Factors associated with Maternal Attachment of Breastfeeding Mothers

PURPOSE: This study aimed to identify factors associated with maternal attachment of breastfeeding mothers, with a focus on the mothers' breastfeeding characteristics. METHODS: Data were collected from 217 mothers who breastfed their healthy baby for 1 month after childbirth and had no postpartum complications. The data were analyzed by hierarchical regression analysis. RESULTS: The factors significantly associated with maternal attachment were an emotional exchange with one's baby (β=.41, p < .001), breastfeeding confidence (β=.20, p=.022), depression (‘quite a bit or more’, β= −.18, p=.005), and depression (‘a little’, β=−.14, p=.024). The model explained 38.4% of variance in maternal attachment. CONCLUSION: In order to improve attachment, nurses should be actively supported in helping mothers in the first month postpartum adapt to breastfeeding. Interventions to prevent postpartum depression should also be conducted.

Factores asociados con la participación de pacientes en ensayos clínicos en cáncer / Some reasons why patients take part in cancer clinical trials Abstract

Resumen Introducción: El desarrollo de ensayos clínicos (ECA) en cáncer requiere fundamentalmente de la participación voluntaria de pacientes; sin embargo, no todos están dispuestos a hacerlo y de esto afecta su desarrollo. Los factores más influyentes identificados en otros estudios sobre la decisión de participar han sido: falta de información sobre el diseño del estudio, métodos de aleatorización, tipos de tratamiento, uso de placebos, toxicidad y efectos adversos asociados. Objetivo: Determinar en una muestra de pacientes enfermos de cáncer la disposición a participar en un ensayo clínico y establecer los factores relacionados con la decisión. Métodos: Se realizó un estudio observacional de corte transversal en una muestra de pacientes enfermos de cáncer que incluyó un análisis de regresión logística teniendo como variable dependiente, si la persona estaría dispuesta a participar en un ensayo clínico y un conjunto de variables explicativas. Resultados: Se entrevistaron 366 pacientes, el 84% manifestó no tener conocimiento sobre los ensayos clínicos, el 63% estuvo dispuesto a participar y el porcentaje restante argumentaron factores para no participar como: el temor, el desconocimiento, los riesgos y la posible afectación a su estado de salud. Los factores que más se asociaron con la disposición a participar en un ECA fueron: conocer los aspectos sobre los ECA sobre riesgos y beneficios, así como los derechos de participar y el consentimiento informado. Conclusiones: Se requieren estudios adicionales que permitan identificar los factores asociados con la participación de pacientes enfermos de cáncer en los ECA. Sin embargo, es necesario realizar estrategias conducentes a mejorar la comunicación y la información hacia los pacientes. © 2017 Instituto Nacional de Cancerología.

Abstract Background: Cancer clinical trials require the voluntary participation of patients for their adequate development. Not all patients wish to do this, thus affecting their development. In other studies, the most important identified reasons in that influence the decision have been lack of information about study design, randomisation methods, and kind of treatment, use of placebos, toxicity, and side effects of the investigational medicinal product. Objective: To evaluate the volition to participate in clinical trials, as well as to establish the reasons associated with this in a sample of patients. Methods: A cross-sectional observational study was conducted on a sample of cancer patients. This included a logistic regression analysis, taking the volition to participate in clinical trials as the dependent variable, along with a group of explanatory variables. Results: A total of 366 patients were interviewed. Although 84% did not know about clinical trials, 63% were willing to participate. The reasons the remaining percentage gave for declining to participate were fear, lack of information about risks and benefits, rights, and informed consent. Conclusion: Additional studies are required to identify the reasons associated with participation in cancer clinical trials. Furthermore, strategies are required for improving the information and communication for patients to take part in clinical trials.

