Objective This study tested the effectiveness of a brief, learner-centered, breaking bad news (BBN) communication skills training module using objective evaluation measures. Methods This randomized control study (N = 66) compared intervention and control groups of students (n = 28) and residents’ (n = 38) objective structured clinical examination (OSCE) performance of communication skills using Common Ground Assessment and Breaking Bad News measures. Results Follow-up performance scores of intervention group students improved significantly regarding BBN (colon cancer (CC), p = 0.007, r = −0.47; breast cancer (BC), p = 0.003, r = −0.53), attention to patient responses after BBN (CC, p < 0.001, r = −0.74; BC, p = 0.001, r = −0.65), and addressing feelings (BC, p = 0.006, r = −0.48). At CC follow-up assessment, performance scores of intervention group residents improved significantly regarding BBN (p=0.004, r = −0.43), communication related to emotions (p = 0.034, r = −0.30), determining patient's readiness to proceed after BBN and communication preferences (p = 0.041, r = −0.28), active listening (p = 0.011, r = −0.37), addressing feelings (p < 0.001, r = −0.65), and global interview performance (p = 0.001, r = −0.51). Conclusion This brief BBN training module is an effective method of improving BBN communication skills among medical students and residents. Practice implications Implementation of this brief individualized training module within health education programs could lead to improved communication skills and patient care.

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Researchers have determined that early childhood (EC) educators need to have personal and social skills and competencies to address the emotional demands of the EC profession. Research is lacking regarding how preservice programs help prepare students emotionally for the EC profession and on whether online courses are a suitable environment for future EC teachers to learn these skills. The purpose of this study was to explore if and how personal and social emotional intelligence (EI) competencies were being embedded and modeled in community college preservice EC educator online courses. This qualitative multiple case study design was employed using a conceptual framework based on Goleman's EI theory and included 3 community college preservice EC faculty member participants. Research questions targeted self-awareness, motivation, and empathy competencies and data sources included faculty interviews, syllabi, assignment descriptions, asynchronous discussion forum prompts, and faculty feedback on student assignments. Data analysis included using values coding and the identification of relevant themes as related to Goleman's EI theory. Results indicated that while faculty perceived EI as important and that they modeled competencies in online discussions and feedback, there were not many embedded activities in the online courses that provided practice or helped to show growth in EI competencies. This study contributes to positive social change for EC faculty by acting as an impetus for the intentional incorporation of EI activities in online environments, leading possibly to better prepared EC teachers and therefore improved teacher quality of life and teacher retention.

This study explores the acculturation experiences of long-term Western residents in Japan using a broad intercultural studies approach. First, the historical context of Westerners coming to Japan is discussed. Next, literature from the field of intercultural studies is considered. This literature is used to provide a framework for analyzing Western sojourners’ acculturation experiences in Japan, as well as for choosing the research methods for conducting a qualitative analysis. The research involved interviewing 12 expatriates from English-speaking countries who have been in Japan for at least 10 years. Their acculturation experiences were analyzed, with a particular focus on finding hidden barriers to acculturation. The study concludes that numerous barriers to acculturation do exist. Commonly observable barriers included lack of employment security for some sojourners, and a poor fit between an individual’s personality and the host culture. These issues are applicable to anyone adapting to life in a different culture. However, this research also exposed a number of hidden barriers arguably unique to the Western sojourner’s acculturation experience in Japan. These barriers include the challenge of developing satisfying relationships with Japanese, due primarily to different expectations for psychological closeness and self-disclosure in Japan and the West. Another is the social effect of Othering, the centuries-old process where Japanese society divides things into those which are Japanese and those which are not, and the consequent empathy deficit that Japanese experience toward outsiders. The thesis concludes by offering recommendations for how long-term Western residents in Japan can improve their adaptation and acculturation experience. These include the obvious advantages of learning the Japanese language, and the less obvious benefits of learning and practicing mindful intercultural communication.

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No description available.

