Coneixement i gestió del dol patològic per part dels infermers/es a l'atenció primària de Girona

Per entendre l’experiència d’una pèrdua i dur a terme una intervenció amb una valoració holística del pacient amb dol, és útil conèixer que aquesta pèrdua és present a la vida humana i que tota persona és susceptible a viure-la. Cada pas que fem en el nostre camí perdem coses, des de persones a un objecte significatiu, fins a les coses més efímeres com és la joventut, els somnis o les idees que ens permeten l’enfrontament a les dures “realitats de la vida”L’objectiu d’aquest estudi és valorar el coneixement del concepte de dol, dol patològic i dóna a conèixer quin és el procés de dol a partir de la teoria de les etapes d’ Elisabet Kübler-Ross, Parkes i Worden com els pares de les tasques d’aquest procés. Per altra banda pretén, donar a conèixer la detecció d’un dol per així evitar la cronificació d’aquest i que el pacient pugui dur a terme un bonacompanyament del dolLa metodologia es realitzarà a partir d’un estudi d’anàlisis qualitatiu i quantitatiu, descriptiu i bivariant en els professionals d’infermeria de les àrees bàsiques de salut de la ciutat de Girona: Girona 1(CAP Santa Clara), Girona 2 (CAP Can Gibert del Pla), Girona 3 (CAP de Montilivi) i Girona 4(CAP Taialà)Per l’anàlisi estadística descriptiva i bivariant s’utilitzarà el programa SPSS v20 per l’anàlisi quantitativa i el programa N-Vivo 10 per l’anàlisi qualitativa. I per l’obtenció dels resultats es realitzarà una anàlisis descriptiva bivariant. Els resultats obtinguts en aquest estudi ens ajudaran a detectar necessitats relacionades amb la formació i l’aprenentatge dels professionals de l’atenció primària i la manca de recursos en relació al dol

Intervención psicológica en la obesidad : Un estudio comparativo entre el enfoque cognitivo conductual y el enfoque humanista

En este estudio se compara la intervención psicológica por excelencia en casos de obesidad y sobrepeso, la intervención cognitivoconductual, con la intervención humanista. Mediante el seguimiento de tres grupos de investigación a los que se prescriben restricciones propias de una dieta hipocalórica, uno sometido a terapia humanista individual, otro sometido a terapia cognitivoconductual grupal y un tercero sometido a una formación nutricional (grupo de cuasicontrol), este estudio pretende determinar si un enfoque humanista y la atención pormenorizada a la idiosincrasia del cliente marcan la diferencia en el tratamiento de la obesidad y/o el sobrepeso.

La cultura contemporánea del sufrimiento

Puesto que el título elegido para este artículo es poco preciso, conviene advertir al lector qué se encontrará en las siguientes páginas. Lo que sigue forma parte de un estudio en curso sobre la experiencia contemporánea del sufrimiento. De los distintos aspectos de dicho estudio se han seleccionado aquí dos cuestiones: la distribución social del sufrimiento y la construcción de la experiencia del sufrimiento en las sociedades tardocapitalistas. La razón última de la combinación de estas dos cuestiones es explicar la percepción que hoy se tiene del sufrimiento ajeno y, también, del sufrimiento propio.

Geografías psicológicas de los recursos educativos

¿Qué recursos dispone un profesor, alumno, padre o escuela para optimizar los procesos de enseñanza y aprendizaje? El objetivo del articulo es presentar un modelo teórico que permita responder esta pregunta. Tradicionalmente los 'recursos educativos' -artefactos implicados en las actividades de enseñanza-aprendizaje- se han reducido a ciertos instrumentos como un manual o libro de texto, una libreta o una pizarra.Sin embargo, la psicología cultural advierte que nuestra geografia fisica (personas, objetos y simbolos de nuestro derredor) tiene también un valor psicológico y educativo. En base al modelo ecológico de Bronfenbrenner propone­ mos la existencia de cuatro tipos de recursos: los 'micro-recursos', los 'meso-recursos', los 'exo-recursos' y los 'macro-recursos'. Después de definir estos conceptos los ilustramos con ejemplos derivados de distintas experiencias y programas de investigación e intervención como el "funds of knowledge" ('fondos de conocimiento') de Arizona

