Social Network Of Patients Research Articles

A multidimensional modeling of predictors influencing the adjustment to a colostomy

Purpose: Factors contributing to the postoperative adjustment of patients who had undergone permanent colostomy surgery were studied. Design: Cross-sectional study. Setting and Subjects: Sixty patients who underwent colostomy surgery at 5 hospitals in Santiago, Chile, between 1987 and 1995 were evaluated. Subjects were between the ages of 27 and 89 and underwent colostomy surgery from 4 months to 19 years before data collection. Methods and Instruments: A demographic questionnaire and a semistructured interview were used to elicit information concerning psychosocial reactions to a colostomy and perceptions about the changes in lifestyle created by the ostomy. Medical records were reviewed for information about disease-related characteristics and an ostomy self-care scale measured coping skills. Adjustment to the colostomy procedure was measured by means of the Olbrisch ostomy adjustment scale. Results: Patient adaptation to a colostomy is primarily affected by the following factors: (1) the level of ostomy self-care; (2) psychological support, and (3) social support from family and significant others. Conclusion: Successful adjustment to a permanent colostomy is most likely to occur if the patient receives adequate instruction in self-care and has the appropriate psychological support to integrate the new physical changes into a healthy body image. This includes continued acceptance from family and the patient's social network.

The role of the social network in active euthanasia and physician-assisted suicide

Objective:To obtain insight into the involvement of a patient's social network in the process leading to theadministration of euthanasia and assisted suicide (EAS). Design:Descriptive, retrospective. Method:Data were collected by means of anonymous questionnaires sent to a random sample of 521 generalpractitioners (GPs) in the Province of North Holland and 521 GPs from the rest of the Netherlands and all 713 Dutch nursing home physicians (NHPs). The data were collected over the period 1986 to June 1990 inclusive. Results:GPs and NHPs had discussions most often with the partner of the patient about the patient's request for EAS, thedoctor's intention to administer EAS and the actual administering of EAS. According to both the GPs and the NHPs the social network practically always agreed with the doctor's decision to administer EAS. The persons who were most often present at the patient's bedside when EAS was administered were the patient's partner and children (29%). Often, especially in the cases of GPs, the decision not to report EAS was determined by the desire of relatives and/or the physician not to involve the relatives in a judicial inquiry. ConclusionTo a large extent the social network was involved in the patient's request for EAS, the doctor's intention toadminister EAS and the actual administering of EAS. This seems to be important both for good decision-making with regard to EAS and for helping relatives to come to terms with the loss of a dear one.

The social network of patients with schizoaffective disorder as compared to patients with diabetes and to healthy individuals

The social network was evaluated by means of the self-rating scale ‘Interview Schedule for Social Interaction’ (ISSI) and semi-structured interviews in married patients with a DSM-III diagnosis of schizoaffective disorder ( N = 17, partners, N = 16), married patients with diabetes ( N = 10, partners, N = 10) and in married healthy individuals ( N = 8, partners, N = 8). The two latter groups were comparison control groups matched for sex and age to the patients with a schizoaffective disorder. The scores on the ISSI and its subscales for the groups were compatible to those found in other Swedish studies. Patients with a schizoaffective disorder both experienced that they had less access to (AVAT) and were less satisfied with their deep emotional relations (ADAT). The same patients had a higher level of neuroticism as compared to the rest. The patients with a schizoaffective disorder had less often than the patients with diabetes been informed about their disease. Moreover, the partners to the patients with a schizoaffective disorder had not been informed about the disease and experienced that they had fewer social contacts (AVSI). A challenge for the professional network in psychiatry is to improve the information and education to families in which one member is struck by a schizoaffective disorder.

