Reality Distortion Research Articles

Attachment Style and Reality-Testing Impairment Among Patients with Schizophrenia: A Descriptive Correlational Study

Background: Insecure attachment styles are an area of research that is currently receiving much attention because it has an important role in developing many psychological disorders and might have an effect on an individual's perception of his outer reality. In this respect, assessment of attachment styles among patients with schizophrenia can be informative in indicating how well the patients perceive their reality accurately. Aim: This study aimed to determine the attachment style and reality testing impairment among patients with schizophrenia. As well, investigate the relationship between them among those patients. Setting: This study was conducted at El-Maamoura hospital for Psychiatric Medicine in Alexandria. Subjects: A representative sample of 200 randomly recruited patients with schizophrenia were the subjects of the present study. Tools: A Socio-Demographic and Clinical Data Sheet, Bell Reality Testing Inventory (BRTI), and The Psychosis Attachment Measure (PAM). Results: The study showed that 54.5% of the studied patients exhibited an avoidant attachment style and the patients who exhibited an anxious attachment style constitute 40%. Moreover, 60% of the studied patients had a moderate level of reality-testing impairment and 36.5% had severe impairment. A statistically significant positive correlation between psychotic attachment styles and reality-testing impairment was found (r=0.394, p=0.000). More specifically, there was a statistically significant positive correlation between the avoidant attachment style and the three domains of reality-testing impairment as well as the total scores (r= 0.577, 0.179, 0.278, 0.501 respectively, were p=0.000). Meanwhile, a statistically significant positive correlation between the anxious attachment style was found only with the Hallucinations & Delusions domain of reality-testing impairment (r =0.291, p=0.000). Conclusion: It can be concluded that almost all patients with schizophrenia exhibit insecure attachment styles, with avoidant attachment style being the most prevalent, usually at a severe level in the majority of cases. On the other hand, the great majority of these same patients present with reality-testing impairment reflected in its three domains: reality distortion, the uncertainty of perception, and hallucinations & delusions. Evidence of a correlation between attachment styles and reality testing impairment, (both of the total and sub total domains) in these patients usually and frequently there. Recommendations: Building up a secure, structured, and consistent environment for patients with schizophrenia to modify their insecure attachment styles and hope to become more reality-oriented.

Association Between Failures in Perceptual Updating and the Severity of Psychosis in Schizophrenia

Recent accounts suggest that delusions and hallucinations may result from alterations in how prior knowledge is integrated with new information, but experimental evidence supporting this idea has been complex and inconsistent. Evidence from a simpler perceptual task would make clear whether psychotic symptoms are associated with overreliance on prior information and impaired updating. To investigate whether individuals with schizophrenia or schizoaffective disorder (PSZ) and healthy control individuals (HCs) differ in the ability to update their beliefs based on evidence in a relatively simple perceptual paradigm. This case-control study included individuals who met DSM-IV criteria for PSZ and matched HC participants in 2 independent samples. The PSZ group was recruited from the Maryland Psychiatric Research Center, Yale University, and community clinics, and the HC group was recruited from the community. To test perceptual updating, a random dot kinematogram paradigm was implemented in which dots moving coherently in a single direction were mixed with randomly moving dots. On 50% of trials, the direction of coherent motion changed by 90° midway through the trial. Participants were asked to report the direction perceived at the end of the trial. The Peters Delusions Inventory and Brief Psychiatric Rating Scale (BPRS) were used to quantify the severity of positive symptoms. Data were collected from September 2018 to March 2020 and were analyzed from approximately March 2020 to March 2021. Critical measures included the proportion of responses centered around the initial direction vs the subsequent changed direction and the overall precision of motion perception and reaction times. A total of 48 participants were included in the PSZ group (31 [65%] male; mean [SD] age, 36.56 [9.76] years) and 36 in the HC group (22 [61%] male; mean [SD] age, 35.67 [10.74] years) in the original sample. An independent replication sample included 42 participants in the PSZ group (29 [69%] male; mean [SD] age, 33.98 [11.03] years) and 34 in the HC group (20 [59%] male; mean [SD] age, 34.29 [10.44] years). In line with previous research, patients with PSZ were less precise and had slower reaction times overall. The key finding was that patients with PSZ were significantly more likely (original sample: mean, 27.88 [95% CI, 24.19-31.57]; replication sample: mean, 26.70 [95% CI, 23.53-29.87]) than HC participants (original sample: mean, 18.86 [95% CI, 16.56-21.16]; replication sample: mean, 15.67 [95% CI, 12.61-18.73]) to report the initial motion direction rather than the final one. Moreover, the tendency to report the direction of initial motion correlated with the degree of conviction on the Peters Delusions Inventory (original sample: r = 0.32 [P = .05]; replication sample: r = 0.30 [P = .05]) and the Brief Psychiatric Rating Scale Reality Distortion score (original sample: r = 0.55 [P = .001]; replication sample: r = 0.35 [P = .03]) and severity of hallucinations (original sample: r = 0.39 [P = .02]; replication sample: r = 0.30 [P = .05]). The findings of this case-control study suggest that the severity of psychotic symptoms is associated with a tendency to overweight initial information over incoming sensory evidence. These results are consistent with predictive coding accounts of the origins of positive symptoms and suggest that deficits in very elementary perceptual updating may be a critical mechanism in psychosis.