Aggression and its Management in Adolescent Forensic Psychiatric Care

The overall goal of this study was to explore and identify good aggression management methods and on that basis to produce recommendations for aggression management in the adolescent forensic setting. The study was conducted in three phases. In Phase I, staff’s (n = 58) perception of adolescent aggressive behaviour and methods to manage it was examined. In Phase II, staff’s (n = 30) perception of treatment settings and treatment interventions available were studied. In Phase III, the effectiveness of an aggression management programme was evaluated. The data were collected during the period 2004-2007. Participants perceived adolescent aggressive behaviour in a similar way and described aggressive behaviour as being a comprehensible phenomenon. Management methods used to control aggressive situations were alike, although the practical solutions varied between the study units, especially regarding coercive methods. Staff members proposed more time and better opportunities to discuss and evaluate the aggression situation in order to improve the methods used. The treatment settings were similar in studied forensic units and interventions were primarily focused on psychological aspects, including management of aggressive behavior. A comprehensive aggression management programme proved to be effective in decreasing incidents of violence. The use of coercive methods in aggression situations decreased and injuries to the staff became less frequent. If staff members intend to apply high quality management methods in aggression situations they have to share a consistent understanding of aggressive behaviour and need to be aware of the various methods available. In addition, they should learn more about assessment methods in order to improve aggression management. International comparison of aggression, methods for managing it and service provision creates a starting point for developing equal care provision and realization within and between European countries.

Anxiety and depression symptoms in recurrent painful renal lithiasis colic

Several studies have reported that symptoms of anxiety and depression are significantly associated with diseases characterized by painful crises. However, there is little information about the psychological aspects of recurrent painful episodes of renal stone disease. Our objective was to evaluate the association of symptoms of anxiety, depression and recurrent painful renal colic in a case-control study involving 64 subjects (32 cases/32 controls) matched for age and sex. Cases were outpatients with a confirmed diagnosis of nephrolithiasis as per their case history, physical examination, image examination and other laboratory exams. Patients had a history of at least two episodes within a 3-year period, and were currently in an intercrisis interval. The control group consisted of subjects seen at the Ophthalmology Outpatient Clinic of this University Hospital with only eye refraction symptoms, and no other associated disease. Symptoms of anxiety were evaluated by the State-Trait Anxiety Inventory and symptoms of depression by the Beck Depression Inventory. Statistically significant differences were observed between patients with nephrolithiasis and controls for anxiety state (P = 0.001), anxiety trait (P = 0.005) and symptoms of depression (odds ratio = 3.74; 95%CI = 1.31-10.62). The Beck Depression Inventory showed 34.5% of respondents with moderate and 6% with severe levels of depression. There was a significant linear correlation between symptoms of anxiety (P = 0.002) and depression (P < 0.001) and the number of recurrent colic episodes (anxiety-state: P = 0.016 and anxiety-trait: P < 0.001). These data suggest an association between recurrent renal colic and symptoms of both anxiety and depression.

Why are people liberal? : a motivated social cognition perspective

The present dissertation examined why people adopt or endorse certain political ideologies (i.e., liberal or conservative). According to a motivated social cognition perspective (Jost, Glaser, Kruglanski, & Sulloway, 2003a; Kruglanslpsychological needs (e.g., Jost, Glaser et aI., 2003a). However, there is minimal research examining why individuals adopt political liberalism. By focussing on the political right and not considering the political left, there might be other motivational underpinnings of political orientation that have been overlooked. In four studies, the present dissertation ail)1ed to fill this gap by investigating what chronic and situationally induced needs underlie political orientation, with a focus on political liberalism. Based on psychological the9ries of ideology, research examining political conservatism, and experimental research examining differences between liberals and conservatives, it was proposed that four social-cognitive needs (Need for Inclusiveness, Need for Understanding, Need for Change, and Avoidance of Decisional Commitment) would be associated with liberalism. Moreover, research suggests that the relations between the needs and liberalism might be moderated by political sophistication (e.g., Converse, 1964). University students (Study 1; n == 201) and community adults (Study 2; n == 197) completed questionnaires assessing political liberalism, political sophistication, and individual differences 're~ective of the four proposed needs. As predicted, correlation and hierarchical regression analyses in both Studies 1 and 2 indicated that political liberalism was related to Need for Inclusiveness, Need for Understanding, and Need for Change. 11 Avoidance of Decisional Commitment uniquely predicted political liberalism in Study 2; however, contrary to predictions, it was unrelated to political liberalism in Study 1. Furthermore, some of these relations were moderated by political sophistication, such that among individuals with a greater knowledge of politics, the relation between certain needs and liberalism was positive. To explore the role of situationally induced needs on political liberalism, each of the four proposed needs were manipulated in Study 3. Participants (n == 120) completed one of five scrambled-sentence tasks (one for each need condition and control condition), measures of explicit and implicit political liberalism, political sophistication, and state and trait measures indicative of the four proposed needs. The ~anipulation did not successfully prime participants with the needs. Therefore, a replication of the analyses from Studies 1 and 2 was conducted on the dispositional needs. Results showed that Need for Inclusiveness, Need for Understanding, and Need for Change were linked with greater explicit and implicit political liberalism. Study 4 examined the effect of manipulated Need for Inclusiveness on participants' endorsement ofpolitical liberalism, independent of conservatism. Participants (n == 43) were randomly assigned to a Need for Inclusiveness or control condition, and completed separate measures of political liberalism and conservatism, and political sophistication. Participants in the Need for Inclusiveness condition reported greater liberalism than those in a control condition; this effect was not moderated by political sophistication. Generally, the findings from this dissertation suggest that there might be other needs underlying political ideology, especially political liberalism. Thus, consistent with others' (Jost, Glaser et aI., 2003a), individuals might adopt political liberalism as a way of gratifying certain psychological needs. Implications and future research are discussed.

