• 【我的性生活可以吗?性焦虑在儿童性虐待和对妇女的性胁迫之间的关联中的中介作用。】 复制标题 收藏 收藏
    DOI:10.1080/10538712.2020.1774697 复制DOI
    作者列表:Girard M,Dugal C,Hébert M,Godbout N
    BACKGROUND & AIMS: :Empirical studies suggest that childhood sexual abuse is associated with sexual revictimization by a male romantic partner in female survivors. Yet, the potential mechanisms underlying this association remain understudied. Past studies indicated that women childhood sexual abuse survivors report more sexual anxiety, which in turn was linked to an increased risk of sustaining sexual coercion. The current study, conducted with a sample of 448 adult women from the community, aimed to examine sexual anxiety as a potential mechanism in the association between childhood sexual abuse and sexual coercion sustained by women in heterosexual romantic relationships. Results from path analyses confirmed the indirect effect of sexual anxiety in the relationship between childhood sexual abuse and sexual coercion victimization. Findings indicated that childhood sexual abuse is associated with higher levels of sexual anxiety, which in turn, was linked to a higher frequency of sexual coercion experiences perpetrated by the romantic partner. This study contributes to a better understanding of the determinants of sexual violence against women and provides an empirical basis to better inform prevention initiatives and guide future interventions.
    背景与目标: : 实证研究表明,儿童时期的性虐待与女性幸存者中男性浪漫伴侣的性伤害有关。然而,这种关联背后的潜在机制仍未得到充分研究。过去的研究表明,女性童年性虐待幸存者报告了更多的性焦虑,这反过来又与持续性胁迫的风险增加有关。当前的研究以来自社区的448名成年女性为样本,旨在研究性焦虑是儿童性虐待与异性恋浪漫关系中女性所遭受的性胁迫之间的潜在联系。路径分析的结果证实了性焦虑在儿童性虐待与性胁迫受害之间的间接影响。研究结果表明,儿童时期的性虐待与较高水平的性焦虑有关,而这又与浪漫伴侣进行的性胁迫经历的频率更高有关。这项研究有助于更好地了解对妇女的性暴力的决定因素,并为更好地为预防举措提供信息和指导未来的干预措施提供了经验基础。
  • 【老年痴呆症或智力低下患者的身体护理中的非正式胁迫。】 复制标题 收藏 收藏
    DOI:10.1177/096973309900600408 复制DOI
    作者列表:Tännsjö T
    BACKGROUND & AIMS: :This article discusses under what circumstances patients who are suffering from senile dementia or mental retardation should be submitted to coercive care, who should decide about this kind of coercion, and in what legal framework it should take place. A distinction is drawn between modest (i.e. of moderate degree) and meddlesome coercion. The use of modest coercion is defended. It is argued that medical personnel ought to decide exclusively about the use of modest coercion. However, no law should render legitimate the use of even modest coercion. It is conceded that to prohibit the use of a kind of coercion that is expected to take place is hypocrisy. It is argued that this is, however, an acceptable form of hypocrisy.
    背景与目标: : 本文讨论了在什么情况下患有老年性痴呆或智力低下的患者应接受强制护理,谁应决定这种强制,以及应在何种法律框架下进行。适度 (即中等程度) 和多管闲事的胁迫之间有区别。使用适度的胁迫是辩护的。有人认为,医务人员应该完全决定使用适度的胁迫。但是,任何法律都不应使使用适度的胁迫成为合法。人们承认,禁止使用预期会发生的一种胁迫是虚伪的。有人认为,这是一种可以接受的虚伪形式。
  • 【男性性胁迫的启动、停止和持续。】 复制标题 收藏 收藏
    DOI:10.1037/0022-006X.74.4.732 复制DOI
    作者列表:Hall GCN,DeGarmo DS,Eap S,Teten AL,Sue S
    BACKGROUND & AIMS: :Patterns of sexually coercive behavior were examined among 266 Asian American and 299 European American men over 1 year. Noncoercer (n = 358), desister (n = 120), initiator (n = 39), and persistent (n = 48) sexually coercive groups were identified. The strongest predictor of sexual coercion was past sexual coercion. Persistent sexual coercers were higher than the other groups in delinquency and hostile masculinity and were nearly twice as likely to engage in laboratory sexual harassment. Loss of face attenuated self-reported sexual coercion and laboratory sexual harassment risk among Asian Americans and attenuated only laboratory sexual harassment risk among European Americans. These findings suggest that the heterogeneity of sexually coercive behavior and ethnicity are important research and clinical considerations.
