty, as well as sustain the requirement of broad based clinical training in genetic counseling. Further, these data provide additional evidence of the reliability and validity of the BNE Scale to characterize groups of individuals eligible for genetic counseling.     

Comparison of the background, needs, and expectations for genetic counseling of adults with experience with Down syndrome, Marfan syndrome, and neurofibromatosis

We describe an analysis of the responses of 605 adults with experience with Down syndrome, Marfan syndrome, or neurofibromatosis (NF) to the BNE Scale, a scale specifically designed to assess the background, needs, and expectations (BNE) of genetic counseling patients. Significant group differences were found. Specifically, the respondents in the Down syndrome group reported more favorable beliefs about the condition and the availability of social support than the respondents in the other groups. Respondents in the NF group reported more unsureness about their condition and a greater need for genetic information than members of the other groups. Notably, having positive feelings about the condition was negatively correlated with support group interest for respondents of the Marfan syndrome group (r = ?0.159, P < 0.01). Having an affected child was associated with interest in health provider input (t = ?3.4; P = 0.001) and the desire to talk about psychosocial issues (t = ?2.9; P = 0.004). However, previous experience with genetic counseling was not found to affect BNE. These results support the usefulness of the BNE Scale to compare the BNE of patient groups, as well as provide important insight into the BNE of individuals seeking counseling about Down syndrome, Marfan syndrome, and NF. © 2011 Wiley‐Liss, Inc.     

医科大学生自尊团体心理辅导研究

目的:研究团体心理咨询对医科大学生自尊水平的影响。方法:应用缺陷感量表(FIS)筛选出自尊水平偏低的22名医科大学生,其中男8名,女14名;年龄19～23岁,平均20.4±1.1岁,采用团体心理咨询模式进行为期八周的咨询,以缺陷感量表(FIS)、焦虑自评量表(SAS)、抑郁自评量表(SDS)为评估工具,在实验前、后两次对被试进行测查。结果:经过团体心理咨询后,大学生的自尊水平有明显提高,缺陷感量表的各个分量表和总量表的分值都有增加,辅导前后差异有显著性(P<0.01);学生的焦虑、抑郁水平降低,辅导前后差异有显著性(P<0.01)。结论:团体心理咨询能提高大学生自尊水平,缓解大学生的焦虑和抑郁症状。     

The Harris-Lingoes subscales: fact or fiction?

The subjectivity of the Harris-Lingoes MMPI content subscales was examined by asking expert judges (N = 13) to group items from appropriate clinical scales that represented similar content, attitudes or traits. The mean subgroups were compared to the Harris-Lingoes subscales, and item groupings were consensually validated and replicated. Judges developed more content categories per scale than Harris and Lingoes, but showed relatively little agreement on item groupings. Nine consensually validated and replicated subscales were highly similar to nine Harris-Lingoes subscales, while nine other replicated subscales were moderately similar to seven Harris-Lingoes subscales. Twelve Harris-Lingoes subscales were unrelated to the replicated subscales.     

心理咨询师/治疗师与来访者对职业伦理的态度比较

目的:考察我国当前心理咨询或治疗师与来访者在心理咨询与治疗领域职业伦理上的态度和意识,以帮助专业人员更好地理解和解决职业伦理困境,并为制定我国在该领域的职业伦理规范提供参考。方法:采用自编心理咨询与治疗职业伦理意识和态度问卷对48名专业人员(咨询师/治疗师)和48名来访者进行调查,比较两组人群在职业伦理意识和态度上的差异,以及一些重要人口学变量的可能影响。结果:两组人群在自编问卷的12个条目评判上有显著差异,其中涉及咨询关系原则4条(如47.9%的来访者认为专业人员可以和来访者发展私人关系,专业人员持同样看法的为4.2%,P<0.01);保密性原则1条;职业责任原则2条;评估、测量和解释原则2条;督导、培训和教学原则2条,另有一条为询问被调查者是否听闻过有违伦理的行为,发现来访者知晓的违反伦理行为(35.4%)显著少于专业人员(97.9%)(P<0.001);专业人员群体在17个条目上评判一致,仅在涉及咨询关系原则的1条目有争议,即48.3%的专业人员认为在来访者和咨询师价值观冲突时应转介来访者,51.7%的专业人员认为不应转介;来访者群体则在11个条目上评判一致,有4个争议条目,其中涉及咨询关系原则的条目3条(即在咨询师可否和来访者发生私人关系,咨询可否给来访者带来伤害,咨询师可否接受来访者的礼物问题上持肯定或否定意见的来访者都在40%以上);职业责任原则的条目1条,即56.3%的来访者认为咨询师可以按照自己的喜好选择病人,46.7%的来访者则持反对意见。结论:专业人员总体上表现出较强的伦理意识和较为一致的伦理态度,而来访者的伦理态度更不一致,两组人群在保密原则和咨询关系方面的态度差异尤其明显。     

