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Biomedical subjects

M Silberfeld

Publications and source records attributed to M Silberfeld.

At least 37 records · Page 2Linked to original sources

Psychiatric services: a survey of nursing homes and homes for the aged in Ontario.

A survey was conducted to determine perceptions and attitudes of psychiatric services available to nursing homes and homes for the aged across Ontario. A questionnaire was sent by mail to medical and nursing directors separately. Thirty-six point eight percent of responders reported that the nursing home residents never receive psychiatric care, and 88.2% of responders estimated the total psychiatric care received by all of their residents per month was five hours or less. Almost three-quarters of the responders stated that they require more psychiatric services. Significantly more nursing directors than medical directors wanted more psychiatric services. Southwestern Ontario, followed by Northern Ontario, had the least perceived availability of a visiting psychiatrist. Perceived availability was greatest in larger urban areas and least in rural areas. The mean percentage of residents perceived to have psychiatric or behavioural problems was 30.5%, while the mean percentage perceived to require psychotropic medication was 37.4%. Physical aggression, wandering and agitation were identified as the behavioural problems of greatest concern to staff. When a visiting psychiatrist is not available, residents sometimes have to travel long distances for psychiatric evaluation. Planning is required to facilitate and encourage the development of efficient and effective psychiatric services for long term care facilities for the elderly.

Aged↗

A preliminary report on the discrepancy between clinical and test evaluations of competence.

This report demonstrates the discrepancy that can occur between clinical and test evaluations of competence. It presents retrospective examination of 35 assessments of competence performed on 24 subjects by a multidisciplinary competency panel. The findings of the panel are compared with the subjects' results on the Cognitive Competency Test and on the Mini-Mental State Examination. The results show that the multidisciplinary competency panel will more often find subjects competent than indicated by their psychometric test scores. A process approach to the use of tests is recommended. Reliance on tests to decide the outcome of difficult cases does not appear to be warranted.

Adult↗

Heterogeneity in responses to cancer. Part I: Psychiatric symptoms.

Heterogeneity in psychiatric responses to disease specific diagnosis is demonstrated for two groups of cancer patients who are comparable in prognosis and treatment intensity. Implications of this heterogeneity are drawn for etiological study and for planning psychiatric interventions.

Adaptation, Psychological↗

Heterogeneity in responses to cancer. Part II: Sexual responses.

Heterogeneity in psychosexual responses to disease-specific diagnosis is demonstrated for two groups of cancer patients with testis cancer and Hodgkin's disease who are comparable in prognosis and treatment intensity. The two groups of patients and their partners are shown to differ in their ability to recover from psychiatric problems associated with the diagnosis and/or treatment of cancer.

Adaptation, Psychological↗

Psychiatric consultation services in an oncology hospital.

Psychosocial oncology has become an area of considerable interest over the past ten to fifteen years. There has been little written about the development of psychiatric services or the profile of such services to this population. This paper describes the historical evolution of a psychiatric consultation service in a cancer hospital and provides a statistical analysis of the patient population and services provided. The special need for continuity of care and a comprehensive biopsychosocial approach is elaborated and clinical examples are reported. Finally, directions for the future development of this kind of service are suggested.

Adaptation, Psychological↗

Erotic transferences.

Erotic transferences occur on a spectrum reflecting the ease or difficulty of their management. They represent sexualized re-enactments of important childhood relationships. This phase in psychotherapy may be a transient developmental feature or in some instances, assume a formidable resistance to further insightful work. Two case illustrations are given to indicate the breadth of this spectrum. Reasons are discussed for such differences in erotic transferences and their resolutions.

Adult↗

Suicide attempters, ideators and risk-taking propensity.

The personality dimensions related to risk-taking propensity in suicide patients were sought. Two dimensions, responsibility and self-esteem, were helpful in distinguishing between suicide involved patients, and non-suicide related cases.

Choice Behavior↗

Measurement of individual preferences. The importance of "situation-specific" variables.

Women in two Ontario cities were asked to express their preferences about a medical decision: A fictitious patient with cancer was to be treated either conservatively without hope of cure, or radically, by a risky treatment having cure or immediate death as possible outcomes. Situation-specific variables were varied systematically across the sample by varying the levels of the fictitious patient's physical and psychosocial health and achievement motivation. The results obtained indicate that individual preferences shift in response to changes in the situation in which the decision is made. These findings raise questions about the uses to be made of measurements of preferences, especially in relation to what is meant by a "best decision."

Adult↗

Use of the life table method in determining attrition from treatment.

Life table analysis of attendance at an outpatient clinic indicates levels of attrition similar to those reported by follow-up and other studies of treatment for drug dependence. With appropriate qualifications, rates of attrition may be viewed as measures of treatment outcome.

Actuarial Analysis↗

A correlation between cognitive performance and daily functioning in elderly people.

The Mini-Mental State Examination (MMSE) is widely used to detect dementia, but the diagnosis of dementia also depends on a decline in the level of daily functioning. Little is known about the relationship between performance on the MMSE and daily living abilities. This relationship was investigated in this study of an elderly population by comparing scores on the MMSE with those on both a direct assessment of everyday tasks and an indirect questionnaire about activities of daily living and physical self-maintenance. Forty-five subjects with varying mental abilities participated in the study. A significant correlation was found between MMSE scores and the measures of functional abilities; but the specificity and sensitivity to the diagnosis of dementia would be increased by assessing functional status, even indirectly, as well as cognitive ability.

Activities of Daily Living↗