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PubMed2004

[A study of the social representations in chemotherapy: a way to analyse the relations between patients and oncologists].

This research aims to study social representations throughout chemiotherapy, out of a population composed of doctors specialized in Oncology on one hand, and patients dealing with cancer during their chemiotherapy on the other hand. Our methodology is situated among quantitative methods using SPSS for Anovas to analyze statistics datas, EVOQ and Alceste for the pragmatic analysis of the discourse. The datas were collected from a questionnaire including items and words associations. We were interested in chemiotherapy which appears as a social object likely to generate a representative process from which emerges a serie of adaptative strategies belonging to both cognitivo-behaviourism and emotional spheres. chemiotherapy leads to an adaptation of the patient and remains a mediator in the doctor-patient's relation. As far as representations are "action guides", the existence of a representation specific to patients and doctors, allowes us to point out, through a semantic and emotional gap a technical medicine which is, in the future, likely to tend to existentialism.

Antineoplastic Agents↗
PubMed2003

[Rules for psychiatric emergency hospitalization].

The author describe how psychiatric emergencies are dealt with in France. Emergency rooms can admit these patients 24 hours a day particularly somato-psychiatric emergencies as well as situations of existential crisis. Many psychiatric hospitals have also designed a 24 hours a day response to emergencies but with a great diversity depending on local situations. Free-will hospitalization is the most common response but some situations can require commitment to a psychiatric hospital. The author describes in details the enforcement of the law in the case of hospitalization without patients's consent.

Commitment of Persons with Psychiatric Disorders↗
PubMed2004

[The establishment of "Ezrath Nashim" Psychiatric Hospital in Jerusalem: selected issues].

This article describes the process of the establishment and early years of "Ezrath Nashim" Psychiatric Hospital in Jerusalem. Economic aspects in the continuous and daily life of the institution are emphasized, and existential difficulties that were involved in its regular management are mentioned. Selected issues such as economic difficulties and maintenance of the hospital are discussed based on historical documents. The resemblance between the early history and the current state of affairs in the mental health field in Israel is presented and stressed.

Female↗
PubMedDate not supplied

[The right to be born and the need to be born healthy... questions in medical ethics].

INTRODUCTION: Science, thanks to the commitment of huge amount of human capitals, in many cases supported even by enormous fund investment, gain continuously ground reaching new position and spreading out the borders on human chances in a sphere so delicate like birth. New genetic screening tests, new contraceptive drugs using even more sophisticated features, comply with the new law on assisted insemination, put up new challenges involving all the scientific-social environments and necessitate precise answers on ethical side, but even concrete commitment on vocational training. PROBLEM: In this case we take working examples distinguished only on perception, as the pre-implant diagnosis, the morning after pill, and certain about the recent legislation on assisted insemination, to highlight their common scientific and cultural milieu. These problems call for an unquestionable and unique response, to restore clarity about choices involving the need and ability on human being to look for and find answers about existential matter as the beginning of life. Human being value and its significance need to be relentlessly restated, just because they are endlessly debated by a synergy of the emotional point of view, even impressive, and new stand out techniques. PROPOSAL: in that sense vocational training is undeniable goal, even more, but not only, in a Faculty of Medicine. A student needs to learn to reflect on the relations between scientific forthcoming and their ethical and bioethical repercussion.

Contraceptives, Postcoital↗
PubMed1992

[Psycho-ecologic aspects of defense mechanisms].

Classical defense mechanisms are used not only intraindividually to strengthen a threatened ego-Organization, but also between individuals to stabilise endangered social relationships. According to a psychoecological way of thinking, any person has an existential need of productive, ongoing, mutual exchange in his or her social niches, in particular in those situations in which the inner equilibrium is threatened. Social relationships are used to support the threatened person in the use of classical defense mechanisms. People close to the individual have an important influence on reinforcing or weakening of the intrapersonal defenses, and therapists have to learn to take this into account.

