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Biomedical subjects

L K Zeltzer

Publications and source records attributed to L K Zeltzer.

51 records · Page 3Linked to original sources
PubMed1987

Communicating with adolescents from culturally varied backgrounds: a model based on Mexican-American adolescents in south Texas.

Health care delivery to Mexican-American adolescents requires knowledge of the general health needs of adolescents, as well as culturally determined beliefs about health and illness. Specific concepts about the cause and treatment of a variety of symptoms may cause some Mexican-American families to seek help from parallel systems of health care (i.e., the curandera and the physician). By understanding the family's beliefs about the problem, the physician can incorporate both systems to enhance a positive outcome. The physician needs to be aware of the extent to which the family both suffers with the ill adolescent patient and contributes to the acquisition of the patient's health. Differences in the extent of acculturation between adolescents and their parents may intensify the common parent-adolescent conflicts seen as a developmental phenomenon. As with any adolescent patient, a thorough history will help to assess the problem and will provide clues as to the best methods for intervention.

Acculturation↗
PubMed1985

Does ethnicity constitute a risk factor in the psychological distress of adolescents with cancer?

To determine if ethnicity constitutes a risk factor in the psychological distress of adolescents with cancer, ethnic comparisons (Hispanic versus Anglo) were made on four psychological measures administered to 54 adolescents with cancer. Data from the largely Mexican-American San Antonio sample were then compared to test scores from a largely Anglo Los Angeles sample. A San Antonio subsample of 25 adolescents with cancer who received behavioral intervention for relief of treatment-related distress were retested on these psychological measures at six months following intervention and test score changes were compared to those found in a similar Los Angeles study. No ethnic differences were found on any measure. The Los Angeles findings of normal trait anxiety and self-esteem in adolescents with cancer and the findings that adolescents with cancer perceive little control over their health and the significant impact of their illness were similar to those in San Antonio. Reasons for the even higher impact of illness found in the San Antonio sample are discussed. Adolescents from both sites demonstrated similar reductions in their trait anxiety scores following behavioral intervention. We conclude that ethnicity per se does not appear to have a major influence on the experience of cancer in adolescents. Nevertheless, our findings suggest that membership in a minority group and a clinic's attitudes toward ethnic differences may play important roles in acceptance or rejection of behavioral intervention and thus merit investigation.

Adolescent↗
PubMed1985

A controlled study of education for improving compliance with cromolyn sodium (Intal): the importance of physician-patient communication.

The effectiveness of an educational program to increase compliance with cromolyn sodium was assessed in 31 children and adolescents 6 to 17 years of age. Patients were randomly assigned to an education or noneducation group. A standard education program regarding asthma and asthma medications was provided to the education group during four monthly visits. At each visit, all patients were assessed in terms of knowledge of asthma and medications, asthma-related symptoms, and pulmonary function. Patients were also asked to self-rate their compliance. The education program increased the patients' knowledge of cromolyn, and appeared to result in increased cromolyn compliance. Post-hoc analyses, however, suggested that increased compliance did not correspond to improved medical status unless the quality of management (by physician and parents) of the child's asthma was taken into account. These results suggest that inadequate management of asthma in children may be a more serious problem than patient noncompliance.

Adolescent↗
PubMed1985

The role of imagery in the treatment of dying children and adolescents.

The care of terminally ill children and adolescents is often complicated by depression and the patient's inability to express needs and fears verbally. The patient's own mental imagery provides an alternate means of communication. Clinical cases illustrate some of the ways in which imagery may play a crucial role in helping these young patients to express age-appropriate needs and fears regarding helplessness, separation from loved ones, and death.

Adolescent↗
PubMed1984

Psychosomatic problems in adolescents. Why they occur, how to intervene.

