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Biomedical subjects

S LeBaron

Publications and source records attributed to S LeBaron.

18 recordsLinked to original sources
PubMed1991

A randomized, controlled study of behavioral intervention for chemotherapy distress in children with cancer.

Fifty-four pediatric cancer patients were studied to determine the relative efficacy of two forms of behavioral intervention for reducing chemotherapy-related distress. Following baseline assessment, subjects were randomly assigned to receive either hypnosis, non-hypnotic distraction/relaxation, or attention placebo (control) during the subsequent identical chemotherapy course. Observational and interview measures of anticipatory and postchemotherapy nausea, vomiting, distress, and functional disruption served as outcome data. Results indicated that treatment condition was the single best predictor of change from baseline to intervention, with children in the hypnosis group reporting the greatest reduction of both anticipatory and postchemotherapy symptoms. The cognitive distraction/relaxation intervention appeared to have a maintenance effect in which symptoms did not get much worse or much better, while children in the control group had symptoms that consistently became worse over time. Emetic potential of the chemotherapy and the prophylactic use of antiemetics each appeared to contribute to the overall severity of symptoms. While the efficacy of hypnosis in the management of chemotherapy distress is supported, the complexities of interacting biologic and psychologic factors are highlighted.

Adolescent↗
PubMed1989

The role of imagery in the treatment of a patient with malignant melanoma.

Feelings of hopelessness and apathy in critically ill patients can present significant obstacles to rational, logical solutions. Forms of psychotherapy which are entirely verbal are often limited in their effectiveness to resolve such existential crisis. Other modes of therapy which employ imagery may be more effective. The patient's own imagery appears to have particular value as a vehicle for resolving impossible dilemmas which are experienced by patients facing imminent death.

Adult↗
PubMed1988

Assessment of quality of survival in children with medulloblastoma and cerebellar astrocytoma.

To determine the quality of survival for children with posterior fossa tumors, comprehensive neuropsychological, behavioral, and academic assessment and physician ratings of functional status were obtained on 15 brain tumor patients (ages 6-19 years) at a median of 20 months post-diagnosis. More than 50% of the children (whether irradiated or not) experienced major problems in academic, motor, sensory, cognitive, and emotional function. All but two children were reported by teachers to be "slow workers," and four of 15 patients were able to maintain their school work in regular classes. Although 80% of the patients were rated by physicians as having "excellent" or "good" functional status, no relationship was found between these global ratings and psychometric measures. Although the affected site was the posterior fossa, deficits also involved higher cortical function. These findings indicate the need for further evaluation of treatment effects and the provision of intervention for survivors.

Achievement↗
PubMed1988

Chemotherapy side effects in pediatric oncology patients: drugs, age, and sex as risk factors.

Nausea, vomiting, and the extent to which chemotherapy-bothered children were assessed by patient and parent ratings for 31 children (65 courses) receiving combination chemotherapy with either high-dose cyclophosphamide or doxorubicin/daunorubicin. Patients and parents both reported more severe vomiting with cyclophosphamide than with the anthracyclines. The use of antiemetics did not affect emesis for the former drug; for the anthracyclines, there was more severe emesis for courses with antiemetics than for those with none. Adolescents reported more severe nausea than children, and females reported both more nausea and bother than males. There were no significant age or sex findings for parent reports. The findings suggest that chemotherapy-related nausea and vomiting in children is a complex phenomenon not accounted for by drugs alone.

Adolescent↗
PubMed1986

Hypnosis and hypnotizability: implications for clinical intervention.

Increasing laboratory and clinical research during the past 25 years has greatly enhanced understanding of hypnosis. Drawing on this research, the authors illuminate the many factors that define the domain of hypnosis, the most crucial of which is individual differences in hypnotizability. The important treatment ramifications of this factor are discussed, as are its pathogenic and diagnostic possibilities. The authors examine hypnotizability from a developmental perspective and conclude with an in-depth discussion of the clinical use of hypnosis with children, who have been shown to be particularly susceptible to hypnotic suggestion.

Adolescent↗
PubMed1985

A controlled study of education for improving compliance with cromolyn sodium (Intal): the importance of physician-patient communication.

The effectiveness of an educational program to increase compliance with cromolyn sodium was assessed in 31 children and adolescents 6 to 17 years of age. Patients were randomly assigned to an education or noneducation group. A standard education program regarding asthma and asthma medications was provided to the education group during four monthly visits. At each visit, all patients were assessed in terms of knowledge of asthma and medications, asthma-related symptoms, and pulmonary function. Patients were also asked to self-rate their compliance. The education program increased the patients' knowledge of cromolyn, and appeared to result in increased cromolyn compliance. Post-hoc analyses, however, suggested that increased compliance did not correspond to improved medical status unless the quality of management (by physician and parents) of the child's asthma was taken into account. These results suggest that inadequate management of asthma in children may be a more serious problem than patient noncompliance.

Adolescent↗
PubMed1985

Pediatrics and psychology: a collaboration that works.

The growing relationship between pediatrics and psychology is described. Differences and similarities in training and orientation between psychologists and pediatricians are discussed, as well as three different models of collaboration. Pediatrician-psychologist collaboration can result in significant improvements in: comprehensive primary health care, treatment of psychosomatic disorders, and management of children suffering from a combination of medical, family, and adjustment problems. Research and health care legislation are two additional areas where collaboration between pediatrics and psychology is proving to be valuable.

Adolescent↗
PubMed1985

Paternalistic vs egalitarian physician styles: the treatment of patients in crisis.

According to previous reports, the quality of the physician-patient relationship plays an important role in medical outcome. A patient's responsiveness to suggestions, perceptions of treatment, and physical distress may be affected both by the type of interpersonal relationship and by the patient's anxiety. To test these hypotheses, 57 women who received elective abortions were treated by the physician in either a "paternalistic" or "egalitarian" interpersonal style. Each patient was tested for responsiveness to suggestions regarding changes in somatic perception such as heat or pain; a measure of psychological dependency on the physician was also obtained in addition to ratings of discomfort and signs of physiological distress during the medical procedure. Patient anxiety was not related to any of these variables, but patients treated in a paternalistic manner had higher responsiveness to suggestibility (P less than .001), felt they could depend more on the physician and perceived him as warmer and more supportive (P less than .01), had less discomfort during the procedure (P less than .05), and had a lower incidence of physiological distress compared with patients treated in an egalitarian manner. It was concluded that, for patients in crisis, paternalistic treatment by a physician may promote positive psychological and medical outcome.

Abortion, Induced↗
PubMed1985

The role of imagery in the treatment of dying children and adolescents.

The care of terminally ill children and adolescents is often complicated by depression and the patient's inability to express needs and fears verbally. The patient's own mental imagery provides an alternate means of communication. Clinical cases illustrate some of the ways in which imagery may play a crucial role in helping these young patients to express age-appropriate needs and fears regarding helplessness, separation from loved ones, and death.

Adolescent↗