Adaptation, Psychological↗
PubMed2004

Sexual abuse in childhood and youth as psychopathologically relevant life occurrence: cross-sectional survey.

AIM: To assess the perpetrators of sexual abuse in childhood, forms of simultaneous abuse, and characteristics of the families of origin, and the possible effects of abuse on health in adult life. METHODS: A cross sectional study conducted between 1998 and 2002 included a random group of 936 inpatients (723 women) aged (mean+/-standard deviation) 41.0+/-2.5 years at the psychosomatic clinic in Simbach, Germany. The following questionnaires, previously validated in German, were used to assess the patients: Questionnaire for Life Story and Partnership, Scale for Survey of Quality of Life, Existential Orientation Scale, Leipzig Incidence and Psychological Stress Questionnaire, Questionnaire for Assessment of One's Own Body, Survey of Life Satisfaction, Frankfurt Physical Concept Scale, Giessen Complaint Survey, and the Survey for Collection of Health Behavior Data. We compared the inpatients who had been sexually abused in their childhood (n=250) with other psychiatric inpatients in the control group (n=486). RESULTS: Out of 250 sexually abused patients, 25.7% were victimized by fathers/stepfathers, 4% by mothers/stepmothers, 12.4% by aunts or uncles, 10% by brothers or sisters, 7.6% by grandmothers/grandfathers, 30.1% by family acquaintances, and 29.3% by strangers. Unlike the parents of patients in the control group, the parents of sexually abused patients had more conflicts, especially over alcohol consumption (p<0.001) and extramarital affairs (p<0.001), they divorced more frequently during the first seven years of the patient's life (p<0.001), and had more underlying emotional (p<0.001) and physical illnesses (p=0.006). Significantly more sexually abused patients reported having poor concentration (odds ratio [OR]=5.03; 95% confidence interval [CI]=1.98-9.70; p<0.001) and sexual handicaps (OR=5.16; 95% CI=1.81-11.39; p<0.001), tended to hide their body (OR=3.65; 95% CI=1.69-7.30; p<0.001), abused illicit drugs (OR=2.38; 95% CI=1.08-6.01; p<0.001), had borderline personality disorder (OR=4.21; 95% CI=2.44-8.40; p<0.001), and suicidal ideation (OR=2.87; 95% CI=1.71-5.96; p<0.001). CONCLUSION: The patients who were sexually abused in childhood had significantly less satisfactory lives and more frequent psychiatric illnesses, suicidal ideation, disturbed social functioning and perception of the body, and psychosomatic diseases.

Adolescent↗
PubMed2003

Selected psychological problems of patients with cardiac transplantation on a permanent pacing treatment.

The aim the study was to evaluate the psychological condition (psychological functioning) of patients after cardiac transplantation who were treated permanent pacing. The study group consisted of 8 men, aged 19-60, after cardiac transplantation. Due to persistent disorders of cardiac rhythm the patients were implanted a pacemaker. Besides the basic clinical tests the patients underwent the following psychological tests: State-Trait Anxiety Inventory (STAI) by C.D. Spielberger, Scale PIL by J.C. Crumbaugh and L.T. Maholick and The Adjective Check List ACL by H.G. Gough and Heilbrun. The applied methods allowed to define the structure and level of anxiety. They also made it possible to analyze the subjects' acceptance of life and their perception of the sense of life as well as determination of a characteristic set of mental needs. The studied subjects presented a high level of anxiety both as a condition and as a feature. No symptoms of existential neurosis were confirmed, but a high level of perception of the sense of life with correct evaluation of the value of life were revealed. Comparison of the real and the ideal concept of oneself allowed to select a set of psychological needs. The real concept of oneself was characterized by moderate needs determining the realization of the desire to succeed, moderate needs characteristic of social functioning in the direct interpersonal contacts, and moderate needs connected with the attitude towards life. In the ideal concept of oneself considerably higher intensity was noted concerning the set of needs connected with success. Clearly the need for contacts with the opposite sex was increased as well as the need for sharing one's own experiences and feeling with others. Self-control, self confidence and personal adaptation were also found to be greater.

