PubMed Health⌕ Search

Biomedical subjects

A Towers

Publications and source records attributed to A Towers.

5 recordsLinked to original sources
PubMed2001

Embracing vulnerability: risk and empathy in palliative care.

This paper discusses a case example from a larger case narrative study conducted by the authors during 1995-1999. The case illustrates the premise that the dying experience is ultimately a complex experience and one that the caregiver may never truly understand. Both patient and caregivers remain learners. We propose that while the process of achieving empathic communication necessarily demands "good listening," the palliative care provider may be invited to go beyond the domain of listening, to emotional realms that are neither easy nor comfortable. This paper examines two aspects of empathy: 1) the process of learning to empathize with persons who are dying; 2) empathy as a therapeutic act that requires vulnerability and personal risk within the patient-caregiver relationship.

Amyotrophic Lateral Sclerosis↗
PubMed1999

Communication between family physicians and oncologists: qualitative results of an exploratory study.

OBJECTIVE: To study communication between family physicians (FPs) and oncologists, and to look at the factors that may influence FP involvement in cancer care. DESIGN: This survey design uses a qualitative methodology, where the data are analyzed using a modified grounded theory approach. SETTING: This was a multisite study using 14 focus groups of FPs, followed by structured telephone interviews with 116 FPs in 6 different Canadian provinces. MAIN OUTCOME MEASURE: Interview questions were used to explore the actual and desired roles of FPs in cancer care, and the quality of communication with oncologists with reference to a particular cancer patient in the FPs' practice. RESULTS: Physicians providing cancer care must consider complex psychosocial and biomedical factors, more so than with other chronic diseases, and so written communication alone is inadequate. Family physicians require face-to-face and/or telephone communication with the oncologist to negotiate their respective roles, and to discuss the patient's prognosis and the effectiveness of proposed treatments. Family physicians expressed a desire to become more involved in all stages of cancer care in both the biomedical and psychosocial aspects, and to help better define their roles throughout the illness trajectory. CONCLUSION: These results suggest opportunities to improve the communication, coordination and comprehensiveness of shared cancer care provided by family physicians and oncologists in different clinical settings.

Canada↗
PubMed1993

Physiologic and psychologic characteristics of an elderly population with chronic constipation.

OBJECTIVES: To characterize colorectal physiologic parameters and psychological profiles in subjects > or = 60 yr with chronic constipation who have not sought medical advice. METHODS: Colorectal physiologic studies and psychologic profiles were obtained in 18 self-identified constipated subjects and 17 nonconstipated control subjects. Constipation was defined as two or fewer bowel movements/week and/or defecatory difficulty for at least 6 months. All subjects underwent colonic transit with radiopaque markers, anorectal manometry and completed a self rated inventory assessing psychological distress (SCL-90-R). RESULTS: Slow colonic transit occurred in five constipated subjects. Pelvic floor dyssynergia and/or increased rectal compliance were found in nine subjects versus only two controls. One-third of constipated subjects scored in the top 10th percentile for global psychologic distress with higher scores for somatization, depression, and anxiety than control subjects. Neither physiologic nor psychologic abnormalities were predictable on the basis of patterns of bowel complaints. CONCLUSIONS: Colorectal physiologic and psychologic dysfunctions are common in elderly constipated subjects who do not seek medical attention for bowel dysfunction.

Aged↗
PubMed1993

Serum sex hormones and severity of osteoarthritis of the hand.

OBJECTIVE: To examine the relationship of endogenous sex hormones to the severity of radiographic hand osteoarthritis (ROA) in 229 white women, mean age 74 years. METHODS: Hand ROA was graded according to the Kellgren-Lawrence scale and according to individual features of OA: osteophytes, joint space narrowing, subchondral sclerosis, lateral deformity and joint collapse. Two measures of hand ROA were considered: the worst joint score assigned to any one of 10 hand joints and the sum of the scores for the 10 joints. RESULTS: Comparison of the age and obesity adjusted sex hormone concentrations by the worst Kellgren-Lawrence score or the worst score of the individual features of OA revealed little difference. There were no trends in the sex hormone concentrations with increasing severity of hand ROA. CONCLUSIONS: Our results do not support an association between endogenous hormone levels and severity of hand ROA.

Aged↗