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Results for “PROBLEM SOLVING”

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PubMed1981

Systematic instruction in laboratory medicine. Effects on the clinical problem solving performance of medical students.

Modified patient management problems were administered to senior medical students in pre- and postexamination formats to evaluate the effects of systematic instruction in laboratory medicine on clinical problem solving performance. Significant improvements were noted on several of the derived performance measures studied. Most improvements could be attributed to the course of instruction, some were problem dependent, and students with some prior clinical experience exhibited more improvement than did their less experienced colleagues. Evidence is presented to suggest that poor problem solving performance, as evident from pre-examination results, reflects not any inherent problem solving deficiency, but a specific lack of knowledge. The greater degree of improvement exhibited by inexperienced students toward greater hypothesis specificity and higher diagnostic goal indices leads us to speculate that inexperienced students structure knowledge differently from their experienced counterparts. It is concluded that systematic instruction aimed at improving laboratory utilization is capable of evaluation and, at least in simulated format, leads to improved clinical problem solving. The implications are discussed.

Clinical Laboratory Techniques↗

PubMed2002

Parasuicidal behaviour and interpersonal problem solving performance in older adults.

OBJECTIVES: To test the hypothesis that interpersonal problem-solving performance in older adults with a recent episode of parasuicide is poorer than that of depressed patients and community controls. DESIGN: A cross-sectional design was used to assess differences between older parasuicidal patients, depressed patients, and community controls in interpersonal problem solving performance. METHOD: An existing outcome measure of interpersonal problem-solving, the Means End Problem-Solving (MEPS) procedure, was modified in order to make it more suitable for older adults. It was then administered to 18 older adults with an episode of parasuicide in the previous 14 days, 18 older adults who were being treated for clinical depression, and 22 older adults attending community groups. Comparisons between the groups in terms of performance on the MEPS were made. RESULTS: When level of depression was controlled for, parasuicidal patients were poorer at generating relevant means of reaching given outcomes to interpersonal problems than community controls. There was no difference between the parasuicidal and depressed groups in terms of relevancy scores. There were no significant differences between groups in terms of other MEPS outcome variables. CONCLUSIONS: Parasuicide in older adults is related to a deficit in interpersonal problem solving performance that cannot be completely explained in terms of depression. Further investigation of interpersonal problem-solving in relation to parasuicide and depression in older adults is required, perhaps using process measures of interpersonal problem solving to clarify the nature of the difficulties. The modified MEPS is acceptable to older adults and can be easily administered.

Aged↗

PubMed2004

Problem-solving competency of nursing graduates.

AIM: This paper reports a study describing and evaluating the outcomes of problem-based learning (PBL) programmes in nursing schools in South Africa in terms of the competence of graduates to solve problem in actual clinical settings, and comparing this competence with that of graduates from non-PBL programmes. BACKGROUND: The nursing literature tends to equate problem-solving with patient-centred problems or the nursing process. However, it is also a skill used in managing the work role, working in a team and managing a health care unit. Problem-solving refers to the process of selectively attending to information in a patient care setting. The investigation of problem-solving in nursing is complicated by the complex relationships between different cognitive processes. METHODS: A qualitative evaluation study, descriptive and comparative in nature, was carried out. In-depth interviews were held with graduates and their supervisors, asking them to identify problem-solving incidents in which they had been involved. Template analysis style and Benner's interpretive approach were used to analyse the data. FINDINGS: The majority of the incidents described by the graduates (84%) were graded at the advanced beginner level or above. The majority of incidents at the novice level came from the non-PBL group. 'Using people skills' and 'being assertive' were the two problem-solving strategies most often used. The PBL group fared better than the non-problem-based group in the level of their problem-solving ability. CONCLUSION: The findings of this study suggest that further research is warranted into the problem-solving abilities of PBL graduates, their personal development over time and at different stages of practice. In addition, it would be interesting to follow the development of their problem-solving abilities over time.

Adult↗

PubMed2002

Language and mathematical problem solving among bilinguals.

Does using a bilingual's 1st or 2nd language have an effect on problem solving in semantically rich domains like school mathematics? The author conducted a study to determine whether Filipino-English bilingual students' understanding and solving of word problems in arithmetic differed when the problems were in the students' 1st and 2nd languages. Two groups participated-students whose 1st language was Filipino and students whose 1st language was English-and easy and difficult arithmetic problems were used. The author used a recall paradigm to assess how students understood the word problems and coded the solution accuracy to assess problem solving. The results indicated a 1st-language advantage; that is, the students were better able to understand and solve problems in their 1st language, whether the 1st language was English or Filipino. Moreover, the advantage was more marked with the easy problems. The theoretical and practical implications of the results are discussed.

