Biomedical subjects

S Kreitler

Publications and source records attributed to S Kreitler.

At least 19 recordsLinked to original sources

PubMed2005

Quality of life and gender identity in Parkinson's disease.

UNLABELLED: We examined the correlation between gender identity (perception of masculinity or femininity) and quality of life (QoL) of 124 Parkinson's disease (PD) patients without dementia (69 men, 55 women, mean age 65.8+/-10.2 years, mean disease duration 8.5+/-5.8 years, mean Hoehn and Yahr [H&Y] stage 2.7+/-0.8). All patients underwent clinical examinations and completed the PDQ-39 and the quality of sexual life questionnaire. Their masculine or feminine stereotypes were determined by the Bem Sex Role Inventory (BSRI) modified by Dior. QoL was significantly correlated with disease duration (r=0.262, p<0.01), H&Y staging (r=0.330, p<0.001) and disease severity (UPDRS) (r=0.432, p<0.001). The QoL of androgynous men and women (i.e., with strong feminine and masculine characteristics) was significantly (p<0.05) better than the other gender groups. A significant interaction was found between the sexes to gender identity (p<0.05). CONCLUSION: Androgynous PD patients cope better with their disease in terms of QoL parameters, especially androgynous women.

Adaptation, Psychological↗

PubMed2001

Pain and quality of life.

This paper deals with the impact of pain on quality of life (QOL). Two major factors have contributed to the enhanced importance of QOL in recent years: the increasing frequency of pain and the resources devoted to its treatment, and the growing theoretical insight that pain affects the person as a whole. QOL is defined as the person's evaluation of his or her well-being and functioning in different life domains. It is a subjective, phenomenological, multidimensional, dynamic, evaluative, and yet quantifiable, construct. Commonly used scales for its assessment (eg, WHOQOL, SF-36) are described. Studies show that pain affects most domains of QOL, primarily physical and emotional functioning. The effect depends on the extent, duration, acuteness, intensity, affectivity, and meaning of the pain as well as on the underlying disease and the individual's characteristics. QOL is sensitive also to the treatment of pain and treatment modalities, as shown particularly by studies on cancer pain. Pain reduction is not always attended by the expected improvement in QOL. Pain is not synonymous with poor QOL and constitutes only one important factor determining QOL. The main conclusions are that treatment of pain should be multidisciplinary, considering the impact of pain and the treatment on QOL and targetting also improvement of the affected domains of QOL.

Journal Article↗

PubMed2001

Effects of homeopathic treatment in women with premenstrual syndrome: a pilot study.

Alternative therapies in general, and homeopathy in particular, lack clear scientific evaluation of efficacy. Controlled clinical trials are urgently needed, especially for conditions that are not helped by conventional methods. The objective of this work was to assess the efficacy of homeopathic treatment in relieving symptoms associated with premenstrual syndrome (PMS). It was a randomised controlled double-blind clinical trial. Two months baseline assessment with post-intervention follow-up for 3 months was conducted at Hadassah Hospital outpatient gynaecology clinic in Jerusalem in Israel 1992-1994. The subjects were 20 women, aged 20-48, suffering from PMS. Homeopathic intervention was chosen individually for each patient, according to a model of symptom clusters. Recruited volunteers with PMS were treated randomly with one oral dose of a homeopathic medication or placebo. The main outcome measure was scores of a daily menstrual distress questionnaire (MDQ) before and after treatment. Psychological tests for suggestibility were used to examine the possible effects of suggestion. Mean MDQ scores fell from 0.44 to 0.13 (P<0.05) with active treatment, and from 0.38 to 0.34 with placebo (NS). (Between group P=0.057). Improvement >30% was observed in 90% of patients receiving active treatment and 37.5% receiving placebo (P=0.048). Homeopathic treatment was found to be effective in alleviating the symptoms of PMS in comparison to placebo. The use of symptom clusters in this trial may offer a novel approach that will facilitate clinical trials in homeopathy. Further research is in progress.

Adult↗

PubMed1999

Denial in cancer patients.