    背景与目标: : 在266年以上的亚裔美国人和299名欧美男性中检查了性胁迫行为的模式。确定了非胁迫者 (n = 358),desister (n = 120),引发剂 (n = 39) 和持续性 (n = 48) 性胁迫组。性胁迫的最强预测因素是过去的性胁迫。持续的性胁迫者在犯罪和敌对男子气概方面高于其他群体,从事实验室性骚扰的可能性几乎是其两倍。面部丧失减轻了亚裔美国人自我报告的性胁迫和实验室性骚扰风险,而仅减轻了欧洲美国人的实验室性骚扰风险。这些发现表明,性胁迫行为和种族的异质性是重要的研究和临床考虑因素。
  • 【非自愿住院对药物依从性,治疗参与度和强迫感的长期影响。】 复制标题 收藏 收藏
    DOI:10.1007/s00127-013-0687-x 复制DOI
    作者列表:Jaeger S,Pfiffner C,Weiser P,Längle G,Croissant D,Schepp W,Kilian R,Becker T,Eschweiler G,Steinert T
    BACKGROUND & AIMS: PURPOSE:The purpose of the study was to examine the long-term influence of involuntary hospitalization on medication adherence, engagement in out-patient treatment and perceived coercion to treatment participation. METHODS:In a naturalistic observational multi-centre study, 290 voluntarily and 84 involuntarily hospitalized patients with schizophrenia or schizoaffective disorder had been followed up over a period of 2 years with half-yearly assessments. Assessments included self-rated medication adherence, externally judged medication adherence by blood levels, engagement in treatment and perceived coercion. The statistical analyses were based on multilevel hierarchical modelling of longitudinal data. Level and development of the outcome was controlled for involuntariness, for sociodemographic characteristics and clinical history. RESULTS:Involuntariness of the index-hospitalization did not have an effect on the development of treatment engagement or medication adherence judged by blood levels in the course of the follow-up period when the models were controlled for sociodemographic variables and clinical history. It was associated, though, with a continuously lower self-rated medication adherence. Moreover, former involuntarily hospitalized patients more often felt coerced in several treatment aspects at the follow-up assessments. Yet, there was no difference between the voluntary and involuntary group with regard to the development of the levels of adherence or coercion experiences over time. CONCLUSIONS:Involuntary hospitalization does not seem to impair future treatment engagement in patients with schizophrenia, but formerly involuntarily hospitalized patients continue to be more sensitive to subjective or real coercion in their treatment and more vulnerable to medication non-adherence. Hereby, their risk of future involuntary hospitalization might be increased.
    背景与目标:
  • 【对强迫治疗严重神经性厌食症的思考。】 复制标题 收藏 收藏
    DOI: 复制DOI
    作者列表:Carney T,Crim D,Wakefield A,Tait D,Touyz S
    BACKGROUND & AIMS: BACKGROUND:The high mortality of severe anorexia nervosa causes clinicians to consider any legal avenues for coercing acutely-ill patients to remain in treatment or refeeding programs, such as mental health laws or adult guardianship laws. METHOD:Review of pattern of laws for coercing treatment in various jurisdictions and retrospective file analysis over 4.7 years for a specialist anorexia unit in the State of New South Wales, Australia, to isolate attributes associated with resort to two different avenues of legal coercion. RESULTS:Coercion is most likely indicated for patients with more chronic histories (prior AN admissions), already known to the unit, where they present with other psychiatric illnesses and a low BMI. Compared to voluntary admissions, coerced patients were significantly more likely to experience the refeeding syndrome (an indicator of being seriously medically compromised). They were more likely to be tube fed and placed on a locked unit. LIMITATIONS:Sample size, limited variables and retrospective analysis method. CONCLUSIONS:The study suggests that, where available, clinicians will use legal coercion to help treat severe medical crisis situations, or manage behaviors such as vomiting, excessive exercise/sit-ups, or of absconding to no fixed abode when patients are very young.
