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Biomedical subjects

H Drake

Publications and source records attributed to H Drake.

13 recordsLinked to original sources
PubMed1996

Attitudes towards termination for fetal abnormality: comparisons in three European countries.

Attitudes towards termination for a range of genetic conditions were studied in health professionals and lay people in three European countries: Germany, Portugal and the UK. The health professionals consisted of geneticists in all countries and additionally obstetricians from Portugal and the UK. The lay persons consisted of pregnant women, and male and female non-medical university employees. In all, more than 1,700 study participants completed questionnaires. Overall, health professionals were more likely than the lay persons to report that they would opt for termination following diagnosis of a fetal abnormality. Differences were found between countries and study groups. German respondents were least likely to report that they would undergo termination in the case of a fetal abnormality while Portuguese respondents were most likely to report that they would undergo a termination. Further studies are needed to determine first the extent to which differences between health professionals and lay samples reflect a difference in perception of disability, including tolerance of having a child with a disability; and second, whether such differences result in health professionals presenting termination of pregnancy in a way that is not concordant with patients' value systems.

Abortion, Induced↗
PubMed1995

Attributions for disability: the influence of genetic screening.

There is currently much debate on how the widespread availability of prenatal testing for fetal abnormalities influences attributions for the birth of children with disabilities. The aim of the current study is to determine how the birth of a child with Down syndrome is explained when information is provided on whether the mother underwent testing in pregnancy, and the reasons for that. Using a between subjects design, four groups (pregnant women, general samples of men and women, geneticists and obstetricians) from three EC countries (Germany, Portugal and the U.K.) completed one of two vignettes. The vignettes described a mother giving birth to a child with Down syndrome, in one, following her decline of the offer of testing, in the other, following no offer of test from the hospital. Subjects rated the mother's perceived control over the outcome, the extent to which she was to blame, and the extent to which health professionals might be to blame. In all three countries and for all study groups, screening history of the mother was the single most important factor influencing attributions of control and blame following the birth of a child with Down syndrome. A mother who declined the offer of testing was seen as having control over this outcome, and was in part blamed for it. The results of this study suggest that both health professionals and lay groups make judgments about women's roles in the birth of children with disabilities. These findings require replication in studies assessing attributions rated from spontaneous speech, of people with personal and professional experiences of the births of children with disabilities.(ABSTRACT TRUNCATED AT 250 WORDS)

Adult↗
PubMed1994

Counselling following diagnosis of a fetal abnormality: the differing approaches of obstetricians, clinical geneticists, and genetic nurses.

Women receiving a positive diagnosis of an abnormality during pregnancy may be counselled about a termination by one of several types of health professionals including obstetricians, geneticists, and genetic nurses. There is anecdotal evidence to suggest that these groups differ in both their approaches to counselling and their attitudes towards abnormality. The aim of the current study is to document how genetic nurses, geneticists, and obstetricians describe their own counselling of women following the diagnosis of specific fetal abnormalities. Obstetricians reported counselling in a significantly more directive fashion than did geneticists, who in turn reported counselling in a more directive way than did genetic nurses. The extent to which the groups differed in their reported approaches varied across conditions. The most marked difference was evident for Down's syndrome: 94% of genetic nurses, 57% of geneticists, and 32% of obstetricians reported counselling non-directively. Future research needs to focus on what these different groups see as the objectives of counselling in this situation, how they actually counsel, and with what effects.

Attitude of Health Personnel↗
PubMed1994

Counselling following diagnosis of fetal abnormality: a comparison between German, Portuguese and UK geneticists.

The principle of non-directiveness in genetic counselling is embraced by all relevant professional bodies. Little is known about the extent to which it is endorsed by geneticists, or incorporated into their clinical practice. The aim of the current study is to document how geneticists in three European countries, Germany, Portugal and the UK, report counselling women at risk for having children with a range of conditions. While geneticists in all three countries reported counselling in a largely non-directive style, this varied both across genetic conditions and between countries. German and Portuguese geneticists were significantly more directive than UK geneticists, although they differed in the way in which they were directive. German geneticists were more likely to encourage continuation of pregnancies, while Portuguese geneticists were more likely to encourage termination of affected pregnancies. There was no strong consensus on approaches to counselling for any of the genetic conditions, defined as agreement between 70% of all three groups of geneticists. Despite strong professional codes of non-directiveness, geneticists report being somewhat directive in some counselling situations. Future research needs to focus on what geneticists are trying to achieve in genetic counselling, how they actually counsel, and with what effects.