Analysis of Variance↗

PubMed1997

Cognitive-behavioral remediation of problem solving deficits in children with acquired brain injury.

The inability to problem solve can have a deleterious impact on a student's academic performance and social adjustment. Children with an acquired brain injury (ABI) are at risk for deficits in problem solving skills. This case study and series of multiple baseline experiments examined the effects of a multi-component cognitive-behavioral training program on the remediation of problem solving deficits in five children with ABI. Results indicated that the training program resulted in a substantial decrease in errors on a computerized problem solving task used to monitor problem solving performance during baseline and treatment. In addition, significant improvements were found on two of four standardized measures of problem solving abilities. Finally, students, parents and teaching staff reported a high degree of satisfaction with and generalization of the training program.

Brain Injuries↗

PubMed1990

Stress, coping style, and problem solving ability among eating-disordered inpatients.

Stress levels, coping style, and problem solving ability among bulimic and anorexic individuals were explored. Bulimics (n = 33) reported a greater number of negative life events and feelings of being pressured than did a non-eating-disordered group. Anorexics (n = 12) reported higher levels of anxiety and depression than the other groups. Both anorexics and bulimics reported higher levels of stress, lower levels of confidence in their ability to solve problems, a tendency to avoid confronting problems, a reluctance to share personal problems, and feelings of being driven. Implications are suggested.

Adaptation, Psychological↗

PubMed1993

Social problem solving in suicidal adolescents.

Whether adolescent suicide attempters would have deficits in interpersonal problem solving and the relation between social problem solving, suicide intent, and medical lethality were evaluated. Compared with psychiatric and normal controls, adolescents who attempted suicide exhibited poorer social problem-solving abilities, particularly in terms of problem orientation. Specifically, suicide attempters brought more maladaptive cognitive-emotional-behavioral response sets to problematic situations than did psychiatric and normal controls. Both suicide attempters and psychiatric controls had similar deficits in problem-solving skills (e.g., generation of alternatives, decision making, and solution implementation) compared with nonhospitalized peers. Social problem solving was not found to be correlated with suicide lethality or intent.

Adaptation, Psychological↗

PubMed2006

Problem-solving ability and comorbid personality disorders in depressed outpatients.

Major depressive disorder (MDD) is associated with poor problem-solving abilities. In addition, certain personality disorders (PDs) that are common among patients with MDD are also associated with limited problem-solving skills. Attempts to understand the relationship between PDs and problem solving can be complicated by the presence of acute MDD. Our objective in this study was to investigate the relationships between PDs, problem-solving skills, and response to treatment among outpatients with MDD. We enrolled 312 outpatients with MDD in an open, fixed-dose, 8-week fluoxetine trial. PD diagnoses were ascertained via structured clinical interview before and after fluoxetine treatment. Subjects completed the Problem-Solving Inventory (PSI) at both time points. We used analyses of covariance (ANCOVAs) to assess relationships between PD diagnoses and PSI scores prior to treatment. Subjects were divided into three groups: those with PD diagnoses that remained stable after fluoxetine treatment (N=91), those who no longer met PD criteria after fluoxetine treatment (N=119), and those who did not meet criteria for a PD at any time point in the study (N=95). We used multiple chi(2) analyses to compare rates of MDD response and remission between the three PD groups. ANCOVA was also used to compare posttreatment PSI scores between PD groups. Prior to fluoxetine treatment, patients with avoidant, dependent, narcissistic, and borderline PDs reported significantly worse problem-solving ability than did patients without any PDs. Only subjects with dependent PD remained associated with poorer baseline problem-solving reports after the effects of baseline depression severity were controlled. Patients with stable PD diagnoses had significantly lower rates of MDD remission. Across PD groups, problem solving improved as MDD improved. No significant differences in posttreatment problem-solving were found between PD groups after controlling for baseline depression severity, baseline PSI score, and response to treatment. Treatment with fluoxetine is less likely to lead to remission of MDD in patients with stable PDs. More study is needed to investigate causal links between PDs, problem solving, and MDD treatment response.

Adult↗

PubMed1978

Problem-solving as a function of age, sex and the role appropriateness of the problem content.

