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Biomedical subjects

R J Hafner

Publications and source records attributed to R J Hafner.

At least 19 recordsLinked to original sources
PubMed1992

Assaults by patients: the experience and attitudes of psychiatric hospital nurses.

Four hundred and twenty-five nurses working in a 420 bed metropolitan psychiatric hospital were asked to complete a questionnaire about their experience of physical assault by patients and their attitude toward the problem. 61% returned the questionnaire. The overall mean annual rate of assault per nurse was 2.0, with student psychiatric nurses (mean 6.7) significantly more at risk than any other group. Nurses working in the psychogeriatric area reported more than double the rate of assaults reported by nurses working in rehabilitation services. 60% of respondents were female; there were very few sex differences in attitudes to assault. Overall, nurses reported a high tolerance for assault, although they recognised it as an experience that was often very traumatic psychologically. Views about managing assaultiveness differed widely, and this lack of consensus probably hinders the development of optimal strategies to deal with what is a major problem in many psychiatric units.

Adaptation, Psychological↗
PubMed1991

Predicting schizophrenia outcome with self-report measures of family interaction.

This study is based on 18 patients admitted to a psychiatric hospital with a DSM-III-R diagnosis of schizophrenia who currently were living with one or both parents. Patients and parents completed several questionnaire, including the Parental Bonding Index (PBI), the Family Environment Scale (FES), the Hostility and Direction of Hostility Questionnaire (HDHQ), and the Brief Symptoms Inventory. Observer ratings of patients' symptoms also were made. Outcome was predicted best by patients' ratings of mothers on the PBI and by mothers' scores on the HDHQ Criticism of Others scale. Other significant outcome predictors were the number of previous admissions to hospital, patients' scores on the HDHQ Projected Hostility scale and the FES Expressiveness scale, and fathers' scores on the FES Achievement-Orientation scale.

Adolescent↗
PubMed1991

Medical visits and psychological disturbance in chronic low back pain. A study of a back education class.

Associations between the frequency of medical visits and psychological disturbance were explored using chronic low back pain patients from a back education class. Psychometric measures included the illness Behaviour Questionnaire (IBQ), somatic problems, and current mood. Males and females responded similarly on all psychological measures. Pain duration and IBQ disease affirmation significantly predicted visits to both general practitioners and specialists. Additional predictors for specialist visits included a self-rated pain/mood association, sex, age, and IBQ denial. Patients' expectations and attitudes about illness and treatment appeared most central to medical visits and several different forms of psychological disturbance accompanied increased visits.

Activities of Daily Living↗
PubMed1991

Attitudes of psychiatric patients and their relatives to involuntary treatment.

In 1979 a Guardianship Board assumed responsibility in South Australia for the welfare of those mentally ill or handicapped people unable to look after their own health or safety, or to manage their own affairs. This study examines the attitudes to guardianship and involuntary treatment of 79 patients referred to the Board from a psychiatric hospital, all of whom were under guardianship at the time of the study. Forty-seven of their relatives took part in the project, which included measures of patients' psychiatric symptoms and relatives' punitiveness. Although almost 70% of patients objected to Guardianship in principle, they made more positive than negative statements about it. Nearly 60% rated involuntary treatment, including medication, as helpful. Patients reported a level of psychiatric symptoms less than half of that of a psychiatric outpatient sample. Relatives were strongly in favour of Guardianship, stating frequently that it allowed an improved relationship between themselves and the patient. Patients who believed that they were suffering from a mental illness were comparatively happy about being under Guardianship, and a belief that the patient was mentally ill was significantly associated with reduced extrapunitiveness in relatives.

Activities of Daily Living↗
PubMed1991

Morbid obesity: effects on the marital system of weight loss after gastric restriction.

Eighty morbidly obese married women and 69 of their husbands completed a self-report measure of personal and marital adjustment before the women proceeded to gastric restriction surgery. Fifty-five women and 41 husbands repeated the measure 12 months after surgery, at which time the women had lost a mean of 35.4 kg. Women rated themselves as significantly more attractive and sociable, and rated their husbands as significantly less sociable and interesting, than before surgery. Husbands rated their wives as excessively sociable after surgery, the reverse of their previous view. The data offered some support for a family systems view of morbid obesity, but the systemic effect appeared weak, and is probably not a major contributor to wives' morbid obesity in most cases.

Adult↗
PubMed1991

Essential hypertension: hostility, psychiatric symptoms and marital stress in patients and spouses.

Scores on self-report questionnaire measures of hostility, psychiatric symptoms, marital dissatisfaction, and assertion discomfort/behaviour were compared for male (n = 26) and female (n = 25) patients with essential hypertension and their spouses, and matched normotensive controls. Correlations and factor analysis revealed clinically meaningful associations between elevated psychiatric symptoms, hostility, and assertive behaviour. These differed for male and female patients, especially regarding assertive behaviour. The findings suggest that communication training might be helpful for a sizeable proportion of married patients with essential hypertension.

Adult↗
PubMed1991

Quality of life after gastric bypass for morbid obesity.

