Subject(s)
Asthma/psychology , Hospitalization , Self-Assessment , Adolescent , Adult , Aged , Female , Humans , Male , Middle Aged , Physician-Patient RelationsABSTRACT
Evidence indicating that corticosteroid therapy may adversely affect attention and memory in asthmatic subjects is reviewed. The potential impact of corticosteroid dosage levels (high versus low) and treatment regimens (daily versus alternate day) on attention and memory is discussed. Findings indicate that the suppression of ACTH by corticosteroids may have different effects on attention and memory as a function of the sex of the asthmatic patient. The need to establish what the effects of theophylline-induced reductions of cerebral blood flow and cerebral oxygen tension are on higher cognitive processes are outlined. The importance of establishing whether or not medications commonly used for the treatment of asthma create deficits of memory or attention that interfere with medical compliance is emphasized.
Subject(s)
Adrenal Cortex Hormones/adverse effects , Mental Processes/drug effects , Theophylline/adverse effects , Adrenal Cortex Hormones/administration & dosage , Adrenocorticotropic Hormone/metabolism , Adrenocorticotropic Hormone/pharmacology , Animals , Attention/drug effects , Central Nervous System/drug effects , Cerebrovascular Circulation/drug effects , Cushing Syndrome/psychology , Dose-Response Relationship, Drug , Humans , Hypothalamo-Hypophyseal System/drug effects , Memory/drug effects , Peptide Fragments/pharmacology , Pituitary-Adrenal System/drug effects , Theophylline/administration & dosageABSTRACT
Mislabeling of symptoms was studied in a group of 587 chronic asthmatic patients. Results indicated a wide variation in both the frequency and type of mislabeling, with over 26 per cent of the patients mislabeling one or more nonairways obstruction symptom clusters as being an asthma attack. Several demographic and personality factors were found to correlate with mislabeling. Finally, mislabeling was associated with medical outcome, with mislabelers being 40 per cent more likely than nonmislabelers to be rehospitalized for their asthma within six months of discharge.
Subject(s)
Asthma/diagnosis , Communication , Physician-Patient Relations , Semantics , Adolescent , Adult , Aged , Asthma/psychology , Female , Humans , Male , Middle Aged , Outcome and Process Assessment, Health Care , Patient Readmission , PersonalityABSTRACT
The failure of patients to comprehend medical advice or to recall accurately the instructions their physicians give them may destroy the effectiveness of even the most scientifically sound treatment regimen. The proper use of practical and simple communication techniques may greatly assist the physician in educating the patient. Knowledge of the current status of research on the recall of medical information will assist the practitioner in communicating so that patients can improve their retention of medical instructions and advice.
Subject(s)
Memory , Mental Recall , Patient Compliance , Physician-Patient Relations , Anxiety , Asthma/therapy , HumansABSTRACT
In a sample of intractable adult asthmatics, the prevalence of Bender-Gestalt signs suggestive of neuropsychological problems was documented. Sixty-five per cent of the sample was found to have equivocal or definite Bender-Gestalt signs suggestive of cerebral dysfunction. A clear majority of the asthmatics manifested definite signs of memory impairment when they were asked to recall the Bender designs. The study provides the first documentation of the neuropsychological sequelae of asthma in adults.
Subject(s)
Asthma/diagnosis , Bender-Gestalt Test , Adult , Asthma/psychology , Brain/physiopathology , Female , Humans , Male , Memory Disorders/diagnosis , Middle AgedSubject(s)
Affective Symptoms/therapy , Hypnosis/methods , Language Disorders/therapy , Adult , Cough/therapy , Female , HumansABSTRACT
Certain patient styles perpetuate chronic physical illness, defeat medical treatment, and increase the utilization of medical services. Two such extreme styles among asthmatic patients are indexed by the MMPI panic-fear scale, reflecting either (a) helpless dependency and anxiety, or (b) excessive inappropriate independence. The present findings indicate that both of these patient styles are related to excessively high hospitalization rates during the two 1-year periods after discharge from intensive treatment, even among patient groups having asthma of similar objective severity. The discussion centres upon the increased demand for medical services, and the need for early identification of patients whose personal styles contribute to the maintenance of illness.
