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1.
Omega (Westport) ; : 302228231207900, 2023 Oct 20.
Artigo em Inglês | MEDLINE | ID: mdl-37863659

RESUMO

This study investigates perceived interactions with the deceased, a phenomenon reported across societies, with 30-34% of individuals likely experiencing at least one ADC in their lifetime. Despite this prevalence, studies examining the impact of ADCs' on those who have lost partners are limited. We present data from 70 individuals reporting partner ADCs via an online survey. Forty percent reported accelerated recovery and 42.9% confirm the ADCs' significant influence in their grieving, with 61% expressing a desire for continued contact. ADCs, interestingly, didn't worsen their pain. The influence on grief-related sadness varied: 41% noted no change, while 40% reported reduced sadness. Forty-seven percent acknowledged ADCs eased their loss acceptance. The data highlight ADCs' substantial, potentially therapeutic role in grief and healing, despite varying effects on sadness and recovery. This study underscores the ADCs' possible positive influence on bereaved partners, advocating for a deeper understanding of this phenomenon in the grieving process.

2.
Omega (Westport) ; 87(3): 884-901, 2023 Aug.
Artigo em Inglês | MEDLINE | ID: mdl-34240655

RESUMO

After death communications(ADCs) are defined as perceived spontaneous contacts with living individuals by the deceased. This research presents on a subset of data from a recent large international survey of individuals who experienced ADCs and provided systematic information regarding these experiences. In our research we explore the impact of having an ADC on reported spirituality, religiosity, beliefs and attitudes about death and dying and also explore the moderating factors of this impact. We found that having an ADC was perceived as a positive life experience and that it was associated with a reduction in fear of death, belief in life after death and that the deceased could communicate with the living, and increased reported spirituality. Moderating factors include aspects of having or desiring physical contact with the deceased as well as perceiving some emotional reaction to the ADCs. Future directions for research exploration are also provided based on our findings.


Assuntos
Religião , Espiritualidade , Humanos , Medo
3.
Saf Health Work ; 9(4): 381-387, 2018 Dec.
Artigo em Inglês | MEDLINE | ID: mdl-30559985

RESUMO

BACKGROUND: Physician behaviors that undermine a culture of safety have gained increasing attention as health-care organizations strive to create a culture of safety and reduce medical errors. We developed, implemented, and assessed a course to teach physicians skills regarding effective coping and interpersonal communication skills and present our results regarding outcomes. METHODS: We examined a professional development program specifically designed to address unprofessional or distressed behaviors of physicians, and we evaluated the impact on burnout, quality of life, and emotional flooding scores of the physicians. Assessments of burnout, quality of life, and emotional flooding were assessed preintervention and postintervention. RESULTS: Results demonstrated statistically significant reductions over time in physicians' emotional flooding and emotional exhaustion (EE). Specifically, using a Wilcoxon Signed-Rank test, results revealed that flooding scores at follow-up were statistically significantly lower than at baseline, V = 590, p < 0.05, and EE and personal accomplishment distributions were found to significantly deviate from normal as indicated by Shapiro-Wilks tests (p < 0.05). A Wilcoxon signed-rank test indicated that EE scores were significantly higher at baseline compared to follow-up 1, V = 285, p < 0.05. CONCLUSION: We conclude that the physician participants who enrolled in the educational skills training program improved scores on emotional flooding and EE and that this may be indicative of improved skills related to their experiences and learning in the program. These improved skills in physicians may have a positive impact on the overall culture of safety in the health system setting.

4.
Alcohol Clin Exp Res ; 35(9): 1694-704, 2011 Sep.
Artigo em Inglês | MEDLINE | ID: mdl-21676008

RESUMO

BACKGROUND: Psychological factors such as motivation to change and self-efficacy influence drinking outcomes in alcohol-dependent individuals who are enrolled in pharmacobehavioral studies. Previous results from our research clinic indicated that initial stage of change of heavy drinkers enrolled in a pharmacobehavioral trial was significantly associated with alcohol consumption. However, overall empirical findings regarding the consistency and extent of the connection between motivational factors and behavior are mixed. This may be in part because of the impact of changes in motivation over the course of treatment and/or characteristics of the individuals receiving the intervention. Our goal in the present study was to examine the extent to which levels of motivation and self-efficacy changed during the treatment phase of a pharmacobehavioral treatment trial, and the extent to which these variables affected drinking behavior in subsets of alcohol-dependent individuals. METHODS: We conducted an exploratory evaluation of changes in motivation, temptation to drink, confidence to abstain, and drinking behavior over time during the treatment phase of a pharmacobehavioral study involving 321 alcohol-dependent individuals. We also examined the extent to which individual variables such as initial drinking severity, onset of alcohol dependence, and medication status influenced changes in motivation, self-efficacy, and drinking behavior. RESULTS: Participants reported improvements in motivation to change, self-efficacy for change, and drinking behaviors over the course of treatment. As hypothesized, motivation to change and self-efficacy for change were related to specific dimensions of posttreatment drinking. Heavy drinkers reported more improvement in drinking behaviors than did nonheavy drinkers. Early-onset drinkers who were on medication reduced their drinking more than those on placebo, and these drinking changes appear to be partially mediated by reductions in temptation. CONCLUSIONS: Reductions in drinking occur and are predicted by increased motivation to change, reduced temptation to drink, and increased confidence to abstain in this population of alcoholic-dependent individuals. Early and late onset and heavy drinkers and those taking medications displayed differential changes in drinking behavior, some of which were explained by the mediating effects of self-efficacy. This is a first step in understanding more about which alcoholic individuals respond best to treatment and what mechanisms may be involved in the changes in drinking and drinking-specific changes in frequency and intensity of drinking.


