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V Tähkä

Publications and source records attributed to V Tähkä.

17 recordsLinked to original sources
PubMed1993

The patient-doctor relationship and metabolic control in patients with type 1 (insulin-dependent) diabetes mellitus.

OBJECTIVE: Our hypothesis was that patient-doctor relationship experienced positively by the patient is associated with adequate compliance behavior and thus to the long-term metabolic control of diabetes. METHOD: Cross-sectional study of 100 consecutive adult patients with Type 1 diabetes treated in a diabetes out-patient department. From a questionnaire, four scores (direct estimate of physician, satisfaction with the place of treatment, self-esteem score, security with the patient-doctor relationship) determining the patient-doctor relationship were formed. In score 3 (self-esteem score) the impact of the patient-doctor relationship to the patients' self-esteem was indirectly estimated. The anonymous data taken from diabetes register including information about treatment of diabetes, metabolic control and end-organ complications were returned together with the questionnaire. On the basis of GHbA1c diabetic patients were divided into two groups: with adequate metabolic control (GHbA1c < or = 8.0%) or with poor/moderate control (GHbA1c > 8.0%). RESULTS: In univariate analyses the score 3 associated with metabolic control (p < 0.001). In logistic regression analyses the nephropathy (t = 2.80, p < 0.05) and score 3 (t = 3.98, p < 0.001) were associated with metabolic control. CONCLUSION: Patient's positively-experienced patient-doctor relationship was associated with good metabolic control of diabetes.

Adult↗
PubMed1987

On the early formation of the mind. I: Differentiation.

This is the first of three papers, in which the early structuralization of the mind is investigated. The main themes dealt with in this paper are the following: The earliest ways of experiencing are discussed and two successive levels of psychological experiencing are distinguished. The undifferentiated mind is conceptualized as a pure pleasure formation. Undifferentiation is regarded as especially susceptible to adultomorphic misinterpretations. The part object concept and the ways to conceptualize symbiosis are examples. Undifferentiated representations of gratifications are examined both as primary structures with a regulatory function and as raw material for the emerging self and object. The birth of self-experience, initiating differentiation, is proposed to originate from the first mentally represented pain. Self and object are seen to emerge as 'all good' and are therefore constantly threatened by frustration-aggression, made possible by the differentiation. Drive theory is briefly considered. Drive is defined as a purely energic concept without qualities of its own. Aggression is not regarded as an independent drive but as the way frustration originally becomes mentally represented. Anxiety is defined and discussed as a primary affective experience of the self when its existence is threatened. Finally, after questioning the so-called symbiotic longings, the earliest ways of protecting the primary differentiation are discussed.

Aggression↗