    背景与目标:
  • 【精神病学中的审议、同意和胁迫伦理。】 复制标题 收藏 收藏
    DOI:10.1136/jme.2006.019695 复制DOI
    作者列表:Liégeois A,Eneman M
    BACKGROUND & AIMS: :In psychiatry, caregivers try to get free and informed consent of patients, but often feel required to restrict freedom and to use coercion. The present article develops ethical advice given by an Ethics Committee for Mental Health Care. The advice recommends an ethical ideal of shared deliberation, consisting of information, motivation, consensus and evaluation. For the exceptional use of coercion, the advice develops three criteria, namely incapacity to deliberate, threat of serious harm and proportionality between harm and coercion. The article also discusses the viewpoints of the ethical advice and of the European Convention on Human Rights and Biomedicine: is the advice in agreement with the Convention and can the advice refine the guidelines of the Convention for the particular context of psychiatry? Although the Convention emphasises the autonomy of the individual patient, whereas the advice focuses on the relationships between the partners involved, the advice enjoys a complementary and supportive function in the application of the Convention.
    背景与目标: : 在精神病学中,护理人员试图获得患者的自由和知情同意,但经常感到需要限制自由和使用胁迫。本文提出了由精神卫生护理伦理委员会提供的伦理建议。该建议建议共享审议的道德理想,包括信息,动机,共识和评估。对于强制的特殊使用,该建议制定了三个标准,即无能力进行故意,严重伤害的威胁以及伤害与胁迫之间的相称性。本文还讨论了《道德建议》和《欧洲人权与生物医学公约》的观点: 该建议是否与《公约》一致,该建议能否针对精神病学的特定背景完善《公约》的指导方针?尽管《公约》强调患者个人的自主权,而《建议》侧重于所涉伙伴之间的关系,但《建议》在适用《公约》方面具有补充和支持作用。
  • 【计划生育诊所伙伴暴力干预,以降低与生殖胁迫相关的风险。】 复制标题 收藏 收藏
    DOI:10.1016/j.contraception.2010.07.013 复制DOI
    作者列表:Miller E,Decker MR,McCauley HL,Tancredi DJ,Levenson RR,Waldman J,Schoenwald P,Silverman JG
    BACKGROUND & AIMS: BACKGROUND:This study examined the efficacy of a family-planning-clinic-based intervention to address intimate partner violence (IPV) and reproductive coercion. STUDY DESIGN:Four free-standing urban family planning clinics in Northern California were randomized to intervention (trained family planning counselors) or standard of care. English-speaking and Spanish-speaking females ages 16-29 years (N = 906) completed audio computer-assisted surveys prior to a clinic visit and 12-24 weeks later (75% retention rate). Analyses included assessment of intervention effects on recent IPV, awareness of IPV services and reproductive coercion. RESULTS:Among women reporting past-3-months IPV at baseline, there was a 71% reduction in the odds of pregnancy coercion among participants in intervention clinics compared to participants in the control clinics that provided standard of care. Women in the intervention arm were more likely to report ending a relationship because the relationship was unhealthy or because they felt unsafe regardless of IPV status (adjusted odds ratio = 1.63; 95% confidence interval=1.01-2.63). CONCLUSIONS:Results of this pilot study suggest that this intervention may reduce the risk for reproductive coercion from abusive male partners among family planning clients and support such women to leave unsafe relationships.
    背景与目标:
  • 【住院精神病护理的短期结果 -- 胁迫和治疗特征的影响。】 复制标题 收藏 收藏
    DOI:10.1007/s00127-006-0131-6 复制DOI
    作者列表:Wallsten T,Kjellin L,Lindström L
    BACKGROUND & AIMS: AIMS:Little is known about the outcome of brief inpatient treatment interventions in routine psychiatric practice. The aim of this article was to study if subjective and assessed outcome of brief psychiatric inpatient care are related to patient characteristics, coercion at admission and during care, and other treatment characteristics. METHOD:A total of 233 involuntarily and voluntarily admitted patients were interviewed within 5 days from admission and at discharge or after 3 weeks of care. Outcome was measured as reported by patients and by change in GAF (Global Assessment Scale) scores. RESULTS:Predictors for a positive subjective outcome were if the patients reported that they had been well treated by the staff and had contact persons at the ward. Predictors for a GAF improvement were a low GAF score at admission and a mood disorder diagnosis. CONCLUSIONS:Subjectively reported outcome and outcome measured by assessing change in level of functioning differed. Coercion was not related to outcome. The way the patient perceived they had been treated by the staff was strongly related to subjective outcome.
