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Biomedical subjects

N Cousins

Publications and source records attributed to N Cousins.

13 recordsLinked to original sources

A structured psychiatric intervention for cancer patients. I. Changes over time in methods of coping and affective disturbance.

We evaluated the immediate and long-term effects on psychological distress and coping methods of a 6-week, structured, psychiatric group intervention for postsurgical patients with malignant melanoma. The intervention consisted of health education, enhancement of problem-solving skills, stress management (eg, relaxation techniques), and psychological support. In spite of good prognosis, most patients had high levels of psychological distress at baseline, comparable with other patients with cancer. However, at the end of brief psychiatric intervention, the experimental subjects (n = 38), while not without some distress, exhibited higher vigor and greater use of active-behavioral coping than the controls (n = 28). At 6 months' follow-up, the group differences were even more pronounced. The intervention-group patients then showed significantly lower depression, fatigue, confusion, and total mood disturbance as well as higher vigor. They were also using significantly more active-behavioral and active-cognitive coping than the controls. These results indicate that a short-term psychiatric group intervention for patients with malignant melanoma effectively reduces psychological distress and enhances longer-term effective coping.

Acquired Immunodeficiency Syndrome

A structured psychiatric intervention for cancer patients. II. Changes over time in immunological measures.

We evaluated the immediate and long-term effects on immune function measures of a 6-week structure psychiatric group intervention for patients with malignant melanoma. Along with a reduction in levels of psychological distress and greater use of active coping methods, the following immune changes were seen at the 6-month assessment point in the intervention-group patients (n = 35) compared with controls (n = 26): significant increases in the percent of large granular lymphocytes (defined as CD57 with Leu-7) and natural killer (NK) cells (defined as CD16 with Leu-11 and CD56 with NKH1) along with indications of increase in NK cytotoxic activity; and a small decrease in the percent of CD4 (helper/inducer) T cells. At the 6-week follow-up point, the majority of these changes were not yet observable. The results indicate that a short-term psychiatric group intervention in patients with malignant melanoma with a good prognosis was associated with longer-term changes in affective state, coping, and the NK lymphoid cell system. Affective rather than coping measures showed some significant correlations with immune cell changes.

Adaptation, Psychological

Stress.

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Biological Evolution

The development and management uses of a patient classification system for a high-risk perinatal center.

A patient classification system for a labor and delivery unit, a maternal-fetal intensive care unit, and an antepartum monitored unit is a complex but necessary component for staffing units with frequently changing patient census and varying patient acuity. This article describes the processes used to develop such a classification system and to predict staffing needs, in advance, in four-hour time blocks in the labor and delivery unit and in eight-hour time frames in the maternal-fetal intensive care unit and the antepartum monitored unit. The article also identifies direct nursing care and indirect nursing care activities and defines the levels of care needed.

Female