ABSTRACT
OBJECTIVES: To describe the health-related quality of life of patients visiting a tertiary referral centre for facial palsy, and to analyse factors associated with health-related quality of life, using the FaCE Scale instrument. DESIGN: Retrospective cohort study. SETTING: The Facial Nerve Center at the Massachusetts Eye and Ear Infirmary, a tertiary referral centre. PARTICIPANTS: Patients with a peripheral facial palsy visiting the centre for an initial consultation between August 2007 and June 2012. MAIN OUTCOME MEASURES: The total FaCE score and the FaCE social function subdomain. Multiple regression models were developed to identify factors associated with the total FaCE score and FaCE social function score. RESULTS: A total of 794 patients with a mean age of 47.0 ± 16.0 years were analysed in this study, of which 59.9% were female. The mean House-Brackmann, Sunnybrook, total FaCE and FaCE social function scores were 3.6 ± 1.5, 48.2 ± 21.2, 47.3 ± 19.3 and 55.5 ± 19.2, respectively. Increasing age (r = -0.229, P < 0.001) was associated with a lower total FaCE score. Female gender (r = -4.422, P = 0.033) and increased duration of palsy (r = -0.018, P = 0.041) were associated with lower FaCE social function scores. CONCLUSIONS: While counselling patients on what to expect during the recovery process after facial paralysis is an important part of any clinical visit, FaCE score correlations suggest that female patients with chronic facial palsy and increased age constitute a patient category that may require additional time and attention to prevent or mitigate psychosocial dysfunction.
Subject(s)
Facial Expression , Facial Muscles/physiopathology , Facial Paralysis/psychology , Health Status , Quality of Life , Adolescent , Adult , Aged , Aged, 80 and over , Facial Paralysis/physiopathology , Female , Follow-Up Studies , Humans , Male , Middle Aged , Retrospective Studies , Severity of Illness Index , Young AdultABSTRACT
This article includes two separate studies: the first explores the impact of caregiver AOD use on CPS case substantiation; the second compares CPS-involved and CPS-noninvolved females in AOD treatment systems. Results suggest that cases with indications of AOD use are more likely to be substantiated than cases without; and increasing numbers of children and younger maternal ages are risk factors for CPS involvement among AOD-using women. Related findings are also presented, followed by implications for practice and research.
Subject(s)
Alcoholism/epidemiology , Caregivers , Child Welfare/statistics & numerical data , Substance-Related Disorders/epidemiology , Adult , California/epidemiology , Child Abuse , Child, Preschool , Employment , Ethnicity , Female , Humans , Income , Logistic Models , Nevada , Single ParentABSTRACT
This article describes the addiction recovery process and its impact on parenting behaviors-information needed by child welfare workers involved in decisionmaking regarding family reunification. Two models of recovery-from alcoholism and from cocaine addiction-are reviewed, along with issues encountered in recovery, particularly for women. Case examples and discussion demonstrate how child welfare workers can apply these models in determining the appropriateness of reunification.
Subject(s)
Alcoholism/rehabilitation , Child Welfare , Cocaine-Related Disorders/rehabilitation , Family Relations , Mothers/psychology , Treatment Outcome , Adult , Child , Child, Preschool , Decision Making , Female , Humans , Male , Parenting/psychology , Recovery of Function , Recurrence , Social Work/methodsSubject(s)
Brain/immunology , Central Nervous System Viral Diseases/immunology , Murine hepatitis virus/immunology , Spinal Cord/immunology , T-Lymphocytes, Cytotoxic/immunology , Acute Disease , Animals , Brain/virology , Central Nervous System Viral Diseases/virology , Coronavirus Infections/immunology , Coronavirus Infections/virology , Male , Mice , Mice, Inbred BALB C , Murine hepatitis virus/physiology , Spinal Cord/virologyABSTRACT
Increasing concerns regarding the cost of medical care have led to research that has found a relationship between alcohol abuse, increased medical problems, longer hospital stays, and higher medical costs. Research has also found a positive relationship between alcohol availability and crime, car accidents, and liver cirrhosis deaths. One area of interest is how alcohol availability, as measured by the number of alcohol outlets, is related to medical care needs. The purpose of this study was to examine the relationship between the geographic density of alcohol outlets and the number of alcohol-related hospital admissions. Alcohol-related ICD-9 codes were selected based on epidemiologic research in the literature to determine alcohol-related morbidity from the California Discharge Data System, which collects information on all hospital admissions and discharges in California. In San Diego County, in 1996, 3,759 admissions were alcohol-related. Alcohol-related admissions for each zip code were compared to the number of liquor licenses that were held by each zip code through a multiple regression analysis. The regression model demonstrated that the number of liquor outlets was a significant predictor of alcohol-related hospital admissions, net of other predictors. Implications are discussed, including regulation of alcohol availability, which may have a beneficial impact on alcohol morbidity.
