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Biomedical subjects

Roger Baker

Publications and source records attributed to Roger Baker.

7 recordsLinked to original sources
PubMed2004

Emotional processing and panic.

In this paper Rachman's concept of emotional processing was extended and a model highlighting the psychological operations underpinning processing was specified. Using this model, the aim was to investigate, by means of a questionnaire, whether patients with panic disorder (n=50) have more emotional processing difficulties than two samples of healthy controls (London, n=406; Aberdeen, n=125). The panic disorder group did have significantly more emotional processing difficulties than the control groups, showing a marked tendency to control feelings of anger, unhappiness and anxiety. Three emotional processing dimensions distinguished the panic from the control groups: greater control of emotional experiences ('smothering' or 'bottling up' emotions), greater awareness of feelings and more difficulties in labelling emotions. The authors hypothesise that emotional processing deficits act as a vulnerability factor for developing panic attacks.

Adult↗
PubMed2003

Effects of multi-sensory stimulation for people with dementia.

BACKGROUND: Over recent years multi-sensory stimulation (MSS) has become an increasingly popular approach to care and is used in several centres throughout Europe. This popularity could be explained by the limited alternatives available to staff and a widely held belief that MSS is a friendly and highly humane approach. A randomized controlled trial was therefore essential to evaluate the effectiveness and extent of the benefits of MSS. AIM: To assess whether MSS is more effective in changing the behaviour, mood and cognition of older adults with dementia than a control of activity (playing card games, looking at photographs, doing quizzes, etc.). METHODS: A total of 136 patients from three countries [United Kingdom (UK), the Netherlands and Sweden] were randomized to MSS or activity groups. Patients participated in eight 30-minute sessions over 4 weeks. Ratings of behaviour and mood were taken before, during and after sessions to investigate immediate effects. Pre-, mid-, post-trial and follow-up assessments were taken to investigate any generalization of effects to cognition and behaviour and mood at home/on the ward or at the day hospital. RESULTS: There were limited short-term improvements for both the MSS and activity groups immediately after sessions, and limited short-term improvements between the groups during sessions. There were no significant differences between the groups when assessing change in behaviour, mood or cognition at home/on the ward or at the day hospital. In the UK, however, behaviour at the day hospital for both groups remained stable during the trial but deteriorated once the sessions had stopped, and active/disturbed behaviour at home improved but likewise deteriorated once sessions had stopped. CONCLUSIONS: Overall, MSS was found to be no more effective than an activity in changing the behaviour, mood or cognition of patients with dementia in the short- or long-term.

Acoustic Stimulation↗
PubMed2003

GP referrals for counselling: a review and model.

Considerable efforts have been made to describe and evaluate general practitioner (GP) referral of patients to counsellors, although the literature describing contributory factors in the referral process is inconclusive. The aim of this study was to conduct a comprehensive literature review and present the information in a cohesive and practical model that might be of interest to both doctors and counsellors. An English language computerised literature search was conducted. The title or abstract contained any, or a combination of the following keywords: 'patient characteristics', 'counselling', 'primary care', and 'referral'. A further search was conducted based on relevant articles referenced in the above selection. A model was developed that showed an array of factors related to the patient, the GP, the GP-counsellor relationship, and external variables. Their interaction resulted in a complex collaborative process between the patient, GP and counsellor. These and their consequences were discussed, along with future research needs.

Algorithms↗
PubMed2003

Effects of multisensory stimulation in people with Huntington's disease: a randomized controlled pilot study.