Treatment of Symptom Clusters in Schizophrenia, Bipolar Disorder and Major Depressive Disorder With the Dopamine D3/D2 Preferring Partial Agonist Cariprazine.

Cariprazine is currently approved for the treatment of patients with schizophrenia (USA and EU), and for manic, depressive, and episodes with mixed features in bipolar I disorder (USA): several randomized controlled studies have also explored its efficacy in patients with major depressive disorder. This review summarizes its current therapeutic uses and potential advantages for treating the main symptoms of schizophrenia, bipolar I and major depressive disorder, considering its pharmacodynamic properties, efficacy, and tolerability. Its predominantly D3 receptor preferring affinity, with functional selectivity according to the prevailing neuronal environment, contributes to its efficacy across a wide array of psychopathological symptoms (including reality distortion, disorganized thought, negative symptoms, mood disturbance, anhedonia, and cognitive impairment), and to a favorable side effect profile. Cariprazine may be a “drug of choice” in patients with predominant negative and cognitive symptoms of schizophrenia, as well as those with metabolic syndrome. Further investigation of its relative efficacy when compared to aripiprazole or other active comparators is warranted. Its effectiveness in the treatment of bipolar mania, bipolar I depression and bipolar I episodes with mixed features, with minimal accompanying metabolic changes is well-established. The longer half-life and delayed time to relapse in patients diagnosed with schizophrenia when compared to other second-generation antipsychotics represent other advantages, given the high rates of non-adherence and frequent relapses seen in clinical practice. Its efficacy in overlapping symptom domains in other major psychiatric disorders appears promising.

Startups – Tom Eisenmann analyzes the most prevalent failure patterns and how to avoid them

PurposeThe Fail-Safe Startup: Your Roadmap for Entrepreneurial Success, the new book by entrepreneurship researcher Tom Eisenmann, sets out to help improve the odds by looking more closely at the most prevalent causes of startup failure and how to avoid them.Design/methodology/approachEisenmann research led him to identify six distinct patterns that explain a large proportion of startup failures, three relating to early stage failures and three to late stage.FindingsStrong demand from early adopters may lead a founder to scale up prematurely.Practical/implicationsEntrepreneurs must research differences in the needs of likely early adopters and mainstream customers during the upfront customer discovery phase.Originality/valueEntrepreneurs must research differences in the needs of likely early adopters and mainstream customers during the upfront customer discovery phase. 10; 10;The line between visionary entrepreneur and cult leader can become blurry, and a founder?s ?reality distortion field--useful for motivating others to help pursue the founder?s dream?can become a liability.