Denial is a basic mechanism for coping with stressful themes, common in healthy and sick individuals. This article deals with the role and functions of denial in cancer, reviewing empirical studies about the effects of denial on cancer prevention, screening, undergoing tests for early detection, delay in seeking medical attention and getting treatment, complying with medical instructions, and coping with the disease in different stages. Special sections are devoted to the possible role of denial as a risk factor for cancer, the effects of denial on disease course and survival, and the relation of denial to immunocompetence. Major conclusions are that denial may have a positive effect when applied in the first phase of coping, after diagnosis, because it reduces anxiety. This holds also for the terminal stage. The negative effects of denial are that it may interfere with getting treatment (e.g., delay in going to the doctor, not showing up for follow-ups, noncompliance), may disrupt the process of assimilating the stressful event, may affect adversely interpersonal relations, and constitutes a cumulative stressor depressing even immunocompetence. The use of denial varies with the severity of the situation, the patient's personality, and his or her familial and cultural background. A large body of research examined the hypothesis that a tendency toward denial could be one of the risk factors for cancer. Despite evidence supporting the occurrence of denial as a correlate of cancer, a lot of research is necessary to clarify the role of denial in general and of anger specifically as a factor affecting the occurrence of cancer and the course of disease and survival.

Denial, Psychological↗

PubMed1999

Empirical comparison of two psychological therapies. Self psychology and cognitive orientation in the treatment of anorexia and bulimia.

The authors investigated the applicability of self psychological treatment (SPT) and cognitive orientation treatment (COT) to the treatment of anorexia and bulimia. Thirty-three patients participated in this study. The bulimic patients (n = 25) were randomly assigned either to SPT, COT, or control/nutritional counseling only (C/NC). The anorexic patients (n = 8) were randomly assigned to either SPT or COT. Patients were administered a battery of outcome measures assessing eating disorders symptomatology, attitudes toward food, self structure, and general psychiatric symptoms. After SPT, significant improvement was observed. After COT, slight but nonsignificant improvement was observed. After C/NC, almost no changes could be detected.

Adult↗

PubMed1996

The cognitive orientation of compliance in short- and long-term type 2 diabetic patients.

Previous research showed that providing diabetic patients with information about diabetes is mostly insufficient for compliance. The purpose was to develop a new model for studying and promoting compliance in diabetes based on the theory of cognitive orientation (Kreitler & Kreitler), which assumes that in addition to knowledge it is necessary to consider the patient's goals, values and self image. We expected cognitive contents (beliefs) to be related to compliance, more in long-term than short-term patients. The subjects were 112 Type 2 diabetic patients. They were administered a Cognitive Orientation Questionnaire of Diabetic Compliance assessing cognitive contents in terms of four belief types (goals, norms, self and general) referring to relevant themes (e.g. discipline, reducing tensions). Compliance was assessed in terms of physical measures (HbA and number of complications) and behavioral measures based on information provided by the medical staff about glucose testing, taking medication, diet, exercise, independence, and follow-ups. The results showed that beliefs predicted (by discriminant analyses) the compliance measures more in long-terms and enabled describing the personality dynamics of compliers. The findings support a cognitive model of compliance. It predicts better in long-term than short-term diabetic patients.

Aged↗

PubMed1995

Psychosocial effects of level of information and severity of disease on head-and-neck cancer patients.

This study examined the psychosocial effects of levels of information available to patients and compared them with those of disease severity. A questionnaire with multiple-choice and open-ended questions assessing quality of life in various domains (e.g., fears and worries, functioning in the family) and scales assessing anxiety, anger, and depression were administered to patients and their partners or closest relatives. The subjects were 55 head-and-neck cancer patients (40 men and 15 women) in disease stages I to IV, grades of tumors G1 to G3-4, with disease durations ranging from three months to 21 years. They were divided into three groups on the basis of the amounts of information they had about their disease and prognosis, and again on the basis of disease severity, based on stages and patients' evaluations. The numbers of psychosocial variables differentiating significantly between the groups deviated significantly from chance in both groupings. The results showed more effects for information than for disease severity. The highly informed were better adjusted in interpersonal relations and had more intimacy with family, but had more fears, anxiety, changes in their lives, worries about health, and concern with physical symptoms. The reports of partners were fewer and lent some support to those of patients. Disease severity affected mostly fears, anxiety, and worries about health.

Aged↗

PubMed1995

The effects of short-term exercise on the cognitive orientation for health and adjustment in myocardial infarction patients.

