No description available.

Shaken Baby Syndrome (SBS) is a potentially lethal form of child abuse. Primary prevention efforts have been targeted towards educating the general population, especially pregnant women and new parents, about the dangers of shaking. It is hypothesized that there are identifiable perinatal risk fadors for children that make them more at risk for injury from SBS than other forms of Abusive Head Trauma (AHT). All hospitalized children with suspected AHT (n=206) over a 14-year period who were referred to a multidisciplinary child protection center, were identified. The records of 24 children were not included in the study because they were not available for review, the child did not have a primary head injury, or the child was adopted and birth records were not available. Nonaccidental injury was confirmed in 116 of the remaining children. These included 72 (62%) children fitting SBS criteria, and 44 (38%) children identified as having other AHT. Case analysis included review of hospital and multidisciplinary child protection center records. The SBS and AHT groups were compared to separate perinatal risk fadors that might assist in identifying children at increased risk for SBS. Results of the analysis demonstrated that there was no significant difference between groups evident in the perinatal history. These preliminary findings support the follOWing conclusion that in contrast to many published reports, the perinatal information on the child did not provide significant pre-injury risk identifiers. It was concluded that changes in early educational programs and media campaigns are needed to reduce the sequalae of head trauma in infants and children. Programs must focus on AHT in general, rather than only SBS.

No description available.

The purposes of this study were: (a) to identify which of four competing theories best accounted for self help as a learned outcome of chronic illness experience, and (b) to generate a Self Help Model that could be used to explicate self help as a learned response to chronic illness. The concepts of severity of chronic illness, intimate dependency reinforcers, self induced dependency reinforcers, cue outcome independence reinforcers, enabling skill, self help and life quality were specified in a causal format that allowed a competitive test of four different theories. The theories tested were instrumental passivity theory, self induced dependency theory, an adaptation of learned helplessness theory and learned resourcefulness theory. The study utilized a causal modeling design to assess a five stage model. A judgment sample of 786 individuals having a diagnosis of arthritis or an arthritis related condition were mailed questionnaires. Two hundred seventy-eight subjects responded, a 36 percent return rate. Seven scales using a visual analogue response format indexed the theoretical concepts. Reliability and validity estimates were conducted to assess psychometric properties of the instruments. Model parameters were estimated using multiple regression statistical techniques. Residual analysis was conducted to estimate violations of the causal model and statistical assumptions. Factors from one theory, the learned resourcefulness theory, emerged as more credible than factors from any single other theory. However, the data did evidence factors from other theories that were significant. Self induced sick role reinforcers and cue outcome independence reinforcers were found to slightly reduce perception of enabling skill (B = -.31 and B = -.12, respectively; R² = .11). Intimate dependency reinforcers and cue outcome independence reinforcers were found to slightly reduce perception of self help (B = -.34 and B = -.24, respectively; R² = .19). These factors helped to identify environmental and intra-person contingencies that led to reduction in self help. The learned resourcefulness factor, enabling skill, demonstrated the mediating skills that worked to enhance self help (B = .44; R² = .29). The Self Help Model generated to explicate self help as a learned response to chronic illness explained 50 percent of the variance in perceived self help. Self help had a direct positive impact on life quality (B = .61; R² = .46). By knowing the factors influencing a patient’s self help response to chronic illness experience, the nurse is better able to plan more effective self help promoting interventions for individuals, or groups of patients. Nurses who promote a self help response in those having a chronic illness could improve their life quality.

Almost everyone experiences an incident, illness, or concern that requires clinical advice or assistance. Most persons obtain the desired care and renew their daily activities. Some people, however, appear to be (medical) problem-prone, wellness-resistant or reinforced by illness sequelae. Individuals who maintained illness behaviors are often called, for example, chronic pain, asthma, or psychiatric patients by caregivers who focus on diagnoses. Some patients may be viewed as primarily chronic, with specific diagnoses considered secondary. Chronicity is here defined as a measure of individual, situation, exposure, and provider interaction outcomes. Independent of disease processes, chronicity-producing interactions often predict inappropriate and atypical medical utilization patterns. The assessment of chronicity, its precursors, and dynamics may identity high risk person, situation, provider, and environment combinations and permit more effective and relevant prevention and treatment strategies. The study patient chronicity, the Pre-Assistance Questionnaire (PAQ) was developed with 320 items on medical, personal, and situational topics. PAQ responses from 60 medical and 40 psychiatric VA outpatients were correlated with three estimators of patient chronicity: PAQ totals (from an empirically-derived key), clinicians' subjective ratings of patients' chronicity, and indices of subjects' 2 year use of VA medical center resources. PAQ totals correlated significantly with 240 items, medical usage with 119, and clinicians' ratings with 100. For replication, a 40 item short form was given to 120 medical and 80 psychiatric outpatients. Thirty-four items correlated significantly with two of the three measures, 26 with all three. The short form demonstrated high reliability (alpha = .91; test-retest reliability = .90; split-half reliability = .89). PAQ totals, chronicity ratings, and use indices showed no significant differences across from administrations although the psychiatric patients scored significantly higher (more chronic) on all measures. The findings support a general chronicity construct and suggest many applications from the screening of potential employees to the development of specific treatment plans matched to particular PAQ patterns. The major message, however, is that public health, medical, psychological, and sociological constructs may be integrated into a comprehensive model of medical utilization patterns that provides views of illness, wellness, and health care delivery and assessment.

