The Use of Home Therapy Programmes for Improving Recovery of the Upper Limb following Stroke

The effectiveness of home therapy programmes for facilitating recovery of stroke patients' reaching movements was tested. Twenty-two patients were visited regularly at home for approximately 9 weeks following their discharge from a rehabilitation unit. Twelve patients were assessed and provided with a programme of exercises, while 10 were visited for assessment only. The home therapy group's performance on a peg transfer test improved significantly more than that of the control group. Compliance rates with the programmes were high. These results lead to suggestions for further evaluation of home therapy.

The relationship of attribution of responsibility to acute stress disorder among hospitalized burn patients

Attribution of responsibility for a traumatic event has been related to subsequent adjustment. Self-blame has been associated with better adjustment in some cases and worse in others, whereas other-blame has consistently been associated with poorer outcomes. This study assessed the relationship between attribution of responsibility and acute stress disorder (ASD) in burn victims. Hospitalized burn patients (N = 124) underwent psychological assessment within 2 weeks of their burn injury. Participants were categorized as reporting self-blame (N = 49), other-blame (N = 36), both (N = 10), or neither (N = 29). Twenty-three percent of those with other-blame were diagnosed with ASD, compared with 0% of those with self-blame. Self-blame and other-blame also were related to ASD in logistic regression analyses controlling for demographic and medical variables. With both types of blame in the same model, self-blame was significantly associated with lower rates of ASD, whereas other-blame was related to higher rates, but this did not reach significance. When analyzed in separate models, both of these relationships attained statistical significance. These findings have implications for identifying and treating people at risk for posttraumatic stress disorder after exposure to trauma.

'It's Not My Fault-But Only I Can Change It": Counterfactual and Prefactual Thoughts of Managers

In testing for the self-serving bias in performance evaluation, the authors propose that comparing managers' counterfactual and prefactual thoughts about subordinates' performance is more conclusive than the attributional approach and also offers practical advantages. In a study with 120 managers, a 4-way interaction of subordinate performance, temporal perspective, direction, and reference confirmed the predicted pattern. Managers' thoughts about how a weak performance could have been enhanced had external references, but thoughts about how such a performance could be enhanced in the future focused on the leader. This asymmetry was only observed for weak performance. Results are discussed with regard to biases in leaders' performance evaluations and to how counter- and prefactual thoughts could be used for leadership research and practice.

Expectations and quality of life of cancer patients undergoing radiotherapy

Expectations, real or false, affect the way patients respond to their illnesses. We assessed therapy-related expectations in relation to global quality of life in 55 cancer patients before and after radiotherapy. Factor analysis indicated that therapy-related expectations come into three broad categories--pain/emotional control, healing and tumour/symptom control. 35 patients expected 'healing' even though curative treatment was intended in only 19 and all patients had been fully informed. The expectation of healing was associated with high quality of life, and the same was true of perception of healing after radiotherapy. In the group as a whole, quality of life was little altered by radiotherapy, but it became substantially worse in those patients who had expected healing but perceived that this had failed, even though physician-assessed Karnofsky status did not change. These findings indicate that the expectation of healing, in cancer patients, is a component of a good global quality of life, whereas more limited expectations (pain control, tumour control) relate to lower quality of life. Patients' expectations deserve further study as a novel approach to improving care.

Quality of life after pelvic ring injuries: follow-up results of a prospective study

A follow-up after 2 years on average could be done in 43 cases of pelvic ring injuries. Seven were type A, 8 type B and 28 type C lesions. Every type A lesion was treated non-operatively. External fixation and non-operative management were used with type B injuries. As well as non-operative treatment, both internal and external surgical techniques were employed for type C fractures. While group A hardly mentioned pain in the follow-up, groups B and C suffered dorsal pelvic pain of comparable intensity irrespective of the therapeutic measures taken. Anatomic reduction does not guarantee freedom from pain. We also rated hip joint flexibility and ability to walk according to the Merle D'Aubigné score. Because of their pelvic injuries 50% of the type C patients changed their profession. The sequelae of the accident on sports and leisure time activities will be considered as well as the subjective contentment evaluated. Unstable and dislocated pelvic ring injuries permanently interfere to a high degree with the quality of life. It is remarkable that many of the traumatic lesions which interfere with the quality of life are caused by the traumatic violence itself and cannot be influenced by the manner of surgical stabilization.