Previous studies have shown that cardiovascular patients benefit from exercise. The explanations are partly physical and partly psychological, yet evidence for the latter is contradictory, possibly because only selected samples start and maintain prolonged exercising. The authors examined psychological effects of short-term exercise started as soon as possible after myocardial infarction, focusing on the motivation for health of 62 male and female patients who had had a myocardial infarction 7 to 10 days earlier. Patients were divided into those who exercised for a week in a recovery camp, those who merely stayed for a week in the camp, and those who did not stay in the camp. Results of before and after tests indicated that two scores of the motivation for health (goals and norms) of patients in the exercise group increased, even when complications, former exercising, and infarct location were considered. A month later, 53 of the patients completed a cardiological adjustment questionnaire. The exercise group scored higher than the others on 8 of 9 domains, including subjective health state, sexuality, and work. Even short-term supervised exercise, if done immediately after infarction, has a great potential for beneficial psychological effects, the authors concluded.

Adaptation, Psychological↗

PubMed1995

Cognitive and motivational determinants of academic achievement and behaviour in third and fourth grade disadvantaged children.

While most studies on the determinants of learning deal with either cognition or motivation, there is a growing awareness that both should be considered. Our purpose was to examine the relative roles of cognitive and motivational factors for the scholastic achievement and behaviour of disadvantaged children. Cognition was conceptualised in terms of the psychosemantic theory that assesses cognitive processes by characteristics of the individual's meaning assignment (Kreitler & Kreitler, 1987a). Motivation was conceptualised in terms of the cognitive orientation (CO) theory which assumes that cognitive contents guide behaviour (Kreitler & Kreitler, 1982). Participants were 57 third and fourth graders of both genders, recommended for a remedial summer programme. They were administered the Meaning Test assessing cognitive abilities; the CO Questionnaire of Motivation for Learning assessing the disposition to learn; and the Metropolitan Achievement Test and the IOWA tests assessing verbal, mathematical and working skills. Teachers completed the Teacher-Child Rating Scale assessing six scholastic behaviours. Regression analyses showed that all dependent variables were predicted by the cognitive and motivational variables, better by specific than global predictors. Cognitive variables contributed more to the predictions, especially of academic achievements, and more in the case of verbal than mathematical abilities. In girls, motivational factors played a larger role than cognitive factors, absolutely and relative to boys. Implications for promoting scholastic achievements are discussed.

Achievement↗

PubMed1994

Carotid endarterectomy for symptom-free stenosis: the patient's point of view.

Determining the indication for carotid endarterectomy in a given patient with a totally symptom-free internal carotid artery stenosis depends on objectively assessing the risk of non-operative versus operative treatment, as well as on the patient's attitude towards immediate versus long-term risk. In order to study patients' attitudes and preferences, four groups of subjects were asked to complete two questionnaires: the first examined people's perceived deterioration in their quality of life if they sustained a stroke of a defined severity. The second checked the attitude towards risk of operative versus non-operative treatment at different levels of an expected annual stroke rate without surgery. This preliminary study showed the feasibility of studying these subjective elements, and also pointed to problem areas in this type of research. The existence of individual as well as group differences in patients' values and preferences should be considered in the decision-making process.

Adult↗

PubMed1993

Life satisfaction and health in cancer patients, orthopedic patients and healthy individuals.

Life satisfaction (LS) is one of a set of constructs defining quality of life. Previous studies showed that LS was sometimes related to health and sometimes not. The study was designed to examine the relation of LS as a general construct to satisfaction in specific domains. We assumed that there is a tendency to maintain an acceptable level of LS even under stressful and threatening conditions, that it is related to optimism and that the likelihood of attaining satisfaction in a particular domain affected the selection of domains on which LS is based. We expected that in cancer patients LS would be related to more domains but not to health. The study was done with 55 head-and-neck cancer patients, of all stages and grades of tumor; 51 orthopedic patients, victims of accidents with good recovery chances; and 55 healthy individuals. The healthy individuals and orthopedic patients were matched (in terms of group values) to the cancer patients in age, gender and education. Single-item measures of LS and optimism, and a questionnaire with 49 multiple-choice items assessing adjustment in 13 domains were administered to all subjects. The results showed that in cancer patients LS was related to most domains but not to health and not to optimism, whereas in the other groups it was related to few domains including health, and also to optimism. The findings support the tendency to maintain LS with the materials available to the individual, and show that health is related to LS only if its maintenance or attainment are realistic goals. Thus, both bottom-up and top-down theories of LS are supported.

