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Biomedical subjects

R Pallister

Publications and source records attributed to R Pallister.

6 recordsLinked to original sources

New hope for a disabling condition. Cognitive-behavioral approaches to panic disorder.

1. Panic disorder, which encompasses both biological and psychological dimensions, is a common anxiety-related problem that can result in significant disability. 2. Cognitive-behavioral approaches to panic disorder are effective in 70% to 80% of patients treated, and generally involve a combination of patient education, relaxation training, exposure, and cognitive restructuring. 3. Mental health nurses can benefit their panic disorder patients by becoming aware of cognitive-behavioral treatment options, and should consider adding these methods to their repertoire of therapeutic skills.

Cognitive Behavioral Therapy↗

The effectiveness and efficiency of health promotion in specialty clinic care.

Chronic illnesses make up the majority of health problems in North America. Many chronically ill persons adjust over time to their illnesses; however, there remains a small but important group of those less adjusted, who are concentrated in specialty clinics and are high users of health care resources. This randomized clinical trial investigated the impact of health promotion interventions in the form of problem-solving counseling or phone support that augmented conventional clinic medical care. Chronically ill, poorly adjusted outpatients (n = 293) attending clinics were randomly assigned to receive additional problem-solving counseling, phone call support, or neither. Psychosocial adjustment to illness, utilization, and expenditures of health services were the main outcomes measured. There were no overall significant differences between groups in their change in psychosocial adjustment and expenditures for health and social care. However, interaction analyses (P < 0.05) gave an indication of who might benefit from these interventions. Those who lived alone and infrequently used problem-solving behaviors to cope with their illness significantly improved their adjustment to illness and had fewer health service expenditures if they received problem-solving counseling. Supportive telephone calls were most effective for those who lived with someone and frequently used problem-solving coping behaviors. These findings suggest that health promotion services should be targeted to outpatients described by specific social support and coping characteristics.

Adaptation, Psychological↗

Problem-solving counselling or phone-call support for outpatients with chronic illness: effective for whom?

The purpose of this randomized controlled trial (RCT) was to determine the effectiveness of problem-solving counselling or phone-call support provided by nurses to outpatients not well adjusted to chronic illness. Subjects (N = 293) completed measures at baseline and after the six-month period of intervention for psychosocial variables including coping behaviours, purpose in life, and psychosocial adjustment to illness. Subjects receiving phone-call support from nurses demonstrated less psychological distress. Results also suggest that problem-solving counselling improves psychosocial adjustment to chronic illness for outpatients who live alone, infrequently use problem-solving coping skills, or frequently use avoidance coping methods. As well, outpatients with a low purpose in life who show infrequent use of problem-solving coping skills appear to benefit most from problem-solving counselling provided by nurses. On the other hand, those not well adjusted who frequently use problem-solving coping seem to be served more effectively by phone-call support.

Adaptation, Psychological↗

Prevalence and characteristics of frequent attenders in a prepaid Canadian family practice.

Frequent attenders in family practice represent a small proportion of the total population, yet they consume a large amount of services. A description of their characteristics and problems is needed in order to design a therapeutic intervention tailored to meet these needs. A comparative analytic survey of 9,313 patients was done in order to isolate three cohorts: 200 zero users in the previous year, 200 modal (one to two times per year) users, and 200 frequent users (nine or more times per year). It was found that frequent attenders (who represented 4.5 percent of the practice, yet generated 21 percent of the annual visits) differ from infrequent attenders in that they have twice the probability of being single; are more physically, socially, emotionally distressed; suffer from problems of self-esteem; show a slightly greater degree of family dysfunction; tend to be unemployed, retired, or mothers of infants; are externally controlled or tend to rely on others for help; receive low incomes, retirement pensions, or family benefits; tend to be high users of other physician, social work, nursing, and laboratory services; consume a significantly greater number of pills than their infrequent user counterparts; and tend to present more emotional and gastrointestinal complaints than their modal user counterparts.

Adolescent↗