Adaptation, Psychological↗
PubMed2004

Is dentistry a profession? Part 1. Professionalism defined.

Individual dentists and organized dentistry alike invariably claim to be (members of) a profession. This label is cherished because it suggests special social, moral and political status. However, almost every self-respecting occupation nowadays claims to be a profession. Hence, the question arises as to what exactly is meant when dentists claim to be professionals and, more important, whether they can justifiably lay claim to this label. Rather than reviewing the manifold and divergent discussions in the literature about professionalism, the author proposes--in this first of 3 consecutive articles--a definition of the term "profession" that is based on the literal origins of the word. Next, it is argued that a profession arises out of a social contract between the public and a service occupation that professes to give priority to the existential needs of the people served. In the second article, the author deduces several professional responsibilities. The third and final article examines whether and to what extent dentistry fulfills these responsibilities and outlines some future challenges.

Clinical Competence↗
PubMed2003

Towards disability ethics: a social science perspective.

In the social sciences, debates about the discursive and material constitution of subjectivity and identity no longer appear to be at loggerheads. This has important implications for how we are to construct a framework for thinking about disability ethics. Following recent inroads in disability theory and in the sociology of ethics, we would argue that one of the aims of a disability ethics is not to view disability exclusively as a question of impairment, but to reclaim the social aspects of impairment in conjunction with the embodied aspects of disability. We would also suggest that the social and cultural construction of impairment, or abnormal corporeality, cannot be considered apart from the moral and existential relations that exist between disabled and non-disabled persons. The question we want to raise in this discussion is whether thinking disability ethics through a bioethics framework is adequate to this task.

Bioethics↗
PubMed2001

[Incurable oncological patient?].

Despite the significant advances in oncology achieved during the last two decades more than half the patients die as a result of the tumour or associated complications. When we are unable to cure the patient, he is described as incurable. The word is however frequently conceived in a distorted way, i.e. unfit to be treated. If the objective of our treatment is only the tumour. Then active treatment really ends with the possibilities of anti-tumour treatment. If however the objective of our therapeutic efforts is man - the oncological patient, we must conceive active treatment and care as a certain continuous process where from the very beginning anti-tumourous treatment is combined by supporting and palliative treatment as regards bodily symptoms, psychosocial and existential needs. Termination of anti-tumourous treatment then does not imply termination of active treatment, in conjunction with changed therapeutic objectives only the ratio and relative importance of different elements of supportive treatment changes. The presented work deals with some unfortunate consequences when the term unfit to be treated is mistaken for incurable and is the concept of a model of an active team approach to incurable patients.

Humans↗
PubMed2005

[A model for therapeutic interventions in emotional responses to enforced geographical relocation of populations in Israel].

BACKGROUND: The planned mandatory geographical relocation of the population inhabiting the Gush Katif settlements, planned to take place in July 2005, stands at the focus of public debate and has aroused virulent disagreements an ideological, political, national and security issues. AIMS: In order to prepare for professional assistance in coping with possible emotional problems arising from the forced relocation and in order to create support systems for professional interventions on the personal and family levels, the national health administration is seeking to design an adequate inclusive program, based at least partly on lessons learned from the relocation of populations from Sinai peninsula (Yamit and Rafiah areas) in April of 1982. However, little has been reported in the literature which can aid in designing a suitable intervention, tailored for an event such as this. Based on an analysis of the differences between combat- and terror-related trauma, and the forthcoming forced relocation of the civilian population of an entire geographical area, we propose a specifically adapted approach to professional intervention in the possible emotional consequences of the events. THE PROPOSED MODEL: The proposed principles are a mirror image of the accepted principles for combat reaction: distance from the arena as opposed to proximity, delayed intervention (after the acute phase) instead of immediacy, and expectation for actions related to adapting to a new existential reality rather than the expectation for speedy return to the arena. These principles seem to us far more suited to the demands of the complex situation ahead, in order to provide relief and assist in adaptation, and to prevent later complications of possible emotional sequelae.

