Client-centered Research Articles

Social-Emotional Profiles of Preschool Children: An Investigation of Demographic Disparities and Intersectionality.

This study aims to enhance our understanding of the diverse nature of social-emotional development and explore the demographic disparities and intersectionality of social determinants among children, with an emphasis on underserved populations of children in low-resource environments. Young children living in low-income families are exposed to a wide array of social and systemic risks that increase the propensity for poor learning and social-emotional development. Using data from the Head Start Family and Childhood Experiences Survey (FACES, this study focuses on the social-emotional development of a nationally representative sample of young children enrolled in the Head Start program (n = 1921, 50.18% male). Employing a person-centered approach, we assessed teacher-rated social-emotional competence, including approach to learning, social cooperation, aggression, hyperactivity, and anxiety/depression/withdrawal, to classify young children's social-emotional development. This study identified four distinct social-emotional profiles-Adaptive, Average, Moderate Risk, and High Risk-through latent profile analysis. Furthermore, multinomial regression analysis revealed demographic disparities within each social-emotional profile, and significant intersectionality was found between race/ethnicity, age, and disability status in the social-emotional profiles. This research provides valuable insights for better supporting each child's unique needs.

Integrating Sexual and Reproductive Health Equity Into Public Health Goals and Metrics: Comparative Analysis of Healthy People 2030's Approach and a Person-Centered Approach to Contraceptive Access Using Population-Based Data.

The Healthy People initiative is a national effort to lay out public health goals in the United States every decade. In its latest iteration, Healthy People 2030, key goals related to contraception focus on increasing the use of effective birth control (contraceptive methods classified as most or moderately effective for pregnancy prevention) among women at risk of unintended pregnancy. This narrow focus is misaligned with sexual and reproductive health equity, which recognizes that individuals' self-defined contraceptive needs are critical for monitoring contraceptive access and designing policy and programmatic strategies to increase access. We aimed to compare 2 population-level metrics of contraceptive access: a conventional metric, use of contraceptive methods considered most or moderately effective for pregnancy prevention among those considered at risk of unintended pregnancy (approximating the Healthy People 2030 approach), and a person-centered metric, use of preferred contraceptive method among current and prospective contraceptive users. We used nationally representative data collected in 2022 to construct the 2 metrics of contraceptive access; the overall sample included individuals assigned female at birth not using female sterilization or otherwise infecund and who were not pregnant or trying to become pregnant (unweighted N=2760; population estimate: 43.9 million). We conducted a comparative analysis to examine the convergence and divergence of the metrics by examining whether individuals met the inclusion criteria for the denominators of both metrics, neither metric, only the conventional metric, or only the person-centered metric. Comparing the 2 approaches to measuring contraceptive access, we found that 79% of respondents were either included in or excluded from both metrics (reflecting that the metrics converged when individuals were treated the same by both). The remaining 21% represented divergence in the metrics, with an estimated 5.7 million individuals who did not want to use contraception included only in the conventional metric denominator and an estimated 3.5 million individuals who were using or wanted to use contraception but had never had penile-vaginal sex included only in the person-centered metric denominator. Among those included only in the conventional metric, 100% were content nonusers-individuals who were not using contraception, nor did they want to. Among those included only in the person-centered metric, 68% were currently using contraception. Despite their current or desired contraceptive use, these individuals were excluded from the conventional metric because they had never had penile-vaginal sex. Our analysis highlights that a frequently used metric of contraceptive access misses the needs of millions of people by simultaneously including content nonusers and excluding those who are using or want to use contraception who have never had sex. Documenting and quantifying the gap between current approaches to assessing contraceptive access and more person-centered ones helps clearly identify where programmatic and policy efforts should focus going forward.

