Rehabilitation Psychology Case Study

Rehabilitation Psychology Case Study Rehabilitation Psychology Case 2: Mary Lee was only 22 years old and was involved in a serious car accident 1 year ago. She sustained multiple fractures in her spine and has become a quadriplegic (C5 level). She is now wheelchair bound and needs to live with her parents (both nearly 60 years old). She is fully dependent for all her ADL and is pondering what to do with the rest of her life. She has always been proud of her good looks before and wanted to be a movie star. Now her boyfriend has left her and she is feeling very lonely and depressed. Leung Kar Ming, Kevin Word Count: 800 words Many victims of serious car accidents survived with impaired physical functions. Hong Kong record a high number of traffic accidents with more than 20,200 casualties per year1. Traffic accident (42.1%) is the most reported cause of spinal cord injury (SCI)2. In our case, Mary Lee is one of the unfortunate victims sustaining multiple fractures in her spine. Incomplete (30.1%) and complete (20.4%) quadriplegia are the most frequent categories of persons with SCI2. Less than 1% experienced complete neurologic recovery by hospital discharge2. There are seven factors affecting patients coping with SCI: personal resources, health-related factors, social physical context, cognitive appraisal, adaptive tasks, copping skills and health-related outcomes3. I. Personal resources These include self-efficacy (SE), self-esteem, sense of coherence (SOC), spirituality, optimism, intellect and other personality characteristics3,4. These factors are associated with positive coping, and are determinants of adjustment to long term outcomes4,5. Mary was a pretty girl and dreamed of becoming a movie star. The traffic accident took away her health, good looks, relationship and became wheelchair bounded. It is essential to help Mary regain a high SE, self-esteem and SOC. II. Health-related factors More than 50% of SCI patients suffer from chronic pain which significantly affects quality of life (QOL)3,4,8,9. Patients who experience more pain tend to catastrophize more and have a decreased mental health well-being. Psychological factors helps contribute to the relationship between pain intensity and depression8,9,10. Substance abuse, especially abuse of drugs prescribed for spasticity and pain, may contribute to further health problems8. In Mary’s case, it is very important that clinicians can provide effective pain control, and build a positive relationship with Mary to aid the effectiveness of the treatments. III. Social physical context After the injury, Mary became fully dependent on her parents. Her parents, at their retirement age, have to learn to provide support and adapt to their daughter’s functional limitation. Her boyfriend has left her making her very depressed. It is important that these social and physical contexts are addressed. Social context is the relationship, support and expectations of the significant others. Physical context focuses on accessibility, mobility, autonomy, as well as the personal space and privacy of the patient3,4. Finding of positive meaning in lives involves a continuous search for comfortable relationships between self, disability and society4,6,7,10. Encouraging engagement in social activities can work as a distraction technique to increase mood levels7,8. The burden of the caregiver should not be neglected. Care-giving burden is associated with locus of control, social support, and modes of coping. Caregivers also add to the discredit of self by making the injured person entirely dependent on them. Gaining independence from the caregiver is also a key to restoring competency in persons with SCI. Interventions should be tailored towards the needs of the care recipients as well as the caregivers. IV. Cognitive appraisal Cognitive appraisal is how an individual views a situation. Appraisals have a strong association with adjustment. It is important that focus on appraisal of the cause of injury is shifted to the appraisal of having an SCI. Such individuals were found to be well-adjusted psychologically. Visible disabilities affected Mary significantly. Assistance to help her regain her self-image, develop coping skills, making the best use of her remaining bodily function and adjustments of dealing with disability is important. V. Adaptive tasks Mainly focuses on how the individual adapts to the new situation and how they prepare for an uncertain future. Individuals, like Mary, should be encouraged to be able to make decisions on choices of care, commitment to achieving individual goals and sustain independence. Such individuals with SCI are more likely to engage in positive coping strategies. VI. Coping skills Engaging strategies includes self-control, social support, accepting responsibility, problem solving and positive appraisal, resulting in an internal locus of control. Total locus of control, sense of coherence, self-worth, hope, purpose in life and positive affect were consistently associated with greater QOL. Disengaging strategies, however, should be discouraged. These include denial, wish-fulfilling fantasy, self and other blame to SCI and substance abuse. Mary needs to overcome invisible barrier to social contacts. She learns to cope with environmental factors by enhancing functions of her arms and hands and learning wheelchair skills. VII. Health-related outcomes This is mainly the effects of the coping strategies. Also focus on the reduction of stress, emotion control, self-image, self-esteem and social relationship. The use of cognitive behavioral therapy (CBT) can improve the psychosocial outcomes in individuals with SCI. The society is in high demand for clinicians to help patients to recover and resume their normal life activities. Interventions that promote coping and adjustment include: 1. physically, helping individuals on environmental adaptations, training on independent living skills and pain management; 2. psychologically, with the use of CBT and peer counseling; 3. socially, such as providing vocational rehabilitation, social engagement and family counseling. References Census and Statistics Department (2013). Hong Kong monthly digest of statistics. Hong Kong: Hong Kong Special Administrative Region National Spinal Cord Injury Statistical Center (U.S.) (2009). Spinal cord injury: The facts and fiqures. Birmingham, Ala: National Spinal Cord Injury Statistical Center (NSCISC). Martz, E, Livheh, H. (Eds.). (2007). Coping with chronic illness and disability: Theoretical, empirical, and clinical aspects. New York: Springer. Chapter 6. Peter C, MÃ ¼ller R, Cieza A, Geyh S. (2012) Psychological resources in spinal cord injury: a systematic literature review. Spinal Cord.;50(3):188-201. Review. Kilic SA, Dorstyn DS, Guiver NG. (2013) Examining factors that contribute to the process of resilience following spinal cord injury. Spinal Cord..;51(7):553-7. van Leeuwen CM, Post MW, Westers P, van der Woude LH, de Groot S, Sluis T, Slootman H, Lindeman E. (2012 ) Relationships between activities, participation, personal factors, mental health, and life satisfaction in persons with spinal cord injury.Arch Phys Med Rehabil.;93(1):82-9. Simpson G, Jones K. (2013) How important is resilience among family members supporting relatives with traumatic brain injury or spinal cord injury? Clin Rehabil.;27(4):367-77. Chevalier Z, Kennedy P, Sherlock O.(2009) Spinal cord injury, coping and psychological adjustment: a literature review. Spinal Cord.;47(11):778-82. Review. Putzke JD, Richards JS, Hicken BL, DeVivo MJ. (2002) Predictors of life satisfaction: a spinal cord injury cohort study. Arch Phys Med Rehabil. 83(4):555-61. Mehta S, Orenczuk S, Hansen KT, Aubut JA, Hitzig SL, Legassic M, Teasell RW;(2011) Spinal Cord Injury Rehabilitation Evidence Research Team. An evidence-based review of the effectiveness of cognitive behavioral therapy for psychosocial issues post-spinal cord injury. Rehabil Psychol.;56(1):15-25. Review.