From the ground up : understanding how teachers and administrators make sense of tension

Strategies designed to improve educational systems have created tensions in school personnel as they struggle to respond to competing demands of ongoing change within their daily realities. The purpose of this case study was to investigate how teachers and administrators in one elementary school made sense ofthese tensions and to explore the factors that constrained or shaped their responses. A constructive interpretative case study using a grounded theory approach was used. Qualitative data were collected through document analysis, semi-structured interviews, and participant observation. In-depth information about teachers' and administrators' experiences and a contextual understanding oftension was generated from inductive analysis of the data. The study found that tension was a phenomenon situated in the context in which it arose. A contextual understanding of tension revealed the interactions between the institutional, personal, and emotional domains that continually shaped individual and group behavioural responses. This contextual understanding of tension provided the means to reinterpret resistance to change. It also helped to show how teachers and administrators reconstructed identities and made sense in context.. Of particular note was the crucial nature of the conditions under which teachers and adlninistrators shaped meaning and understood change. This study sheds light on the contextual intricacies of tension that may help leaders with the complex design and implementation of educational change..

Asymmetrical balance of power in preadolescents' mutual friendships

Dyadic friendShip' asymmetry was examined in relation to gender, friendship quality, and friendship status. Sixty-nine grade five children and their mutual, same-sex, friends participated in a laboratory session comprised ofvarious activities and completed questionnaires to identify mutual friends and evaluate friendship quality. Asymmetry of power was assessed observationally during an origami task. Variations in balance of power were evident in children's friendships. Boys' dyads had significantly greater levels of asymmetry than girls' dyads. Regardless of gender, asymmetry was associated with lower friendship quality, particularly as indexed by validation and caring and conflict resolution. Asymmetry was unrelated to differences in friendship status. Furthermore, relative individual power within the friendship was not related to individual perceptions offriendship quality. The implications ofthese findings in the theoretical and empirical literature were considered and suggestions for future research were made.

Completing the picture: the effects of video game practice on verbal and performance I.Q. scores in high functioning children

The strength and nature of the video game practice effect on tests of visual and perceptual skills were examined using high functioning Grades Four and Five students who had been tested with the WISC-R .for the purpose of gifted identification and placement. The control group, who did not own and .play video games on a sustained basis, and the experimental group, who did own a video game system and had some mastery of video games, including the -Nintendo game, "Tetris", were each composed of 18 juniorg:r;-ade students and were chosen from pre-existing conditions. The experimental group corresponded to the control group in terms of age, sex, and community. Data on the Verbal and Performance I.Q. Scores were· collected for both groups and the author was interested in the difference between the Verbal and Performance Scores within each group, anticipating a P > V outcome for the experimental group. The results showed a significant P > V difference in the experimental, video game playing group, as expected, but no significant difference between the Performance $cores of the control and experimental groups. The results, thus, indicated lower Verbal I.Q. Scores in the experimental group relat'ive to 'the control group.' The study conclu~ed that information about a sUbject's video game experience and "learhing style pref~rence is important for a clear interpretation of the Verbal and Performance I.Q. Scores of the WISC-R. Although the time spent on video game play may, 'indeed, increase P~rformance Scores relative to Verbal Scores for an individual, the possibilities exist that the time borrowed and spent away from language based activities may retard verbal growth and/or that the cognitive style associated with some Performance I.Q.subtests may have a negative effect on the approach to the tasks on the Verbal I.Q. Scale. The study also discussed the possibility that exposure to ,the video game experience, in pre-puberty, can provide spatial instruction which will result in improved spatial skills. strong spatial skills have been linked to improved performance and preference in mathematics, science, and engineering and it was suggested that appropriate video game play might be a way to involve girls more in the fields of mathematics and science.

