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Biomedical subjects

T Sensky

Publications and source records attributed to T Sensky.

51 records · Page 3Linked to original sources
PubMed1989

Type A behaviour pattern and glycaemic control in type I diabetes.

People who exhibit the type A behaviour pattern have different approaches to problems compared with their non-type A counterparts. On the basis of published work on such differences, a number of predictions were tested in 85 outpatients with type I diabetes. Contrary to expectations, no differences were observed in glycaemic control between type A and non-type A diabetics of either sex. However, dividing type A diabetics according to their health locus of control beliefs yielded significantly different groups in terms of glycaemic control.

Adult↗
PubMed1986

The general hospital psychiatrist: too many tasks and too few roles?

What should the general hospital psychiatrist do, and how should he do it? In psychiatric settings, psychiatrists may legitimately confine their attention to those patients whose disorders can be classified according to ICD-9, but in general hospital settings, the same approach defines a very restricted range of activities. Evidence is reviewed which highlights the differences between psychiatric disorders encountered in psychiatric hospitals and those found in primary care or general hospital settings. Different activities proposed for the general hospital psychiatrist, and the results of research comparing these, are reviewed. A recent study is discussed in which alteration of the psychiatrist's method of practice in a general medical unit produced considerable changes in the pattern of psychiatric referrals. Evaluation of the efficacy of their interventions should remain the ultimate goal of general hospital psychiatrists. This can be adequately undertaken only by means of better understanding of the process by which general hospital patients attract psychiatric referral.

Hospitals, General↗
PubMed1985

Referrals to psychiatrists in a general hospital--comparison of two methods of liaison psychiatry: preliminary communication.

Patients on a general medical ward were offered a liaison psychiatric service with 'unlimited' access, in which referrals were accepted from nurses, other paramedical staff and junior doctors in addition to senior medical staff. This new service (method II) was compared with the usual liaison service (method I, referrals initiated or approved by senior medical staff only) which was continued in parallel on a comparable general medical ward. Method II resulted in a threefold increase in referral rate and led to a significant alteration in the types of problem attracting referral. Despite the much higher rate of method II referrals, however, similar percentages of referrals by both methods were offered psychiatric follow up. The results do not support the commonly held belief that it is the failure of ward staff to recognize psychiatric morbidity which accounts for the low rate of referrals to many psychiatric liaison services.

Adult↗
PubMedDate not supplied

PRISM: Pictorial Representation of Illness and Self Measure. A brief nonverbal measure of illness impact and therapeutic aid in psychosomatic medicine.

The burden of illness is important for patients but complex and difficult to describe, let alone measure. A novel instrument is described that, according to preliminary data, measures what in German is termed Leidensdruck--the perceived burden of suffering due to illness. The measure--Pictorial Representation of Illness and Self Measure (PRISM)--takes less than 5 minutes to complete and is unusual in relying only minimally on language. The PRISM is being developed as a research tool and has been used effectively in routine clinical practice. To illustrate the latter application, three case vignettes are presented, demonstrating how the PRISM can enhance the patient's description and understanding of his/her illness and circumstances, facilitate patient-clinician communication, and help to monitor salient changes with treatment.

Activities of Daily Living↗
PubMedDate not supplied

Graphic representation of illness: a novel method of measuring patients' perceptions of the impact of illness.

BACKGROUND: Health outcome is multi-faceted, and for both research and clinical practice, greater knowledge of its facets is required. The Pictorial Representation of Illness and Self Measure (PRISM) was developed as a simple, rapid measure of the current impact of illness and symptoms on the individual. METHODS: The PRISM task was completed by 26 outpatients with rheumatoid arthritis participating in a larger study of psychosocial correlates of arthritis, which included assessment of disease variables, functional impairment, pain, depression and patients' appraisals of their illness. In the PRISM task, the patient was asked to imagine that a small board represents his/her life and a fixed disk on the board represents his/her 'self'. The task was to place another (Illness) disk on the board to represent the current importance of illness in the patients' life. The main outcome measure was the distance between the Self and Illness disks. FINDINGS: Only 2 patients had difficulty understanding the task. PRISM distance did not correlate with any disease variables. It correlated inversely with pain, functional impairment and depression, and positively with coping resources. PRISM distance correlated with perceived control over illness and negatively with awareness of illness. INTERPRETATION: PRISM is an innovative measure, simple and well accepted by patients. It appears to measure what in German is termed leidensdruck, the burden of suffering due to illness. It offers a promising measure of an intangible but important health outcome, hitherto neglected, applicable to research interventions and clinical practice.

Activities of Daily Living↗
PubMedDate not supplied

Sense of coherence - a mediator between disability and handicap?

BACKGROUND: The aim of this study was first to analyze the associations between disability and handicap and Antonovsky's concept of sense of coherence (SOC); secondly, to find out how the SOC concept could be integrated in the WHO model of impairments, disabilities, and handicaps (ICIDH). METHODS: Data from two studies were used: one on patients with rheumatoid arthritis, one on severely injured accident victims. Objective measures of the illness or the injury were conceptualized as indicator variables for disability, whereas variables related to the patients' subjective judgement were conceptualized as indicator variables for handicap. Correlations were calculated between both sets of variables and the SOC scale total score. RESULTS: SOC showed no significant correlation with 'disability variables' (rheumatoid arthritis: HAQ, SF36 physical functioning; accidental injuries: ISS, GCS). However, significant correlations were found between SOC and all 'handicap variables' (rheumatoid arthritis: HAD, SF36 social functioning; accidental injuries: CAPS-2, IES, SCL-90-R depression subscale). CONCLUSIONS: SOC is related to the psychosocial effects of health problems. It may be understood as a mediator between disability and handicap. Prospective studies are needed to clarify whether the SOC scale can be used as an outcome predictor with regard to psychosocial adaptation, in acute as well as in chronic health problems.

Accidents↗
PubMedDate not supplied

Antonovsky's sense of coherence: trait or state?

BACKGROUND: The aim of this study was first to analyze the stability of Antonovsky's Sense of Coherence (SOC) as a measure of a person's world view over time; secondly, to investigate its relationship with depression and anxiety. METHODS: Data from two longitudinal studies were used: a study of severely injured accident victims (n = 96), and a study of patients suffering from rheumatoid arthritis (RA, n = 60). The 13 items short version of the SOC scale and measures of depression and anxiety (Symptom Checklist, Hospital Anxiety and Depression Scale) were administered repeatedly over 6-12 months in both studies. RESULTS: In the sample of accident victims, a significant decrease in the SOC mean score was observed during the first half year after the accident. During the same time period, symptoms of anxiety and depression decreased significantly. In the second half year after the accident, SOC as well as measures of psychopathology remained stable. RA patients showed high stability of SOC and measures of anxiety and depression over time. In both samples, between-time correlations of SOC scores were high (r > or = 0. 70, p<0.01), indicating a high test-retest stability of SOC. Furthermore, in both samples, significant negative correlations of a moderate to high degree (r = -0.28 to -0.73, p<0.01) were found between SOC and measures of anxiety and depression. CONCLUSIONS: SOC can be seen as a relatively stable (trait) measure. However, traumatic events such as life-threatening accidents may change a person's world view and thus their SOC, even if psychiatric symptoms abate. This suggests that SOC is not merely a proxy measure of psychopathology, but rather a partially independent, general measure of a person's world view.

Accidents, Traffic↗