PubMed Health⌕ Search

Biomedical subjects

T A McClellan

Publications and source records attributed to T A McClellan.

7 recordsLinked to original sources
PubMed1992

A day hospital program for dual diagnosis patients in a VA Medical Center.

A day hospital program for patients with mental illness and substance abuse problems at a Veterans Affairs medical center uses nonconfrontational group therapy as the primary treatment modality. The goals of the six-to-eight-week program are to reduce substance abuse, improve medication compliance, and reduce the number of hospitalizations. Aftercare is available for patients who complete the program. The authors suggest that patients' ability to relate well to others in group therapy is the primary factor influencing successful outcome. During a 30-month period, 66 percent of the patients admitted to the day hospital program completed it. Three cases illustrating the variable outcomes of patients treated in the program are presented.

Adult↗
PubMed1991

Negative effects of a smoking ban on an inpatient psychiatry service.

Although many psychiatric inpatient units have banned smoking, the authors suggest that problems associated with implementation of no-smoking policies in these settings have been underreported. Over a two-year period after implementation of a smoking ban on inpatient units at a Veterans Affairs medical center, an estimated 20 to 25 percent of patients who smoked had difficulty adjusting to the ban, and some patients experienced major disruption in their treatment. Four cases illustrating problems in treating highly disturbed, nicotine-dependent patients are presented. The authors recommend that inpatient settings where smoking is banned should accommodate patients who cannot tolerate abrupt smoking cessation by providing smoking areas or allowing off-unit smoking breaks.

Adult↗
PubMed1989

Management of HIV-positive psychiatric patients who fail to reduce high-risk behaviors.

The authors describe clinical and legal dilemmas faced by staff involved in providing inpatient psychiatric treatment to two HIV carriers who continued to practice high-risk behaviors after learning of their HIV infection. Staff were unsure of their obligation to report the patients under a state law giving the commissioner of health broad discretion to limit the freedoms of HIV-infected individuals who continue to practice high-risk behaviors. Treatment of the patients also raised concerns about the appropriateness of treating noncompliant HIV-infected patients in traditional psychiatric settings and the lack of suitable aftercare facilities. The authors advocate developing a specialized treatment approach for noncompliant HIV-infected patients and provide a series of recommendations that might serve as the foundation for such an effort.

Acquired Immunodeficiency Syndrome↗
PubMedDate not supplied

The voluntary acceptance of HIV-antibody screening by intravenous drug users.

Intravenous drug abusers in a methadone program in Minnesota were offered HIV-antibody screening to determine the degree of interest in screening and extent of infection. Thirty-nine (85 percent) were willing to be tested. Only seven refused. All patients were aware of acquired immunodeficiency syndrome (AIDS) and their high risk of exposure to the AIDS virus through sharing of injection paraphernalia. None reported exposure to additional risk factors, such as homosexual or bisexual activity or having received a blood transfusion. Of the patients tested, none was positive for HIV antibodies. The high degree of patient interest in screening was unanticipated as was the lack of positive laboratory findings for HIV antibodies. Factors associated with acceptance of testing included patient awareness of high seroprevalence rates, indifference to potential negative social consequences of positive HIV-antibody status, and the voluntary nature of the testing. These findings raise a cautious sense of optimism about HIV-antibody screening for similar risk groups.

Adult↗