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Biomedical subjects

G G Kent

Publications and source records attributed to G G Kent.

15 recordsLinked to original sources
PubMed1995

Conflicting demands in surgical practice.

975 Fellows of the Association of Surgeons of Great Britain and Ireland were circulated with a questionnaire which was designed to assess the extent to which they experienced conflicts between personal, clinical and administrative demands. Seventy-one per cent of the 305 respondents indicated that they had experienced such conflicts within the previous three weeks. When a conflicts between administrative and clinical demands was experienced, surgeons gave priority to each in similar proportions, but when personal or family needs conflicted with clinical or administrative demands, their personal lives were almost always given a lower priority. The surgeons reported that these types of conflict often affected the quality of patient care and 60 per cent indicated that they were considering early retirement.

Adult↗
PubMed1994

The relationship between stress and the onset and exacerbation of psoriasis and other skin conditions.

The role of stressful life events in the progress of various skin conditions was studied retrospectively in patients who presented with either psoriasis (where there is some agreement about the importance of stress), urticaria, acne, alopecia and non-atopic eczema (where there is some uncertainty regarding the role of stress), or malignant melanoma, fungal infection, basal cell carcinoma and melanocytic naevi (where stress is considered less relevant). When patients in the three groups were matched for age, those with psoriasis were more likely to report that the experience of stress pre-dated the onset and exacerbations of their condition than patients with other skin diseases. For the psoriasis patients the most common types of life events were family upsets (such as bereavements), and work or school demands, but chronic difficulties were also common. There was no relationship between the severity of stress and time to onset or exacerbations. The results support the notion that stress is more likely to be associated with the onset of psoriasis than other conditions, but also that there may be considerable individual variation in the ability to cope, suggesting that psychological interventions may be helpful for particular patients.

Acne Vulgaris↗
PubMed1994

A comparison of the backgrounds of first time and repeated overdose patients.

This study examines the differences between two groups of parasuicide patients: 'first-timers' (patients admitted to hospital following their first overdose) and 'repeaters' (patients admitted with an overdose who had made at least one previous suicide attempt). The two patient groups were compared for factors known to increase the risk of parasuicide as well as for the experience of self-reported past sexual abuse and for symptoms of post traumatic stress disorder (PTSD). Out of a total of 100 patients interviewed, seven (15%) of first-timers gave a history of sexual abuse and complained of an average of 0.55 symptoms of PTSD. Among repeaters, 28 (53%) gave a history of sexual abuse and complained of an average of 1.84 symptoms of PTSD. Both results were statistically significant at P < 0.001.

Adolescent↗
PubMed1992

Factors associated with the decision to refer patients with anxiety disorders or sexual dysfunction.

The decision to refer patients to outside agencies is a complex one, seemingly related to patient, doctor and practice variables. Although there is a wide variation in referral rates between doctors, attempts to specify relevant demographic characteristics have been largely unsuccessful. The present study involves an examination of the factors which general practitioners report would affect their decision to refer, or not refer, patients portrayed in four case studies, two with anxiety disorders and two with sexual dysfunction. The results suggest that very different variables may be relevant for apparently similar conditions. The factor which most consistently distinguished between frequent and infrequent referers was the time they believed was required for treatment, but perceived responsibility for treatment was also important. Seventy per cent of the variance in referral decisions for sexual dysfunction but only 26% of the variance for anxiety disorders was accounted for by such variables as perceived expertise, time required for treatment and confidence in agencies. Demographic factors, such as age and level of training, were not associated with referral behaviour. Suggestions for further research, especially to do with the processes involved in decision making, are outlined.

Anxiety Disorders↗
PubMed1992

Medical student involvement in a major disaster.

Five to six months after the deaths of 95 football spectators at Hillsborough football ground, senior clinical students at Sheffield Medical School were surveyed in order to assess their degree of involvement with the disaster. Approximately one student in eight could be said to have had a high level of involvement. Students with high involvement showed higher levels of distress on both the General Health Questionnaire and the Impact of Events Scale. Only a small minority of students attended psychological debriefing groups or counselling sessions, perhaps due to the stigma attached to professional help-seeking. The results have implications for medical training and provision of support within medical schools.

Anxiety↗
PubMed1992

Priorities of undergraduate dental education: what do students think?