The Role of Financial Managerial Accounting Function

Accounting is a major part of an organization or business, it help to provided information needed to manage and make economic decision in order to move the company or organization forward. Financial and managerial accounting work together with emphasis on the future of the company, but have different proposes that helps to enhance the organization both ways as in internal and external. The main purpose of financial accounting is to provide an external performance of the company or organization accomplishment to their stockholder, lenders, financial analysts, and creditors, tax authorities by prepare financial statement. However, it also reports past and present transactions on the balance sheet and the company’s income and cash flow statement. Managerial accounting is use to focus on providing information within the company or organization, of which includes planning and making decision for the company, it’s a manager’s job, he/she must have proficiency in the managerial accounting because it is the foundation of the company’s future, and the manager’s aim is to control the company’s operation by improving the way internal reports and external financial statement will be used in decision making within the company. In addition, Managerial accounting deal with topics such as cost behavior, profit planning, operational budgeting are all financial decision to be made to produce the external financial statements and its the managers of the managerial accounting department responsibility to have them done. To compare the two accounting system I would have to say they have similar function, they both produce reports one for external and one for internal that is use for making decision for the company. The managerial accounting deal with confidential financial reports that is used by the CEO’s within the organization or company, these reports are consist of sales forecasting, the company’s budgets analysis and comparative analysis and any type of merge or consolidation reports the company did in a day, weeks or months. In addition, these reports is generated on a timely basic such as weekly or monthly it is more flexible than financial reports, and it does not focus on general accepted accounting principles (GAAP). Moreover it is use by the CEO to fore see the future of where the company is going. The financial accounting is more concern with the external aspect of the company, so when generating the reports for their stockholders, lenders, financial analysts, and others outside of the company they apply the general accepted accounting principles (GAAP). In addition financial account reports or focus on the past in a more historical factor of the four financial statement of which include a balance sheet, income statement, owners’ equity statement and cash flows statement, the report are generated for a set period of time such as a fiscal year to give the company a history for the hold years. In conclusion financial and managerial accounting can be said that they play a very important part in business making decision, if the rules are apply in the correct and ethical manner by the CEO’s and mangers .