The purpose of this study was to investigate problem-solving ability as a function of age, sex and problem content by using 20 problems chosen from the problem-solving literature. The problems were administered without time limits to 8 males and 8 females in each of three age groups: 20--30, 40--50, 60--70. Analysis revealed that only age influenced performance with the middle-age group scoring significantly higher than the other groups. Analysis of the time required by each age group to solve the problems showed the young group required significantly less time than the other groups. Finally, the young group was seen to make more errors of commission while the older group made more errors of omission.

Adult↗

PubMed1993

Personal problem-solving system for scoring TAT responses: preliminary validity and reliability data.

Personal problem solving has emerged as an important construct in the cognitive-behavioral literature, yet there is a lack of clinically useful, performance-based measures practitioners can use to assess the personal problem-solving skills of their clients. Two studies evaluated the validity and reliability of a scoring system for measuring personal problem-solving processes via the Thematic Apperception Test (TAT; Morgan & Murray, 1935). In Experiment 1, undergraduate students (N = 87) completed two measures of personal problem solving, as well as three TAT cards, which were scored using the Personal Problem-Solving System (PPSS; Renan, 1990). In Experiment 2, an additional group of undergraduates (N = 56) responded to three TAT cards on two separate occasions and also completed a different measure of personal problem solving. Results from both studies supported the use of the PPSS for scoring TAT responses to assess personal problem-solving processes. Suggestions for future research are highlighted.

Journal Article↗

PubMed2006

The perceived problem-solving ability of nurse managers.

STUDY RATIONALE: The development of a problem-solving approach to nursing has been one of the more important changes in nursing during the last decade. Nurse Managers need to have effective problem-solving and management skills to be able to decrease the cost of the health care and to increase the quality of care. STUDY AIM: This descriptive study was conducted to determine the perceived problem-solving ability of nurse managers. METHOD: From a population of 87 nurse managers, 71 were selected using the stratified random sampling method, 62 nurse managers agreed to participate. Data were collected through a questionnaire including demographic information and a problem-solving inventory. The problem-solving inventory was developed by Heppner and Petersen in 1982, and validity and readability studies were done. It was adapted to Turkish by Sahin et al (1993). The acquired data have been evaluated on the software spss 10.0 programme, using percentages, mean values, one-way anova and t-test (independent samples t-test). RESULTS: Most of the nurses had 11 or more years of working experience (71%) and work as charge nurses in the clinics. It was determined that 69.4% of the nurse managers did not have any educational training in administration. The most encountered problems stated were issues related to managerial (30.6%) and professional staff (25.8%). It was identified that nurse managers who had received education about management, following scientific publication and scientific meeting and had followed management models, perceived their problem-resolving skills as more adequate than the others (P>0.05). CONCLUSION: In this study, it was determined that nurses do not perceive that they have problem-solving skills at a desired level. In this context, it is extremely important that this subject be given an important place in both nursing education curriculum and continuing education programmes.

Adult↗

PubMed2004

Assessment of problem-solving: a key to successful diabetes self-management.

Problem-solving skill is important for chronic illness self-management. This project prospectively evaluated a measure of diabetes problem-solving skill for its reliability, convergent validity, sensitivity to intervention, and relationship to change in behavior. Postmenopausal women with type 2 diabetes (N = 279) participated in a RCT to evaluate a lifestyle modification program. The 9-item Diabetes Problem-Solving Inventory (DPSI) was used to assess how patients cope with challenges to diabetes self-care. The DPSI was found to have good inter-rater reliability and internal consistency for a brief scale, be moderately stable over time, and relate significantly to hypothesized variables. DPSI scores improved significantly more in the lifestyle change condition than in controls and were related to improved outcomes. Mediation analyses indicated that the increase in problem-solving was a partial mediator of outcomes. Results support the reliability, predictive ability, and sensitivity to change of the DPSI. Directions for future research on problem-solving and chronic illness are discussed.

Adult↗

PubMed1996

Context and development in family problem solving with preadolescent children.

This study analyzed correlates of social problem solving in 63 2-parent families with a preadolescent child during structured discussions in the home. The longitudinal design assessed families when the preadolescent was about 9.5 years old and again 2 years later. Links between problem solving and features of the immediate ecological context were examined. There was a substantial decline in the quality of family problem solving during preadolescence associated with changes in the participation and affective behavior of fathers and preadolescents. Although problem solving was not less effective on autonomy topics, it was markedly worse when parents, rather than the preadolescent, selected the topic for discussion. Preadolescent topic selection triggered a pattern of productive participation and affective behavior in both parents and preadolescents. The results clarify the nature of ambivalent parent-child relations just prior to puberty by specifying changes in family problem solving which correspond with preadolescent autonomy striving.

