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1.
Weingarten HR 《Death education》1981,4(4):369-383
Viewing themselves in two hypothetical roles-as terminal patients and as family members related to a terminal patient-48 adults were surveyed on their expectations and preferences about how information should be communicated when a terminal illness is first diagnosed. Identifying with the patient role, respondents believed patients should be told the truth immediately and unconditionally. In contrast, respondents indentifying with family members perceived conditions under which the rights of patients should be abridged. In this latter role, male respondents were significantly less likely than males to imagine themselves as able to inform a loved one about a terminal illness. Nevertheless, for both sexes, early childhood experiences communicating about death and dying were found to be a better predictor of the case with which respondents can imagine communicating with a terminally ill loved one than are current adult attitudes and experiences. Regardless of personal ease in discussing death, however, most respondents thought the physician, not family members or other health care professionals, should decide when and how the terminally ill adult should be informed--a noteworthy finding in light of the fact that 83 percent of all respondents consider physicians poorly equipped for this role. 相似文献
2.
OBJECTIVE: This survey was conducted to: (1) document child protective services (CPS) agencies' actual practices regarding prenatal drug exposure; (2) examine urban and rural differences in CPS responses; (3) explore whether CPS practices varied as a function of county median income, birth rate, population size, or percent minority births; and (4) assess respondent satisfaction with their county's current responses. METHOD: Data were collected via a nationwide telephone survey of child welfare supervisors from two urban and two rural counties in every state (N = 200). RESULTS: Ninety percent of counties (100% of urban and 80% of rural) reported receiving referrals of infants with prenatal drug exposure. Among those receiving referrals, extreme variations in practice were found; all possible response options (from very inactive to very aggressive) were equally represented on key questions (e.g., filing court petitions, taking custody). Rural counties tended to have stronger responses than urban counties (t[175] = -2.26, p = .024). County response did not vary with county-level median family income, percent minority births, or birth rate. Despite wide variations in practice, the majority of respondents (69%) felt their county's response was appropriate. Of respondents who did indicate that their county's response was inappropriate, most (85%) felt that the county needed to do more to protect children. CONCLUSIONS: There is currently tremendous variation across US counties in CPS responses to, and beliefs regarding, the issue of prenatal drug exposure. Some of this variation is due to differences between urban and rural counties, with little variation explained by differences in median income or percent minority births at the county level. There is a need for research-based guidance and consensus building in CPS practice in this area. 相似文献
3.
Understanding the relevance of basic science knowledge in the determination of patient assessment, diagnosis, and treatment is critical to good medical practice. One method often used to direct students in the fundamental process of integrating basic science and clinical information is problem‐based learning (PBL). The faculty facilitated small group discussion format traditionally used for PBL is a significant challenge for faculty and facilities with a large class. To provide inductive learning to a large class early in the preclerkship curriculum, a series of online, case‐based tutorials was created using the method of inquiry‐based learning. The tutorial paradigm is designed to challenge students through a guided inquiry process in which clinical skills and basic science information are seamlessly joined. The psychosocial dimension of patient care is added to the documented case presentation of the tutorials in the form of patient/physician history taking and physical examination videos. These videos augment the written case with additional information providing the student with visual exposure in methods of patient communication and appropriate professional patient/physician interactions that address competencies of patient care, communication, and professionalism. The tutorials were made available via learning management system course sites. The study tracked usage of the tutorials by 270 first‐year medical students. Anat Sci Educ 2:238–243, 2009. © 2009 American Association of Anatomists. 相似文献
4.
Christine V. Millward 《Perspectives: Policy and Practice in Higher Education》2016,20(4):137-142
In December 2014, the Office of the Independent Adjudicator (OIA) introduced the ‘Good practice framework for handling complaints and academic appeals’ which will inform external judgement on each university's approach to conflict management from the current academic year 2015–2016. The framework aims to improve the complaint process for higher education student complainants. However, based on the outcomes of one of the few empirical studies researching students’ complaints, the author argues that it is the wider experience for complainants that must be addressed and to do so effectively the sector must change the culture of concern surrounding complaints and recognise the vulnerability of a student body that expects guidance in all aspects of its engagement with the university. A positive institutional stance that seeks to learn from complaints and assumes a proactive approach to student communication will support both earlier conflict resolution and an improving experience for students in a scenario where academic failure now has lifetime ramifications in respect of future employment. 相似文献
5.
