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Psychological and social problems in HIV infection: interviews with general practitioners in London.

OBJECTIVE: To assess current practice and opinions of general practitioners in London about managing psychological and social problems relating to HIV infection. DESIGN: A stratified random sample of general practitioners, including those with a range of experience of people with HIV infection, were interviewed by medically trained interviewers. SETTING: Doctor's surgeries. PARTICIPANTS: 270 General practitioners working within the area covered by London postcodes. RESULTS: Two thirds of doctors had treated at least one patient with HIV infection and described their work with these patients. General practitioners were counselling and educating many of their patients about AIDS and associated risk behaviours and were aware of the need for careful attention to confidentiality. Doctors with no experience of patients with HIV infection were often older, in singlehanded practice, less inclined to deal with drug abusers or to counsel their patients on risk behaviours, and more in favour of insurance companies' policies towards people with HIV infection. CONCLUSIONS: General practitioners in London are quickly becoming involved in the care of patients with HIV infection and their relatives and friends. Many are counselling patients and testing for antibodies themselves and regard this as an integral part of their work. A considerable workload in primary care comprised patients who obsessively fear contracting HIV infection.

AIDS Serodiagnosis↗

Depression. Nursing implications of a clinical and social problem.

Depression is a phenomenon with concurrent personal, social, and clinical dimensions. Each person is affected by depression differently and expresses depressive symptomatology in a unique manner. Socially, the incidence of depressive illness in the general population is three times that of schizophrenia. The cost of depression in terms of lost days at work and treatment is estimated to be $29 billion in 1991. Diagnosing and treating depressive illnesses depend on the clinical manifestations of the illness and the assessment skills of the practitioner. Different treatment modalities such as psychotherapy, psychopharmacology, and electroconvulsive treatments can be effective singularly or in combination to assist the patient in regaining his or her functionality in daily life.

Depression↗

Psychological and social problems in burn patients after discharge. A follow-up study.

Approximately 18 months after discharge we were able to screen 42 burned adult patients for psychological and social problems. Using independent semi-standardized interviews, validated psychological questionnaires and standardized self-reports of the patients, we obtained three separate evaluations. The interreliability between the three different 'judges' varied from poor to moderate. Research suggests that 40% of burned adult patients have psychological problems. The cycle of recovery is dynamic. Only 21% need psychological help 18 months after discharge, but half of these are in danger of becoming 'drop-outs' because they do not receive the necessary treatment. A follow-up consisting of psychological questionnaires six months post-discharge appears to be a good and efficient instrument in limiting the drop-out risk.

Adaptation, Psychological↗

[Psycho-social problems in rehabilitation (author's transl)].

This contribution contains the results of a study on rehabilitation of patients undergoing treatment in the Alpen-Sanatorium in Bad Tölz, Germany, which was planned as a prestudy for an extensive examination of psycho-social problems of this group of patients and their chances for rehabilitation. The especially important age-group of those between 50- and 60-years-old for a successful geroprophylaxis was chosen. In this essay the connections between graded seriousness of the illness and the social classes of the patients as well as the following problems: difficulties, situated in the personality, general satisfaction with place in life, real worries, disturbances in childhood and youth, and decisive turning points in life, are worked out.

Aged↗

Behavioural problems, social competence and self-concept in siblings of children with autism.

INTRODUCTION: This study investigated the psychological adjustment of siblings of children with high-functioning autism (HFA) in comparison with siblings of normally developing children in the domain of behavioural problems, social competence and self-concept. METHOD: Twenty-nine siblings of children with HFA and 29 siblings of children without a disorder participated in the study. Standardized, written questionnaires were used. RESULTS: Siblings of children with HFA, especially brothers and sisters between 6 and 11 years old, had more behavioural problems than siblings of the control group. Sisters of children with HFA ascribed higher social competence to themselves. Sisters of children with HFA between 12 and 16 years old had a more positive self-concept. In both groups siblings with a more negative self-concept had less social skills and siblings with a more positive self-concept scored better in the social domain. Finally, in accordance with the control group, the perception of the siblings' social competence of parents of children with HFA broadly matched the perception siblings had of themselves. DISCUSSION: Overall, siblings of children with HFA are not more susceptible to adaptation problems than siblings of children without a disorder. Implications for practice and further research are discussed.

Adaptation, Psychological↗

[Alcoholism as a social problem. The alcoholic patient in a permissive societies--possibilities for prevention].

While the permissive attitude of our society promotes the use of alcohol in a wide variety of ways, alcohol addiction is a social stigma. Addictive alcohol abuse often arises from an acquired habit of drinking to reduce conflict and tension. A social history may reveal the patient's weaknesses and his resources. It has been shown that alcoholics have inadequate capabilities (resources) for dealing with stressful situations. With respect to the prevention of alcohol misuse in our society, a new health awareness might help reduce an individual's "alcohol risk".

Adaptation, Psychological↗