By L. Konrad. Bates College. 2018.

Four Then purchase 15 mg mentax visa, the theoretical and empirical concepts of cop- categories for assessing behaviors are termed ing and adaptation processing and self-consistency “adaptive modes discount mentax 15mg amex. Central to Roy’s theoretical model is the belief that adaptive responses support health mentax 15 mg visa, The Roy Adaptation Model (Roy mentax 15 mg lowest price, 1984 cheap mentax 15mg line, 1988a, 1988b; Roy & Andrews, 1991, 1999; Roy & Roberts, 1981) provides the framework for programs of Adaptive responses support health, which nursing research, particularly the constructs for the is defined as a state and a process of being research exemplar involving elderly patients with and becoming integrated and whole. Scientific assumptions for the Roy has described strategies for knowledge devel- model have been based on general systems theory opment based on the model and a structure of and adaptation-level theory (Roy & Corliss, 1993). Knowledge-development strategies that she to include Roy’s redefinition of adaptation for the has integrated through decades of work include twenty-first century (Roy & Andrews, 1999). The model construction; theory development (includ- cosmic unity stressed in Roy’s vision for the future ing concept analysis, synthesis, and derivation of emphasizes the principle that people and the earth propositional statements); philosophic explication; have common patterns and integral relationships. The structure for knowledge emphasis shifts to the purposefulness of human includes the broad categories of the basic and existence in a universe that is creative. The clini- People, both individually and in groups, are viewed cal science of nursing investigates specifically the as holistic adaptive systems, with coping processes role of the nurse in promoting adaptation and acting to maintain adaptation and to promote per- human and environment transformations. Cognitive recovery from head injury was the adaptive patterns; (2) the adaptive modes; that is, focus of the research. The first study used a re- their development, interrelatedness, and cultural peated measures design to describe changes in cog- and other influences; and (3) adaptation related to nitive performance over six months of recovery for health, particularly person and environment inter- 50 patients (Roy, 1985). The initial pilot study of nine matched stabilizer-innovator effectiveness; (2) changes pairs shows some promising trends. Graphs of re- within and among the adaptive modes; and (3) covery curves on all nine measures showed earlier nursing care to promote adaptive processes, partic- improvement of performance in the treated group ularly in times of transition, during environmental as compared with the matched group that did not changes, and during acute and chronic illness, receive the planned nursing interventions to pro- injury, treatment, and technologic threats. The intervention has been extended the structure of knowledge (Roy & Andrews, 1999). Another funded research project in clini- to promote adaptation and how they relate to the cal progress focuses on nurse coaching for symptom adaptive modes. The second major research effort, to conduct a review and synthesis of research, based again within the basic science of nursing, used a sys- on the Roy Adaptation Model, to identify and lo- tematic controlled comparison of survey data col- cate the literature from a 25-year period, to conduct lected in six hospitals across the United States. One the critical analysis, and to present the findings in a purpose within the larger study aims was to exam- research monograph (Roy et al. From 1970 ine levels of wellness in relation to levels of adapta- through 1994, a total of 163 studies met the inclu- tion. Only English-language publications measures of physiologic adaptation were related to were included. The sample included 94 articles in levels of wellness, but no evidence was found of a 44 different research and specialty journals from relationship between psychosocial adaptation and five continents. There was, however, tions and theses from a total of 35 universities and such a relationship in the least acute care setting colleges in the United States and Canada that were and for patients with longer hospital stays. The was suggested that adaptation is a process that takes major concepts of the model were used to organize place over time. Further, Roy (1977) noted that the the presentation of the review of this extensive use measures of levels of wellness were limited and not of the Roy Adaptation Model in nursing research. A model of cognitive information modes and processes; physiologic, self-concept, role processing was developed (Roy, 1988b, 2001), and a function, and interdependence modes; stimuli; and program of research was initiated to contribute to intervention. The Roy quality of the research and for the linkages of the re- Adaptation Model focuses on enhancing the basic search to the model. The studies that met the estab- lished criteria for adequacy of the quality of the The Roy Adaptation Model focuses on research and links to the model were used to test enhancing the basic life processes of the propositions derived from the model. As the studies were analyzed, the find- ings were used to state ancillary and practice life processes of the individual and group. This process is demon- A major concentration of nursing activity is to as- strated in the exemplar