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Biomedical subjects

K R Cohen

Publications and source records attributed to K R Cohen.

At least 19 recordsLinked to original sources
PubMed1999

Doctor discontent.

Explore the source record for details and available documents.

Delivery of Health Care↗
PubMed1999

Motivational interviewing and treatment adherence among psychiatric and dually diagnosed patients.

The effect of motivational interviewing on outpatient treatment adherence among psychiatric and dually diagnosed inpatients was investigated. Subjects were 121 psychiatric inpatients, 93 (77%) of whom had concomitant substance abuse/dependence disorders, who were randomly assigned to: a) standard treatment (ST), including pharmacotherapy, individual and group psychotherapy, activities therapy, milieu treatment, and discharge planning; or b) ST plus motivational interviewing (ST+MI), which involved 15 minutes of feedback on the results of a motivational assessment early in the hospitalization, and a 1-hour motivational interview just before discharge. Interviewers utilized motivational techniques described in Miller and Rollnick (1991), such as reflective listening, discussion of treatment obstacles, and elicitation of motivational statements. Results indicated that the proportion of patients who attended their first outpatient appointment was significantly higher for the ST+MI group (47%) than for the ST group (21%; chi2 = 8.87, df = 1, p<.01) overall, and for dually diagnosed patients (42% for ST+MI vs. 16% for ST only; chi2 = 7.68, df = 1, p<.01). Therefore, brief motivational interventions show promise in improving outpatient treatment adherence among psychiatric and dually diagnosed patients.

Adult↗
PubMed1995

Patient-centered care: a revolution in medicine.

Systems management has the potential to become the catalyst for a private sector revolution that could replace public sector attempts at health care reform. This article will attempt to illustrate the concepts behind systematic, totally integrated, individualized, patient-centered health care--what the authors have coined "systems management of medicine."

Acute Disease↗
PubMed1989

Non-odontogenic beta-hemolytic necrotizing fasciitis of the face.

A case report of a severe, rapidly aggressive necrotizing fasciitis of the facial tissues demonstrates the need to consider anatomic, systemic, and bacterial factors in evaluating this disease. Early diagnosis is critical for optimum management. Surgical debridement is the cornerstone of treatment and must be complemented with aggressive supportive therapy and antibiotics. In this instance of non-odontogenic beta-hemolytic necrotizing fasciitis of the face, aggressive care resulted in management of the disease process to a point where the patient's perioral wounds stabilized and were not of immediate significance to her death.

Aged↗
PubMed1985

Incidence and implications of alexithymia in chronic pain patients.

Alexithymia is a clinical phenomenon that has been found to occur with some frequency in psychosomatic disorders. Its prevalence in psychosomatic patients suggests that it could be observed in chronic pain patients as well. The present study examines the incidence of alexithymia in chronic pain patients as assessed by the Archetypal Test with Nine Elements (AT9). Patients' scores on the AT9 (SAT9) were examined in conjunction with McGill Pain Questionnaire (MPQ) data, MMPI subscale scores, and patient data. There were no significant relationships found between SAT9, MMPI, and MPQ scores. These observations are examined with reference to the nature of the assessment instruments used. Implications of these observations for theory and therapy are discussed.

Affective Symptoms↗
PubMed1983

Relationship of heterophoria to stereopsis.

Eighty patients with 6/7.5 (20/25) or better visual acuity in each eye noted differences in stereoacuity with crossed and uncrossed disparity. Esophoric patients who perceived a difference were more likely to have greater stereoacuity with uncrossed disparity, and exophoric patients who perceived a difference were more likely to have greater stereoacuity with crossed disparity. Asymmetry of Panum's area may be a factor in this phenomenon.

Esotropia↗
PubMed1983

The measure of symbolic function in alexithymic pain patients.

The archetypal test with 9 elements (AT9), a tracer of symbolic function, was completed by 30 pain patients in whom alexithymia had been measured by two means: the Beth Israel psychosomatic questionnaire (BIQ) and the Minnesota multiphasic personality inventory (MMPI) alexithymia scale. Results show a correlation of adequate statistical significance (p less than 0.05) between the AT9 and the BIQ but not with the MMPI alexithymia scale. The scored AT9 (SAT9) allows one to discriminate between forms and degrees of disorganization in symbolic activity within an alexithymic population. The AT9 measures something central to the construct of alexithymia and its advantages and possibilities over other tools to assess alexithymia are discussed.

Affective Symptoms↗
PubMed1983

The SAT9: a quantitative scoring system for the AT9 test as a measure of symbolic function central to alexithymic presentation.

This paper reports the result of preliminary efforts to devise a more objective and quantifiable system with which to score the AT9 test. The AT9 traces symbolic function, a trait central to an alexithymic presentation, and until now has been available only to those clinicians who have the prior knowledge necessary to projectively interpret it. Based on a sample of 42 patients, the inter-rater reliability on the new scale (SAT9) reaches highly acceptable levels of significance as does the correlation between the SAT9 and the ranked projectively interpreted protocols (RPAT9). These results support the further refinement of the SAT9 scale as a means of facilitating the use of this test as a measure of a central alexithymic process.

Adult↗
PubMedDate not supplied

Accommodative esotropia in adults.

The accommodative convergence/accommodation (AC/A) ratio is thought to be fixed throughout life. We present 11 patients who, in adulthood, show a situational increase in their AC/A ratio. Since all patients had a history of accommodative esotropia with and without a nonaccommodative component, we feel the situational increase in the AC/A ratio is in response to the additional effort needed to correct the patients' facultative hyperopia. These patients demonstrate the importance that all adults with acute onset of commitant esotropia and a history of accommodative esotropia should wear full correction before a prism is incorporated into their glasses or surgical intervention is considered.

Accommodation, Ocular↗