    背景与目标:
  • 【受高度胁迫的患者: 工作人员的理解。】 复制标题 收藏 收藏
    DOI:10.3109/01612840.2013.871088 复制DOI
    作者列表:Bowers L,Wright S,Stewart D
    BACKGROUND & AIMS: :Measures to keep staff and patients safe (containment) frequently involve coercion. A small proportion of patients is subject to a large proportion of containment use. To reduce the use of containment, we need a better understanding of the circumstances in which it is used and the understandings of patients and staff. Two sweeps were made of all the wards, spread over four hospital sites, in one large London mental health organization to identify patients who had been subject to high levels of containment in the previous two weeks. Data were then extracted from their case notes about their past history, current problem behaviours, and how they were understood by the patients involved and the staff. Nurses and consultant psychiatrists were interviewed to supplement the information from the case records. Twenty-six heterogeneous patients were identified, with many ages, genders, diagnoses, and psychiatric specialities represented. The main problem behaviours giving rise to containment use were violence and self-harm. The roots of the problem behaviours were to be found in severe psychiatric symptoms, cognitive difficulties, personality traits, and the implementation of the internal structure of the ward by staff. Staff's range and depth of understandings was limited and did not include functional analysis, defence mechanisms, specific cognitive assessment, and other potential frameworks. There is a need for more in-depth assessment and understanding of patients' problems, which may lead to additional ways to reduce containment use.
    背景与目标: : 确保工作人员和患者安全 (遏制) 的措施经常涉及胁迫。一小部分患者受到很大比例的安全壳使用。为了减少安全壳的使用,我们需要更好地了解使用安全壳的情况以及患者和工作人员的理解。在伦敦的一个大型精神卫生组织中,对所有病房进行了两次清扫,分布在四个医院地点,以识别在过去两周中受到高度遏制的患者。然后从他们的病例记录中提取有关其过去历史,当前问题行为以及相关患者和工作人员如何理解它们的数据。采访了护士和精神病顾问,以补充病例记录中的信息。确定了26名异质患者,代表了许多年龄,性别,诊断和精神病专科。导致使用遏制的主要问题行为是暴力和自我伤害。问题行为的根源在于严重的精神症状,认知困难,人格特质以及工作人员实施病房的内部结构。员工的理解范围和深度有限,不包括功能分析,防御机制,特定的认知评估和其他潜在框架。需要对患者的问题进行更深入的评估和了解,这可能会导致减少安全壳使用的其他方法。
  • 【操纵和武力作为性胁迫策略: 概念和经验差异。】 复制标题 收藏 收藏
    DOI:10.1002/ab.20200 复制DOI
    作者列表:Lyndon AE,White JW,Kadlec KM
    BACKGROUND & AIMS: :This study examines the relationship between perpetrator characteristics, situational characteristics, and type of sexual coercion tactics used to obtain sexual contact (including sexual intercourse) with an unwilling partner. Men who used manipulation or force were compared to each other and to men who engaged in only consensual sex. Participants were college men drawn from the first wave of a 5-year longitudinal study. Stepwise discriminant function analyses, univariate analyses of variance (ANOVA), and chi(2) analyses tested group differences. As predicted, men who used force reported more childhood sexual abuse, witnessed more domestic violence, were more accepting of male violence, and were less likely to endorse love as a motive for sex than men in both the manipulation and consent groups. Men in the force group were also more likely to have had a casual relationship with the woman, and to be drinking and also intoxicated during the coercive incident than men in the manipulation group. Hypothesized differences between men who used force and manipulation regarding parental physical punishment, traditional gender role attitudes, delinquency, hedonistic and dominance motives for sex, prior sexual contact, and the length of the relationship were not supported. The results suggest that types of tactic used in sexual assaults can be distinguished on the basis of person and situational variables and that knowledge of these differences can facilitate future research, as well as rape deterrent and intervention programs.