A systematic review of the neural correlates of multisensory integration in schizophrenia

Multisensory integration (MSI), in which sensory signals from different modalities are unified, is necessary for our comprehensive perception of and effective adaptation to the objects and events around us. However, individuals with schizophrenia suffer from impairments in MSI, which could explain typical symptoms like hallucination and reality distortion. Because the neural correlates of aberrant MSI in schizophrenia help us understand the physiognomy of this psychiatric disorder, we performed a systematic review of the current research on this subject. The literature search concerned investigated MSI in diagnosed schizophrenia patients compared to healthy controls using brain imaging. Seventeen of 317 identified studies were finally included. To assess risk of bias, the Newcastle-Ottawa quality assessment was used, and the review was written according to the Preferred Reporting Items for Systematic Reviews and Meta-analysis (PRISMA). The results indicated that multisensory processes in schizophrenia are associated with aberrant, mainly reduced, neural activity in several brain regions, as measured by event-related potentials, oscillations, activity and connectivity. The conclusion is that a fronto-temporal region, comprising the frontal inferior gyrus, middle temporal gyrus and superior temporal gyrus/sulcus, along with the fusiform gyrus and dorsal visual stream in the occipital-parietal lobe are possible key regions of deficient MSI in schizophrenia.

TH65. POLYGENIC RISK SCORES FOR ADHD AND TREATMENT RESPONSE TO METHYLPHENIDATE

Gliomas are rare, slow-growing brain tumors. The insula is related to self-knowledge, theory of the mind, interpersonal relationships, distortion of reality and the appearance of positive symptoms. There is little current literature on these type of tumors in the insula and psychosis.A 32-year-old male patient, diagnosed with Paranoid Schizophrenia with significant auditory hallucinations, and a low-grade glioma in the left insular region on routine brain MRI examination. We discuss the possible relationship between the persistence and refractoriness of psychotic symptoms with this finding.The insula may be the main affected brain region in schizophrenia. In psychotic patients, deficits in the insular structure are associated with the presence and severity of positive and negative symptoms. They had reduced volumes of bilateral gray matter from the insula, especially on the right side.

Blending of Fiction with Historical Reality in Salman Rushdie’s Midnight’s Children and Grabiel Gracia Marquez’s One Hundred Years of Solitude

This paper investigates the use of magic realism as a strategic tool in Salman Rushdie’s Midnight’s Children (1981) and Gabriel Garcia Marquez’s One Hundred Years of Solitude (1967). Both the authors belong to two distinct continents; still, they have similar histories and stories of struggle. They develop a unique relationship while untangling reality. They create the mysterious relationship between the human beings and their circumstances in a way more realistic than the realist text.Also, the textual analysis reveals the basic goal of both the novelist to revisit their past through magic realism as both of them believe in the distortion of reality as outcome of colonial impact in their respective societies. In this sense, this paper justifies the rationale behind the blending of fiction and historical reality in both the novels. In doing so it explores how the unsayable in today’s world of asymmetrical power and domination could be said through the use of tools and elements of magic realism such as hybridity, authorial presence, metafiction, awareness of mystery in a real world setting.

The illusion of matter, energy, environmental issues

  The subject of this research is the establishment of correlation between the illusion of the world of matter and environmental issues. The object of this research is the concepts of “illusion”, “matter”, and “energy”. The author traces the evolution of representations of the illusion of the world and its perception. The author dwells on the philosophical aspects of quantum physics, questioning the postulates of materialism on the primacy of matter, and acknowledgement of its esthesis by human as the criterion of the only true being. Special attention is given to the role of consciousness in the illusory distortion of matter and quantum field reality, which is substantiated by the complexity of comprehension of multiple quantum phenomena. The author underlines the need for studying the correlation between environmental issues and the processes in quantum field reality. The main conclusion consists in explication of the fact that the material world is perceived delusively by imperfect human sensory receptors, and its very being is somewhat an illusion. For denoting a single substance, the author employs the term “foreign matter”, which implies the imperceptible reality of energy waves of different frequency. A hypothesis of the continual-energy model of atom, which complements the Rutherford discrete-corpuscular planetary model of atom is advanced. The author’s special contribution lies in the statement that the actual causes of many environmental issues should be sought for not in the world of matter, but in the foreign matter of quantum field reality. The novelty consists in the proposal to develop the consciousness of anthropocentrism, naturecentrism, and theocentrism, which prompt the reduction to part (merism), to the whole (holism) or uniform (henotheism) respectively; and the consciousness of post-holism, where the uniform (i.e. energy) is within the whole and each part of the physical world, considering its unique characteristics. It is noted that the worldview of ecocentrism, and ecological version of post-holism form the true environmental picture of the world.  