Alcohol Abuse Essay

†¢ †¢ †¢ †¢ Alcohol is a drink containing ethanol It is a lipid that is highly water soluble A psychoactive drug that has a depressant effect. Distribution: Ethanol is distributed equally in all body tissue according to water content. †¢ Metabolism: A healthy body can metabolize 15ml of alcohol/hour †¢ Alcohol is metabolized by the liver but 10% is excreted unchanged in the breath, sweat and the urine Metabolism of alcohol Alcohol Aldehyde Dehydrogenase Acetaldehyde (Toxic) Alcohol Dehydrogenase H2 and Acetic Acid (Nontoxic) Alcohol Abuse †¢ A psychiatric diagnosis describing the recurring use of alcoholic beverages despite its negative consequences. †¢ Also termed as â€Å"Alcoholism† †¢ Pattern of drinking that results in harm to one’s health, interpersonal relationships, or ability to work. Cause of Alcohol Abuse †¢ There is no known cause for alcohol abuse. †¢ The reason for alcohol abuse is complex. †¢ A. Psychodynamic Theory †¢ Attitudes and behaviors of the client †¢ Problems †¢ Stress, anxiety, depression †¢ Peer pressure. †¢ B. Biologic Theory †¢ G.enetic predisposition of the client MANIFESTATIONS OF alcohol abuse †¢ Continue to drink, even when health, work, or family are being harmed †¢ Are not able to control drinking — being unable to stop or reduce alcohol intake †¢ Miss work or school, or have a decrease in performance because of drinking †¢ Need to use alcohol on most days to get through the day. Manifestations of alcohol abuse †¢ Do not care about or ignore how they dress or whether they are clean †¢ Try to hide alcohol use †¢ Shake in the morning or after periods when they have not a drink †¢ Poor judgment †¢ Irritable. Complications of alcohol abuse †¢ Elevated liver function test †¢ Alcoholic Hallucinosis †¢ Withdrawal symptoms such as: x Tremors x Sweating x Palpitations x Agitation †¢ Delirium tremens †¢ Wernicke-Korsakoff syndrome †¢ Peripheral Neuritis †¢ Gastric ulcers Treatment for ALCOHOL ABUSE †¢ Abstinence from alcohol †¢ Medication treatment such as: †¢ Long-acting Benzodiazepams: tx of alcohol withdrawal †¢ Chlorhexidine (Librium) †¢ Diazepam (Valium) †¢ Lorazepam (Ativan) †¢ Disulfiram (Antabuse) †¢ Naltrexone (ReVia) †¢ Subject to a rehabilitation facility. Nursing Management †¢ Teach the patient the effects of chemical abuse on the body. †¢ In communicating with the patient be in a matter-of-fact and respectful manner. †¢ Maintain a positive, supportive environment. †¢ Build a therapeutic rapport with the patient by providing relief from his or her symptoms and meeting physiologic and safety needs. †¢ Present reality without challenging or escalating the patient’s anxiety and thought disturbances. †¢ Remain objective to the patient and the family. †¢ Closely monitor your patient during your shift to identify subtle changes and intervene appropriately. †¢ Assess mental status and sleep pattern, and provide emotional support to reduce anxiety.

Shark Conservation essays

Shark Conservation essays The people's battle against the terrors of the sea And the sharks' fight to survive Shark populations have been hit hard lately. It remains to be seen whether tough new conservation measures will help them recover. - Conniff - In October 1992, a surfer named Rick Gruzinsky was attacked while surfing in Oahu. Only suffered minor scratches. Two weeks later, a shark killed an 18 year old body border off the beaches of Oahu. He bled to death on the beach. Earlier in 1992, also off Oahu, a surfer disappeared leaving behind only a surf board with a huge bite mark. A few months before that, a tiger shark killed a woman by tearing off her limbs while snorkeling, off Maui. An Angry Posse Goes After The Killers - The Fight Against Or For Sharks The public's reaction to these attacks was in part predictable. Parents kept their children out of the water, and the legislature debated "tiger shark eradication," and the tourist industry was scared out of their minds. The state of Hawaii sent out a posse to dispatch any large sharks it could find in areas where the attacks were recorded. The outcry on behalf of the sharks was at least as loud as the clamor against them. The rate of attack was determined not by how many sharks you took out of the ocean, but how many people you put in it. Around 8 million people use the beaches of Hawaii each year, and only a minuscule 2.4 attacks are averaged. The annual toll of 30 or 40 deaths are by drowning. Public also took a stand on behalf of the sharks Under pressure , the state ultimately diverted much of its control money to conduct research. Mixed feelings began surfacing everywhere people live with sharks. Widespread concern that shark populations have plummeted worldwide. South Africa, for example, declared the great white shark a protected species and imposed a ban on fishing for the creatures Australia has ban...