Alexithymia, fear of bodily sensations, and somatosensory amplification in young outpatients with panic disorder

To elucidate the relationships between alexithymia, fear of bodily sensations, and somatosensory amplification in young patients with panic disorder (PD), authors evaluated 84 patients. Measures were the Panic Attack and Anticipatory Anxiety Scale, the Toronto Alexithymia Scale (TAS-20), the Body Sensations Questionnaire (BSQ), the Somatosensory Amplification Scale, the Agoraphobic Cognitions Questionnaire (ACQ), and the Hamilton Rating Scale for Depression. Alexithymic patients showed higher scores on all rating scales. Higher BSQ and ACQ scores, together with the Difficulty in Identifying Feelings and Difficulty in Describing Feelings subscales of the TAS-20 were predictors of severity of PD. Results of the present study do not support a direct role of somatosensory amplification in PD. Authors discuss study limitations and future research needs.     

少年网络攻击行为评定量表的编制及信效度检验

目的:编制我国少年网络攻击行为评定量表(AOABS),并检验其信效度。方法:方便抽取689名中学生和大学生进行问卷调查,回收有效问卷597份。通过项目分析筛选题目,将整体样本随机分半后分别进行探索性因素分析(n=297)和验证性因素分析(n=300)以检验量表的结构效度,并检验量表的信度。结果:少年网络攻击行为评定量表分为工具性攻击(instrumental aggression)和反应性攻击(reactive aggression)两个分量表,每个分量表内部又分为外显攻击和关系攻击两部分。自编量表的两个分量表经探索性因素分析所得的题目载荷在0.52～0.75之间,累积方差贡献率分别为52.75%和53.24%;两个分量表经验证性因素分析所得模型均符合心理测量学要求(RMSEA0.08,NFI0.9,NNFI0.9,CFI0.9)。两个分量表的Cronbachα系数分别为0.83和0.86。结论:少年网络攻击行为评定量表具有良好的结构效度和内部一致性信度,可以用于测量我国少年在网络上的攻击行为。     

Assessing the unmet information,support and care delivery needs of men with prostate cancer

This study identified the key Unmet Needs of men with localized prostate cancer. A series of Nominal Groups were used to identify needs, from which a 135-item survey was developed to assess both the Importance and Unmet Need of each item. An Importance-Weighted Unmet Need score was calculated for each item, incorporating both the Importance and the degree to which the need was unmet. Surveys (n=500) were distributed in four geographically distinct areas, with a response rate of 46%. Respondents were 90% Caucasian, 80% married, with a mean age of 66 years, and mean education of 14 years. Care delivery needs were most important and least unmet, while Support needs were least important and most unmet. However, when degree to which needs were unmet was weighted by Importance, information needs had the highest Importance-Weighted Unmet Need scores. The greatest Unmet Needs for information were in knowledge of recurrence issues and in side effects of the illness and its treatment.     

巴甫洛夫气质问卷中文版(PTS-C)的编制

目的:编制适合我国成人使用的巴甫洛夫气质问卷中文版(PTS-C).方法:对我国14岁以上不同性别、职业、文化程度的363名被试施测巴甫洛夫气质问卷通用条目,依据标准的条目筛选程序对条目进行筛选,得到PTS-C.然后对初三、高三和大三年级学生280名施测PTS-C和EPQ,对成人组被试64名两次施测PTS-C,间隔时间两周.结果:PTS-C问卷包括兴奋强度、抑制强度和灵活性三个分量表,每个分量表各24题,共72题.PTS-C问卷的一致性信度(Cronbach α系数:0.74～0.85)和再测信度(r:0.84～0.88)较高,PTS-C与EPQ分量表的相关水平符合理论预期,验证性因素分析表明问卷具有良好的结构效度.结论:PTS-C可以用于我国成人气质研究.     