Assuntos
Consumo de Bebidas Alcoólicas/epidemiologia , Consumo de Bebidas Alcoólicas/psicologia , Alcoolismo , Comportamento Aditivo/psicologia , Depressores do Sistema Nervoso Central/efeitos adversos , Etanol/efeitos adversos , Motivação , Adulto , Consumo de Bebidas Alcoólicas/tratamento farmacológico , Alcoolismo/tratamento farmacológico , Alcoolismo/psicologia , Alcoolismo/reabilitação , Comportamento Aditivo/tratamento farmacológico , Terapia Cognitivo-Comportamental , Relação Dose-Resposta a Droga , Método Duplo-Cego , Feminino , Humanos , Masculino , Pessoa de Meia-Idade , Placebos , Escalas de Graduação Psiquiátrica , Autoeficácia , Temperança , Adulto Jovem
5.
Curr Drug Abuse Rev ; 3(1): 49-62, 2010 Mar.
Artigo em Inglês | MEDLINE | ID: mdl-20088819

RESUMO

Cocaine dependence is a complicated, destructive, and often chronic illness that is difficult to treat. In this article we review the challenges in treating cocaine dependence, as well as recent developments and future directions in psychosocial and pharmacological treatment relevant to treatment of cocaine dependence. Cocaine is one of the most addictive drugs because of its immediate and powerful rewarding effects. Often, cocaine dependent individuals experience difficulty abstaining due to cognitive impairments from repeated cocaine use, strong use-related social and environmental cues, and high levels of life stress. Cocaine use also affects areas of the brain related to motor function, learning, emotion, and memory, further complicating the administration of effective interventions. In addition, development of treatments for cocaine dependence has been complicated by the tendency for abusers not to complete treatment programs and their propensity for relapse. Despite these challenges, some treatment approaches, such as cognitive behavioral therapy (CBT) and medications have shown promise in successfully treating cocaine dependence. However, individually, each of these treatments exhibit weakness in longitudinal studies where long-term abstinence is the primary outcome of interest. Although other treatments are being explored, thus far, the combination of CBT and pharmacotherapy has elicited the best results for treating cocaine dependence with respect to patient retention and relapse prevention following abstinence. No treatment method has yet been shown to completely and effectively treat cocaine dependence. More research is necessary to test treatment programs and garner further information in order to better understand and treat cocaine dependence.


Assuntos
Transtornos Relacionados ao Uso de Cocaína/terapia , Encéfalo/efeitos dos fármacos , Terapia Cognitivo-Comportamental , Terapia Combinada , Tratamento Farmacológico , Humanos , Cooperação do Paciente , Psicoterapia de Grupo , Ensaios Clínicos Controlados Aleatórios como Assunto , Prevenção Secundária , Resultado do Tratamento
6.
Artigo em Inglês | MEDLINE | ID: mdl-17945578

RESUMO

In this paper we present a mathematical model and a computer simulation of the relationship between behavioral control of Type 1 diabetes (T1DM), blood glucose (BG) variability, and hypoglycemia-associated autonomic failure (HAAF). A stochastic behavioral self-control process was coupled with a dynamical system simulation of the dampening effect of counterregulation on BG oscillations. The resulting bio-behavioral control system was able to reproduce characteristics of hypoglycemic events in the field, such as temporal clustering of hypoglycemic episodes associated with HAAF, and occurrence of severe hypoglycemia as a result of periods of HAAF augmented by increased BG variability.


Assuntos
Doenças do Sistema Nervoso Autônomo/diagnóstico , Automonitorização da Glicemia/métodos , Glicemia/análise , Diabetes Mellitus Tipo 1/diagnóstico , Diabetes Mellitus Tipo 1/prevenção & controle , Hipoglicemia/diagnóstico , Hipoglicemia/prevenção & controle , Modelos Biológicos , Autocuidado/métodos , Adulto , Doenças do Sistema Nervoso Autônomo/sangue , Doenças do Sistema Nervoso Autônomo/etiologia , Doenças do Sistema Nervoso Autônomo/prevenção & controle , Simulação por Computador , Diabetes Mellitus Tipo 1/sangue , Diabetes Mellitus Tipo 1/complicações , Feminino , Humanos , Hipoglicemia/sangue , Hipoglicemia/etiologia , Masculino , Resultado do Tratamento
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