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Results for “PROBLEM SOLVING”

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PubMed1996

An evaluation of the problem-solving ability of diplomates from a comprehensive nursing programme.

The aim of this South African study was to obtain a measurement of the problem-solving ability of diplomates from a basic nursing programme with this skill included in its programme objectives. The problem-solving skills of diplomates from this programme were compared with those of first years to determine if there is an improvement in the problem-solving skills. A comparison was also made with a different basic programmes not claiming to teach problem-solving. The research design selected for this study was the ex post facto design. Data were collected using the Triple Jump Method which is an interview technique. The findings suggested that the level of the problem-solving skills of the comprehensive nursing programme diplomate is not satisfactory. There was, however, some improvement in the problem-solving ability from the first to the fourth year. The level of performance of the fourth years was slightly higher than that of the third years of the three-year nursing programme, who were used as the control group. Recommendations on selection teaching and evaluation of students, as well as further research, were made.

Adult↗

PubMed1998

Critical thinking. A framework for problem solving in the occupational setting.

1. Critical thinking is essential in providing quality nursing care. Understanding the process of critical thinking increases the nurse's efficiency in the skill of problem solving. 2. To employ the critical thinking process, the nurse must analyze and criticize a problematic or change situation, reason, make inferences, and reach conclusions. 3. The result of critical thinking is attaining goals, solving problems, and making decisions. 4. Critical thinking is a process and not an outcome.

Clinical Competence↗

PubMed2001

The efficacy of problem-solving treatments after deliberate self-harm: meta-analysis of randomized controlled trials with respect to depression, hopelessness and improvement in problems.

BACKGROUND: Brief problem-solving therapy is regarded as a pragmatic treatment for deliberate self-harm (DSH) patients. A recent meta-analysis of randomized controlled trials (RCTs) evaluating this approach indicated a trend towards reduced repetition of DSH but the pooled odds ratio was not statistically significant. We have now examined other important outcomes using this procedure, namely depression, hopelessness and improvement in problems. METHOD: Six trials in which problem-solving therapy was compared with control treatment were identified from an extensive literature review of RCTs of treatments for DSH patients. Data concerning depression, hopelessness and improvement in problems were extracted. Where relevant statistical data (e.g. standard deviations) were missing these were imputed using various statistical methods. Results were pooled using meta-analytical procedures. RESULTS: At follow-up, patients who were offered problem-solving therapy had significantly greater improvement in scores for depression (standardized mean difference = -0.36; 95% CI -0.61 to -0.11) and hopelessness (weighted mean difference =-3.2; 95% CI -4.0 to -2.41), and significantly more reported improvement in their problems (odds ratio = 2.31; 95% CI 1.29 to 4.13), than patients who were in the control treatment groups. CONCLUSIONS: Problem-solving therapy for DSH patients appears to produce better results than control treatment with regard to improvement in depression, hopelessness and problems. It is desirable that this finding is confirmed in a large trial, which will also allow adequate testing of the impact of this treatment on repetition of DSH.

Cognitive Behavioral Therapy↗

PubMedDate not supplied

Collaborative problem-solving in telemedicine and evidence interpretation in a complex clinical case.

This study examined clinical problem-solving processes in the context of a telemedical consultation, in order to verify to what extent the technological environment preserves the characteristics of medical reasoning that are known to occur in more traditional clinical settings. This study also provided an opportunity for examining certain fundamental aspects of medical reasoning about complex cases. Within a case-study design, we used a theoretical framework and qualitative methods originating from cognitive science. Expert physicians used reasoning strategies commensurate with the complexity of the case. The technological context of the telemedical consultation did not overly contrive the interaction, allowing them to use real-time problem-solving processes characterizing medical reasoning in naturalistic settings. The results also suggest that high levels of expertise in the presence of very complex cases may elicit a particular configuration of problem-solving processes, associating certain reasoning patterns that are usually related to non-expert problem-solving with others that are typical of expertise. We believe that the evaluation of image transmission and diagnostic performance in telemedicine, as well as the determination of its indications and technological configurations, may benefit from taking into account, with the help of cognitive methodologies, the interacting problem-solving modalities that may be encountered in this context.

Adult↗

PubMed1998

Family rigidity, adolescent problem-solving deficits, and suicidal ideation: a mediational model.