MARILYN ESPE‐SHERWINDT 《Support for Learning》2008,23(3):136-143
In the 1990s, the developing field of early intervention with young children with disabilities and their families adopted family‐centred practice as its philosophical foundation. Family‐centred practice includes three key elements: (1) an emphasis on strengths, not deficits; (2) promoting family choice and control over desired resources; and (3) the development of a collaborative relationship between parents and professionals. During the last two decades, the field of early childhood disability has successfully defined the working principles of family‐centred practice for practitioners. Although research has acknowledged that the paradigm shift to family‐centred practice is neither simple nor easy, a substantive body of evidence demonstrates that (a) family‐centred practice can be linked to a wide range of demonstrated benefits for both children and families, and (b) families are more satisfied and find family‐centred practice to be more helpful than other models of practice. 相似文献
6.
This study examined physician‐patient communication as it relates to expectations that patients and physicians hold for themselves and each other. Dimensions of mutual role expectation were determined to be physician as humanistic practitioner, physician authority, patient in the sick role, and patient as consumer. The study tested five hypotheses. Results showed patients had significantly higher expectations for patients in the sick role than had physicians. Other role expectations varied significantly by age within physician and patient groups. The implications of these differences for physician‐patient communication are discussed. 相似文献
7.
OBJECTIVES: The two aims of this study were to: (1). describe the prevalence and characteristics of domestic adult and child physical violence in the homes of children and adolescents evaluated in a specialized sexual abuse clinic and (2). describe parent or caretaker responses to domestic adult and child violence and child sexual abuse, including tendencies to report or seek medical care. METHOD: A consecutive sample of 164 subjects (ages 7-19) were interviewed in a sexual abuse clinic regarding in-home violent or abusive experiences among family members that had occurred at any time during their childhood. RESULTS: Fifty-two percent of these children and teenagers reported spousal violence in their home. Fifty-eight percent of child sexual offenders who were in-home males also physically abused their adult female partner. Half of in-home males who were physically violent to children also sexually abused them. In 86% of homes with partner violence, the children were also physically assaulted. There was no difference in sexual abuse disclosure rates or patterns for children living with or without adult violence. CONCLUSIONS: Sexually abused children should be questioned about physical abuse and the presence of violence among adults in their home. Safety plans for sexually abused children should incorporate screening for family violence and safety plans for parents and siblings of child victims, when appropriate. 相似文献
8.
9.
Christine Adams-Tucker 《Child abuse & neglect》1981,5(3):361-367
A retrospective overview of 28 sexually-abused children evaluated at a university-based child guidance clinic is reported. These 28 cases are scrutinized and empirical data are culled on the following sociodemographic and clinical variables: age, gender, race, family composition, referral source, presenting complaints, type of referral, psychiatric history of the child and family, diagnosis, disposition, type and duration of treatment, and a severity rating (done by parents) of the child's behavioral maladjustment. Historical information about the sexual abuse is presented: molester, type of abuse, duration of abuse and recency of sex abuse. The sociodemographic findings reveal the sex-abused child prototype to be a white girl, 9 years old, from a working class family headed by both parents or by mother alone. She was abused by an adult male relative. If a boy, abuse was by a male age-mate. Genital abuse was the most frequent type with sexual intercourse of very high frequency for children of all ages. Many psychiatric difficulties were reported in the families of these children. Some children had more than one molester. The clinical findings show psychic suffering among all studied children—most of moderate levels, behavior reactions. All but 3 children had therapy recommended to them. Presenting difficulties were for sexual abuse per se and/or for a wide-ranging variety of symptom complaints. The socioclinical overview of sexually molested children compells researchers to look closer at broader, extra-familial, cultural and socio-economic issues in the lives of these children and not just at psychopathologies of individual molesters and family units. 相似文献
10.
《Journal of College Student Psychotherapy》2013,27(4):239-252
To see if writing about former abuse reduced depression, somatic, and sleep complaints, 664 undergraduates were screened for past physical or sexual abuse. Of those abused, 88 consenting students were randomly assigned to no-writing control or writing (20 minutes on 4 different days) about abuse or trivial topics. All completed pre-, post-, and 4-week follow-up testing. At follow-up, all reported significantly less depression and fewer somatic and sleep complaints; groups were not significantly different. For students reporting past physical or sexual abuse, interacting with professionals, earning class credit, and receiving thanks may be enough to reduce depression, somatic complaints, and sleep disturbances. 相似文献
11.