Assessing family involvement in traumatic brain injury rehabilitation: the development of a new instrument.

A measure for assessing family involvement in traumatic brain injury rehabilitation (TBI) was developed. The Family Involvement Assessment Scale (FIAS) is theoretically based on Barrer's (1988) model of family involvement in TBI rehabilitation, which highlights two dimensions, "support" and "involvement." An initial pool of 337 items believed to be related to the constructs of "support" and "involvement" was generated. Forty-nine items were systematically selected from the initial pool and included in a preliminary assessment form in which 172 professionals rated the items on the dimensions of support and involvement. Eleven items were subsequently eliminated from the original pool based on these ratings. The remaining 38 items were used by 181 of the professionals to evaluate the involvement of actual family members of patients receiving TBI rehabilitation services in their programs. A factor analysis was performed on a remaining pool of 38 items. Three factors with an eigenvalue greater than 2.0 accounted for 48.8% of the total variance. One item that did not significantly load on any of the factors was eliminated. The FIAS includes a final set of 37 items, comprised of three subscales based on the factor analysis. Two of the scales, the Involvement-Rehabilitation (IR) scale and the Support (S) scale correspond, respectively, to Barrer's (1988) dimensions of "involvement" and "support." The third scale, Involvement-Patient (IP), is a unique construct that measures the degree to which a family member is involved in the rehabilitation process with respect to their involvement and relationship with the patient. The three scales yielded adequate internal reliabilities. Correlation coefficients between the scales indicated that the IR and S scale are not statistically related, but the IP scale is significantly related to both the IR and S scales. Interrater and test-retest reliability, and concurrent and predictive validity for the FIAS are still to be determined.     

住院病人护士观察量表的因子分析

目的：提高住院病人护士观察量表（NOSIE－30）在精神科临床的实用性。方法：对只有项目名称、项目评分等级的原量表制定项目定义和评分标准。培训后合格的研究者对164例首发精神分裂症住院病人每两周进行一次NOSIE评定,共评估994人次。将994份资料随机分A、B两组,按照A组资料进行主成分等分析的结果修订原量表,然后用B组资料进行验证并与原量表比较。结果：A组资料因子分析发现每个因子的结构与原量表的7个分量表不尽相同。根据不同情况进行项目调整。最后保留30项中的26项。形成5个分量表。在B组资料比较原量表与修订量表时,5个分量表的特征均优于7个分量表。结论：本研究结果表明原NOSIE－30R 7个分量表并不能反映病人的独立症状群,为了提高该工具的实用性,应该重新修订其分量表。     

Information need,learning need and educational need,definitions and measurements: A systematic review

BackgroundThere are various definitions and tools for Information Need (IN), Learning Need (LN) and Educational Need (EN) which are used interchangeably in the patient education.ObjectiveClarifying the definitions of IN, LN and EN as well as comparing item generation methods and the dimensions of the available tools to be used appropriately.MethodsWe searched PubMed/Scopus/Embase/Science Direct databases from 1960 to 2019. Two reviewers selected studies and extracted data independently.ResultsWe identified 22 tools comprised of 14 IN, 5 LN and 3 EN tools. The Patient Learning Needs Scale (PLNS) was the only general tool. The content of tools includes anatomy, physiology, diagnostic tests, symptoms, treatments, medications, diet, activity and self-care. No difference was found between EN/LN/IN tools in terms of item generation and dimensions according to their concept definitions. Seven tools assessed all 7 domains of patient education components.ConclusionThe EN, LN and IN are different concepts, but using these concepts in the tools is not based on their definitions and they have been used interchangeably. IN and LN tools were more complete and comprehensive.Practical implicationsThe findings of this review can help researchers and clinicians to use EN, LN and IN tools more appropriately.     