In recent years there has been an increasing interest in the teaching of behavioural sciences to dental undergraduates, but psychologists and sociologists can meet with resistance to their teaching from both staff and students. In an attempt to understand this resistance further, this paper provides the results of a cross-sectional survey conducted with undergraduate students at two UK dental schools. The results indicate that students believe that training in technical aspects of care (e.g. practice in manual skills, knowledge about anatomy) should assume a substantially higher priority than training in social aspects (e.g. practice in communication skills, knowledge about psychology). The students felt that they were increasingly prepared for both aspects of practice as they progressed through the course, and senior students were more likely to believe that their dental schools should give a higher priority to history-taking and psychological methods to control pain and anxiety than junior students. These results present a considerable challenge for psychologists and sociologists teaching at dental schools and suggest that appropriate curriculum design and integrated teaching may be the way forward.

Attitude of Health Personnel↗
PubMed1991

Medical students' reactions to a nursing attachment scheme.

This paper provides a description of preclinical students' reports after two shifts on a nursing attachment scheme. Quotations were taken from short essays which were submitted as part of their course work in psychology. The experience had clear effects on some students and could have lasting implications for their later work as doctors. Themes gathered from essays included aspects of patient care (loss of independence, uncertainty, and the effects of the hospital structure), the nursing role (especially the surprise at the high level of technical skill shown by nursing staff), the doctor's role (particularly the importance of the nurse-doctor relationship), and emotional reactions in students. The students raised several ethical issues. Although the attachment had many positive consequences, including an increase in motivation to continue on the medical course and an increased appreciation of the individual needs of patients, it did raise issues which the students were unable to deal with or analyse adequately. Further support and teaching in particular areas are recommended.

Attitude of Health Personnel↗
PubMed1990

Thinking about anxiety.

Dental anxiety is often considered to involve physiological and behavioural changes, but it also involves patients' beliefs and thoughts about treatment. This paper reviews several studies in this area, concentrating on how such thought processes may serve to maintain high levels of anxiety, even in patients who attend their dentist regularly. Some implications of these studies for the treatment of persistent anxiety are outlined.

Anxiety↗
PubMed1987

Primary malignant tumors of the small bowel. The Hartford Hospital experience, 1969-1983.

The medical records of 51 patients with primary small bowel cancer were reviewed. Twenty patients had carcinoid tumors, 17 had adenocarcinomas, 8 had leiomyosarcomas, and 6 had lymphomas. Presenting complaints were protean in nature and only 33 percent of patients had a correct diagnosis at the time of operation. Curative resection was attempted in 55 percent, but most patients presented late in their illness and only 27 percent had localized tumors. Survival has been poor: at most recent follow-up, 59 percent were dead, 14 percent were alive with disease, and 27 percent were alive and well. Earlier diagnosis may improve survival. Patients at risk for these tumors are usually more than 50 years of age with vague complaints such as weight loss, pain, abdominal fullness, and fatigue. They should undergo complete evaluation centered around exhaustive radiographic studies and liberal use of endoscopy.

Adenocarcinoma↗
PubMed1987

Hypertension associated with unilateral hydronephrosis as a complication of Crohn's disease.

Obstructive uropathy with hydronephrosis is a well-known complication of Crohn's disease. The treatment for this condition is still controversial. This is the case study of a 14-year-old girl with documented right-sided obstructive uropathy secondary to Crohn's disease associated with renin-mediated hypertension secondary to her obstructive uropathy. The patient had complete resolution of her hypertension following surgery, which involved only resection of the involved bowel without ureterolysis.

Adolescent↗
PubMed1984

Locus of control and oral health.

People with an "internal" locus of control believe that ability and effort are important factors in affecting what happens to them, whereas those with an "external" locus of control believe that this is more a matter of luck or fate. Patients whose oral health was rated as being "good" scored in a more internal fashion on a locus of control questionnaire than patients whose oral health was "moderate" or "poor," suggesting that locus of control beliefs are important in the design of preventive programs on a personalized basis.

Adolescent↗
PubMed1981

The patient is the expert: a technique for teaching interviewing skills.

Aspects of a teaching development intended to encourage patient-centredness in medical interviewing is discussed. Patients are asked by their local general practitioner to volunteer their time in order to be interviewed by medical students and then to stay on afterwards to discuss their impressions of the students' behaviour. It is argued that this approach to teaching interviewing skills enables students to examine the assumptions they make about the patient and to become aware of their difficulties in discussing sensitive issues.

Education, Medical, Undergraduate↗