Multiple personality and self-injury.
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Biomedical subjects
Publications and source records attributed to E L Cook.
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Seventy-two kidneys have been transplanted-47 from related donors, and 25 from cadaver donors-into 63 recipients. No donor died or experienced a complication requiring more than one extra week of hospitalization. Six recipients died. Three of the six recipients died from complications. Two of the six died only because they declined to resume hemodialysis, and one died in prison of unusual circumstances after seven and one-half years of good health and kidney function. Five patients are surviving by virtue of a second transplant. Eight patients are now on hemodialysis. Seven patients with transplants are not in excellent physical health and five other patients with excellent health and renal function are nonetheless frequently depressed and easily upset over minor physical disabilities. A majority of the recipients have been rehabilitated to a gratifying extent.
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As a result of clinical observation of 444 patients hospitalized for treatment of acute burn injury at Humana Burn Center between July 1983 and October 1986, we have developed a seven-stage method of assessing and assisting the burn victim's psychological recovery. This method delineates the stages in the normal psychological healing process in burn victims and offers specific suggestions for staff interventions to assist the patient at each stage. This method can be utilized in an integrated fashion by all members of the multi-disciplinary burn team to expedite the patient's psychological recovery and to maximize his compliance with necessary treatment modalities.
Improved survival rates for patients with major burn injuries and the consistent finding of significant long-term psychologic disability among survivors of burn trauma call for a redefinition of the role of the psychiatric consultant in the care of patients with burns. In addition to the traditional functions of diagnosis and treatment of discrete psychiatric disorders in patients with burns, this expanded role includes assisting the patient's normal process of psychologic adaptation after injury, assessing and managing burn pain, and facilitating communication among all members of the burn team. The functions of the psychiatrist are most effectively carried out when the psychiatrist is able to participate on a regular basis in the care of every patient as a member of the burn team.