Emotions↗
PubMedDate not supplied

Contributions of Martha Rogers to the development of nursing knowledge.

Martha Rogers' greatest contribution may be her introduction into nursing of a questioning stance about the prevailing models of science, leading to increased acceptance of alternative paradigms, a variety of research methods, and explorations of topics such as existentialism and Eastern philosophy. Nursing is a richer, more diverse profession because of Martha Rogers.

History of Nursing↗
PubMed2004

[Suicide and depression in the elderly].

Twenty per cent of the annual 12,000 deaths by suicide in France occur in subjects aged over 65. The rate of suicide by age in the population increases with aging. Aged people usually commit suicide by more violent means than younger people. Overall, the risk of suicide is multiplied by 20 in depressed subjects and by 40 in case of previous suicide attempt. This risk is probably higher in the aged. Suicide attempts are always to be sternly considered in aged people on account of the risk of a second successful attempt but also of a diminished life expectancy due to somatic as well as psychiatric reasons. Suicidal ideas are frequent in aged subjects but they strongly suggest depression which should be actively investigated. The so-called existential suicide, expression of the free will of subjects devoid of any psychiatric disorder who want, willingly and consciously, make an end to their life, probably exists. However, the high frequency of depression associated with suicide induces to be especially watchful in case of suicide ideas or previous suicide attempt in aged subjects.

Adult↗
PubMedDate not supplied

Effectiveness of a mind-body skills training program for healthcare professionals.

CONTEXT: Because of the increased use and benefits of mind-body therapies, it is important that healthcare professionals receive training in these modalities. OBJECTIVE: To determine whether healthcare professionals who attended the Center for Mind-Body Medicine's training program were incorporating mind-body skills into their professional or personal practices and whether they had a greater sense of life satisfaction. DESIGN: Repeated measures analysis. SETTING: Annual training programs were held in hotels and conference centers in the US. PARTICIPANTS: Four hundred fifty-one healthcare professionals attended the programs from 1998 to 2001. Two hundred fifty-nine completed the one-year follow-up survey, and 307 completed the well-being survey. INTERVENTION: The week-long program included didactic and experiential training in biofeedback, meditation, autogenics, imagery, and movement/exercise, as well as self-expression in small groups through drawings, written exercises, and genograms. MAIN OUTCOME MEASURES: Questionnaires on previous training and personal and professional use of mind-body approaches were administered before and one year after the program. The Existential Well-Being (EWB) scale also was administered before and immediately after the training. RESULTS: There was a significant increase in the personal use of mind-body skills and the number of participants who were teaching their clients to use all modalities and a significant decrease in the number of participants who were referring clients to others for training. Participants also had significantly higher life satisfaction scores after the program. CONCLUSION: This professional training program was effective in promoting the personal and professional use of mind-body skills and in enhancing the personal fulfillment of trainees.

Adult↗
PubMed2005

A new framework for facilitating decisions on death and dying.

The troubling public, moral and legal issues surrounding questions of death and dying need a new focus on the virtues of compassion and respectfulness, on a better understanding of a person as someone who has deep emotional, spiritual, and social aspects and needs, and whose body is more than "physical machine," but is "lived body" which gives persons the capacity to act in the world and to feel and suffer deeply. Western medicine needs to re-humanize death; physicians need to see themselves as "assisting" persons in dealing with health, life and death in the context of being able to assert their values and beliefs and to realize their goals. Western medicine's concepts of 'benefit' and 'harm,' are too narrow, as is their fight to 'preserve life' at all costs. Finally, the present approach to death and dying, except for the Hospice movement, neglects the patient's emotional, psychological, social, and existential suffering.