Family rigidity and adolescent problem-solving deficits have each been linked to adolescent suicidal behaviors. The objective of the present study was to evaluate the hypothesis that family rigidity has primarily an indirect effect on adolescent suicidal ideation through its effect on adolescent problem-solving deficits. College students and their parents completed the Family Adaptability and Cohesion Evaluation Scale II. Students also completed the Problem-Solving Inventory and the Adult Suicidal ideation Questionnaire. Structural equation models confirmed that family rigidity has an indirect effect on adolescent suicidal ideation through its effect on adolescent problem-solving deficits. Directions for treatment efforts are discussed.

Adaptation, Psychological↗

PubMed2006

The deep play of medicine: discursive and collaborative processing of evidence in medical problem solving.

Ethnographic research was conducted in the thoracic ward of a Norwegian university hospital in order to study collaborative medical problem solving. As a general principle, evidence-based medicine is supposed to lead the process of medical problem solving. However, medical problem solving also requires evidence of a different kind. This is the more concrete form of evidence, such as X rays and other representations, that guides medical practice and makes sure that decisions are grounded in sound empirical facts and knowledge. In medicine, 'evidence' is on the one hand an abstract category; on the other hand, it is a tool that is practically enacted during the problem-solving work. Medical evidence does not 'show itself'. As such it has an emergent quality. Medical evidence has to be established and made practically useful in the collaborative settings by the participants in order to make conclusions about diagnoses and treatment. Hence, evidence is an interactional product; it is discursively generated and its applicability requires discourse. In addition, the production of medical evidence requires more than medical discourse and professional considerations. This paper looks at the production processes and use of medical evidence and the ambiguous meaning of this term in practical medicine.

Clinical Medicine↗

PubMedDate not supplied

Adult age differences in monitoring of practical problem-solving performance.

A scale measuring practical problem-solving ability in adulthood was developed in a preliminary study and demonstrated to have satisfactory psychometric properties for research purposes: there was satisfactory internal consistency, discriminant validity, and there were significant relationships between performance and a measure of subjective experience. The purpose of the main investigation was to examine performance awareness on this measure of practical problem-solving ability. Younger (19-40 years) and older (59-84 years) subjects estimated performance either before and after taking the test (prediction/postdiction condition) or only after exposure to the materials (postdiction only). When the unsigned discrepancies between actual and expected performances were considered, there were no age differences in performance awareness of either time of estimation, but neither age group demonstrated improved accuracy from prediction to postdiction. When the directions of estimation errors were considered, older adults were significantly more likely to overestimate performance at both times of estimation compared to younger adults, who underestimated performance. Importantly, the same pattern of results was obtained with subjects who estimated only after taking the test and those who made predictions and postdictions.

Adult↗

PubMed1982

Training counseling and problem-solving skills with university students.

Often nonprofessionals lack specific instruction in relevant counseling and problem-solving skills. The effects of training procedures on counseling and problem-solving behaviors were examined experimentally with university students. The procedures involved the use of behavioral specifications, rationales, situational examples, study guides, and practice plus feedback on performance. Following training, the average percentage of occurrence of counseling and problem-solving behaviors increased to 89%. Generalization data in sessions with actual clients and expert ratings of the overall quality of counseling provided evidence of generalization to other settings and other evaluative dimensions of counseling and problem-solving performance.

Adult↗

PubMed1992

Problem solving to prevent work injuries in supported employment.

A problem-solving strategy was used to teach three groups of 3 individuals in supported employment how to prevent work-related injuries. The problem-solving strategy was taught in two training phases. The first training phase involved the use of cue cards, and the second involved the withdrawal of the cue cards. Interviews and staged generalization assessments in the participants' natural work environments were conducted before, during, and up to 12 weeks after training. In these assessments, situations were presented that were either similar or dissimilar to situations presented in training. Results of both the interviews and staged assessments indicated that the participants' newly acquired problem-solving skills generalized to similar and dissimilar situations.

Cues↗

PubMed2004

When planning fails: individual differences and error-related brain activity in problem solving.

The neuronal processes underlying correct and erroneous problem solving were studied in strong and weak problem-solvers using functional magnetic resonance imaging (fMRI). During planning, the right dorsolateral prefrontal cortex was activated, and showed a linear relationship with the participants' performance level. A similar pattern emerged in right inferior parietal regions for all trials, and in anterior cingulate cortex for erroneously solved trials only. In the performance phase, when the pre-planned moves had to be executed by means of an fMRI-compatible computer mouse, the right dorsolateral prefrontal cortex was again activated jointly with right parahippocampal cortex, and displayed a similar positive relationship with the participants' performance level. Incorrectly solved problems elicited stronger bilateral prefrontal and left inferior parietal activations than correctly solved trials. For both individual ability and trial-specific performance, our results thus demonstrate the crucial involvement of right prefrontal cortex in efficient visuospatial planning.