    背景与目标: : 这项研究研究了犯罪者特征,情境特征和用于与不愿意的伴侣进行性接触 (包括性交) 的性胁迫策略类型之间的关系。将使用操纵或武力的男人彼此比较,并将其与仅进行自愿性行为的男人进行比较。参与者是从为期5年的纵向研究的第一波中抽取的大学生。逐步判别函数分析,单变量方差分析 (ANOVA) 和chi(2) 分析测试了组差异。正如预期的那样,在操纵和同意组中,使用武力的男人报告了更多的童年性虐待,目睹了更多的家庭暴力,更接受男性暴力,并且不太可能将爱情作为性动机。与操纵组中的男人相比,在强迫事件中,武力组中的男人与女人有随意的关系,喝酒和陶醉的可能性也更高。假设在父母的身体惩罚,传统的性别角色态度,犯罪,享乐主义和性支配动机,先前的性接触以及关系的长短方面使用武力和操纵的男性之间存在差异。结果表明,可以根据个人和情况变量来区分性侵犯中使用的策略类型,并且对这些差异的了解可以促进未来的研究以及强奸威慑和干预计划。
  • 【因饮食失调而住院的患者的感知胁迫和感知入院需求的变化。】 复制标题 收藏 收藏
    DOI:10.1176/ajp.2007.164.1.108 复制DOI
    作者列表:Guarda AS,Pinto AM,Coughlin JW,Hussain S,Haug NA,Heinberg LJ
    BACKGROUND & AIMS: OBJECTIVE:Ambivalence toward treatment is characteristic of eating disorders, and patients are often admitted to inpatient programs under pressure from clinicians, family, friends, educators, or employers. This study evaluated patient perceptions of the admissions process and perceived need for hospitalization and assessed whether these perceptions remain stable in the short term. METHOD:A total of 139 patients with eating disorders completed a 13-item self-report scale on the admission experience when they were admitted to a behavioral inpatient specialty program and again 2 weeks into their hospitalization. RESULTS:Patients with anorexia nervosa reported higher levels of perceived coercion and pressure and a lower sense of procedural justice than did those with bulimia. Patients under 18 (N=35) reported more perceived coercion than did adult patients (N=104), and a trend was noted for them to disagree that they needed hospitalization. Perceptions of coercion, of pressure by others toward hospitalization, and of procedural justice were stable in the short term. However, of the 46 patients (30 of them adults) who initially did not endorse needing admission, 20 patients (17 of them adults) changed their minds by 2 weeks into hospitalization and agreed that they needed hospital admission. CONCLUSIONS:Nearly half of patients with eating disorders who denied a need for treatment on admission converted to acknowledging that they needed to be admitted within 2 weeks of hospitalization. Since treatment avoidance is associated with poor outcome, these findings suggest a need for studies assessing the long-term outcome and ethics of pressuring patients with eating disorders into treatment.
    背景与目标:
  • 【精神病患者在入院过程中对胁迫的感知的事实来源。】 复制标题 收藏 收藏
    DOI:10.1176/ajp.155.9.1254 复制DOI
    作者列表:Lidz CW,Mulvey EP,Hoge SK,Kirsch BL,Monahan J,Eisenberg M,Gardner W,Roth LH
    BACKGROUND & AIMS: OBJECTIVE:The purpose of this study was to determine what predicts patients' perceptions of coercion surrounding admission to a psychiatric hospital.

    METHOD:For 171 cases, the authors integrated data from interviews with patients, admitting clinicians, and other individuals involved in the patients' psychiatric admissions with data from the medical records. Using a structured set of procedures, coders determined whether or not nine coercion-related behaviors occurred around the time of admission. Correlation and regression analyses were used to describe the predictors of patients' scores on the MacArthur Perceived Coercion Scale.

    RESULTS:The use of legal force, being given orders, threats, and "a show of force" were all strongly correlated with perceived coercion. A least squares regression accounted for 43.3% of the variance in perceived coercion. The evidence also suggested that force is typically only used in conjunction with less coercive pressures.

    CONCLUSIONS:Force and negative symbolic pressures, such as threats and giving orders about admission decisions, induce perceptions of coercion in persons with mental illness. Positive symbolic pressures, such as persuasion, do not induce perceptions of coercion. Such positive pressures should be tried in order to encourage admission before force or negative pressures are used.

