Blood groups association with Mental retardation
Background: There were no more previous studies to indicate a possible association between ABO, RhD blood groups with Mental retardation. The objective of this study was to find is there any possible relation between ABO, RhD blood groups with mental retardation persons in Jazan, Saudi Arabia.
Methodology: A finger prick blood samples were collected from 93 mentally retarded (MR) male children’s and 300 healthy subjects as control group. Blood samples (393) were tested for ABO and RhD blood groups by routine slide method. Consanguinity, Paternal and Maternal ages and Birth order were determined for each MR as well as control group subjects in this study.
Results: The frequency of ABO blood groups in MR subjects and in control group subjects were showed in Table- I. The frequency of blood group-A in MR subjects(35.5%) was predominant than blood group-A among the control group subjects (23%). RhD blood group distribution among MR subjects and control groups were showed in Table- II. The percentage of consanguinity, the mean paternal age, maternal age and birth order were showed respectively in Table- III, IV & V. .
Conclusion: There was an association between blood group-A and Rh-negative subjects and the occurrence of mental retardation. Another association was found between the occurrence of mental retardation and birth order. Most of the MR subjects were first or second child in their family. This may indicate a genetic background for mental retardation. There was no effect of consanguinity or maternal and paternal ages on the occurrence of mental retardation.
Subject: The transfer is a hinge moment in a patient’s hospitalisation
For the care team, it represents a moment of separation punctuated by the elaboration of the end of the relationship. During the hospital stay, the different exchanges between patient and caregiver allow the creation of a therapeutic bond. The patient “offers” his history, fears and expectations and he invest himself in the verbal exchange as well as in the relationship. The team, in collaboration with the patient, proposes a therapy, a programme, an environment where he can be heard, it assists him in the establishment of the strategies to cope with or to approach his situation. This team is thus depositary of confidence, information and know-how that should be essential elements when moving to another structure.
For the receiving team this is the moment of a new encounter. To make the best out of it, it has to possess the practical and useful information to work safely but also to setup as quickly as possible some reference points for the patient. The information it receives must be as pertinent and objective as possible to gather the optimum conditions to create a reassuring and comforting environment for the person it is receiving.
For the patient, the separation from the places and the people who cared for him can be an anxiogenic moment. Indeed, during his stain within the unit he can express himself, exchange, find a space where to be listened and to exchange with the nurses as well as with the doctors and with the other hospitalised patients, by adapting himself to the rules of the units and to the proposed care programme. During the transfer he will be once more prompted to repeat the work of integration and adaptation
This is why we would like to focus our work on the consideration of the psychological dimension in the therapeutic follow-up during the transfer of a patient from one unit to the other on the Belle Idée site.
Objectives: During this work we propose to:
Delimitation of the area of investigation: We plan to study the admission and crisis management unit (les Sillons1) and a Intellectual Disability Unit, Le Lison (UPDM), within the psychiatric department of Belle Idée.
Summary of documentation: In order to produce this work, we have questioned ourselves about our history and our experience in our respective units. We have recalled the difficulties encountered (lack of information and of specific tools) when patients were transferred within our care units.
To verify whether our remarks were objectives, we have met with Ms VAUCHER, the nurse in charge of care (Infirmière Responsable des Soins – IRS) of the Psychiatric Department to validate this problematic.
During this meeting, Ms. Madame VAUCHER underlines the importance of transferring the information between two care units that meet around the person in care.
The latter does not always possess the cognitive skills to express with words his needs, his difficulties, his habits, his rituals, his pleasures. Sometimes the ability to judge is scarcely or not at all present.
In the future we intend to contact various experts and specialists, focusing on the investigation sites and centred on our research theme.
These different encounters make us sensitive and question us about:
Concerning bibliography: We were not able to find studies directly treating the issue of the transfer of a patient between different care units. We therefore make reference to the different existing works dealing with the concepts of reception, the oral and written transmission of the information, theoretical and practical juridical aspects, the experience of the different actors and the end of the relationship
The continuity of care is an important concern. The COMPAQH organisation, in collaboration with the HAS (previously ANAES), aims to develop quality of care indicators for the health institutions and also to establish effective ways to make use of these indicators. In its 2003 report “Ensure the continuity of the patient care” it states that “the continuity of care from the patient’s standpoint is an experience which he lives with the caregivers; from the caregiver point of view continuity resides in the extension of the therapy in time. These two elements must be present for continuity to be there.” According to him, “Three types of continuity can be identified: information continuity, relational continuity and the continuity of the treatment.”.