Application of psychiatric assessment scale of cognitive and volition capacity in violent crimes / 中华行为医学与脑科学杂志

ObjectiveTo explore the feasibility of psychiatric assessment scale of cognitive and volition capacity(PASCVC) in violent crimes.MethodsThe PASCVC,criminal responsibility rating scale for violence(CRRSV) and criminal responsibility rating scale(CRRS)were used respectively in 244 forensic psychiatric cases.All cases were classified by the judicial surveyor into three grades including complete lost,partial lost and normal,the results were compared with expert's opinions.Results①PASCVC was composed of two subscales:cognitive capacity and volition capacity.There were significant differences in rating average score of three groups (complete lost,partial lost and normal) of total scale,cognitive capacity and volition capacity subscales were 9.96±7.53,69.15±10.290,101.16±6.034;20.29±4.971,37.13±5.388,2.55±2.612;18.32±2.595,30.07±4.595,48.34±4.147 respectively and there were significant differences between them.②27 items had good correlation with the scale(r=0.157~0.915).③According to the reference demarcation points of scale,12 criteria were carried out by using stepwise discriminant analysis.The accuracy of retrospective cumulative square was 97.1%.④Total scale and subscales consistency of three demarcation point grading assessment results were consistent with expert's opinions,the Kappa values were 0.925,0.848 and 0.930 respectively (P<0.01);PASCVC consistency with CRRSV and CRRS,the correlation coefficients were 0.952 and 0.961 respectively (P<0.01),the Kappa values were 0.830 and 0.881 respectively (P<0.01).Conclusion The PASCVC is feasible to be used in violent crimes.

Considerações sobre a Causalidade Psíquica e a Escolha na Psicanálise / Considerations on Psychical Causality and Choice in Psychoanalysis

RESUMO Freud, ao elaborar sua metapsicologia, buscando explicações para a vida psíquica e seus fenômenos, acaba deparando-se com a velha questão filosófica a respeito do determinismo e do livre arbítrio. É evidente que o prisma pelo qual Freud desenvolveu sua teoria é completamente diferente dos demais campos do saber. No entanto, o enigma era o mesmo. O que significavam, para a teoria psicanalítica, os fenômenos psíquicos estudados por Freud? Eram eles produtos do acaso, da liberdade consciente, ou resultados de algum determinismo? Investigamos neste trabalho como os conceitos psicanalíticos de inconsciente, causalidade psíquica, sobre-determinação e escolha se articulam a essas questões.

ABSTRACT In developing his metapsychology seeking for explanations of mental life and its phenomena, Freud ends up facing the old philosophical question concerning determinism and free will. It is clear that Freud's approach in developing his theory is completely different from other fields of knowledge. However, the enigma was the same. What did the psychical phenomena studied by Freud mean to psychoanalytical theory? Were they the product of chance, of conscious freedom, or the result of some form of determinism? In this paper we investigate how the psychoanalytical concepts of the unconscious, psychical causality, overdetermination and choice relate to these questions.

Korean Cancer Patients' Awareness of Clinical Trials, Perceptions on the Benefit and Willingness to Participate / Journal of the Korean Cancer Association, 대한암학회지

PURPOSE: The purpose of this study was to assess current levels of awareness of clinical trials (CTs), perceptions regarding their benefits and willingness to participate to CTs among Korean cancer patients. MATERIALS AND METHODS: From December 2012 to August 2015, we distributed questionnaires to cancer patients receiving systemic anti-cancer therapy at Seoul National University Hospital, Seoul, Korea. RESULTS: A total of 397 out of 520 requested patients (76.3%) responded to the survey. Among the 397 patients, 62.5% were female and the median age was 52 years. Overall, 97.4% (387/397) answered that they have at least heard of CTs. When asked about their level of awareness, 23.8% (92/387) answered that they could more than roughly explain about CTs. The average visual analogue scale score of CT benefit in all patients was 6.43 (standard deviation, 2.20). Patients who were only familiar with the term without detailed knowledge of the contents had the least expectation of benefit from CTs (p=0.015). When asked about their willingness to participate in CTs, 56.7% (225/397) answered positively. Patients with higher levels of awareness of CTs showed higher willingness to participate (p < 0.001). Heavily treated patients and patients with previous experience regarding CTs also showed a higher willingness to participate (p < 0.001). The perceived benefit of CTs was higher in the group willing to participate (p=0.026). CONCLUSION: The patient’s level of awareness regarding CTs was positively related to the positive perception and willingness to participate. Although the general awareness of CTs was high, a relatively large proportion of patients did not have accurate knowledge; therefore, proper and accurate patient education is necessary.

