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Biomedical subjects

W J Reynolds

Publications and source records attributed to W J Reynolds.

At least 19 recordsLinked to original sources
PubMed2000

Do nurses and other professional helpers normally display much empathy?

Empathy, the ability to perceive and reason, as well as the ability to communicate understanding of the other person's feelings and their attached meanings, is held to be a core characteristic of a helping relationship. This paper examines some of the observations that motivated the authors' interest in how registered nurses learn how to offer empathy to clients. First, while empathy is crucial to all helping relationships, professional helpers do not normally offer much empathy. Second, while nurses are meant to provide helping relationships, they do not tend to show much empathy to clients. The relevance of empathy to clinical nursing and the potential consequences of low-empathy nursing for clients is considered. It will be shown that, in the past, a low level of empathy has been reported among the helping professions, including nursing, indicating that many professional helpers are not as helpful as they ought to be. While most studies of empathy in professional relationships are more than a decade old, more recent studies report similar results.

Empathy↗
PubMed1999

Empathy has not been measured in clients' terms or effectively taught: a review of the literature.

Empathy, the ability to communicate an understanding of a client's world, is said to be a crucial component of all helping relationships. The first part of this paper focuses on the failure of measures of empathy to reflect clients' views about the ability to offer empathy. It is argued that, if clients are able to perceive the amount of empathy in helping relationships, they are able to advise professionals about how to offer empathy. The second part of this paper examines the inconclusive research evidence that existing courses have enabled professionals to offer empathy, and the disagreement about how empathy is best taught. The literature reviewed in this paper substantiates these observations.

Education, Nursing↗
PubMed1999

Empathy: a crucial component of the helping relationship.

The literature reviewed in this paper substantiates the widely held view that empathy is crucial to all forms of helping relationships. While most studies cited are more than a decade old, the relationship between empathy and helping remains unchallenged in the 1990s. Additionally, while there is confusion about whether empathy is a personality dimension, an experienced emotion, or an observable skill, it is shown that empathy involves an ability to communicate an understanding of a client's world. Finally, a definition of empathy considered to be relevant to clinical nursing is introduced, which includes the need to understand client's distress, and to provide supportive interpersonal communication. It is argued that there is a need to revisit the role of empathy in the context of current health care delivery.

Attitude of Health Personnel↗
PubMed1997

Peplau's theory in practice.

Peplau's theory of interpersonal relations provides a useful framework for investigating clinical phenomena and guiding nurses' actions. The author describes clinical application of selected concepts from Peplau's theory which supports this assumption. While the case data are encouraging, it is suggested that there is a need to test the clinical effectiveness of Peplau's concepts by utilizing experimental research designs.

Anxiety↗
PubMed1997

Comorbidity between myofascial pain of the masticatory muscles and fibromyalgia.

This study compared myofascial pain of the masticatory muscles to fibromyalgia. Study data show that, in both myofascial pain and fibromyalgia patients, facial pain intensity and its daily pattern and effect on quality of life are very similar. This indicates that fibromyalgia should be included in the differential diagnosis for myofascial pain of the masticatory muscles. However, with the higher prevalence of neurologic and gastrointestinal symptoms, and the stronger words used to describe the affective dimension of pain, it is apparent that fibromyalgia may be a more debilitating condition than myofascial pain of the masticatory muscles. Since the intensity of facial pain was strongly and significantly correlated to the body-pain index in fibromyalgia but not in myofascial pain patients, it can be concluded that facial pain may be part of the clinical manifestations of fibromyalgia, but it is unlikely to be related to body pain in myofascial pain patients. On the other hand, while body pain is episodic in most myofascial pain patients, it is constant and more severe in the majority of fibromyalgia patients. This difference in the pain patterns suggests that body pain in fibromyalgia and myofascial pain could have different etiologies. The lack of correlation between the intensity of pain and the length of time since onset also supports the concept that myofascial pain of the masticatory muscles and fibromyalgia are unlikely to be progressive disorders.

Adult↗
PubMed1996

The effects of bright light treatment on the symptoms of fibromyalgia.