Bakgrund   Schizofreni bedöms vara en av de tio mest funktionsnedsättande tillstånden i världen och omkring 20 miljoner människor har diagnosen. Det är den vanligaste psykossjukdomen och innebär för många drabbade ett lidande med en negativ inverkan på personens psykosociala tillvaro och fysiska hälsa. Personer med schizofreni utsätts ofta för stigmatisering i samhället, vilket resulterar i social utsatthet och ensamhet. Även i vården förekommer stigmatisering av sjukdomen, och att befinna sig i vårdsammanhang är för vissa personer med schizofreni sammankopplat med diskriminering och känslor av utsatthet. Sjuksköterskors professionella ansvar är att bemöta alla personer med respekt och med ett etiskt förhållningssätt. Det är av stor vikt att sjuksköterskor har kompetens att bemöta personer med schizofreni med ett personcentrerat förhållningsätt för att främja patientgruppens psykiska och fysiska hälsa.   Syfte Syftet var att belysa sjuksköterskors attityder och erfarenheter av att bemöta personer med schizofreni i olika vårdkontext.    Metod  En litteraturöversikt där resultatet baserades på15 vetenskapliga artiklar. Författarna har använt databaserna PubMed och CINAHL för att finna de vetenskapliga artiklarna. Tydliga urvalskriterier beskrivs i litteraturöversikten och artiklarna är sökta mellan åren 2010 till 2020. En integrerad dataanalys har utförts på inkluderade resultatartiklar.   Resultat Resultatet indikerar att stigmatisering av personer med schizofreni förekommer i större grad hos bland sjuksköterskor med mindre arbetserfarenhet. En öppen och ärlig dialog framkom som viktiga aspekter i patientrelationen mellan sjuksköterskor och patienter med schizofreni.   Slutsats Enligt funna resultat visades att högre kompetens gav mer trygghet hos sjuksköterskorna vilket tydliggör vikten av rätt utbildning hos sjuksköterskor för att kunna arbeta personcentrerat. Att reflektera kring sina egna fördomar och sin egen attityd kan minska en negativ attityd mot personer med schizofreni. Reflektionen medför också en minskad stigmatisering av patientgruppen. En öppen och ärlig kommunikation kan även främja relationen mellan sjuksköterskan och patienten och främja välmående. / Background  Schizophrenia is estimated to be one of the ten most disabling conditions in the world with around 20 million people affected. It is the most common psychotic disease and has a negative impact on the person's psychosocial existence and physical health. People with schizophrenia are often exposed to stigma in society, which results in social vulnerability and loneliness. Even in healthcare, stigma is preceded about the disease and being in a care context is for some people with schizophrenia linked to discrimination and feelings of vulnerability. Nurses' professional responsibilities is to treat all people with respect and with an ethical approach. It is of importance that nurses have the competence to care for people with schizophrenia with person-centered care in order to improve their wellbeing mentally and physically.   Aim The aim was to describe nurses' attitudes and experiences of treating people with schizophrenia in different care contexts.   Method A literature review where the results were based on 15 scientific articles. To find the scientific articles the authors have used the databases PubMed and CINAHL. Clear selection criterias was described in the literature review and articles are sought between year 2010 to 2020. An integrated data analysis has been performed on included results articles.   Results  The result indicates that stigmatization of people with schizophrenia occurs to a greater extent in nurses with less work experience. An open and honest dialogue emerged as important aspects in the nurse-patient relationship.   Conclusions According to the results found, it was shown that higher competence gave more security to the nurses, which clarifies the importance of the right training for nurses to be able to work person-centered. Reflecting on one's own prejudices and one's own attitude can reduce a negative attitude towards people with schizophrenia. The reflection also leads to a reduced stigma of the patient group. Open and honest communication can also promote the relationship between the nurse and the patient and promote well-being.

