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PubMed1996

Road to awareness: an individualized training package for increasing knowledge and comprehension of personal deficits in persons with acquired brain injury.

Research suggests that awareness of one's deficits may be a significant factor in the recovery process after acquired brain injuries (ABI). Various methods have been employed to teach awareness of the potential sequelae of ABI. The present study extended the use of a board game format to teach awareness to adults with ABI who exhibited serious unwanted behaviours. It used an individualized training package in conjunction with a game format in order to more specifically target individual client awareness of personal deficits in two areas: cognition and behaviour. Training focused on the first three levels within Bloom's Cognitive Taxonomy: knowledge, comprehension, and application. Components of both the multiple-baseline and multiple-probe design were used to demonstrate experimental control. All three participants responded favourably to training, as evidenced by increases in percentage of questions answered correctly during the game sessions and in pre/post-generalization probes in both cognitive and behavioural categories.

Adult↗
PubMed2006

Why doesn't a family member of a person with advanced dementia use a substituted judgment when making a decision for that person?

OBJECTIVE: The objective of this study was to identify what standard of decision making a family member uses when making medical decisions for their relative with advanced dementia. METHODS: Thirty family members of patients with advanced dementia from an Alzheimer disease center and a suburban long-term care facility were interviewed using a semistructured interview. All interviews were audiotaped, transcribed, and analyzed using qualitative data analysis techniques. RESULTS: Family members were split almost evenly in the standard they used when making medical decisions for their relative: substituted judgment (43%) or best interests (57%). However, few who used the substituted judgment standard viewed it as distinct from best interests. Instead, both standards were taken into consideration when making medical decisions. In addition to not having discussions about healthcare preferences, the reasons for not using a substituted judgment included: the need for family consensus, unrealistic expectations of the patient, the need to incorporate their relative's quality of life into the decision, and the influence of healthcare professionals. Family members who did not have discussions about healthcare preferences identified various barriers to the discussion, including waiting too long, avoiding the topic, and the patient's denial of dementia. CONCLUSION: These data suggest several reasons why surrogate decision-makers for persons with advanced dementia do not use the substituted judgment standard and the potential value of interventions that would allow patients with early-stage dementia and their family members to discuss healthcare preferences.

Aged↗
PubMed1993

Learning needs of persons with epilepsy: a comparison of perceptions of persons with epilepsy, nurses and physicians.

The purpose of this study was to describe and compare patients', nurses' and physicians' perceptions of learning needs of persons with epilepsy. The study is based on adult learning theory which states that learning needs dictate receptivity to information and knowledge of learning needs can help structure teaching sessions. Study participants were recruited from patients attending epilepsy clinics, neuroscience nurses employed at study hospitals or working with neurologists or neurosurgeons and neurologists or neurosurgeons practicing in the state. The sample sizes were: 59 patients, 85 nurses and 38 physicians. Data were analyzed using frequencies, percent and analysis of variance. Data analysis revealed that patients, nurses and physicians similarly ranked major areas of learning needs. However, differences in the ranking of individual learning needs were noted between patients and health care providers. An understanding of the differences and similarities among the groups provides useful information for educational programs for epilepsy patients.

Adult↗
PubMed1995

Guidelines for optimal medical care of persons with Down syndrome. International League of Societies for Persons with Mental Handicap (ILSMH).

There are numerous clinical conditions observed in persons with Down syndrome, as described above, which should be taken into consideration in the course of their medical care and management. If provided with optimal medical services, pursuing specific evaluations and examinations, with a focus on preventive aspects and fostering well being in all areas of human functioning, the quality of life of individuals with Down syndrome can be enhanced significantly and their contribution to society substantial.

Adolescent↗
PubMed1988

Do personal computers make doctors less personal?

Ten months after the installation of a computer in a general practice surgery a postal survey (piloted questionnaire) was sent to 390 patients. The patients' views of their relationship with their doctor after the computer was introduced were compared with their view of their relationship before the installation of the computer. More than 96% of the patients (n = 263) stated that contact with their doctor was as easy and as personal as before. Most stated that the computer did not influence the duration of the consultation. Eighty one patients (30%) stated, however, that they thought that their privacy was reduced. Unlike studies of patients' attitudes performed before any actual experience of use of a computer in general practice, this study found that patients have little difficulty in accepting the presence of a computer in the consultation room. Nevertheless, doctors should inform their patients about any connections between their computer and other, external computers to allay fears about a decrease in privacy.

Attitude to Computers↗
PubMed1987

The interpreter's personality in Draw-A-Person interpretation: a study of interpersonal style.

This study investigated the relationship between accuracy in figure drawing interpretation and interpersonal style. Subjects were 66 undergraduates who completed the Minnesota Multiphasic Personality Inventory (MMPI), the Interpersonal Check List (ICL), and a figure drawing interpretation task. The MMPI and ICL were scored and interpreted using Leary's Interpersonal System, which provides for a multilevel assessment of interpersonal functioning. Interpretive skill was found to be associated with "affiliative" interpersonal styles (p < .05), and lack of interpretive skill was associated with "disaffiliative" interpersonal styles (p < .05) at two of the three levels examined. The role of unconscious processes in figure drawing interpretation, the nature of the interpretive process, and implications for the selection of skilled interpreters are discussed with reference to the interpersonal characteristics of the interpreter.

