ABSTRACT
The effect of replacing fluoxetine with sertraline at two dosage-conversion ratios was studied. Outpatients at a Veterans Affairs mental health clinic who were being treated with fluoxetine were randomly assigned to receive either 50 or 75 mg of sertraline hydrochloride for every 20 mg of fluoxetine (as the hydrochloride salt) or to continue to receive their current dosage of fluoxetine. The subjects were given the Hamilton Depression Rating Scale (HDRS) and the Beck Depression Inventory (BDI) at baseline and were re-examined at one-month intervals for three months with the HDRS and BDI and the Clinical Global Impression of Change. Each patient was re-evaluated by the same blinded investigator. A total of 45 patients (42 men and 3 women) completed the study. The final overall response did not differ significantly among the three groups. There were also no significant differences among the groups in the proportions of patients with HDRS and BDI scores classified as improving, worsening, or not changing. Improvement was more common in patients receiving the higher dosage of sertraline. Few adverse effects were reported. Outpatients receiving fluoxetine were switched to sertraline therapy without a loss of control of depression and without substantial adverse effects.
Subject(s)
1-Naphthylamine/analogs & derivatives , Antidepressive Agents/therapeutic use , Depression/drug therapy , Fluoxetine/therapeutic use , 1-Naphthylamine/therapeutic use , Ambulatory Care , Female , Humans , Male , Psychiatric Status Rating Scales , Sertraline , Single-Blind MethodABSTRACT
Chronic pain, which affects an estimated 80 million Americans, has untold effects on personal productivity, self-esteem, functioning of the family, and cost to the healthcare delivery system. The author describes how the nursing process offers an effective framework from which nurses can provide psychosocial care to clients with chronic pain. Helping clients to assume responsibility for their own well-being, achieve independence in their lives, and practice healthy coping mechanisms are major goals of such psychosocial care.
Subject(s)
Nursing Assessment , Pain/nursing , Analgesia/methods , Chronic Disease , Family , Humans , Interviews as Topic , Pain/psychologyABSTRACT
Residency programs need to anticipate the parental needs of their residents as more residents have children during residency. Ad hoc or crisis mode responses to resident pregnancy result in individual and group distress and dysfunction. Described in this paper is a maternity and parental leave policy for a psychiatric training program at a military hospital. This policy provides a framework for policies in other residency and military work situations.
