Rebecca Cogwell Anderson

Psychological adjustment following work-related hand injury : 18-month follow-up

Severe, work-related hand injuries are often accompanied by a significant number of psychological symptoms that are frequently associated with posttraumatic stress disorders. These symptoms occur in the following four domains of psychological functioning: cognitive, affective, physiological, and behavioral. This study examined the incidence of a variety of symptoms occurring with work-injured patients. Interviews were conducted at 1 week, 3 months, 6 months, 12 months, and 18 months after injury. Symptom frequencies were recorded. The results indicate that many of these symptoms were persistent 18 months later and continued to be significantly debilitating. The results support the need for psychological intervention after severe, work-related hand injuries.

What Influences Public Perceptions of Silicone Breast Implants

In an effort to determine public attitude regarding breast implants in the wake of what many might consider biased media publicity, surveys of women and men in Milwaukee were made. Questionnaires appropriate to each of four groups [patients with reconstructions (n = 54), mastectomy without reconstruction (n = 14), those with augmentation mammaplasty (n = 26), and the general public (n = 60)] were administered. Some of the findings included the following: Over 98 percent had heard of the controversy; most had received their information from the media, with less than 10 percent referring to a medical journal; only 6 percent felt that the media coverage was objective, while 88 percent felt that the media were biased; almost two-thirds of those in the general population were not aware of any other method of reconstruction; and almost half that same group would have significant hesitancy in having the procedure on themselves or a family member were it indicated. In summary, our findings would substantiate the fact that the media do exert a very significant influence on the publics perception of silicone breast implants. Though most people surveyed generally consider the media biased, they still use them as the primary source for their negative conclusions on the matter. Though the media cannot be viewed as our ally in this matter, we, as a group, might be better served by minimizing conflict, which makes the whole issue less newsworthy.

Complications and salvage of an ectopically replanted thumb

The ectopic replantation of a thumb is described after a mutilating hand injury. The case was followed by a series of complications and surgical procedures to treat these complications. Through perseverance and multiple microsurgical procedures the patient attained a functional hand. The patients psychological and physical course is described.

Psychological well-being of the breast reconstruction patient: a pilot study.

Though the sample size is small and limited to Caucasian women, the results of this study are promising with respect to a positive adjustment following breast cancer and breast reconstruction. The individuals in this group were functioning very well psychologically. These women were relatively free of anxiety and depression. They employed useful means of coping and held appropriate attributions with respect to their own health. A limitation of the study was the lack of a control group, and the principal investigator is currently conducting another study that employs a control group as well as comparisons with women who have undergone mastectomy without reconstruction and lumpectomy. Continued research regarding psychological well-being of women with breast cancer in general and women who undergo reconstruction specifically is recommended.

RECONSTRUCTION AND AUGMENTATION PATIENTS' REACTION TO THE MEDIA COVERAGE OF SILICONE GEL-FILLED IMPLANTS: ANXIETY EVALUATED

Media coverage tends to focus on sensational aspects. Especially prominent are controversial items related to public health and well-being. This research examined the response by breast-reconstruction and breast-augmentation patients to extensive media coverage regarding silicone gel-filled implants. Results of our survey suggested that media coverage influenced these women. Common concerns expressed by respondents included autoimmune disease, capsular contracture, leakage, increased risk of cancer, and anxiety. All respondents used consultation with their physicians as a primary means of coping with anxiety. Anxiety over media coverage Jed to some hesitancy concerning use of implants by surveyed patients. Patients who experienced difficulty with their reconstruction noted more anxiety associated with media coverage

Body dysmorphic disorder: recognition and treatment.

&NA; Body dysmorphic disorder (BDD) is classified as a somatoform disorder in the Diagnostic and Statistical Manual of Mental Disorder ‐IV‐TR (DSM‐IV‐TR) (American Psychiatric Association, 2000). According to the DSM‐IV‐TR, BDD is characterized as a preoccupation with an imagined defect in appearance. If a slight physical anomaly exists, the persons concern is markedly excessive and this preoccupation causes clinically significant distress or impairment in social, occupational, or other important areas of functioning. This diagnosis is most appropriately used when symptoms associated with this dissatisfaction with the body shape and size are not better explained by an eating disorder (American Psychiatric Association, 2000).

The need to modify health education programs for the mentally retarded and developmentally disabled

The health of individuals who are diagnosed as developmentally disabled or mentally retarded has long been a concern of health professionals. Historically health education has addressed the life style and health issues associated with the norm of the population. While there have been many advances in health education which are admirable, modification of health education programs for the developmentally disabled remains an important consideration. Those areas of health education which might be adapted to the developmentally disabled include mental and emotional health, substance abuse, sexuality and reproduction nutrition, weight control, fitness, and other factors related to disease prevention and overall health and well being. From a review of the literature, it seems that successful modification of health education materials for the developmentally disabled incorporates the use of repetition, involvement of health care providers and family, a focus on managing stress and value clarification as well as the enhancement of self-esteem and self-worth. In general, the health issues of concern for the mentally retarded and the developmentally disabled are not markedly different from that of the general population. It does appear that additional research is necessary for the adaptation of programs which could provide this much needed training for developmentally disabled and mentally retarded individuals.

A Worksite Parenting Program

With more and more companies offering wellness programs for their employees, it seems reasonable to offer parent training classes to employees as an educational tool and a means of coping with stress. A series of parenting classes was developed using the STAR Parenting Model. The STAR Model teaches parents to stop, think, ask, and respond to their children based on tenets of cognitive behavior management. Classes taught to faculty and staff of the university were well attended and participants indicated that the method positively altered their parenting practices. Parents are challenged by their young children and by their jobs and careers. Parenting education at work may help to ease some employee stress and improve their parenting practices.

Adjustment Issues Related to Bilateral Prophylactic Mastectomy in Women at Elevated Risk of Developing Breast Cancer

Breast cancer is the most common cancer diagnosis for North American and Western European women. Increased knowledge in availability of genetic testing has helped to identify those women at high risk of eventually developing breast cancer. This has resulted in more women considering bilateral prophylactic mastectomy as a viable preventative option. Although the efficacy of the procedure has been established, much less is known about the psychological impact of undergoing this procedure. In order to assess these factors, we reviewed what is currently known about the psychological impact of undergoing bilateral prophylactic mastectomy. Searches were conducted and inclusion criteria revealed articles that focused on the psychological components involved with undergoing a bilateral prophylactic mastectomy. The findings are summarized and fell broadly into one or more of the following three areas: (1) satisfaction or regret following the surgery, (2) psychosocial functioning after the surgery, and (3) predictors of quality of life. Plastic surgery nurses have a unique opportunity to impact important psychological considerations, such as expectations of the early postoperative period, body image concerns, and psychological distress.

Success and Failure Attributions in Smoking Cessation among Men and Women

1. Smoking behavior is intermingled with a very complicated array of social and psychological processes which suggests the presence of sociocultural factors that directly influence smoking behavior. 2. Social and cultural factors which distinguish former smokers from smokers indicate that behavioral factors may be related to the ability to successfully stop smoking. 3. Evidence suggests that attributional patterns differ according to gender, with women being more external and employing more luck attributions than men. 4. When attribution and self-efficacy expectations were combined with demographic variables, increased understanding of the cessation process increased and predictive power of success in smoking cessation improved.