Psychology of computer use: XLV. Cognitive spontaneity as a correlate of computer anxiety and attitudes toward computer use

The relationship of cognitive spontaneity with measures of computer anxiety and attitudes toward computer use was investigated in a sample of 178 individuals attending advanced courses in management. As expected, a significant negative relationship between cognitive spontaneity and computer anxiety was found. The relationship remained significant even with statistical control for computer experience. The relationship between cognitive spontaneity and attitudes toward computer use was positive but not significant. The results imply both a direct and an indirect relationship between cognitive spontaneity and computer anxiety. Further, the results support the suggestion that computer anxiety and attitudes toward computer use are related but distinct constructs.     

Initiating a patient service partner program

Rising costs and the need to increase patient satisfaction are driving hospitals to restructure care delivery. At one hospital, housekeeping, food service and nurse technician duties are combined to form one nurse-extender role: the Patient Service Partner (PSP). Findings about patient and nurse satisfaction before and after implementation show that nurses agreed that the PSP program improved patient care delivery and helped control costs. Patients reported the same or higher rating of satisfaction with various aspects of their hospitalization. Call lights were answered more quickly and attitudes of personnel answering the lights were more positive. Nurses are finding more time for patient education and documentation.     

Bias in the standardized mortality ratio when using general population rates to estimate expected number of deaths

OBJECTIVE: The present study was undertaken to determine current attitudes and behaviour toward informed consent for antipsychotic medication and documentation of the informed consent process in patient charts. METHOD: Thirty psychiatrists treating a minimum of 10 patients on antipsychotic medication were selected from teaching and nonteaching hospitals. Clinicians completed questionnaires on their behaviour and attitudes regarding documentation of informed consent and antipsychotic medication. Physicians' charts were reviewed to ascertain documentation. RESULTS: Psychiatrists reported sometimes documenting the informed consent process. The chart review revealed that, on average, each psychiatrist had documentation in 23% of charts. Physicians who either were affiliated with a teaching hospital or spent more time reading medical journals were more likely to document the informed consent process. CONCLUSIONS: Physicians who use antipsychotic medication as a treatment in their practice are not routinely documenting the informed consent process in patient records. Physicians should pay more attention to this aspect of record keeping because it is their only record of the consent process.     

Attitude similarity in marital therapy.

Measured the evaluative attitudes, before and after treatment, of 10 couples involved in marital therapy, and compared these with the initial attitudes of their therapists. Contrary to previous research, results indicate that improvement in marital therapy was associated with attitudinal convergence between the 2 marriage partners instead of between patient and therapist. However, a significant trend was noted for patients to acquire their therapist's attitudes during treatment regardless of their improvement. Results suggest that improvement in marriage therapy may be more efficaciously predicted by determining the parameters of the husband-wife relationship, that could result in their attitudinal convergence, than by the similarity between the individual patient and therapist. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Integrating play and family therapy methods: A survey of play therapists' attitudes in the field.

The researchers surveyed 295 members of the Association for Play Therapy on their attitudes related to working with families when treating children. The results indicated the majority of play therapists held attitudes conducive to involving families in their approaches with children. However, mixed findings were found in specific areas related to the implementation of play therapy with families, suggesting barriers may exist. These mixed findings included a decreased percentage of play therapists that felt like play therapy was effective in family therapy when compared with the high level who felt that play and family therapy approaches could be integrated. Moreover, the respondents were divided on issues such as parents' willingness to be involved in therapy with their children and if parents were actually resistant to being included in sessions with their children. These mixed findings suggest that a wide range of attitudes and experiences about parental involvement exist among play therapists in the field. The authors raise key questions for the play therapy field to consider in more depth and suggest improvements that may be needed in play therapy education to increase the efficacy of play therapists' skills in working with families. (PsycINFO Database Record (c) 2011 APA, all rights reserved)     

Affective reactions toward computer-based intelligence testing.