Psicologia e gestores escolares: mediações estéticas e semióticas promovendo ações coletivas / Psychology and school managers: aesthetic and semiotic mediations promoting collective actions

O presente artigo tem por objetivo apresentar parte de uma pesquisa de doutorado que investigou o potencial das ações do psicólogo escolar na promoção de mudança das práticas de gestão. Adotam-se os pressupostos teórico metodológicos da Psicologia Histórico cultural, sobretudo os de Vygotsky. As informações foram construídas a partir de sínteses derivadas da transcrição de gravações em áudio de encontros semanais, com duração média de duas horas, realizados ao longo de quatro anos. Participaram deste estudo um diretor, um vice-diretor e dois orientadores pedagógicos de uma escola pública municipal localizada em uma cidade do interior de São Paulo. Nesses espaços diversas expressões artísticas foram utilizadas como estratégias deflagradoras de reflexão e ampliação da consciência dos gestores. Resultados revelam que é preciso um investimento permanente do psicólogo escolar em espaços que favoreçam a ressignificação, a atribuição de sentidos e a construção de motivos coletivos para que as mudanças nos modos de gerir a escola ocorram.

This article is part of a Doctoral dissertation that investigated the potential of actions carried out by a school psychologist to bring about changes and improve management practices. This study was based on theoretical and methodological assumptions of cultural-historical Psychology, especially the insights of Vygotsky. Data were collected at a municipal public school, located in an inland city in the state of São Paulo, through transcriptions of audio recordings of two-hour weekly meetings over a period of four years. The meetings were held with the school principal, the assistant principal, and two school counselors, participants of this study. During these meetings, artistic expressions were used to encourage reflections and increase administrative staff's awareness. The results obtained indicated that school psychologists should use effective approaches to promote resignification, attribute meanings, and build collective motives to improve school management.

Concept Analysis of Volition for Health Behavior Practice in Patients with Chronic Disease

PURPOSE: The purpose of this study was to define and clarify the concept of volition for health behavior. METHODS: For this study the process of Walker & Avant’s concept analysis was used. Seventeen studies from electronic data basses met criteria for selection. RESULTS: Volition can be defined by the following attributes: 1) planning, 2) maintenance of self-efficacy, and 3) self regulation. The antecedents of volition consisted of: 1) risk awareness, 2) outcome expectation, 3) perceived self-efficacy, and 4) social support. The consequences occurring as a result of volition were: 1) prevention of disability and complications, 2) improvement of functional ability, and 3) enhencement of quailty of life. CONCLUSION: Definition and attributes of volition identified by this results can be applied to develop measurements and intervention programs for chronic patients health behavior.

Desejo de maternidade frente ao diagnóstico de síndrome da imunodeficiência adquirida / Desire for motherhood when facing the diagnosis of acquired immunodeficiency syndrome / El deseo para la maternidad delante del diagnóstico de la síndrome de la inmunodeficiencia adquirida

As gestantes soropositivas para o vírus da imunodeficiência humana (HIV) constituem uma situação especial para a assistência pré-natal. Este estudo objetivou reconhecer aspectos que envolvem mulheres em relação ao desejo de maternidade frente ao diagnóstico de soropositivividade ao HIV. Estudo descritivo, qualitativo cujos sujeitos foram 11 mulheres soropositivas na faixa etária entre 26 e 38 anos, com predominância do ensino fundamental incompleto e cinco solteiras. Os resultados demonstram que elas conhecem a necessidade da realização de tratamento para evitar a transmissão vertical, sendo esta sua principal preocupação, e que o prazer de ser mãe vai além do próprio diagnóstico. O cuidado de enfermagem deve ser integral e individual para esse grupo, assistindo-as de forma holística e humanizada.

Seropositive women for human immunodeficiency virus (HIV) are a special situation for healthcare, especially when pregnant and going through prenatal care. This study aimed to recognize issues that involve women in relation to the desire for motherhood facing the diagnosis of HIV infection and the role of health professionals in the care to these women. A qualitative descriptive study, performed with 11 HIV-positive women in reproductive ages. The results show that they are aware of the necessity of treatment to prevent vertical transmission, this being its main concern, and that the pleasure of being a mother goes beyond the diagnosis itself. Nursing care should be integral to that group and individual, assisting them holistically and in a humanized manner. It is concluded that nurses need to improve nursing care involving these women, once they require full accompaniment to reduce risks of vertical transmission of the virus and for improved quality of life.