This article is based on research undertaken as part of a study of sustainable school design in Thailand. Since school design solutions are inevitably affected by educational theory and practice, in the search for appropriate building solutions, it has been necessary to review Thai educational theories and practices that relate to the sustainability approach. Recently, there have been several attempts at the international level to respond to sustainability concepts and practices in both educational and architectural fields. These have included changes to the physical building through the introduction of techniques like passive solar cooling, and curriculum changes such as the use of native plants in the school grounds for science teaching. In Thailand, sustainable practices in both fields appear to be in their infancy. This article aims to explore one current Thai educational practice that presents the possibility of responding to sustainability concepts via culturally sensitive education. The practice is based on the three Buddhist principles of learning: sila sikkha (moral conduct); samadhi sikka (mind training); and panna sikkha (wisdom development). In this holistic approach, the principles are practised simultaneously and can be applied to many dimensions, including personal, family, school and communal levels, to cultivate responsive sustainable living practices for the learners. Because the majority of Thai people are Buddhists, this approach may be an alternative way of developing sustainable education in Thailand. It also presents a way to apply local knowledge to promote sustainable ways of living in particular contexts. This may be the first step in the development of sustainable school design in Thailand and could become an integrated part of the country's sustainable systems. 相似文献
12.
Janelle R. Harding 《Educational gerontology》2017,43(9):462-467
Research has shown that healthcare providers are not proactive in assessing and educating the aging adult population about sexual health. Barriers to discussing sexual issues by healthcare providers commonly cited in the literature include lack of time, lack of perceived knowledge, and personal embarrassment. Using an online survey collector, the survey was distributed to advanced practice registered nurses, doctors of osteopathy, medical doctors, and physician assistants in general practice in a mid-western state who care for patients 50 years and older. The results of this survey showed that only 28% of the respondents routinely assess the sexual health of aging adults. Nearly half of the providers that responded felt that they find it difficult to proactively assess the sexual health of an aging adult. Common barriers of patient discomfort, lack of time, and low medical importance reveal a need for interventions. 相似文献
13.
In developing individual education plans for children who need assistive technology devices, school psychologists will increasingly be called upon to assist in the decision making process regarding electronic augmentative and alternative communication (AAC) devices. A thorough assessment is required to select a device that is most appropriate for the child and their family. Assessment factors which must be considered within five domains (child, AAC device, service system, family, culture) are reviewed. A self-checklist is provided to help school psychologists develop and conduct thorough “best practice” assessments for the target population. © 1997 John Wiley & Sons, Inc. 相似文献
14.
Howard P. Parette Amanda C. Quesenberry Craig Blum 《Early Childhood Education Journal》2010,37(5):335-343
Technology use permeates virtually all aspects of twenty-first century society, though its integration in early childhood
settings and recognition as a developmentally appropriate practice remains problematic. A position is taken that education
professionals may be ‘missing the boat’ by not embracing technology usage as a developmentally appropriate practice. Concerns
are presented that both preservice education and inservice professional development require substantial improvement if early
childhood education professionals are to both recognize the role of technology in developmentally appropriate practice and
develop skills in using it in classroom settings. 相似文献
15.
Health education, research, and training rely on the altruistic act of body donation for the supply of cadavers. Organ transplantation and research rely on donated organs. Supply of both is limited, with further restrictions in Australia due to requirements for a next-of-kin agreement to donation, irrespective of the deceased's pre-death consent. Research suggests health workers are less likely to support the donation of their own bodies and/or organs, despite recognizing the public good of donation, and that exposure to gross anatomy teaching may negatively affect support for donation. Attitudes to body and organ donation were examined in Australian students studying anatomy. Support for self-body donation (26.5%) was much lower than support for self-organ donation (82.5%). Ten percent of participants would not support the election of a family member or member of the public to donate their body, and just over 4% would not support the election of a family member to donate their organs, with one-to-two percent not supporting this election by a member of the public. Exposure to gross anatomy teaching was associated with an increased likelihood of consideration of issues about body and organ donation, whether for self, family, or the public, and registration as an organ donor. Exposure decreased participants' willingness to donate their own body, with those who practiced a religion least likely to support body donation. Gross anatomy courses provide an opportunity to inform future healthcare workers about altruistic donation, albeit with a recognition that religious or cultural beliefs may affect willingness to donate. 相似文献
16.
The core values in medical practice which are essential for the humane outlook of a physician are clubbed within the domain of medical professionalism. Professionalism along with other discipline-independent skills (human skills) is propagated implicitly in medical schools as components of a “hidden curriculum.” Evidence suggests a strong association between “hidden curriculum” delivery and development of professionalism in the human dissection room. In this review article, the authors have tried to highlight a few exclusive practices adopted by medical schools which enhance the implementation of the “hidden curriculum” within the practice of human dissection and successfully inculcate the key components of professionalism such as integrity, respect, and compassion among students. These distinctive concepts are aimed at humanizing the experience of anatomical dissection by revealing the identity of the donors along with their personal details either through display of video clips of donor interviews, interactions with the family members of the donor over a meal or recognition of the donor as a mentor and organizing memorial services in honor of donors after conclusion of the dissection in the presence of their family members. The resounding success of these good practices in building professionalism among medical students from the onset of the academic curriculum has signaled a new chapter in anatomical sciences education. It has become imperative to recognize the visionary efforts of a select few medical educators and begin incorporating these recent trends into the delivery of the “hidden curriculum” within the evolving gross anatomy education model. 相似文献
17.
