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Biomedical subjects

D G Larson

Publications and source records attributed to D G Larson.

9 recordsLinked to original sources
PubMed2000

End-of-life conversations: evolving practice and theory.

This article examines the evolution of and need for "end-of-life conversations." Barriers to end-of-life discussions that have been identified in patients and families, health care professionals, and health care systems can seriously interfere with the quality of remaining life for terminally ill patients. Strategies for enhancing end-of-life discussions are most productively linked to (1) physicians' interpersonal communication skills, (2) a patient-centered model of care, (3) a focus on quality of remaining life, and (4) innovative clinical models for implementing these discussions earlier in the care process. We conclude that end-of-life conversations must become a routine, structured intervention in health care and that advance care planning is best viewed as one component in a series of ongoing end-of-life discussions. Randomized trials are needed to examine new approaches and models for enhancing end-of-life conversations. JAMA. 2000;284:1573-1578.

Advance Care Planning↗
PubMed1999

Immediate angioplasty for acute myocardial infarction: a community hospital's experience.

This study describes prospective outcome data from 100 consecutive patients presenting with acute myocardial infarction and treated with immediate angioplasty in a community hospital setting. Successful angioplasty was achieved in 86% of patients with a mean reperfusion time of 77.5 minutes. Only 4 patients did not survive initial hospitalization; three of these initially presented with cardiogenic shock. The survival rate in noncardiogenic shock patients was 98.9%. Four patients underwent repeat angioplasty of the infarct-related artery and 6 patients were referred for coronary artery bypass surgery during initial hospitalization. During the 6 month follow-up, nine patients required repeat hospitalization. Seven of these patients presented with recurrent ischemia; four underwent repeat angioplasty and 3 coronary artery bypass surgery. There were no subsequent deaths or reinfarctions during the 6 month follow-up. The angioplasty success rate and clinical outcomes in this study compare favorably to previous trials performed in select interventional centers and suggest that immediate angioplasty can be the preferred reperfusion therapy in a community hospital setting.

Acute Disease↗
PubMed1982

Mental health training and the hospice community: a national survey.

This article summarizes a national survey of the hospice community. Respondents provided detailed information in the following areas: (a) What formal mental health training is provided for staff members? (b) Who conducts this training? (c) What areas are covered and where would more training be useful? (d) How is the training conducted--what formats and teaching materials are used? and (e) How much training do staff members receive? The results of the survey indicate that the hospice community is making a concerted effort to meet the mental health training needs of its paid staff members and volunteers. However, more than half of the hospices surveyed expressed a need for further training in 26 of the 33 issues and skills covered in the questionnaire, and many reported a need for a more systematic and comprehensive mental health curriculum. The findings point to several areas of particularly great need and provide a basis for the development of future mental health training in the hospice community.

Hospices↗
PubMed1981

Borderline personality and the Rorschach test.

Rorschach responses of borderline persons, acute and chronic schizophrenics, normals, and neurotics were compared on summary, composite, and fabulized combination scores and on a score reflecting decline in the quality of responses to individual cards. The groups' summary scores were as ego function theory would predict; normals had the highest scores, followed by neurotics, borderline persons, acute schizophrenics, and chronic schizophrenics. In a three-group comparison, discriminant-function analysis correctly classified most of the borderline and acute and chronic schizophrenic subjects. In a two-group comparison, stepwise regression analysis correctly classified most of the borderline and acute schizophrenic subjects. The borderline persons tended to produce more fabulized combination responses and show a greater decline in response quality on each card. The associative drift and sporadic reasoning problems imputed to borderline persons clinically distinguished the borderline sample's Rorschach records.

Adolescent↗