[pt] A falta de consciência da doença, também denominada anosognosia, é um sintoma comum da Doença de Alzheimer (DA). Sua estrutura funcional e seus mecanismos subjacentes, contudo, não são inteiramente compreendidos. O nível de consciência possui grande relevância para o sucesso do tratamento e para o fardo do cuidador. Outro fator de considerável impacto nas relações interpessoais e, portanto, no bem-estar dos pacientes e cuidadores, é o processamento emocional. A presente tese explora esses tópicos através de quatro artigos. No Artigo 1, utiliza-se a modelagem de equações estruturais (SEM, do inglês structural equation modeling) em uma grande amostra de pessoas com DA para investigar a natureza da relação entre função cognitiva, estado de humor e funcionalidade na previsão do nível de consciência da condição. Os resultados demonstraram que uma menor funcionalidade cognitiva e um maior nível de estado depressivo de humor influenciaram negativamente a capacidade dos pacientes de realizar atividades da vida cotidiana, o que, por sua vez, se mostrou associada a uma maior consciência da doença. O Artigo 2 investigou as origens executivas e mnemônicas da anosognosia na DA, utilizando uma tarefa de tempo de reação e medindo a consciência a respeito da performance na tarefa. Os dados demonstraram que o monitoramento online dos pacientes estava preservado, enquanto o monitoramento a médio e longo prazo esteve comprometido. Tal achado foi corroborado por resultados de dados eletrofisiológicos. Dessa forma, os resultados fortalecem as evidências favoráveis a uma natureza mnemônica, e não executiva, da anosognosia na DA, o que se mostra de acordo com o Cognitive Awareness Model (CAM). O Artigo 3 investigou a reatividade emocional a imagens negativas, auto-relevantes e neutras utilizando medidas de excitação e valência, gravações de expressões faciais e dados eletrofisiológicos. A reatividade emocional dos pacientes de DA foi similar à de jovens adultos, mas as respostas eletrofisiológicas foram elevadas quando comparadas às de idosos saudáveis, o que pode ser explicado por uma falta de mecanismos de controle cognitivo. A apatia esteve associada a menores respostas eletrofisiológicas a figuras negativas, e a consciência de prejuízos sociais se relacionou com maiores níveis de excitação em imagens auto-relevantes. Por sua vez, o Artigo 4 discutiu como a DA afeta as habilidades emocionais através de uma revisão de literatura sobre a empatia desses pacientes. Os aspectos afetivos da empatia deste grupo clínico estiveram relativamente preservados, enquanto foram apresentados déficits nos componentes cognitivos. Os prejuízos relacionados aos componentes afetivos foram principalmente atribuídos a um declínio cognitivo geral. Nossos achados ressaltam que diferentes fatores influenciam a consciência da doença na DA, enfatizando o papel de sintomas neuropsiquiátricos, do funcionamento cognitivo e das atividades da vida diária. Além disso, processos executivos pareceram estar preservados, ao passo que dificuldades em atualizar e consolidar esse conhecimento podem ser uma possível causa de anosognosia na DA. Ademais, sugerimos que as habilidades emocionais são amplamente preservadas em pacientes de DA. Tais resultados são de grande importância para a prática clínica. Pesquisas translacionais são necessárias para implementar os achados de pesquisas em abordagens terapêuticas específicas. / [en] Lack of awareness of condition, also termed anosognosia, is a common symptom in Alzheimer s disease (AD). However, its functional structure and underlying mechanisms are not fully understood. Level of awareness has great relevance for treatment success and caregiver burden. Another factor that has considerable impact on interpersonal relationships and thus on well-being of patients and caregivers is emotional processing. The current thesis explores these topics through four articles. In Article 1, structural equation modeling (SEM) was used in a large sample of people with AD (PwAD) to investigate the nature of the relationship between cognitive function, mood state, and functionality in predicting awareness. Results showed that lower cognitive function and higher level of depressive mood state negatively influenced PwAD s ability to perform daily living activities, which in turn were associated with better awareness. Article 2 investigated executive and mnemonic origins of anosognosia in AD, with a reaction time task being applied to examine awareness of task performance. The findings demonstrated that online monitoring was preserved, while medium- and long-term monitoring were impaired. This was supported by results from electrophysiological data. The results strengthen the evidence for a mnemonic rather than executive nature of anosognosia in PwAD in accordance with the Cognitive Awareness Model (CAM). Article 3 investigated emotional reactivity to negative, self-relevant, and neutral pictures using ratings of arousal and valence, facial expression recordings and electrophysiological data. Emotional reactivity of PwAD was similar to young adults, but electrophysiological responses were elevated compared to healthy older adults, which might be explained by a lack of cognitive control mechanisms. Apathy was associated with reduced electrophysiological responses for negative pictures, and awareness of social impairments was linked to higher arousal ratings of self-relevant pictures. Article 4 discussed how higher emotional abilities are affected by AD, through a review of the literature on empathy in this clinical group. PwAD showed a pattern of relatively preserved affective aspects and impairments in cognitive components of empathy, whereby impairments in affective components can mainly be attributed to a general cognitive decline. Our findings highlight that different factors influence awareness in AD, emphasizing the role of neuropsychiatric symptoms (NPS), cognitive functioning and activities of daily living. Moreover, executive processes seem to be preserved, whereas impairments in updating and consolidation of this knowledge seem to be a possible cause for anosognosia in AD. Furthermore, we suggested that emotional abilities are largely preserved in PwAD. Our results have great significance for clinical practice. Translational research is needed to implement research findings into specific therapeutic approaches.

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The Group Questionnaire (GQ) is a 30-item, self-report measure of the group relationship that was developed in the present study. It is based off of Johnson's new three factor model of the group relationship which includes Positive Bonding, Positive Working, and Negative Relationship. This study involved two parts, the creation of the GQ followed by the validation and refinement of the GQ using 486 participants from three populations - outpatient university counseling center, inpatient state hospital, and non-patient AGPA process groups. Confirmatory Factor Analysis (CFA) was used to test the goodness-of-fit of Johnson's model to each of the populations separately and as a whole. Following the refinement process, results showed the GQ to have good fit to the model for each population. Distinct differences in response pattern were found between the three populations. Reliability estimates were predominantly in the good range. Implications for future utility of the GQ include using it as a clinically relevant and efficient assessment tool to inform clinicians of the quality of the group psychotherapy relationship and to potentially predict group outcome.