The romantic revolution essays

The romantic revolution essays Romanticism made a greater difference to us than anything else since the Renaissance. It was a precursor to a whole new reference for thinking, and structuring society. Berlin traces the evolution of romanticism with its many levels of comprehension and implications in modern thought. He leads us through historical vicissitudes engendered by this new authenticity of ideas. He brings light to the suppositions and eventualities (conditional) that the romantics sermonized. The Romantics said the same question can have more than one answer and were the first to say the answer was not something built into the universe. Berlin gives due relevance to the fact that romanticism was responsible for bringing pluralism to the fore from the predominantly monistic views held by society. He writes in My Intellectual Path, a society in which many opinions are held, and those holding different opinions are tolerant of each other, and is better than a monolithic society in which one opinion is bindi ng on everyone (Berlin 58). The history of Western Civilization contains a long and frequently bloody and always intellectually and imaginatively very stimulating record of collisions between different versions of the world's order. But we need to recognize that fundamental to them all was a belief that there was an order to be discovered, at least in part. Berlin had noted three important conceptual changes in western culture which altogether replaced classical notions of the existence of monistic order in reality. One of the first changes was seen during the rise of stoicism where the concept of public was replaced by the inner convictions of the individual. The second was the irreconcilability between natural and moral values that politics was in fact in conflict, as Machiavelli suggested, with Christian ethics. Suddenly there was an interest in two different points of view, that of the individual and the church. Thirdly and the most revo...

Appendicitis A Medical Perspective Case Study Example | Topics and Well Written Essays - 750 words

Appendicitis A Medical Perspective - Case Study Example Despite the belief that appendicitis is a disease that contains minimal health risk, it may still require extensive knowledge for a better medical management of such condition. The definite source for appendicitis is never truly established. Appendix, as mentioned earlier, is an appendage of the colon with no specific function. Contrary to this point, some literature asserts that the appendix is a pouch-like portion that serves as an immune function in young adults--protecting the body against invading microorganisms (Balch 2006, 207). Such theory lends little credit as to why this area is commonly infected itself. With its hollow shape, many believe that in the process of waste disposal, fecal products may fill the space in the appendix and when trapped, disrupts its natural function (Mayo Clinic Staff 2009). The disruption causes it to swell and be pus-filled as an effort to dispel the unwanted contents. On the other hand, the source of infection may come from foreign viral invasion in the alimentary canal (Lewis 2007). Viral infection stimulates the body’s defense, prompting antibodies in the scene in order to flush out viral microorganisms. This consequently results in inflammation, hence, appendicitis. Detection of appendicitis is not as easy as it sounds. Ample knowledge and experience by the medical staff are necessary for accurate clinical diagnosis. The classic physical diagnostic parameters to determine appendicitis are the following: â€Å"pain, nausea or vomiting, sensitivity ... (on) the appendix, and fever† (Hecht 2004, 30). However, such signs and symptoms are also common among other abdominal diseases. Hence, further diagnostic measures should be employed in accurately identifying appendicitis. An article clearly illustrated several methods of assessing the pain elicited with several movements.

Analyze formation of Canada's trade policy or environmental policies Essay

Analyze formation of Canada's trade policy or environmental policies with respect to domestic political and economic forces. Discuss the advantages and disadvantages - Essay Example The main advantage of environment regulation through command-and-control intervention is political support despite its inefficient features. It has high symbolic value for public that identifies prohibition with higher efficiency than taxing pollution discharge. It favors existing industries with political leverage and acts a barrier for new firms. Most importantly it identifies it as cost effective measures that would not pose charges directly to the public. It gives discretionary powers to the bureaucracy which is politically motivated. The exemptions from strict laws are used as tools for negotiation for political gains. The major disadvantage of the command-and-control measure is that it promotes inequality and inefficiency in the garb of perceived costs. It is also a short term policy that deters new firms to be innovative in effluent discharge. From the economists’ perspectives, effluent charges would remove disparity and would act as discouragement for high discharge of pollutants by industries at large. Its results could only be seen on long term basis, hence, it is not favored by political forces. (words: