Analysis of long-term stress reactions in emergency room patients: An initial study

The psychological stress reactions of 44 family medicine patients who were treated in the emergency room were examined approximately a year after the event. Patients were assessed on several psychological measures, including one for posttraumatic stress disorder (PTSD), and on their perception of how stressful the event was initially and now. Results show continuing stress reactions related to the emergency room event. Three patients endorsed symptoms indicating full PTSD and 13 appeared to have at least partial PTSD. Age appeared to be a factor in the presence of stress symptoms and in degree of perceived communication with the physician.     

Sensitizing Medical Residents to Fantasies and Alignments in the Family: Mastering Psychosocial Skills in the Medical Encounter

In this paper, it is proposed that a) psychosocial medicine is best taught in a setting that provides technical and emotional support, while seizing for teaching only those moments when the learner is most receptive; and b) that the setting should avoid the development of a separate psychosocial skills curriculum, but should take the student where he or she is and integrate the psychosocial skills into his or her everyday biomedical practice. The paper gives specific case examples in which family based psychosocial issues were preeminent in the clinical problem-solving medical residents faced.     

TEACHING SELF-ADMINISTRATION OF SUCTIONING TO CHILDREN WITH TRACHEOSTOMIES

We examined the effectiveness of using dolls to teach young children with tracheostomies to self-administer a suctioning procedure. Four children between the ages of 5 and 8 years, who had had tracheostomies for 6 months or longer, participated. After skills were taught via doll-centered simulations, in vivo skills were evaluated. All of the training and probe sessions were conducted in the participants' classrooms or homes. Results of a multiple baseline design across subjects and skill components indicated that the performance of all children improved as a function of training. Skill maintenance was demonstrated by all participants during follow-up assessments conducted 2 to 6 weeks posttraining. Results of a questionnaire completed by caregivers and interviews with the children revealed high levels of satisfaction with the training procedures and outcomes.     

The place of human values in the language of science: Kuhn,Saussure, and structuralism

The current paradigm in medicine generally distinguishes between genetic and environmental causes of disease. Although the word paradigm has become a commonplace, the theories of Thomas Kuhn have not received much attention in the journals of medicine. Kuhn's structuralist method differs radically from the daily activities of the scientific method itself. Using linguistic theory, this essay offers a structuralist reading of Thomas Kuhn's The Structure of Scientific Revolutions. Our purpose is to highlight the similarities between these structuralist models of science and language. In part, we focus on the logic that enables Kuhn to assert the priority of perception over interpretation in the history of science. To illustrate some of these issues, we refer to the distinction between environmental and genetic causes of disease. While the activity of scientific research results in the revision of concepts in science, the production of significant differences that shape our knowledge is in part a social and linguistic process.     

VISITING THE DENTIST: A BEHAVIORAL COMMUNITY ANALYSIS OF PARTICIPATION IN A DENTAL HEALTH SCREENING AND REFERRAL PROGRAM

One-hundred and twenty-five families in the Medicaid Early Periodic Screening, Diagnosis and Treatment Program were assigned to one of five treatments to encourage parents to obtain health care service following the dental screening of their children: (a) a control procedure, in which parents were given a dentist's name; (b) a multiple contact procedure, in which parents received a postcard and two telephone call reminders; (c) a problem-solve procedure, in which a social worker aide conducted a brief session with the parent; (d) an incentive procedure, in which parents selected among four gifts that were contingent on seeking care; (e) an incentive + problem-solve procedure, in which the latter two treatments were combined. The multiple contact, incentive, and incentive + problem-solve techniques were significantly more effective in initiating dental visits than the control procedures. Families assigned to the intensive strategies were most likely to complete treatment. A cost-efficiency analysis showed the multiple contact technique to be a low-cost and highly effective procedure.     

Enhancing the care of children with chronic diseases through the narratives of patient,physician, nurse and carer

We tested the hypothesis that a narrative approach may enhance a bio‐psycho‐social model (BPS) in caring for chronically ill children. Forty‐eight narratives were collected from 12 children with six different medical conditions, their mothers, physicians, and nurses. By a textual analysis, narratives were classified on their predominant focus as disease (biological focus), illness (psychologic focus), or sickness (social focus). Sixty‐one percent of narrative’ text were classified as illness, 28% as disease and 11% as sickness. All narratives had a degree of illness focus. Narratives by patients and physicians on the one hand, and nurses’ and mothers’ on the other were disease focused. Narratives were also evaluated with respect to the type of medical condition: Illness was largely prevalent in all but Crohn’s disease and HIV infection, the latter having a predominance of sickness most probably related to stigma. Narrative exploration proved a valuable tool for understanding and addressing the needs of children with complex conditions. Narrative approaches allow identification of the major needs of different patients according to health conditions and story tellers. In the narratives, we found a greater illness and disease focus and surprisingly a low sickness focus, except with HIV stories. Narrative medicine provides a tool to strengthen the BPS model in health care.     

Self-Compassion and Need Frustration Moderate the Effects of Upward Appearance Comparisons on Body Image Discrepancies

Abstract

Drawing from diverse theoretical frameworks, we examined predictors of discrepancy between current and ideal body image in a sample of 396 Greek adolescents. The participants completed assessments of the frequency of comparing oneself with someone of perceived better appearance, appearance evaluations, frustration of basic psychological needs, and appearance self-compassion. We found that upward appearance comparisons negatively predicted appearance evaluation, which in turn was a negative predictor of body image discrepancy. Moderated mediation analyses showed that appearance self-compassion buffered, whereas psychological need frustration augmented the negative effects of upward comparisons on appearance evaluation. Our findings contribute to the growing literature on body image discrepancies in adolescence by examining moderating factors that amplify or buffer such discrepancies, hence identifying viable intervention pathways.     

A citation network analysis of career mentoring across disciplines: A roadmap for mentoring research in sport

ObjectiveGiven our limited understanding of mentoring in sport, reviewing research from other disciplines has the potential to advance knowledge in this context. Therefore, the purpose of this study was to synthesize and evaluate the mentoring literature across disciplines in order to bridge existing knowledge and to situate the mentoring in sport literature.DesignA citation network analysis.MethodA comprehensive literature search was conducted to locate influential career mentoring articles, books, and book chapters across all disciplines. Subsequently, this body of literature was evaluated using citation network to (a) identify the major career mentoring disciplines, (b) locate the most influential career mentoring texts, (c) evaluate the transfer of knowledge across disciplines, and (d) situate and evaluate the mentoring in sport literature.ResultsThe literature search resulted in a mentoring network of 1,819 texts and 10,951 citation links. Five major mentoring disciplines emerged: academic medicine, industrial and organizational psychology, education, nursing, and psychology. The industrial and organizational psychology and academic medicine disciplines were the most substantial mentoring disciplines. Further, the findings suggest the literature is relatively disconnected within and across disciplines. In regard to sport, the mentoring research represented 1.47% of the full-network (29 texts and 50 citation relations) and is interwoven into the industrial and organizational psychology literature.ConclusionGiven the limited sport texts uncovered in the citation network analysis, sport scholars can stand to benefit from the wealth of existing career mentoring literature in other disciplines. Accordingly, the identification of seminal career mentoring disciplines and texts serves to provide sport mentoring scholars with a roadmap to further promote the advancement and dissemination of mentoring knowledge and research.     

The arrogant physician--a Judaic perspective

Arrogance among physicians is all too common. This is in sharp contrast with medicine's sacred religious origins. The author presents a concise historical review of the Judaic perspective on the role of the physician, his position in the community, and the attitudes/values that should characterize his healing pursuit.