OBJECTIVE: To investigate the effects of bright light treatment on the symptoms of pain, mood, and sleep in patients with fibromyalgia (FM) reporting seasonality of symptoms on the Seasonal Pattern Assessment Questionnaire (SPAQ). METHODS: A randomized 10 week crossover study compared the effects of 4 weeks of "visible electromagnetic fields" (EMF) (light condition; mean 4750 lux, SD 2337 lux) to 4 weeks of "nonvisible EMF" (no light condition) in 14 patients with FM having a minimum SPAQ score of 11. The light visor system (Bio-Brite) was fitted with an opaque filter for the "nonvisible EMF" control condition. RESULTS: No significant differences were found between treatment conditions on tenderness measured with dolorimetry, self-ratings of sleep, pain, mood, and global measures. Mood was not related to pain or sleep. There was significant reduction in depression scores and subjective pain, but increased tenderness and nocturnal awakenings related to time. CONCLUSION: The were no significant differences between the light and no light conditions on pain, mood, or sleep in patients with FM reporting seasonality of symptoms. No relationship was found between mood and the symptoms of FM (i.e., pain, sleep, and fatigue).

Adult↗
PubMed1996

The effect of zolpidem in patients with fibromyalgia: a dose ranging, double blind, placebo controlled, modified crossover study.

OBJECTIVE: This dose ranging, double blind, placebo controlled, modified crossover study examined whether zolpidem would improve the disturbed sleep, fatigue, mood and pain symptoms in patients with fibromyalgia (FM). METHODS: All symptoms were rated over 4 nights and 4 conditions for 16 consecutive nights during which 19 patients (mean age 42 years) randomly received placebo or zolpidem 5 mg, 10 mg, or 15 mg at bedtime. RESULTS: The 16 patients who completed the study reported no significant differences in ratings of pain, number of tender points, mood, sleep quality, morning fatigue, morning sleepiness or ability to concentrate. Compared to the placebo group, patients treated with zolpidem recorded significantly reduced time to fall asleep, increased sleep time, reduced awakenings, overall improvement in sleep and daytime energy, but a lower rating for evening energy. Zolpidem at the 10 mg dose was rated most acceptable for sleep. Adverse incidence rates were highest in the placebo group and lowest in the zolpidem 10 mg group. One person withdrew because of migraine while taking zolpidem 10 mg. CONCLUSION: Short term treatment with zolpidem (5 to 15 mg) does not affect the pain of FM, but is useful for sleep and daytime energy in this patient population.

Adult↗
PubMed1994

Comparison of amitriptyline, cyclobenzaprine, and placebo in the treatment of fibromyalgia. A randomized, double-blind clinical trial.

OBJECTIVE: To compare the relative efficacy and tolerability of amitriptyline, cyclobenzaprine, and placebo in the treatment of fibromyalgia, and to identify predictors of response to amitriptyline and cyclobenzaprine. METHODS: Two hundred eight patients who fulfilled the American College of Rheumatology criteria for the classification of fibromyalgia were entered into a 6-month prospective, double-blind, multicenter trial and were randomized to 1 of 3 treatment groups: amitriptyline, cyclobenzaprine, or placebo. RESULTS: After 1 month, 21%, 12%, and 0% of the amitriptyline, cyclobenzaprine, and placebo patients, respectively, had significant clinical improvement (amitriptyline versus placebo P = 0.002, cyclobenzaprine versus placebo P = 0.02, amitriptyline versus cyclobenzaprine P not significant). These percentages increased to 36%, 33%, and 19%, respectively, at the 6-month assessment (P not significant). The nature and frequency of side effects reported by patients treated with amitriptyline and those reported by patients treated with cyclobenzaprine were similar. A normal Minnesota Multiphasic Personality Inventory (MMPI) profile at baseline was predictive of clinical improvement at the 1-month evaluation (odds ratio 3.3, 95% confidence interval 1.2-9.0). However, neither the MMPI profile nor any of the demographic, clinical, or functional parameters evaluated at baseline predicted long-term response. CONCLUSION: Our data confirm the short-term efficacy of amitriptyline and cyclobenzaprine in a small percentage of patients with fibromyalgia. Long-term efficacy could not be demonstrated because of a higher-than-expected placebo response. Predictors of response to these drugs could not be determined.

Amitriptyline↗
PubMed1991

Allopurinol sensitivity in a patient with chronic tophaceous gout: success of intravenous desensitization after failure of oral desensitization.

Sensitivity to allopurinol, which occurs in 10-15% of patients, can seriously limit the drug's use in chronic tophaceous gout. Oral allopurinol desensitization has been advocated for sensitive patients in whom use of the drug is warranted. We report the successful use of intravenous allopurinol desensitization in a patient with chronic tophaceous gout in whom oral desensitization had previously failed.

Administration, Oral↗
PubMed1991

The effects of cyclobenzaprine on sleep physiology and symptoms in patients with fibromyalgia.

