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Reality therapy: a realistic approach to enterostomy rehabilitation.
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An outcome evaluation of reality orientation therapy with geriatric patients in a state mental hospital.
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Reality orientation therapy: a study investigating the value of this therapy in the rehabilitation of elderly people.
The Leeds Technique for Therapy with the Aged is described and evaluated. The purpose of the study was two-fold--to evaluate the therapy itself, and to examine it as a possible extra incentive for nurses working with the aged. Forty-six elderly patients were included in the study. Fourteen took part in a pilot study. Later, in a more carefully controlled investigation, the remaining 32 patients were divided into two groups, one of experimental subjects and one of control subjects. Improvement was assessed using the Clifton Assessment Schedule (CAS) and the Stockton Geriatric Rating Scale (SGRS). Twenty-five of the 30 experimental subjects improved and 10 were discharged. Eight of the 16 control subjects improved, but none was discharged.
[The panorama of illnesses in advanced age. On the possibilities and reality of therapy].
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Controversies and realities of therapy for varicosis.
Proponents of surgical eradication of varicose veins claim a high cure rate. Proponents of the conservative methods of multiple injections of sclerosing agents claim that this money-saving ambulatory method avoids hospitalization and loss of working time, that the end results are quite satisfactory and that any recurrences can be easily dealt with by reinjections. Both methods are effective. Both have their indications. Many surgeons use sclerotherapy after surgery as complementary therapy. Radical views recommending surgery or injections exclusively are contrary to the principles of good medical care and do injustice to the patient. A simple venographic technic demonstrating the status of the greater saphenous veins is described.
Boron neutron capture therapy for cancer. Realities and prospects.
Boron neutron capture therapy (BNCT) is based on the nuclear reaction that occurs when a stable isotope, boron-10 (10B), is irradiated with low-energy thermal neutrons (nth) to yield (4He) alpha-particles and 7Li nuclei (10B+nth-->[11B]-->4He+7Li+2.31 MeV). The success of BNCT as a tumoricidal modality is dependent on the delivery of a sufficient quantity of 10B and nth to individual cancer cells to sustain a lethal 10B(n, alpha) 7Li reaction. The current review covered the radiobiologic considerations on which BNCT is based, including a brief discussion of microdosimetry and normal tissue tolerance. The development of tumor-localizing boron compounds was discussed, including the sulfhydryl-containing polyhedral borane, sodium borocaptate (Na2B12H11SH), and boronophenylalanine (BPA), both of which are currently being used clinically in Japan as capture agents for malignant brain tumors and melanomas, respectively. Compounds currently under evaluation, such as boronated porphyrins, nucleosides, liposomes, and monoclonal antibodies (MoAbs), were also considered. Nuclear reactors have been used as the exclusive source of neutrons for BNCT. The use of low-energy (0.025 eV) thermal neutrons and higher-energy (1-10,000 eV) epithermal beams, beam optimization, and possible alternative neutron sources (accelerators) were also discussed. Clinical studies performed in the United States during the 1950s and 1960s for the treatment of malignant brain tumors were reviewed. Current studies in Japan and future studies in Europe and the United States concerning the treatment of glioblastomas and melanomas by BNCT were discussed, as were critical issues that must be addressed if BNCT is ever to be a useful therapeutic modality.
The Iowa therapeutic community model of chemical dependency treatment.
A model of inpatient chemical dependency treatment used in several facilities in Iowa is described. Through combining 12 Step, Therapeutic Community and Reality Therapy concepts, the issues of denial, control, and self centeredness are addressed in developmental phases. Individualizing the program through multidisciplinary input is explained in terms of identifying hindrances in perceiving reality and assisting the patients reduce resistance in a downhill process of increasing wholeness and growth.
Reality orientation. A milieu therapy used in an institution for the aged.
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[Language destruction in the derealization- and depersonalization process].
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Reality orientation, a therapy for psychogeriatric patient: a controlled study.
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The idealisation of therapy: fantasy versus reality in clinical practice.
In this paper, object-relations theory is used to illuminate problems encountered in the psychotherapeutic management of severely disturbed psychiatric patients. The hazards of idealisation of the psychiatrist by the patient are reported in four case histories. Attention is drawn to the subsequent breakthrough of negative feelings where idealisation had been unrecognised or unwittingly encouraged. Some implications for the more successful management of the transference in patients such as these are discussed.
Therapy for the elderly: return to reality.
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Electroshock therapy: myths and realities.
The methodology of the 1940s provided the data base for the myths that grew up around electroshock therapy. Since then indications have been refined and techniques drastically revised--as with many other medical treatments. When administered for carefully defined indications, in the proper setting by an experienced team, and with appropriate safeguards, EST is safe, effective, and often the treatment of choice.
[Reality approach in senile dementia. Fundamental methodologies of occupational therapy in psychogeriatrics].
Occupational therapy in psychogeriatrics has always been practiced empirically, aimed mainly at merely occupying patients. In the light of recent findings from the old age psychological research, a specific method should cope with certain forms of lost intellectual capacities. The purpose of this work is to define as accurately as possible the field of occupational therapy in psychogeriatrics. Three main concepts towards a systematic approach can be proposed: a) Those related to a careful observation of spontaneous activities dealing with the relationship between the patient and the world around him, and which lead to a classification of these activities. b) Concepts related to the most elementary level of intervention in occupational therapy termed as "objective relationship", in other words the construction of the external objective world as opposed to the world of phantasms or magical thought. c) Concepts, at a more sophisticated level, related to the instrumental aspects of traditional occupational therapy. An important distinction should thus be made between local and inclusive constituent parts of an activity.
Tissue plasminogen activator for thrombolytic therapy: expectation versus reality.
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Pragmatic realities in uremia therapy.
The present status and future prospects of uremia therapy in the United States are reviewed. Approximately 3500 renal transplants were done in 1976 as compared to 3700 in 1975. Functional two-year survival of grafts has not changed recently (40 to 45 per cent for cadaver donors; 70 to 75 per cent for siblings), but patient survival with cadaver grafts continues to improve (now 65 per cent at two years). Patients on hemodialysis in facilities are increasing rapidly. Only 13 per cent are on home dialysis, as compared with nearly 40 per cent five years ago. Home patients do at least as well as those in centers (80 per cent two-year survival) and cost 40 per cent less. Physician bias probably explains the trend to center dialysis, but pending legislation may provide new incentives for home treatment. Prospects for technical advances are good, but a greater federal investment in research and development is needed. Dollars saved on the center dialysis could be used for this purpose.
Community therapy. Milieu therapy: the need for individualization.
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