    背景与目标: 目的 : 本研究的目的是确定什么预测了患者对精神病院住院的强迫观念。
    方法 : 对于171例,作者整合了来自患者访谈的数据,接受临床医生和其他参与患者精神科入院的个人的医疗记录数据。编码人员使用一组结构化的程序,确定在入院前后是否发生了九种与胁迫相关的行为。相关和回归分析用于描述麦克阿瑟感知胁迫量表上患者得分的预测因子。
    结果 : 使用法律武力,被命令,威胁,“武力表现” 都与感知到的胁迫密切相关。最小二乘回归解释了感知胁迫的43.3% 方差。证据还表明,武力通常仅与较小的胁迫压力一起使用。
    结论 : 武力和负面的象征性压力,例如威胁和下达有关入院决定的命令,会引起对精神疾病患者的胁迫感。积极的象征性压力,例如说服,不会引起人们对胁迫的看法。在使用力或负压之前,应尝试使用这种正压以鼓励进入。
  • 【补体胁迫的电生理相关性。】 复制标题 收藏 收藏
    DOI:10.1162/jocn.2009.21333 复制DOI
    作者列表:Kuperberg GR,Choi A,Cohn N,Paczynski M,Jackendoff R
    BACKGROUND & AIMS: :This study examined the electrophysiological correlates of complement coercion. ERPs were measured as participants read and made acceptability judgments about plausible coerced sentences, plausible noncoerced sentences, and highly implausible animacy-violated sentences ("The journalist began/wrote/astonished the article before his coffee break"). Relative to noncoerced complement nouns, the coerced nouns evoked an N400 effect. This effect was not modulated by the number of possible activities implied by the coerced nouns (e.g., began reading the article; began writing the article) and did not differ either in magnitude or scalp distribution from the N400 effect evoked by the animacy-violated complement nouns. We suggest that the N400 modulation to both coerced and animacy-violated complement nouns reflected different types of mismatches between the semantic restrictions of the verb and the semantic properties of the incoming complement noun. This is consistent with models holding that a verb's semantic argument structure is represented and stored at a distinct level from its syntactic argument structure. Unlike the coerced complement noun, the animacy-violated nouns also evoked a robust P600 effect, which may have been triggered by the judgments of the highly implausible (syntactically determined) meanings of the animacy-violated propositions. No additional ERP effects were seen in the coerced sentences until the sentence-final word that, relative to sentence-final words in the noncoerced sentences, evoked a sustained anteriorly distributed positivity. We suggest that this effect reflected delayed attempts to retrieve the specific event(s) implied by coerced complement nouns.
    背景与目标: : 这项研究检查了补体胁迫的电生理相关性。当参与者阅读并对合理的胁迫句子,合理的非胁迫句子以及高度令人难以置信的违反动画的句子做出可接受性判断时,对erp进行了衡量 (“记者在喝咖啡休息前开始/写/惊讶了这篇文章”)。相对于非强制补语名词,强制名词引起N400效应。这种效果不受强制名词所暗示的可能活动的数量的调节 (例如,开始阅读文章; 开始撰写文章),并且在幅度或头皮分布上与动画引起的N400效果没有差异-违反补体名词。我们建议,对强制和违反动画的补语名词的N400调制反映了动词的语义限制与传入补语名词的语义属性之间的不同类型的不匹配。这与模型一致,该模型认为动词的语义参数结构在与句法参数结构不同的层次上表示和存储。与强制补语名词不同,违反动画的名词还引起了强大的P600效果,这可能是由违反动画的命题的高度不可信 (语法确定) 含义的判断触发的。在强迫句子中没有看到其他ERP效果,直到句子-最后一个单词相对于非强迫句子中的句子-最后一个单词引起了持续的前向分布的积极性。我们建议这种效果反映了延迟尝试检索强制补语所隐含的特定事件的尝试。
  • 14 Subtle coercion in psychiatric practice. 复制标题 收藏 收藏

    【精神病实践中的微妙胁迫。】 复制标题 收藏 收藏
    DOI:10.1046/j.1365-2850.1998.00104.x 复制DOI
    作者列表:Lützén K
    BACKGROUND & AIMS: Making nursing decision for patients who cannot communicate their own wishes and needs is a common problem in psychiatric and mental health nursing. The aim of this article is to present the findings of a qualitative study focused on situations in which patients do not cooperate with a nursing decision about what should be done for them. The design of the study utilized some steps associated with the grounded theory method. Data were collected from unstructured interviews with 10 British nurses with long experience in psychiatric nursing. By implementing the strategy of constant comparative analysis of the transcribed interviews, it was found that nurses use different types of subtle coercion in order to achieve their own goals for the patient. These goals were justified as being in the best interest of the patient. The main components of subtle coercion are part of a process consisting ofassessing a patient's competency for self-choice; acting strategically; modifying the principle af autonomy; justifying strategies; and reflecting ethically on the action taken. The study indicates that further empirical investigation of clinical situations involving subtle coercion is required. Particular attention should be paid to organizational factors and how these contribute to the use of subtle coercion.

