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Biomedical subjects

S M Valente

Publications and source records attributed to S M Valente.

At least 19 recordsLinked to original sources
PubMed2001

Treating attention deficit hyperactivity disorder.

Attention deficit hyperactivity disorder (ADHD) is a chronic childhood disorder characterized by inattention, distractibility, impulsivity, and restlessness. ADHD symptoms impair the child's ability to function at home, in school, and in the community. When ADHD is untreated, the child is at increased risk for school failure, substance abuse, and psychiatric disorders. New clinical practice guidelines from the American Academy of Pediatrics specify diagnosis and treatment for childhood ADHD, including psychosocial interventions, psychopharmacology, educational modifications, skill training, and social support.

Attention Deficit Disorder with Hyperactivity↗
PubMed2000

Evaluating and managing intimate partner violence.

An estimated 18% to 25% of female primary care and prenatal patients suffer from intimate partner violence, and 31% to 44% of women report some abuse during their lifetimes. Violence is often unreported because women fear the batterer's reprisals, time-consuming court procedures, shame, blame, and unreliable legal sanctions. Screening for domestic violence should be a routine aspect of health care. Clinicians must ask direct questions about violence and detect subtle and overt clues. This article presents the historical context of violence and examines screening, evaluation, treatment, and ethics.

Battered Women↗
PubMed2000

Understanding oncology nurses' difficulties caring for suicidal people.

Clinical challenges occur when patients consider suicide. Despite improved treatment, people with cancer have an increased risk of suicide. While previous research examined patients' perspectives, this study describes the nurse's perspective of difficulty of caring for suicidal patients. Suicidal ideas constitute common psychiatric complications of cancer, however we know little of the nurse's difficulties in care giving. As part of a larger study of oncology nurses' knowledge, we randomly surveyed 1,200 clinical oncology nurses and 434 returned completed questionnaires (37%). This paper describes content analysis of oncology nurses' narratives about their difficulties responding to suicidal patients. Six categories emerged: religious/other values, uncomfortable feelings, inadequate knowledge, personal experiences, and weight of professional responsibility which made it difficult for most nurses to care for suicidal patients. Some nurses reported they had no difficulties. Care giving is also difficult because the patient's right to choose suicide may conflict with the nurse's professional obligation to prevent suicide.

Attitude of Health Personnel↗
PubMed1998

Rational suicide among patients who are terminally ill.

Patients' end-of-life decisions challenge nurses. Often, aggressive, life prolonging strategies create ethical dilemmas for nurses when patients decide to stop treatment. In Oregon, assisted suicide is legal and will have a profound effect on nursing practice. When a patient considers suicide, nurses need to examine the patient's mental health, symptom management, and rational decision-making ability. Evaluation of suicide risk is a priority. Nurses need to recognize that medical land psychological symptoms often trigger thoughts of suicide, but prompt treatment of pain and symptoms also reduces suicide risk. Ethical issues and guidelines for management of patients considering suicide and evaluation of rationality are presented.

Aged↗
PubMed1998

Pediatric epilepsy: primary care treatment and health care management.

Childhood seizures are encountered frequently in the primary care setting. Seizures can cause considerable embarrassment and discomfort--as well as dangerous consequences--if not properly treated. Accurate diagnosis often depends on history and a parent's or teacher's clear and reliable description of the seizure. About two-thirds of properly treated patients achieve seizure remission within 10 years of diagnosis. In this article, the authors review standards of treatment and present the latest findings on the treatment of epilepsy. The goal of pharmacologic treatment is to reduce the frequency of seizures with few adverse effects. Because all antiepileptic drugs affect cognition to same degree, diminishing the potential cognitive and psychosocial effects of epilepsy is also a treatment goal. Commonly used and new antiepileptic drugs are discussed. Patient education is an important part of care and requires discussion of beliefs about epilepsy, lifestyle, self-esteem, and resources.

Anticonvulsants↗
PubMed1997

Diagnosis and treatment of major depression among people with cancer.

Although depressive disorders are common among 20-25% of people with cancer, they are frequently unrecognized. Untreated depression in the presence of comorbid conditions may result in more frequent clinic visits, increased costs, extended hospitalization, and reduced compliance and quality-of-life. Oncology clinicians need not have psychiatric expertise to play a major role in the detection and treatment of depression and in the prevention of suicide. Using early detection and screening tools, the nurse can identify depressed patients and can collaborate in their treatment. Approximately 80-90% of depressed patients are effectively treated with psychotherapy, and/or pharmacologic, or somatic, interventions. Failure to diagnose or reluctance to treat depression among patients with cancer is a common error and can increase morbidity and mortality.

Adult↗
PubMed1996

Diagnosis and treatment of panic disorder and generalized anxiety in primary care.

Anxiety is one of the common yet underdiagnosed mental health problems of Americans; as many as 20% of people seeking primary care have symptoms of treatable anxiety disorders. Untreated anxiety increases costly visits to urgent care. Clinicians need to screen for anxiety among patients at risk who have physical symptoms such as shortness of breath, nervousness, gastrointestinal upset, palpitations, muscle aches, tension, and insomnia. Other diagnostic clues include restlessness, nervousness, phobias, trembling, fatigue, and shaking. Onset typically occurs in the 20s but may occur at any age. Symptoms of two anxiety disorders, generalized anxiety disorder (GAD) and panic disorder, are discussed. A combination of treatments including antidepressant and anxiolytic medications, behavioral treatments, education (e.g., self-management, relaxation), and counseling (e.g., coping strategies) have high success rates; psychiatric consultations or referrals are useful.

