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PubMed1986

Perceptions of quality of life following divorce: a study of children's prognostic thinking.

The general quality of latency-aged children's prognostic thinking and the way in which they view the long-range impact of divorce upon peer adaptation are explored. When interviewed about responses to two fictional peers with marked behavior problems, 80 children in the third and fifth grades displayed an optimism in their prognostic thinking about the future of these peers. In general, peers from divorced homes were perceived as having a more positive future adjustment than peers from intact homes. However, male subjects from disrupted homes revealed a significantly pessimistic orientation regarding the impact of divorce upon the future; females from disrupted homes had a strikingly optimistic view. Implications for school-based interventions are discussed.

Adaptation, Psychological↗

PubMed2005

Is blood really thicker than water? Assisted reproduction and its impact on our thinking about family.

The traditional notion that a family is built around and based on blood or genetic ties is challenged when assisted human reproduction utilizing donor gametes is used. A focus on the family--in contrast to the individual--requires from medicine an extension of thinking in which a model that incorporates treating infertility and building a family becomes the norm. Such a model will require that attention is given to the psychological and social needs of the would-be parents, thus enabling them to approach their family building with confidence. This confidence is expected to carry through to their sharing with their offspring the nature of their family building and thus avoid the stigma that leads to secrecy. Research relating to dimensions of family building when donor insemination has been used is reviewed. The impact of professional attitudes, along with the policies adopted by governments concerning access to genetic information for offspring, significantly influences the families built with assistance of donor gametes or embryos. The evolution of professional thinking in this area is reviewed, along with the increasing involvement of governments.

Anxiety↗

PubMed2001

"I will start treatment when I think the time is right": HIV-positive gay men talk about their decision not to access antiretroviral therapy.

In a qualitative study, 20 HIV-infected Australian gay men were interviewed about their decision not to access antiretroviral drug therapy. The main reasons given for the decision were fear of side effects; fear of long-term damage to body organs; the inconvenience of the treatment regimens; belief that the regimen's demands would be a threat to morale; and belief that there was no reason to start therapy in the absence of AIDS-related symptoms. Actions taken by the men to monitor and maintain their health included seeing a doctor regularly; having regular T-cell and viral load tests; and trying to maintain a positive outlook by not letting HIV/AIDS 'take over' their lives. Almost half the men considered they had been subjected to unreasonable pressure to access therapy and there was considerable pride at having resisted this pressure. The findings suggest that the men disagreed with the biomedical model for managing HIV/AIDS only on the question of if and when to access therapy. They also suggest that underlying the men's dissent from the biomedical model was a different mode of thinking than is required by the model: while the model demands thinking that is abstract, the men focused strongly on factors close to the 'here and now' of immediate experience. The practical implications of the findings are explored.

Adult↗

PubMed2000

Medical education, research, and scientific thinking in the 21st century (part two of three).

BACKGROUND: During the 20th century medical education has been largely preoccupied with discussions of the venues and methods for teaching. Little attention has been paid to what should be learned about the scientific paradigm underlying research and practice. A 17th century model has gradually produced an increasingly narrow, monocausal, reductionistic view of health and disease. Much good has resulted, but this "belief system" fails to accommodate or explain the meaning and impact on patients' health of diverse internal and external experiences and influences. During this period quantum mechanics and its ever-expanding capacity to accommodate new information and enhance understanding have superseded Newtonian physics in much scientific thinking. METHODS: A broad range of historical and contemporary scientific literature is examined in support of four central questions in this three-part series: (1) Are there reasons to examine these matters now? (2) How is medical scientific thinking influenced by the general reorientation of science during the 20th century? (3) Are there reasons now to examine the impact of these changes on medicine? (4) Will a change of paradigm affect medical practice, research, and education? RESULTS: The extraordinarily productive contemporary biomedical model should be expanded beyond the physical and biological to incorporate meaningful information about how each patient's experiences impinge on health status. CONCLUSIONS: Family and other primary care physicians together with collaborators in the biological and behavioral sciences and other health professions should undertake rigorous research to establish the validity of the expanded paradigm espoused. Its impact on practice, research, education, and policies could be profound.

Journal Article↗

PubMed2000

Medical education, research, and scientific thinking in the 21st century (part three of three).