Primary care physicians who are willing to trust their own intuition and abilities can adequately evaluate and treat many psychosomatic problems of adolescence. Most of these problems reflect normal developmental stress rather than major psychiatric disorders. Thus, obtaining an adequate history and listening to the patient before embarking on a "rule out organic disease" pathway are basic. As Sir William Osler said, "It is more important to know what sort of patient has a disease than what sort of disease a patient has." By applying this maxim, primary care physicians may find treatment of adolescents with psychosomatic disorders a rewarding, rather than a frustrating, experience.

Adolescent↗
PubMed1984

A prospective assessment of chemotherapy-related nausea and vomiting in children with cancer.

The purpose of this study was to determine if cancer chemotherapy invariably produces nausea and vomiting, if the extent of emesis is influenced by the number of drugs in a regimen, and if children's patterns of symptoms remain stable during repeated courses of the same agents. Forty-nine children with cancer (ages 5-21) prospectively rated (1-10 scale) their nausea and vomiting within 3-5 days after the administration of each course of chemotherapy. Chemotherapy courses which included antiemetics were eliminated from the analysis. No agents were found which never or always produced nausea and vomiting. No systematic increases or decreases in vomiting occurred as agents were added or subtracted from chemotherapy regimens and there was no association between the number of agents in a regimen and the extent of nausea and vomiting. Most patients' symptoms fluctuated widely. Only 4/49 patients (8%) had minimal symptoms (ratings of 1s and 2s) during chemotherapy and there were no patients who always had nausea and vomiting (ratings greater than or equal to 3s) with every course. The data suggest that nondrug variables influence chemotherapy-associated nausea and vomiting in children.

Adolescent↗
PubMed1982

Continued self-destructive behaviors in adolescent suicide attemptors, Part II--a pilot study.

This investigation examined the continued self-destructive behaviors of adolescent suicide attemptors treated at Childrens Hospital of Los Angeles from 1972 through 1978. A total of 235 questionnaires were mailed to subjects who were hospitalized as a result of an accident, illness, or suicide attempt. The questionnaire was designed to elicit data with respect to the occurrence, frequency of occurrence and medical consequences of various self-destructive behaviors. The results suggest that certain continued self-destructive behaviors may be manifested by adolescents who have attempted suicide. Implications of the findings of this pilot study are discussed with regard to developing a theoretical model of self-destructive behaviors in adolescent suicide attemptors and the clinical prediction of adolescent suicide.

Accidents↗
PubMed1981

Continued self-destructive behaviors in adolescent suicide attemptors: part I.

Adolescent suicide has become an increasingly important problem in today's society. In an effort to understand the precipitating factors in adolescent suicide attempts and the professional response to the adolescent attempting suicide, a comprehensive review was undertaken at the Children's Hospital of Los Angeles (CHLA). A total of 232 subjects admitted to CHLA from January 1972 through July 1978 were included in a retrospective chart analysis. Data on adolescents who had attempted suicide were extracted from their medical records and compared with those of matched groups of adolescents admitted for reasons other than suicide attempt. Comparisons were made of demographic data, family background, hospital admissions, and professional involvement. Our findings confirmed that most attemptors are female midadolescents and are likely to use drugs in the attempt. In addition, our results underscored the importance of the family with respect to the precipitation of an adolescent suicide attempt and the subsequent treatment approach.

Accidents↗
PubMedDate not supplied

Children's memories for painful cancer treatment procedures: implications for distress.

Children (ages 3 to 18, N = 55) diagnosed with leukemia were tested for their memories of lumbar punctures (LPs), a repeated and painful part of the cancer treatment protocol. Memory for both event details and the child's emotional responses was assessed one week after the LP. Children of all ages displayed considerable accuracy for event details, and accuracy increased with age. Overall recall accuracy for event details and emotional responses was similar. Recall among children given oral Versed was similar to that among children not given Versed. Finally, higher distress predicted greater exaggerations in negative memory 1 week later (although controlling for age weakened this relationship); moreover, greater exaggerations in negative memory predicted higher distress at a subsequent LP. These results indicate that children's memories play an important role in their experience of distress during repeated stressful events.

Adolescent↗