Discharge procedures for the mentally ill: The co-operation process among psychiatry, primary health care, and social services: A regional perspective

One hundred twenty-one psychiatric inpatients were followed up during a 2 ½-year period. The main aim was to study the degree of co-operation among psychiatry, primary health care, and social services for discharged patients. After 2 ½ years 60% of the group were discharged into the community, but almost half of them were readmitted to hospital. Other agencies are involved in the discharge process but are often contacted too late. Housing and home care services seem to be successful forms of community provision. Hospital staff need to be better informed about the economic problems and the unemployment and activity needs of patients to provide appropriate forms of social service support. They tend to underestimate the effectiveness of a patient's social network owing to inadequate investigation of the issue and are unduly pessimistic about the life situation of the patient.

Decision processes preceding full mouth extractions.

Full mouth extraction is the final step in a continuous process in which not only dental but also social processes play a role. In a research project concerning the reasons for full mouth extractions in The Netherlands, it was found that over one-third of the patients had considered full mouth extractions at least once before, and 16% considered it frequently over a period of many years. Anxiety was the most important reason for not visiting a dentist. In the patients' view in 86% of the cases they were the initiator of the decision to have all their teeth extracted. According to the dentist the patients initiated full mouth extraction in 70% of the cases. Dentists and patients agreed that irregular attenders more often took the initiative than regular attenders. Most patients (87%) had discussed the decision to have all teeth extracted with one or more persons; different contacts were reported by 14% percent of the patients. According to Freidson's lay referral theory two groups could be identified: a group with a severely truncated lay referral structure and a group characterized by a more extended lay referral structure. The first group was older (46 versus 36 yr) and had a more positive attitude towards full dentures. In order to avoid problems dentists are recommended to involve (a representative of) the patient's social network when important decisions have to be taken.

Social network therapy for cocaine dependence.

The article describes an approach to the treatment of cocaine dependent patients in which the patient's social network is used to bolster his attempts to achieve stable abstinence. The network is drawn from persons close to the patient, typically members of his immediate family or close friends, and is used for social support in assuring compliance with the treatment regimen and in undercutting denial. The function of the regimen is explained to the patient and network members: It is conducted to assure the patient's abstinence from the outset of treatment, to mitigate against the occurrence of slips, and to support reintegration into treatment should relapses to alcohol or drug use occur.

Home visiting by nursing students to patients with Parkinson's disease.

Thirty ambulatory Parkinson's disease patients diagnosed with Stage I, II, and III illness were visited at home by 15 senior baccalaureate nursing students on a weekly basis for one year. The purpose of the home visit was to assess the patient, implement a regimen of mild exercise, and increase the patient's social network. Twenty-nine patients completed one year of weekly exercise sessions under the supervision of a nursing student. This article includes a demographic description of the sample, an outline of the exercise regimen, a report on the assessment tool that was used to collect the data, and a discussion of the program's educational value for the students. Peripheral activities such as organization of the support group and education of caregivers are discussed. Requirements of the study are explained. Analysis of the collected data is under way. An empirical report is forthcoming this year.

Attitudes toward health in social networks: Their influence on physician utilization

Many variables contribute to medical consumption. This study concentrates on those that can relate to health education, namely, (1) attitudes, beliefs, and behavioral intentions concerning health and medical care and (2) the influence of the patient's social network on medical consumption. Both complexes appear to influence the number of physician visits by three selected groups of patients. Emotional components are more influential than cognitive ones. Support from the social network appears to reinforce rather than replace professional help. The question is how health educators can adjust strategies to these findings.

An experimental evaluation of crisis intervention

The importance of psychosocial crisis in health care is reviewed in the fight of research on the nature and consequences of such experiences. Studies that have evaluated crisis intervention are summarized. Conceptions of crisis, of crisis resolution and crisis intervention are presented, and some typical crisis-precipitating events described. A controlled trial of crisis intervention with patients hospitalized for treatment of road trauma is then described. Results presented show that crisis intervention was effective in returning patients to normal functioning at 3–4 months after injury and may have reduced length of hospitalization. At follow-up, patients not receiving intervention were as disturbed as typical psychiatric outpatients. Evidence is presented to show that the effect was due, in large measure, to mobilization of genuine concern and to reduction of hostility and misunderstanding from people in the patient's social network. Methodological problems are considered, directions for further research defined and implications for practice outlined.