The purpose of this study was to examine the interrelationships among the themes of Taylor's (1983) Cognitive Adaptation Theory for schoolagers with asthma. In addition, the influence of Taylor's (1983) themes on the children's social behavior was also tested. The three themes of Taylor's (1983) theory included A Search for Meaning, Restoration of Self-Esteem, and Gaining a Sense of Self-Mastery. Two components of A Search for Meaning included the Impact of Disease and the Cause of Disease. Relating Behaviors-Cooperating Behaviors was the index of social behavior. Forty-five Caucasian children between the ages of seven and ten years who had a diagnosis of asthma and did not have any mental disability were the convenient sample. Data were collected in the children's homes. Three questionnaires and two interviews were used to measure Taylor's (1983) themes and Relating Behaviors-Cooperating Behaviors. Descriptive statistics were used to answer the research questions and provide additional findings related to the conceptual framework. Two relationships among Taylor's (1983) themes were significant (p ≤ .05). Children who reported greater impact of asthma upon their lives (Impact of Disease) reported lower self-esteem (Restoration of Self-Esteem). Children who reported greater impact of asthma upon their lives (Impact of Disease) also reported a lesser internal locus of control orientation (Gaining a Sense of Self-Mastery). The Cause of Disease was the only concept which correlated significantly with Relating Behaviors-Cooperating Behaviors and thus, influenced this concept. Children who named a cause for their asthma reported more relating and cooperating skills. The Cause of Disease explained 6.5% of the variance for Relating Behaviors-Cooperating Behaviors. Characteristics of the children's asthma condition and their families were significantly related to the themes of Taylor's (1983) theory and Relating Behaviors-Cooperating Behaviors. Developmental differences were found from age group analyses. The classification of the children's responses for the cause of asthma and reliability and validity estimation for the HIIS were also reported. Five potential sources of error which may have affected the findings included design, instrument, subject, investigator, and specification errors. Suggestions for future research with the conceptual framework were discussed.

The relationship of spirituality, self-transcendence, and social support to morale in chronically ill elderly was the focus of this research study. The research was based upon a developmental framework of aging. Individuals answered questionnaires regarding their perspectives on the above variables to determine how significantly the variables related to feelings of morale. Findings revealed that self-transcendence and social support were significantly correlated with morale in this population. No significant relationship between spirituality and morale was found. Self-transcendence and social support together accounted for 45% of the variance in predicting morale in the chronically ill elderly. Findings also revealed existing relationships between spirituality and gender, education level and social support, and length of illness and social support.

This study briefly reviews both historical and recent conceptualizations of dependency. In particular, it focuses on this concept's applicability to patients with chronic illnesses, especially those with allergies. Type and degree of dependency were seen as an important factor in the approach to the medical and psychological treatment of clinical ecology patients. The purpose of the study was to develop an objective measure of dependency which could quickly identify patients whose dependency conflicts interfere with the treatment process. The study was divided into three phases. In the first phase test responses by 84 inpatients to the CAQ, MMPI, and the HAT as well as historical and demographic data were analyzed by a series of stepwise discriminant analysis. The 53 resulting items were examined for those which most concisely discriminated between the two identified groups (pathologically dependent and nonpathologically dependent). These 15 items were used to test 120 additional patients in phase II. Fourteen items were retained and the coefficients obtained classified the patients in phase I and II with a 98.81 percent and 94.17 percent degree of accuracy respectively. These classification coefficients were used to classify another 30 patients in phase III with a 96.67 percent rate of accuracy. These results provide exceptionally strong support for the hypothesis that group classification can be obtained through the use of an objective screening instrument. The pathologically dependent patients tend to focus on disease, frequently are unemployed, have histories of childhood illnesses, have limited emotional controls, are depressed, ambivalent, and distrustful. Additionally, they experience difficulty establishing goals or accepting personal responsibility. Those patients identified as nonpathologically dependent exemplify the more positive aspects of these traits. The pathologically dependent patients appear to be caught in a dilemma between wellness and satisfaction of dependency needs. While all patients need an organized approach to treatment, the pathologically dependent require an extremely structured repititious approach and may require long term psychological intervention in order to make positive steps toward wellness.

Thesis (M.A. (Clinical Psychology)) -- UNiversity of Limpopo, 2014 / A number of studies have revealed that chronic diseases are common in all communities. This study explored the views of indigenous healers regarding the causes and treatment of chronic diseases in Ga-Dikgale community. A qualitative approach was followed and participants were selected through snowball sampling. Seven participants (2 males and 5 females) who are indigenous healers were recruited for the study. Data was collected using in-depth semi-structured one-to-one interviews and analysed using content analysis. The results of the study are presented in terms of the following themes: a). Participants’ views regarding the types of chronic diseases: despite the divergent views held by indigenous healers regarding chronic diseases, they all perceive these debilitating conditions as incurable. b). Participants’ own explanations of the causes of chronic diseases: it appeared the causes of chronic diseases were attributed to both cultural beliefs and modern medical science. c). Participants’ experiences and subjective notions on the treatment methods for chronic diseases: it was found that Western medicine is considered the most viable option to treat chronic diseases instead of indigenous medicine. d). Participants’ descriptions of the most common diseases that they treat: indigenous healers treat non-chronic conditions instead of chronic diseases. e). Participants’ own perceptions of their roles in the community: it appeared indigenous healers felt they received support from their community as they were consulted mostly for non-chronic conditions; and f). Participants’ recommendations on how people with chronic diseases should be managed: indigenous healers recommend that people should seek medical intervention for treatment of chronic diseases. The study further revealed that indigenous healers in this community are not always the first line of treatment for chronic conditions. Instead, it was found that indigenous healers tend to advice patients with chronic diseases to seek medical intervention rather than traditional healing. The study is concluded by recommending further investigation on chronic diseases, including the possibilities of integrating indigenous healing and Western-oriented health care systems.

Thesis (Ph. D.)--University of Hawaii at Manoa, 1982. / Bibliography: leaves 349-358. / Microfiche. / x, 358 leaves, bound ill., maps 29 cm