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Biomedical subjects

L W Foster

Publications and source records attributed to L W Foster.

9 recordsLinked to original sources
PubMed2006

Allogeneic BMT and patient eligibility based on psychosocial criteria: a survey of BMT professionals.

BMT professionals were compared regarding their willingness to proceed with allogeneic BMT given select psychosocial issues. A questionnaire was sent to 660 physician members of ASBMT, 92 social work members of BMT Special Interest Group, Association of Oncology Social Work, and 626 nurse members of BMT Special Interest Group, Oncology Nursing Society; 597 responded with a response rate of 43.5%. Items included background information, followed by 17 case vignettes; each represented a different psychosocial issue to which respondents indicated whether or not they would recommend proceeding with allogeneic BMT. In every vignette, at least 10% of respondents indicated they would not proceed. In six vignettes, at least 64% indicated do not proceed: suicidal ideation (86.8%), uses addictive illicit drugs (81.7%), history of noncompliance (80.5%), no lay caregiver (69.3%), alcoholic (64.8%), and mild dementia/Alzheimer's (64.4%). In 10 vignettes, at least 73% indicated proceed. On four vignettes, professional subgroups differed in their recommendation on whether or not to proceed with allogeneic BMT. Qualitative data suggest that this decision is contingent on the perceived acuity, severity, and currency of the psychosocial issue, patient ability to comply with treatment given the issue, and its manageability as a risk factor for treatment related vulnerability and outcomes.

Bone Marrow Transplantation↗
PubMed1997

Moral judgments in the rationing of health care resources: a comparative study of clinical health professionals.

Social workers, physicians, and nurses from a major urban teaching hospital were assessed and compared regarding their attitudes toward the rationing of health care. Responses to eighteen statements of considered moral judgments in the rationing of health care resources were analyzed in terms of levels of agreement with each. All three professional groups rejected rationing based on patient age and socioeconomic worth. However, social workers and physicians were more likely than nurses to consider such factors as cost-benefit ratios, quality of life, relative strength of a patient's moral claim, and scarcity of resources in rationing decisions. Study findings appear to portray social workers and physicians as being more utilitarian and nurses more egalitarian in rationing decisions. Implications for practice in a managed care environment are presented.

Adult↗
PubMed1993

Postpolio survivors: needs for and access to social and health care services.

A needs assessment survey of 268 polio survivors residing in Maine explored the incidence of postpolio syndrome as well as perceived need for and access to social and health care services. A large proportion reported experiencing postpolio syndrome. Although knowledgeable of their condition, a majority perceived that they had no access to knowledgeable physicians or social and health care services and most were having difficulty coping. Findings indicate that polio survivors' self-appraisal of their illness status is related to their perceived need for and access to social and health care services. The need for community-based services, including medical, rehabilitative, educational, and social work services, is indicated.

Adult↗
PubMed1993

Bioethics: social work's response and training needs.

Hospital social workers (N = 255) from ten urban teaching hospitals in seven states were surveyed regarding their practice responses and training needs in bioethics. Responses to twenty-one practice situations in bioethics were analyzed in terms of levels of encountering ethical concerns, clinical participation and preparedness to handle ethical concerns. Whereas worker responses were greater in practice situations appearing more psychosocial than biomedical in nature, training needs were greater in those situations appearing more biomedical than psychosocial in nature. Rationing of health care, the number one training need across service specialties, stands out as the practice situation in which ethical concerns were encountered with the least preparation and participation. Prior training in ethical principles and analysis and service on a hospital ethics committee associated significantly with higher levels of worker responses. Implications for social work education and practice in today's health care environment are presented.

Adult↗
PubMed1989

Failure to thrive: paradigm for the frail elder.

A retrospective study of 82 elderly "failure to thrive" (FTT) inpatients suggests that FTT is diagnosed when the elderly patient's functional ability to live with multisystem diseases, cope with the ensuing problems, and manage his/her own care are remarkably diminished and no longer responsive to health care interventions. In an attempt to clarify the clinical picture of FTT, we used standardized questionnaires to abstract data from medical charts.

Aged↗
PubMedDate not supplied

Cognition and the cancer experience. Clinical implications.

OBJECTIVES: The authors demonstrate the application of cognitive therapy in oncology care by presenting a brief review of theory and relevant case studies. MATERIALS AND METHODS: In light of the life and death nature of the fears evoked by cancer, it is important for the oncology clinician to recognize the role that cognition plays in patient responses to the diagnosis and treatment of cancer. After presentation of a theory base that creatively links cognition and the cancer experience, key cognitive concepts are defined and discussed. Case material illustrates the application of these concepts and how oncology clinicians can use select interventions adapted from the brief mental health treatment modality of cognitive therapy to promote adjustment to cancer. RESULTS: Patient and family views about cancer have emotional and behavioral consequences, influence ability to cope with diagnosis and treatment, and serve to focus clinical intervention. Cognitive interventions can help patients and families think about cancer in objective, adaptive ways. Focusing on perceptions and questions of meaning, clinicians can be effective using cognitive lines of questioning that expand patient stories and elicit beliefs about cause, control, and responsibility for their cancer. CONCLUSIONS: Cognitive interventions are brief and solution-focused interventions that acknowledge and build on generalist interviewing skills common to each discipline. As such, they are particularly useful in physical health settings where work is fast paced and clinicians are faced with the challenge of dealing in a collaborative manner with patient and family coping responses as they apply to the medical problem and care plan.

Adaptation, Psychological↗