Death↗
PubMed2005

[The actualization of nursing care for the child living with AIDS: being, knowing and shared doing].

This article is the result of considerations resulting from the dissertation Meeting of care, lived and dialogued, of the nursing team with the child-being who lives with AIDS, which aimed at understanding the meaning of such care under the look of the Humanistic Nursing Theory of Paterson and Zderad. It is a phenomenological-existential and qualitative study with hermeneutic analysis proposed by Motta and Crossetti in the light of Ricouer. The expressiveness of caring was unveiled as: act of life; authentic; the lived and dialogued meeting; need for taking care of oneself as an opening for the meeting; maternity handling; the need of approaching the hospital world to the child's world and compassion attitude.

Acquired Immunodeficiency Syndrome↗
PubMed2005

[Multidisciplinary approach of the obese child to the dietary residency of "Clairs Vallons"].

The pediatric obesity has become a real problem for the public health. One estimates that about 16% of the Belgian pediatric population and up to 33% of the Americans are concerned by this problematic. 70% of the teenagers will remain obese once adult if no treatment is proposed during the childhood. Because of that evolution, some journalists wrote: "that the old continent would be able to catch up with the new world in the next ten years". The malnutrition is not however the only factor at the origin of the obesity. The sedentary lifestyle (lack of exercise, TV, Internet, video games) the domestic organization, the "various emotional stress "are to be blamed. It is without taking into consideration the paradox of our consumption society that while extolling the cult of the slim, young and dynamic body, etc., pushes us to consume more, encouraging in some social and cultural surroundings to go for the immediate pleasure to the detriment of the knowledge - understanding - of our own body. Which places the obese child in an existential paradox. If on top of it there is a domestic predisposition to the plumpness, the kilograms in excess are threatening the unsecured child and new sufferings stand out on the horizon : relational unrests, isolation, social dismissal, reduction of the esteem of selfesteem as well as lack of confidence, less freedom, depression, etc. Not only are they victims of mockeries, aggressiveness and exclusion, the children put their health in danger. On those children we can notice an increase of the impact of cardiovascular pathologies, diabetes, cancers of the intestines, etc. In "Clairs Vallons" we put the hypothesis that the children and the teenagers who come here in custody could suffer from a lack of presence as well as people listening to them and that therefore to would search for comfort in eating. We consider that all interventions based solely on the interdiction of the symptom have no result, causes more suffering and a displacement of the symptom. The therapeutic work to the Dietary Residency of "Clairs Vallons" consists therefore in a global approach of the child within a multidisciplinary team (pediatrician, dietitian, psychologist, physiotherapist, social assistant, orthofenist, educator and teacher) all united around the concept "to eat happy".

Child↗
PubMed2005

Assessing quality of life of patients with advanced chronic obstructive pulmonary disease in the end of life.

Given the limitations of existing health-related quality-of-life (QOL) measures in capturing the end-of-life experience of patients with advanced chronic diseases, an empirically grounded instrument, the quality-of-life concerns in the end of life questionnaire (QOLC-E), was developed. Though it was built on the McGill quality of life questionnaire (MQOL), its sphere is more holistic and culturally specific for the Chinese patients in Hong Kong. One hundred and forty-nine patients with advanced chronic obstructive pulmonary disease (COPD) or metastatic cancer completed the questionnaire. Seven factors (28 items) which emerged from the factor analysis were grouped into four positive (support, value of life, food-related concerns, and healthcare concerns) and four negative (physical discomfort, negative emotions, sense of alienation, and existential distress) subscales. Good internal consistency and concurrent validity were shown. The results also revealed that these two groups of patients had similar QOL concerns. The validity of applying QOLC-E as an outcome measure to evaluate the effectiveness of palliative and psychoexistential interventions has yet to be tested.

Activities of Daily Living↗