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Biomedical subjects

D Gilboa

Publications and source records attributed to D Gilboa.

11 recordsLinked to original sources
PubMed2001

Long-term psychosocial adjustment after burn injury.

The paper examines the relevant professional literature in order to explore how adjustment after burn injury may be enhanced. For this purpose, the unique characteristics of burn injury, and particularly the psychological meaning of the skin injury, are examined. An attempt is made to understand why some researchers find that a majority of this population suffers psychological disturbance, while others show that it is a 'normal' population, with no premorbid psychopathology. The ways of enhancing the psychological adjustment of burn victims, beginning with the acute phase of hospitalization and until long-term adjustment in the community, are discussed. These include, mainly, integrative team work to create a 'cover' as a skin substitute around the patient, social support, different techniques of psychotherapy when necessary, and job placement. In an attempt to learn what happens to burn patients a year after injury and later, we reviewed studies of their situation in terms of work, the family (including sexual functioning) and social interaction. In light of all this, the possibility of predicting long-term psychological adjustment among burn victims and the variables that may be relevant to this, such as, size of the burn or, rather, the individual's personality traits, are discussed.

Adaptation, Psychological↗
PubMed1990

Burn patients' use of autohypnosis: making a painful experience bearable.

Autohypnosis (that is performing hypnosis in the absence of the therapist) was used for adjuvant analgesic and anxiolytic therapy in 18 burn patients. It combines the advantages of hypnosis without being limited by the availability of the hypnotic therapist immediately prior to painful activities. Autohypnosis is less time and labour consuming, and therefore less expensive. Out of 180 patients treated with autogenic relaxation techniques only 48 (27 per cent) entered a state of hypnosis that enabled them to cope with their pain, and 18 (10 per cent) achieved autohypnosis. Most of these patients needed some auxiliary devices such as recorded instructions or telephone calls.

Adolescent↗
PubMed1990

Emotional and psychosocial adjustment of women to breast reconstruction and detection of subgroups at risk for psychological morbidity.

Thirty-four women who had undergone breast reconstruction after mastectomy for breast cancer were evaluated as to their emotional and psychosocial adjustment. Standardized psychological tests and a self-report questionnaire were used, along with the surgeon's evaluation of the aesthetic success of the reconstruction. Two psychodiagnostic tests were found to be of use in identifying maladjusted women who do not gain optimal benefit from the reconstruction: a questionnaire that evaluates the level of depression (Beck) and another that assesses the level of optimism (Cantrill). No correlation was observed between the surgeon's evaluation of the reconstruction's aesthetic success and the women's satisfaction. It was found that there are two groups of emotional-high-risk women: single women and women receiving adjuvant therapy. It is suggested that emotional-high-risk patients be given psychological support concerning the importance of the mastectomy and their reaction to breast reconstruction.

Adaptation, Psychological↗
PubMed1989

[Sex reassignment surgery in a trans-sexual].

Trans-sexualism is a psychiatric disorder characterized by the conviction that one's gender identity does not conform to one's biological sex. The current Diagnostic and Statistical Manual of Mental Disorders gives 5 diagnostic criteria for trans-sexualism which most health care professionals accept. Although many trans-sexuals derive some gratification from assuming roles appropriate to their desired gender, a substantial number are convinced that only sexual transformation can bring meaningful relief of their feelings of despair. Approximately 2/3 of trans-sexuals who undergo sex reassignment procedures are improved at follow-up. A relatively advanced age and secondary trans-sexualism (transvestites and effeminate homosexuals) are risk factors for poor prognosis in those requesting sex reassignment. In recent decades the demand for sex reassignment has increased, as have the number and variety of psychological, hormonal and surgical treatments proposed. The operative procedures currently employed for sex reassignment give reasonably good esthetic and functional results, and in 1986 the Israel Ministry of Health permitted its government hospitals to perform them. A 23-year-old male trans-sexual is reported who underwent successful surgery for sex change and now, 1 year later, is satisfied with the result.

