テスト理論の項目分析に基づいた術後看護用CAI教材の有効性 : 累積正答率の分析による成績低・中・高群の学習達成度

Our CAI is a multimedia self-learning material incorporating videos, pictures, X-rays, and audio-based information obtained from patients who underwent gastrectomy under general anesthesia. Because our previous study (Takeuchi et al., 2004) did not analyze the final cumulative correct response rates for the entire courseware, the present study assessed them to clarify the efficacy of multimedia CAI materials. Based on the learning history of each learner, the learning process of low-, moderate- and high-performance groups was ascertained by item analysis of test theories.The results showed that the average correct-response rate for the final test was 84.6%, and from the viewpoint of goal achievement, the present learning material therefore appears to be effective. Furthermore, when comparing the initial and final cumulative correct response rates, multimedia CAI learning was able to raise the knowledge level of the learners and reduce the differences among the low, moderate and high-performance groups.筆者らが開発したコンピュータ教材（CAI）は，実際に全身麻酔で胃切除術を受けた患者から得た情報を基に，ビデオ映像・写真・音声などを組み込んだ自己学習教材である。本研究は，前回の報告（竹内他，2004）を発展させたものであり，前回分析しなかった最終累積正答率の分析を行うことによって，マルチメディアCAI教材の有効性を評価するものである。分析に当たっては，各学習者の学習履歴をとり，そのデータをテスト理論における項目分析の手法を利用して，成績低群・中群・高群の学習過程を検討していった。その結果，全体の最終平均正答率は84.6％であり，学習目標の達成基準を満たす教材であることが確認できた。さらに，初回正答率と最終累積正答率を比較した結果，マルチメディアCAIによる学習は，学習者の知識水準を一定以上引き上げることができ，かつ成績低群・中群・高群の差が縮まるということが明らかとなった

トウニョウビョウ カンゴ ジッセン ノウリョク ヒョウカ シヒョウ ノ シンライセイ ダトウセイ ノ ケンショウ

原

Psychiatric disorders and clinical correlates of suicidal patients admitted to a psychiatric hospital in Tokyo

<p>Abstract</p> <p>Background</p> <p>Patients admitted to a psychiatric hospital with suicidal behavior (SB) are considered to be especially at high risk of suicide. However, the number of studies that have addressed this patient population remains insufficient compared to that of studies on suicidal patients in emergency or medical settings. The purpose of this study is to seek features of a sample of newly admitted suicidal psychiatric patients in a metropolitan area of Japan.</p> <p>Method</p> <p>155 suicidal patients consecutively admitted to a large psychiatric center during a 20-month period, admission styles of whom were mostly involuntary, were assessed using Structured Clinical Interviews for DSM-IV Axis I and II Disorders (SCID-I CV and SCID-II) and SB-related psychiatric measures. Associations of the psychiatric diagnoses and SB-related characteristics with gender and age were examined.</p> <p>Results</p> <p>The common DSM-IV axis I diagnoses were affective disorders 62%, anxiety disorders 56% and substance-related disorders 38%. 56% of the subjects were diagnosed as having borderline PD, and 87% of them, at least one type of personality disorder (PD). SB methods used prior to admission were self-cutting 41%, overdosing 32%, self-strangulation 15%, jumping from a height 12% and attempting traffic death 10%, the first two of which were frequent among young females. The median (range) of the total number of SBs in the lifetime history was 7 (1-141). Severity of depressive symptomatology, suicidal intent and other symptoms, proportions of the subjects who reported SB-preceding life events and life problems, and childhood and adolescent abuse were comparable to those of the previous studies conducted in medical or emergency service settings. Gender and age-relevant life-problems and life events were identified.</p> <p>Conclusions</p> <p>Features of the studied sample were the high prevalence of affective disorders, anxiety disorders and borderline PD, a variety of SB methods used prior to admission and frequent SB repetition in the lifetime history. Gender and age appeared to have an influence on SB method selection and SB-preceding processes. The findings have important implications for assessment and treatment of psychiatric suicidal patients.</p

Modeling the direct and indirect relationships between cognitive style, daily life stress and mental distress

Objective: Daily life stress is a trigger of mental illness in college students who are in late adolescence and in the dominant age group of mental illness. This study clarified the effects of the cognitive style of empathizing-systemizing(E-S) together with daily life stress on mental distress through a mediation process with cognitive appraisal and coping style. Gender differences in the relationship were also investigated. Method: The scales of empathizing and systemizing, daily life stress, cognitive appraisal rating, tri-axial coping, and Hopkins symptom checklist were administrated to second-year Japanese college students using an anonymous questionnaire. The size of 804 (403 men, and 401 women) cross-sectional data, with the average age of 19.62 years were obtained. The valid response rate was 82.4%. Results: Simultaneous multiple group analysis revealed that higher mental distress was directly associated with lower empathizing in men, while it was associated with higher systemizing in women. The model showed that the effects of E-S and daily life stress on mental distress were mediated by the mediation process. The relationship between daily life stress and mental distress was smaller than that between E-S and mental distress. The E-S directly related to cognitive appraisal which were also predicted by daily life stress, but not directly related to coping. Limitations: This study is a cross-sectional study. Future longitudinal studies are needed to identify causal relationships between cognitive styles and strategies, and mental distress. Conclusions: The cognitive style (E-S) can be more important indicators of mental distress than daily life stress in late adolescent college students