Analysis of Linguo-cultural Picture of LIE in Systemic Data

The article presents Lithuanian linguistic cultural image of LIE (MELAS) reconstructed from lexicographic data. The analysis of the lexicographic definitions of this lexeme in Lithuanian dictionaries (The Dictionary of Lithuanian Language, The Dictionary of Contemporary Lithuanian, the dictionaries of synonyms and antonyms and Lithuanian etymological sources) provides two views of the concept: synchronic and diachronic. The diachronic view shows the semantic development of the word, the specification of its meaning (the loss of the primary and the acquisition of new meanings). The synchronic view shows the basic meaning of the concept and its profiles in contemporary language. The research revealed that the basic meaning is LIE as a subject’s purposeful distortion of reality with the purpose of deception. The dominating aspects are: a subject’s purposeful activity and an object that a subject wants to deceive. Lexicographic data distinguished several profiles of LIE: (1) LIE as entertainment (when lie is used for joking, visual storytelling and has no negative purpose), (2) LIE as unethical issue (when lying is seen as negative, sinister activity) and (3) LIE as psychologically necessary element of life (when lie is seen as useful, helping to get out of difficult situations). The analysis is concluded with the cognitive definition of lie, providing its linguo-cultural view in Lithuanian.

Do reality distortions contribute to an increased risk of violent offending in schizophrenia? – a narrative review

AimsTo critically examine the factors that drive an increased risk of violence in the schizophrenic population, with emphasis on the role played by reality distorted symptoms.BackgroundA multitude of studies have reported a positive association between schizophrenia and violence. Many of the risk factors for violence among the non-mentally disordered population, such as substance use, childhood conduct problems and victimisation, are the same as for persons with schizophrenia. There remains controversy however as to whether reality distorted symptoms themselves contribute to the increased risk of violence.MethodRelevant literature was identified through a search of the following databases: PubMed, EMBASE, and PsycINFO. Data were appraised and synthesised to provide a comprehensive overview of the current evidence base for the role of reality distorted symptoms in violence in schizophrenia.ResultStudies ascertaining the contribution of reality distorted symptoms in violent behaviour have produced contradictory results. At a population level, several epidemiological surveys have found little or no contribution for reality distorted symptoms. Such studies frequently show that violence can be accounted for almost entirely by other factors such as substance use and victimisation. However studies investigating relationships between clinical diagnoses and population-wide violence may be unable to detect association at the symptom level. A number of studies have found strong associations between schizophrenia and violence which was not explained by comorbid substance use and have shown strong associations between specific reality distorted symptoms (in particular persecutory delusions accompanied by anger) and violent behaviour.ConclusionThere is heterogeneity in the relationship between schizophrenia and violence. Factors that are associated with increased risk of violence among the schizophrenic population are also pertinent to those without mental disorders. With regards to the pathways to violence in schizophrenia the following conclusions may be drawn: there is an well-established increased risk of violence associated with schizophrenia which has been replicated in many studies; this risk is driven largely by substance use but other factors such as victimisation are also important; there is evidence that reality distorted symptoms, particularly persecutory symptoms, play a role in violent behaviour in some patients, particularly when co-occurring with anger; finally, there may be shared aetiological links between schizophrenia and antisocial behaviour.

