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Biomedical subjects

S LeBaron

Publications and source records attributed to S LeBaron.

34 records · Page 2Linked to original sources
PubMed1985

Pediatrics and psychology: a collaboration that works.

The growing relationship between pediatrics and psychology is described. Differences and similarities in training and orientation between psychologists and pediatricians are discussed, as well as three different models of collaboration. Pediatrician-psychologist collaboration can result in significant improvements in: comprehensive primary health care, treatment of psychosomatic disorders, and management of children suffering from a combination of medical, family, and adjustment problems. Research and health care legislation are two additional areas where collaboration between pediatrics and psychology is proving to be valuable.

Adolescent↗
PubMed1985

Paternalistic vs egalitarian physician styles: the treatment of patients in crisis.

According to previous reports, the quality of the physician-patient relationship plays an important role in medical outcome. A patient's responsiveness to suggestions, perceptions of treatment, and physical distress may be affected both by the type of interpersonal relationship and by the patient's anxiety. To test these hypotheses, 57 women who received elective abortions were treated by the physician in either a "paternalistic" or "egalitarian" interpersonal style. Each patient was tested for responsiveness to suggestions regarding changes in somatic perception such as heat or pain; a measure of psychological dependency on the physician was also obtained in addition to ratings of discomfort and signs of physiological distress during the medical procedure. Patient anxiety was not related to any of these variables, but patients treated in a paternalistic manner had higher responsiveness to suggestibility (P less than .001), felt they could depend more on the physician and perceived him as warmer and more supportive (P less than .01), had less discomfort during the procedure (P less than .05), and had a lower incidence of physiological distress compared with patients treated in an egalitarian manner. It was concluded that, for patients in crisis, paternalistic treatment by a physician may promote positive psychological and medical outcome.

Abortion, Induced↗
PubMed1985

The role of imagery in the treatment of dying children and adolescents.

The care of terminally ill children and adolescents is often complicated by depression and the patient's inability to express needs and fears verbally. The patient's own mental imagery provides an alternate means of communication. Clinical cases illustrate some of the ways in which imagery may play a crucial role in helping these young patients to express age-appropriate needs and fears regarding helplessness, separation from loved ones, and death.

Adolescent↗
PubMed1984

Psychosomatic problems in adolescents. Why they occur, how to intervene.

Primary care physicians who are willing to trust their own intuition and abilities can adequately evaluate and treat many psychosomatic problems of adolescence. Most of these problems reflect normal developmental stress rather than major psychiatric disorders. Thus, obtaining an adequate history and listening to the patient before embarking on a "rule out organic disease" pathway are basic. As Sir William Osler said, "It is more important to know what sort of patient has a disease than what sort of disease a patient has." By applying this maxim, primary care physicians may find treatment of adolescents with psychosomatic disorders a rewarding, rather than a frustrating, experience.

Adolescent↗
PubMed1984

The effectiveness of behavioral intervention for reduction of nausea and vomiting in children and adolescents receiving chemotherapy.

Fifty-one children 6-17 years of age rated the severity of nausea, vomiting, and the extent to which chemotherapy bothered them during each course of chemotherapy. Sixteen patients had no symptoms and the doses administered to 16 others were not constant so that matched courses could not be assessed. After baseline measurement of two matched courses, the remaining 19 patients were randomized to receive hypnosis or supportive counseling during two more matched courses. An additional course with no intervention was assessed in half of the patients. No significant reduction of symptoms was demonstrated prior to intervention. However, intervention with both hypnosis and supportive counseling was associated with significant reductions in nausea, vomiting, and the extent to which these symptoms bothered patients (all p less than 0.001). Also, after termination of intervention, symptom ratings remained significantly lower than baseline. The data indicate that chemotherapy-related nausea and emesis in children can be reduced with behavioral intervention and that reductions are maintained after intervention has been discontinued.

Adolescent↗
PubMed1984

Paradoxical effects of prophylactic phenothiazine antiemetics in children receiving chemotherapy.