As far as the patient reception is concerned, Christophe BITTOLO proposes in his paper “Hospital reception and psychological process: therapeutic and institutional issues in psychiatry” (“Accueil hospitalier et processus psychiques : enjeux thérapeutiques et institutionnels en psychiatrie.”, Revue de psychothérapie psychanalytique de groupe. Editions : ERES p143¬-159.2001), to approach some individual and institutional issues. According to him, the patient hospitalisation is an instrumental moment in the healing process and in the continuation of the therapy.
As far as written transmission is concerned, we are interested in the history of the nurse written transmission. According to Bernard GRADIN et Michèle GROSJEAN in they research “Et en plus elles diagnostiquent... La recatégorisation de la profession infirmière.” (“They even make diagnosis… The re-classification of the nurse profession”), the nurse should use the “nurse file”, afterwards renamed “file of nurse care” and more recently “care file”, which is the written medium of information and transmission of the therapy of each patient since the seventies.
The transfer of information creates the heritage of what has been done, it allows to establish the history of a patient. Hervé BOKOBZA, in “Les enjeux de la transmission en psychiatrie” (“The challenges of the transmission in psychiatry”) in Journal français de la psychiatrie n°27, 2006, considers the transmission as an action, the one of passing on as we pass on life, a name, a heritage. According to him, psychiatry is specially confronted with this issue as the psychiatric patient in his discomfort, always raises the issue of the origins, of the filiation or identity, and therefore of the transmission.
We also took inspiration from the HES diploma work of Ms LUDWING, attending the Ecole de La Source, with the title “Ce que tu écris te ressemble : mais à quoi ressemble l’écriture infirmière.” (“What you write resembles to you. But to what nurse writing does resemble?”). Her work “consists in understanding how the nurses consider the usage of writing via the production of written transfer notes, and, more specifically, of the nurse observations.
When considering the issue of the computerisation of the transfer note, we have considered the work of Sylvie PALMIER, (2007) Réseaux ville/hôpital, transmettre pour mieux soigner. (The network city / hospital, transmission for a better care) in SOINS n°702 p44-46. This article conveys the idea that the nursing activity, as well as the rest of the medical domain, cannot remain unaffected by the profound changes of the Information Society. Therefore the new communication technologies open the road to modernity.
To confront the end of the relationship, we have used PEPLAU, H. (1995) Relations interpersonnelles en soins infirmiers. (Interpersonal relationships and nursing care) Paris : InterEditions. Indeed, she explains that the end of the relationship has to be elaborated since the beginning of the hospitalisation, and that it can reactivate a feeling of abandonment.
To conclude we would like to mention the phase of crisis intervention, DE COULON, N (1994). La crise : stratégies d’intervention thérapeutique en psychiatrie. (The crisis: strategies of therapeutic intervention in psychiatry) Paris : Gaétan Morin. Indeed, the end of the therapeutic bond may reactivate the symptomatology. Therefore the team that initiate the transfer may observe a resurgence of the anxiety and the receiving team may find a patient with crisis symptoms.
All individuals are regularly exposed to humor in their social interactions and are predisposed to this type of communication. Everyone's experiences can vary since humor is very complex: it can be a positive influence from life experiences or, on the contrary, be very destructive. This is exponentially true for people with developmental disabilities. This population type is very fragile within their environment. However, they are often exposed to humor in their every day lives as it is a integral part of human relations. Thus, we can question the usage of humor within this type of population and how it can surpass the cognitive-linguistic competencies.
The main goal of this research was to discover the different aspects and uses of humor as an educational tool to accompany those with developmental disabilities. One of the discoveries was the advantage of humor in reducing the intensity of certain situations, especially the ability to diffuse them, but also the importance it could have when used with authority in education. Furthermore, it was discovered that humor improved the attention of the disabled to better focus as the affective relationship was triggered. Humor helped the disabled to feel free of the imposition of authority. The use of humor in an educational relationship is the foundation of a collaborative relationship as it helps the disabled feel invested and involved. It is equally a place of comfort for the educators as it gives them the necessary distance to handle emotional aspects in heated interactions. However, if humor is transformed into the domination or abuse of power of the disabled, it can become a poisonous tool. To the contrary, humor can be the essence of mediation when used as an educational process with respect and love and care for others.