Studied affective reactions as a function of computer-based vs. traditional examiner testing procedures. Within the context of a Latin square design, 24 male and 24 female undergraduates were individually tested with the WAIS, the Slosson Intelligence Test, and the Slosson Intelligence Test via computer. Ss also completed the State-Trait Anxiety Inventory and an attitude measure before and after all testing sessions. Results indicate that the computer testing procedures led to significantly higher levels of state anxiety and less favorable attitudes in comparison to the examiner testing procedures. These negative affective reactions are seen as a function of certain computer testing procedures. (17 ref.) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

A-B therapist perceptions and preferences for schizophrenic and psychoneurotic clients.

Administered an extended version of the a-b scale to 141 experienced, practicing psychotherapists. Ss also completed scales designed to assess therapist attitudes toward working with schizophrenic and psychoneurotic clients, personal liking for specific schizophrenic and psychoneutrotic clients, and orientation toward interpersonal relationships. Analysis of variance results revealed no evidence suggesting that a and b therapists differentially perceive or prefer schizophrenic or psychoneurotic clients. There was evidence suggesting that a therapists initially like both schizophrenic and psychoneurotic clients as individuals more than b therapists. By the time therapy had ended, these differences between a and b therapists tended to dissipate with schizophrenic clients. However, b therapists' personal liking of their psychoneurotic clients actually declined during therapy. (18 ref.) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Stages of therapist comfort with sexual concerns of clients.

Discusses the necessity for therapists in training to go through a process of examining their personal sexual beliefs and attitudes before they can be comfortable with the kind of sexual material brought up by many clients. The reactions of therapists in training to a course in which they use methods that are specifically intended to help them with the process of becoming comfortable with client sexual concerns are described. Feedback from students suggests that they go through at least 4 overlapping stages of comfort with the kind of sexual material that is likely to be presented by their clients. These stages are (1) an examination of their views and concerns about their own personal sexual issues, (2) increasing awareness and appreciation of problems and emotional reactions as the clients experience them, (3) a new freedom in discussing sexual matters, and (4) an awareness of a new level of comfort with clients and increased willingness to share sexual material. (16 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Effective ingredients in psychotherapy: Prediction of outcome from process variables.

Examined the impact of (a) exploration of the psychodynamic roots of patients' conflicts, (b) warmth and friendliness of the therapist-offered relationship, and (c) positiveness of patients' attitudes toward working in therapy on the outcome of brief therapy with 35 college males exhibiting symptoms of depression, anxiety, and social introversion. Symptoms were confirmed by elevated scores on the Depression, Psychasthenia, and Social Introversion scales, respectively, of the MMPI. Analyses of process ratings for audiotaped segments from 4 sessions throughout the course of therapy revealed that the activities of therapists of differing theoretical orientations and of professional vs untrained, "inherently helpful" therapists could be distinguished. Although patients' attitudes toward the therapist and patient involvement in the therapy process did not differ as a function of the type of therapist, the process dimension that most consistently predicted therapy outcome was patient involvement. Exploratory processes and therapist-offered relationship had a lesser influence on outcome. (71 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Intensive care unit bedside documentation systems. Realizing cost savings and quality improvements

Automating intensive care unit (ICU) documentation saves time and assists in interpreting data and planning care. The current economic climate makes the cost of ICU computer systems prohibitive for many institutions. Any expenditure without a measurable return on investment will be scrutinized carefully. The literature describing ICU computer system benefits often is difficult to interpret. No two implementations, hospitals, or benefit study designs have been the same. Each implementation has many unique variables. These variables make study comparison and replication potentially impossible. The authors have concluded that replicating previous studies may not be relevant if the goal is to justify system cost. The objective is met by designing a study that evaluates changes in data management activities as well as issues unique to the study unit or institution. The purpose of this article is to review the findings of previous benefits studies related to ICU documentation systems and to suggest other measures to support cost justification for expensive bedside documentation systems.     

