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A psychiatric POMR for use by a multidisciplinary team.

A psychiatric problem-oriented medical record designed for use by multidisciplinary teams was introduced at Fairfield Hills Hospital in Newtown, Connecticut, in 1972. The need for revision in the hospital's medical record system had been pointed up by the development of the teams, which shared more equally in responsibility for patient care, and by problems in meeting Medicare standards. The authors describe the various forms that make up the POMR. Most of the forms are completed by the teams in regularly scheduled conferences.

Connecticut

Management of primary bladder cancer by a multidisciplinary team.

Results of management of a closed series of primary bladder carcinoma over a 20-year period by a multidisciplinary team are presented. Patients were classified by the TNM method before treatment. These experiences indicate that stage and grade are relevant to prognosis and treatment. The TNM classification can be precise and practical when used diligently by a treatment team. Although no new methods of treatment are offered, the treatment now available may be utilized to better effect if programmed to allow care of the patients by a team, especially if the team explores the limits of radiation and surgery in their hands.

Adenocarcinoma

Behavior modification of chronic pain: a treatment program by a multidisciplinary team.

A treatment program for chronic pain is reported which focuses on modification of patient pain behavior. After an outpatient pain clinic screening by a multidisciplinary team, the patient with chronic pain (duration of 6 months or longer) is admitted for a 7--8 week inpatient program followed by a 4-week outpatient period. The first week of the inpatient program is used for evaluation of pain behaviors, recording use of pain medications, activity levels, and tolerance for special conditioning exercises. The program is aimed at extinguishing pain behaviors and use of pain medications, increasing activity level, reinforcing well behaviors, and returning patients to full active lives, normal for their sex and age. Of the 34 patients completing the program and returning to full active normal lives, 74% (25) have maintained this attained goal at the time of follow-up from 6 months to 7 years later.

Adult

Some personality differences among the multidisciplinary team.

Professional and student psychologists, social workers, physiotherapists and occupational therapists were administered a demographic questionnaire, the Dogmatism Scale and the Personality Research Form. Significant and trend differences on each of these measures were obtained between the four professional groups, the professional and student groups and the professional groups and the norms for the measures. The possible role of these differences in the operation of the multidisciplinary team is discussed.

Authoritarianism

Psychiatric training for emergency medicine residents on a multidisciplinary team.

The Cincinnati General Hospital Emergency Department has a training program for emergency medicine residents on a multidisciplinary emergency psychiatry team. This essential training should occur in the emergency department setting rather than in psychiatric inpatient units of state hospital settings. There are advantages and disadvantages to this arrangement. Nonmedical members of the emergency psychiatry team train and support emergency medicine residents in a multidisciplinary approach to treatment. Some observations are made about how the emergency medicine residents deal with emotionally disturbed patients. Finally, 80% of emergency medicine residents responded to questionnaire on their reactions to the multidisciplinary emergency psychiatry team.

Attitude of Health Personnel

Verbal communication between students in multidisciplinary health teams.

The study reported here was connected with the influence of two variables--the context in which communication occurs, and the concept availability of various health professionals--upon the verbal interaction of various health professionals. Specifically, the verbal output of health professionals in groups consisting entirely of their own professional peers (i.e. all nurses, or all medical students) was compared with that of professionals in multidisciplinary health teams. The study, in attempting to delineate possible barriers to effective verbal interaction, has important implications for the functioning of multidisciplinary health teams.

Australia

The school health team and school health physician: new role and operation.

A new concept of school health redefines the school physician's role as dealing primarily with behavior and learning disorders in children. It is an on-site operation, using a multidisciplinary team of professionals. We outlined internal team operations, as well as modes of remediation. Many types of behavior and learning problems were seen by our school health team during the first year of operation. It is important to recognize the multiplicity of diagnoses on individual elementary school children, as well as the differentiation of early organics from late functional primary causes. We need to reassess the delivery of school health care. The expansion of school health to include the multidisciplinary team approach to behavior and learning problem is a primary priority. We suggest using outside medical agencies for periodic physical illness.

Adolescent

[Introduction to the epidemiological study of five years of extra-hospital psychosocial practice at Ixelles].

This work is aimed at encompassing five years (1969-1973) of extra-hospital psychosocial activity performed by a multidisciplinary team of the sector of the population of Ixelles (85.000 inhabitants). Apart from a population study, we have focused on all consultants (676 patients) in a statistical frame. We have defined three directions: 1. Obtaining a complete picture of the consulting population according to epidemiological and clinical variables. 2. The control in our daily practice of three classical goals which underline the work in sector (permanence -- multidisciplinary team work -- priority to psychotics). 3. The attempt to verify some common assertions in psychiatry, general and social: relationship between season and pathology, between obligation to consults (for the patient) and social class, between type of pathology and social class. Our results for the two last issues differ from those of Hollingshead and Redlich.

Adult