Self-image among early adolescents: revisited.

Early adolescence is the developmental period during which children make the physical, psychological, cognitive, and social transitions to adolescence. Because the development of a healthy conceptualization of the self is foundational to adequate functioning later in life, self-image is a concept of interest to clinicians and researchers. Offer, Ostrov, and Howard (1981) conducted considerable research in the area and demonstrated that early adolescents have the capacity for self-reflection and are willing to share their reflections with others. Most early adolescents tend to be self-conscious due, chiefly, to the numerous physical and emotional changes occurring during this time period (M. P. Strommen & A. L. Strommen, 1985). Behavior is characterized by moodiness, impulsiveness, peer influence (Robin, 1985), and a growing resistance to authority. These factors usually result in an awkward child attempting to exert independence in an unprecedented fashion about a variety of topics (Manning, 1983). The purpose of this study was to investigate the self-image of early adolescents, aged 11 to 14 years, in order to plan for the health and developmental needs of middle school children and their families. Survey data were collected to answer the questions: (a) What is the self-image of a representative sample of middle school students in the community?; and (b) Are there differences in self-image based on gender, race, and parental occupation?     

Self-image and burnout in psychiatric staff

Burnout was tested for in 754 mental health workers and related to self-image as assessed with Structural Analysis of Social Behavior (SASB, Benjamin 1974). A positive relation was found between burnout and negative self-image, and between the experience of personal accomplishment and positive self-image. Compared to self-image, gender, age and work setting did not explain any variance in burnout. Highly burned-out persons had a significantly more negative self-image than staff who had rated themselves as low burnout. Finally, the relation between self-image and burnout was studied in 210 subjects who had completed their self-image ratings one year before burnout was measured, with the same results: a negative self-image was related to higher burnout one year later. One general conclusion is that a tendency in staff to treat themselves in negative ways may function as a negative filter for coping with difficulties at work and thus be a risk factor for burnout.     

Diabetes, major depression, and functional disability among U.S. adults

OBJECTIVE: The goal of this study was to determine prevalence and odds of functional disability in individuals with diabetes and comorbid major depression compared with individuals with either diabetes or major depression alone. RESEARCH DESIGN AND METHODS: Data on 30,022 adults aged > or = 18 years from the 1999 National Health Interview Survey (NHIS) were analyzed. Four disease categories were created: no diabetes and no major depression, major depression alone, diabetes alone, and diabetes and comorbid major depression. Prevalence of functional disability was calculated for each disease category. Multiple logistic regression was used to determine the odds and correlates of functional disability by disease category controlling for age, sex, race/ethnicity, education, income, census region, and disability-associated comorbidity. STATA was used for all analyses to account for the complex survey design of NHIS. RESULTS: Irrevalence of functional disability by disease category was as follows: no diabetes and no major depression (24.5%); major depression (51.3%); diabetes (58.1%); and diabetes and comorbid major depression (77.8%). With no diabetes and no major depression as reference and after adjusting for relevant covariates, the odds of functional disability was 3.00 (95% CI 2.62-3.42) for major depression, 2.42 (2.10-2.79) for diabetes, and 7.15 (4.53-11.28) for diabetes and comorbid major depression. CONCLUSIONS: Individuals with diabetes and comorbid major depression have higher odds of functional disability compared with individuals with either diabetes or major depression alone. Additional studies are needed to establish a causal relationship.     

Work disability and diabetes.

OBJECTIVE: To determine the rates and demographic determinants of work disability, hours worked per week, work-loss days, and wages in individuals with diabetes. RESEARCH DESIGN AND METHODS: A probit regression analysis was performed on a cross-sectional population-based survey of U.S. noninstitutionalized civilian population (National Medical Expenditures Survey--2, 1987). The sample was restricted to individuals aged > or = 25 years. A total of 1,502 individuals reported having diabetes, and 20,405 did not. Information on workforce participation and income were collected quarterly. Work disability was defined as a self-report of having been unable to work because of illness or disability for > or = 2 quarters in 1987. RESULTS: Work disability was reported by 25.6% of individuals with diabetes, compared with 7.8% of those without diabetes. Work disability rates were higher for older people, females, and African-Americans, and lower for Hispanics and for individuals with greater non-wage income. Individuals with diabetes engaged in the workforce had more work-loss days than did nondiabetic individuals, but had similar hourly wages. Predicted mean earnings were significantly lower for individuals with diabetes at all ages, resulting in $4.7 million loss in earnings in 1987 due to work disability. CONCLUSIONS: Work disability is significantly higher for individuals with diabetes than for those without diabetes at all ages, and results in a significant decrease in earnings. A disproportionate burden of work disability is borne by older individuals and women with diabetes. Better information on the determinants of work disability in individuals with diabetes is needed.     

