Showing papers on "Physical disability published in 1975"

Assessment of the psychosocial outcome after severe head injury.

Abstract: Rehabilitation services for the severely brain injured are often inadequate and one of the chief factors responsible is undue emphasis on the contribution of physical disability with scant attention to the serious emotional and intellectual handicaps incurred. Weakness, spasticity and dysphasis tend to recover eventually to a variable extent but mental handicap is often the cause of serious and lasting disablement. For a determination of the outcome of severe brain injury in terms of its effect on daily living, the relation between physical disability, mental handicap and social reintegration has been assessed quantitatively. Three assessment scales have been constructed and used in a study of 58 severely brain damaged patients. This revealed that the duration of post-traumatic amnesia correlates highly with the degree of social, mental and physical disability incurred. Daily living was affected primarily by impairment of intellect and personality and, to a lesser extent, by physical incapacity, but only rarely by the developments of symptoms of mental illness. Using the Wechsler Adult Intelligence Scale, the time course of cognitive recovery was also assessed. Recovery curves and the relation of cognitive impairment to social and physical handicap will be demonstrated.

Sexual conseling of the physically disabled.

Abstract: Sexual satisfaction and feelings of self-esteem play an important role in the ability to adapt to an acquired physical disability. A framework has been presented to show how sexual function is affected by different types of physical disability, and spinal cord injury has been selected as a specific example. Sexual counseling for the disabled differs little from that for the able-bodied--the same principles apply. It is appropriate to remind not only the counselor but also the disabled that (1) loss of sensation does not mean loss of feelings, (2) loss of potency does not mean loss of ability, (3) loss of urinary continence does not mean loss of penile competence, and (4) loss of genitalia does not mean loss of sexuality.

The family doctor and the social worker.

Abstract: Through cooperation with a social worker attached to his practice, a family doctor can obtain valuable help in coping with patients who present problems of marriage, parenthood, old age, bereavement, physical disability and psychiatric illness. This help does not replace that already available from existing services, need not interfere in the doctor-patient relationship, and increases the doctor's effectiveness.

Psychological Effects of Physical Disability

Abstract: SUDDEN physical trauma resulting in permanent disability can cause great psychological turmoil that may result in maladjustment unless help is available. An adult, disabled through sudden trauma, can be sure of receiving adequate medical treatment through the National Health Service. He has every probability, after the acute stage is over, of receiving rehabilitation through a team of several professionals, each treating the disability in his own particular way. The range of movement in a stiff joint will be measured and increased if possible, weak muscles will be strengthened and future training or employment may be discussed. Throughout all this it will be unlikely, at any point, for help to be offered with the psychological problems such an adult faces. He is expected to achieve adequate adjustment to what may be the most psychologically traumatic event of his life without professional help and often in circumstances that mitigate against such adjustment. Initially, he will face a dramatic change in his environment, a period in which sensory input is severely reduced. Not only may senses be damaged or sensation lost, in the atmosphere of a hospital bed total stimulation is reduced. It has been shown by Hebb' that such a reduction commonly leads to confusion and disorganization. There will also be considerable anxiety. As soon as consciousness of the present disability is sufficient the patient is aware of all the possible deprivations that may be his in the future but at the same time, unaware of the possible compensations. The doubt, which the doctor is often unable to allay at this stage, as to how severe and lasting the damage is, adds to this anxiety. Additionally, grief will be present especially if there is an actual loss, as in amputation or loss of sensation and movement in one or more limbs as in paralysis. The adult will be mourning his loss, with the typical components common to the grief reaction depression, a sense of loss and guilt. The latter has been little considered with the physically handicapped but is sometimes verbalized both by the patient and his contacts. The C.V.A. may say that he \"shouldn't have worked so hard\" or the R.T.A. \"if only he'd been more careful\". Their associates may clearly say \"He brought it on himself\" even if they do not say it to the patient. This guilt needs to be faced and resolved. During this initial stage the patient will be unusually susceptible to influence and to the example of those around him. It has not proved possible to correlate a particular pattern of response to a particular disability. (Fordyce.\") However acertain pattern of stages can be held to be usual in the newly disabled just as certain patterns have been discerned in other stressful situations. (For example the studies done on relocation through urban renewal, Brown 1965, and one on Unwed Mothers, Bernstein 1960). The pattern of these phases here is, according to Herman-