Secondary pneumonia. It can be prevented by care

An oncology nursing team at the Freiburg University Hospital have developed a detection and prevention plan for respiratory complications. The plan was originally applied only to oncology patients, but due to its positive results it has since been put in practice in other parts of the hospital. Each patient that enters the hospital fills out a medical survey that is used as a baseline to decide what level of risk the patient presents in acquiring a respiratory infection during their hospitalization. A point system obtained from the survey is evaluated on a scale that allows the nursing care to be adjusted accordingly.     

The need for single registration care homes. 2: Divisions and problems

The first article in this series, published last week, examined the current provision of care for older people in nursing and residential homes. The authors also detailed the RCN proposals in a report in last week's issue. This week, in the second of two articles, the authors discuss the divisions and polarisations which make the two-tier system unworkable for a client group with a wide range of needs.     

Deception can be acceptable.

Comments on the article by A. Ortmann and R. Hertwig (see record 1997-04731-011) in which they vehemently argue against any deception of participants in psychological research. Their sophisticated arguments against deception in research are neither precise nor imperative, addressing only questionable negative long-term effects of deception in research. It is argued that (1) acceptability of an experimental treatment and acceptability of deception must be kept separate, (2) deception is necessary in research on certain topics, and (3) participants understand and even accept deception when they are carefully debriefed. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Psychology can be indispensable to health care reform and the patient-centered medical home.

The Patient Protection and Affordable Care Act (PPACA) was passed into legislation in March 2010, making health care reform a reality. Perhaps the most well-developed model of primary care that aligns with the PPACA's agenda is the patient-centered medical home (PCMH). Integrated care, as defined by collaborative care between mental health and primary care providers and systems, will undoubtedly play a critical role in the success of the PCMH. The role of psychology and integrated care in the PCMH as well as training implications for psychologists are discussed. This article is intended to challenge our discipline to embrace psychology as a health care profession that must prepare for and solidify its added value in the health care delivery models of the future. Requisite skill sets for primary care psychologists and existing training opportunities are presented. Finally, possible mechanisms for training psychologists in integrated care and the professional roles primary care psychologists can expect to fill are proposed. (PsycINFO Database Record (c) 2011 APA, all rights reserved)     

Age-related changes in cardiac physiology. Can they be postponed or treated by drugs?

In this paper preliminary findings from the first stage of an English National Board (ENB) commissioned study investigating the educational needs of community practitioners in relation to their responsibilities for student learning are presented. A national postal survey of all educational centres offering nurse and/or midwifery education was undertaken in the latter half of 1993. Information was collected regarding the nature and planning of the community practice components of courses. The main methods of support for practitioners included the provision of the ENB 998/997 courses and liaison meetings between educational centres and community practice areas. Practitioners were often required to both supervise and assess students on practice placements, the length of these placements varying enormously. For those centres offering the mental health and learning disability branches of the Diploma in Higher Education in Nursing Studies (Project 2000), a significant proportion lacked teachers with specialist community qualifications. The investigation took place at a time of great upheaval, with 42% of centres reporting that they were in the process of amalgamation. The findings demonstrate that community nurses and midwives undoubtedly contribute to the education of nurse and midwife students and consequently have educational needs which must be addressed if they are to continue to supervise students.     

Regional neonatal intensive care: its benefits can now be measured

Region III was the first are in Virginia to develop neonatal transport and education to rural locations, as reported previously in this journal. There appears to be a growing acceptance of RNIC services in Region III with a simultaneous drop in neonatal mortality rates below national and state levels; however, until regional neonatal mortality rate is more equal to the mortality rates in the central hospital, RNIC cannot be said to have made its full impact.     

The need for cognition.

Developed and validated the Need for Cognition Scale (NCS). In Study 1, a pool of items was administered to 96 faculty members (high-need-for-cognition group) and assembly line workers (low-need-for-cognition group). Ambiguity, irrelevance, and internal consistency were used to select items for subsequent studies. Factor analysis yielded one major factor. In Study 2, the NCS and the Group Embedded Figures Test were administered to 419 undergraduates to validate the factor structure and to determine whether the NCS tapped a construct distinct from test anxiety and cognitive style. The factor structure was replicated, and responses to the NCS were weakly related to cognitive style and unrelated to test anxiety. In Study 3, 104 undergraduates completed the NCS, the Marlowe-Crowne Social Desirability Scale, and a dogmatism scale. Results indicate that need for cognition was related weakly and negatively to being closeminded, unrelated to social desirability, and positively correlated with general intelligence. Study 4 (97 undergraduates) furnished evidence of the predictive validity of the NCS. (32 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Linking level of care to level of need: Assessing the need for mental health care for nursing home residents.

What are the mental health status and active treatment needs of nursing home residents? A stratified random sample of 828 residents in 25 facilities serving Medicaid recipients was assessed for levels of physical and psychosocial functioning. Although 91.2% had sufficiently high levels of medical and physical care needs to justify nursing home placement, 79.6% also had moderate to intense needs for mental health care. Older residents, relative to their younger counterparts, had more intense medical and mental health care needs. It was also found that psychiatric diagnosis was a poor indicator of mental health service needs, particularly among elderly individuals. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

The need for inclusion of psychological trauma in the professional curriculum: A call to action.