Stress dimensions, patterns of coping, and psychopathological risk among nurses: a person-centred approach

BackgroundNurses are increasingly demanded to achieve gold-standards of care with fewer resources. Dealing effectively with stress experienced in their daily-work-life is thus crucial. This study is based on the Demands-Resources-and-Individual-Effects (DRIVE) Nurses Model and applied the person-centred approach with a twofold objective: 1. to identify patterns of coping strategies (Problem-Focused; Seek-Advice; Self-Blame; Wishful-Thinking; Escape/Avoidance) adopted by nurses to deal with perceived stress; 2. to explore potential differences in perceived Demands (Effort), Resources (Rewards, Job-Control, Social-Support), and Psychopathological Symptoms (Anxiety, Phobic-Anxiety, Obsessive–Compulsive, Somatization, Depression, Interpersonal-Sensitivity, Hostility, Psychoticism, Paranoid-Ideation) according to the emerged patterns.MethodThis cross-sectional study was reported by using the STROBE Checklist. Overall, 265 nursing professionals completed self-report measures. Non-hierarchical k-means-cluster-analysis was employed to derive patterns of coping. MANOVAs were used to test differences in Demands, Resources, and Psychopathological Symptoms according to the emerged patterns.ResultsThree stable and meaningful patterns of coping were identified and labelled as Active/Solution-Oriented, Dysregulated/Emotion-focused, and Passive/Disengaged. Nurses belonging to Dysregulated/Emotion-focused group emerged to be at higher risk (higher effort/psychopathological suffering; lower resources) – followed by Passive/Disengaged group – in comparison with nurses belonging to Active/Solution-Oriented group.ConclusionFostering nurses’ awareness of their latent coping patterns and supporting active approaches/emotional regulation strategies for stress management should represent a key goal when defining interventions promoting nurses’ health within/beyond the healthcare settings.

How virtue, competence, and dominance conjointly shape status attainment at work: Integrating person-centered and variable-centered approaches.

Status researchers have recognized virtue, competence, and dominance as distinct, viable routes to attaining status. While acknowledging that these routes could be compatible and may not operate independently, prior research relying on a variable-centered perspective has largely neglected their potentially complex interactions. This article integrates a person-centered perspective with the variable-centered perspective to explore how different routes conjointly shape workplace status. Study 1A (N = 537) employs latent profile analysis, an inductive person-centered method, to re-analyze existing survey data, identifying seven distinct profiles of virtue, competence, and dominance that people use to attain status. Study 1B (N = 988) confirms the existence of these profiles in an independent sample of full-time U.S. workers, albeit with nuanced differences in levels. Across our initial studies, these profiles differ in status attainment, with a profile characterized by high virtue and competence but low dominance associated with the highest status-a key discovery challenging to uncover using the variable-centered approach alone. Study 2 (N = 792), a preregistered experiment manipulating the three routes in hypothetical scenarios, gathers causal evidence confirming these profiles' varying effectiveness. Study 3 (N = 785), another preregistered experiment using refined manipulations, corroborates the findings of Study 2 and provides evidence for the relevance of these causal insights to real-life workplace contexts. This research has several crucial implications: reaching the top requires a combination of multiple routes; conflating virtue and competence under the umbrella of "prestige" obscures their unique contributions; and dominance's positive effect on status is not universally applicable. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

Capturing the Heterogeneity of Word Learners by Analyzing Persons.

Accurately capturing children's word learning abilities is critical for advancing our understanding of language development. Researchers have demonstrated that utilizing more complex statistical methods, such as mixed-effects regression and hierarchical linear modeling, can lead to a more complete understanding of the variability observed within children's word learning abilities. In the current paper, we demonstrate how a person-centered approach to data analysis can provide additional insights into the heterogeneity of word learning ability among children while also aiding researchers' efforts to draw individual-level conclusions. Using previously published data with 32 typically developing and 32 late-talking infants who completed a novel noun generalization (NNG) task to assess word learning biases (i.e., shape and material biases), we compare this person-centered method to three traditional statistical approaches: (1) a t-test against chance, (2) an analysis of variance (ANOVA), and (3) a mixed-effects regression. With each comparison, we present a novel question raised by the person-centered approach and show how results from the corresponding analyses can lead to greater nuance in our understanding of children's word learning capabilities. Person-centered methods, then, are shown to be valuable tools that should be added to the growing body of sophisticated statistical procedures used by modern researchers.

