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Biomedical subjects

J Tsiantis

Publications and source records attributed to J Tsiantis.

30 records · Page 2Linked to original sources

Change in care staff's attitudes towards people with learning disabilities following intervention at the Leros PIKPA asylum.

The pilot intervention project at Leros PIKPA asylum sought to change the management of residents by decreasing care staff's tendency to view people with learning disabilities with attitudes of custodial segregation (e.g. "they should all live in institutions") and categorisation (e.g. "they are all alike"). To that end, staff were trained on the job in resident management and participated in seminars, sensitisation groups, clinical case presentations and visits to model rehabilitation units. To investigate whether staff attitudes towards people with learning disabilities had been influenced, staff members responded to a questionnaire of such attitudes, in March 1991 (initial assessment) and a year later (reassessment). Factor analyses of attitude ratings at initial assessment revealed a strong negative attitudinal construct, "Rejective and custodial segregation--Categorisation", according to which institutionalisation was the only appropriate type of care for people with learning disabilities, regardless of individual differences. At reassessment, however, this factor had split into two independent ones, "Rejective and custodial segregation" and "Categorisation", suggesting that the staff had understood that custodial care did not apply to all persons with learning disabilities indiscriminately. Reassessment factors further indicated that staff had comprehended the appropriateness of alternative care forms--community and home care. Analysis of Categorisation and Custodial segregation attitude ratings showed that only staff's tendency to view the disabled as "all alike" (Categorisation) had decreased at reassessment. The latter change and the structural change revealed by the factor analyses imply that staff's attitudes underwent a small but significant modification.

Adolescent↗

Mortality among institutionalised people with learning disabilities in Greece: a 30-year survey at the Leros PIKPA asylum.

The life expectancy of institutionalised people with learning disabilities is shorter than that of the general population. Data on population dynamics in institutions for such people are vital for planning purposes. Mortality can be considered a crude measure of quality of health care. Mortality data on the 914 admissions to the Leros PIKPA asylum for children and young adults with learning disabilities and associated problems in the years 1961-91 were reviewed. The overall crude mortality rate was 59.2 deaths per 1000 person-years. Twenty-two per cent of the deaths occurred within a year after admission. Age-specific mortality rates were particularly high for those aged one to four years, and declined thereafter. Male residents had lower mortality than female residents in almost all of the age groups. Compared with sex- and age-specific mortality data for the general population of Greece, the observed rates were 20-150 times higher but still comparable to those reported for people with more severe learning disabilities in institutions in other countries. Lifetable analysis by length of stay showed that male residents had a statistically significant higher probability of survival than female residents, which could not be attributed to age-related differential mortality. Culture-specific differential admission criteria may account for the observed sex difference.

Adolescent↗

Development of a WHO Child Care Facility Schedule (CCFS): a pilot collaborative study.

This paper describes the research conducted by a WHO collaborative study group for the development of a questionnaire method for the assessment of quality in child-care settings. The results of an inter-rater reliability study undertaken in Greece and Nigeria suggest that the Child Care Facility Schedule (CCFS), composed of 80 items, offers a satisfactory system of rating, especially after modifications were made to refine certain items, alter the scoring system so as to grasp nuances, and clarify the instructions in the users' manual, including revisions in the interviewing technique. A validity study to confirm the usefulness of this method is being carried out in Athens.

Child Care↗

A multi-level intervention approach for care of HIV-positive haemophiliac and thalassaemic patients and their families.

The experience gained from the application of an on-going multilevel intervention programme through an interdisciplinary team approach to the management of 30 HIV-positive children, adolescents and young people aged from 7 to 21 years (20 haemophiliac and 10 thalassaemic patients) and their families is described. The objective of the intervention was to assess the family's needs, to help parents and other family members to contain the anxiety of seropositive children and to improve their interraction with the family as well as with others in their social environment. The intervention was also designed to help family members to cope with their grief. Work with the medical and nursing staff, on the other hand, was intended to increase their understanding of the emotions caused in them by occupational stress, such as fear, anxiety, prejudice and feelings of guilt related to the iatrogenous nature of the infection. The need for follow-up studies is stressed to allow assessment of the effectiveness of the intervention and to search for protective factors, successful coping skills, strategies and adaptational resources.