study reported here. Given the priority of this notion, Roy fo- three categories to assess the potential of research cused efforts on further conceptual and empirical findings for use in practice: Category 1—high po- work to understand this human ability and nursing tential for implementation based on positive find- practice based on that understanding. This review Drawing from knowledge in the neurosciences, her showed the breadth and depth of the Roy model’s early theory development and research on the use in nursing research in qualitative and quantita- model, and her observations in neuroscience nurs- tive research and in instrument development stud- ing practice, Roy proposed a nursing model for ies, using populations of individuals and groups (of cognitive processing (Roy, 1988b, 2001). Cognitive all ages, both in health and in illness, and in all areas processes in human adaptation are described as fol- of nursing practice). A review of the next five years lows: input processes (arousal and attention, sensa- of research, including 57 identified studies, is un- tion and perception), central processes (coding, derway, along with a critique, examples, and rec- concept formation, memory, language), output ommendations for the use of instruments to processes (planning and motor responses), and measure concepts of the Roy Adaptation Model emotion. Through these cognitive processes, adap- (visit the Roy Adaptation Association Web site at: tive responses occur. Taylor (1983), in a study of cancer patients, pro- posed a related theory of cognitive adaptation.

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Try to check the accuracy of the information by reading at least some of these sources yourself discount mentax 15mg online. It is fair to say that all authors discount mentax 15mg amex, researchers cheap mentax 15 mg online, and organizations have at least some bias and that the information from any site can be invalid cheap mentax 15mg visa. But good material attempts to be fair by acknowledging other possible positions order mentax 15mg on-line, interpretations, or conclusions. A critical examination of the nature of the websites you browse for information will help you determine if the information is valid and will give you more confidence in the information you take from it. Because all research has the potential to be invalid, no research ever “proves” a theory or research hypothesis. Internal validity is greater when confounding variables are reduced or eliminated. Scientists use meta-analyses to better understand the external validity of research. The researchers labeled the glasses with only an “M” (for Pepsi) or a “Q” (for Coke) and asked the participants to rate how much they liked the beverage. The research showed that subjects overwhelmingly preferred glass “M” over glass “Q,” and the researchers concluded that Pepsi was preferred to Coke. Determine the criteria that were used to select the studies and report on the findings of the research. Basic research and applied research inform each other, and advances in science occur more rapidly when both types of research are conducted. The results of psychological research are reported primarily in research reports in scientific journals. These research reports have been evaluated, critiqued, and improved by other scientists through the process of peer review. The methods used by scientists have developed over many years and provide a common framework through which information can be collected, organized, and shared. In addition to requiring that science be empirical, the scientific method demands that the procedures used be objective, or free from personal bias. Scientific findings are organized by theories, which are used to summarize and make new predictions, but theories are usually framed too broadly to be tested in a single experiment. Therefore, scientists normally use the research hypothesis as a basis for their research. Scientists use operational definitions to turn the ideas of interest—conceptual variables—into measured variables. Decisions about whether psychological research using human and animals is ethical are made using established ethical codes developed by scientific organizations and on the basis of judgments made by the local Institutional Review Board. These decisions are made through a cost-benefit analysis, in which the costs are compared to the benefits. If the potential costs of the research appear to outweigh any potential benefits that might come from it, then the research should not proceed. Descriptive research is designed to provide a snapshot of the current state of affairs. Descriptive research allows the development of questions for further study but does not assess relationships among variables. The results of descriptive research projects are analyzed using descriptive statistics. Correlational research assesses the relationships between and among two or more variables. It allows making predictions but cannot be used to draw inferences about the causal relationships between and among the variables. Linear relationships between variables are normally analyzed using the Pearson correlation coefficient. The goal of experimental research is to assess the causal impact of one or more experimental manipulations on a dependent variable. Because experimental research creates initial equivalence among the participants in the different experimental conditions, it allows drawing conclusions Attributed to Charles Stangor Saylor.