Journal Article↗
PubMed1991

Where's the beef? Putting personality back into personality assessment.

This article attempts to demonstrate the value of using a psychoanalytic theory of personality for psychological testing. This approach has more clinical utility than a solely research-based one. It recasts test data into conceptually related constructs that have internal consistency to each other and are directly relevant to psychotherapeutic treatment. Such theoretical recasting serves an organizing function, an integrative function, a clarification function, and a predictive function for the clinical inference process. Furthermore, a psychoanalytically oriented approach to testing allows for the expansion in sources of data that one considers in the testing situation. Five different sources of data emerge from the testing situation once one refocuses on theoretical constructs rather than test signs. These include test scores, test content, the patient-examiner interaction, patient behavior, and examiner countertransference.

Journal Article↗
PubMed2004

A discriminative study of health-related quality of life assessment in HIV-1-infected persons living in Japan using the Multidimensional Quality of Life Questionnaire for persons with HIV/AIDS.

The aim of this study is to evaluate the discriminative properties of the Multidimensional Quality of Life Questionnaire for HIV infection (MQoL-HIV) and to determine those factors contributing to the health-related quality of life (HRQoL) of HIV-1 infected persons living in Japan. The MQoL-HIV, the Nottingham Health Profile (NHP) as a generic instrument, and the Center for Epidemiologic Studies-Depression Scale (CES-D) as a psychological measure were administered in 375 patients as a multiple-centre study. The score distribution of the MQoL-HIV showed a unimodal distribution. The Cronbach's alpha coefficient scored more than 0.7 in seven out of 10 domains, but was low in both the physical functioning and sexual functioning domains. There was a strong correlation between the CES-D and MQoL-HIV index scores (R-0.73). Relatively high coefficient values were found between psychiatric and nervous symptoms and the index score (R=-0.60). In total, the MQoL-HIV may possess discriminative properties.

Adult↗
PubMed1990

Expressive therapy in conjunction with psychotherapy in the treatment of persons with multiple personality disorder.

This article examines the prevalence and complexity of multiple personality disorder as well as the contributions that psychiatry and occupational therapy make in its treatment. The value of activity is that it serves as a nonverbal mediator of communication. Activities are also useful in helping the therapist to obtain a patient's history, which is necessary for abreaction (i.e., the patient's reliving and recalling of the original abuse). Abreaction is a precursor to the integration of the abusive memories into the patient's current life.

Dissociative Identity Disorder↗
PubMed1995

Personal trainer, personal coach.

The increasing number of fresh faces in the management ranks, many of them with highly polished credentials but little in the way of practical experience in the work-a-day management world, has increased the need for a new consulting professional--the personal coach. There simply aren't enough volunteer mentors to accommodate the growing medical management profession. Whatever the conditions under which this new professional's services are sought, both the individual to be coached and the organization for which the individual works should approach the arrangement with care and planning. The author offers some guidance for making the arrangement pay off.

Administrative Personnel↗
PubMed2003

[The personal data act, clinical trials and data privacy. Rules for treatment of personal data in clinical trials and scientific research projects].

The Danish Act on Processing of Personal Data applies to all processing of data for the purpose of carrying out medical trials and other scientific or statistical studies. Prior to the commencement of the processing of data, a private controller, i.e. a pharmaceutical company, shall notify the Danish Data Protection Agency and obtain the authorisation of the Agency. The article presents the various conditions laid down by the Agency for the carrying out of the processing operations. Furthermore, special attention is drawn to the data subject's various rights. In order to ensure the privacy of the data subject and to protect data against accidental or unlawful destruction, loss or alteration and against unauthorized disclosure, the controller shall implement certain technical and organisational security measures laid down by the Agency. When a controller leaves the processing of data to a processor, the processor is obliged to ensure compliance with the given measures. The Data Protection Agency supervises that the processing is carried out in compliance with the provisions of the Act and the conditions laid down by the Agency.

Clinical Trials as Topic↗
PubMed1992

[Personal memories of personally experienced pediatrics (1946-1991)].

As a kind of farewell speech about my pediatric activity some personal experiences are described, which are of special interest for me and perhaps of a certain historic interest for the reader. The occurrences derives from my profession at the University-Clinics of Pediatrics in Vienna, Bern, Basel and Innsbruck.

Austria↗
PubMed1992

[Unemployment among long-term sick-listed persons. From the project Evaluation of Follow-up of Long-term Sick-listed Persons].

The aim of the study was to compare two subgroups of patients with long-term sickness certificate, i.e. a group who were unemployed after eight weeks of incapacity for work and a group who still had a paid job at the end of the eight weeks. 712 patients who received a medical certificate II after eight weeks of incapacity for work in 1988 were followed up for another 12-15 months by means of information collected as a routine at the local National Insurance Offices in five municipalities in Norway. Of our total sample of patients, the sub-group of unemployed persons differed in a number of ways from the group who still had a job. Among the unemployed the duration of sickness certificate was longer and there were higher frequencies of mental disorders and diseases of the nervous system/sense organs. Admission to hospital was less frequent, however, among the unemployed group than among the group who still had a job. The rate of return-to-work observed after one year of sickness certificate was lower among the unemployed.