Adult↗

PubMed1989

Perceived problem-solving skills and drinking patterns among college students.

The cognitive social-learning-theory literature on alcohol abuse points to failure to generate appropriate alternative behaviors to drinking as a major predictor of relapse to drinking. Viewing drinking as a continuous variable, ranging from abstinence to abuse, it should be possible to demonstrate a relationship between problem-solving abilities and drinking patterns. The hypothesis that individuals' perceived problem-solving skills are related to their pattern of alcohol use was examined. It was expected that poorer perceived problem-solving skills would be related to maladaptive use of alcohol in response to problem situations. 192 students in Introductory Psychology at a midsized southern university participated. Each subject completed questionnaires assessing frequency and quantity of alcohol use, and stimuli associated with the onset of drinking. The Problem-solving Inventory was used to measure perceived problem-solving skills. Drinking pattern variables were formed by factor analysis. Canonical correlation analysis of the data supported the hypotheses. Students with lower confidence in problem-solving capabilities reported greater use of alcohol to cope with negative emotions and to escape from responsibilities than students with high confidence in their abilities. Amount of alcohol consumed was not related to problem-solving skills.

Adaptation, Psychological↗

PubMed2004

The construct of problem solving in higher level neuropsychological assessment and rehabilitation.

Three inter-related studies examine the construct of problem solving as it relates to the assessment of deficits in higher level outpatients with traumatic brain injury (TBI). Sixty-one persons with TBI and 58 uninjured participants completed measures of problem solving and conceptually related constructs, which included neuropsychological tests, self-report inventories, and roleplayed scenarios. In Study I, TBI and control groups performed with no significant differences on measures of memory, reasoning, and executive function, but medium to large between-group differences were found on timed attention tasks. The largest between-group differences were found on psychosocial and problem-solving self-report inventories. In Study II, significant-other (SO) ratings of patient functioning were consistent with patient self-report, and for both self-report and SO ratings of patient problem solving, there was a theoretically meaningful pattern of correlations with timed attention tasks. In Study III, a combination of self-report inventories that accurately distinguished between participants with and without TBI, even when cognitive tests scores were in the normal range, was determined. The findings reflect intrinsic differences in measurement approaches to the construct of problem solving and suggest the importance of using a multidimensional approach to assessment.

Adult↗

PubMed1979

The effects of EMG feedback training during problem solving: a case study.

The present case study investigated the effects of competing task demands on biofeedback training to reduce frontalis muscle tension. Baseline levels of frontalis muscle tension were recorded for relaxation and problem solving. The subject was trained to decrease muscle tension with biofeedback for the problem-solving task alone. The results indicated that EMG training during problem-solving was successfully accomplished. Frontalis muscle tension during relaxation baseline did not change as a result of reductions in muscle tension during problem-solving feedback training. This suggests that the decrease of muscle tension cannot be attributed to reductions in overall muscle tension levels. Instead, training was specific to the problem-solving feedback phases. Additionally, it was found that accuracy in problem-solving did not decline as a result of simultaneous feedback training. Thus EMG biofeedback training can be accomplished and exercised without disruption of ongoing mental activity.

Adult↗

PubMed2001

Social skills and problem-solving training for children with early-onset conduct problems: who benefits?

Families of 99 children with early-onset conduct problems, aged 4-8 years, were randomly assigned to a child training treatment group (CT) utilizing the Incredible Years Dinosaur Social Skills and Problem Solving Curriculum or a waiting-list control group (CON). Post-treatment CT children had significantly fewer externalizing problems at home, less aggression at school, more prosocial behavior with peers, and more positive conflict management strategies than CON children. Significantly more CT than CON children showed clinically significantly improvements on reports and independent observations of aggressive and noncompliant behavior. The differential treatment response was evaluated according to child comorbidity with attention deficit hyperactivity disorder (ADHD), parenting discipline practices. and family risk factors. The only risk factor related to failure to make improvements in child conduct problems after treatment was negative parenting (i.e., maternal critical statements and physical force). The long-term follow-up 1 year later indicated that most of the significant post-treatment changes were maintained.

Age of Onset↗

PubMed1989

The relation between stressful life events and adjustment in elementary school children: the role of social support and social problem-solving skills.