A look at today's behavior therapists.

Studied questionnaire responses of 45 members of the Association for Advancement of Behavior Therapy in order to develop a profile of characteristics and practices of behavior therapists. Findings indicate that behavior therapists are apparently becoming more flexible in their attitudes and practices and more eclectic. Most Ss have not had personal therapy, use a variety of behavioral techniques, and treat a wide range of adjustment disorders and a diverse set of clients. (13 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Developing a computer workshop to facilitate computer skills and minimize anxiety for early childhood educators.

Early childhood educators (n=133) were assigned to 1 of 3 instructional conditions (direct, guided discovery, or no-exposure control) to assess the impact of computer workshops on their level of computer anxiety, computer knowledge, and comfort with computer technology. Groups were matched for computer experience and anxiety, early childhood education (ECE) experience, and ECE center. The direct and guided discovery groups attended a 3-hr hands-on workshop covering hardware, software, and Internet material. Immediately after the workshops, computer anxiety was lower and comfort with computer technology increased. Six months later, the control group had reduced computer anxiety, but the other groups maintained greater knowledge and comfort. Direct instruction reduced computer anxiety slightly but did not promote the acquisition of information of the guided condition. Overall, workshops provided gains that could translate into more effective and efficient computer use in the classroom. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Experienced therapists’ approach to psychotherapy for adults with attachment avoidance or attachment anxiety.

Interviews were conducted with therapists (N = 12) nominated by peers as especially effective in working with clients with adult interpersonal problems. Open-ended questions asked how these therapists would approach 2 adult clients described in brief vignettes as having high attachment avoidance or anxiety. A coding team used a grounded theory approach to identify 8 higher order themes in the interviews: Conceptualization, Client Defenses, Managing Boundaries, Markers of Progress, Therapist Reactions, Targeted Interventions, Corrective Relational Patterns, and Internal Representations and Models. These themes were integrated into an inclusive theoretical model based on the core concept of therapists’ strategic management of therapeutic distance. The distance necessary to engage clients initially is adjusted later in therapy to create a corrective attachment in the psychotherapy relationship that facilitates change. Therapists described how, after engagement, they gradually increase therapeutic distance for clients with attachment anxiety who must then manage resulting frustration while learning to function more autonomously. Therapists gradually insist on decreased therapeutic distance to help clients with attachment avoidance overcome their fears of intimacy. Therapists discussed the specific techniques they use to manage therapeutic distance. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Factors predicting the use of technology: Findings from the center for research and education on aging and technology enhancement (create).

The successful adoption of technology is becoming increasingly important to functional independence. The present article reports findings from the Center for Research and Education on Aging and Technology Enhancement (CREATE) on the use of technology among community-dwelling adults. The sample included 1,204 individuals ranging in age from 18-91 years. All participants completed a battery that included measures of demographic characteristics, self-rated health, experience with technology, attitudes toward computers, and component cognitive abilities. Findings indicate that the older adults were less likely than younger adults to use technology in general, computers, and the World Wide Web. The results also indicate that computer anxiety, fluid intelligence, and crystallized intelligence were important predictors of the use of technology. The relationship between age and adoption of technology was mediated by cognitive abilities, computer self-efficacy, and computer anxiety. These findings are discussed in terms of training strategies to promote technology adoption. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Computer aided adjustment of the phrenic pacemaker: automatic functions, documentation, and quality control