Adolescent↗
PubMedDate not supplied

[Personal experience in the treatment of pulmonary tuberculosis in mentally retarded persons].

The results of the therapy of pulmonary tuberculosis in 90 mentally retarded patients in various forms and degrees of retardation are presented. General and clinical condition of 62 patients was very bad prior to the onset of antituberculotic therapy and most of them were immobile due to the mental retardation and dissemination of pulmonary tuberculosis. In 30 patients advanced form of tuberculosis, in 54 patients mild form and in 6 patients a minimal degree of tuberculosis were found. In hospitalized patients all clinical forms of pulmonary tuberculosis were found. The therapy started with triplicate antituberculotic therapy and the patients were also administered other drugs due to their mental retardation. During the first two months of antituberculotic therapy a high mortality rate was registered (27 or 30%) especially in younger patients. The reason for such high rate cannot be attributed only to pulmonary tuberculosis but also to the primary disease as was the main reason of patients' hospitalization at the institute for mentally retarded persons. Many complications in antituberculotic use could not be registered since many of the basic data could not be obtained from mentally retarded subjects. The complete recovery or improvement of pulmonary tuberculosis was achieved in 63 patients.

Adult↗
PubMedDate not supplied

[Personality characteristics of alcoholic subjects using the Minnesota Multiphasic Personality Inventory (MMPI)].

The results obtained in an investigation carried out on male alcoholics who had not drunk for three years are presented and evaluated. The research was carried out on a sample of 200 subjects aged between 30 and 50, average schooling, belonging to AA groups. The purposes of the study were to identify the psychopathological features of the sample in relation to the neurotic and psychotic aspects of the personality. A comparison was subsequently made with a similar female sample selected from a previous research. An abbreviated form of the MMPI test was used in the clinical part.

Adult↗
PubMed1988

Quantitation and fractionation of nutrient hepatic blood flow in normal persons, in persons with portal hypertensive cirrhosis, and after small-diameter portacaval H grafts.

Patients maintaining portal perfusion following small-diameter portacaval H grafts have better survival and lower portasystemic encephalopathy rates than those with reversed flow. To determine why this is so, we measured nutrient hepatic blood flow with the use of 99m-Tc-diisopropyl-IDA (DISIDA) clearance pharmacokinetics fractionated into its hepatic arterial and portal venous components. Patients with cirrhosis and portal hypertension had significantly lower nutrient hepatic blood flow than normal persons; this was due almost entirely to reduced portal flow. In patients with prograde portal flow after small-diameter H grafts nutrient hepatic blood flows were nominally reduced from levels seen in patients with portal hypertensive cirrhosis. Postoperative patients with reversed portal flow had significantly less nutrient hepatic blood than those with prograde flow. There was no evidence of significant hepatic arterial compensation for lost portal flow. Of four hemodynamic variables--portal flow direction, portal flow, arterial flow, and nutrient hepatic blood flow--only nutrient hepatic blood flow showed an independent correlation with clinical outcome. Portal perfusion is a critical factor in maintenance of adequate nutrient hepatic blood flow, primarily because hepatic arterial flow does not compensate chronically for lost portal perfusion.

Hemodynamics↗
PubMed1979

Idiopathic calcium nephrolithiasis. 2. Differences between hypercalciuric and normocalciuric persons with recurrent kidney stone formation and persons without such a history.

Normocalciuric and hypercalciuric patients with idiopathic recurrent calcium nephrolithiasis were compared with healthy individuals without such a history to examine the factors that predispose normocalciuric patients to stone formation. The urine calcium excretion rate was higher in the normocalciuric patients than in the control subjects (227 v. 183 mg/24 h; P less than 0.01), but the urine calcium concentration was not significantly different. The urine magnesium and citrate excretion rates and concentrations were lower in the normocalciuric patients than in the control subjects (P less than 0.001), while the urine uric acid and oxalate excretion rates and concentrations and the urine saturation with brushite (CaHPO4-2H2O) were not significantly different. These results suggest the importance of slight increases in the urine calcium excretion rate together with decreased urine magnesium and citrate excretion rates in normocalciuric persons with recurrent calcium stone formation. The urine of the hypercalciuric patients was more highly saturated with brushite than the urine of the normocalciuric patients and the control subjects, and the excretion rates of uric acid and oxalate were increased in the hypercalciuric patients. The hypercalciuric patients had a higher urine creatinine excretion rate than the normocalciuric patients and a higher daily urine volume than the control subjects, which suggests that differences in lean body mass or fluid and food intake, or both, may be important determinants of these differences in crystalloid excretion. As in the normocalciuric patients, the urine citrate excretion rate and concentration were decreased in the hypercalciuric patients compared with the control subjects.

Adult↗