This study investigated the relation between stressful life events and adjustment in elementary school children, with particular emphasis on the potential main and stress-buffering effects of social support and social problem-solving skills. Third through fifth graders (N = 361) completed social support and social problem-solving measures. Their parents provided ratings of stress in the child's environment and ratings of the child's behavioral adjustment. Teachers provided ratings of the children's behavioral and academic adjustment. Hierarchical multiple regressions revealed significant stress-buffering effects for social support and problem-solving skills on teacher-rated behavior problems, that is, higher levels of social support and problem-solving skills moderated the relation between stressful life events and behavior problems. A similar stress-buffering effect was found for problem-solving skills on grade-point average and parent-rated behavior problems. In terms of children's competent behaviors, analyses supported a main effect model of social support and problem-solving. Possible processes accounting for the main and stress-buffering effects are discussed.

Achievement↗

PubMed1996

The relationship between resource constraints and physician problem solving. Implications for improving the process of care.

OBJECTIVES: Research suggests that physicians will engage in more vigilant problem-solving under conditions of resource constraints than under conditions of resource slack. Increased vigilance related to physicians' clinical strategies enhances care by disposing physicians toward more optimal care choices. The authors examine whether pressures for clinical resource constraints encourage increased and sustained vigilance in problem-solving among cardiologists treating acute myocardial infarction. METHODS: The physician problem-solving process is reconstructed from the medical records of all eligible cases of acute myocardial infarction treated by the physician sample set over a 6-year period. The sample period encompasses phases of both resource slack and resource constraints. The Herfindahl index is used to measure the relative amount of vigilant problem-solving activity exhibited in each of five major tactical areas of the physician care strategies in each year of the study. RESULTS: The results support the hypothesis that resource constraints initially promote a shift to increased vigilance in physician problem-solving. Only one of the five major tactical areas, however, is characterized by sustained vigilance over time. The other areas are, instead, associated with a substantial reduction in vigilant activity after the initial peak period. CONCLUSIONS: The results suggest that resource constraints do set the stage for improved clinical decision-making. Sustained vigilance, however, appears to apply only to those portions of the care strategy for which the physician can draw a clear link between optimizing clinical activity and reducing resource consumption. For those portions of the care strategy for which the physician cannot establish a clear link, ongoing pressures to conserve resources results in reduced vigilance and a potential reduction in quality of clinical decision-making.

Cardiology↗

PubMed1991

Parent-child problem-solving interactions in families of visually impaired youth.

Investigated problem-solving and conflict-resolution strategies, an important aspect of family functioning, in visually impaired adolescents and their parents. Visually impaired adolescents were compared to adolescents with spina bifida and a control group of adolescents without disabilities. Parent-adolescent dyads participated in a problem-solving discussion of topics reflecting family disagreement. Videotapes of these discussions were rated for patterns of interaction using the Marital Interaction Coding System (MICS-III). Examination of positive and negative reciprocal patterns of interaction using sequential analyses and contrasting frequencies of specific behavioral codes revealed no differences between groups for adolescents, mothers, and fathers on the problem-solving discussion. Results are discussed in terms of (a) the impact of visual impairment on family functioning and (b) the need to identify those subgroups of visually impaired and their families that may be at heightened risk for maladjustment.

Adaptation, Psychological↗

PubMed2006

Neurocognitive and symptom correlates of daily problem-solving skills in schizophrenia.

Functional outcome for individuals with schizophrenia has been associated with cognitive impairment. Deficits in attention, memory, speed of information processing and problem-solving skills affect independent functioning, vocational performance, and interpersonal functioning. This study investigated the relationship between neurocognitive functioning, clinical symptoms and daily problem-solving skills in seriously and persistently ill persons. Thirty-eight inpatients and outpatients were administered a neurocognitive battery for attention, working memory, processing speed, perceptual organization, and executive functioning; and semi-structured clinical interviews using the BPRS and SANS. Estimates of daily problem-solving skills were obtained using the relevant factor subscale from the Independent Living Scales (ILS-PB). Daily problem-solving skills were significantly correlated with negative symptoms, processing speed, verbal memory, and working memory scores. A regression model using an enter method suggests that working memory and negative symptoms are significant predictors of daily problem-solving skills and account for 73.2% of the variance. Further analyses demonstrate that daily problem-solving skills and negative symptoms were significantly different for inpatients and outpatients and significantly correlated with community status. The findings suggest the ILS-PB has utility as a proxy measure for assessing real-world functioning in schizophrenia.

Activities of Daily Living↗