Female↗

PubMed1993

Psychosocial problems in head-and-neck cancer patients and their change with time since diagnosis.

BACKGROUND: Little is known about the psychosocial effects of cancer survivors especially after the first stage of adjustment. The study was designed to provide information about the major psychological problems of head-and-neck cancer patients and their change with time since diagnosis. PATIENTS AND METHODS: The subjects were 55 head-and-neck cancer patients, 40 men and 15 women with disease stages I to IV, grade of tumors G1 to G3-4, and disease duration in the range of 3 months to 21 years. A questionnaire with multiple-choice and open-ended questions assessing adjustment in 14 domains (e.g., fears and worries concerning health, functioning in the family) was administered to patients and their partners or closest relatives as well as scales assessing anxiety, anger and depression. RESULTS: The results showed that the domains that were most problem-laden included coping with health problems, fears, communication with the partner and social relations. Comparing the problems of patients in different time periods (0.5-1.5 years after diagnosis, 1.5-5 years, and over 5 years) showed that many medical problems decreased with time but most psychological ones including anxiety and anger deteriorated markedly. CONCLUSIONS: Head-and-neck cancer patients suffer from a broad range of psychosocial problems that become exacerbated with time. The deterioration in quality of life may reflect 'patient burnout' which could be decreased by acquiring adequate coping skills.

Adaptation, Psychological↗

PubMed1993

Laughter in a psychiatric ward. Somatic, emotional, social, and clinical influences on schizophrenic patients.

The study was designed to explore the potential therapeutic effects of humor on hospitalized schizophrenics. For this purpose, in the first stage, we conducted a review of findings in regard to physical health, emotions, psychiatric state, and social behavior. In the second stage, we carried out an experiment with 34 resident patients in two chronic schizophrenic wards who were exposed to 70 movies during 3 months. The experimental group was exposed to humorous movies only, and the control group to different kinds of movies. Before and after the exposure to films for 3 months, both groups were tested on different health, emotional, social, and clinical measures using the Cognitive Orientation of Health Questionnaire, the Shalvata Symptom Rating Scale, blood pressure, heart rate, Perceived Verbal and Motor Aggression (rated by nurses), the Multiple Affect Adjective Check List, the Social Support Questionnaire 6, and the Brief Psychiatric Rating Scale (BPRS; rated by psychiatrists). Covariance analyses yielded significant reductions in Perceived Verbal Hostility, BPRS scales (total score, anxiety/depression), and significant increases in BPRS (activation) and degree of staff support experienced by the patients. The results indicate that the effects of exposure to humor may be mediated by the effects on the staff of the incidental exposure to humorous films.

Adult↗

PubMed1992

Doctor-patient communication in a cancer ward.

This study explored doctor-patient interaction by focusing on a specific type of encounter in an oncology ward, designed to enable discussion of the case by the doctors and informing the patient. In line with the cognitive orientation theory of Kreitler and Kreitler, the encounter's effects were examined in regard to three aspects--disease, treatment, and general state--on four levels: the information the patients have, their feelings, the information they desire, and the information they consider desirable. The patients were 52 men and women with different cancer diagnoses. Comparable questionnaires were administered to the patients before and after the meeting, and to the doctors only after it. The patients responded before and after also to Spielberger's scales of state anxiety and state anger. The results showed that patients claimed they had gained hardly any new information concerning the disease and their overall state. There were no decreases in the desired and desirable information. Their feelings were affected negatively to a slight extent, especially concerning treatment. In a quarter of the subjects, anxiety decreased and was replaced by anger. In regard to all levels and aspects there was a large gap between the evaluations of doctors and patients. The major conclusions were that patients and doctors differ in the meaning they assign to information, and that patients are conflicted in regard to asking for the personally relevant information they want.

Anger↗

PubMed1992

What do cancer patients' spouses know about the patients?

