摘要:

ObjectiveTo test the hypothesis that changes in housing, particularly those involving social separations, would have a negative impact on survival in rhesus monkeys experimentally inoculated with the simian immunodeficiency virus (SIV).MethodsAn archival methodology was used. Colony records at four Regional Primate Research Centers were screened, and data pertaining to demographics, contents of the inoculum, medical history before and after inoculation, and housing relocations and social companions were coded. The final sample size totaled 298 individuals.ResultsFollowing statistical control of covariates, housing relocations and social separations in the 90-day period before SIV inoculation and in the 30-day period after inoculation were associated with decreased survival. There was evidence that housing disruptions occurring earlier after inoculation were associated with shorter survival. Finally, a subset of animals was found to have been socially housed after SIV inoculation; such experience had negative consequences for survival.ConclusionsThe results indicate that psychosocial experiences that likely produce a stressful state are associated with shorter survival in SIV-infected monkeys.

ISSN:0033-3174    

出版商:OVID    

年代:1998

数据来源: OVID

ISSN:0033-3174    

出版商:OVID    

年代:1998

数据来源: OVID

ISSN:0033-3174    

出版商:OVID    

年代:1998

数据来源: OVID

摘要:

ObjectiveTo assess whether work characteristics and social support are predictors of physical, psychological, and social functioning.MethodWork characteristics (Karasek and Siegrist models) and social support at baseline were used to predict health functioning measured by the SF-36 General Health Survey 5 years later in a prospective cohort study of 10,308 British male and female civil servants.ResultsEffort-reward imbalance and negative aspects of close relationships predicted poor physical, psychological, and social functioning after adjustment for the potential confounding effects of age, employment grade, baseline ill health, and negative affectivity. These psychosocial characteristics seem to act in a similar way in the healthy and those with existing illness. Psychological demands at work in women, and low confiding/emotional support in men, also predicted poor functioning. Etiologically, these effects are not mediated through health-related behaviors.ConclusionsNegative aspects of work (high demands and effort-reward imbalance) and negative aspects of close relationships are independent powerful predictors of poor health functioning. They may have an etiological role, which is independent of baseline illness.

ISSN:0033-3174    

出版商:OVID    

年代:1998

数据来源: OVID

ISSN:0033-3174    

出版商:OVID    

年代:1998

数据来源: OVID

ISSN:0033-3174    

出版商:OVID    

年代:1998

数据来源: OVID

摘要:

ObjectiveTo review the evidence supporting the biopsychosocial model in understanding patients with gastrointestinal disorders (GI).MethodEssay of personal experience and review of related literature through a MEDLINE search.ResultsThrough clinical examples of three common gastrointestinal disorders, a case is made to refocus our understanding from a biomedical or disease-based model of illness to a biopsychosocial model. With the latter model, the psychosocial and biological predeterminants are seen to interact in the clinical expression of illness and disease. With gastroesophageal reflux disease, the evidence shows that stress can lead to amplification of heartburn symptoms that is independent of the degree of reflux. Functional gastrointestinal pain is "an illness without disease," where structural or physiological disturbance of the GI system does not exist. Rather, the symptoms are understood in terms of visceral hypersensitivity as modulated by central nervous system activity. With the Crohn's disease example, the clinical expression of the disorder is not explained by the degree of disease activity. Rather, the symptoms and impaired quality of life relate to preexisting psychosocial determinants. The observed association of stress with disease activation in Crohn's disease is explained by stress-related alterations in psychoimmunological function via the hypothalamic-pituitary-adrenal axis.ConclusionsGastrointestinal disorders, as a model for other medical conditions, exemplify the important role of an integrated, biopsychosocial model of illness.

ISSN:0033-3174    

出版商:OVID    

年代:1998

数据来源: OVID

ISSN:0033-3174    

出版商:OVID    

年代:1998

数据来源: OVID

摘要:

ObjectiveWe investigated whether patient-centered communication skills can be taught to residents in Internal Medicine by using a time-limited behaviorally oriented intervention.MethodResidents working at the Department of Internal Medicine were randomly assigned to an intervention group (IG; N = 19) or a control group (CG; N = 23). In addition to 6 hours of standard medical education per week, the IG received specific communication training of 22.5 hours duration within a 6-month period. Initially and 10 months later, participants performed interviews with simulated patients. Interviews were rated by blinded raters who used the Maastricht History and Advice Checklist-Revised.ResultsCompared with the CG, the IG improved substantially in many specific communication skills. Both groups improved in the "amount of medical information identified" and in the ability to "communicate about feasibility of treatment."ConclusionPatient-centered communication skills such as those presented in this intervention study can be taught. The ability to gain medical information and the readiness to communicate about aspects of medical treatment seem to improve with more professional experience; however, they also profit from the intervention.

ISSN:0033-3174    

出版商:OVID    

年代:1998

数据来源: OVID

ISSN:0033-3174    

出版商:OVID    

年代:1998

数据来源: OVID