Co-operative education and the development of self-esteem, an internal locus of control and work habits

This study compared approximately 50 grade 12 students studying In th~ co-operative education mode with approximately 50 grade 12 students studying in a traditional English course. Measures of self-esteem, locus of control and work habits were compared before and at the conclusion of one semester's involvement in the different programs. Using Coopersmith's Self-Esteem Inventory, the students who had chosen to study in the co-operative education mode scored significantly higher than the students in the traditional course. At the end of the semester, the co-operative education students' scores remained significantly higher than the English students'. Although the test showed no sjgnifi~ant changes in self-esteem. anecdotal reports indicated that co-operative education students had increased self-esteem over the semester. No significant differences in locus of control were observed between the two groups at any time. Significant differences in work habits were observed. While both groups had the same number of absences and the same marks before taking these courses, students who were involved in co-operative education had significantly fewer absences and significantly higher marks than the students studying in the traditional course. Anecdotal reports also indicated an improv~ment in work habits for students who had been involved in co-operative education. Recommendations of the study are for further research to determine more exactly how self-esteem and work habits develop in co-operative education students. Also. students. parents, teachers. and administrators need to be made aware of the success of this program.

Correlates and outcomes of severe bullying: internalizing maladjustments of adolescent bullies, victims and bully- victims

The current study examined the association between involvement in bullying and victimization and internalizing difficulties such as self-esteem, social anxiety, depression and body image. Possible gender differences were also examined. The participants, high school students from Southern Ontario (N=533), were drawn from a larger, data set as part ofa study that was completed by the Youth Lifestyle Choices: Community Research Alliance (YLCCURA). The students completed a self-report questionnaire on a number ofmeasures; including, bullying, victimization, self-esteem, social anxiety, depression and body image. The results of this study suggest that those students who self-identified as victims and bully-victims also report higher levels of anxiety and depression than controls and bullies. Severe victims and bullyvictims had a lower body image than severe bullies and controls, whereas severe bullies seem to have a higher body image score than controls. These results are relevant when considering treatments and interventions for students experiencing adjustment difficulties who may also be at risk for bullying victimization. The results also suggest that particular attention needs to be focused on those adolescents who play multi-roles in bullying situations (i.e., bully-victims), since these students may come to the attention ofthe school system for externalizing behaviours, but may also need assistance for internalizing maladjustments.

Effectiveness of computer training on attentional skills

This paper presents two studies, both examining the efficacy of a computer programme (Captain's Log) in training attentional skills. The population of interest is the traumatically brain injured. Study #1 is a single-case design that offers recommendations for the second, .larger (N=5) inquiry. Study #2 is an eight-week hierarchical treatment programme with a multi-based testing component. Attention, memory, listening comprehension, locus-of-control, self-esteem, visuo-spatial, and general outcome measures are employed within the testing schedule. Results suggest that any improvement was a result of practice effects. With a few single-case exceptions, the participants showed little improvement in the dependent measures.

Evaluation of self-esteem before and after preceptorship experience for student nurses

seventy-eight diploma nursing students participated (from a class of 112 students) in completing the Coopersmith Self-Esteem Inventory administered by mailed questionnaire before and at the end of the preceptorship. Also a rating form was completed by 70 preceptors to determine how the observed level of self-confidence compared to self-reported self-esteem at the end of the preceptorship program. As well, four preceptors and five preceptees completed weekly diaries and six preceptors and six preceptees participated in weekly phone interviews with the investigator. Overall, self-esteem went up after the preceptorship. A comparison was made between the pretest and posttest using the t-test (dependent paired samples). Significant difference (p=.05) was demonstrated. Self-confidence ratings by preceptors were inaccurate as they had no relation to the self-reported self-esteem level of students. The diaries and interviews of preceptors and preceptees were a rich source of data as well.

Factors affecting treatment decision making for women with breast cancer

This study examined the factors affecting treatment decision making for young women with early stage breast cancer. Thirty women, aged 35 to 52 years, were presented information about two equally effective chemotherapy treatments following surgery for breast cancer using an educational instrument called a "decision board." Although equally effective, the treatments differ with regards to side effects and treatment schedule. The purpose of this research was to investigate what factors affect the decision-making process. Following administration of the decision board, women were given a take-home version to review and asked to return one to two weeks later with a decision, at which time they completed a questionnaire. theoretical framework for this study was constructed from the literature on self-directed learning and critical thinking. The Overall, the factors rated most important to the treatment decision were related to quality of life, side effects, and length of treatment. Five factors were found to be rated significantly different by the women who chose one treatment versus the other in terms of importance to their decision. These were side effects in general, vomiting, hair loss, family role, and the number of trips to the cancer centre required for treatment.Implications and recommendations for patient education, research, and practice evolved from the findings of this study.