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OBJECTIVE:To examine the utility of the Basic Personality Inventory (BPI) as a complementary tool to the Multidimensional Pain Inventory (MPI) for the evaluation of patients with chronic pain. It was hypothesized that patients labelled 'dysfunctional' on the MPI would exhibit the highest levels of psychological distress as indicated by scores on BPI, followed in order by those labelled 'interpersonally distressed', and those described as 'adaptive copers'. It was anticipated that this pattern would be independent of sex. In addition, validity of the BPI as a measure of psychological distress among patients with pain was examined using psychiatric diagnostic ratings as independent criteria.METHODS:Three hundred and twenty-six patients with non-malignant chronic pain seeking admission to a private pain clinic, an inpatient treatment program or a short term, multidisciplinary outpatient chronic pain program completed both the MPI and the BPI at a single sitting as part of a routine assessment procedure. The majority of patients underwent psychiatric assessment which specified Diagnostic and Statistical Manual of Mental Disorders-III-R (DSM-III-R) or DSM-IV diagnosis. Psychiatric diagnosis was determined for a subsample of 110 patients in the present investigation by conducting a random chart review.RESULTS:The MPI patients classified as 'dysfunctional' manifested significantly higher levels of BPI measured psychopathology than both 'interpersonally distressed' and 'adaptive coper' groups. 'Adaptive copers' reported the lowest levels of psychological dysfunction while those labelled 'interpersonally distressed' exhibited intermediate levels of dysfunction. Individuals with high levels of emotional distress as determined from the BPI were more likely to have an axis 1 disorder.CONCLUSIONS:The BPI is an accepted valid and reliable generic measure of emotional well-being and may be used as a complementary index to the disease-specific MPI in assessing chronic pain patients. A psychometric assessment battery consisting of the MPI and BPI can assist both clinicians and researchers in identifying problem areas that may impede treatment of patients with chronic pain and in assessing treatment outcomes.

We hypothesized that a prior history of a major depressive disorder would not compromise the efficacy of percutaneous transluminal coronary angioplasty (PTCA), a coronary revascularization procedure, in improving quality of life and health status when comparing patients with no previous history. To determine the utility of screening for risk for depression in heart patients scheduled for PTCA, 190 patients were administered a two-item depressive disorders screener prior to PTCA and the SF-36 and Seattle Angina Questionnaire prior to and 6 months post procedure. Results reveal that while those with no prior history of depression had statistically better quality of life and health status outcomes than those with a probable past depression, (P

This investigation has sought to determine reasons for the disproportionately higher number of females entering CAPD as opposed to home hemodialysis. A sample of 295 home dialysis patients, 97 women and 198 men, were compared in terms of modality of choice, baseline demographic characteristics, treatment outcome, and quality of life. The results indicate that there is no apparent rationale for the current selection basis.

We studied adaptability to the stresses of bome bemodialysis and CAPD programs by asking patients (143 on bemodialysis; 53 on CAPD) to assess particular treatment -associated stressors. A 14-item questionnaire was constructed to measure areas in which the patients felt stress and the intensity of the stress. Also we used a self-rating scale to obtain information about both the patient's overall and bis or ber physical wellbeing. The majority of patients complained of physical weakness and an inability to sleep. This paper outlines stressors for each treatment modality, and based on patient self-assessment concludes that the two modes of treatment are comparable.

An important part of health behavior variability is a supportive environment. This paper examines the concept and discusses its application to a general and geriatric home dialysis population. Social environment is analyzed along three interrelated dimensions: social support, social integration, and social network. The authors conclude that a multimethod approach for assessing environmental support is preferred over a single-item index. Furthermore, a supportive interpersonal environment is important for patients and family, both as a preventive agent and as a protective buffer against the impact of ESRD related stress.

Two groups of home dialysis patients (40 on CAPD and 37 on home hemo dialysis) matched for length of time on dialysis, and for demographic background were studied and compared. The CAPD patients were significantly more satisfied with the support received from household members and from spouses, more satisfied with the relations with spouses, more understood by them and more understanding of their spouses. Sexual satisfaction declined in both groups. However, sexual satisfaction was slightly higher in the CAPD group and these patients experienced slightly less difficulty in adjusting to the decline; none of these differences were statistically significant.

Although peritoneal dialysis for the treatment of renal failure became a reality earlier in this century, the advent of the more efficient and convenient hemodialysis retarded the progress of peritoneal procedures. After a slow start, peritoneal dialysis now appears to be gaining acceptability. It is seen by Gutman1 as at least an equally satisfactory alternative to hemodialysis, and by Fenton et al. as a major advance in promoting home dialysis.2

For the past 25 years, dialysis has been advocated as an artificial replacement therapy for the functional loss of kidneys. Thousands of patients with chronic renal failure have been kept alive who otherwise would-have died. At present, in excess of 80 000 persons in the United States are on dialysis, a dramatic increase from the 2398 of 15 years ago [1]. This increase, in large measure, is due to the technological and treatment advances in renal replacement therapy. However, technologies such as automated dialysis systems [2, 3], bacteriologically safe catheters [4], and modified peritoneal dialysis procedures such as CAPD [5] or its automated nocturnal form, ‘prolonged dwell’ peritoneal dialysis [6], do more than sustain life. They enhance patients’ physical status and tolerance for home treatment [7] and free them from the constraints of extracorporeal hemodialysis [8], thus contributing to overall improvement in patients’ cognitive acuity and psychosocial functioning [9–12].

There is an unprecedented increase in the number and proportion of elderly people in all industrial nations. Barring catastrophes such as nuclear war, pandemic infections, or an overheating of our planet, at the beginning of the next century the United States and Canada can expect to have more than 40 million old people.

The importance of the review of literature, a component of any research study, has been relatively downgraded by occupational therapists because it is time-consuming. In order to encourage novice researchers and illustrate the importance of a comprehensive review of related literature, a review was carried out in the area of auditory feedback and the teaching of the use of myo-electrically controlled prostheses. This illustration of method in research includes initial ideas, assumptions and facts, the researchable question, the literature review and the conclusions drawn from the review which help guide the researcher in his potential study.

An analysis of factors influencing the survival of 285 home-dialysis patients followed for a minimum of 18 months suggests that psychosocial and demographic factors may be more important than physiological variables in determining survival.