Decision-Making and Management of Self-Care in Persons with Traumatic Spinal Cord Injuries: A Preliminary Study

Patients and physicians understand the importance of self-care following spinal cord injury (SCI), yet many individuals with SCI do not adhere to recommended self-care activities despite logistical supports. Neurobehavioral determinants of SCI self-care behavior, such as impulsivity, are not widely studied, yet understanding them could inform efforts to improve SCI self-care. We explored associations between impulsivity and self-care in an observational study of 35 US adults age 18 - 50 who had traumatic SCI with paraplegia at least six months before assessment. The primary outcome measure was self-reported self-care. In LASSO regression models that included all neurobehavioral measures and demographics as predictors of self-care, dispositional measures of greater impulsivity (negative urgency, lack of premeditation, lack of perseverance), and reduced mindfulness were associated with reduced self-care. Outcome (magnitude) sensitivity, a latent decision-making parameter derived from computationally modeling successive choices in a gambling task, was also associated with self-care behavior. These results are preliminary;more research is needed to demonstrate the utility of these findings in clinical settings. Information about associations between impulsivity and poor self-care in people with SCI could guide the development of interventions to improve SCI self-care and help patients with elevated risks related to self-care and secondary health conditions.

Research on the self-defence electronic jamming decision-making based on the discrete dynamic Bayesian network

The manner and conditions of running the decision-making system with self-defense electronic jamming are given. After proposing the scenario of applying discrete dynamic Bayesian network to the decision making with self-defense electronic jamming, a decision-making model with self-defense electronic jamming based on the discrete dynamic Bayesian network is established. Then jamming decision inferences by the aid of the algorithm of discrete dynamic Bayesian network are carried on. The simulating result shows that this method is able to synthesize different targets which are not predominant. In this way, various features at the same time, as well as the same feature appearing at different time complement mutually; in addition, the accuracy and reliability of electronic jamming decision making are enhanced significantly.

Decision-making competency, self-determination, and health lifestyle in nursing students

Introduction: This study identifies and analyzes the levels of relations between decision-making competency, self-determination, and health lifestyle in nursing students. Methods: This study was designed as a descriptive research to identify the relations of nursing students’ decision-making competency, self-determination, and health lifestyle. The subjects were 187 nursing students. Data were collected using a structured questionnaire and were analyzed by the IBM SPSS Statistics 19 program. Results: Decision-making competency of nursing students was 3.38 ± 0.41 points, and self-determination was 3.07 ± 0.38 points. Stress and physical exercise were the general and health-related lifestyle factors that contributed to the differences in decision-making competency. There were no differences in self-determination according to these factors. Conclusion: The results of the study showed that the levels of decision-making competency and self-determination in nursing students were moderate. Further studies are recommended for the development of these core abilities in nursing students.

Group training on the improvement of college students'career decision-making self-efficacy

A group training was conducted on 17 college students to improve their career decision-making self-efficacy (CDMSE). The result showed that there was significant difference between the pre-test and the post-test for the experimental group (n = 17), whereas no significant difference was found between the pre-test and the post- test for the control group (n = 17). In the pre-test, there was no significant difference between the experimental group and the control group, and obvious difference between the two groups was found in the post-test. This indicated that the group training was effective on improving the CDMSE of the college students whose scores of CDMSE were below 27% point of the total students.

The Impact of Simulation Education on Self-Efficacy in Pre-Registration Nursing Students

This literature review primarily aims to explore and synthesise the previous studies in simulation education research conducted over the past five years related to the effects of simulation training on the self-efficacy of undergraduate pre-registration nursing students. The second aim of this study is to explore additional outcome variables that were examined in the previous studies. Five electronic databases were searched systematically. These databases were MEDLINE, CINAHL Plus, Scopus, Embase and PsycINFO. The PICO model was employed to identify the search terms, with a thesaurus being used to provide synonyms. Reference lists of relevant articles were examined and hand searches of journals were also undertaken. The quality of each study was assessed using the Simulation Research Rubric (SRR). A total of 11 studies were included. All studies explored the impact of simulation education on undergraduate pre-registration nursing. Six studies explored nursing students’ competence and performance and two papers examined their critical thinking. Problem solving, learning motivation, communication skills and knowledge acquisition were examined once. The majority of studies indicated that simulation training has a positive impact on pre-registration nursing students’ self-efficacy and other outcome variables. Furthermore, the study results indicate that simulation training is more dependable than traditional training, and students were extremely satisfied with the simulation training. However, most of the studies included in this review had several gaps, including study design, sample size and dissimilarities between the scales used. Further research with large samples, reliable and valid instruments, and outcomes measures (such as critical thinking and transferability of skills) is required to provide better insight into the effectiveness of simulation in undergraduate nursing education. .

