Correction of distortion in distressed mothers' ratings of their preschool-aged children's Internalizing and Externalizing scale score

Increased maternal psychopathology may bias mothers' ratings about child psychopathology. In this study we examined whether internalizing and externalizing behavior problems in young children were biased through maternal psychopathology. The clinical sample comprised 247 preschool-age patients who attended the Family Day Hospital in Münster, Germany. Internalizing and externalizing behavior problems were assessed by the CBCL/1.5-5, and maternal psychopathology was assessed by the SCL-90-R Global Severity Index (GSI). Three theoretical perspectives were tested by comparing the model fit of three structural equation models, namely the accuracy, distortion, and combinatory model. All of the models aimed to integrate multi-informant ratings from mother, therapists, and kindergarten teachers, but differed in the question which paths had to be significant. The distortion model fit the data best and supported the notion that there was a psychopathology-related bias in mothers' ratings. On the basis of this finding, we developed correction formulas comparable to Müller and Furniss (2013), in order to statistically control for this distortion. We discussed post-hoc explanations about why mothers with increased psychopathology gave higher ratings on the CBCL/1.5-5, including a better recall of internalizing symptoms, less flexible and effective parenting, and more perceived distress by child externalizing behavior.     

The desirability of an Intensive Care Unit (ICU) Clinician-Led Bereavement Screening and Support Program for Family Members of ICU Decedents (ICU Bereave)

Purpose

Many bereaved family members (FMs) of intensive care unit decedents experience symptoms of complicated grief (CG) or social distress, but there is no standard screening or follow-up for these individuals. We determined the desirability and need for an intensive care unit–based bereavement screening and support program for these FMs.

Methods

We surveyed bereaved FMs to measure symptoms of CG, prolonged grief disorder, and social difficulties and the desire for support; and staff physicians and nurses at 2 teaching hospitals in Toronto, Canada, to determine comfort and interest in providing routine bereavement support.

Results

We could not contact 69% of FMs largely because of inaccuracies in the patient record. Of the 64 who were contacted, 32 (50%) agreed to be surveyed a mean (SD) of 7.4 (2.2) months after the loss of their relative. Among eligible staff, 57 (61%) of 94 completed the questionnaire. Nine (28%) FMs met subthreshold criteria for CG or prolonged grief disorder, and 7 (22%) met criteria for social distress. Only 10 (31%) had received professional support for emotional symptoms, and 2 (6%) received professional assistance for their social difficulties. Fifty-eight percent supported routine screening, and 68% wanted to receive (or receive more) support. Fifty-five percent of FMs expressed a strong willingness to meet with the medical team to review events surrounding the death of the patient, which was the type of support that the health care staff were most comfortable providing. Most staff (85%) reported providing emotional support at the time of death, but few provided any support afterwards. Fifty-six (98%) of 57 would be willing to support or participate in a formal bereavement screening and support program. Respondents cited the need for training and dedicated time to carry out such a program.

Conclusions

An ICU-based bereavement screening and support program for FMs of ICU decedents is both needed and desirable, although there are important needs and barriers. Future studies should evaluate the effectiveness for such a program at improving outcomes among bereaved FMs.     

中医院校护理本科生学习适应性的调查研究

目的调查护理本科生学习适应性,为护理教育者指导护理专业学生改善学习适应性提供依据。方法采用学习适应性量表对251名在校护理本科生进行调查。结果护理本科生学习适应性为(3.52±0.44)分,各维度得分不均衡。高年级、家庭教育类型为放任型的护理专业学生学习能力高(P<0.05)。低年级护理本科生学习态度端正(P<0.05),专业满意度为学生学习动机、教学模式、学习能力、学习态度及学习适应总分的重要影响因素(P<0.05)。结论护理本科生学习态度端正,但学习动机和环境得分较低。护理教育者应针对护理学专业学生的学习适应问题引导其寻找内在的学习动力,形成良好的学习态度,为其提供良好的学习环境。     

调节训练联合综合疗法治疗儿童高度远视性弱视的临床观察

目的探讨眼肌调节训练联合综合疗法治疗儿童高度远视性弱视的疗效以及对远视屈光度的影响。方法选择高度远视性弱视儿童101例（202眼）,其中使用眼肌调节训练联合综合治疗的研究组49例（98眼）,常规综合治疗的对照组52例（104眼）。两组分别治疗1年以上,治疗结果采用方差分析及t检验进行统计学分析。结果治疗后研究组的矫正视力为0．75±0．22,基本治愈率为62．24％（61／98）,与对照组的0．54±0．20及23．07％（24／104）相比,差异均有统计学意义（P〈0．01）。对两组3—4岁、5—6岁、〉6岁各年龄层进行分别比较后,发现6岁以下两组治愈率,差异有统计学意义（P〈0．01）。治疗后两组远视等效球镜度的差异有统计学意义（P〈0．01）。结论眼肌调节训练联合综合疗法治疗高度远视性弱视能有效降低远视屈光度,提高弱视疗效,需要早期发现和早期治疗。     

Trauma périnéal à l'accouchement,intimité, ajustement dyadique et fonction sexuelle de nouveaux couples parentaux

Objective

This study focuses on perineal trauma during childbirth and its relationship to postnatal marital and sexual issues as expressed by the sexual function and perceived intimacy of new parent couples in Ontario.

Les facteurs de rémission du trouble de l’adaptation : la parole aux patients. Une étude qualitative

Background

Adjustment disorder (AD) is a frequent clinical diagnosis defined by the patient's reaction to an external factor and reversibility. While it is known that the prevalence of AD varies depending on setting and diagnostic tools utilized, the literature is rather scarce when it comes to AD's investigation or remission factors. Unlike other psychiatric disorders, the fact that there is a factor triggering AD makes it especially suitable to learn more about triggering elements, reversibility and factors of remission.

Le trouble de l’adaptation à la vie embarquée

Being a sailor means being able to travel long distances, for an extended period of time, in an environment with multiple constraints: ships are places where living space and access to fresh air are limited, cramped living quarters are the rule, and the prospect of impending danger cannot be excluded. The French Navy recruits many sailors each year, but some of them encounter difficulties adapting to their jobs, and these difficulties are often recurrent throughout their careers. The prevention of adjustment disorders in a military environment is a continuous process and is centered on the detection of at-risk personalities, and on a close medical surveillance throughout their career, which can reveal short-term vulnerabilities in a sailor that temporarily reduce their ability to adapt.     

疾病风险调整方法在病种精细化评价中的应用

目的应用疾病风险调整方法，实现对各专科病种平均住院天数、次均费用等指标的合理预测，为病种管理提供依据。方法应用疾病风险调整方法对某三甲综合医院2016年-2019年住院患者出院病案首页信息进行挖掘，围绕O/E指数、AW、ACMI和ACMP等主要监测指标展开分析。结果通过疾病风险调整，ACMI、ACMP更加合理地展现了服务难度，应用O/E值实现了分时间、分科室、分病种设置指标合理目标值，同时解决了各科室、病种间监测指标的横向比较问题。结论疾病风险调整方法能够更加真实、客观地评价临床服务能力、服务效率及技术水平，但其有效程度取决于历史数据的真实性、完整性和准确性。