Svein Bergvik

Psychotherapy supervision conducted by videoconferencing: a qualitative study of users’ experiences:

Psychiatry residents in Norway have 70 hours of mandatory psychotherapy supervision to develop insights into the therapeutic relationship. Six supervision pairs (six candidates and two supervisors) conducted five videoconferencing-based supervision sessions (384kbit/s) and five face-to-face sessions alternating weekly for 10 sessions. Following completion of the 10 sessions for candidates and supervisor B, and the 50 sessions for supervisor A, all subjects completed a semi-structured interview within two weeks. The eight subjects reported a wide range of experiences and attitudes. The results suggested that the quality of supervision can be satisfactorily maintained by using videoconferencing for up to half of the 70 hours required. The precondition for this estimate is that the pair in question have met face to face and established a relationship characterized by mutual trust and respect. Further studies, which include supervision pairs not having previously established relationships, are needed in order to indicate the generality of this precondition. The most obvious implication of this study is the potential for implementing decentralized models for recruiting and educating psychiatrists.

Videoconferencing in psychiatry: a survey of use in northern Norway.

A survey of the use of videoconferencing in mental health care was carried out in northern Norway. A questionnaire was distributed to all user institutions in northern Norway at the same time that ISDN became available, in mid-1995. The questionnaire completion rate for locations recorded as participants in videoconferencing sessions was 62%. Within six months, a total of 1028 persons had participated in 140 videoconferencing sessions from 35 institutions. The purposes of videoconferencing included meetings (50%), supervision, training and teaching (31%), clinical consultations (14%) and tests or demonstrations (5%). The alternative forms of contact which videoconferencing replaced included travel (59%), no contact (25%), telephone (14%), and mail or fax (2%). No problems were reported in 55% of the sessions; in 19% there were audio problems, in 14% there were picture problems, in 5% attempts to connect failed and in 5% disconnection occurred. The majority of users (87%) reported that they were satisfied or very satisfied with the facility; 8% were uncertain and 5% were less satisfied or totally dissatisfied. Continued surveying will provide longitudinal data on the diffusion of telepsychiatry in northern Norway.

Impacts of Home-Based Telework on Quality of Life for Employees and Their Partners. Quantitative and Qualitative Results From a European Survey

The study investigates the effects of home-based telework on quality of life (QoL). Four dimensions of QoL were analysed; overall satisfaction with life, sense of belonging, sense of becoming and sense of being. Through cross-national survey data (from 217 job holders and 112 partners) and by means of structural equation modeling, a positive association was found between home-based telework to a workers sense of belonging (beta = 0.30, p < 0.001). On the other hand, a negative path was detected from the job holders home-based telework to his or her partners overall satisfaction with life (beta = −0.27, p < 0.05). After controlling for subdimensions of life quality, home-based work did not affect the job holders overall life satisfaction. Moreover, the more concentration the job holder reported, the lower the sense of belonging was reported by his or her partner (beta = −0.28, p < 0.05). No simple explanation for the negative effects were found, but our interviews with the group of workers and their families leave us the impression that the problem of overworking and withdrawal was most relevant to the cases, in combination with negative spill-over effects and unclear boundary settings in the home.

Psychometric properties of the Type D scale (DS14) in Norwegian cardiac patients

The combination of negative affectivity (NA) and social inhibition (SI) - the Type D Personality - is associated with poor outcomes in coronary artery disease (CAD) patients. A Norwegian translation of the standard instrument measuring Type D (DS14) was tested on 432 CAD patients receiving coronary revascularization treatment. Factor analysis produced two factors with high inter-item reliability, indicating that the Norwegian DS14 has acceptable psychometric properties. Eighteen percent were classified as Type D, lower than has been reported elsewhere. Type D was associated with anxiety, depression, and passive coping. NA correlated positively with depression, anxiety, and passive coping. SI correlated positively with depression and anxiety, and negatively with active coping. The prevalence of Type D was higher among women, and negatively correlated with time since treatment. The variation in Type D prevalence among studies needs further elucidation as does the predictive power of continuous scoring of the Type D trait.

Psychotherapy supervision conducted via videoconferencing: A qualitative study of users' experiences

The 70 h of mandatory psychotherapy supervision for psychiatry residents in Norway is designed to develop insight into the therapeutic relationship. Essential in fulfilling the intentions of psychotherapy supervision is, for example, the ability to openly express and utilize personal experiences, emotions, and reactions. Six supervision pairs?six candidates and two supervisors?participated in a study to evaluate the quality of the psychotherapy supervision process when the supervisors and candidates communicate by means of interactive audiovisual videoconferencing (VC)? Each candidate and their respective supervisors participated in 60 supervised sessions, with 5 VC-based and 5 face-to-face sessions alternating every other session weekly. The part of the study reported in this article is based on qualitative interviews conducted at the conclusion of the 10 sessions. The article concludes that the quality of psychotherapy supervision can be satisfactorily maintained by using VC (384 kbit/sec) for up to 50%...