OBJECTIVE: To investigate whether behavioural, motor and physiological responses of individuals with Huntington's disease (HD) to a controlled multisensory environment (MSE) are effective as a therapeutic (sustained effects) or leisure (immediate effects) activity. DESIGN: Pilot study--a randomized, controlled, two-group design. SETTING: Specialist residential unit for people with mid-late stage HD. SUBJECTS: Twelve patients with HD (one subject from each group dropped out during the study after week 8 due to medical complications). INTERVENTIONS: Patients attended eight, 30-minute sessions over a four-week period, of multisensory stimulation (MSE, treatment group) or relaxation activities (control group). MAIN OUTCOME MEASURES: Between-group comparisons for changes between assessment sessions for two behavioural assessments: Rehabilitation Evaluation--Hall and Baker (REHAB), Behaviour and Mood Disturbance Scale (BMD); a motor assessment: the dyskinesia section of the St Hans Rating Scale (SHRS); physiological measures: blood pressure, heart rate and respiratory rate. Secondary measures during intervention sessions included behavioural assessment using the Interact. RESULTS: There were no significant differences found between the groups for any main outcome measures made between sessions. The MSE group showed some positive effects within-sessions, with the Interact showing significant between-group differences in immediate effects on mood (p = 0.028). There was also a significantly different change over time for within-session changes in stimulation levels (p = 0.0002) and mood (p = 0.0001) between the groups. No physiological effects were observed in relation to sessions in either group. Two MSE subjects underwent changes in medication during the study period. CONCLUSIONS: There was no therapeutic effect of MSEs over the four-week study period. MSEs appear to be more effective thanconventional relaxation techniques as a leisure activity.

Affect↗
PubMed2003

Breathlessness clinics within specialist palliative care settings can improve the quality of life and functional capacity of patients with lung cancer.

This paper is a development on recent research that proved the value of non-pharmacological techniques and strategies in the management of breathlessness in lung cancer. It evaluates the intervention in a specialist palliative care setting using an outpatient clinic at Lewis-Manning House. Referrals were made by the patients' physician or specialist nurse. Patients (n = 30) were assessed and treated by the senior physiotherapist in charge of the clinic over three sessions. A number of outcomes were measured at various stages of the patients' treatment. The results have confirmed and strengthened the previous published results. Highly significant improvements in patients' breathlessness, functional capacity, activity levels and distress levels have been shown. For example, the percentage of patients experiencing breathlessness several times or more per day was reduced from 73% to 27% four weeks later. In addition, this project has been able to demonstrate significant improvements in quality of life and high levels of satisfaction with the interventions. Qualitative data enhanced the findings of objective measurements.

Aged↗
PubMedDate not supplied

Attitudes to restraint for the prevention of falls in hospital.

INTRODUCTION: Fall prevention measures in hospital are often considered to be restraint and unsuitable for clinical practice. The aim of the study was to explore attitudes to restraint and what are acceptable fall prevention measures in hospital. METHODS: A structured questionnaire was completed by 200 subjects (100 patients/relatives and 100 care professionals) in a British hospital. RESULTS: Ninety-nine percent agreed that fall prevention was important. There was 84.5% agreement that restraint is justified to prevent harm and 81.5% disagreement that restraint should never be used if the patient is at risk of falling. Disagreement was stronger among patients/relatives (91 vs. 72%; p = 0.001). Seventy seven percent disagreed that restraint is not acceptable even if discussed with patients and relatives. Significant differences in agreement were identified between patients/relatives and care professionals for the following statements: 'restraint should always be an option in patients if the patient is at risk of falling' (82 vs. 45%; p < 0.0001), 'restraining methods are acceptable at the discretion of care professionals' (91 vs. 43%; p < 0.0001), 'restraint is an infringement of personal freedom' (35 vs. 66%; p < 0.0001) and 'restraint is necessary if it frees staff to do more clinical work' (51 vs. 10%; p < 0.0001). A wide range of acceptability was identified for various measures of restraint: observation beds (95%), bed/chair alarms (80%), bed rails (77%), identification bracelets (95%) and risk labels at the head of the bed (75.5%). Direct binding (5.5%) or tranquilliser use (9%) was considered highly unacceptable. CONCLUSIONS: When there is a lack of evidence of effectiveness, fall prevention guidelines are formulated on the basis of expert opinion influenced by ethical considerations, cultural attitudes and society's values. Such information is important to formulate informed fall prevention policies.

Accident Prevention↗