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At least 847 records · Page 47Linked to original sources
PubMed2005

Decision-making capacity of elderly patients assessed through the vignette method: imagination or reality?

This article evaluates whether providing hypothetical or realistic information influences the assessment of decision-making capacity in elderly patients with (and without) cognitive impairment. Decision-making capacity was assessed by means of a clinical vignette that presented a choice about whether to undergo an endoscopic procedure. The following standards of decision-making capacity were evaluated quantitatively and qualitatively: ability to evidence a choice, to understand, to reason, and to appreciate a situation. The vignette was presented to patients in either a hypothetical or real situation. In the hypothetical situation cognitively impaired patients performed significantly poorer than cognitively non-impaired patients on all abilities associated with decision-making capacity (with the exception of evidencing a choice). The realistic situation showed the same pattern among cognitively impaired and non-impaired patients in their ability to understand and in the total vignette score. Both types of patients reasoned about and appreciated the realistic situation equally well. Qualitative analysis revealed that patients gave comparable answers in both hypothetical and realistic situations. The answers were not related to standards of decision-making capacity. Moreover, personal circumstances were taken as a reference point for making a decision, regardless of the situation. We did not find any major differences between the hypothetical and realistic situation. Our findings do raise questions about the validity of hypothetical vignettes, however, especially when used with cognitively impaired persons.

Aged↗
PubMedDate not supplied

Discovery of meaning through imagined experience, writing, and evaluation.

Writing is frequently referred to as a skill. Its value, however, is most often judged by what it produces, when, ironically, studying the process of writing may be the best way to improve the product. This teaching plan asks students to develop a meaningful written product while focusing on context, content, and process evaluation. It also provides a learning experience that has the potential to enhance empathy and caring among nursing students.

Curriculum↗
PubMed1998

Gender and projective imagination of threat in achievement and affiliation situations.

In a study by Pollak and Gilligan (1982) where fantasies of violence were seen as indicative of perception of danger, women responded with more violent imagery to situations of achievement, whereas men responded with more violent imagery to affiliation situations. This indicates gender differences in motivational needs, which corresponds to modern gender development theories (e.g., Chodorow, 1978). In the present studies, the hypotheses that women fear achievement situations whereas men fear situations of affiliation were tested on Swedish samples totaling 44 men and 47 women. In Study 1, the hypothesis that violent imagery correlates with affiliation themes in the stories written by men was partly supported, whereas the hypothesis that violent imagery would be highly correlated with achievement themes in the stories written by women was not confirmed. In Study 2, no support was obtained for the hypotheses. In sum, contrary to previous studies, no substantial support was obtained for the hypothesis that women connect violent imagery with achievement situations, whereas some evidence was found for the hypothesis that men construe danger as arising from affiliation situations. The greater incidence of violence in men's fantasy reported in previous studies was not supported in either of the two studies. The results are discussed in the context of cross-cultural differences.

Adult↗
PubMed2003

Effector-independent representations of simple and complex imagined finger movements: a combined fMRI and TMS study.

Kinesthetic motor imagery and actual execution of movements share a common neural circuitry. Functional magnetic resonance imaging was used in 12 right-handed volunteers to study brain activity during motor imagery and execution of simple and complex unimanual finger movements of the dominant and the nondominant hand. In the simple task, a flexible object was rhythmically compressed between thumb, index and middle finger. The complex task was a sequential finger-to-thumb opposition movement. Premotor, posterior parietal and cerebellar regions were significantly more active during motor imagery of complex movements than during mental rehearsal of the simple task. In 10 of the subjects, we also used transcranial magnetic brain stimulation to examine corticospinal excitability during the same motor imagery tasks. Motor-evoked potentials increased significantly over values obtained in a reference condition (visual imagery) during imagery of the complex, but not of the simple movement. Imagery of finger movements of either hand activated left dorsal and ventral premotor areas and the supplementary motor cortex regardless of task complexity. The effector-independent activation of left premotor areas was particularly evident in the simple motor imagery task and suggests a left hemispherical dominance for kinesthetic movement representations in right-handed subjects.

Adult↗