Anxiety↗
PubMed1994

Psychotherapist reactions to the suicide of a patient.

A patient's suicide may evoke the therapist's personal grief and influence professional competence or suicide prevention skills. The incidence of suicide by patients in therapy is examined and empirical studies of therapist response--which commonly includes grief, guilt, self-blame, anger, fear, and self-doubt--are reviewed. Bereavement theories and support programs are described.

Adaptation, Psychological↗
PubMed1994

Messages of psychiatric patients who attempted or committed suicide.

The stigma attached to suicide, and a qualitative analysis of psychiatric patients' suicide messages that emerged from a study of psychological characteristics and communications of suicidal psychiatric patients, are described. In this retrospective study, the suicide messages from clinical records of 25 suicide completers and a matched cohort of suicide attempters from a Veterans Affairs Medical Center were analyzed. A qualitative method developed by Leenaars in 1992 was used to examine themes in suicide messages. Analysis indicated that clear suicidal messages are sent by most psychiatric patients, and that some useful distinctions exist between messages of completers and attempters. Suicide messages offer worthwhile indicators of suicide that assist clinicians in their therapeutic and preventive roles. The themes of the psychiatric patients' suicide messages included unbearable psychological pain, interpersonal relations, and aggression-rejection. The present study enhances clinicians' recognition of themes in suicide messages and improves the estimation of suicide risk among psychiatric patients.

Adult↗
PubMed1994

Nurses' grief.

Bereavement, a well-established threat to health and work performance, is one of the most universal human responses that nurses experience. Because patient death is frequent, oncology nurses commonly experience bereavement; they may identify with the family, feel sad at the death, or feel awkward in responding to a death. After patients die, nurses manage bereavement tasks such as making sense of the death, managing mild to intense emotions, and realigning relationships. These tasks become more difficult when multiple deaths are encountered or when a conflict about the death occurs. Understanding theories, models, tasks, and factors influencing their bereavement may help nurses to facilitate their own grief and to reduce bereavement overload. The purpose of this article is to review knowledge and factors that influence nurses' bereavement and offer guidelines for managing grief. Information for this article was derived from several sources: (a) a review of existing literature; (b) clinical experience; and (c) analysis of personal inventories from over 300 nurses attending the authors' bereavement workshops.

Adaptation, Psychological↗
PubMed1993

Evaluating suicide risk in the medically ill patient.

Common medical conditions, treatments, medications, and depression can increase the risk of suicide, which is the eighth leading cause of death in the United States. Health care providers are in key positions to prevent suicide because most people seek medical treatment for physical symptoms and they give clues before they commit suicide. Unfortunately, suicide risk typically remains undetected because suicide clues, including depression, are overlooked. This article reviews assessment of suicide risk, incidence of completed suicide, and interventions in primary care settings. Suicide lethality, therapeutic strategies, and referrals are considered. Depression is discussed because it is the most common precipitant of suicide in primary care.

Adaptation, Psychological↗
PubMed1993

Adolescent grief after suicide.

After suicide of a loved one, adolescents may develop emotional problems and depression, and are at increased risk of suicide. They thus constitute a major population in need of counseling. Age, social support, development tasks, and death concepts determine how adolescents react to the experience of grief. Suicide changes the bereaved adolescent's role, identity, expectations, and daily activities, and may heighten anxiety about whether life is worthwhile.

Adaptation, Psychological↗
PubMed1991

Electroconvulsive therapy.

Electroconvulsive therapy treatment for severely depressed adults is increasing because it economically and rapidly reduces symptoms in most patients. Improved administration and unilateral electrode placement have decreased complications. However, concern exists about cognitive and other adverse effects of electroconvulsive therapy. Nurses are in a critical position to educate patients about electroconvulsive therapy, to be advocates for patients' rights, and to monitor responses to treatment. Because both depression and electroconvulsive therapy may impair cognitive functioning, nurses should renegotiate patients' consent during electroconvulsive therapy. Nurses who know, research, and evaluate memory and confusion can effectively observe and diminish the side effects of electroconvulsive therapy.

Adult↗
PubMed1991

Deliberate self-injury. Management in a psychiatric setting.

Self-injury is a significant clinical problem of psychiatric patients, although the prevalence of self-injury in specific disorders is unclear. Nurses can assess and intervene in the psychological causes and behavioral sequelae self-injury. Each patient's early history, dynamics, and motives for self-injury require evaluation. Behavioral techniques (eg, reinforcement) and psychodynamic techniques, such as exploring feelings and anxiety, can help patients understand their self-destructive tendencies. Patients can learn to anticipate anxiety-provoking situations, plan strategies to manage anxiety, cope with feelings, and reduce self-injury.

Adult↗
PubMed1990

Clinical hypnosis with school-age children.

Despite the fact that nurses are in key positions to learn and use hypnosis to bolster a child's symptom management, ability to solve problems, or self-esteem, they lack knowledge about the clinical effectiveness of hypnosis. Substantial clinical literature demonstrates that hypnosis effectively reduces anxiety, enhances coping, and has been used successfully to treat behavior disorders, school phobias, and sleep disorders. Hypnosis can effectively reduce a child's anxiety and symptoms and has few side effects when used competently. With education and supervision, nurses can effectively use hypnosis to improve a child's mastery and self-esteem and to reduce severe levels of anxiety.

Anxiety Disorders↗