Adult↗
PubMed1987

Facilitation of ECT by caffeine pretreatment.

In this study, eight patients participated in a standardized protocol to assess the effects of caffeine on seizures in ECT. Caffeine sodium benzoate (500-2000 mg) was administered intravenously 10 minutes before ECT, and seizure duration was compared with that of a previous treatment unmodified by caffeine. Seizure duration was significantly increased during ECTs preceded by caffeine. Three other patients given caffeine when seizures of adequate duration could no longer be elicited at maximal stimulus levels experienced longer seizures. Administration of caffeine was not associated with significant cardiovascular or other (including cognitive) adverse effects.

Benzoates↗
PubMed1984

A team work model in a burn unit with the integration of a clinical psychologist.

This paper describes team work in a burn unit in Tel Hashomer Hospital, Israel, which is intended to answer the problems which arise during the period in hospital following burning injury. The model was constructed after observing the emotional reactions of patients, which disturbed not only their ability to cope efficiently, but also caused additional suffering to themselves, their families and the hospital staff. The main emphasis is on: (1) the recognition and treatment of both the physical and emotional requirements of the patient; (2) involvement of the family in the treatment; and (3) active cooperation between all those who have a professional interest in the patient's treatment, welfare and recovery. The coordinator and integrator of these elements is the clinical psychologist.

Burn Units↗
PubMed1984

Various approaches to burn care in the Lebanon War, 1982.

All soldiers severely burned during the Lebanon War, 1982, were hospitalized in one of four facilities, in each of which different methods of burn care are practiced. These methods represent the various approaches to burn care in different centers in the world and in the literature. Resuscitation was adequate in all facilities. Oral hyperalimentation, although administered in different ways, is recognized as a main factor in preventing infections and enhancing healing in burn victims. The main aspect in which opinions differ is the care of the wound itself. However, it was clear after examining many of the patients from the different centers that tangential excision is superior to delayed excision, and certainly to conservative treatment. The difficulties in comparing different methods of treatment are discussed. Early and continuous psychological surveillance is necessary for the successful recovery and rehabilitation of burn patients; a special teamwork model was developed to promote this approach.

Burns↗
PubMedDate not supplied

The burn as a continuous traumatic stress: implications for emotional treatment during hospitalization.

Relating to the patient with burns as being posttraumatic calls for specific guidelines in emotional therapy. But it seems that burn injury differs from other posttraumatic situations in that it confronts the patient with a much more complex situation, including not only the actual burn experience but also the ensuing difficult period of hospitalization and the subsequent renewed encounter with the social environment. That is why we see the patient with burns as suffering from a Continuous Traumatic Stress Disorder rather than from a Posttraumatic Stress Disorder. Although both disorders confront the patient with the same symptoms and with the experience of shattering the stimulus barrier and that of the basic assumptions, like the concept of self, invulnerability, and the world, they still differ in duration of the trauma. This calls for "dos and don'ts" as treatment principles at the time of the hospitalization, which help the patient's ability in coping with the continuous trauma.

Adaptation, Psychological↗
PubMedDate not supplied

Personality traits and psychosocial adjustment of patients with burns.

Existing literature demonstrates a relationship between selected personality traits and coping, a relationship explored here in a sample of 61 male Israeli patients with burns. Successful coping was assessed by the 5-item Satisfaction With Life Scale and 2 single-item measures of adjustment to the specific injury. Results suggest that adjustment to the traumatic experience of a burn injury is strongly related to specific personality traits rather than to the physical features of the injury. As predicted, successful coping was found to be positively related to the personality dimensions of extroversion, optimism, self-mastery, and hope, and negatively related to neuroticism and social anxiety. The importance of a patient's ability to elicit social support as a means of coping was also considered. Psychologic intervention is suggested as a consequence of the results obtained.

Adaptation, Psychological↗