scholarly journals A longitudinal study of the turning points and trajectories in therapeutic relationship development

2020 ◽  
Author(s):  
Ayana Horton ◽  
Gail Hebson ◽  
David Holman

Abstract Background The therapeutic relationship refers to the interpersonal relationship between the healthcare professional and patient (Peplau, 1997). The importance of the therapeutic relationship is widely recognised across healthcare professions (e.g., nurses - Peplau, 1997; physicians - Weeger & Farin, 2017; psychotherapists - Martin et al, 2000; occupational therapists - Weiste, 2018; physiotherapists- Fuentes et al, 2014). Despite the importance of therapeutic relationships, there are significant gaps in the knowledge base on how these relationships develop. To address these gaps, this study explores relationship dynamics by identifying relational turning points and trajectories. Methods Data collection was based on the Retrospective Interview Technique (RIT) and consisted of two phases. In the first phase patients and therapists were asked to tell the story of their therapeutic relationship development and as part of this, identify the turning points that occurred. In the second phase, therapists-patient dyads were observed from their first interaction to their last to identify potential turning points and at the end of the relationship a participant verification interview was conducted with both dyadic partners individually. Template analysis was used to analyse the data. Results Therapists identified 6 distinct categories of turning points; Progress Towards Goals, Set-backs in Progress Towards Goals, Interpersonal Affective Bonding with Patients, Interpersonal Problems with Patients, Positive Feedback, and Negative Feedback. Patients identified 5 categories of turning points; Progress Towards Goals, Set-backs in Progress Towards Goals, Interpersonal Affective Bonding with Therapists, Agreement with Therapist and Change in Treatment. These turning points varied regarding their impact on the trajectory of the therapeutic relationship. The trajectory patterns identified were stable, upward, downward, and multidirectional. Conclusion This study makes an important contribution to our understanding of therapeutic relationship dynamics. The results expose the challenges that therapists and patients face in building high-quality therapeutic relationships, the diversity of therapeutic relationships, and how these relationships develop over time. This is the first study to use a turning point analysis in research on therapeutic relationships.

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Ayana Horton ◽  
Gail Hebson ◽  
David Holman

Abstract Background The importance of the therapeutic relationship is widely recognised across healthcare professions. Despite the importance of therapeutic relationships, there are significant gaps in the knowledge base on how these relationships develop. To address these gaps, this study explores relationship dynamics by identifying relational turning points and trajectories in therapeutic relationships between occupational therapists and physical therapists and their patients. The implications for how a focus on these relational aspects can enhance clinical practice will be discussed. Methods Data collection was based on the Retrospective Interview Technique and consisted of two phases. In the first phase patients and therapists were asked to tell the story of their therapeutic relationship development and as part of this, identify the turning points that occurred. In the second phase, therapists-patient dyads were observed from their first interaction to their last to identify potential turning points and at the end of the relationship a participant verification interview was conducted with both dyadic partners individually. Template analysis was used to analyse the data. Results Therapists identified 6 distinct categories of turning points; Progress Towards Goals, Set-backs in Progress Towards Goals, Interpersonal Affective Bonding with Patients, Interpersonal Problems with Patients, Positive Feedback, and Negative Feedback. Patients identified 5 categories of turning points; Progress Towards Goals, Set-backs in Progress Towards Goals, Interpersonal Affective Bonding with Therapists, Agreement with Therapist and Change in Treatment. These turning points varied regarding their impact on the trajectory of the therapeutic relationship. The trajectory patterns identified were stable, upward, downward, and multidirectional. Conclusion This study makes an important contribution to our understanding of therapeutic relationship dynamics in the occupational and physical therapy context. The results expose the challenges that therapists and patients face in building high-quality therapeutic relationships, the diversity of therapeutic relationships, and how these relationships develop over time. This is the first study to use a turning point analysis in research on therapeutic relationships.


