[Social function of the physician].
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OBJECTIVE: The present work seeks to validate the Duke-UNC questionnaire as modified by Broadhead, which is used to measure social support in its qualitative dimension. DESIGN: It is a transversal, prospective and observational study. LOCATION: The study has been done at the primary care level, corresponding to the basic health area of Cartuja (Granada). PATIENTS: The questionnaire was administered to 139 patients seen in the offices of the Cartuja Health Centre. 25 of them were male and 114 female, of an age ranging from 18 to 84. The subjects were selected on a systematic base of three by three with a random starting-point from among people over 18 years old visiting the office. INTERVENTIONS: To check the reliability and validity of the questionnaire, Pearson's, Edward's and Cronbach's alpha techniques were used. The factorial analysis was verified by the varimax rotation method. MEASUREMENTS AND MAIN RESULTS: We have observed that the questionnaire correctly measures qualitative social support, it being appreciated that the correlation coefficients are high, as is the internal consistency of the scale. After the factorial analysis we also confirmed the existence of two components: Factor 1 which measures the confidential social support and Factor 2 which measures the affective social support. CONCLUSIONS: The Duke-UNC questionnaire reduced to 11 items is a fast and simple instrument for detecting the level of social support in its affective and confidential dimensions. Its use will allow us to discover situations of high social risk; permitting us in these cases to carry out the relevant support interventions.
The authors assessed the outcome of children with juvenile rheumatoid arthritis following an average of 18 years since the onset of the illness. Two-thirds of the patients with the systemic form were asymptomatic. Juvenile rheumatoid arthritis which began with pauciarticular involvement and progressed to polyarticular involvement had the most severe disability, affecting 25% of these patients. Social and professional pursuits were most often satisfactory in spite of numerous problems encountered during the school years.
In view of the strong evidence supporting the hypothesis that high Expressed Emotion of a key relative contributes to relapse in psychiatric patients, methods used in Expressed Emotion research were applied in an investigation of psychiatric disorder in stroke patients receiving hospital based rehabilitation and support. Patient mood in 37 stroke patients was related to the critical attitude of a key relative. Patient depression may also have been associated with severity of dysphasia, but no link was found between patient mood and the other measures of cognitive or physical deficit used in this study. Psychiatric distress in the key relative had a rather different causal basis. Relatives' psychiatric disorders were associated with physical burden, cognitive deficit, and severity of dysphasia. This study suggests that, when the patient is dependent for self-care, rehabilitation-assisted recovery may alleviate relative distress more than patient distress.
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Mental condition of 142 patents with a diagnosis of schizophrenia (according to ICD X:F 20) first admitted to Psychiatric Hospital at the age of 13-18 was assessed twice. The first assessment took place during their first hospitalization at Psychiatric Hospital, the second one--23 years later. PANSS, BPRS GAS Scale were used at the examination. Mean value of the exacerbation of symptoms and improvement rate were calculated for each group of symptoms: positive, negative and psychopathological. The interpretation of the links between selected factors and rates of improvement as well as the mean value of exacerbation of symptoms were obtained on PANSS Scale. The links between the life assessment index before the first hospitalization and a mean value of points on the PANSS Scale at the discharge from hospital and in the cathamnesis for positive and negative symptoms as well as i cathamnesis for psychopathological symptoms were proved. The obtained data confirm that after the first discharge from hospital more patients function better in life than after cathamnestic examination.