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Biomedical subjects

G E Dickinson

Publications and source records attributed to G E Dickinson.

At least 19 recordsLinked to original sources
PubMed2000

Death experiences and hospice: perceptions of college students.

The purpose of this study was to investigate college-age students' awareness of and involvement in hospice and to ascertain information regarding their own experiences with death and their preferences about death and dying. Our data were gathered through a mailed survey to 521 biology majors at an undergraduate college in the southeastern United States (122 responded or 23%). The majority of respondents were aware of hospice, yet less than 25% had any involvement with hospice. Over 90% of the respondents had seen a dead body, and one-third had witnessed a death. Statistically significant differences by gender were found only with awareness of hospice, with women being more knowledgeable. With health professions as the goal for most of these students, a similar study with a cohort of non-college students, or even non-health-profession-bound college students, would serve as an interesting "control" group.

Adolescent↗
PubMed1997

Detached concern and death anxiety of first-year medical students: before and after the gross anatomy course.

The purpose of this study was to gather data from first-year medical students prior to their taking gross anatomy and again at the end of the course to determine if changes occur regarding death anxiety and detached concern toward patients. Chi-square and t-tests were used to assess statistical significance. From the 84 students for whom we had data both prior to and after gross anatomy, only the sociodemographic variable of sex was consistently related to the two dependent variables. Women reported more death anxiety prior to and after the gross anatomy course and were more likely to disagree with the need for detached concern.

Adult↗
PubMed1996

Death education in U.S. medical schools, 1975-1995.

PURPOSE: To examine medical school offerings on relating to terminally ill patients between 1975 and 1995. METHOD: Three national surveys of U.S. medical schools were conducted in 1975, 1985, and 1995. Totals of 107, 113, and 113 questionnaires were returned (response rates of 95%, 90%, and 93%, respectively). The information sought through the questionnaires included the types of courses on death and dying offered, the numbers of years the courses had been offered, the percentages of students taking the courses, and the professional backgrounds of the instructors. RESULTS: Overall, from 1975 to 1995 the number of medical school offerings in death education increased. Although the number of full-time courses increased from seven in 1975 to 14 in 1985, it dropped to nine in 1995. The percentage of schools offering occasional lectures and short courses on death and dying, often integrated into other courses, increased from 80% in 1975 to 82% in 1985 to 90% in 1995. While not offering full-time courses on death and dying, many schools noted that they offered three-week courses on ethical issues related to death. A team approach to teaching death education was used by a majority of schools over the two decades (59% in 1975, 62% in 1985, and 76% in 1995). Schools with no formal death education offering decreased from 14 in 1975 to six in 1985 to two in 1995. CONCLUSION: The increased emphasis on medical students' learning to deal with death and acquiring communication skills for relating to terminally ill patients and their families should lead to better working relations between physicians and dying patients. The continued use of instructors from outside the medical profession seems to reflect a genuine desire by medical educators to consider the dying patients' needs and to handle ethical issues. Such an increased humanistic emphasis should help both dying patients and students.

Data Collection↗
PubMed1994

A decade beyond medical school: a longitudinal study of physicians' attitudes toward death and terminally-ill patients.

Physicians were surveyed soon after graduation from medical school in 1976 to determine their attitudes toward death and terminally-ill patients and their families. A follow-up survey of the 1093 respondents was made in 1986 to ascertain if changes had occurred in their attitudes. Eight of the eleven Likert-type items showed statistically significant differences over time and by attitudes toward terminally-ill patients and their families. These data present evidence to suggest that physicians in 1986 were more open in telling dying patients their prognosis than in 1976.

Adult↗
PubMed1992

High-dose epinephrine in adult cardiac arrest.