群体决策可靠性的分层反馈与多级度量

为了提高群体决策质量,获得更加可靠的决策结果,结合语言环境下考虑专家自信度的异构多属性群决策问题,建立了群体决策可靠性的分层反馈机制与多级度量模型。利用三支决策思想将各方案各属性下对应子群体中的专家按照自信度的高、中、低划分成三类,进而,依次从子群体的专家构成、自信度以及共识度3个层次对决策可靠性进行量化分析,建立由粗到细、逐层细化的反馈机制,为决策过程的可靠性调整和控制提供途径;综合考虑子群体中高、中自信度专家的占比以及自信度和共识度等影响因素,构建多级可靠性度量模型,并形成针对方案级决策和整体决策的两级可靠性判定规则,有效提升决策结果的可解释性。在此基础上,提出一种可靠性驱动的异构多属性群决策方法,通过供应商选择实例分析并验证了所提方法的可行性和有效性。

护理本科实习生自我效能和职业认同在转型冲击与职业决策困难间的链式中介效应

目的 探讨护理本科实习生自我效能和职业认同在转型冲击与职业决策困难间的中介作用。方法 2022年12月—2023年3月采用方便抽样法,采用护理本科实习生转型冲击评价量表、一般自我效能感量表、护生职业认同问卷、职业决策困难问卷对来自北京市、山东省、河南省13所高校的365名护理本科实习生进行问卷调查。结果 护理本科实习生的职业决策困难得分为(37.85±9.37)分。自我效能、职业认同在转型冲击与职业决策困难之间起中介作用,包括自我效能的独立中介效应(效应值0.145)、职业认同的独立中介效应(效应值0.171)、自我效能—职业认同的链式中介效应(效应值0.048)。结论 护理本科实习生转型冲击通过自我效能和职业认同间接对职业决策困难发挥作用。护理教育者可通过降低护理本科实习生的转型冲击,提高其自我效能和职业认同,从而减轻实习生的职业决策困难。

新高考改革选科的自我—他人决策差异:责任感的中介作用

以X省Y市4所普通高中的883名高一学生为对象,考察新高考改革选科中是否存在自我—他人决策差异,以及责任感在这一差异中所起的作用。研究发现:新高考改革选科中存在自我—他人决策差异,责任感在这一差异中起着中介作用;相较于为自我选科,学生为他人选科时感知到的责任感较小,更倾向于为他人选择高兴趣—高难度的科目;学生自我选科时感知到的责任感较大,更倾向于为自己选择低兴趣—低难度的科目。因此,社会各界尤其是学校和家长应深入了解高中生选科现状,树立“远景性”的选科导向,重视学生兴趣与潜能的发掘;科学认识选科责任,各方协同,助力学生合理选科;正视自我—他人选科差异,聚力优化选科决策。

非小细胞肺癌患者决策自我效能现状及其相关影响因素分析

目的:探析非小细胞肺癌患者决策自我效能现状,并分析相关影响因素。方法:选取2020年1月—2022年8月九江市第一人民医院收治的80例非小细胞肺癌患者作为研究对象,采用中文版决策自我效能量表评估患者决策自我效能,详细统计所有患者的临床资料,调查并对比患者相关资料,将可能的因素纳入,采用线性回归分析非小细胞肺癌患者决策自我效能的相关影响因素。结果:经评估,80例非小细胞肺癌患者决策自我效能得分范围为50~79分,平均得分(62.50±7.50)分;经线性回归分析结果显示,文化程度、家庭月收入、社会支持以及希望水平是非小细胞肺癌患者决策自我效能的影响因素,差异有统计学意义(t=4.627、-3.386、4.679、-3.956,P<0.05)。结论:非小细胞肺癌患者决策自我效能总体处于中等水平,文化程度、家庭月收入、社会支持以及希望水平是其重要的影响因素。

高校毕业生未来时间洞察力对求职行为的影响——基于职业规划能力和职业决策自我效能感的作用机制

以天津市高校毕业生为例,实证分析了未来时间洞察力、职业决策自我效能感、职业规划能力与毕业生求职行为的关系。研究表明:高校毕业生的未来时间洞察力、职业决策自我效能感、职业规划能力、求职行为之间两两显著正相关。高校毕业生未来时间洞察力可以直接预测求职行为,也可以通过职业决策自我效能感的中介作用间接影响求职行为,职业规划能力在其中有负向调节作用。

