Measurement of ethical behavior in leisure among high- and low-risk adolescents.

Based on Aristotelian ethics, an "Adolescent Ethical Behavior in Leisure Scale" (AEBLS) was developed. Sixty-two items were created and reviewed by a panel of experts for content-related evidence of validity. Two validity studies were then conducted. In Study 1, data from 419 high- and low-risk adolescents were used to examine correlations between the AEBLS scores and measures of substance use, school bonding, and dispositional leisure boredom. All hypotheses about relations between these variables and the AEBLS were supported. In Study 2, an experiment was conducted to assess construct-related evidence of validity. Seventy-one adolescents completed the AEBLS and evaluated images of sensory and cortical recreation activities to which they were exposed. Consistent with the hypotheses, significant positive correlations were found between the AEBLS and evaluation of cortical activities, and significant negative correlations were found between the AEBLS and evaluation of sensory activities. Results support the use of AEBLS scores to discriminate between ethical leisure behaviors of high- and low-risk adolescents.

Mindfulness and people with stomas.

Persons with a stoma must contend not only with the immediate physical changes produced by the operation but also with psychologic adjustments, changes in body image, changes in self-concept, and the chronic stress of stoma care and physical functioning. Mindfulness training can enable these persons to make the necessary adjustments in a more realized and conscious manner. The practice of mindfulness training has been demonstrated to be effective in dealing with clinical and psychologic problems. Mindfulness is defined as being fully awake and is characterized as being nonjudging, having a beginner's mind, being trusting, nonstriving, accepting, and letting go. Mindfulness training is described, and roadblocks to the practice of mindfulness are discussed and exemplified. Resources on the practice of mindfulness and applications to persons with ostomies are provided. Mindfulness training is proposed as an adjunct to patient education or support groups.

The psychologic impact of ostomy surgery on persons 50 years of age and older.

There have been few studies on the psychologic effects and reactions to ostomy creation in persons older than 50 years. Eighty-nine patients with ostomies (42 female, 47 male) were evaluated to see how ostomy creation affected them. Six instruments were used to make these assessments: Surgery Preparedness Inventory, Surgical Adjustment Scale, Social Interaction Inventory, Self-Esteem Inventory, Geriatric Depression Scale, and Life Satisfaction Inventory-A. In addition to these six instruments, the participants in the study were asked to state their greatest concern. Older men and women showed similar patterns in surgical preparedness, adjustment to operation, and level of self-esteem. Men reported lower satisfaction with life than did women. Men also had more difficulty in social interactions than did women. Twice as many men as women reported mild to moderate depression. Older women reported poorer health status; if unmarried, they reported less satisfaction with life than younger or married women. More of those reporting good current health reported a positive adjustment to ostomy creation than did those who reported poor health. Those who did not feel hindered by their ostomies reported higher scores on well-being than did those who felt hindered. The more time that has passed after operation, the better patients felt. Four major concerns were reported: (1) concern with being able to care for themselves; (2) leakage from the pouch, odor, and gas noises; (3) other health problems; and (4) recurrence of cancer. Good current health and a sense of well-being are important to positive adjustment after ostomy creation. These areas would be well worth monitoring and should be promoted by the caregivers.

Follow up retrospective study of compliance with a standard of care for retinopathy of prematurity in one neonatal intensive care unit.

A retrospective chart review was conducted to determine the impact of recently instituted guidelines on compliance with the standard of care for retinopathy of prematurity (ROP) in the Newborn Intensive Care Unit at the University of Utah Medical Center. In a previous study, it was found that infants eligible for participation in a National Institutes of Health-funded study of ROP were routinely receiving screening eye examinations, whereas infants who qualified for ROP screening according to the standard of care, but not eligible for the study, were seen infrequently. Consequently, a plan to improve the compliance with the standard of care for all infants who fit the standard criteria was implemented. The comparison revealed significant improvement in compliance rates. In one subgrouping of infants, compliance rose from three of 16 (18.75%) infants screened for ROP according to the standard of care, to nine of 11 (82%) infants screened for ROP according to the revised standard. This increase in compliance appears to be due to adherence to guidelines recommended in an earlier study, which included increasing staff awareness of the standard of care, designating a person to schedule and track infants who fit the screening criteria, and including the need for ROP screening on the admission and discharge summary.

Compliance with a standard of care for retinopathy of prematurity in one neonatal intensive care unit.

Standards of care are an integral part of providing safe and proper health care to the public. One such standard is the screening of premature infants for retinopathy of prematurity. In a retrospective chart review of 67 infants in an intensive care nursery, a high incidence of non-compliance with the standard was found in infants with over 1251-g birth weight, but that infants under 1251-g birth weight and eligible for participation in an investigation of retinopathy of prematurity had a high degree of compliance with the standard. These findings resulted in the adoption of recommendations to improve compliance with the standard.

Reflections on the self state dream.

Self psychologists contend that patients with narcissistic personality disorders have dreams which cannot be understood in terms of current psychoanalytic dream theory and that these dreams, called self state dreams, have a different origin and structure. The manifest content of these dreams is said to reveal the reactions of healthy sectors of the psyche to disturbing changes in the condition of the self. Self psychologists are said to be able to understand these dreams directly, without the patients' associations, as portrayals of the dreamers' dread of threats to the integrity of the self. The authors raise questions about these contentions. They conclude that the self state dream will remain a dubious concept until a more extensive psychology of dreaming is provided by self psychologists.

A biopsychosocial model of premenstrual syndrome.

The authors describe the application of a biopsychosocial model to premenstrual syndrome. In this model one assumes that premenstrual syndrome is the result of an interaction between biologic, psychologic, and social factors. A six-point approach to the evaluation of women with multiple premenstrual symptoms is also presented. Finally, the benefits of this model for the clinician and investigator are reviewed.

Conscious dream synthesis as a method of learning about dreaming: a pedagogic experiment.

Stimulated by Freud's comments on the unique perspectives offered by "building up dreams by synthesis," the authors applied this idea to the St. Louis Psychoanalytic Institute's introductory course on the psychology of dreaming. Each student was assigned the task of purposefully and consciously synthesizing a dream, utilizing certain assigned information and meeting the specified criteria. In the use of this device, it was anticipated that the conscious active effort required to duplicate the usually passively experienced processes of dreaming and the unconscious dream work would lead to a deeper understanding and appreciation of the dream.