BACKGROUND: During the 20th century medical education has been largely preoccupied with discussions of the venues and methods for teaching. Little attention has been paid to what should be learned about the scientific paradigm underlying research and practice. A 17th century model has gradually produced an increasingly narrow, monocausal, reductionistic view of health and disease. Much good has resulted, but this "belief system" fails to accommodate or explain the meaning and impact on patients' health of diverse internal and external experiences and influences. During this period quantum mechanics and its ever-expanding capacity to accommodate new information and enhance understanding have superseded Newtonian physics in much scientific thinking. METHODS: A broad range of historical and contemporary scientific literature is examined in support of four central questions in this three-part series: (1) Are there reasons to examine these matters now? (2) How is medical scientific thinking influenced by the general reorientation of science during the 20th century? (3) Are there reasons now to examine the impact of these changes on medicine? (4) Will a change of paradigm affect medical practice, research, and education? RESULTS: The extraordinarily productive contemporary biomedical model should be expanded beyond the physical and biological to incorporate meaningful information about how each patients experiences impinge on health status. CONCLUSIONS: Family and other primary care physicians together with collaborators in the biological and behavioral sciences and other health professions should undertake rigorous research to establish the validity of the expanded paradigm espoused. Its impact on practice, research, education, and policies could be profound.

Journal Article↗

PubMed2002

Coping with terminal illness: the role of hopeful thinking.

Using Snyder's theory of hope, the role of hope in the process of dying from a terminal illness is discussed. In this theory, hope is defined as the perceived capability to produce workable routes to desired goals (pathways thinking) and the requisite motivation to use those routes (agency thinking). Strategies by which individuals can maintain and even increase hope during the dying process are described, along with interventions to maintain patients' hope. Directions for future research are suggested.

Adaptation, Psychological↗

PubMed2003

Symptom distress, catastrophic thinking, and hope in nasopharyngeal carcinoma patients.

The purposes of this study were to explore symptom distress, catastrophic thinking (catastrophizing) and hope, and factors predicting hope in Taiwanese nasopharyngeal carcinoma (NPC) patients within 3 years of receiving radiation therapy (RT). Instruments used were the modified Symptom Distress Scale, disease catastrophizing scale (modified from Coping Strategies Questionnaire), and Herth's Hope Index. Adult NPC patients (N = 115; 33 undergoing RT, 44 who completed RT within 1 year, and 38 who completed RT more than 1 year but less than 3 years) were recruited from an outpatient RT center in Northern Taiwan. Although participants' overall symptom distress was mild to moderate, they scored moderate level for several distressful symptoms: dry mouth, fatigue, hearing difficulty, loss of appetite, insomnia, and pain. Patients undergoing RT had greater symptom distress than subjects in the other 2 groups. Regression analysis revealed that catastrophizing was the only predictor of hope. Patients who engaged in catastrophizing reported much lower levels of hope. Particular care and attention are recommended to help NPC patients deal with the top distressful symptoms listed. Nursing interventions to reduce catastrophic thinking and enhance hope are discussed.

Adaptation, Psychological↗

PubMedDate not supplied

Prevalence of principled thinking by critical care nurses.

The advanced technology surrounding the nursing care of the acutely ill patient has precipitated many ethical issues. The first step in understanding how nurses respond to these ethical issues is to become familiar with their moral reasoning and use of ethical principles in making decisions. This research report describes the responses of critical care nurses to six vignettes of the Nursing Dilemma Test as a measure of their use of principled thinking to decide on actions in specific ethical situations. Nurses used principled thinking more often to respond to ethical situations than purely practical responses.

Critical Care↗

PubMed2004

Is it wise not to think about intraabdominal hypertension in the ICU?

PURPOSE OF REVIEW: This review focuses on the available literature published in the past 2 years. MEDLINE and PubMed searches were performed using intraabdominal pressure, intraabdominal hypertension, and abdominal compartment as search items. The aim was to find an answer to the question: "Is it wise not to measure or even not to think about intraabdominal hypertension in ICU?" RECENT FINDINGS: It is difficult to find a good gold standard for intraabdominal pressure measurement. Bladder pressure can be used as an intraabdominal pressure estimate provided it is measured in a reproducible way. Automated continuous intraabdominal pressure monitoring has recently become available. Key messages are (1). body mass index and fluid resuscitation are independent predictors of intraabdominal hypertension; (2). intraabdominal hypertension increases intrathoracic, intracranial, and intracardiac filling pressures; (3). transmural or transabdominal filling pressures combined with volumetric parameters better reflect preload; (4). volumetric target values need to be corrected for baseline ejection fractions; (5). intraabdominal hypertension decreases left ventricular, chest wall and total respiratory system compliance; (6). best positive end-expiratory pressure can be set to counteract intraabdominal pressure; (7). acute respiratory distress syndrome definitions should take into account best positive end-expiratory pressure and intraabdominal pressure but not wedge pressure; (8). lung protective strategies should aim at deltaPplat (plateau pressure - intraabdominal pressure); (9). intraabdominal hypertension causes atelectasis and increases extravascular lung water; (10). intraabdominal hypertension is an independent predictor of acute renal failure; (11). monitoring of abdominal perfusion pressure can be useful; and (12). intraabdominal hypertension triggers bacterial translocation and multiple organ system failure. SUMMARY: The answer is that it is unwise not to measure intraabdominal pressure in the ICU or even not to think about it.