The effectiveness of prophylactic phenothiazine antiemetics on reduction of nausea and vomiting was assessed for 23 children (age, 9-17 years) who had intermittently received antiemetics (ie, for one course but not for another). Each patient was his own control and the courses with antiemetics were compared to the matched courses without antiemetics (Wilcoxon matched-pairs, signed-ranks test). In each case, the matched courses with and without antiemetics were temporally consecutive and equivalent for chemotherapeutic agents and dosages. Significantly higher ratings for severity of nausea (P less than .004), vomiting (P less than .02), and the extent to which these symptoms bothered patients (P less than .001) were found during courses with prophylactic antiemetics. Duration (in hours) of nausea and vomiting was analyzed for the last eight consecutive study patients; in eight of eight patients, a significantly longer duration of nausea (P less than .05) and vomiting (P less than .02) was found for the courses in which antiemetics were given prophylactically. This study suggests that prophylactic phenothiazine antiemetics do not predictably reduce children's nausea and vomiting and may even be associated with an increase in symptoms. Further studies in children are needed to determine which patients might benefit most from antiemetic intervention.

Adolescent↗
PubMed1984

A prospective assessment of chemotherapy-related nausea and vomiting in children with cancer.

The purpose of this study was to determine if cancer chemotherapy invariably produces nausea and vomiting, if the extent of emesis is influenced by the number of drugs in a regimen, and if children's patterns of symptoms remain stable during repeated courses of the same agents. Forty-nine children with cancer (ages 5-21) prospectively rated (1-10 scale) their nausea and vomiting within 3-5 days after the administration of each course of chemotherapy. Chemotherapy courses which included antiemetics were eliminated from the analysis. No agents were found which never or always produced nausea and vomiting. No systematic increases or decreases in vomiting occurred as agents were added or subtracted from chemotherapy regimens and there was no association between the number of agents in a regimen and the extent of nausea and vomiting. Most patients' symptoms fluctuated widely. Only 4/49 patients (8%) had minimal symptoms (ratings of 1s and 2s) during chemotherapy and there were no patients who always had nausea and vomiting (ratings greater than or equal to 3s) with every course. The data suggest that nondrug variables influence chemotherapy-associated nausea and vomiting in children.

Adolescent↗
PubMed1982

Hypnosis and nonhypnotic techniques for reduction of pain and anxiety during painful procedures in children and adolescents with cancer.

Hypnosis was compared with nonhypnotic behavioral techniques for efficacy in reducing pain and anxiety in 27 children and adolescents during bone marrow aspiration and in 22 children and adolescents during lumbar puncture. The patients and independent observers each rated (scale of 1 to 5) pain and anxiety during one to three procedures prior to intervention and one to three procedures with intervention. Prior to intervention for both groups, pain during bone marrow aspiration was rated as more severe (P less than 0.01) than pain during lumbar puncture. During bone marrow aspiration pain was reduced to a large extent by hypnosis (P less than 0.001) and to a smaller but significant extent by nonhypnotic techniques (P less than 0.01), and anxiety was significantly reduced by hypnosis alone (P less than 0.001). During lumbar puncture only hypnosis significantly reduced pain (P less than 0.001); anxiety was reduced to a large degree by hypnosis (P less than 0.001) and to a smaller degree by nonhypnotic techniques (P less than 0.05). Thus hypnosis was shown to be more effective than nonhypnotic techniques for reducing procedural distress in children and adolescents with cancer.

Adolescent↗
PubMed1982

Neuropsychological assessment of children with medulloblastoma.

There is little information available about specific psychological deficits experienced by children with medulloblastoma. Most of the data reported so far are based on standardized intelligence tests which are only a partial representation of a child's total behavioral repertoire. Clinical neuropsychological assessment is a well-standardized and accurate means of identifying specific deficits. However, this psychometric approach to assessment must also be combined with an individualized, subjective assessment of each patient. These data must be obtained longitudinally in order to show changes over time.

Behavior↗
PubMedDate not supplied

Congenital metatarsal synostosis.

The authors discuss congenital synostoses in a 28-year-old patient. They emphasize the importance of early correction to prevent alteration of foot function and development of early deformities.

Adult↗