The utility of subtle and obvious MMPI subscales based on scale-specific ratings

Investigated the utility of subtle items for the MMPI PD and MA scales. Obvious, neutral, and subtle item subscales were developed based on scale-specific ratings. College students' (N = 98) scores on these scales were compared with scores on a Social Nonconformity scale, the Sensation Seeking Scale, and an Activity-level Biographical Questionnaire. The results suggested that when MMPI items are rated specifically for psychopathy, the obvious items are of greatest utility and contribute most to the prediction of criterion behaviors, while the subtle items provide no significant contribution. For items rated specifically for hypomania, however, the situation remains inconclusive, and the possibility exists that neutral or subtle items could have some utility for prediction of some criterion behaviors.     

Towards a genetically validated new affective temperament scale: a delineation of the temperament phenotype of 5-HTTLPR using the TEMPS-A

BackgroundAlthough it has been described that affective temperaments are associated with the 5-HTTLPR, less attention was paid to the association between this polymorphism and subscales and items related to each affective temperament. The aim of our study was to investigate the association of affective temperament subscales and individual items with the s allele of the 5-HTTLPR.Method138 psychiatrically healthy women completed the TEMPS-A questionnaire and were genotyped for 5-HTTLPR. Scores of subjects on the temperament scales, subscales and items in the three genotype and the two phenotype groups were compared using ANOVA. We selected items with significantly different mean scores between the three genotype groups and the two phenotype groups separately and performed item analysis.ResultsSubjects in the different 5-HTTLPR genotype and phenotype groups have significantly different score on scales measuring depressive, cyclothymic, irritable and anxious temperaments, and several subscales composing these temperamental scales. Subjects in the three genotype groups scored significantly different on 11 items, 8 of these remained in a derived genotype scale after item analysis. Subjects in the two phenotype groups had significantly different scores on 12 items, 9 of them were retained in a derived phenotype scale after item analysis.LimitationsOur sample was relatively small and included only women.ConclusionsOur data provide support for the association of affective temperaments with the s allele. Although the cyclothymic temperament shows the strongest association, all temperaments within the depressive superfactor have a similar share in this association. The newly derived 5-HTTLPR Phenotype Scale shows strong association with 5-HTTLPR genotype and phenotype, therefore this scale should be further investigated in relation to psychiatric disorders, as well as psychological traits and temperaments.     

青少年宽恕倾向问卷的编制及应用

目的:编制适用于青少年的宽恕倾向问卷,并探索青少年的宽恕倾向特点。方法:通过开放式问卷和访谈收集初始问卷条目,然后采用探索性和验证性因素分析对问卷进行检验。结果:青少年宽恕倾向问卷由22道题目组成,包括人际宽恕和自我宽恕两个分问卷:人际宽恕包括宽恕他人和报复他人两个维度,自我宽恕包括宽恕自己和惩罚自己两个维度。应用问卷调查发现:男生报复他人倾向显著高于女生,而女生惩罚自己倾向高于男生;青少年宽恕他人和宽恕自己的倾向均随年龄增长而下降。结论:所编问卷具有良好的信效度,可以作为评估青少年宽恕倾向的工具。     

心理咨询门诊咨客人格障碍倾向的分布特点

目的:研究心理咨询门诊咨客人格障碍倾向的分布特点.方法:采用系统抽样法,以人格障碍诊断问卷(Personality Diagnostic Questionnaire,PDQ+4)为工具,对1402例就诊于心理咨询门诊的咨客进行调查研究.结果:心理咨询门诊咨客的PDQ+4总分及各分量表分均高于正常人群常模[如,总分( 38.23±17.04)vs.(22.79±14.10), P<0.001].女性边缘型得分高于男性[(4.25±2.48)vs.(3.97±2.41),P=0.031],而反社会型、偏执型、分裂型、被动攻击型得分低于男性[(1.31±1.55)vs.(1.71±1.64),(2.75±1.87)vs.(3.02±1.93),(3.31±2.17)vs.(3.56±2.21),(2.71±1.69)vs.(2.93±1.64);均P＜0.05].按年龄分层后,PDQ+4总分及各分量表分(除分裂样人格障碍外)均随年龄增长呈下降趋势(如,总分18～24岁(41.73±16.28),25～34岁(39.46±16.95),35～44岁(33.88±16.24),≥45岁(30.64±17.21),P<0.001].各分量表阳性率最高的是强迫型(58.5%)和回避型(54.0%),其次是边缘型(44.4%).心理咨询门诊咨客PDQ+4的3因素分析中,因子1至3分别对应人格障碍C、B、A 3群,方差累计贡献率已达到67%.结论:心理咨询门诊咨客的人格障碍倾向较正常人群更常见,大部分类型人格障碍倾向随年龄增长有缓解趋势,与人格障碍的类群理论构想有一定程度地吻合,提示在咨询工作中要重视对咨客人格的评估与治疗.     