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As with obstruction of any part of the body the objective is to define the site of obstruc- tion and its cause mentax 15mg cheap. The initial investigation was an abdominal ultrasound which showed a dilated intrahepatic biliary tree discount mentax 15 mg free shipping, common bile duct and gallbladder but no gallstones buy mentax 15 mg amex. The pancreas appeared normal 15 mg mentax with visa, but it is not always sensitive to this examination owing to its depth within the body 15mg mentax with mastercard. It showed a small tumour in the head of the pancreas causing obstruction to the common bile duct, but no extension outside the pancreas. The patient underwent partial pancreatectomy with anastamosis of the pancreatic duct to the duodenum. Follow-up is necessary not only to detect any recurrence but also to treat any possible development of diabetes. During the singing of a hymn she suddenly fell to the ground without any loss of consciousness and told the other members of the congregation who rushed to her aid that she had a complete par- alysis of her left leg. She has no relevant past or family history, is on no medication and has never smoked or drunk alcohol. She works as a sales assistant in a bookshop and until recently lived in a flat with a partner of 3 years’ standing until they split up 4 weeks previously. Examination She looks well, and is in no distress; making light of her condition with the staff. The left leg is completely still during the examination, and the patient is unable to move it on request. Superficial sensation was completely absent below the margin of the left buttock and the left groin, with a clear transition to normal above this circumference at the top of the left leg. There was normal withdrawal of the leg to nociceptive stimuli such as firm stroking of the sole and increasing compression of Achilles’ tendon. The superficial reflexes and tendon reflexes were normal and the plantar response was flexor. The clues to this are the cluster of: • the bizarre complex of neurological symptoms and signs which do not fit neuroanatom- ical principles, e. None of these on its own is specific for the diagnosis but put together they are typical. In any case of dissociative disorder the diagnosis is one of exclusion; in this case the neuro- logical examination excludes organic lesions. It is important to realize that this disorder is distinct from malingering and factitious disease. The condition is real to patients and they must not be told that they are faking illness or wasting the time of staff. The management is to explain the dissociation – in this case it is between her will to move her leg and its failure to respond – as being due to stress, and that there is no underlying serious disease such as multiple sclerosis. A very positive attitude that she will recover is essential, and it is important to reinforce this with appropriate physical treatment, in this case physiotherapy. The prognosis in cases of recent onset is good, and this patient made a complete recovery in 8 days. Dissociative disorder frequently presents with neurological symptoms, and the commonest of these are convulsions, blindness, pain and amnesia. Clearly some of these will require full neurological investigation to exclude organic disease. She lives alone but one of her daughters, a retired nurse, moves in to look after her. The patient has a long history of rheumatoid arthritis which is still active and for which she has taken 7 mg of prednisolone daily for 9 years. For 5 days since 2 days before starting the antibiotics she has been feverish, anorexic and confined to bed. On the fifth day she became drowsy and her daughter had increasing difficulty in rousing her, so she called an ambulance to take her to the emergency department. Examination She is small (assessed as 50 kg) but there is no evidence of recent weight loss. Her pulse is 118/min, blood pressure 104/68 mmHg and the jugular venous pressure is not raised. Her joints show slight active inflammation and deformity, in keeping with the history of rheumatoid arthritis. This is a common problem in patients on long-term steroids and arises when there is a need for increased glucocorticoid output, most frequently seen in infections or trauma, including surgery, or when the patient has prolonged vomiting and therefore cannot take the oral steroid effect- ively. It is probably due to a combination of reduced intake of sodium owing to the anorexia, and dilution of plasma by the fluid intake.