Abortion, Induced↗
PubMed1994

The South London Somatisation Study. II. Influence of stressful life events, and secondary gain.

BACKGROUND: A study of the influence of life-event stress on the onset and course of acute somatisation in primary care. METHOD: Forty-four somatisers were compared with 11 subjects who had psychiatric disorder but complained only of psychological symptoms, 39 patients who had 'mixed' conditions involving independent physical and psychiatric illness, 90 patients who had physical illness, and 123 healthy members of the general population. RESULTS: Severely threatening life events were more common among all subjects with psychiatric disorder. A novel contextual rating of the potential of stressors to produce symptoms for 'secondary gain' was developed. In the 38 weeks before symptom onset, somatisers and psychologisers were more likely to have experienced at least one event which had this potential. Somatisers were also less likely to adopt neutralising coping efforts when faced with such a crisis. CONCLUSIONS: The likelihood of adopting neutralising efforts was closely related to the presence of a joint index of parental problems in care and exposure to physical illness in the subject's childhood. In a two-year follow-up, subsequent functional illnesses were also associated with experiences which had secondary-gain potential, and subjects with childhood risk factors continued to have higher rates of crises with secondary-gain potential and to fail to adopt neutralising coping strategies.

Adaptation, Psychological↗
PubMed1993

The South London Somatisation Study. I: Longitudinal course and the influence of early life experiences.

In a two-year longitudinal study, a two-stage screening procedure was used to identify subjects in primary care with emotional disorder presenting with a recent onset of physical symptoms and a comparison sample of patients presenting with physical symptoms only. Somatisers (n = 44) were defined as subjects who had an emotional disorder but who presented with physical symptoms that could not be attributed to organic disease. The course and outcome of these conditions were compared with those of pure emotional disorder (n = 11), pure physical disorder (n = 90) and 'mixed' conditions (n = 39). The physical symptoms of somatisers were less likely to improve and lagged behind those of the other groups, and 16 of these acute somatisers went on to develop chronic somatoform disorders. Among somatisers, changes in physical symptom levels throughout the follow-up closely mirrored changes in emotional arousal. Emotionally disordered subjects reported more instances of parental lack of care, but somatisers were also more likely than other groups to report parental physical illness and to have had more physical illness themselves in childhood. A logistic regression suggests that adult somatisation is best modelled by parental lack of care followed by childhood illness.

Adolescent↗
PubMed1982

Psychotropic drug use by women: characteristics of high consumers.

One thousand one hundred and eighty-seven women were interviewed concerning their use of psychotropic medication, health and visits to physicians, use of tobacco and alcohol, and life-style and general satisfaction. Subjects were categorized as high, moderate, and non-consumers of psychotropes; respectively, 5.5%, 22.6%, and 71.9% of the sample. High drug consumers typically were older, reported being in poorer health, visited physicians more frequently (and more frequently for undefined reasons), rated themselves as more unhappy, were less well educated, were more likely unemployed, smoked more but drank less alcohol, and were more likely unemployed, smoked more but drank less alcohol, and were more likely to have children than the moderate users or abstainers. The findings are shown to support in part the hypotheses that social and psychological problems of women are expressed vaguely and subsequently are more likely medicalized than those of men. The implications of these findings for drug prevention programs and future research are discussed.

Adolescent↗
PubMed1980

The intervention of a modulator with learning disabled children.

Tested the role of a child modulator, an investigator, and coordinator of services for learning disabled children. Ninety regular third- and fourth- grade children with average intelligence were selected from a population of 1,030 children on the basis of low scores on the Pupil Rating Scale and at least one of four Metropolitan Achievement subtests and were assigned randomly to one of three groups. The first group received the services of the modulator for a 6-month period, while the respective schools were informed of the teachers' ratings and achievement test scores for the second group, and the third group was an untreated control. In addition to the selection procedures, school grades, the Piers-Harris Self-Concept Scale and the Connors Parents Questionnaire were completed before and after treatment. The results showed teacher ratings and achievement score changes for all groups with the modulation group superior only in teacher ratings of Personal-Social behavior. Follow-up testing 18 months later between the modulated and school informed group within the Piers-Harris Scale and ratings by unbiased teachers reflected numerous differences, which suggests a growing self-confidence in the modulated Ss. The positive usefulness of this form of intervention in meeting the general needs of the child and in treating the concomitants of school failure are discussed.

Canada↗