Adaptation, Psychological↗

Schizophrenia in children: a review of European research.

European literature on childhood schizophrenia is divergent and vast. The topic itself is controversial and complex. The article reviews selected European literature on childhood schizophrenia and presents the most important trends of research from the literature. Extensive work has been devoted in tracing and defining the boundaries of childhood schizophrenia from infantile psychosis, autism, organic psychoses, and borderline states, and of mapping out the condition. The factor of development as an important variable when studying diagnostic criteria and the course of the condition was singled out by many researchers. The evidence from the research on etiological factors was also reviewed, and most authors seem to agree on a nature-nurture interaction model. The different treatment modalities and approaches are also presented and discussed. Finally, a proposal is made for comparative studies to be carried out that will cover course and followup.

Adolescent↗

Family reactions and their management in a parents group with beta-thalassaemia.

The parents of children with beta-thalassaemia displayed various patterns of emotion (guilt, death anxiety, denial of feelings) and their behaviour towards the child was inappropriate (overprotective, conspiracy of silence); this could affect his psychosocial development and lead to tension within the family. Some parents were overdemanding and even hostile to hospital staff, thus making the management of cases difficult. The therapeutic team has tried to concentrate on these problems in order to clarify them and give support to the families. This has facilitated communication within the family as well as between the family and hospital staff, and had diminished the problems.

Adjustment Disorders↗

Changes in the hostility of schizophrenic patients during treatment.

Hostility towards self and others often precipitates admission to hospital of the schizophrenic patient. A follow-up study of 24 newly admitted schizophrenic patients during eight weeks of treatment indicated high intropunitiveness and extra-punitiveness at admission which decreased concurrently with psychopathology. The larger change was in intro-punitiveness, resulting in an increase in the original predominance of extra-punitiveness. The various measures of hostility were not predictive of response to treatment at eight weeks. Comparisons between the schizophrenic group and a group of depressed patients indicated significant differences in the expression of hostility. At admission the schizophrenic patients are less intro-punitive and more extra-punitive than the depressed patients, these differences disappearing after eight weeks of treatment. This finding tends to support the psychodynamic view of projective and introjective mechanisms in these two illness groups.

Adolescent↗

The temporal relationship between hostility and depressed mood.

Nineteen depressed in-patients were studied in a follow-up design for 8 weeks or until discharge, using three depression scales and a hostility questionnaire. It was hypothesized within a cognitive theory of depression that, self-rated hostility being a measure of negative thoughts and attitudes, changes in hostility would precede mood changes. Analysis was by contemporaneous and cross-correlations between mood and hostility measures. High intercorrelations were obtained among the mood ratings which decreased significantly over time, as did two of the four hostility measures. The hypothesis was confirmed by the cross-correlations between nurses' mood ratings and intropunitiveness and direction of hostility. The cross-correlations with Beck and Hamilton scales supported the hypothesis at a non-significant level.

Adult↗

The movement of hostility during recovery from depression.

Sixteen depressed in-patients from a hospital in Athens were assessed using the Hamilton Rating Scale and the Hostility and Direction of Hostility Questionnaire. Comparison of admission, discharge and mid-treatment scores showed that: (1) There was a larger drop in depression score in the first half of treatment. (2) Hostility scores, except for extrapunitiveness, decreased significantly over time, larger changes occurring in the first half of treatment. (3) Comparisons with British scores showed that during illness there were no significant differences between British and Greeks, though the latter tended to be more extrapunitive. At recovery, the Greeks were significantly more extrapunitive. The movement of hostility in depressive illness, the validity of the HDHQ and need for national norms are discussed.

Adult↗