BACKGROUND: Recent studies suggest that doses of epinephrine of 0.1 mg per kilogram of body weight or higher may improve myocardial and cerebral blood flow as well as survival in cardiac arrest. Such studies have called into question the traditional dose of epinephrine (0.007 to 0.014 mg per kilogram) recommended for advanced cardiac life support. METHODS: We randomly assigned 650 patients who had had cardiac arrest either in or outside the hospital to receive up to five doses of high-dose (7 mg) or standard-dose (1 mg) epinephrine at five-minute intervals according to standard protocols for advanced cardiac life support. Patients who collapsed outside the hospital received no advanced-life-support measures other than defibrillation before reaching the hospital. RESULTS: There was no significant difference between the high-dose group (n = 317) and the standard-dose group (n = 333) in the proportions of patients who survived for one hour (18 percent vs. 23 percent, respectively) or who survived until hospital discharge (3 percent vs. 5 percent). Among the survivors, there was no significant difference in the proportions who remained in the best category of cerebral performance (90 percent vs. 94 percent) and no significant difference in the median Mini-Mental State score (36 vs. 37). The exploration of clinically important subgroups, including those with out-of-hospital arrest (n = 335) and those with in-hospital arrest (n = 315), failed to identify any patients who appeared to benefit from high-dose epinephrine and suggested that some patients may have worse outcomes after high-dose epinephrine. CONCLUSION: High-dose epinephrine was not found to improve survival or neurologic outcomes in adult victims of cardiac arrest.

Adult↗
PubMed1991

Learning to care for the dying: a survey of medical schools and a model course.

Education on death and dying is relatively new in the United States; a recent survey indicated that there is little consensus on teaching methods and content of courses. This paper reports the authors' 1989 survey of 111 U.S. medical schools, and describes a death and dying seminar offered at the Yale School of Medicine using patients as teachers. Regarding the survey, the authors mailed questionnaires to 124 schools; 111 responded. Twelve of the schools (11%) provided no formal teaching in death and dying. Of the 99 schools that did, 30 provided one or two lectures in the first two years. Fifty-one schools taught death and dying as a module of a larger required course, and 18 schools offered an elective. Lecture was the predominant teaching method, and patient participation was usually restricted to a class presentation. Regarding the Yale seminar, each student meets individually with a patient during the semester and in small groups with the instructor to discuss the interviews, personal reactions, and professional issues in the care of his or her patient-teacher. This seminar enables students to learn the personal effects of serious illness, coping techniques used in daily living, characteristics of the caring physician, and skills needed to provide compassionate care.

Attitude to Death↗
PubMed1989

An evaluation of the effect of repeated doses of oral activated charcoal on salicylate elimination.

The authors investigated the effect of repeated doses of oral activated charcoal on salicylate elimination in six healthy volunteers. On two occasions (phase I and phase II; separated by one week) each subject received 1300 mg of aspirin as an aqueous solution. On the second occasion (phase II) each subject also received a total dose of 55 g of aqueous activated charcoal initiated 4 hours after salicylate administration (25 g initial dose, followed by three 10 g doses at two hour intervals). Serum salicylate levels were measured from one to twelve hours post aspirin ingestion. The pharmacokinetic analysis showed no significant change between phase I and phase II for either the salicylate elimination half-life or the area under the concentration versus time curve from 4-12 hours post aspirin ingestion. Reasons for the lack of effect of repeated doses of charcoal on salicylate elimination are discussed and, these results cannot necessarily be extrapolated to the overdose situation. Further investigation is warranted to assess the effect of repeated doses of activated charcoal in the salicylate-overdosed patient.

Administration, Oral↗
PubMed1989

Evaluation of the validity of the Done nomogram in the management of acute salicylate intoxication.

