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The psychological management of the patient with chronic illness and his family
149 ence with eight patients in an ICU is described, and guidelines are given for family meetings. Factors assuring a successful family meeting include careful attention to leadership, timing, communication, and clear priorities. THE ROLE OF THE HEALTH PROFESSIONAL
The basic tenet of the paper is that health education is part and parcel of the nursing process and, therefore, greater involvement of nurses in health education is a logical and rational extension of their role. EVALUATION
8) The psychological management of the patient with chronic illness and his family LEVENSTEIN, S. Hum. Behav. Subcommittee, Fae. Gen. Pract., Coll. Med. South Africa, Cape Town, South Africa L A # . Med. J. 57(10), 361-362, 1980
10) The role of lay workers in community health education: Experiences of the North Karelia project NEITTAANMAKI, L., KOSKELA, K., PUSKA, P., and McALISTER, A. L. Co-Ordinating Cent., North Karelia Project., Univ. Kuopio, Finland Scand. J. Soc. Med. 8(1), 1-7, 1980
Chronic illness, whether physical or mental, has a profound psychological effect on the affected individuals and their families. It is necessary for the general practitioner to h a v e a good grasp of these aspects of the care of such patients and their families, not only in order to be of Assistance in alleviating the emotional stresses that chronic illness places on them, but also so as to ensure.maximal compliance with the treatment regimen of the illness itself. Studies have demonstrated that the most important factor determining patient compliance is the quality of the doctor-patient relationship. Special mention is made of the "illness solution" in families and the ways in which the gen:ral practitioner can deal with this situation.
The role of natural community leaders in serving as lay health workers in a comprehensive community health program has been explored. In rural Finland, nearly 300 persons were trained to detect cardiovascular risk factors (smoking, high-cholesterol diet, high blood pressure) in their communities, and to advise community members of the desirability of lowering these risk factors. Initial data from studies of the lay health workers and their intervention work support the concept that carefully selected community health workers, who are to varying degrees representative of their local populations, can act effectively as intermediaries in preventive health care strategies.
9) The challenge of health education for nurses in the 1980s SMITH, J. P. Brent Hlth. Dist., London, United Kingdom I. Adv. Nuts. 4(5), 531-543, 1979 As nurses are the largest group of health workers, it is argued that their potential for influence, so far as health education is concerned, is very great. The health problems associated with demographic changes in British society, smoking, alcohol, road accidents, dental decay, mental health and the sexual revolution, are focused on; and the health education contribution ~hat nurses (and other health workers) can make to alleviate and prevent problems is discussed. The important role of "significant others" is also stressed. Problems associated with general lack of basic biologizal and health information, and with the physically handicapped and immigrant groups are also noted ,vith concern and are considered to be particular "hallenges to nurses. Nurses are urged to develop Lheir social skills, to constantly update their knowlzdge about British society, and to commit themselves ~o the aims of health education. It is also argued that Ihey need missionary zeal so that they will take health -~ducation to the people in the community at large.
[~RD QUARTER/1980
11) Ethical conflicts in long-term care of the aged: Nutritional problems and the patient-care worker relationship NORBERG, A., NORBERG, B., GIPPERT, H. and BEXELL, G. Dept. Int. Med., Univ. Lund, St. Lars Hosp., Lund, Sweden Br. Med. J. 280(2611), 377-378, 1980 The relationship of the patient and care worker was analyzed by observation and unstructured group discussion in four long-stay somatogeriatric wards at Saint Lars Hospital. Investigation centered on patients entering the terminal phase who could no longer be spoon-fed. The relationship was complicated and reciprocal, and failure by the care worker to interpret 'her role and the dying patient's behavior correctly led to emotional conflict and double-binding, with resultant anxiety for both herself and the patient. Infusions and tube-feeding prescribed in such cases were given not for the patient's benefit but to relieve anxiety in care workers and relatives. Permitting the patient a natural, painless death from water deficiency may be preferable to prolonging pain and discomfort by intervening with infusions and tube-feeding.
The basic tenet of the paper is that health education is part and parcel of the nursing process and, therefore, greater involvement of nurses in health education is a logical and rational extension of their role. EVALUATION
8) The psychological management of the patient with chronic illness and his family LEVENSTEIN, S. Hum. Behav. Subcommittee, Fae. Gen. Pract., Coll. Med. South Africa, Cape Town, South Africa L A # . Med. J. 57(10), 361-362, 1980
10) The role of lay workers in community health education: Experiences of the North Karelia project NEITTAANMAKI, L., KOSKELA, K., PUSKA, P., and McALISTER, A. L. Co-Ordinating Cent., North Karelia Project., Univ. Kuopio, Finland Scand. J. Soc. Med. 8(1), 1-7, 1980
Chronic illness, whether physical or mental, has a profound psychological effect on the affected individuals and their families. It is necessary for the general practitioner to h a v e a good grasp of these aspects of the care of such patients and their families, not only in order to be of Assistance in alleviating the emotional stresses that chronic illness places on them, but also so as to ensure.maximal compliance with the treatment regimen of the illness itself. Studies have demonstrated that the most important factor determining patient compliance is the quality of the doctor-patient relationship. Special mention is made of the "illness solution" in families and the ways in which the gen:ral practitioner can deal with this situation.
The role of natural community leaders in serving as lay health workers in a comprehensive community health program has been explored. In rural Finland, nearly 300 persons were trained to detect cardiovascular risk factors (smoking, high-cholesterol diet, high blood pressure) in their communities, and to advise community members of the desirability of lowering these risk factors. Initial data from studies of the lay health workers and their intervention work support the concept that carefully selected community health workers, who are to varying degrees representative of their local populations, can act effectively as intermediaries in preventive health care strategies.
9) The challenge of health education for nurses in the 1980s SMITH, J. P. Brent Hlth. Dist., London, United Kingdom I. Adv. Nuts. 4(5), 531-543, 1979 As nurses are the largest group of health workers, it is argued that their potential for influence, so far as health education is concerned, is very great. The health problems associated with demographic changes in British society, smoking, alcohol, road accidents, dental decay, mental health and the sexual revolution, are focused on; and the health education contribution ~hat nurses (and other health workers) can make to alleviate and prevent problems is discussed. The important role of "significant others" is also stressed. Problems associated with general lack of basic biologizal and health information, and with the physically handicapped and immigrant groups are also noted ,vith concern and are considered to be particular "hallenges to nurses. Nurses are urged to develop Lheir social skills, to constantly update their knowlzdge about British society, and to commit themselves ~o the aims of health education. It is also argued that Ihey need missionary zeal so that they will take health -~ducation to the people in the community at large.
[~RD QUARTER/1980
11) Ethical conflicts in long-term care of the aged: Nutritional problems and the patient-care worker relationship NORBERG, A., NORBERG, B., GIPPERT, H. and BEXELL, G. Dept. Int. Med., Univ. Lund, St. Lars Hosp., Lund, Sweden Br. Med. J. 280(2611), 377-378, 1980 The relationship of the patient and care worker was analyzed by observation and unstructured group discussion in four long-stay somatogeriatric wards at Saint Lars Hospital. Investigation centered on patients entering the terminal phase who could no longer be spoon-fed. The relationship was complicated and reciprocal, and failure by the care worker to interpret 'her role and the dying patient's behavior correctly led to emotional conflict and double-binding, with resultant anxiety for both herself and the patient. Infusions and tube-feeding prescribed in such cases were given not for the patient's benefit but to relieve anxiety in care workers and relatives. Permitting the patient a natural, painless death from water deficiency may be preferable to prolonging pain and discomfort by intervening with infusions and tube-feeding.