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Biomedical subjects

J Dekker

Publications and source records attributed to J Dekker.

172 records · Page 10Linked to original sources

A comparison of sex therapy and communication therapy: couples complaining of orgasmic dysfunction.

Forty-eight couples who complained of female orgasmic dysfunction received one of two therapies: sex therapy and communication therapy. Each couple was treated by a team of one male and one female therapist. Pretherapeutic, posttherapeutic and follow-up measurements showed that female sexual satisfaction increased in both therapies, but that the increase came more quickly in sex therapy. Male sexual satisfaction increased in sex therapy, but diminished in communication therapy. A two-phase model of the sexual response was tested against the therapeutic results. The experience of sexual interaction and the orgasmic experience improved in males and females in sex therapy, and in females in communication therapy. The male experience of sexual interaction deteriorated in communication therapy, while the male orgasmic experience initially increased and subsequently diminished again. Satisfaction with the total relationship increased in the males in communication therapy, and in the females in sex therapy.

Adult↗

Structural joint changes, malalignment, and laxity in osteoarthritis of the knee.

OBJECTIVE: To assess the relationship between (i) structural joint changes (i.e. joint space narrowing and osteophyte formation) and laxity and (ii) joint malalignment and laxity in osteoarthritis (OA) of the knee. METHODS: A cross-sectional study was carried out on 35 outpatients with osteoarthritis of the knee. Weight-bearing radiographs of the knees were used to assess joint space narrowing (JSN) and osteophyte formation. Knee joint laxity was assessed using a device that measures the angular deviation of the knee in the frontal plane (varus-valgus laxity). Malalignment was assessed using a goniometer. All analyses were performed using knees as units of analysis (i.e. 70 knees). RESULTS: The mean laxity of 70 knees was 8.0+/-4.1 degrees. Knees with minute JSN were significantly more lax than knees with no JSN. There was no significant relationship between osteophyte formation and laxity. Malaligned knees were significantly more lax than aligned knees. CONCLUSION: Both joint space narrowing and malalignment are related to laxity. These results support the premise that biomechanical factors play a role in the degeneration of the osteoarthritic knee joint.

Adult↗

The number of therapeutic sessions in logopedic care: a description and analysis.

The aim of this study was (i) to describe the number of therapeutic sessions in logopedic care in the Netherlands and (ii) to analyse which factors determine the number of sessions. An analysis was performed on a data set of 517 patients who received logopedic treatment. Data concerning patient characteristics, medical diagnosis, logopedic diagnosis (in terms of impairments, disabilities and handicaps) and the number of sessions were available. The mean number of sessions was 17.2 (SD 10.7). In a multivariate analysis 19.4% of the total amount of variance in the number of sessions was explained; impairments were the only significant determinant. Language development impairments, aural impairments and impairments of auditory functions were associated with a relatively large number of sessions; impairments in reading and writing were associated with relatively few sessions. Recommendations for the design of future studies on the optimal number of sessions are derived from these findings.

Adolescent↗

Reliability of the assessment of impairments and disabilities in survey research in the field of physical therapy.

OBJECTIVE: to evaluate the reliability of diagnostic assessment based on clinical observations by physical therapists. DESIGN: interobserver studies between two pairs of physical therapists. SETTING: two primary-care physical therapy practices. PATIENTS: all applying to the practices for treatment. EXCLUSIONS: physical therapy in previous 3 months, or need for acute treatment. ASSESSMENTS: schedule derived from the ICIDH. RESULTS: agreement on disabilities better than on impairments, the latter revealing problems particularly with pain and restricted range of motion. CONCLUSIONS: reliability of assessments of most of the categories considered was reliable; in two categories the reliability was poor, and the categories were modified.

Activities of Daily Living↗

Reliability of the diagnosis of impairments in survey research in the field of chiropody.

Chiropody is a rather unknown paramedical profession in The Netherlands. A chiropodist treats foot and nail problems or postural deviations which may be corrected by means of remedial foot therapy. There is no history of scientific research on chiropody. A necessary first step is a survey on professional practice, diagnosis and treatment. A requirement for a survey study is a reliable registration form. In this study a registration form that draws on the conceptual framework of the ICIDH (International Classification of Impairments, Disabilities and Handicaps) was tested on inter-observer reliability. A chiropodist and a trainee examined 49 patients. Reliability was determined using two measures: the percentage of agreement and Cohen's Kappa. Findings of this study indicate that the reliability of the registration form for the assessment of the chiropody diagnosis is satisfactory.

Adult↗

Application of the ICIDH in survey research on rehabilitation: the emergence of the functional diagnosis.

The International Classification of Impairments, Disabilities, and Handicaps (ICIDH) has been hypothesized to be an excellent conceptual framework for the functional diagnosis, i.e. the evaluation of health problems by rehabilitation specialists. The ICIDH-based functional diagnosis was assessed in a series of survey studies on physical therapy, exercise therapy, occupational therapy, podiatry, and speech therapy. The results show that the functional diagnosis tends to be reliable; that treatment goals, derived from the diagnosis, offer a sensible characterization of care given by rehabilitation specialists; and that treatment goals validity predict the selection of interventions by rehabilitation specialists. It is concluded that the application of the ICIDH in research on the functional diagnosis is highly appropriate. In future studies the concept of the functional diagnosis and the diagnostic procedures should be further developed.

Disability Evaluation↗