PubMed Health⌕ Search

Biomedical subjects

N Hamilton

Publications and source records attributed to N Hamilton.

43 records · Page 3Linked to original sources
PubMedDate not supplied

A pilot study of interpersonal psychotherapy by telephone with cancer patients and their partners.

A single-arm pilot study explored the feasibility of adapting in Interpersonal Psychotherapy (IPT) by telephone to reduce psychological distress and to enhance coping during cancer treatment. Therapy focuses on role transitions, interpersonal conflicts, and grief precipitated by cancer. Breast cancer patients receiving high-dose chemotherapy received weekly sessions with a psychologist throughout chemotherapy and for 1 month afterwards. Patients could invite one 'partner' to receive individual telephone IPT. Psychosocial functioning was assessed using standardized measures at study entry, after chemotherapy, and following telephone IPT. Accrual and participation supplied evidence of feasibility: 14 patients and 10 partners were recruited, 82.5% of those eligible. Patients had a mean of 16 sessions; partners had a mean of 11. Participants rated their satisfaction with the program between 'good' and 'excellent'. A test of the efficacy of telephone IPT requires a larger, randomized trial. In order to standardize the intervention, a treatment manual was developed. This study indicated the importance of outreach to family members as well as to cancer patients, intensive patient education about oncology treatment and the medical care setting, and psychosocial services that continue after cancer treatment has been completed.

Adaptation, Psychological↗
PubMedDate not supplied

Developing a sociological framework for dually diagnosed women.

This exploratory study was conducted with the purpose of enumerating both particular social stressors (e.g., the presence of trauma) and the incidence of a comorbid diagnosis (i.e., personality disorder[s] and substance abuse) on a sample of women in a residential therapeutic community. The women in the study were assessed within the first 3 weeks following admission into drug treatment, and then again 6 months after leaving the program. The initial assessment generally took 2 hours and consisted of the Structured Clinical Inventory for DSM-III-R-Patient edition (SCID-II), Addiction Severity Index (ASI), and the Millon Clinical Multiaxial Inventory-II (MCMI-II). Clinically significant scores on the MCMI-II antisocial and borderline personality scales were noted in this study. This study found women with histories of delinquent and/or criminal behavior before drug use were more likely to have used more types of drugs and have used multiple drugs together. These women also tended to have had a history of being abused, either emotionally, physically, or sexually. This group was also less successful on all outcome measures during 6-month follow-up. Moreover, the lifetime incidence of emotional, physical, and sexual abuse reported for this group at the baseline assessment was high--57.1% emotional abuse, 48.9% physical abuse, and 39.7% sexual abuse. These results are consistent with the research literature that indicates abuse plays a central role in the development and chronic effect of personality disorders and, in particular, posttraumatic stress disorder.

Adolescent↗
PubMedDate not supplied

Patient preferences for control in medical decision making: a scenario-based approach.

OBJECTIVE: This study evaluated patient preferences about involvement in medical decision making and factors that might influence these preferences. METHODS: A questionnaire was used that had one general question and 10 different clinical scenarios, followed by a list of seven options that described varying degrees of patient participation in the clinical decision-making process. The participants were patients presenting to a family practice residency clinic. RESULTS: Using paired t tests, patient responses to seven of 10 clinical scenarios (70%) were statistically significantly different from their responses as predicted by the general question. Six responses showed a positive relationship, ie, patients wanted to give the physician more control than they indicated by their response to the general question. Paired t tests then compared responses to each scenario with responses to every other scenario; 26 of 45 (58%) were significantly different. A factor analysis suggested groupings of scenarios. Significant differences for decision-making preferences were found among age groups and among educational levels. Cronbach's alpha, a measure of internal consistency, was calculated at .81. CONCLUSIONS: Although preference for level of control in medical decision making varied by scenario, our patients most often preferred physicians to play the primary role in decision making. Patient preferences for general decision making correlated poorly with preferences in specific scenarios.

Adolescent↗