One year after gastric restriction surgery, 70 per cent of 118 women completed a questionnaire about lifestyle and eating behaviour changes. Mean weight loss was 35.4 kg. Patients reported a moderate reduction in appetite, and most avoided specific foods which they previously enjoyed, usually because of epigastric discomfort and/or nausea and vomiting. Patients had initiated or resumed a mean of 1.8 activities, most of which involved physical exercise. Sexual interest, enjoyment and frequency were all increased. Raised sexual satisfaction correlated strongly with overall outcome satisfaction. Seventy-two per cent of respondents rated themselves as very pleased, and 18 per cent as fairly pleased, with the overall results of the operation, and responses to the open-ended questions were often strikingly enthusiastic. However, most patients emphasized the difficulty of adjusting to radically new eating habits in the first 2-3 months after surgery, during which they experienced their greatest need for social support and encouragement.

Adult↗
PubMed1990

Obsessive-compulsive disorder: an exploration of some unresolved clinical issues.

The study data were obtained from a questionnaire survey of a South Australian community support group for obsessive-compulsive disorder (OCD). The response rate was 47%, yielding 81 questionnaire sets completed by members who, on the basis of their questionnaire responses, were judged to meet DSM-III-R criteria for OCD. The clinical and demographic characteristics of the respondents were very similar to those of previously reported clinical populations. Mean age at onset of OCD was 18 years and mean duration 17 years; 55% of respondents rated their current OCD as extremely or very severe. Seventy-seven percent had received psychiatric treatment (mean 55 occasions) and 47% had attended clinical psychologists or professional counsellors (mean 20 occasions). Those who reported prominent fears of losing control of motor behaviours had received a significant excess of outpatient and inpatient psychiatric treatment. Most respondents reported the presence of all 4 identified components of OCD, of which the obsession/rumination component was central. Levels of OCD correlated strongly with levels of overall psychopathology, and fertility rates were significantly reduced in those patients who reported the most symptoms.

Adult↗
PubMed1990

Husbands' adjustment to wives' weight loss after gastric restriction for morbid obesity.

This study examined the personal and marital adjustment of husbands before and one year after their wives had gastric restriction surgery for morbid obesity. Seventy-five married women and their husbands were assessed by clinical interview and self-report questionnaires before surgery. Forty-three husbands (57 per cent) returned questionnaires at the 12 month follow-up, and in 36 cases both partners did so. Four couples separated in the first year after surgery. Husbands' self-reported personal adjustment before surgery was essentially normal, but their marital dissatisfaction was significantly elevated. Twelve months after surgery, their scores improved on the measure of psychoneurotic symptoms, and on assertion discomfort, extrapunitiveness and marital dissatisfaction. However, there was a significant reduction in assertion behaviour. In contrast, wives (who had lost an average of 35.4 kg) reported significant increases in extrapunitiveness and assertion behaviour, the latter increase being associate with raised marital dissatisfaction in husbands. This finding suggested that husbands' adaptation to wives' increased assertiveness is often a problem in the first year after surgery, confirming reports in the clinical literature.

Adaptation, Psychological↗
PubMed1979

Agoraphobic women married to abnormally jealous men.

Of 36 married female agoraphobics treated by the author over a period of 3 years, seven were married to men who displayed abnormal jealousy. In all these cases the husbands' jealousy adversely influenced their wives' response to treatment, and improvement in wives was associated with increased morbidity in their husbands.

Adult↗
PubMed1979

Behavior therapy as a test of psychoanalytic theory.

The author describes 4 patients in whom radically new symptoms appeared after intensive behavior therapy. He suggests that fresh symptoms are most likely to develop in a small minority of patients who are unable to learn more adaptive psychological defense mechanisms during or after behavior therapy and that psychoanalytic theory may help predict the nature of such symptoms.

Adaptation, Psychological↗
PubMed1978

Teaching psychotherapy in mental hospitals.

This paper deals with the early results and problems of establishing and developing a regional training programme in psychotherapy, using peripatetic senior lecturers. The difficulties of a psycho-analytic approach to psychotherapy in mental hospitals are discussed, and a model of psychotherapy more suitable for general application in mental hospitals and district general hospital psychiatric units is proposed.

Education, Medical, Graduate↗
PubMed1977

A psychiatric study of women with urgency and urgency incontinence.

26 patients with frequency, urgency and urgency incontinence, without bladder or urethral abnormality, underwent psychiatric evaluation. They were divided into 2 groups according to the degree of neuroticism found. Treatment by group and individual psychotherapy showed that approximately one-third of the patients benefited considerably, one-third refused treatment or ceased prematurely and one-third improved slightly or not at all. The importance of excluding organic bladder or urethral disease prior to psychiatric assessment is stressed.

Adolescent↗
PubMed1977

The husbands of agoraphobic women: assortative mating or pathogenic interaction?

Symptom and personaltiy profiles of 33 agoraphobic women and their husbands are examined, revealing some evidence for assortative mating. The implications of this are discussed, and predictions are made about the changes required within a marriage in order to permit the effective symptomatic treatment of the female partner.

Agoraphobia↗