2021 ◽  
Author(s):  
Ayana Horton ◽  
Gail Hebson ◽  
David Holman

Abstract BackgroundThe importance of the therapeutic relationship is widely recognised across healthcare professions. Despite the importance of therapeutic relationships, there are significant gaps in the knowledge base on how these relationships develop. To address these gaps, this study explores relationship dynamics by identifying relational turning points and trajectories in therapeutic relationships between occupational therapists and physical therapists and their patients. The implications for how a focus on these relational aspects can enhance clinical practice will be discussed.Methods Data collection was based on the Retrospective Interview Technique and consisted of two phases. In the first phase patients and therapists were asked to tell the story of their therapeutic relationship development and as part of this, identify the turning points that occurred. In the second phase, therapists-patient dyads were observed from their first interaction to their last to identify potential turning points and at the end of the relationship a participant verification interview was conducted with both dyadic partners individually. Template analysis was used to analyse the data.ResultsTherapists identified 6 distinct categories of turning points; Progress Towards Goals, Set-backs in Progress Towards Goals, Interpersonal Affective Bonding with Patients, Interpersonal Problems with Patients, Positive Feedback, and Negative Feedback. Patients identified 5 categories of turning points; Progress Towards Goals, Set-backs in Progress Towards Goals, Interpersonal Affective Bonding with Therapists, Agreement with Therapist and Change in Treatment. These turning points varied regarding their impact on the trajectory of the therapeutic relationship. The trajectory patterns identified were stable, upward, downward, and multidirectional.ConclusionThis study makes an important contribution to our understanding of therapeutic relationship dynamics in the occupational and physical therapy context. The results expose the challenges that therapists and patients face in building high-quality therapeutic relationships, the diversity of therapeutic relationships, and how these relationships develop over time. This is the first study to use a turning point analysis in research on therapeutic relationships.


2021 ◽  
Author(s):  
Ayana Horton ◽  
Gail Hebson ◽  
David Holman

Abstract BackgroundThe importance of the therapeutic relationship is widely recognised across healthcare professions. Despite the importance of therapeutic relationships, there are significant gaps in the knowledge base on how these relationships develop. To address these gaps, this study explores relationship dynamics by identifying relational turning points and trajectories in therapeutic relationships between occupational therapists and physical therapists and their patients. The implications for how a focus on these relational aspects can enhance clinical practice will be discussed.Methods Data collection was based on the Retrospective Interview Technique and consisted of two phases. In the first phase patients and therapists were asked to tell the story of their therapeutic relationship development and as part of this, identify the turning points that occurred. In the second phase, therapists-patient dyads were observed from their first interaction to their last to identify potential turning points and at the end of the relationship a participant verification interview was conducted with both dyadic partners individually. Template analysis was used to analyse the data.ResultsTherapists identified 6 distinct categories of turning points; Progress Towards Goals, Set-backs in Progress Towards Goals, Interpersonal Affective Bonding with Patients, Interpersonal Problems with Patients, Positive Feedback, and Negative Feedback. Patients identified 5 categories of turning points; Progress Towards Goals, Set-backs in Progress Towards Goals, Interpersonal Affective Bonding with Therapists, Agreement with Therapist and Change in Treatment. These turning points varied regarding their impact on the trajectory of the therapeutic relationship. The trajectory patterns identified were stable, upward, downward, and multidirectional.ConclusionThis study makes an important contribution to our understanding of therapeutic relationship dynamics in the occupational and physical therapy context. The results expose the challenges that therapists and patients face in building high-quality therapeutic relationships, the diversity of therapeutic relationships, and how these relationships develop over time. This is the first study to use a turning point analysis in research on therapeutic relationships.