中青年糖尿病患者共享决策现状及影响因素的路径分析

目的探究中青年糖尿病患者共享决策现状、影响因素及作用路径,为患者共享决策研究和干预提供参考。方法采用一般资料调查表、领悟社会支持量表、决策自我效能量表、电子健康素养量表、简易版疾病感知问卷及共享决策问卷对215例中青年糖尿病患者进行调查。利用结构方程模型分析共享决策影响因素及作用路径。结果中青年糖尿病患者共享决策得分为85.36±13.23,疾病感知、电子健康素养、领悟社会支持、决策自我效能是患者共享决策的影响因素,直接效应分别为-0.345、0.280、0.274、0.163(均P<0.05)。疾病感知、电子健康素养、领悟社会支持分别通过决策自我效能间接影响共享决策(均P<0.05)。结论中青年糖尿病患者共享决策水平处于中等偏上水平,患者决策自我效能可直接影响共享决策,也可发挥间接效应影响共享决策水平。降低患者负性疾病感知,提高其电子健康素养、领悟社会支持、决策自我效能水平能提高患者共享决策参与度。

高职护生职业认同的影响因素分析

目的:了解高职护生职业认同现状,分析共情、职业决策自我效能和职业认同的关系,为提升高职护生职业认同提供对策和依据。方法:采用一般资料调查表、护生共情量表、大学生职业决策自我效能感量表和护生职业认同问卷,对1269名高职护生进行问卷调查。分析高职护生职业认同的影响因素及高职护生共情、职业决策自我效能和职业认同的相关关系。结果:单因素分析显示,不同性别、年级、家庭氛围、与同学关系、与老师关系、学习状态、学习成绩和护理是否第一专业的高职护生职业认同得分差异均有统计学意义(P<0.01)。Pearson相关分析显示,高职护生共情各维度得分及总分与职业认同总分均呈明显正相关关系(P<0.01),高职护生职业决策自我效能各维度得分及总分与职业认同总分均呈明显正相关关系(P<0.01)。多元线性回归分析显示,高职护生职业认同从大到小的影响因素依次为职业决策自我效能、学习状态、护理是否第一志愿、共情和与老师关系(P<0.05~P<0.01)。结论:高职护生的共情能力越强,职业决策自我效能感越高,职业认同程度越高。高职护生的职业认同有待加强,学校管理者和护理教育者应意识到职业认同的重要性,采取有针对性的干预措施提升高职护生的职业认同感,稳定护理队伍。

某三甲儿童医院重症患儿照顾者决策疲劳现状及影响因素分析

目的调查某三甲儿童医院重症患儿照顾者决策疲劳现状,并分析其影响因素。方法采用便利抽样法,于2022年6月-2023年6月选取在儿童重症监护室(pediatric intensive care unit,PICU)住院治疗的118例重症患儿的照顾者作为研究对象,采用一般资料调查表、决策疲劳量表、家庭成员决策自我效能量表对其进行调查。结果该组重症患儿照顾者决策疲劳量表得分为(12.16±3.81)分,决策疲劳量表得分与家庭成员决策自我效能量表得分呈负相关(r=-0.882,P=0.012)。多元线性回归分析结果显示,重症患儿照顾者性别、患儿入住PICU天数、家庭平均月收入、决策自我效能是患儿照顾者决策疲劳的独立影响因素(R^(2)=0.952,_(△)R^(2)=0.902,F=16.819,P<0.001)。结论PICU重症患儿照顾者决策疲劳处于中等水平,医护人员应重点关注女性、家庭平均月收入低、患儿入住PICU时间长、决策自我效能水平低的患儿照顾者,及时向照顾者提供重症患儿病情、治疗方案、预后等信息,加强其心理支持,提升照顾者决策自我效能,从而降低其决策疲劳水平。

医护患共同决策模式在甲状腺癌手术患者中的应用

目的:探讨医护患共同决策模式在甲状腺癌手术患者中的应用效果。方法:选取2022年1月1日~2023年4月1日行甲状腺癌手术的158例患者随机分为对照组和研究组各79例,对照组给予常规护理干预,研究组给予医护患共同决策模式。比较两组干预前后焦虑自评量表(SAS)评分、抑郁自评量表(SDS)评分、一般自我效能感量表(GSES)评分、简易应对方式问卷(SCSQ)评分、健康信念评分、中文版癌症治疗功能评价系统量表(FACT-G)评分、护理满意度。结果:干预后,两组SAS、SDS评分均低于干预前(P<0.05),且研究组低于对照组(P<0.01);干预后,两组GSES评分高于干预前(P<0.05),且研究组高于对照组(P<0.01);干预后,两组SCSQ中积极应对评分高于干预前(P<0.05),消极应对评分低于干预前(P<0.05),且研究组优于对照组(P<0.01);干预后,两组健康信念、FACT-G评分均高于干预前(P<0.05),且研究组高于对照组(P<0.01);研究组护理满意度高于对照组(P<0.05)。结论:将医护患共同决策模式应用于甲状腺癌手术患者,可有效缓解其负性情绪,提高自我效能感,使患者积极应对疾病,提高健康信念、生活质量和护理满意度。