Ethnic socialisation profiles and depression among ethnic minority adolescents in China: a person-centred approach

BackgroundEthnic socialisation plays a vital role in the development of ethnic minority adolescents. However, the generalizability of research findings beyond the context of immigrant societies in the United States remains unclear.MethodsUtilising a person-centred approach, this study analysed a sample of 2,600 ethnic minority adolescents in China (55.8% female, Mage = 14.93 ± 1.82) to explore ethnic socialisation patterns, and their correlations with depression.ResultsLatent profile analysis revealed four distinct ethnic socialisation profiles: low-frequency, moderate-frequency, high-frequency and proactive integration orientation. Adolescents with the high-frequency profile displayed the highest levels of depression, followed by those with the moderate-frequency profile, whereas adolescents with the low-frequency and proactive integration orientation profiles showed a lower risk of depression.ConclusionsWithin the sociocultural context of China, ethnic minority families’ ethnic socialisation practices demonstrate unique characteristics. Various ethnic socialisation messages are integrated in diverse patterns to exert influence on adolescents.

Naturalistic patterns of sustained attention across early childhood: Developmental profiles and longitudinal associations with executive functions.

The capacity to sustain attention over time develops rapidly over early childhood and is associated with socioemotional and cognitive outcomes. However, sustained attention has largely been studied in either shared or independent contexts, leading to gaps in our understanding of how trade-offs between sustained attention to shared versus individual targets may predict later outcomes. We examined this question in a longitudinal sample of 1,290 children (49% female, 43% Black), living in predominately rural, low-income regions, using a naturalistic shared picture book reading task. Children's sustained attention to individual relative to shared targets during the book reading task was measured at 24 and 35 months. Using latent profile analysis, we identified four developmental profiles of children's attentional trajectories: three of the profiles differed in the extent that children' attention shifted toward more socially directed relative to individually directed attention; a fourth profile showed atypical decreases in both socially directed and individually directed attention across development. Importantly, heterogeneity in children's attentional profiles were associated with differences in executive functions at 48 months of age. Specifically, children who showed greater relative increases in socially directed attention had higher executive functions performance, whereas children with atypical decreases in attention showed substantial deficits in this domain. These findings reveal distinct longitudinal patterns of sustained attention in naturalistic contexts and show that heterogeneity in these patterns are robust predictors of subsequent executive functions. This person-centered approach provides novel insights into how quantitative and qualitative changes in attention may impact executive functions development and may help identify children at risk for nonnormative trajectories. (PsycInfo Database Record (c) 2024 APA, all rights reserved).

“They made me feel like I mattered”: a qualitative study of how mobile crisis teams can support people experiencing homelessness

BackgroundMobile crisis teams (MCTs) can be important alternatives to emergency medical services or law enforcement for low-acuity 911 calls. MCTs address crises by de-escalating non-violent situations related to mental health or substance use disorders and concurrent social needs, which are common among people experiencing homelessness (PEH). We sought to explore how an MCT in one city served the needs and supported the long- and short-term goals of PEH who had recently received MCT services.MethodsWe conducted 20 semi-structured interviews with service recipients of the Street Crisis Response Team, a new 911-dispatched MCT implemented in San Francisco in November 2020. In the weeks after their encounter, we interviewed respondents about their overall MCT experience and comparisons to similar services, including perceived facilitators and barriers to the respondent’s self-defined life goals. We analyzed interview transcripts with thematic analysis to capture salient themes emerging from the text and organized within a social-ecological model.ResultsNearly all respondents preferred the MCT model over traditional first responders, highlighting the team’s person-centered approach. Respondents described the MCT model as effectively addressing their most immediate needs (e.g., food), short-term relief from the demands of homelessness, acute mental health or substance use symptoms, and immediate emotional support. However, systemwide resource constraints limited the ability of the team to effectively address longer-term factors that drive crises, such as solutions to inadequate quality and capacity of current housing and healthcare systems and social services navigation.ConclusionsIn this study, respondents perceived this MCT model as a desirable alternative to law enforcement and other first responders while satisfying immediate survival needs. To improve MCT’s effectiveness for PEH, these teams could collaborate with follow-up providers capable of linking clients to resources and services that can meet their long-term needs. However, these teams may not be able to meaningfully impact the longstanding and complex issues that precipitate crises among PEH in the absence of structural changes to upstream drivers of homelessness and fragmentation of care systems.