Las mujeres embarazadas que son seropositivas para el virus de inmunodeficiencia humana (VIH) son una situación especial para la atención en la salud, en especial cuando están embarazadas y realizan el prenatal. Este estudio objetivó describir el deseo de maternidad delante al diagnóstico de infección por el VIH y el rol de los profesionales de salud en la asistencia a las mujeres. Un estudio cualitativo descriptivo, realizado con 11 mujeres VIH-positivas en edad reproductiva. Los resultados muestran que ellas conocen la necesidad de la realización de tratamiento para prevenir la transmisión vertical, siendo su principal preocupación; que el placer de ser madre va más allá del diagnóstico; y que la atención de enfermería debe ser integral e individual para este grupo, ayudándoles de manera holística y humanizado. Se concluye que la enfermera necesita mejorar la atención volcada para estas mujeres, una vez que requieren total acompañamiento para disminuir los riesgos de la transmisión vertical del virus y para una mejor calidad de vida.

¿Son relevantes los procesos volitivos y de autorreflexión en los programas de reducción de peso? / Are relevant self-reflection and volition process in lose weight programs?

El sobrepeso se ha convertido en uno de los problemas de salud más importantes en el último siglo, no sólo por el deterioro en la calidad de vida de las personas que lo sufren, también por su relación con enfermedades como la diabetes, las cardiopatías y el cáncer. Desarrollo. La mayoría de los tratamientos están orientados a mantener el equilibrio entre el ingreso (dieta) y el gasto (actividad física) energético, mientras los factores psicológicos, y en menor grado los sociodemográficos, no reciben la importancia que merecen por su papel en la etiología y desarrollo de este problema de salud. Objetivo. Analizar y reflexionar, a través de la literatura científica presente en los últimos años, sobre la necesidad de educar y entrenar en dos procesos centrales e inductores de la pérdida de peso, como son la autorreflexión y la volición, muy relacionados con el correcto desarrollo psicológico de las personas. Conclusiones. La focalización en los aspectos volitivos y autorreflexivos de la conducta en personas con sobrepeso podría mejorar la efectividad del tratamiento por la estrecha relación que mantienen con la motivación ("querer adelgazar") y el autoconcepto ("imagen de uno mismo"), procesos éstos que se han mostrado importantes en la reducción de peso.

Overweight has become one of the most important health problems in the last hundred years, not only owing to the deterioration in quality of life of the persons suffering from it, but also because of its relation to diseases such as diabetes, heart disease and cancer. Development. Most treatments are oriented towards maintaining a balance between intake (diet) and expenditure of energy (physical activity), whereas psychological, and to a lesser degree, socio-demographic, factors do not receive they attention they deserve for their role in the etiology and development of this health problem. Objective. To analyze and reflect, based on the most recent scientific literature, about the need to educate and train individuals in two central process that induce weight loss: self-reflection and volition, very closely related to correct psychological development. Conclusions. Focusing on volitional and self-reflexive aspects of behavior in persons who are overweight could improve the effectiveness of treatment owing to the close relation between motivation ("wanting to lose weight") and self-concept ("one's image of oneself"), processes that have been shown to be important in weight reduction.

Contrastación de dos modelos motivacionales de autodeterminación para predecir la deserción en universitariosContrastación d dos modelos motivacionales de utodeterminación para predecir la deserción en universitarios / Contrast between two self-determination motivational models in order to predict university students' dropout / Contraste de dois modelos motivacionais de autodeterminação para a previsão de abandono da universidade

En el marco de la teoría motivacional de la autodeterminación, esta investigación contrastó dos modelos estructurales de medida para predecir la conducta de deserción en estudiantes universitarios de la ciudad de Bogotá. Se administraron siete pruebas en formato tipo rating, estructuradas a partir de instrumentos originales en inglés y analizadas psicométricamente con el modelo de Rasch. Participaron 1118 estudiantes universitarios, hombres y mujeres, de ocho carreras profesionales de cinco universidades de Bogotá. Los resultados apoyan un modelo estructural reespecificado que predice que los estudiantes universitarios que perciben apoyo a la autonomía académica, la satisfacción de las necesidades psicológicas básicas y niveles de autodeterminación en el salón de clases, tienen menos intención de desertar, lo que a su vez conduce a disminuir la deserción real de la carrera.

