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Journal ArticleDOI

Psychological aspects of the care of children with cystic fibrosis.

01 May 1970-JAMA Pediatrics (American Medical Association)-Vol. 119, Iss: 5, pp 424-432
TL;DR: With early recognition of the disease the patient and his family often become involved in a program of intensive treatment that continues for the remainder of his life, with death usually intervening in early adult life.
Abstract: Recent advances in detection and management of cystic fibrosis have significantly improved the affected individual’s chances of survival beyond childhood years. With early recognition of the disease the patient and his family often become involved in a program of intensive treatment that continues for the remainder of his life.1’3 The daily care at home necessitates large expenditures of time and effort for the patient and his parents. The financial burden can be considerable, resulting often in the depletion of savings and the forgoing of luxuries and vacations. Siblings frequently must defer their needs and desires as the patient becomes the focus of attention. In the more severe cases, recurrent hospitalization of the sick child for complications disrupts family routine and creates emotional crises. Finally, despite the most adequate care, the course of the disease may be inexorable, with death usually intervening in early adult life4.
Citations
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Journal ArticleDOI
TL;DR: A new, simple, and comprehensive system for evaluating patients with cystic fibrosis based primarily on pulmonary parameters of the disease and considers simple pulmonary function tests and certain complications which have been shown to have prognostic significance is presented.

270 citations

Journal ArticleDOI
TL;DR: Psychiatric disorders and behaviour problems were found to be commoner in children and adolescents with inflammatory bowel disease (IBD) than in matched comparison groups with tension headache and diabetes as well as in healthy children.
Abstract: Psychiatric disorders and behaviour problems were found lo be commoner in children and adolescents with inflammatory bowel disease (IBD) than in matched comparison groups with tension headache and diabetes as well as in healthy children. Depression, anxiety and low self-esteem were common. Many children denied their problems. This may be due to the type of illness, its social consequences and the embarrassment experienced by the children. Discrepancies were found between the children's and their mothers' replies. These results are discussed in terms of their implication fur paediatric practice.

154 citations

Journal ArticleDOI
TL;DR: The unique feature of severe psychopathology secondary to physical disorder was marked social isolation accompanied by a low level of aggressive behavior outside the home.
Abstract: Psychiatric disorder in 304 children with four congenital conditions was compared with that of 360 normal children and across conditions, three that involve the brain and one that does not. Children with physical disability were at increased risk for psychiatric disturbance. Those with conditions involving the brain had greater psychopathology than children with cystic fibrosis. Severity of physical disability had little effect on psychopathology. The risk of psychiatric disturbance in children with conditions involving the brain varied directly with level of mental retardation. In addition, brain involvement conferred a risk of social isolation independent of mental retardation. The unique feature of severe psychopathology secondary to physical disorder was marked social isolation accompanied by a low level of aggressive behavior outside the home.

152 citations

Journal ArticleDOI
TL;DR: Several domains were identified in which siblings as well as parents of sick children were more susceptible to adjustment problems, though 'risk' seemed to relate more closely to illness-specific variables than the presence or absence of illness.
Abstract: Summary Focusing on the adjustment of the siblings of three groups of male children; with pervasive developmental disability, diabetes and no known chronic illness, the present study failed to support the view that siblings of ill children are uniformly at greater risk for psychosocial impairment. However, several domains were identified in which siblings as well as parents of ill children were more susceptible to adjustment problems, though ‘risk’ seemed to relate more closely to illness-specific variables than the presence or absence of illness. Several sex differences were found suggesting that same-sexed siblings may be more vulnerable to maladjustment than opposite-sexed pairs. The results are discussed in terms of their implications for investigation and intervention for families with an ill member.

139 citations

Journal ArticleDOI
TL;DR: A new conceptual model of parental overprotection is presented which takes into account child, parent, family, socio-cultural, environmental and resiliency factors.
Abstract: Dimensions of parental overprotection are clarified in a critical review of the research and clinical literature. An indulgent style of parenting is distinguished from an overprotective parent-child relationship. Differential antecedents and outcomes are proposed for each of these forms of parent-child interaction. Measures of protection are reviewed. A new conceptual model of parental overprotection is presented which takes into account child, parent, family, socio-cultural, environmental and resiliency factors. Directions for future research are suggested.

