Psychosocial Challenge Research Articles

Behavioral Effects of Chemotherapy in Children with Cancer

Chemotherapy-related distress constitutes a medical and psychosocial management challenge with significant implications for patients' adjustment to and compliance with anticancer therapy. Because of wide interpatient variability in levels of distress before and after chemotherapy, identifying the treatment and patient variables that act as risk factors for aversive reactions has become important. This article discusses the scope and determinants of chemotherapy- related nausea, vomitin and behavioral distress in pediatric cancer patients, with special attention to anticipatory symptoms. Findings from a three-year prospective study of distress in children and adolescents receiving chemotherapy are summarized. The value of behavioral assessment studies is considered from the viewpoint of professionals' ability to design for and target interventions selectively to patients who are at greatest risk.

An ethical excursion through labeling the mentally retarded

Review of a representative body of research data concerning the effects of the “mentally retarded” (MR) label on parents, teachers, college students, nonretarded children, communities, and persons labeled fails to support the extravagant claim of some investigators that the labeling process has psychologically damaging effects upon the individuals labeled as well as society. Negative reactions to labels could be minimized by extensive public education and counseling. Labels should be retained as formal instruments essential to establishing the eligibility of the retarded for special assistance, and for maintenance of communication within and between disciplines, without which contemporary society could not operate. An argument for the judicious use of labels is fashioned, recommending replacement of the MR label by “AD” (adaptively deficient), in keeping with the modern view of mental retardation as a psychosocial challenge deemphasizing IQ and requiring adjustment of the whole personality to demands of a complex environment (e.g., coping skill, motivation). Parents, teachers, friends, employers, and public officials could support the AD's struggle to effectively participate in community life by promoting the perennial values of respect for human dignity, fairness, equality, autonomy, and compassion. As a result of monitoring the success of such programs in all settings, public policy administrators could formulate rational approaches to improvement of service programs in the national interest.

BUM ROUNDS AT SAN FRANCISCO GENERAL HOSPITAL

The major burn victim can be a tremendous medical and psycho-social challenge. Adequate care requires a team approach to initiate acute management, prevent and treat complications, and rehabilitate the patient to a functional status. The basic guidelines for these areas are outlined, along with a means of auditing burn care. This review will attempt to highlight the current thought on the pathophysiology, management, and prevention of burns, and will describe the procedures we use in our hospital. A number of controversies still exist among experts in burn care, and we will try neither to avoid nor to solve these controversies.