Electrical stimulation of the phrenic nerves of patients with complete ventilatory insufficiency with the Vienna respiratory pacemaker has been in clinical use since 1983. During the adjustment of stimulation parameters with this device, the following problems have occurred: for some measurements like the recruitment curve, series of complete inspiration cycles have to be stimulated, which causes the danger of muscle fatigue for unconditioned patients. The documentation is completed predominantly by hand, taking time and increasing the possibility of error. As a first step to solve these problems, we developed a new stimulation and measurement system. It consists of a PC with data acquisition hardware, the necessary sensors, and amplifier circuitry. The implanted stimulator is controlled via the parallel interface. The new system offers some advantages: computer control shortens the time for measurement and documentation, and the stress on the patient and the risk of error is reduced; synchronized measurement makes it possible to use single stimulation pulses instead of bursts and ramps to reduce diaphragm fatigue; digital signal processing improves measurement results and reproducibility; and help functions and self tests are provided, together with a graphical user interface. We used sensors for air flow, diaphragm EMG, and acceleration, on up to 8 channels simultaneously. Combined sample rates of up to 100 kS/s were possible. The system could be adapted for other uses involving functional electrical stimulation with our implantable nerve stimulators. Using this equipment saves a lot of effort, and the adjustment process can be focused on improved stimulation results and better performance for the patient. Current research is studying implementation of automatic functions like acquisition of stimulation thresholds. This could result in a predominantly automated adjustment of the phrenic pacemaker and even in a closed-loop controlled system in the future.     

Gay and lesbian clients' selection of therapists and utilization of therapy.

Examined gay and lesbian clients' therapy utilization and therapist selection. Specifically the study examined whether clients' sexual orientation and gender relate to the total number of therapists seen and to the average duration of therapy, what the demographic characteristics of the therapists chosen by gay and lesbian clients are, the likelihood that gay men and lesbians prescreened potential therapists for gay-affirmative attitudes, the methods used to prescreen, and if the prescreening related to client satisfaction. 172 gay men and 220 lesbians (aged 22–71 yrs) who had seen at least 1 therapist participated in the study. A comparison group of 81 heterosexual individuals matched for demographic characteristics also participated in the study. Results show that 41% of the therapists gay and lesbian Ss saw in the 1990s were gay, lesbian, or bisexual. Of the therapists seen, 63% had been screened for gay-affirmative attitudes by respondents before being selected. Prescreening was associated with higher therapist ratings. Several methods for therapist screening were reported including seeking a referral. Results also show that gay and lesbian Ss reported seeing more therapists and seeing therapists for longer durations than heterosexual Ss. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Psychotherapists' attitudes toward clients reporting mystical experiences.

Studied the proportion of therapy clients who report mystical experiences, the diagnostic attitudes of their therapists, and the influence of personal and professional factors on attitudes toward these clients by analyzing the survey responses of 285 32–82 yr old psychotherapists (primarily males). Of the 20,670 clients seen during a 12-mo period, 4.5% reported a mystical experience; 67% of Ss had seen at least one such client during that period. Psychodynamic and behavioral therapists attributed significantly more pathology to such clients than did humanistic/existential therapists. Responses suggested that some therapists were biased in their diagnostic attitudes toward clients reporting mystical experiences. 50% of Ss said they had personally had a mystical experience. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Statewide adoption and initial implementation of contingency management for substance-abusing adolescents.

Four hundred thirty-two public sector therapists attended a workshop in contingency management (CM) and were interviewed monthly for the following 6 months to assess their adoption and initial implementation of CM to treat substance-abusing adolescent clients. Results showed that 58% (n = 131) of the practitioners with at least one substance-abusing adolescent client (n = 225) adopted CM. Rates of adoption varied with therapist service sector (mental health vs. substance abuse), educational background, professional experience, and attitudes toward treatment manuals and evidence-based practices. Competing clinical priorities and client resistance were most often reported as barriers to adopting CM, whereas unfavorable attitudes toward and difficulty in implementing CM were rarely cited as barriers. The fidelity of initial CM implementation among adopters was predicted by organizational characteristics as well as by several demographic, professional experience, attitudinal, and service sector characteristics. Overall, the findings support the amenability of public sector practitioners to adopt evidence-based practices and suggest that the predictors of adoption and initial implementation are complex and multifaceted. (PsycINFO Database Record (c) 2010 APA, all rights reserved)