Adolescent↗

PubMed1998

Structured problem solving for materiel managers.

A structured approach to problem solving and solution documentation is one of the keys to continuous improvement. Without it, it is quite possible to solve the wrong problem, to solve the right problem in the wrong way, or (maybe worst of all) to solve the same problem over and over again. Companies that have figured out how to solve the right problems in the right way, once and for all, will ultimately move forward much faster than their competitors.

Guidelines as Topic↗

PubMed1995

An empirical method for assessing social problem solving in schizophrenia.

The development of a multimethod social problem-solving battery for schizophrenia is described. The battery is unique in that empirical methods were used throughout its development. The battery includes components that tap skills for response generation and response evaluation. The behavioral components of social problem solving are assessed in an extended role-play format. Individuals with schizophrenia and bipolar disorder, as well as nonpatient controls, completed the social problem-solving battery and cognitive measures. Subjects in the schizophrenia group performed more poorly than controls on measures of the ability to generate and evaluate response alternatives, as well as on the role-play test. The two patient groups did not differ in performance on any of the social problem-solving components. Appropriateness of affect was the most powerful predictor of problem-solving effectiveness.

Adult↗

PubMed2001

The effects of specific retrieval instruction on social problem-solving in depression.

OBJECTIVES: We examine the proposal that social problem-solving in depression may be improved with the retrieval of specific autobiographical memories. DESIGN AND METHODS: Social problem-solving was assessed with the Means-End Problem-Solving task (MEPS; Platt & Spivack, 1975a). Depressed and non-depressed participants were required either to retrieve a specific memory prior to generating a MEPS solution (primed condition) or to report on the memories retrieved during MEPS performance after giving their MEPS solution (non-primed condition). Participants also judged whether the memories retrieved had been helpful or unhelpful for the process of solution generation. RESULTS: In both depressed and non-depressed individuals, priming increased specific memory retrieval but did not improve MEPS performance. An interaction between depression and priming revealed that priming increased the retrieval of helpful memories in the depressed sample. CONCLUSIONS: Specificity is not, in itself, a sufficient retrieval aim for successful social problem-solving. However specific memory priming may be beneficial in depression because it facilitates the recognition of memories which are helpful for problem-solving.

Adult↗

PubMed1989

Explaining the social patterns of depression: control and problem solving--or support and talking?

Research on the social patterns of depression in the community finds consistently that high levels of education and income, being male, and being married are associated with lower levels of depression. We attempt to explain these patterns as the result of two essential social perceptions: the sense of controlling one's own life rather than being at the mercy of powerful others and outside forces, and the sense of having a supportive and understanding person to talk to in times of trouble. In theory, the sense of control reduces depression because it encourages active problem solving, and the sense of support reduces depression because it provides others to talk to. We find evidence for the first proposition: persons who feel in control of their lives are more likely to attempt to solve problems. Perceived control and problem solving decrease depression and largely explain the effects of income and education on depression. We find, however, that support has mixed effects. Support decreases depression, but talking to others when faced with a problem, which increases with the level of support, increases depression. Support explains a small part of the effect of marriage on depression. Control and support have an interactive effect on depression, suggesting that control and support can substitute for one another to decrease depression: a high level of one reduces the need for the other, and a low level of one is remedied by a high level of the other.

Adolescent↗

PubMed1997

Dietetics and foodservice personnel are ready for team problem solving.

OBJECTIVE: To determine the readiness of dietetics and foodservice personnel for contributing to team problem solving. DESIGN: A descriptive, correlation study in which a five-part questionnaire was designed to collect data. SUBJECTS: Dietetics and foodservice personnel (n = 632) in eight hospital settings; 321 subjects (51%) volunteered to participate. STATISTICAL ANALYSES PERFORMED: Statistical data to summarize demographic information and two-way analysis of variance with a Scheffe post hoc analysis was used to investigate differences between dietetics and foodservice personnel on each of the subscales. RESULTS: In general, all respondents were somewhat oriented toward group problem solving and were confident in their problem-solving skills. Problem-solving expertise within the organization decreased for the respondents as the problem moved from their direct work areas to the organization level. Dietitians displayed higher self-efficacy in contributing to problem-solving teams than did foodservice personnel, indicating a 75% chance that they would contribute whereas all other respondents indicated a 50% chance of contributing. APPLICATIONS: The results of this study generate optimism for involving all dietetics and foodservice personnel in team problem solving. However, training activities are needed for both foodservice personnel and dietetics professionals.

Analysis of Variance↗