The assessment of posttraumatic stress disorder: With the clinician administered PTSD scale: Dutch results

The Clinician Administered PTSD Scale was employed with 76 traumatized Dutch subjects from different treatment centers and one social rehabilitation center. Subjects were traumatized either in childhood, in adolescence, or in early adulthood. The CAPS showed an overall agreement with clinical diagnosis of 79%, with a kappa coefficient of .58. Interrater agreement on the CAPS subscales of intensity (intrusion, avoidance, and hyperarousal) varied from .93 to .98. The internal consistency for all core symptoms of DSM-III-R at the CAPS intensity level for current PTSD was .89, and for lifetime PTSD .86. Concurrent validity was established by correlating the CAPS with the Mississippi Scale, the MMPI, and the Impact of Event Scale. All correlations were significant beyond .001. Finally, the CAPS items, both core symptoms and associative features, are discussed in detail at item level.     

Hopelessness at the end of life: The utility of the hopelessness scale with terminally ill cancer patients

Objectives. We sought to investigate the utility of the Beck Hopelessness Scale (HS) in a sample of terminally ill cancer patients by examining the scale properties. Moreover, we sought to identify and remove potentially problematic items in order to ascertain a “purer” index of hopelessness for this population. Design. A cross‐sectional study of 200 hospice inpatients with a life expectancy of less than 6 months. The HS, as well as several other distress measures, were administered to patients at bedside by trained clinicians. Methods. An item analysis of the HS was conducted, looking specifically at item endorsement and item‐total correlations. Three abbreviated versions (3‐item 7‐item, 13‐item) were developed based on certain denoted item‐total correlation cut‐offs. Reliability and validity of the original 20‐item HS was then compared to that of the newly developed abbreviated version. Results. All scales were found to be reliable and valid measures of hopelessness. The three abbreviated versions were more highly correlated with the distress measures than the original version, and the 7‐item and 13‐item subscales outperformed the original HS in the prediction of suicidal ideation and desire for hastened death. Conclusion. The data suggest that the HS may be improved, when applied to a terminally ill sample, by the elimination of problematic items. The development of a shorter, purer measure of hopelessness for this population is crucial given the need to reduce the burden placed on those who participate in end‐of‐life studies, and the important role of hopelessness in the prediction of suicide and desire for hastened death.     

不同文化背景下正常老人认知功能比较

目的：探讨年龄和教育程度相同的中西方老人是否存在某些认知功能领域的差异。方法：应用Mattis痴呆评定量表(DRS)检测上海、香港和美国圣地亚哥三组正常老人的认知功能。DRS有注意、起始／保持、概念形成、结构和记忆等5个因子，总分144分。结果：在年龄、受教育程度匹配的情况下，上海组与香港组比较有显著差异的有一项，而与圣地亚哥组比较有显著差异的有五项。阅读句子回忆和无意义图形再认项目，上海组明显差于圣地亚哥组；几何结构模仿，则上海组明显好于圣地亚哥组。结论：文化背景差异愈大，老人认知功能的差异也愈大。     

中国研究生主观幸福感量表的编制

目的 编制适合中国文化背景的研究生主观幸福感量表.方法 通过对被试开放式问卷所作的回答进行分析整理,制定出包含69道题目的原始问卷,然后采用探索性和验证性因素分析对问卷的因素进行检验.结果 问卷包含12个项目,4个维度(分量表),分别是身心满意度、人际满意度、价值/能力满意度、经济满意度.因素分析结果表明,4个维度可解释总方差的63.66%,各维度的项目载荷在0.46～0.73之间,验证性因素分析表明本量表具有较好的结构效度.结论 编制的研究生主观幸福感量表具有理想的信效度,适合本国研究生使用.