2020 ◽  
Author(s):  
Ayana Horton ◽  
Gail Hebson ◽  
David Holman

Abstract Background The importance of the therapeutic relationship is widely recognised across healthcare professions. Despite the importance of therapeutic relationships, there are significant gaps in the knowledge base on how these relationships develop. To address these gaps, this study explores relationship dynamics by identifying relational turning points and trajectories in therapeutic relationships between occupational therapists and physical therapists and their patients. The implications for how a focus on these relational aspects can enhance clinical practice will be discussed.Methods Data collection was based on the Retrospective Interview Technique and consisted of two phases. In the first phase patients and therapists were asked to tell the story of their therapeutic relationship development and as part of this, identify the turning points that occurred. In the second phase, therapists-patient dyads were observed from their first interaction to their last to identify potential turning points and at the end of the relationship a participant verification interview was conducted with both dyadic partners individually. Template analysis was used to analyse the data.Results Therapists identified 6 distinct categories of turning points; Progress Towards Goals, Set-backs in Progress Towards Goals, Interpersonal Affective Bonding with Patients, Interpersonal Problems with Patients, Positive Feedback, and Negative Feedback. Patients identified 5 categories of turning points; Progress Towards Goals, Set-backs in Progress Towards Goals, Interpersonal Affective Bonding with Therapists, Agreement with Therapist and Change in Treatment. These turning points varied regarding their impact on the trajectory of the therapeutic relationship. The trajectory patterns identified were stable, upward, downward, and multidirectional.Conclusion This study makes an important contribution to our understanding of therapeutic relationship dynamics in the occupational and physical therapy context. The results expose the challenges that therapists and patients face in building high-quality therapeutic relationships, the diversity of therapeutic relationships, and how these relationships develop over time. This is the first study to use a turning point analysis in research on therapeutic relationships.


2018 ◽  
Vol 1 (1) ◽  
pp. 236-247
Author(s):  
Divya Srivastava ◽  
Rajitha B. ◽  
Suneeta Agarwal

Diseases in leaves can cause the significant reduction in both quality and quantity of agricultural production. If early and accurate detection of disease/diseases in leaves can be automated, then the proper remedy can be taken timely. A simple and computationally efficient approach is presented in this paper for disease/diseases detection on leaves. Only detecting the disease is not beneficial without knowing the stage of disease thus the paper also determine the stage of disease/diseases by quantizing the affected of the leaves by using digital image processing and machine learning. Though there exists a variety of diseases on leaves, but the bacterial and fungal spots (Early Scorch, Late Scorch, and Leaf Spot) are the most prominent diseases found on leaves. Keeping this in mind the paper deals with the detection of Bacterial Blight and Fungal Spot both at an early stage (Early Scorch) and late stage (Late Scorch) on the variety of leaves. The proposed approach is divided into two phases, in the first phase, it identifies one or more disease/diseases existing on leaves. In the second phase, amount of area affected by the disease/diseases is calculated. The experimental results obtained showed 97% accuracy using the proposed approach.


