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31.
Atsuhiro Kikuchi md phd Norio Yasui-Furukori md phd Akira Fujii md Hiroshi Katagai md phd Sunao Kaneko md phd 《Psychiatry and clinical neurosciences》2009,63(2):180-185
Aim: Although electroconvulsive therapy (ECT) often causes post-ictal delirium (PID), to date, the specific risk factors of PID have not been described. The purpose of the present study was therefore to elucidate the predictors of PID via identification of the characteristics of patients with PID.
Methods: ECT was conducted in 50 patients and all patients underwent more than four sessions. A sine wave or a brief-pulse square wave ECT instrument was used. After convulsions the patients' PID was monitored for 30 min. The patients were allocated into four groups based on PID severity (none, mild, moderate or severe PID). Variables, including age, gender, duration of illness, diagnosis, clinical features (psychotic or catatonic features) and stimulus waveform (sine or brief pulse square waveform), were analyzed.
Results: Moderate to severe PID developed during the ECT sessions in 18 patients (36%). Most patients with severe delirium were successfully treated with i.v. bolus of propofol (1–2 mg/kg). Although the incidence of PID was 24% in patients without catatonic features, the incidence in patients with catatonic features was extremely high (88%; P < 0.001). Multiple regression analyses showed that the severity of PID correlated significantly with the presence of catatonic features (β = 0.428, P < 0.01).
Conclusion: The presence of catatonic features before ECT is a predictor of PID. Propofol is useful for the treatment of PID. 相似文献
Methods: ECT was conducted in 50 patients and all patients underwent more than four sessions. A sine wave or a brief-pulse square wave ECT instrument was used. After convulsions the patients' PID was monitored for 30 min. The patients were allocated into four groups based on PID severity (none, mild, moderate or severe PID). Variables, including age, gender, duration of illness, diagnosis, clinical features (psychotic or catatonic features) and stimulus waveform (sine or brief pulse square waveform), were analyzed.
Results: Moderate to severe PID developed during the ECT sessions in 18 patients (36%). Most patients with severe delirium were successfully treated with i.v. bolus of propofol (1–2 mg/kg). Although the incidence of PID was 24% in patients without catatonic features, the incidence in patients with catatonic features was extremely high (88%; P < 0.001). Multiple regression analyses showed that the severity of PID correlated significantly with the presence of catatonic features (β = 0.428, P < 0.01).
Conclusion: The presence of catatonic features before ECT is a predictor of PID. Propofol is useful for the treatment of PID. 相似文献
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M. Crowe
rn phd D. Carlyle
rn phd R. Farmar
rn psychotherapist 《Journal of psychiatric and mental health nursing》2008,15(10):800-807
There are problems for mental health nurses in using psychiatric diagnoses as outcomes of their nursing assessments and nursing diagnoses present similar issues. However, there is a need in practice to link the assessment to nursing interventions in a meaningful way. This paper proposes that the clinical formulation can be regarded as central to providing this cohesion. The formulation does not merely organize the assessment findings but is also an interpretation or explanation, made in consultation with the client, of what meaning can be attributed to the issues explored in the assessment process. Because this interpretation is dependent on both the client's and the nurse's explanatory frameworks, there are multiple ways of developing the formulation. It is also an evolving and dynamic statement of understanding. A case example is provided in the paper to illustrate how the same case can be interpreted in different ways and the implications this has for the nursing interventions provided. 相似文献
34.
ANDREW BOTTOMLEY phd CHANTAL QUINTEN msc CORNEEL COENS msc FRANCESCA MARTINELLI msc MURIELLE MAUER phd JOHN MARINGWA phd CHARLES S. CLEELAND phd HENNING FLECHTNER phd CAROLYN GOTAY phd EVA GREIMEL phd MADELEINE KING phd DAVID OSOBA md MARTIN J.B. TAPHOORN phd BRYCE B. REEVE phd JOLIE RINGASH phd JOSEPH SCHMUCKER-VON KOCH phd & JOACHIM WEIS phd 《European journal of cancer care》2009,18(2):105-107
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Alcohol addiction affects many clients that enter the offices of traditional mental health professionals. Their recovery is impacted by what goes on inside the office, in treatment, as well as by involvement outside the office, in 12-step programs as Alcoholics Anonymous (AA). This article examines alcoholism as a thought disorder and cognitive restructuring as an effective model of treatment. Cognitive restructuring occurs in therapy and in AA. It can, therefore, be the bridge that encourages understanding and cooperation between the two factors influencing recovery. 相似文献
38.
S. BROWN mb bs director A. BELGAUMI md consultant A. KOFIDE md consultant R. SABBAH md consultant A. EZZAT md executive director medical clinical operations consultant B. LITTLECHILD team leader M. SHOUKRI phd principal scientist R. BARR md A. LEVIN md 《European journal of cancer care》2009,18(3):313-317
Failure to attend medical appointments (No Show) and loss to follow-up (LTFU) among patients with cancer can adversely affect their treatment and eventual outcome. In a 3-year prospective study of 199 patients with malignant lymphoma, all of those with No Shows were contacted, and reasons given for No Shows were categorized. Of the 340 No Shows, 34.1% were due to hospital-based communication problems, 17.6% to errors in patient communication with the hospital, 7.4% to transportation problems and 16.5% to other personal reasons. Almost one quarter (24.4%) of the patients were not contactable. Reasons for No Show in all categories were instructive as to patients' attitudes to treatment. Nineteen (12.2%) of the 156 patients who had not died in the 3-year follow-up period were identified as LTFU. These 19 LTFU patients accounted for 77 (22.6%) of all No Shows. The data indicate that LTFU in this cohort is significantly less frequent than in a prior cohort followed up for 3 years from 1997 to 1998. These findings suggest that some causes of No Show can be addressed, and individuals are identified as at particular risk for No Show and ultimately LTFU. This study points out that pre-emptive strategies to reduce No Shows may be feasible and efficacious. 相似文献
39.
L. LETRILLIART md phd general practitioner L. MILLIAT-GUITTARD phd research fellow P. ROMESTAING md radio-oncologist A.M. SCHOTT md phd epidemiologist N. BERTHOUX nurse research assistant & C. COLIN md phd professor of epidemiology health economics 《European journal of cancer care》2009,18(2):131-139
Before electronic records become operational, patient-held records provide an opportunity to improve communication between patients and healthcare professionals. Our aim was to design the appropriate organization, layout and content for such a shared record for breast cancer management, based on a consensus between the various stakeholders. We therefore conducted a Delphi study within a working group of 48 members, including patients, oncologists, general practitioners, nurses and other professionals. The procedure featured three rounds during which participants' judgements were collected via mailed questionnaires and quantitative and qualitative feedback was provided on a regular basis. These three rounds were followed by an evaluation phase. Forty members (83%) participated in the three rounds. According to the agreement reached, the shared record was expected to include a front summary card, four sections for groups of users authorized to write down or insert information in the record (patient, physicians, medical auxiliaries and other healthcare professionals), and one section for medical imaging files. In addition, the record was to include specific categories of information as subsections within each of the various user sections. The participant satisfaction rate was over 90% for all aspects of the procedure, with the exception of interaction within the working group (79%). 相似文献
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