Shot on iPhone: Apple's World Picture

Abstract: When in 2007 Steve Jobs launched the iPhone, he quickly skipped over the fact that the device is also a camera. Apple's marketing of its phone-as-camera took flight in 2015 with its World Gallery advertising campaign. The campaign displayed photographs shot by iPhone users from around the globe on billboards around the globe. This essay asks: What do the images in the World Gallery have in common, other than the camera on which they were shot? Starting from that question, the essay explores Apple's Polaroid-inspired American Dream of technology as second nature, while keeping a view on the material reality of the digital age, including Apple's labor practices in China. The essay argues that at Apple, more than with any other company in the world, reality distortion is integral to its core business operations.

The Imbalanced Plasticity Hypothesis of Schizophrenia-Related Psychosis: A Predictive Perspective.

A considerable number of studies have attempted to account for the psychotic aspects of schizophrenia in terms of the influential predictive coding (PC) hypothesis. We argue that the prediction-oriented perspective on schizophrenia-related psychosis may benefit from a mechanistic model that: 1) gives due weight to the extent to which alterations in short- and long-term synaptic plasticity determine the degree and the direction of the functional disruption that occurs in psychosis; and 2) addresses the distinction between the two central syndromes of psychosis in schizophrenia: disorganization and reality-distortion. To accomplish these goals, we propose the Imbalanced Plasticity Hypothesis - IPH, and demonstrate that it: 1) accounts for commonalities and differences between disorganization and reality distortion in terms of excessive (hyper) or insufficient (hypo) neuroplasticity, respectively; 2) provides distinct predictions in the cognitive and electrophysiological domains; and 3) is able to reconcile conflicting PC-oriented accounts of psychosis.

Predicting Long-Term Outcomes in First-Admission Psychosis: Does the Hierarchical Taxonomy of Psychopathology Aid DSM in Prognostication?

The Hierarchical Taxonomy of Psychopathology (HiTOP) is an empirical, dimensional model of psychological symptoms and functioning. Its goals are to augment the use and address the limitations of traditional diagnoses, such as arbitrary thresholds of severity, within-disorder heterogeneity, and low reliability. HiTOP has made inroads to addressing these problems, but its prognostic validity is uncertain. The present study sought to test the prediction of long-term outcomes in psychotic disorders was improved when the HiTOP dimensional approach was considered along with traditional (ie, DSM) diagnoses. We analyzed data from the Suffolk County Mental Health Project (N = 316), an epidemiologic study of a first-admission psychosis cohort followed for 20 years. We compared 5 diagnostic groups (schizophrenia/schizoaffective, bipolar disorder with psychosis, major depressive disorder with psychosis, substance-induced psychosis, and other psychoses) and 5 dimensions derived from the HiTOP thought disorder spectrum (reality distortion, disorganization, inexpressivity, avolition, and functional impairment). Both nosologies predicted a significant amount of variance in most outcomes. However, except for cognitive functioning, HiTOP showed consistently greater predictive power across outcomes-it explained 1.7-fold more variance than diagnoses in psychiatric and physical health outcomes, 2.1-fold more variance in community functioning, and 3.4-fold more variance in neural responses. Even when controlling for diagnosis, HiTOP dimensions incrementally predicted almost all outcomes. These findings support a shift away from the exclusive use of categorical diagnoses and toward the incorporation of HiTOP dimensions for better prognostication and linkage with neurobiology.

Infographie, data visualization, and the danger of reality distortion: The case study of Australia fire 2020

Nowadays, the stream of information to promote environmental consciousness are profoundly dominated by the existence of infographics and data visualization. Beside visually attractive, it is crucial for them to deliver a clear and concise information. This research will uncover infographics and data visualization in conjunction with news about the fire in Australia continent, early in 2020. Some of these visualizations were potentially giving a misleading interpretation to its reader. This research aims to explore the effectiveness of infographics and data visualization channel from the perspective of visual communication design discipline; both from its aesthetics dimension and its content data accuracy. As the outcome, this research is expected to be a reminder that the amount of information in the world is limitless. It is our shared responsibility to be mindful towards each and every material that we consume and share with others.