Author(s):  
Paulo César Antonini de Souza ◽  
Derick Trindade Bezerra

ResumoTendo por campo de investigação o Festival da América do Sul Pantanal (FASP) em 2018, na cidade de Corumbá (Brasil), objetiva-se identificar a materialidade e conceitos que permeiam as manifestações artísticas bidimensionais nesta região de fronteira, a partir da percepção de artistas da Bolívia. A pesquisa se organizou em duas fases: na primeira foi realizado um levantamento em plataformas online de produções acadêmicas em artes visuais, com foco no trabalho bidimensional, utilizando os descritores “arte popular” e “estética latina” resultando em três artigos. Na segunda fase foram selecionados dois trabalhos de uma artista da Bolívia, participante da mostra “Conexão Santa Cruz”, realizada durante o FASP 2018, que foram analisados em seus níveis representacional e simbólico. Pela interpretação das imagens foi possível construir uma leitura sobre a perspectiva da artista a respeito de suas condições culturais dentro da ordenação social em que se encontra situada.Palavras-chave: Artes Visuais. Arte Popular. Arte Regional. América Latina. Representation and symbolism: visual arts on the Brazil/Bolivia frontierAbstractHaving as research field the Festival da América do Sul Pantanal (FASP) in 2018, in the city of Corumbá (Brazil), the objective is to identify the materiality and concepts that permeate the two-dimensional artistic manifestations in this border region, from the perception of artists from Bolivia. The research was organized in two phases: in the first, a survey was carried out on online platforms of academic productions in visual arts, focusing on two-dimensional work, using the descriptors “arte popular” and “estética latina” resulting in three articles. In the second phase, two works were selected by an artist from Bolivia, participating in the exhibition “Conexão Santa Cruz”, held during FASP 2018, which were analyzed at their representational and symbolic levels. Through the interpretation of the images, it was possible to construct a reading on the artist’s perspective regarding her cultural conditions within the social order in which she is located.Keywords: Visual Arts. Folk Art. Regional Art. Latin America.Representación y simbolismo: artes visuales en la frontera de Brasil/BoliviaResumenTeniendo como campo de investigación el Festival de Sudamérica Pantanal (FASP) en 2018, en la ciudad de Corumbá (Brasil), el objetivo es identificar la materialidad y conceptos que permean las manifestaciones artísticas bidimensionales en esta región fronteriza, desde la percepción de artistas de Bolivia. La investigación se organizó en dos fases: en la primera, se realizó una encuesta en plataformas online de producciones académicas en artes visuales, con foco en el trabajo bidimensional, utilizando los descriptores “arte popular” y “estética latina” dando como resultado tres artículos. En la segunda fase, dos obras fueron seleccionadas por un artista de Bolivia, participante de la exposición “Conexão Santa Cruz”, realizada durante FASP 2018, que fueron analizadas en sus niveles representativos y simbólicos. A través de la interpretación de las imágenes, fue posible construir una lectura sobre la perspectiva de la artista sobre sus condiciones culturales dentro del orden social en el que se ubica.Palabras clave: Artes Visuales. Arte Popular. Arte Regional. América Latina.


Author(s):  
A. Geerinck ◽  
C. Beaudart ◽  
J.-Y. Reginster ◽  
M. Locquet ◽  
C. Monseur ◽  
...  

Abstract Purpose To facilitate the measurement of quality of life in sarcopenia, we set out to reduce the number of items in the previously validated Sarcopenia Quality of Life (SarQoL®) questionnaire, and to evaluate the clinimetric properties of this new short form. Methods The item reduction process was carried out in two phases. First, information was gathered through item-impact scores from older people (n = 1950), a Delphi method with sarcopenia experts, and previously published clinimetric data. In the second phase, this information was presented to an expert panel that decided which of the items to include in the short form. The newly created SFSarQoL was then administered to older, community-dwelling participants who previously participated in the SarcoPhAge study. We examined discriminative power, internal consistency, construct validity, test–retest reliability, structural validity and examined item parameters with a graded response model (IRT). Results The questionnaire was reduced from 55 to 14 items, a 75% reduction. A total of 214 older, community-dwelling people were recruited for the validation study. The clinimetric evaluation showed that the SF-SarQoL® can discriminate on sarcopenia status [EWGSOP2 criteria; 34.52 (18.59–43.45) vs. 42.86 (26.56–63.69); p = 0.043], is internally consistent (α = 0.915, ω = 0.917) and reliable [ICC = 0.912 (0.847–0.942)]. A unidimensional model was fitted (CFI = 0.978; TLI = 0.975; RMSEA = 0.108, 90% CI 0.094–0.123; SRMR = 0.055) with no misfitting items and good response category separation. Conclusions A new, 14-item, short form version of the Sarcopenia Quality of Life questionnaire has been developed and shows good clinimetric properties.


Author(s):  
Kui Xu ◽  
Ming Zhang ◽  
Jie Liu ◽  
Nan Sha ◽  
Wei Xie ◽  
...  

