The Therapist's Intuition and Responsiveness: What Makes the Difference between Expert and in Training Gestalt Psychotherapists.

This study aims to investigate the presence of intuition and responsiveness in early students and in experienced students and psychotherapists, which is understood as the ability to integrate bodily sensitivity and cognition of what is experienced with the patient (aesthetic relational knowing-ARK). The study compares how the therapist's felt sense of the phenomenological intersubjective field and aesthetic relational competence differs between a group of experienced students and psychotherapists and a group of beginners. The sample consisted of 128 participants (20 M; 108 F), finally divided into two groups: "experienced students and psychotherapists" and "beginners". The Aesthetic Relational Knowledge Scale (ARKS), a questionnaire consisting of 58 items targeting three factors (empathy, body awareness, and resonance), was administered. Statistical analyses were conducted to assess (i) differences between the two groups (through Student's t and Cohen's d for effect sizes), (ii) the influence of the level of training for each ARK factor using analyses of covariance for testing the possible influence of demographic variables, and (iii) logistic regressions to compare the influence of the three factors of the ARK model on the group variable with groups as a categorical variable. Significant differences between the two groups were found in body awareness and resonance. Body awareness was found to be the variable best discriminating between the beginners and the experienced students and psychotherapists. Despite being non-significant, there is a tendency suggesting that empathy appears more relevant at the beginning of training. The study shows the importance of training for the development of the therapist's intuition and responsiveness, especially in the factors of body awareness and resonance. The results indicate the importance of assessing and supporting the aesthetic and field resonance of therapists in training, increasing quality and depth of the therapist's responsiveness. This study is limited by a correlational design using self-report and on a limited sample, but it shows that the ARKS can monitor the effectiveness of training related to Gestalt therapeutic competencies.

OSA and CPAP therapy: effect of gender, somnolence, and treatment adherence on health-related quality of life.

BACKGROUND: Obstructive sleep apnea (OSA) often has a significant impact on health-related quality of life (HRQoL) with social and psychological implications. For most OSA patients, a reduction in their HRQoL is due to symptoms such as poor sleep quality, excessive daytime somnolence, and fatigue with differences between gender. PURPOSE: This study explores the CPAP treatment effect on self-perceived HRQoL related to gender, somnolence, and CPAP adherence. METHODS: Out of 1082 consecutive Italian outpatients, 125 (82 M) (60.3 ± 9.6 years) completed the prospective observational study and were evaluated at the first visit (T0), and the follow-up visit (T1). Two self-reported HRQoL questionnaires were administered: six subscales Psychological General Well-Being Index (PGWBI) and 12-Item Short-Form Health Survey (SF-12). RESULTS: Scores of PGWBI and SF-12 MCS improved from T0 to T1. Patients with CPAP use ≥ 4 h/night showed a significant improvement in all dimensions evaluated, except for SF-12 PCS. At T1, participants with ESS > 10 improved in all scores, except SF-12 PCS. Gender comparison shows better-perceived HRQoL in males at first visit and CPAP follow-up visit. Variation of PGWBI was significantly correlated with CPAP use, ESS at T0 and T1 (p < 0.0001; r2 = 0.26). CONCLUSIONS: This study provides evidence on the effectiveness of CPAP treatment on perceived HRQoL. Participants with greater adherence to therapy, greater sleepiness, and greater improvement of daytime sleepiness with CPAP therapy, reported a higher quality of life improvement. Gender comparison shows better-perceived HRQoL in males at first visit and CPAP follow-up, despite a more considerable improvement in females.

Immediate effect of CPAP titration on perceived health related quality of life: a prospective observational study.

BACKGROUND: Perceived Health Related Quality of Life (HRQoL) is impaired in obstructive sleep apnea (OSA). This study examines changes in HRQoL aspects occurring immediately after CPAP titration. Furthermore, we analyzed variations in each gender and in patients undergoing home or laboratory-based CPAP titration pathways. METHODS: Twohundredfive outpatients (151 M) (56.7 ± 10.3 years) were evaluated, before first visit and nocturnal diagnostic examination (T0), and the morning after CPAP titration (T1). Two self-reported HRQoL questionnaires were administered: Psychological General Well-Being Index (PGWBI), composed by six subscales, and 12-Item Short-Form Health Survey (SF-12), including Physical (PCS) and Mental Component Summaries (MCS). CPAP titration was performed using auto-adjusting CPAP units at patients' home or in the sleep laboratory. RESULTS: PGWBI scores at T1 improved compared to T0 (p < 0.0001). A similar improvement was observed in SF-12 MCS (p = 0.0011), but not in SF-12 PCS. Changes were independent from anthropometric parameters, OSA severity and excessive daytime sleepiness. Gender comparisons showed better HRQoL in males at both times. At T0, patients who received home or laboratory CPAP titration pathways did not show any differences in PGWBI and SF-12 scores. At T1, PGWBI and SF-12 MCS improved in both home and laboratory groups. CONCLUSIONS: This study gives evidence that first time CPAP application for titration can lead to a general increase in perceived well-being. Gender comparisons showed better perceived HRQoL with more subscales improvements in males after CPAP titration. The improvement was similar with both home and laboratory CPAP titration pathways.

Quality of life in patients at first time visit for sleep disorders of breathing at a sleep centre.

INTRODUCTION: Sleep-disordered breathing adversely affects daytime alertness and cognition. Obstructive sleep apnea (OSA) patients have several typical symptoms including habitual snoring, excessive daytime sleepiness, fatigue, lack of concentration, memory impairment, and at times psychological disturbances. We evaluated different aspects in the health related quality of life (HRQoL) in subjects referred to our sleep laboratory for their first examination for suspicion of OSA. METHODS: One hundred ninety-eight consecutive outpatients (152 M) (mean age 52.7 ± 12.8 years, range 18-82 years; mean BMI 31.0 ± 6.5 kg/m(2), range 17.3-57.8 kg/m(2) were evaluated with two self-reported questionnaires for HRQoL assessment: Psychological General Well-Being Index (PGWBI), that asses anxiety, depressed mood, positive well-being, self-control, general health, vitality, and 12-Item Short-Form Health Survey (SF-12), consisting assesses of Physical and Mental Component Summaries (PCS and MCS). Epworth Sleepiness Scale (ESS) was used to assess daytime sleepiness before nocturnal diagnostic examination. RESULTS: Subjects showed variable HRQoL scores. HRQoL was worse in women than men and it decreased with age. No relation was found with AHI severity (range 0-129 n/h). BMI and TSat90 (range 0-87.9%) affected physical health perception (SF-12 PCS). Furthermore TSat90 influenced PGWBI Vitality subscale. Subjects with ESS > 10 showed a worse HRQoL profile (p < 0.001) in SF-12 and in PGWBI. Multiple regression analysis showed that age, BMI and ESS were significant predictors of SF-12 PCS (p < 0.001; r(2) = 0.23). CONCLUSIONS: A worse HRQoL perception among subjects referred for OSA suspicion was not related to disease severity. BMI and hypoxemia influenced only some HRQoL dimensions, while excessive daytime sleepiness worsens all HRQoL components considered.