Abdomen↗

PubMedDate not supplied

Professional nursing burnout and irrational thinking.

This article reports how professional, job-related burnout in nurses (N = 192) is examined in relation to a developed index of irrational thinking patterns in a large, urban hospital setting. Based on the constructs of Rational Emotive Behavior Therapy (REBT), the study examines maladaptive thinking patterns related to nursing burnout and provides insight into possible educational and staff interventions for the syndrome. Low mean scores on all but two subscales indicate overall strength and stability among this sample. The demonstration that both burnout thoughts (r = 0.451, p = < .01) and burnout behaviors (r = 0.350, p = < .01) are significantly correlated with the perfection and control pattern support the study's assumptions. Nurses who demand perfection and control in themselves and others create unrealistic demands and expectations that cannot be met in the real world of nursing. The investigator believes that a regular stress management program, using the concepts of REBT, can foster professional growth and development, decrease workplace conflict and stress, and provide nurses (and other employees) with strategies and tools to disarm the irrational beliefs that build maladaptive cognitive patterns leading to professional burnout.

Adult↗

PubMedDate not supplied

How economists think about family resources and child development.

Research in child development reveals that the sources, level, stability, and uses of family resources have a profound effect on children's well-being and long-term outcomes. Although that research has incorporated economic constructs and measures, developmentalists generally ignore the formal economic framework for thinking about family resources and child outcomes. Building on the premise that children are an investment, that framework explains how families allocate resources and links that decision to other family choices and to key child outcomes, such as schooling, morbidity, and mortality among others. This article explains economists' general approach to family behavior (the so-called theory of household production) and then describes how that framework is useful for thinking about families and children. The article then outlines how economists model parental investment in children and examines the implications of that approach for developmental science. This discussion is illustrated using an example of interest to developmentalists--the involvement of children and adolescents in after-school activities. A concluding section discusses the benefits of and potential barriers to collaboration between economists and developmentalists.

Child↗

PubMedDate not supplied

Want that is understood well before say that, think that, and false belief: a test of de Villiers's linguistic determinism on German-speaking children.

Two experiments with 79 monolingual German speaking children between 2.5 and 4.5 years showed a consistent developmental gap between children's memory/inference of what someone wanted and what someone wrongly said or thought. For instance, when John is still playing and mother says, "John should be going to bed," more than 70% answered correctly that mother wanted John to go to bed. However, when mother said, "John is going to bed," about 70% answered wrongly that she thought/said that he was still playing. Correct answers emerged with the mastery of the false-belief task. In German, want sentences (about something to happen) obligatorily take the same grammatical that complement as say or think sentences. Therefore, the observed gap constrains de Villier's (1995) linguistic determinism, which claims that acquisition of the necessary grammatical structures for talking about the mind drives children's ability to think about the mind.

Child, Preschool↗

PubMed2004

Thinking aloud about trust: a protocol analysis of trust in risk management.

There are two general theories of trust in risk management. One, derived from normative considerations, claims that trust is based on universally applicable factors such as fairness and objectivity. According to the second, social-psychological theory, trust is based on agreement or similarity and is context specific. Although the first theory is normative, it also claims, along with the second, to be a descriptive account of how trust judgments are made. The present study was designed to test the adequacy of these two theories by using a think-aloud procedure to examine the thinking associated with trust judgments in an experimental simulation of a typical risk management context. Contrary to the universalist theory, results supported two hypotheses derived from the social-psychological theory. First, study participants--who read brief policy statements designed to address global climate change--based their trust judgments on specific forms of agreement, ranging from agreement on the importance of the issue to agreement on values inferred from the policy statement. Second, the extent and depth of participants' conscious information processing was negatively related to the level of trust. Disagreement and distrust generated more conscious consideration than agreement and trust. These results provide a more detailed understanding than previously available of how trust in risk management is based on local forms of agreement that vary across people, contexts, and time.