ХУДОЖЕСТВЕННАЯ ПОЛЕМИКА С А.П.ЧЕХОВЫМ В РАССКАЗЕ Т.Л. ЩЕПКИНОЙ-КУПЕРНИК «ОДИНОЧЕСТВО»

From the earliest works, Chekhov acts as a polemicist with both contemporary literature and with the literature of the immediate past. This polemic is expressed not so much in the direct statements of the writer in letters or in conversations recorded by the memory of the memoirists, but in an artistic form, with the help of an imaginative system. However, there were people who polemicized with Chekhov. On the one hand, these were magazine critics, and on the other, fellow writers. One of these authors was T.L. Shchepkina-Kupernik, who wrote the story "Loneliness" at the age of twenty, which was published in the authoritative journal “Russian Thought” in 1894. The works of Chekhov, which caused the greatest resonance among the reading public: “The Jumping Girl”, “Boring Story”, “Ward No. 6”, became the material for the polemic of the young writer. Shchepkina-Kupernik actually agrees with the opinion of the readers who recognized the element of libel in the story "The Jumping girl", and the element of distortions of reality in others. The author of “Loneliness” creates an artistic picture of the world, which seems to her more realistic than Chekhov’s. However, the story of the young writer does not go beyond the bounds of stencil mass literature. All her claims against the author of “Ward No. 6” turn out to be untenable and demonstrate her lack of understanding of the innovative nature of Chekhov’s work. The complex nature of the dialogic character of his works, based on the art of parody stylization, was not perceived by the opponent, who opposed it with a one-dimensional and simplified image of reality.

Aesthetic Illusion as a Connection of Cognitive Neural Basis, Art Appreciation and Modern Ideology

Illusion is a significant concept in philosophy, art history, literary theory and aesthetics. It has a concrete scientific basis in the perspective of modern cognitive neuroscience. Historically, it has been critically discussed by many philosophers, including Plato, Bacon, Descartes, Kant, and Nietzsche, who considered it to be a distortion of reality. Yet illusion is connected with so many basic aesthetic issues -- such as ambiguity, imagination, and imagery -- that it remains an indispensable concept in modern aesthetics. In the different art media communication of creators with appreciators involves illusory imagery. Its importance is emphasized by Ernst Gombrich in his Art and Illusion, one of the most influential art history texts in the English-speaking world. The concept of illusion becomes the crossing point of classical philosophy and contemporary aesthetics. In this article, the philosophical, psychological and aesthetic bases of illusion will be introduced. In different fields, illusion has different content, but depends on the same psychological mechanisms. The neural mechanisms that underpin aesthetic illusion in contemporary artistic production also function in the modern ideology described by Adorno, Eagleton, and Williams. Not all aesthetic illusions have positive functions, which sometimes leads to distorted cognition and emotional complexity. When it deviates too far from reality, aesthetic illusion contains particular cognitive emotional qualities that conflict with artistic imagery in classical arts. As a bearer of modern aesthetic emotion, it is also shaped by special economic and political situations and always has a kind of ideological character. Thus aesthetic illusion often promotes new configurations of aesthetics and art history.

A Learning Model on the Readiness to Learn Self-Care for Trauma Survivors

Family violence is increasing globally, affecting health outcomes and healthcare resources. Abuse is a form of trauma that can cause mental health issues such as stress, anxiety, disconnection, distortion of reality, and learning difficulties. Trauma survivors are often silent sufferers, who are hard to reach and even more challenging to teach. This translates into poorer health outcomes within this vulnerable group as trauma survivors are not able or ready to implement self-care efforts independently. Therefore, understanding how these survivors learn is vital to facilitate their trauma recovery and empower them to regain autonomy. Educators must hone their ethical pedagogical responsibility in providing care for a diverse learner population which reflects trauma-informed care. Hence, to contribute to advancing pedagogical epistemology, a trauma andragogical model is developed that promotes trauma recovery through the readiness to learn and ability to connect through realities of the self, others, world, and learning environment. This progression reflects a learner’s ability to learn, which influences learner motivation and capacity to pursue self-care behaviors. The Readiness to Learn Self-Care Model for Trauma Survivors, therefore, outlines the steps, or doors, a survivor must go through to reach independent self-care behavior. The model uses ethical principles based on self-determination, autonomy, and health equity to support social justice by providing accessible learning, which is learner centered. The Readiness to Learn Self-Care Model for Trauma Survivors contributes to pedagogical epistemology through articulating anagogical trauma-related principles through philosophical, theoretical, and anecdotal realms.