A large body of research shows that social support in general and of family members in particular plays an important role in determining cancer patients' quality of life. We assumed that the spouse's information about how the patient experiences the situation determines the spouse's ability to help. The present study was designed to examine how much the spouse knows about the attitudes and experiences of their husband or wife who is a cancer patient, and whether this knowledge depends on the questions' structure, disease duration, its severity, or level of patient's information about the disease and prognosis. A questionnaire with multiple-choice and open-ended questions assessing 13 domains (e.g., fears and worries concerning health, functioning in the family, and anxiety) was administered to patients and their partners. Subjects were 55 head-and-neck cancer patients, 40 men and 15 women, with disease stages I to IV, grade of tumors G1 to G3-4, and disease duration of 0.5 to 21 years. The results showed that correspondence between the patients' and their spouses' responses was very low, and was not affected by the structure of the questions or the disease's duration and severity. Correspondence was high only in patients informed about their disease. In the discussion, it was pointed out that when the patient is informed, communication channels in the family are opened and this brings about an increase in the spouses's information about the patient and hence in the spouse's ability to provide the patient the needed social support as a psychotherapeutic agent and a friend. The cancer nurse may play a crucial role in instituting the patient-spouse dialogue.

Adult↗

PubMed1991

Induced versus spontaneous attendance of breast-screening tests by women.

Despite the availability of services and information, not enough women undergo breast-screening tests. A previous study showed that clinic attenders differ from nonattenders in emotions, personality, self-concept, neuroticism, psychosomatics, and health attitudes. Some of these resembled the cancer-prone personality. The present study was designed to test whether nonattenders have higher repression that supports denial and could be persuaded by positive inducements to undergo the tests. Other goals were to examine if the new sample replicates the former findings and if it differs from clinic attenders. The subjects were 210 spontaneous clinic attenders and 210 matched controls from the previous study and 46 positively induced women. They were administered questionnaires assessing emotions, personality, daydreaming, self-concept, neuroticism, somatic complaints, alexithymia, and health attitudes. The findings were that the induced sample scored higher on repressiveness, had more cancer-affected blood relatives, and responded favorably to the positive inducements. They differed from the controls in most of the variables the clinic attenders did but differed from the clinic attenders in 30% of the variables, manifesting more extreme correspondence to the cancer-prone personality. The findings indicate possibilities of drawing more individuals to undergo the tests by emphasizing the positive anxiety-reducing approach.

Adult↗

PubMed1991

Cognitive orientation and genital infections in young women.

The purpose was to explore the psychological determinants of common genital infections in young women. The study was done in the framework of the cognitive orientation theory which assumes that cognition guides behavior and provides predictions of behaviors and psychophysiological phenomena. We expected that beliefs of four types (about self, norms, goals, and general) would predict the occurrence and/or frequency of 17 gynecological symptoms (e.g., itching, swelling, different vaginal discharges, abscesses). The subjects were 195 female volunteers, undergraduates, about 23 years old, without gross gynecological disorders, mostly (87.7%) unmarried, mostly (83.6%) having had intercourse. They were administered anonymously questionnaires about demographic variables, frequency and treatment of gynecological symptoms and 3 urological ones (for control), and about cognitive orientation that referred to pretested themes (e.g., assertiveness, hypochondriasis). Stepwise discriminant and regression analyses showed that the belief types enabled predicting the occurrence and frequency of all symptoms, with a mean 34.5% improvement over the 50% chance level, accounting for 45.7-67.2% of the variance. Also the urological symptoms were predicted although at a lower level. Discussion focuses on the specificity of cognitive-motivational determinants and their role in producing conditions favoring physical pathology.

Adult↗

PubMed1990

The psychological profile of women attending breast-screening tests.

Though the benefits of early detection of breast cancer are generally known, only few women attend breast-screening examinations. The study was designed to gain insight into the problem by exploring the psychological profile of clinic attenders. In order to find out whether there is such a profile, 210 self-referred women were compared with 210 nonattending women, from the same working and social environments, matched in age, education and occupational level. All subjects were administered 10 tests in 7 domains. The tests were administered as part of a health survey. The results showed that clinic attenders scored higher on negative emotions and total emotions and lower on positive emotions; higher on repression; lower on daydreams; lower on range of self-concept, references to others and negative self-references but higher on positive self-references; scored higher on self-references describing oneself in a functional and in a passive way and scored lower on those describing oneself in terms of one's attitudes, body and appearance; scored lower on neuroticism; scored lower on different somatic complaints and health orientation but higher in alexithymia. No differences were found in authoritarianism, locus of control and self-complexity. Conclusions are that there is a psychological profile of clinic attenders, that it is focused on dysphoric emotions, psychological disease promotion and defensiveness and that it includes characteristics of the construct that is sometimes called the cancer-prone personality.

Adult↗