Supplemental Material for How Virtue, Competence, and Dominance Conjointly Shape Status Attainment at Work: Integrating Person-Centered and Variable-Centered Approaches

Supplemental Material for How Virtue, Competence, and Dominance Conjointly Shape Status Attainment at Work: Integrating Person-Centered and Variable-Centered Approaches

Daily life without cranial bone protection while awaiting cranioplasty: a qualitative study

PurposeDecompressive craniectomy is occasionally performed as a life-saving neurosurgical intervention in patients with acute severe brain injury to reduce refractory intracranial hypertension. Subsequently, cranioplasty (CP) is performed to repair the skull defect. In the meantime, patients are living without cranial bone protection, and little is known about their daily life. This study accordingly explored daily life among patients living without cranial bone protection after decompressive craniectomy while awaiting CP.MethodsA multiple-case study examined six purposively sampled patients, patients’ family members, and healthcare staff. The participants were interviewed and the data were analyzed using qualitative content analysis.ResultsThe cross-case analysis identified five categories: “Adapting to new ways of living,” “Constant awareness of the absence of cranial bone protection,” “Managing daily life requires available staff with adequate qualifications,” “Impact of daily life depends on the degree of recovery,” and “Daily life stuck in limbo while awaiting cranioplasty.” The patients living without cranial bone protection coped with daily life by developing new habits and routines, but the absence of cranial bone protection also entailed inconveniences and limitations, particularly among the patients with greater independence in their everyday living. Time spent awaiting CP was experienced as being in limbo, and uncertainty regarding planning was perceived as frustrating.ConclusionThe results indicate a vulnerable group of patients with brain damage and communication impairments struggling to find new routines during a waiting period experienced as being in limbo. Making this period safe and reducing some problems in daily life for those living without cranial bone protection calls for a person-centered approach to care involving providing contact information for the correct healthcare institution and individually planned scheduling for CP.

Understanding the relations between achievement goals and self-regulated learning: a multiple goal perspective

The primary objective was to investigate the relations between college students’ achievement goals and their engagement in self-regulated learning using a person-centered approach. College students (N = 364) completed surveys that assessed mindset, self-efficacy, anxiety, achievement goals, and self-regulated learning. Latent profile analyses identified three types of achievement goal profiles: high all, high approach, and low performance. Results showed that self-efficacy and anxiety were significantly associated with the achievement goal profiles. Students who reported high levels of self-efficacy but low levels of anxiety were more likely to endorse the high approach profile. In addition, we found significant mean-level differences across the achievement goal profiles for students’ reported engagement in self-regulated learning concurrently (time management, procrastination) and later in the semester (motivational regulation, environment management). Students in the high approach profile demonstrated the most adaptive pattern of self-regulated learning. Overall, findings provide support for a multiple goal perspective that endorsing both mastery-approach and performance-approach goals can be beneficial.

Rethinking professional boundaries: the climate crisis and brain health.

Since climate change affects psychiatric, neurological and neuropsychological disorders, as well as brain development, the Irish Doctors for the Environment working group on mental health has changed its title and remit to brain health. Mental health professionals need to respond coherently and effectively to the climate crisis. This need challenges traditional professional, disciplinary and academic boundaries and demands a holistic, person-centred approach. We propose that meeting this challenge is vital if the public, policy-makers and legislators are to grasp the full extent of the significance of climate's impact on brain health.

Attributions for failure and success at primary school: a person-centered approach to causal dimensions

Over the past fifty years, extensive research has examined the influence of causal attributions on cognitions, emotions, and behaviours in educational contexts. However, these studies often relied on inferences about dimensional properties of attributions, and not on students’ perceptions of them. This study innovates by directly assessing these perceptions to identify students’ attributional profiles. 410 French elementary students were randomly assigned to a success or a failure condition and reported their perceptions of their attribution on the locus of causality, stability, and controllability dimensions. Latent profiles analyses (LPA) identified three attributional profiles for both students in the failure condition (‘Hopeless’, ‘Negligent’ and ‘Unsure’), and the success condition (‘Competent’, ‘Industrious’, and ‘Dependent’). LPA also revealed associations between certain profiles and cognitive, emotional and behavioural outcomes, highlighting the relevance of combining direct assessment of causal dimensions and LPA when studying attributions for success and failure and their consequences.