119 citations

References
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Book
01 Jan 1960
TL;DR: In this paper, the ego wards off unpleasure and anxiety, and exercises control over impulsive behavior, affects, and instinctive urges, in psychoanalytic psychology.
Abstract: This book deals with one particular problem that is with the ways and means by which the ego wards off unpleasure and anxiety, and exercises control over impulsive behavior, affects, and instinctive urges. It is a major contribution to psychoanalytic psychology.

2,700 citations

Book
01 Jan 1959
TL;DR: The American Handbook of Psychiatry is an attempt to catalogue and explain the development of psychiatry in the United States in the period of 175 years.
Abstract: AMERICAN HANDBOOK OF PSYCHIATRY , AMERICAN HANDBOOK OF PSYCHIATRY , کتابخانه مرکزی دانشگاه علوم پزشکی ایران

1,170 citations

Journal ArticleDOI
TL;DR: The need for the total family to have an understanding and awareness of CF and to share such knowledge with one another is pointed up; that all problems of the family have to be considered and not just those of the CF child; and that help from other professional people should be utilized along with sources of the community.
Abstract: This study was undertaken to determine whether families of children with cystic fibrosis were experiencing difficulties in meeting family needs and in maintaining normal family relationships. It was found that families were not deprived of the essentials of living, but they were not able to maintain their usual pattern of family relationships. Time and energy precluded carrying on activities with each other and with the children; and there was breakdown in their ability to communicate adequately between themselves and the children regarding important family issues. In order to preserve the family as a functioning unit, someone has to be concerned about the entire family. Of necessity, the family has focused on the sick child, leaving the physician, the nurse, the social worker and/or the social agencies to help the family refocus on its total situation, rather than just a part of it. Traditionally, the mother takes care of the sick child. It is she who takes the child to the doctor9s office and is responsible for carrying out his recommendations. In the care of a CF child, she assumes a heavy burden and frequently is fatigued from this responsibility. Because she is so tired and so occupied, she may misunderstand or distort what she is told by the physician, and may not be able to tell her husband or the children what they need to know in order to participate in family activities and in the care of the CF child. This situation can easily lead to misunderstanding and tension within the family. To avoid this, both parents could be encouraged, at some point, to come together to the physician9s office for discussion. Such discussions could lead to more consideration and appreciation being given to each other. It might lessen the tendency for each to blame the other for the child9s illness and could avoid the feeling voiced by one mother, "I would like to blow him out of his chair so that he would help me and understand what I go through." We also need to realize that the CF child is frequently aware of the demands he makes on the family. If these demands are not discussed freely, then everyone is caught in a "web of silence" revolving around his own feelings of frustration. This creates a burden for everyone, including the CF child, and if not discussed it can impair the psychological functioning of all members. The CF child needs to be encouraged to participate in his own care program and to assume some responsibilities for himself. He should not reach the age of seven being unable to tie his own shoes or dress himself, as has been observed in some CF children. It would seem feasible, therefore, that the CF child should have an awareness of what is wrong with him, and what his abilities and limitations are. The other siblings should also be given as much explanation as possible because they, too, are part of the family and attention and care is being diverted from them. This explanation could make for more understanding on the sibling9s part. While it would still be difficult for him to accept some of the decisions made (such as why the parents could not get home from the hospital in order for him to use the family car for a senior prom), he would know that it was the situation that was causing the decrease in attention and care rather than rejection of him by the parents. In order to give these families as much assistance as possible, the community9s resources should be utilized. Frequently, the parents are unaware of these or need encouragement to avail themselves of services. The homemaker service or visiting nurse service could free the family from constant care; the local youth program could be helpful to the siblings in the family, and Family Service Agencies could be used for counseling on family problems. In summary, this study points up the need for the total family to have an understanding and awareness of CF and to share such knowledge with one another; that all problems of the family have to be considered and not just those of the CF child; and that help from other professional people should be utilized along with sources of the community.

86 citations