Handbook of Health Psychology

By Andrew Baum; Tracey A. Revenson et al. | Go to book overview

who had amputation secondary to blood clots and in those who experienced more preamputation pain and pain in the stump following amputation.

Disability following amputation is believed to be greater for below-the-knee amputations than above-the-knee amputations. Little empirical data has been found to substantiate this belief.


CONCLUSIONS

The continuum of care for health conditions can be grossly divided into acute conditions and chronic conditions. Chronic conditions that require continuous intervention for the same medical problems include rehabilitation services. Rehabilitation is defined as goal oriented interventions designed to develop individuals to their fullest physical, psychological, social, vocational, and educational potential. Psychologists have significant opportunities in each of these domains. In addition, the evolving “post-acute” sector of care that focuses on the integration of an individual into the community following the disabling conditions offers many role opportunities for psychologist.

Rehabilitation requires a broad range of psychological skills ranging from the treatment of more common psychopathological disorders to health psychology intervention to family and marital treatment. System issues are of critical importance in rehabilitation. Both the treating milieu, including the reactions of the rehabilitation staff, the family, and the individual are critical in determining the outcome. Psychologists working in rehabilitation must be knowledgeable of systems interventions and proficient in understanding both the social psychology and the clinical psychology of disability. Increasingly, psychologists in rehabilitation are designing interventions that collate interventions at the individual, family, and community level. At the same time, these interventions also are often sensitive to the diminishment of health resources and to maintaining the individual at the highest level of individual function. Rehabilitation and the chronic sector of care offer an important paradigm for the delivery of psychological services as the number of individuals with disabilities increases in the United States. Delivery systems such as the “cardinal symptom approach” that focus on the most disabling health concerns offer psychologists opportunities to create primary care delivery roles in which they provide continuous, comprehensive, coordinated service to individuals. Although this model may defy traditional definitions of primary care, as health care delivery systems evolve to meet the needs of consumers, traditional definitions will fall by the wayside.


REFERENCES

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Dunn, D. S. (in press). Matters of perspective: Some social psychological issues in disability and rehabilitation. In R. G. Frank & T. R. Elliott (Eds.), Handbook of rehabilitation psychology. Washington, DC: American Psychological Association.

Elliott, T. R. (1998, August). Caregiver problem solving abilities predict adjustmentfollowing SCZ. Paper presented at the convention of the Annual Convention of the American Psychological Association, San Francisco, CA.

Elliott, T. R., & Frank, R. G. (1996). Depression after spinal cord injury. Archives of Physical Medicine and Rehabilitation, 77, 816–823.

Elliott, T. R., & Shewchuk, R. (1995). Social support and leisure activities following severe physical disability: Testing the mediating effects of depression. Basic Applied Social Psychology, 16, 4 7 1 - 587.

Elliott, T. R., Witty, T. E., Herrick, S. E., & Hoffman, J. T. (1991). Negotiating reality after physical loss: Hope, depression, and disability. Journal of Personality and Social Psychology, 61, 608–613.

Frank, R. G. (1994). Families and rehabilitation. Brain Injury, 8(3), 193–195.

Frank, R. G. (1997). Changes in the post-acute health delivery system in the United States: International implications. Proceedings of the 5th conference of the ZATSBZ and 20th conference of the Australian Society for the Study of Brain Impairment, Melbourne,

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Frank, R. G., Chaney, J. M., Clay, D. L., & Kay, D. R. (1991). Depression in rheumatoid arthritis: A re-evaluation. Rehabilitation Psychology, 36(4), 219- 230.

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