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Biomedical subjects

L Ellington

Publications and source records attributed to L Ellington.

6 recordsLinked to original sources
PubMed2006

The Genetic Counseling Video Project (GCVP): models of practice.

Genetic counseling is conceptualized as having both "teaching" and "counseling" functions; however, little is known about how these functions are articulated in routine practice. This study addresses the question by documenting, on videotape, the practices of a national sample of prenatal and cancer genetic counselors (GCs) providing routine pre-test counseling to simulated clients (SCs). One hundred and seventy-seven GCs recruited at two annual conferences of the National Society of Genetic Counselors (NSGC) were randomly assigned to counsel one of six female SCs of varying ethnicity, with or without a spouse, in their specialty. One hundred and fifty-two videotapes were coded with the Roter Interaction Analysis System (RIAS) and both GCs and SCs completed evaluative questionnaires. Two teaching and two counseling patterns of practice emerged from cluster analysis. The teaching patterns included: (1) clinical teaching (31%) characterized by low psychosocial, emotional and facilitative talk, high levels of clinical exchange, and high verbal dominance; and (2) psycho-educational teaching (27%) characterized by high levels of both clinical and psychosocial exchange, low levels of emotional and facilitative talk, and higher verbal dominance. The counseling patterns included: (1) supportive counseling (33%) characterized by low psychosocial and clinical exchange, high levels of emotional and facilitative talk, and low verbal dominance; and (2) psychosocial counseling (9%) with high emotional and facilitative talk, low clinical and high psychosocial exchange, and the lowest verbal dominance. SCs ratings of satisfaction with communication, the counselor's affective demeanor, and the counselor's use of non-verbal skills were highest for the counseling model sessions. Both the teaching and counseling models seem to be represented in routine practice and predict variation in client satisfaction, affective demeanor, and nonverbal effectiveness.

Adult↗
PubMed1999

Neuroticism, symptom presentation, and medical decision making.

In 2 studies, the authors explored whether neuroticism influences illness descriptions in a manner that affects medical decisions. In Study 1, 80 participants presented an imagined illness that was high or low in severity to a confederate medical student. Neuroticism was associated with more elaborate symptom presentations and, among high-severity participants, with more disclosures of psychosocial information. In Study 2, representative videotapes from Study 1 were selected as stimuli to be evaluated by 14 family practice residents. Residents were able to discriminate between severity conditions for low- but not for high-neuroticism participants. Residents also viewed high-neuroticism participants as less credible, less in need of medical treatment, and more in need of mental health treatment than low-neuroticism participants. Correlations suggest the report of psychosocial concerns by high-neuroticism participants contributed to these effects.

Adult↗
PubMed1991

Cognitive dysfunction in multiple sclerosis. II. Impact on employment and social functioning.

We designed a study to assess the specific contribution of cognitive dysfunction to multiple sclerosis patients' problems in daily living. Based on the results of a comprehensive neuropsychological test battery, we classified 100 MS patients as either cognitively intact (N = 52) or cognitively impaired (N = 48). In addition to a neurologic examination, MS patients completed questionnaires on mood and social functioning, underwent a comprehensive in-home occupational therapy evaluation, and were rated by a close relative or friend regarding specific personality characteristics. While there were no significant differences between the two groups on measures of physical disability and illness duration, patients in the cognitively impaired group were less likely to be working, engaged in fewer social and avocational activities, reported more sexual dysfunction, experienced greater difficulty in performing routine household tasks, and exhibited more psychopathology than cognitively intact patients. These findings suggest that cognitive dysfunction is a major factor in determining the quality of life of patients with MS.

Activities of Daily Living↗
PubMed1989

Cerebral disconnection in multiple sclerosis. Relationship to atrophy of the corpus callosum.

Left ear suppression to dichotically presented verbal stimuli has been observed in patients with multiple sclerosis (MS). Rubens and coworkers have suggested that a disconnection of the auditory callosal pathways may account for this finding. To examine this proposal, we compared the performance of 28 MS patients with significant corpus callosum atrophy (CCA) on midsagittal magnetic resonance scans, 16 MS patients without significant CCA, and 64 demographically matched normal control subjects on two laterality tasks: verbal dichotic listening (consonant-vowel syllables) and tachistiscopic object-naming latency. Results indicated that left ear suppression was found only in the MS patients with CCA. Likewise, patients in the MS group with CCA were slow in responding to stimuli presented in the left visual field; this effect was not observed in patients without CCA. These findings support the hypothesis that efficiency of cross-callosal information flow is reduced in MS patients with CCA.

Adult↗