ABSTRACT
Successful coping with stressful events can contribute to improved mental and physical health. Primary care physicians, through their development of positive relationships with patients and use of selected intervention techniques, are in an ideal position to recognize and alter this process.
Subject(s)
Behavioral Medicine/methods , Family Practice/methods , Life Change Events , Primary Health Care/methods , Stress, Psychological/prevention & control , Adaptation, Psychological , Adult , Female , Health Status , Humans , Male , Middle Aged , Patient Education as Topic/methods , Physician-Patient Relations , Psychophysiology , Referral and Consultation , Stress, Psychological/complications , Stress, Psychological/psychologyABSTRACT
BACKGROUND: Childhood sexual abuse has been established as an antecedent to specific psychological disorders in adulthood. Only recently have researchers begun to consider the effects of this early trauma on subsequent physical health status. The current study sought to explore the relationship between a history of childhood sexual abuse in female adults and subsequent self-reported medical complaints. METHODS: This consecutive sample study used a questionnaire to distinguish subjects with a sexual abuse history and those without such a history. Subjects were female patients over 18 years of age at a primary care health center. RESULTS: Twenty-six percent of the 523 subjects who completed the entire questionnaire acknowledged a history of sexual abuse in childhood. This percentage is consistent with estimates for the population at large. The abused group reported more problems in respiratory, gastrointestinal, musculoskeletal, neurological, and gynecological functions. Statistically significant discriminating variables for those who had been abused were (1) total medical complaints reported, (2) previous mental health treatment, and (3) age of first sexual intercourse. Among the abused group, only 5.1% had ever disclosed information about their sexual abuse experiences to a physician. CONCLUSIONS: At least one in four women are survivors of childhood sexual abuse. These women rarely spontaneously reveal this history to a physician, yet they are more likely than nonabused patients to report multisystemic medical complaints. To avoid misdiagnosis and misuse of medical services, physicians should routinely obtain a thorough sexual history, particularly when the patient has multisystem complaints.
Subject(s)
Child Abuse, Sexual/complications , Health Status , Adult , Child , Child Abuse, Sexual/psychology , Female , Humans , Medical History TakingABSTRACT
This study evaluates role expectancies in essential nursing services of nursing home professionals and relatives of residents. Whereas previous studies have indicated substantial role ambiguity, the present research indicates significant agreement between the groups. Even so, areas exist where families deem themselves responsible for a task, but staff expectations are incongruent. Analysis of this process and steps to ameliorate this problem are discussed.
Subject(s)
Family , Homes for the Aged , Nursing Homes , Nursing Staff/psychology , Role , Adult , Aged , Conflict, Psychological , Evaluation Studies as Topic , Humans , Middle AgedABSTRACT
Several previous studies have reported decreased Type A behavior pattern (TABP) after initiation of an exercise program. To determine if changes in TABP could be linked to exercise patterns in a cardiac rehabilitation program, both physical activity and TABP were measured in 81 male cardiac patients over a period of one year after hospitalization for an initial cardiac event. Changes in TABP scores were not associated with differences in activity patterns as measured by kilocalories per week of exercise, self-ratings of both job and leisure-time physical activity levels, or participation in a cardiac rehabilitation program. However, in Type A subjects there was a discrepancy between simple self-ratings of activity and more objective measures of exercise: subjects who had high TABP scores perceived themselves to be significantly more physically active than did subjects with lower TABP scores, even though the more objective estimates of physical activity were not associated with TABP scores.
Subject(s)
Coronary Disease/psychology , Exercise , Type A Personality , Coronary Artery Bypass/psychology , Coronary Disease/surgery , Follow-Up Studies , Humans , Male , Middle Aged , Myocardial Infarction/psychology , Patient Compliance , Postoperative Complications/psychology , Risk FactorsABSTRACT
To examine the temporal stability of the Type A behavior pattern (TABP) after a cardiac event, both a Videotaped Clinical Interview (VCI) (formerly known as the Videotaped Structured Interview) and the Jenkins Activity Survey (JAS) were administered to 81 male and 19 female patients three times during the first year after hospitalization for an initial myocardial infarction, coronary artery bypass graft, or both. There was no intervention other than the usual treatment provided by the medical care system. The test-retest reliability coefficients were moderately high for all measures of TABP. The JAS provided the most reliable scores in both sexes. The Hard Driving and Competitive component of the JAS decreased significantly throughout the year in both men (p less than 0.001) and women (p less than 0.01), but in men all three overall indices of TABP and their components (other than Hard Driving and Competitive) decreased spontaneously between 1 and 3 months, and then increased again by 1 year to nearly the original levels. In women, there were no consistent changes over time among the indices other than that for the Hard Driving and Competitive component of the JAS. Intercorrelations among the indices demonstrate the failure of the JAS to assess the Hostility component of the TABP and the possibility that the Speed and Impatience subscale of the JAS measures different things in men and women. The newest method of scoring the VCI appeared to provide the best index for measuring TABP in male coronary patients, while the original scoring was more reliable for women.
Subject(s)
Coronary Disease/psychology , Personality Tests , Type A Personality , Adult , Aged , Aged, 80 and over , Coronary Artery Bypass/psychology , Coronary Disease/surgery , Female , Follow-Up Studies , Humans , Male , Middle Aged , Postoperative Complications/psychology , PsychometricsABSTRACT
Coronary-prone (Type A) behavior is an independent risk factor for ischemic heart disease (coronary heart disease). Recent investigations indicate that modification of Type A behavior is possible and that such treatment reduces the likelihood of subsequent coronary events. Type A behavior is not difficult to recognize in day-to-day family practice. By recognizing and responding to coronary-prone behavior, family physicians can play an active role in the prevention and treatment of coronary heart disease.