Evidence for motivational interviewing in educational settings among medical schools: a scoping review

BackgroundMotivational interviewing (MI) is a person-centred approach focused on empowering and motivating individuals for behavioural change. Medical students can utilize MI in patient education to engage with patients’ chronic health ailments and maladaptive behaviours. A current scoping review was conducted to 1) determine the types of MI (conventional, adapted, brief and group MI) education programs in medical schools, delivery modalities and teaching methods used; 2) classify educational outcomes on the basis of Kirkpatrick’s hierarchy; and 3) determine the key elements of MI education via the FRAMES (feedback, responsibility, advice, menu of options, empathy, self-efficacy) model.MethodsThis scoping review was conducted via the framework outlined by Arksey and O’Malley. Two online databases, CINAHL and MEDLINE Complete, were searched to identify MI interventions in medical education. Further articles were selected from bibliography lists and the Google Scholar search engine.ResultsFrom an initial yield of 2019 articles, 19 articles were included. First, there appears to be a bimodal distribution of most articles published between the two time periods of 2004--2008 and 2019--2023. Second, all the studies included in this review did not use conventional MI but instead utilized a variety of MI adaptation techniques. Third, most studies used face-to-face training in MI, whereas only one study used online delivery. Fourth, most studies have used a variety of interactive experiences to teach MI. Next, all studies reported outcomes at Kirkpatrick’s Level 2, but only 4 studies reported outcomes at Kirkpatrick’s Level 3. According to the FRAMES model, all studies (n=19; 100%) reported the elements of responsibility and advice. The element that was reported the least was self-efficacy (n = 12; 63.1%).ConclusionOur findings suggest that motivational interviewing can be taught effectively in medical schools via adaptations to MI and a variety of teaching approaches. However, there is a need for further research investigating standardized MI training across medical schools, the adequate dose for training in MI and the implementation of reflective practices. Future studies may benefit from exploring and better understanding the relationship between MI and self-efficacy in their MI interventions.

Illness experience and (unmet) needs of women with Mayer-Rokitansky-Küster-Hauser Syndrome (MRKH): a qualitative analysis of an online forum

Objective Mayer-Rokitansky-Küster-Hauser syndrome (MRKH) is a congenital condition characterized by the underdevelopment or complete absence of the uterus and the upper part of the vagina. Diagnosis is commonly made during adolescence, a sensitive period for psychophysical development, following the absence of menstruation. Having MRKH syndrome can have a profound and multifaceted psychosocial impact that characterizes these women’s subjective experiences, although it continues to be qualitatively understudied. This article explores the lived experience of women with MRKH spontaneously recounted on an online support forum. The aim was to gain insight into the features of the syndrome experience to understand deeply the emotional and social impact of the condition and the individual needs expressed online. Methods Using a naturalistic observation stance, data was collected from an online support forum for MRKH women and systematically analyzed using thematic analysis. Results Four main interconnected themes are identified: the impact of being diagnosed with MRKH, the difficult interaction with the medical environment, challenging social relationships, and the unmet needs of MRKH women. Conclusion A multidisciplinary and person-centered approach that provides effective and sensitive management of the condition and its psychosocial implications, is essential. Recommendations for future research and practical clinical implications for healthcare professionals are proposed.

Two decades of the International Classification of Functioning, Disability and Health (ICF) in health research: a bibliometric analysis

Introduction: We conducted a twenty-year bibliometric analysis of scientific literature, focusing on the trends of The International Classification of Functioning, Disability and Health (ICF) use in health research. Methods: We retrieved 3’467 documents published between 2002 and 2022, sourced from the Web of Science Core Collection database. We used the Bibliometrix and VoSviewer tools for descriptive analyses and data visualization. Results: Our findings indicate a significant increase in ICF application since 2011, with an average annual growth rate of 13.19%. Prominent contributions were observed globally, with notable outputs from the U.S., Canada, Germany, the Netherlands, and Switzerland. The Ludwig Maximilian University Munich, Swiss Paraplegic Research, and McMaster University authored a quarter of the documents (24.6%). Collaboration networks of countries and institutions revealed robust partnerships, particularly between Germany and Switzerland. "Rehabilitation" was the most frequently occurring keyword, although a thematic shift towards epidemiology, aging, and health-related quality of life was observed post-2020. While rehabilitation remained the primary thematic focus, literature post-2020 highlighted epidemiology as a growing area of interest. Conclusions: A steady increase in ICF-based research mirrors the rising interest in a biopsychosocial and person-centered approach to healthcare. However, the literature is primarily produced by high-resource countries, with underrepresentation from low and middle-resource countries, suggesting an area of future research to address this discrepancy.

