Nontraditional Care Research Articles

Alternative medicine: Implications for the surgeon

Alternative medicine: Implications for the surgeon

Assessing homeless veterans using the omaha assessment tool in a nontraditional home care setting

Homelessness is having an inappropriate place to stay and sleep and not having a mailing address for a period of overnight to 6 months or more. The homeless population is diverse and difficult to count.

Comparative study of the efficacy of a self-help group for women following mastectomy using an investigator-generated attitude scale

s from C-L Forum visits to a medium. Further study is warranted to understand the relationship between nontraditional and traditional care and to identify ways of meeting patients’ cultural expectations within the traditional system. Comparative Study of the Efficacy of a Self-Help Group for Women Following Mastectomy Using an Investigator-Generated Attitude Scale S. Pimentel, 1. Romero, M. C. Cuevas National Cancer Instittlfe, Mexico City, DF Studies have shown the importance of an adequate rehabilitation program during the pre-, transand posttreatment phases of breast cancer. However, there are very few studies showing the efficacy of the role of patients as part of a therapeutic team through a self-help group. This study examined the efficacy of a mastectomy self-help group (RETO) through positive attitudinal changes. We examined statistical differences in attitudes between two groups of women after mastectomy: an experimental group that actively participated through RET0 and a control group that did not participate in RETO. To monitor changes in attitudes, we developed an instrument that measured attitudes using a semantic differentiation in seven specific attitudinal areas. The development of the instrument took 2 years, beginning with 250 items. Through five trials, we obtained a total of 56 items which covered the seven areas, with an internal consistency that makes the instrument reliable for our Mexican population. A group of 60 patients with breast cancer who were scheduled to undergo surgery was chosen, age range 20-80. Two groups of 30 each were randomly selected. The same questionnaire was applied twice to the patients at different intervals: immediately after the diagnosis and a month after surgery. Only the experimental group participated in the regular meetings once a week and had the opportunity to be assisted by a member of RETO. Results to be presented are the statistical differences in change of attitudes in both groups in six of the seven areas studies. Impaired Cognitive Functions in Chronic Pain Conditions: Comparing Common “Whiplash” with Nontraumatic Cervical Spine Syndrome B. P. Radanov, G. DiStefano, 1. Hirlinger Department of Psychiatry, University of Bern, Bern, Switzerland Fifty-eight patients suffering from common “whiplash” (group wp) were compared with 35 patients complaining of cervical pain caused by rheumatism (group rh). Groups were comparable in regard to age, sex, and educational attainment, but differed regarding the length of the painful condition; the rh group suffered much longer. Patients underwent clinical psychiatric interview and formal testing which included personality profile, self-rating of cognitive impairment, and well-being. Tasks assessing divided attention and speed of information processing were administered. Clinical diagnosis revealed a relatively high incidence of adjustment disorder with mixed emotions (DSM-III-R 309.28) in group wp. Results on formal testing indicated marked reduction in divided attention in both groups, whereas the speed of information processing was almost unaffected. Differences between the groups were found with regard to self-rated cognitive impairment and well-being. In both tests, group rh indicated no particular problems whereas group wp suffered from gross impairment. On personality profile, group wp scored high on dimension “nervousness,” indicating considerable somatic discomfort. On other personality dimensions no differences were found between the groups, both groups also being comparable to statistical normals. Results indicated a significance of cervical spine pathology for attentional functioning for which the pain might be the central issue. Despite comparable results on formal testing of cognitive functions, groups differed in subjective cognitive impairment and in well-being. This difference could be assumed to reflect the mode in which the compared conditions developed: In group rh, the cervical pathology causing pain (and attentional impairment) developed gradually, giving the patient the possibility to adapt. In group wp, cervical pathology emerged abruptly by the impact injury. An adaptation was not possible, and thus led to problems in coping with the impairment, explaining in particular psychopathological changes.

On behalf of the patient.

In earlier times, physicians were powerless to alter the course of serious illness. Many of their remedies were of no value, and some caused serious harm. In spite of this, the medical profession enjoyed a privileged place. Doctors could often offer a rational explanation to account for symptoms, which, at the minimum, dispelled superstitious notions of illness, and they could provide empathetic care. When every serious disease was hopeless, patients could expect to receive a similar level of care irrespective of their particular malady. In recent times, public awareness has focused on the physician as a master of technical innovation. The emphasis on curative rather than palliative treatment has had the effect of shifting attention toward the treatment of acute illness, i. e., illness which responds to surgical or pharmacologic intervention. Not only is there no cure for amyotrophic lateral sclerosis (ALS), but for patients with chronic diseases even access to care may be limited. Patients, in some cases, actually have to search for a physician who will take an interest in their care. The search may end with a general practitioner since some specialists make it known in one way or another that they are not interested in caring for the chronically ill. In despair, some patients give up entirely, and look to non-traditional care providers for advice and comfort.