    背景与目标: 为无法传达自己的意愿和需求的患者做出护理决策是精神科和精神卫生护理中的常见问题。本文的目的是介绍一项定性研究的结果,该研究侧重于患者不配合护理决定应为他们做些什么的情况。研究的设计利用了与扎根理论方法相关的一些步骤。数据是从对10名在精神病护理方面具有长期经验的英国护士的非结构化访谈中收集的。通过实施对转录访谈进行持续比较分析的策略,发现护士使用不同类型的微妙胁迫来实现患者自己的目标。这些目标被认为符合患者的最大利益。微妙胁迫的主要组成部分是评估患者自我选择能力的过程的一部分; 战略行动; 修改自主原则; 合理的策略; 并从道德上反映所采取的行动。研究表明,需要对涉及微妙胁迫的临床情况进行进一步的实证研究。应特别注意组织因素以及这些因素如何有助于使用微妙的胁迫。
  • 【蚂蚁物种幼虫发育的社会胁迫。】 复制标题 收藏 收藏
    DOI:10.1007/s00114-016-1341-8 复制DOI
    作者列表:Villalta I,Amor F,Cerdá X,Boulay R
    BACKGROUND & AIMS: :Ants provide one of the best examples of the division of labor in animal societies. While the queens reproduce, workers generally refrain from laying eggs and dedicate themselves exclusively to domestic tasks. In many species, the small diploid larvae are bipotent and can develop either into workers or queens depending mostly on environmental cues. This generates a conflicting situation between the adults that tend to rear a majority of larvae into workers and the larvae whose individual interest may be to develop into reproductive queens. We tested the social regulation of larval caste fate in the fission-performing ant Aphaenogaster senilis. We first observed interactions between resident workers and queen- and worker-destined larvae in presence/absence of the queen. The results show that workers tend to specifically eliminate queen-destined larvae when the queen is present but not when she is absent or imprisoned in a small cage allowing for volatile pheromone exchanges. In addition, we found that the presence of already developed queen-destined larvae does not inhibit the development of younger still bipotent larvae into queens. Finally, we analyzed the cuticular hydrocarbon profiles of queen- and worker-destined larvae and found no significant quantitative or qualitative difference. Interestingly, the total amount of hydrocarbons on both larval castes is extremely low, which lends credence on the chemical insignificance hypothesis of larval ants. Overall, our results suggest that workers control larval development and police larvae that would develop into queens instead of workers. Such policing behavior is similar in many aspects to what is known of worker policing among adults.
    背景与目标: : 蚂蚁提供了动物社会分工的最好例子之一。在皇后繁殖的同时,工人通常不产卵,而专门从事家务。在许多物种中,小二倍体幼虫是双能的,主要取决于环境线索,它们可以发育成工人或皇后。这在成虫之间产生了矛盾的局面,成虫倾向于将大部分幼虫抚养成工人,而幼虫的个人兴趣可能是发展成为生殖皇后。我们在裂变性能的蚂蚁Aphaenogaster senilis中测试了幼虫种姓命运的社会调节。我们首先观察到在存在/不存在女王的情况下,常驻工人与女王和工人指定的幼虫之间的相互作用。结果表明,当女王存在时,工人倾向于专门消除女王指定的幼虫,但当她不在或被囚禁在一个小笼子中,以便进行挥发性信息素交换时,则不会。此外,我们发现已经发育的皇后幼虫的存在不会抑制年轻的仍然是双能幼虫向皇后的发育。最后,我们分析了女王和工人指定的幼虫的表皮碳氢化合物分布,没有发现明显的定量或定性差异。有趣的是,两种幼虫种姓上的碳氢化合物总量都非常低,这为幼虫蚂蚁的化学无意义假说提供了依据。总体而言,我们的结果表明,工人控制幼虫的发育,而警用幼虫会发育成皇后而不是工人。这种警务行为在许多方面与成年人中工人警务的已知相似。

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