Pain,disability and rehabilitation practices. A phenomenological perspective

Purpose. Rehabilitation experts and disabled people are faced with the question of pain on a daily basis. This is a complex phenomenon with various different aspects: physiological, social, cultural and personal experience. In this article the author focuses on the personal experience of pain, i.e., the way in which it is experienced by the person in question and how it changes that person, his/her body and life; the author refers to cases of people who became disabled following a road accident or a neuromuscular illness, and takes a phenomenonological and philosophical standpoint.

Method. The article is based upon ethnographical observations made in three settings: assistance departments set up by an association, a wheelchair test centre and a rehabilitation centre.

Results and discussion. The experience of pain has been described as a rupture of a person's relationship with the outside world leading to a loss in capacity. Rehabilitation enables this link to be rebuilt by focusing on the body and thus changing the way in which the person feels his/her body.

Conclusions. This analysis highlights the importance of how pain is experienced and how it is taken into account in rehabilitation practices, whilst at the same time showing how rehabilitation changes this experience.     

Pain, disability and rehabilitation practices. A phenomenological perspective

Purpose. Rehabilitation experts and disabled people are faced with the question of pain on a daily basis. This is a complex phenomenon with various different aspects: physiological, social, cultural and personal experience. In this article the author focuses on the personal experience of pain, i.e., the way in which it is experienced by the person in question and how it changes that person, his/her body and life; the author refers to cases of people who became disabled following a road accident or a neuromuscular illness, and takes a phenomenonological and philosophical standpoint.

Method. The article is based upon ethnographical observations made in three settings: assistance departments set up by an association, a wheelchair test centre and a rehabilitation centre.

Results and discussion. The experience of pain has been described as a rupture of a person's relationship with the outside world leading to a loss in capacity. Rehabilitation enables this link to be rebuilt by focusing on the body and thus changing the way in which the person feels his/her body.

Conclusions. This analysis highlights the importance of how pain is experienced and how it is taken into account in rehabilitation practices, whilst at the same time showing how rehabilitation changes this experience.     

Impairment,disability, and the ICIDH model III: Underlying disease,impairment, and disability

Secondary analysis of data carried out in a national survey of the disabled is used to explore the relationship between underlying condition, impairment and disability, where the conditions are considered in three groups depending on whether they affect control, mechanical performance or energy. Comparison of impairment and disability profiles highlights the role of functional limitation in mediating between disease and disability. Disability profiles were found to be less associated with the underlying condition than were impairment profiles, but this can to some extent be explained by the nature of the functional limitation.     

乳腺癌患者"自我形象紊乱"的诊断和护理

目的探讨"自我形象紊乱"这一护理诊断在乳腺癌行乳房切除患者的运用及其相关护理措施,以便获得经验,更好的为患者服务.方法对80例患者进行收集和问卷调查分析,同时对不同年龄、文化程度与患者发生"自我形象紊乱"的相关关系进行比较,并针对患者的特点进行有效的护理干预.结果 80例患者中43例发生"自我形象紊乱",占53.75%,发生率随受教育的程度的升高而升高,年轻患者发生率较老年患者高.结论 "自我形象紊乱"在乳房切除的患者中的发生率较高,尤其在年轻患者,或受到高等教育的患者发生率相当高."自我形象紊乱"直接影响患者的术后恢复,影响患者的生活质量,因此应予以充分重视,积极治疗,使患者恢复自信心,提高其生活质量.     

Problem drinking in adolescence.

Diagnostic criteria for the early stages of alcoholism are unclearmaccordingly, especially in young problem drinkers, emphasis should be on symptomatic treatment and shifting environmental support away from drinking. Alcohol use is frequently a precursor and a corollary of other drug use. Active intervention by the family physician can be very effective. Starting at age 15, the medical history should include a survey of alcohol consumption.     

Weight problems in adolescence.

Even the normal adolescent must incorporate into his body image radical changes in size, body proportions, and sexual characteristics. Obesity and anorexia, which are commonplace, may be sensitive problems to deal with.