Within the framework of motivation and self-determination theories, this research contrasted two measurement structural models in order to predict university students' dropout behavior in Bogotá. Seven rating-type tests, structured from original instruments written in English and psychometrically analyzed by using the Rasch model were administered. Participants were 1118, university students of both genders enrolled in eight different undergraduate programs at five universities in Bogotá. The results reinforce a re-specified structural model predicting that university students who perceive support to academic autonomy, satisfaction of their basic psychological needs and self-determination levels in the classroom are less likely to desert, which in turn leads to decrease the actual undergraduate program dropout.

No contexto da teoria motivacional de autodeterminação, este estudo contrasta dois modelos estruturais de medida para predizer o comportamento de abandono da universidade dos estudantes na cidade de Bogotá. Foram administrados sete testes tipo rating, estruturadas a partir de instrumentos originais em Inglês e analisadas psicométricamente com o modelo de Rasch. Participaram 1118 estudantes universitários, homens e mulheres, de oito carreiras de cinco universidades em Bogotá. Os resultados suportam um modelo estrutural re-especificado que prevê que os estudantes universitários que recebem apoio para a autonomia acadêmica, a satisfação das necessidades psicológicas básicas e níveis de autodeterminação em sala de aula têm menos intenção de desertar, o que diminui o abandono real da carreira.

Conducta intencional en niños con trastornos por déficit de atención con hiperactividad: resultados preliminares / Volition in attention deficit hyperactivity disorder in childhood: preliminar results

La mayoría de los modelos teóricos que explican el trastorno por déficit de atención con hiperactividad coinciden en señalar la presencia de un déficit motivacional. Sin embargo, son pocos los estudios que se centran sobre la conducta intencional o volición en estos niños. El Modelo de la Ocupación Humana entiende que la volición es un elemento clave en la ocupación humana. El objetivo de este estudio es conocer cómo es la conducta intencional de los niños con trastorno por déficit de atención con hiperactividad para poder establecer objetivos y programas de tratamiento más eficaces con esta población. Método. La muestra está formada por 21 niños con edades comprendidas entre 7 y 11 años y todos ellos fueron evaluados a través del PediatricVolitional Questionaire (PVQ) en dos ocupaciones: actividades de la vida diaria y actividades escolares. Resultados. Los resultados indican que la conducta intencional es diferente en las actividades de la vida diaria y actividades escolares, mostrando una mayor complejidad en las actividades escolares. La conducta intencional es inferior en los niños del subtipo combinado que el grupo control e inatento. Conclusiones. Estos resultados podrían indicar un menor desarrollo del sentido de capacidad o competencia en los niños con el trastorno por déficit de atención con hiperactividad. Los tratamientos deberían fomentar el desarrollo de un sentido positivo de competencia y de identidad ocupacional.

Most of the theoretical models that explain Attention Deficit Hyperactivity Disorder suggest the presence of a motivational deficit. However, few studies that focuses on the intentional or volition in these children. The Model of Human Occupation understands that volition is a key element in the human occupation. The aim of this study is how the volition of children with Attention Deficit Hyperactivity Disorder in order to establish goals and treatment programs more effective with this population. Method. Twenty one children, between seven and eleven years old participated and were assessed through the Pediatric Volitional Questionnaire (PVQ) in two occupations: activities of daily living and school activities. Results. The results indicate that the volition is different in the activities of daily living and school activities, showing more complex school activities. The volition is lower in children in the combined subtype that the control group and inattentive subtype. Conclusions. These results could indicate a less developed sense of capacity or competence in children with attention deficit hyperactivity disorder. The future treatment should encourage the development of a positive sense of occupational identity and occupational competence.