J Natl Med Assoc
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Review
The role of the family in psychosocial adaptation to physical disabilities for African Americans.
The psychosocial adjustment of patients who are experiencing physical disabilities is examined within the context of a family ecological approach. Historical and sociocultural characteristics of African-American families are delineated and explored in terms of their potentially positive impact on the adjustment process. Four family strengths are delineated: strong kinship bonds, strong religious orientation, family role flexibility, and strong education/work ethic. ⋯ Contrary to the predominant deficit theories, a fresh asset-oriented approach is provided. A model of the family adjustment process of African-American clients with disabilities is presented, and some of the important strengths of the African-American family system are examined. Finally, a family strengths model is applied to the therapeutic process.
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The records of 163 penetrating trauma patients who required surgery in a 36-month period between 1988 and 1990 were reviewed. Those patients with head trauma were excluded. Thirty patients were identified as having: similar Injury Severity Scores (ISS), received at least 8 L of crystalloid, and received at least 4 units of packed red blood cells during the first 24 hours after admission. ⋯ Nonsurvivors also had lower hemoglobin levels (7.84 +/- 1 versus 9.1 +/- 2.3) and platelet counts (134.2 +/- 14.1 versus 188.6 +/- 6.3) than survivors. In addition, nonsurvivors demonstrated greater incidence of three major risk factors than did the survivors: hypothermia (75% versus 41%), acidosis (100% versus 27%), and coagulopathy (62% versus 4.5%). Therapeutic measures to limit these risk factors for increased mortality may maximize the chance of survival in these patients.