OBJECTIVE: This cross-sectional controlled study investigated the association between chronic pain, health care utilization and a history of childhood sexual abuse. SUBJECTS: Three groups, constituting 80 women in total, were studied (1) attendees at group therapy for individuals who had experienced childhood sexual abuse (n = 26); (2) Two control groups consisting of nonabused (a) psychiatric outpatients (n = 33); and (b) nurses (n = 21). SETTING: The setting was a university affiliated community and tertiary care hospital in London. Ontario. OUTCOME MEASURES: Each subject voluntarily completed questionnaires documenting history of childhood abuse, pain, psychological symptomatology and medical and surgical history. RESULTS: Sixty-nine percent of the women who had experienced childhood sexual abuse reported a chronic painful condition lasting more than three months, compared to 43% of the combined control groups (p = .026). Women who had experienced childhood sexual abuse reported a greater number of painful body areas (p = .003), more diffuse pain and more diagnoses of fibromyalgia (p = .013). They had more surgeries (p = .037), hospitalizations (p = .0004) and family physician visits (p = .046). CONCLUSIONS: Women with a history of childhood sexual abuse reported more chronic pain symptoms and utilized more health care resources compared to nonabused control subjects. Identification of such a history in the patient experiencing persisting pain may be the first step toward a successful combination of medical and psychosocial interventions. 相似文献
18.
Sherrie L. Seymour Howard J. Sullivan Naomi O. Story Mary Lou Mosley 《Educational technology research and development : ETR & D》1987,35(1):18-23
This study investigated the effects of medium of instructional practice, task difficulty, and gender on continuing motivation.
A total of 139 fifth and sixth graders with previous computer experience completed an initial drill and practice learning
task in one of the two media formats (computer or paper/pencil) at either a hard or easy difficulty level. Subjects' choice
of practice medium for a second learning task was the measure of continuing motivation. Sixty-seven of the 69 computer subjects
(97 percent) chose to return to practice on the computer, whereas only one of 70 paper/pencil subjects (one percent) chose
to return to practice in the paper/pencil form. p<.001. Questionnaire data indicated that computer subjects also evaluated
their own performance on the instructional practice task significantly more highly, reported the task to be significantly
more interesting and easier, and had a greater desire to study more of the subject matter. 相似文献
19.
This study was conducted to determine (a) if the heads of counselor education programs agree on what functions are appropriate for support personnel assisting secondary school counselors, and (b) who should take the responsibility for their training. Questionnaire replies were received from 128 (64.0 percent) of the 200 heads of counselor education programs queried. The respondents were asked to examine a list of 17 functions and (a) indicate if they were appropriate, and (b) specify if counselors, counselor educators, or city/state directors should be responsible for training support personnel to perform each appropriate function. There was significant agreement (X2, d = .01) among them on both questions. Ten of 17 functions were considered appropriate; the counselor was perceived as having the major responsibility for training. A small segment of the sample (11.7 percent) was engaged in training support personnel. 相似文献
20.
Dominique Girodet 《Child abuse & neglect》1981,5(3):335-342
Medical Violence Toward Young Children. Two types of medical “abuse” are to be considered: (1) Mandatory violence in the form of preventive medical activities, i.e., immunizations, and curative medical activities, i.e., intensive care medicine. Means of decreasing the psychological trauma associated with these inevitable activities are considered. (2) Avoidable medical violence, of which three different forms can be identified: ? In the institutions: separation of mother and child is still a common occurrence in maternity hospitals and in pediatric hospital services. ? In medical practice: too often symptoms common in infants and children are dealt with by prescribing unnecessary drugs (cough, cold, crying during the night). ? In placement of children under the pretence of medical cures for such foggy diagnoses as “rickets” or “recurring rhinopharyngitis,” which are cover-ups of the inability or refusal on part of the physician to apprehend a child's real problems. Such placements are apt to irreversibly destroy the psychological bonds of the child with his family.The physicians and health care personnel in general should be better prepared to cope with their own subconscious mechanisms, which often result in questionable automatic reflexes and decisions. This would result in a decrease in physical or symbolic abuses toward children. 相似文献