A Lei de Cotas (12.711/12) está sendo efetiva, eficiente e eficaz? Uma análise seguida de proposta de avaliação a luz da Teoria da Administração Pública gerencialista

Resumo Entender como as Leis, projetos públicos, programas sociais estão de fato impactando a sociedade, se estão funcionando e se estão sendo bem avaliados é imperativo para o novo gestor público. A nova administração pública, desde a década de 1980 requer cada vez mais a utilização do conhecimento científico para se validar, e uma das ferramentas para isso é a utilização do modelo de eficiência, eficácia e efetividade. Assim, este trabalho buscou realizar uma análise por essa perspectiva da Lei de Cotas 12.711/12, interpretando trabalhos que a avaliaram. Concluiu-se que a Lei de Cotas tem sido eficaz no que tange a entrada de alunos beneficiados nas IES, e que os cotistas estão tendo rendimento acadêmico similar aos não-cotistas. Todavia, nenhum trabalho abordou corretamente a eficiência e a efetividade, gerando distorções interpretativas da realidade favoráveis a permanência da Lei, fato que este artigo busca mitigar por destrinchar que faltam dados sobre sua efetividade e eficiência. Em paralelo, criou-se uma proposta de modelo de árvore, que permitiria futuras avaliações sobre a Lei.

Decreasing Falls through Shared Governance

In October 2018, at the unit based forum meeting, clinical nurses evaluated patient fall rates and noticed an increase in patient falls in the Q3 2018. The Q3 2018 fall rate was 6.20. Then nurses analyzed each fall including reviewing CCTV to determine possible causes. One of the falls was due to a slip in the shower. The shower floor was tiled and became slippery when wet. Additional falls occurred in the hallway of the unit and possible causes included reality distortion, unsteady gait due to age, medications, and physical condition. In some cases they noticed the CCTV did not capture a fall because there was no camera in that section of the hallway. The clinical nurses discussed this information with the Clinical Manager, at the November 2018 staff meeting. They suggested re-surfacing the floor to prevent slipping, additional cameras mounted in the hallways, and a second monitor at the other nurses station in an effort to prevent patient falls. After implementing these interventions along with CCTV monitoring the fall rate for Q1 2020 was 2.07 and Q2 2020 was 2.66. Through shared governance, evidence based practice implementation and environment of care enhancements the fall rate decreased by 40%.

PSYCHOLOGICAL ANALYSIS OF FEATURES OF CHILDREN’S AND PARENTS’ PROTECTIVE MECHANISMS

The description of the generally accepted mechanisms of protection which are used by the person is given. The positive and negative consequences for the protective mechanisms of adults and children are analyzed. The main features of the mechanisms of psychological protection are highlighted: impulsiveness, distortion of reality, lack of awareness of the subject of protective forms of behavior. It is emphasized that the protective mechanisms in children are protective and maintain the normal psychological status of the individual. The main causes of protective mechanisms in children are named: anxiety reactions to physical discomfort, fear of separation and independence, fear of death, fear of submission, fear of change. The relevance of this study is substantiated and the purpose of the study is formulated. The procedure for conducting the diagnostic stage of the study is described, the sample is described, as well as the psychological tools. The results of an empirical study of the protective mechanisms of children and their parents are presented. The dominant strategies of psychological protection in two samples are singled out. The content of the dominant protective mechanisms of children and their parents is revealed. The presence of significant differences between the indicators of protective mechanisms of children of different ages was checked. The results of our study are compared with generally accepted ideas about the main mechanisms of psychological protection in children and adults. The main conclusion of the research is made, possible prospects of further scientific developments are formulated.