To evaluate the validity of the Done nomogram in the management of acute adult salicylate intoxications, a retrospective review of cases at our institution was performed. The degree of severity (ie, asymptomatic, mild, moderate, or severe) as determined by plotting the serum concentration and time on the nomogram for 55 acute salicylate intoxications was compared with the degree of severity decided on by three experienced emergency physicians who based their decision on the clinical presentation of the cases and the original criteria devised by Done for each category of severity. Discordant classifications between the nomogram and the physicians provided a basis on which a predictive index for the nomogram and various subsets of cases could be determined. The calculated predictive index for the nomogram was 0.42, with the highest predictive index of 0.79 in the mild salicylate category. The nomogram tends to overpredict the severity of intoxication in the moderate and severe categories. There was no significant difference between predictive indexes of mixed versus nonmixed or enteric-coated acetylsalicylic acid versus plain acetylsalicylic acid cases, although the nomogram had a higher predictive index when used for concentrations drawn six to 12 hours after ingestion (P less than .01, Fisher's exact test). Decisions on management of an acute salicylate overdose should be based on clinical presentation and good judgment as well as the serum salicylate concentration in relation to the time of ingestion.

Adult↗
PubMed1987

Death education in U.S. professional colleges: medical, nursing, and pharmacy.

Physicians, nurses, and pharmacists often practice in death environments. A questionnaire was mailed to 126 medical schools, 396 baccalaureate nursing schools and 72 pharmacy colleges to determine the extent of death education offerings in their curricula. A response rate of better than 80 percent was received. The majority of professional programs had some emphasis on thanatology which was initiated within the past decade.

Attitude to Death↗
PubMed1987

Death education: a survey of U.S. colleges and schools of pharmacy.

This survey was conducted to assess the present state of death education available to pharmacy students at both the BS and PharmD degree levels. Eighty-five percent of the colleges and schools of pharmacy located in the United States provided information concerning: (i) attitudes toward teaching death education; (ii) present offerings; (iii) academic background of instructors and departments responsible for death education programs; and (iv) course information. It was determined that 38 colleges of pharmacy offered some form of death education in their curricula during 1985. However, only 12 schools offered a full semester course, and many schools offered death education as an elective through a discipline other than pharmacy. As a result, a majority of graduates are still leaving pharmacy schools without any instruction in death education. The implications of these and other findings are discussed.

Attitude to Death↗
PubMed1986

Death education in baccalaureate nursing programs.

These findings reveal that an emphasis on death and dying in baccalaureate nursing schools has definitely increased over the past 20 years. Ninety-five percent of the schools reported here have some emphasis on death and dying. The majority of nursing students take the death and dying offerings. Overwhelmingly, the professional background of the instructor is nursing. While only 5 percent of the schools do not offer anything in death and dying, nearly half of these plan to offer something "within the next five years." If death and dying offerings influence students' attitudes, as is suggested in research cited above, baccalaureate nursing programs in the United States apparently have taken positive steps toward helping nurses cope with dying over the past 20 years. If nurses themselves cannot deal with death, caring for a dying patient may be difficult. With continued increased emphasis on death and dying in nursing curricula, both nurses, patients, and patients' families will hopefully benefit.

Curriculum↗
PubMed1981

Death education in U.S. medical schools: 1975-1980.

Surveys from 1975 and 1980 of U.S. medical schools' offerings in death education are compared. A 95 and 96 percent return rate, respectively, for each survey revealed a slight increase in offerings in 1980. A team approach is used, with physicians and theologians most often being cited as facilitators of a lecture/discussion format.

Attitude to Death↗
PubMed1979

Differences in attitudes toward terminal patients among selected medical specialities of physicians.

Medical specialty of physicians was related to attitudes toward dying patients to determine if differences occur as suggested by the literature. Data from a questionnaire completed by 1,012 physicians from the classes of 1972--1975 in five selected medical schools were analyzed using the chi-square distribution to test the relationship between the response to each of the 11 Likert-type statements and the medical specialty of the physicians. Mean responses by medical specialty to the statements were ranked and correlated to Rea's ranking with respect to the probability of dealing with terminal patients by specialty using a Spearman Rank Correlation Coefficient. Support was found for Rea's conclusion that physicians such as oncologists with a high probability of relating to dying patients tended to be more open with the patient whereas a specialty like obstetrics-gynecology with a low probability tended to operate in more of a closed awareness context.

Attitude of Health Personnel↗