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More and more research demonstrates that a large part of everyday behavior is driven by [10] processes that are outside our conscious awareness (Kihlstrom 15mg mentax with visa, 1987) trusted 15mg mentax. And yet order mentax 15mg with amex, although our unconscious motivations influence every aspect of our learning and behavior Freud probably overestimated the extent to which these unconscious motivations are primarily sexual and aggressive 15mg mentax otc. Taken together discount mentax 15 mg with visa, it is fair to say that Freudian theory, like most psychological theories, was not entirely correct and that it has had to be modified over time as the results of new studies have become available. But the fundamental ideas about personality that Freud proposed, as well as the use of talk therapy as an essential component of therapy, are nevertheless still a major part of psychology and are used by clinical psychologists every day. Focusing on the Self: Humanism and Self-Actualization Psychoanalytic models of personality were complemented during the 1950s and 1960s by the theories of humanistic psychologists. In contrast to the proponents of psychoanalysis, humanists Attributed to Charles Stangor Saylor. Arguing that people are free to choose their own lives and make their own decisions, humanistic psychologists focused on the underlying motivations that they believed drove personality, focusing on the nature of the self-concept,the set of beliefs about who we are, and self-esteem, our positive feelings about the self. One of the most important humanists, Abraham Maslow (1908–1970), conceptualized personality in terms of a pyramid-shaped hierarchy of motives(Figure 11. At the base of the pyramid are the lowest-level motivations, including hunger and thirst, and safety and belongingness. Maslow argued that only when people are able to meet the lower-level needs are they able to move on to achieve the higher-level needs of self- esteem, and eventually self-actualization, which is the motivation to develop our innate potential to the fullest possible extent. Maslow studied how successful people, including Albert Einstein, Abraham Lincoln, Martin Luther King Jr. Maslow (1970) believed that self-actualized people are creative, spontaneous, and loving of themselves and others. They tend to have a few deep friendships rather than many superficial ones, and are generally private. He felt that these individuals do not need to conform to the opinions of others because they are very confident and thus free to express unpopular opinions. Self-actualized people are also likely to have peak experiences, or transcendent moments of tranquility accompanied by a strong sense of connection with others. Rogers was positive about human nature, viewing people as primarily moral and helpful to others, and believed that we can achieve our full potential for emotional fulfillment if the self-concept is characterized byunconditional positive regard—a set of behaviors including being genuine, open to experience, transparent, able to listen to others, and self-disclosing and empathic. When we treat ourselves or others with unconditional positive regard, we express understanding and support, even while we may acknowledge failings. Unconditional positive regard allows us to admit our fears and failures, to drop our pretenses, and yet at the same time to feel completely accepted for what we are. The principle of unconditional positive regard has become a foundation of psychological therapy; therapists who use it in their practice are more effective than those who [12] do not (Prochaska & Norcross, 2007; Yalom, 1995). Today the positive psychology movement argues for many of these ideas, and research has documented the extent to which thinking positively and openly has important positive consequences for our relationships, our life satisfaction, and our psychological and [13] physical health (Seligman & Csikszentmihalyi, 2000). Research Focus: Self-Discrepancies, Anxiety, and Depression [14] Tory Higgins and his colleagues (Higgins, Bond, Klein, & Strauman, 1986; Strauman & Higgins, 1988) have studied how different aspects of the self-concept relate to personality characteristics. These researchers focused on the types of emotional distress that we might experience as a result of how we are currently evaluating our self- concept. Higgins proposes that the emotions we experience are determined both by our perceptions of how well our own behaviors meet up to the standards and goals we have provided ourselves (our internal standards) and by our perceptions of how others think about us (our external standards). Furthermore, Higgins argues that different types of self-discrepancies lead to different types of negative emotions. The participants listed 10 thoughts that they thought described the kind of person they actually are; this is the actual self-concept. Then, participants also listed 10 thoughts that they thought described the type of person they would ―ideally like to be‖ (the ideal self-concept) as well as 10 thoughts describing the way that someone else—for instance, a parent—thinks they ―ought to be‖ (the ought self-concept). Those with low self-concept discrepancies were those who listed similar traits on all three lists. Their ideal, ought, and actual self-concepts were all pretty similar and so they were not considered to be vulnerable to threats to their self-concept. The other half of the participants, those with high self-concept discrepancies, were those for whom the traits listed on the ideal and ought lists were very different from those listed on the actual self list. After obtaining this baseline measure Higgins activated either ideal or ought discrepancies for the participants.

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