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Biomedical subjects

J E Miles

Publications and source records attributed to J E Miles.

At least 37 records · Page 2Linked to original sources
PubMed1980

A psychiatric outreach project to a rural community.

In late 1976 the University of British Columbia, working with the provincial health ministry, began an outreach program to rural areas lacking sufficient local psychiatric services. Four teaching hospitals in the province were linked with selected underserved communities to provide both direct service and professional and public education. The psychiatry department of Shaughnessy Hospital in Vancouver was linked with the Dawson Creek community, which had good general health facilities but few specialized services for psychiatric patients. Two psychiatrists began monthly three-day site visits for consultation and education. Staff also provided 24-hour telephone consultation, refresher courses in Vancouver, support for a new psychiatric day care program in the Dawson Creek general hospital, and funding for a temporary psychiatric nurse for the general hospital. Questionnaires completed by local health professionals indicated the project was a success, and that it was of practical value to the professional practice of local physicians, nurses, and social service workers.

Adolescent↗
PubMed1976

Marital therapy of couples in which the husband is a physician.

This paper is concerned with the therapeutic problems posed by the troubled "medical" marriage. Based on the authors' clinical experiences, certain common characteristics of these marriages are identified. Obstacles to early referral such as self-diagnosis and self-treatment are discussed, two illustrative case vignettes are presented, and therapeutic recommendations are outlined.

Affective Symptoms↗
PubMed1976

Discharges against medical advice from voluntary psychiatric units.

About one in every six voluntary mental patients discharges himself against medical advice. But despite the high rate of AMA discharges, the authors found the literature on the subject to be sparse and of little help in explaining why patients leave the hospital against medical advice. They examine the approaches that have been used thus far to study the phenomenon. They also report the findings of their own study, which showed that patients discharged against medical advice had a poorer response to treatment than those discharged in the traditional manner. The study identified factors that contributed to the poor response and were related to the discharge.

Acute Disease↗
PubMed1975

Medical student change during a psychiatry clerkship: evaluation of a program.

The psychiatry clerkship at the University of British Columbia (U.B.C.) emphasizes the teaching model of the student as primary therapist. In the adult program this takes the form of a ward in which clinical clerks are the primary medical agents. In the child program each clerk assesses and treats a new family referral. While the student-ward model has been described previously, this is the first report which attempts to evaluate some aspects of this innovative approach to teaching clinical psychiatry. Student knowledge, attitudes, personality attributes, and expectations were assessed at the beginning and end of the eight-week rotation, and the changes are described. Principal findings included significant differences in the following: psychiatric knowledge, attitudes about psychiatric illness, ratings of the students by the psychiatrist-supervisor, and some student personality characteristics. Most students had rotation experiences which went beyond prior expectations. The changes which occurred were thought to be important, although modest. The implications of the changes are discussed. The level of the patient care in the programs described compared favorably with similar situations in which residents are the primary therapists.

Attitude↗
PubMed1975

The doctor's wife: mental illness and marital pattern.

It is a clinical impression that physicians' wives present in disproportionately large numbers as psychiatric patients; that in the vast majority severe marital problems are present; and that the marital relationships show a similar pattern. The purpose of this paper is to ascertain whether the latter two impressions have any basis in fact. Accordingly, a random sample of twenty physicians' wives who had been in-patients in the University of British Columbia Health Sciences Centre Hospital during the period March 1, 1969 to May 31, 1973, and whose husbands had been interviewed, was selected. The records were reviewed to obtain personal data, pertinent psychiatric history, diagnosis, the personality of husband and wife and information on the marital relationship. These conclusions emerged: 1. Ninety per cent of the patients had a primary diagnosis of depressive neurosis. 2. Ninety-five per cent of the patients had a secondary diagnosis of personality disorder, hysterical personality and passive-aggressive personality in order of frequency. 3. In 90 per cent of the patients there was a history of suicidal preoccupation or attempt. 4. In 55 per cent of the patients there was a history of significant drug and/or alcohol abuse. 5. The patients were more frequently ward management problems. 6. A common marital pattern was noted: a dependent, histrionic wife and an emotionally detached husband. 7. The cases were characterized by their complexity, severity, long duration and difficulties involving the patient and spouse in an appropriate treatment plan. The authors discuss the implications of this study, particularly its significance in provoking examination of what measures might be utilized for early detection and intervention with those physicians and physician-marriages at risk.

Adult↗