The Effectiveness of Person-Centered Therapy in Individual Counseling for Adolescents Experiencing Trauma from Romantic Relationships

The Effectiveness of Person-Centered Therapy in Individual Counseling for Adolescents Experiencing Trauma from Romantic Relationships

Unlocking the benefits of montessori-based reading activities in nursing home: A multiple baseline study on groups of individuals with severe dementia.

Group activities are commonly offered to residents of nursing homes, and increasingly with a person-centred care approach. The aim of this study is to compare the impacts of a Montessori-based reading activity with a more traditional reading activity. A multiple baseline design was used, with 3 groups of 5 older adults with moderate to severe dementia. All sessions were videorecorded and analysed by independent judges, blinded to our hypotheses and conditions. Impacts of the type of activity (storytelling or Montessori-based reading) on verbal interactions, engagement level, affect and behavioural aspects were estimated with both visual analyses and statistical analyses using the between-case standardised mean differences method. Significant differences were found in favour of the Montessori-based activities with regard to the number of verbal interactions, constructive and passive engagement and positive affect expressed, with moderate to large effect size (from 0.46 to 1.66). The Montessori-based reading group activity really seems to be preferable to a more traditional storytelling activity, with multiple benefits for residents. Depending on the preserved abilities and interests of the participants, it can also be aimed at people with severe dementia.

Understanding Romantic Relational Aggression in Emerging Adults Using Latent Profile Analysis of Jealousy and Hostile Attribution Bias.

The present study sought to identify profiles of 753 emerging adults (62.5% females) with different levels of hostile attribution bias (HAB) and jealousy dimensions (i.e., cognitive, emotional, behavioral) and examined differences in their levels of romantic relational aggression (RoRAgg) across profiles. Participants were recruited from Greek universities and completed and online survey. Using a person-centered approach, Latent Profile Analysis indicated the presence of three profiles of participants: a) jealous and hostile intent attributers who had high scores on jealousy dimensions and HAB, b) low risk who scored low on jealousy and HAB, and c) emotionally jealous and moderate hostile intent attributers with moderate cognitive and behavioral jealousy as well as HAB, and high emotional jealousy. As predicted, jealous and hostile intent attributers scored higher on RoRAgg compared with emotionally jealous and moderate hostile intent attributers and low risk. The findings confirm previous research and are discussed in terms of their implications. Interventions targeting relational aggressor's hostile attributions, cognitive suspicions, and negative thoughts should be implemented to reduce RoRAgg.

Nursing care when bathing dependent elderly people at home: A scoping review

Background & Aim: Dependent elderly people have difficulty carrying out activities of daily living and need help with essential life-sustaining activities such as bathing. Nursing care includes technique, organization, and care for the patient's physical and emotional well-being. This study aimed to map the scientific evidence on home bathing care for dependent elderly people. Methods & Materials: A scoping review on home bathing care for dependent elderly people according to the methodology proposed by the Joanna Briggs Institute Collaboration. Nine databases were searched, as well as sources of gray literature. Rayyan software was used to select the studies by two reviewers and a third for the final assessment. Results: 24 studies were selected. The most important aspects of bathing were communication, considering the elderly person's preference for bathing, considering conflict resolution, safety, comfort, and privacy, planning the necessary materials and actions, paying attention to the temperature of the water and the environment, cleaning and tidying the bed, as well as hygiene care such as trichotomy, and nail clipping. Conclusion: It was identified that care is related to specific skincare and planning to carry out the steps in body hygiene. The studies show the importance of guidance from nursing professionals in the process of bathing dependent elderly people at home from the perspective of a person-centered approach and their uniqueness.