医疗决策中患者自主决定权的困境、冲突与破解

在当前的医疗决策中,患者自主决定权行使依旧存在障碍,梳理其历史源流,造成这一现状的原因主要包括来自家庭主义文化、医事父权主义的影响,行为能力制度和监护制度对其的束缚。在此背景下,对“能够享有决定权的关键是具有理性”的观点予以批判,并呼吁患者自治理念的回归,达成与他人代理决策权、医生特殊干预权的协调,建议通过以医疗决定能力来代替行为能力、要求根据实际评估医疗决定能力、建立预先医疗指示体系、明确医疗特殊干预权边界等措施来建构化解冲突的法律体系。

合作-竞争混合型多智能体系统的虚拟遗憾优势自博弈方法

合作-竞争混合型多智能体系统由受控的目标智能体和不受控的外部智能体组成.目标智能体之间互相合作,同外部智能体展开竞争,应对环境和外部智能体的动态变化,最终完成指定的任务.针对如何训练目标智能体使他们获得完成任务的最优策略的问题,现有工作从两个方面展开:(1)仅关注目标智能体间的合作,将外部智能体视为环境的一部分,利用多智能体强化学习来训练目标智能体.这种方法难以应对外部智能体策略未知或者动态改变的情况;(2)仅关注目标智能体和外部智能体间的竞争,将竞争建模为双人博弈,采用自博弈的方法训练目标智能体.这种方法主要针对单个目标智能体和单个外部智能体的情况,难以扩展到由多个目标智能体和多个外部智能体组成的系统中.结合这两类研究,提出一种基于虚拟遗憾优势的自博弈方法.具体地,首先以虚拟遗憾最小化和虚拟多智能体策略梯度为基础,设计虚拟遗憾优势策略梯度方法,使目标智能体能更准确地更新策略;然后,引入模仿学习,以外部智能体的历史决策轨迹作为示教数据,模仿外部智能体的策略,显式地建模外部智能体的行为,来应对自博弈过程中外部智能体策略的动态变化;最后,以虚拟遗憾优势策略梯度和外部智能体行为建模为基础,设计一种自博弈训练方法,该方法能够在外部智能体策略未知或者动态变化的情况下,为多个目标智能体训练出最优的联合策略.以协同电磁对抗为研究案例,设计具有合作-竞争混合特征的3个典型任务.实验结果表明,同其他方法相比,所提方法在自博弈效果方面有至少78%的提升.

人机协同调节:复合脑视角下自我调节学习的新路径

以ChatGPT为代表的生成式人工智能的出现,使人工智能与人类智能之间实现群智联结,形成人机协同的“复合脑”思维。研究在梳理自我调节学习内涵与过程的基础上,聚焦复合脑对自我调节学习的赋能作用,阐述了复合脑支撑自我调节学习的三个层次,即数据支持下协同记录的“数脑”、数据关联下协同分析的“汇脑”、数据赋能下协同决策的“智脑”;剖析了复合脑赋能自我调节学习的“协同判断—协同调整—协同决定”三个过程。最后,基于内外脑决策自主度的变化,提出了共同调节、共享调节、复合调节三种典型样态,支持学习者不断强化主体责任、构建适应未来的复合脑,形成面向未来的高质量学习力。

卵巢癌病人决策困境与自我感受负担及生命意义感的相关性

目的:调查卵巢癌病人决策困境现状,并探讨其与自我感受负担及生命意义感的相关性。方法:采用便利抽样法,2021年1月—2023年6月选取福建省某三级甲等肿瘤医院227例卵巢癌病人作为研究对象,采用一般资料调查表、中文版决策困境量表、自我感受负担量表、生命意义感量表进行调查。结果:227例卵巢癌病人决策困境得分为(34.05±9.64)分,自我感受负担得分为(61.43±14.76)分,生命意义感得分为(40.64±11.33)分。Pearson相关分析结果显示,卵巢癌病人决策困境水平与自我感受负担呈正相关(r=0.884,P<0.05),与生命意义感呈负相关(r=-0.613,P<0.05)。自我感受负担、生命意义感、年龄、文化程度、婚姻状况、人均月收入均是影响卵巢癌病人决策困境的独立因素。结论:卵巢癌病人决策困境处于中等水平,且受自我感受负担及生命意义感影响。临床护理人员应采取相应对策降低其决策困境。