A virtual reality intervention to improve the understanding and empathy for people with dementia in informal caregivers: results of a pilot study

ABSTRACT

Objective: Informal caregivers often experience psychological distress due to the changing functioning of the person with dementia they care for. Improved understanding of the person with dementia reduces psychological distress. To enhance understanding and empathy in caregivers, an innovative technology virtual reality intervention Through the D'mentia Lens (TDL) was developed to experience dementia, consisting of a virtual reality simulation movie and e-course. A pilot study of TDL was conducted.

Methods: A pre-test–post-test design was used. Informal caregivers filled out questionnaires assessing person-centeredness, empathy, perceived pressure from informal care, perceived competence and quality of the relationship. At post-test, additional questions about TDL's feasibility were asked.

Results: Thirty-five caregivers completed the pre-test and post-test. Most participants were satisfied with TDL and stated that TDL gave more insight in the perception of the person with dementia. The simulation movie was graded 8.03 out of 10 and the e-course 7.66. Participants significantly improved in empathy, confidence in caring for the person with dementia, and positive interactions with the person with dementia.

Conclusion: TDL is feasible for informal caregivers and seems to lead to understanding of and insight in the experience of people with dementia. Therefore, TDL could support informal caregivers in their caregiving role.     

Delinquency and drug use among adolescents and emerging adults: The role of aggression,impulsivity, empathy,and cognitive distortions

Risk behaviors are well known to be higher in adolescents and emerging adults. Drug use and delinquency present several common predictive factors. The aim of the present study was to assess the contribution of individual factors (aggression, impulsivity, empathy, and cognitive distortions) to delinquent behaviors, alcohol use and cannabis consumption among adolescents and emerging adults. Participants were between 15 and 25 years of age (M = 18.64 years, SD = 2.61); 325 were adolescents (15–18 years of age, M = 16.56, SD = 1.11, 56.31% of women) and 283 were emerging adults (19–25 years, M = 21.03, SD = 1.62, 50.88% of women). They completed self-report validated questionnaires. Multiple regression analyses showed that all individual factors significantly predicted delinquency. Impulsivity and empathy significantly predicted alcohol use. Concerning cannabis use, impulsivity is the only significantly associated predictor. Moderation analysis showed that specific associations were stronger in adolescents, whereas others were stronger in emerging adults. All these variables explained 69% of the variance of delinquency, 31% of the variance of alcohol use, and 18% of the variance of cannabis use. This model demonstrated acceptable goodness-of-fit criteria. These results may have implications for prevention and intervention.     

The impact of sleep deprivation on visual perspective taking

Total sleep deprivation (TSD) is known to alter cognitive processes. Surprisingly little attention has been paid to its impact on social cognition. Here, we investigated whether TSD alters levels‐1 and ‐2 visual perspective‐taking abilities, i.e. the capacity to infer (a) what can be seen and (b) how it is seen from another person's visual perspective, respectively. Participants completed levels‐1 and ‐2 visual perspective‐taking tasks after a night of sleep and after a night of TSD. In these tasks, participants had to take their own (self trials) or someone else's (other trials) visual perspective in trials where both perspectives were either the same (consistent trials) or different (inconsistent trials). An instruction preceding each trial indicated the perspective to take (i.e. the relevant perspective). Results show that TSD globally deteriorates social performance. In the level‐1 task, TSD affects the selection of relevant over irrelevant perspectives. In the level‐2 task, the effect of TSD cannot be unequivocally explained. This implies that visual perspective taking should be viewed as partially state‐dependent, rather than a wholly static trait‐like characteristic.     

Beyond empathy: clinical intimacy in nursing practice

Abstract Understanding, shared meaning, and mutual trust lie at the heart of the therapeutic nurse–patient relationship. This article introduces the concept of clinical intimacy by applying the interpersonal process model of intimacy to the nurse–patient relationship. The distinction between complementary and reciprocal behaviours, and between intimate interactions and intimate relationships, addresses background concerns about the appropriateness of intimacy in nursing relationships. The mutual construction of meaning in the interactive process between nurses and patients is seen to lie at the heart of clinical intimacy as a hermeneutic enterprise. Intimacy is distinguished from empathy based on intentionality and the status and location of meaning. Reasons for continued investigation into clinical intimacy as an explanatory model for nursing as a hermeneutic practice are presented.     

Discussing health care costs with patients

Escalating health care costs are affecting patients across the country. As employers and insurance companies face higher expenses, they may move to a cost-sharing strategy, which potentially increases financial burdens on patients. In this situation, physicians may find themselves serving as both medical and financial advisors for their patients. Clinical encounters in which patients experience financial hardship can be awkward and frustrating for both parties. Physicians must learn to discuss issues of affordability in a manner that builds, rather than detracts, from a therapeutic alliance. This article describes our experiences using several communication skills that can help in the discussion of health care costs with patients. The primary skill, empathic communication, which includes "we" statements and "I wish ..." statements, serves to create a platform for shared decision-making, negotiation, and a search for alternatives. In addition, it is helpful if physician offices have resource materials available and strategies identified to assist patients facing financial hardship.     

The Importance of Offense Characteristics,Victimization History,Hostility, and Social Desirability in Assessing Empathy of Male Adolescent Sex Offenders

Empathy has been a focus of work with sex offenders; however, there are a limited number of studies supporting this as a deficit. The study investigated the reliability and validity of 3 scales of the Interpersonal Reactivity Index (IRI)—Empathic Concern [EC], Perspective-Taking [PT], and Personal Distress [PD]—within a clinical sample. These scales were also used to examine the differences in empathy among groups of sex offenders. One hundred and twenty-three male adolescent sex offenders (ages 12–19) completed a battery of psychometric measures that included the IRI during a sex-offender-specific assessment. Moderate internal consistency and convergent validity was established for IRI scales. Age and social desirability were related to IRI scores. Victim empathy was not related to IRI scores. Justifications and acceptance of sexual and interpersonal violence were negatively correlated to EC and positively correlated to PD. Those who committed violent offenses reported more EC and PT; however, a generally hostile temperament was negatively related to these scales. Group differences were not found when contrasted with respect to a history of sexual or physical victimization or denial. Researchers using the IRI with male adolescent sex offenders should be cautious of the influence of age and socially desirable responding.     

观点采择干预对青少年学生艾滋病污名的影响

目的了解青少年学生艾滋病污名的现状并探讨观点采择干预对其的影响。方法采用整群抽样法抽取某中学初中一年级5个班的学生,按学号单双分为对照组和干预组。被试对象均采用艾滋病污名问卷进行前测,观点采择干预后,均进行艾滋病污名后测,同时采用基本共情量表测共情水平。比较两组艾滋病污名差异,分析共情在观点采择对艾滋病污名影响中的中介作用。结果完成本研究被试对象为146名,其中对照组72名,干预组74名,艾滋病污名前测对照组及干预组艾滋病污名总分分别为(43. 75±8. 95)分和(44. 40±10. 41)分,两组间差异无统计学意义(P>0. 05)。艾滋病污名后测对照组及干预组艾滋病污名总分分别为(42. 65±11. 40)分和(37. 82±9. 94)分,两组差异有统计学意义(P<0. 05),共情中介效应的系数c(c=-0. 210)、系数a(a=0. 181)、系数b(b=-0. 163)和系数c’(c’=-0. 181)差异均有统计学意义(P<0. 05),中介效应占总效应的比值为14. 05%,共情在观点采择与艾滋病污名关系间存在部分中介作用。结论青少年学生普遍存在艾滋病污名,观点采择干预能有效降低其艾滋病污名,共情在观点采择对艾滋病污名的影响中发挥部分中介作用。