Approach and Avoidance Coping and Regulatory Focus in Patients Having Coronary Artery Bypass Graft Surgery

Coronary artery bypass graft (CABG) surgery is stressful, and the patient’s coping affects recovery and outcome. The aim of the study was to identify patients’ thoughts and concerns, and explore the relevance of approach/avoidant coping and Regulatory Focus Theory (RFT). Nine patients were interviewed, using an interpretative phenomenological approach. The patients made use of various avoidant (e.g. neglecting symptoms, delaying help-seeking, avoiding thoughts) and approach strategies (e.g. persistent search for the diagnosis, mental preparation for surgery). RFT versus approach/avoidant coping is discussed. RFT may contribute to our understanding of motivational cognitions in patients’ coping with illness and treatment.

Users' and GPs' causal attributions of illegal substance use: An exploratory interview study

OBJECTIVE There is a need to explore the beliefs regarding the causes of illegal substance use of the people who themselves use the substances (SU) and their GPs. Increased knowledge about such beliefs--often referred to as causal attributions--may improve mutual understanding and communication between SU and GPs. METHODS Eight SU and five GPs were interviewed about the causes of illegal substance use. They also talked about how substance use was discussed in consultations. Data were analysed qualitatively. RESULTS Both the SU and the GPs believed that several factors usually were important in each case of illegal substance use. The SU more often than the GPs emphasised the positive aspects of illegal substance use. We discerned five main causes: biological, social, lack of self-control, positive experiences, and chance. Several of the SU and GPs emphasised that it was difficult to communicate about substance use. CONCLUSION The GPs and the SU believed illegal substance use is caused by many factors, including biological, social, and lack of self-control. Communicating about illegal substance use is challenging. PRACTICE IMPLICATIONS GPs should be aware of the clinical importance of causal attributions and should explore beliefs held by SU about the causes of their substance use.

Parent-child attachment, academic performance and the process of high-school dropout: a narrative review.

Poor academic performance is a strong predictor of school dropout. Researchers have tried to disentangle variables influencing academic performance. However, studies on preschool and early care variables are seldom examined when explaining the school dropout process. We reviewed the literature on the relationship between caregiver–child attachment and academic performance, including attachment studies from preschool years, seeking out potential contributions to academic performance and the dropout process. The review was organized according to a model of four main mediating hypotheses: the attachment-teaching hypothesis, the social network hypothesis, the attachment-cooperation hypothesis, and the attachment self-regulation hypothesis. The results of the review are summed up in a model. There is some support for all four hypotheses. The review indicates that attachment and early care contribute substantially to dropout and graduation processes. Mediation effects should be given far more attention in future research.

Supporting doctor-patient communication: Providing a question prompt list and audio recording of the consultation as communication aids to outpatients in a cancer clinic

OBJECTIVE To document the effect of a cancer specific question prompt list (QPL) on patients question asking and shared decision-making (SDM), and to evaluate the combined effect of the QPL and consultation audio recording (CAR) on patient outcomes. METHOD This exploratory study compared two groups of patients receiving either a QPL or combined QPL/CAR, to a control group. Measurements included number/types of questions asked, and physician SDM behavior (OPTION score). Questionnaire data included anxiety/depression and quality of life (QoL). RESULTS A total of 93 patients participated (31 Control, 30 QPL and 32 Combined). Patients in the intervention groups asked more questions concerning prognosis (p < .0001), the disease (p = .006) and quality of treatment (p < .001) than patients in the control group, but no impact was found on the OPTION score. An increase in mean consultation length was observed in the intervention groups compared to the control group (44 vs. 36 min; p = .028). Patients rated both interventions positively. CONCLUSION Provision of the QPL facilitates patients to ask a broader range of questions, but does not increase physician SDM behavior. PRACTICAL IMPLEMENTATION The combination of QPL and CAR seems feasible and should be tested in an implementation study following the disease trajectory.

Adapting an Australian question prompt list in oncology to a Norwegian setting-a combined method approach.

PurposeA question prompt list (QPL) is an inexpensive communication aid that has been proved effective in encouraging patients to ask questions during medical consultations. The aim of this project was to develop a QPL for Norwegian cancer patients.MethodsA multimethod approach was chosen combining literature review, focus groups, and a survey in the process of culturally adjusting an Australian QPL for the Norwegian setting. Participants were recruited from the University Hospital of North Norway. They were asked to review and comment on iterative drafts of the QPL.ResultsEighteen patients, mean age 54, participated in the focus groups, and 31 patients, mean age 55, participated in the survey. Focus groups suggested that topics related to accompanying relatives, children as next of kin, and rehabilitation were important and should be added to the original QPL. The survey revealed that most questions from the original QPL were considered both useful and understandable. Although half of the patients found some questions about prognosis unpleasant, the vast majority considered the same questions useful. Questions regarding clinical studies, multidisciplinary teams, and public versus private hospitals had lower ratings of usefulness.ConclusionQPLs require some adjustment to the local cultural context, and a mixed method approach may provide a useful model for future cultural adaptation of QPLs. The present QPL has been adjusted to the needs of oncology patients in the Norwegian health care setting.