Journal Article↗

PubMed1985

Has the discipline of nursing developed to the stage where nurses do 'think nursing'?

With the increasing complexity and changing conditions of nursing practice, as well as the encroachment of other professions on nursing's traditional domain, it is becoming increasingly important for nurses to gain insights into the nature of nursing knowledge and practice. This paper attempts to outline the meaning of the expression 'to think nursing' and the factors involved in such a capacity. The work of nurse scholars is then discussed in terms of their contribution towards developing the discipline of nursing to the stage where nurses do 'think nursing'.

Attitude↗

PubMed1994

How do registered nurses think and experience nursing. A phenomenological investigation.

This research adopts a phenomenological approach to investigate how registered nurses think and experience nursing. Findings from the study highlighted the dynamic nature of how nurses think and experience nursing. This dynamic nature demonstrates the often vulnerable and stressed position nurses find themselves in today when trying to meet their professional aspirations within a medically dominated, bureaucratic health-care system. The findings suggest that not only is educational reform required, but nurses need skills to enable them to form change strategies so that their paradigm of health care can be established. This study represents the very beginning of trying to create that paradigm inductively.

Adult↗

PubMed2005

Thinking about equity in health care.

Public health care systems such as the British National Health Service typically profess two principal objectives: to improve the health of the whole population; and to reduce inequalities in health within it. Given scarce resources, these objectives are often in conflict. Much attention has justifiably been paid, by health economists, to addressing the former objective with methods of economic appraisal. My intention is to focus on the more difficult issue of the pursuit of 'equity' in health care, specifically the desire to reduce inequalities in health. This raises philosophical and policy questions about what makes some people more deserving of care than others, and whether or not society should adopt a forgiving stance towards those who have compromised their health status in some way, and offer access to treatment. Also, decision-makers may need to distinguish between the goal of raising the level of those worse-off and reducing inequality across society as a whole. Moreover, it is important to clarify what we wish to be made less unequal within the realm of health care provision. Tough decisions like these are based on value judgements and trading off one priority against another. In the interests of equity, such decisions need to be transparent and based on the preferences of society as a whole rather than covert and capricious. No manager needs reminding that resources are limited or that if more favourable treatment is accorded to some, inevitably less favourable treatment is accorded to others. Policy-making for a whole unit requires a nurse manager to offer a perspective on multidisciplinary matters and engage in wider public policy issues facing the team. As circumstances change, existing practice may be challenged as unfair, inefficient, or failing to account for important patient characteristics which make them different. Here, thinking clearly about equity is very important, and nurse managers are important as clarifiers of the thinking about what should be considered when making these difficult decisions.

Attitude to Health↗

PubMed1975

Effects of explicit instructions to "be creative" on the psychological meaning of divergent thinking test scores.

The Alternate Uses Test was administered to 50 undergraduate males instructed to produce creative (i.e., novel and worthwhile) uses and to 55 comparable subjects simply instructed to produce as many uses as possible. All uses were rated for creativity. An index of self-assessed creative thinking ability correlated significantly more strongly (p less than .05) with the number of creative uses produced in the qualitatively-oriented condition than with the number of creative or total uses produced in the standard, quantitatively-oriented condition. The correlation between self-rated creative ability and creative uses production in the qualitatively-oriented condition remained significant (p less than .001) after indices of achievement motivation and general verbal aptitude were partialled out. The results were interpreted as demonstrating the value of coordinating informative divergent thinking test instructions with qualitative scoring criteria.

Achievement↗

PubMed2005

Understanding organizational safety using value-focused thinking.

Decision analysis is recognized as the right way to make risk management decisions, using probabilistic techniques to assess the accident risk. It is also accepted that the decisions that individuals in the organization make affect the likelihood of an accident and thus managerial and organizational factors should be included in the risk modeling process. However, decision analytic techniques have not been used to understand the decisions that are made by these individuals. The initial domain for this research is marine transportation. We use the framework of value-focused thinking in order to understand safety decisions made within our research partner organization, a major domestic oil tanker operator. We describe the results of interviews held with managers and employees from this organization. Through these interviews, we sought to understand the values these experts apply in their roles within the organization and the objectives they seek to achieve to contribute to its overall safety performance. The end result is a framework that not only portrays the fundamental objectives of safe operations for various roles in the organization, but also interconnects these different decision contexts. We believe that this approach is fundamentally different from those used in previous work and that this is an interesting application of value-focused thinking.

Journal Article↗