An appreciable disparity exists between the need for services by professionals with expertise in psychological trauma and the availability of these services. Despite the establishment of a solid base of scientific literature on trauma and the growing attunement of society and the media to the adverse psychological impact of traumatic events, this area has yet to be decisively incorporated into the core curriculum of graduate training in psychology and other professions. This paper provides an overview of the prevalence, scope, and impact of trauma in the general population and the current lack of adequate resources to address the psychological difficulties engendered by traumatic experiences. Existing models of trauma training are discussed, and strategies for expanding the availability of trauma training are recommended. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

A training curriculum for professional psychologists in primary care.

Primary care psychology is a growing field that requires specific training opportunities for successful practice. The knowledge and skills that practitioners need for work in this setting are outlined here in detail. This curriculum integrates literature and experience in family psychology, health psychology, and pediatric psychology; considers multiple levels of education and training; and provides illustrative examples. It is a first attempt in an evolving process of integrating historical and cutting edge literature from many areas of psychology and other disciplines to contribute to comprehensive primary care psychology training. It can be used by programs and individual practitioners alike in designing education and training experiences. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Defense processes can be conscious or unconscious.

Comments on an article by P. Cramer (see record 2000-15774-007) which discussed renewed interest in the concept of defense mechanisms. The author dissents from two proposals made by Cramer: (1) that defense mechanisms are used nonintentionally and (2) that they are necessarily unconscious processes. It is argued that Sigmund Freud's position—that defense, including repression, could be conscious or unconscious—is the viable position. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Psychoanalytic supervision and the need to be alone.

Argues that just as infants not left alone (in the marginal presence of their mothers) will not find their true selves, but will develop false selves with conformative tendencies (D. W. Winnicott, 1965), supervisees not left to discover their professional selves in the marginal presence of their supervisors will not develop true professional selves. A false self will then emerge in the place of an authentically experiencing one. This false self will conform to the perceived needs and demands of supervisors, teachers, and various clinical tests. Supervisors must balance the welfare of the patient with the professional developmental needs of the supervisee. A case study is presented as illustrative. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Patient views on primary care services for epilepsy and areas where additional professional knowledge would be welcome

In the past decade there has been increasing interest in the part that general practice can play in the care of people with epilepsy. Primary care services for epilepsy vary from practice to practice. Some studies have suggested that people with epilepsy prefer secondary care services and are not keen for their epilepsy to be managed in general practice, but much of the data were collected in secondary care. This study collected data from various sources about present provision of services, patient satisfaction with services, views about service development, areas where GP knowledge may be improved and whether the site of data collection influenced the results. A questionnaire was piloted, then distributed and collected through branches of the British Epilepsy Association, general practice and secondary care clinics. Data collected were both quantitative and qualitative. One hundred and seventy-eight questionnaires were collected from three sources. The responders were a severe seizure group. Structured care in general practice was uncommon with 54% being seen only when needed. Dose and type of antiepileptic medication was rarely altered in general practice. Information about their condition was given to 44% of the responders by their GP. Sixty-one percent would prefer their epilepsy care to be 'shared' between primary and secondary services. The majority of patients were satisfied with GP services, felt they could easily discuss their epilepsy, but 58% felt they 'rarely' or 'never' received enough information about their condition in general practice. Satisfaction with GP care varied, dependent on where the data were collected. Patients would value more information and more time to discuss the effects of their epilepsy. In conclusion general practice care for epilepsy is still reactive. Patients value more information and more time to discuss implications. The data collection point affects the results; any conclusions about the organisation of epilepsy care should draw data from community patient samples.     

Informal care can be better than adequate: Development and evaluation of the Exemplary Care Scale.

Purpose: To evaluate a new measure assessing excellent, or exemplary, informal care--an aspect of caregiving that has received little attention. The Exemplary Care Scale (ECS) was developed on the basis of insights from previous research with items generated by the authors in consultation with a multidisciplinary research team. Design: 310 informal caregivers and 283 of their elderly care recipients completed the ECS and other measures pertaining to quality of care and its presumed correlates. Results: Factor analyses indicated that the ECS consists of 2 factors reflecting provision of exceptional care (Provide) and respect for care recipient autonomy, wishes, and the like (Respect). The ECS factor structure was equivalent among caregivers and care recipients. Both factors were empirically distinct from existing measures of poor quality and adequate care. Each ECS factor was associated with other care-related constructs in predictable ways, implying construct validity. Conclusions: The ECS, in conjunction with existing measures, provides a more comprehensive assessment of the quality-of-care continuum and should prove useful to researchers and practitioners interested in quality of informal care provided to chronically ill or disabled people. (PsycINFO Database Record (c) 2010 APA, all rights reserved)