Abstract In this paper, we design the simultaneous wireless information and power transfer (SWIPT) protocol for massive multi-input multi-output (mMIMO) system with non-linear energy-harvesting (EH) terminals. In this system, the base station (BS) serves a set of uplink fixed half-duplex (HD) terminals with non-linear energy harvester. Considering the non-linearity of practical energy-harvesting circuits, we adopt the realistic non-linear EH model rather than the idealistic linear EH model. The proposed SWIPT protocol can be divided into two phases. The first phase is designed for terminals EH and downlink training. A beam domain energy beamforming method is employed for the wireless power transmission. In the second phase, the BS forms the two-layer receive beamformers for the reception of signals transmitted by terminals. In order to improve the spectral efficiency (SE) of the system, the BS transmit power- and time-switching ratios are optimized. Simulation results show the superiority of the proposed beam-domain SWIPT protocol on SE performance compared with the conventional mMIMO SWIPT protocols.


2021 ◽  
Vol 13 (5) ◽  
pp. 2745
Author(s):  
Manoj Kumar ◽  
Ritu Dogra ◽  
Mahesh Narang ◽  
Manjit Singh ◽  
Sushant Mehan

Manual transplanting, a pre-dominant practice in almost all the paddy growing areas in India, is laborious, burdensome, and has many expenses on raising, settling, and transplanting nursery. The transplanting process’s limitations motivated the replacement of conventional paddy transplanting methods. The study was divided into two phases. The first phase included laboratory testing of three levels of metering mechanisms, namely cell type (M1) with 10 cells grooved around a circular plate having a 13 cm diameter, inclined plate (M2) containing 24 U shaped cells provided on an 18 cm diameter plate, and fluted roller (M3) with 10 flutes on a 5 cm diameter shaft. The testing matrix included a missing index, multiple index, and seed damage with forward speeds (2.5, 3.0, and 3.5 km/h), and pre-germination levels of 24 h soaked (P1), 24 h pre-germinated (P2), and 36 h pre-germinated paddy seeds (P3)). The second phase included selecting the best combination obtained from the laboratory study and developing a new efficient planter for the puddled field. The inclined plate metering mechanism operating at 2.5 km/h for 24 h pre-germinated seeds was reported most efficient from the first phase. Therefore, a self-propelled 8-row planter equipped with an inclined plate metering mechanism having a row-to-row spacing of 22.5 cm was developed, fabricated, and evaluated in the puddled field. The designed planter was assessed on two different soils: sandy loom (ST1) and clay loom (ST2) and at two different hopper fill levels as ½ filled hopper (F1) and ¾ filled hopper (F2). The number of plants per square meter and hill-to-hill spacing was measured. The on-field evaluation revealed that the number of plants per square meter was non-significantly affected by the type of soil but was significantly affected by hopper fill.


Author(s):  
Vishu Madaan ◽  
Aditya Roy ◽  
Charu Gupta ◽  
Prateek Agrawal ◽  
Anand Sharma ◽  
...  

AbstractCOVID-19 (also known as SARS-COV-2) pandemic has spread in the entire world. It is a contagious disease that easily spreads from one person in direct contact to another, classified by experts in five categories: asymptomatic, mild, moderate, severe, and critical. Already more than 66 million people got infected worldwide with more than 22 million active patients as of 5 December 2020 and the rate is accelerating. More than 1.5 million patients (approximately 2.5% of total reported cases) across the world lost their life. In many places, the COVID-19 detection takes place through reverse transcription polymerase chain reaction (RT-PCR) tests which may take longer than 48 h. This is one major reason of its severity and rapid spread. We propose in this paper a two-phase X-ray image classification called XCOVNet for early COVID-19 detection using convolutional neural Networks model. XCOVNet detects COVID-19 infections in chest X-ray patient images in two phases. The first phase pre-processes a dataset of 392 chest X-ray images of which half are COVID-19 positive and half are negative. The second phase trains and tunes the neural network model to achieve a 98.44% accuracy in patient classification.


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