A double blind, placebo controlled, crossover design study examined overnight sleep physiology, pain, fatigue, and mood symptoms in 12 patients with fibromyalgia treated with cyclobenzaprine. Nine patients completed the study. Patients receiving cyclobenzaprine showed a decrease in evening fatigue (F = 4.7, p less than 0.05) and an increase in total sleep time (F = 4.4, p less than 0.05). Pain, including tender point count and dolorimetry, mood ratings, and alpha non-REM EEG sleep anomaly were unchanged by cyclobenzaprine.

Adult↗
PubMed1988

Priming with nondepolarizing relaxants for rapid tracheal intubation: a double-blind evaluation.

Results of a series of controlled, randomized, double-blind trials investigating intubation conditions with priming sequences of nondepolarizing relaxants are reported. In Phase I of the study the groups received: Group A, tubocurarine (DTC) 3 mg + succinylcholine 1.5 mg.kg-1, Group B, atracurium 0.05 mg.kg-1 + 0.35 mg.kg-1, Group C, vecuronium, 0.01 mg.kg-1 + 0.07 mg.kg-1; in Phase II: Group D, no relaxant, Group E, DTC 0.05 mg.kg-1 + vecuronium 0.07 mg.kg-1, Group F, vecuronium 0.01 mg.kg-1 + vecuronium 0.12 mg.kg-1; in Phase III, Group G, DTC 3 mg + succinylcholine 1.5 mg.kg-1, Group H, vecuronium 0.01 mg.kg-1 + 0.09 mg.kg-1, Group I vecuronium 0.1 mg.kg-1 as a single bolus. Intubation conditions were assessed at 60 seconds. A seven-minute priming interval was used in Phase I and II and a four-minute interval was used in Phase III. Priming produced significantly better intubating conditions than an equivalent single bolus; however, intubating conditions with priming did not appear to match the uniformly excellent conditions produced by succinylcholine. The data suggest that a four-minute priming interval is as effective as a seven-minute interval. The results of this study differed substantially from previous unblinded studies; therefore, it is suggested that a randomized, double-blind design with simultaneous succinylcholine controls be considered a prerequisite for future studies of intubation conditions.

Atracurium↗
PubMed1988

Plasma substance P levels in fibrositis.

The mechanism of pain in the fibrositis syndrome is unknown. We measured plasma levels of substance P in 32 patients with fibrositis and 26 sex and age matched controls using a radioimmunoassay. The mean plasma level of substance P in the patients with fibrositis was 371 +/- 91 pg/ml and in controls 397 +/- 84 pg/ml (p = NS). We conclude that determination of plasma levels of substance P in fibrositis is of no diagnostic value. This does not exclude the possible role of substance P as a neurotransmitter in the fibrositis syndrome.

Adult↗
PubMed1987

IgA related disorders in rheumatoid arthritis.

Serum monomeric and polymeric IgA, IgA rheumatoid factor (IgA-RF) and IgA containing circulating immune complexes (IgA-CIC) were studied in 192 patients with rheumatoid arthritis (RA) to explore the relationships among IgA related abnormalities and to investigate their potential associations with disease activity, immunoregulatory disorders and effect of treatments. Total serum IgA and polymeric IgA (p-IgA) levels were elevated in 23 and 11% of patients with RA, respectively. Their respective mean concentrations in serum were significantly elevated compared to normal values (p less than 0.001 and p less than 0.004). A preferential increase in polymeric rather than monomeric IgA was observed. IgA-RF, detected by a solid phase ELISA, was found in 71% and was associated with decreased grip strength (p less than 0.005), active disease (p less than 0.05), increased p-IgA level (p less than 0.001), elevated p-IgA:total IgA ratio (p less than 0.05), the presence of IgA-CIC (p less than 0.005) and IgM-RF (p less than 0.005). Complement fixing IgA-CIC were detected in 40% of patients by IgA specific conglutinin and anti-C3 binding solid phase ELISA. High molecular weight IgA species precipitated by 2.5% polyethylene glycol from RA sera positive for IgA-CIC were shown to be IgA-RF complexed to IgG. Taken together, our results suggest that IgA-RF are essentially polymeric in nature and circulate as IgA-RF-IgG immune complexes. Although the presence of IgA-CIC was not associated with disease activity, IgA-CIC activated C3 and thus are potentially pathogenic.(ABSTRACT TRUNCATED AT 250 WORDS)

Anti-Inflammatory Agents, Non-Steroidal↗