Subject(s)
Alcoholic Beverages/supply & distribution , Alcoholism/epidemiology , Commerce/statistics & numerical data , Patient Admission/statistics & numerical data , Adult , Age Distribution , Aged , Alcoholism/etiology , California/epidemiology , Diagnosis-Related Groups/statistics & numerical data , Female , Humans , Least-Squares Analysis , Licensure/statistics & numerical data , Male , Middle Aged , Morbidity , Multivariate Analysis , Needs Assessment , Predictive Value of Tests , Residence Characteristics/statistics & numerical data , Risk Factors , Sex DistributionABSTRACT
This study explored the personality traits of 15 women who served as surrogate mothers in a California-based surrogacy program. Their satisfaction with their service providers, i.e., the program director, psychologist, and medical doctor, were explored. All had given birth to one or more children, and five had been a surrogate more than once. 13 used in vitro fertilization, with only two choosing artificial insemination. 15 subjects were given the NEO-R Personality Inventory, a global measure of normal personality traits. Analysis indicated that surrogates overall were very pleased with their experiences, and they differed from the general population on nine personality traits.
Subject(s)
Patient Satisfaction , Personality Inventory/statistics & numerical data , Surrogate Mothers/psychology , Adult , Female , Humans , Infant, Newborn , Patient Care Team , Pregnancy , PsychometricsSubject(s)
Decision Making, Organizational , Decision Support Techniques , Facility Regulation and Control/organization & administration , Human Development , Licensure, Nursing , Nursing Theory , Public Policy , Humans , Organizational Objectives , Organizational Policy , Quality of Life , South Dakota , Specialty BoardsABSTRACT
Child welfare case workers have long known that abuse of alcohol and drugs is a major problem with many parents on their caseloads. This article discusses motivational interviewing, an intervention technique used with substance abusers. Motivational interviewing, which is based on the principles of motivational psychology, postulates that motivation is created in an interaction between the client and worker. Principles of motivational interviewing are discussed and illustrated in a case example.
Subject(s)
Child Abuse/prevention & control , Child of Impaired Parents , Interview, Psychological/methods , Motivation , Parents/psychology , Social Work, Psychiatric/methods , Substance-Related Disorders/prevention & control , Adult , Child , Female , Humans , Professional-Patient RelationsABSTRACT
Alcoholics who receive treatment in in-patient settings are routinely referred to Alcoholics Anonymous upon discharge, yet not all affiliate with A.A. The characteristics of A.A. affiliators have been explored in the past to further improve discharge planning, but to date no studies have described the characteristics of adolescents who affiliate with A.A. The sample used in this study was 70 adolescents who had completed in-patient treatment and were contacted as part of a follow-up survey. Half of the group had affiliated with A.A. A discriminant analysis was used to predict affiliation, and the study found that affiliators were more likely to have had prior treatment, had friends who did not use drugs, had less parental involvement while in treatment, and more feelings of hopelessness. Possible explanations for these findings are discussed as well as areas for further research.
Subject(s)
Alcoholics Anonymous , Alcoholism , Patient Acceptance of Health Care , Adolescent , Adult , Alcoholism/psychology , Alcoholism/therapy , Attitude , Child , Discriminant Analysis , Female , Follow-Up Studies , Forecasting , Humans , Interpersonal Relations , Male , Outcome Assessment, Health Care , Parenting , Patient Discharge , Peer Group , Recurrence , Sampling Studies , Substance-Related DisordersABSTRACT
Behavioral disturbances are common in elderly individuals, particularly in those suffering from dementia. Nurses are called on to manage these problem behaviors both in the nursing home and through home health care. There has been growing interest in nonpharmacological interventions for these problems, most notably behavioral therapies. However, until recently, no information was available regarding the acceptance by health care professionals on the use of these treatments with elderly individuals. The purpose of this study was to assess geriatric nurses' acceptance of two behavioral treatments (differential reinforcement of incompatible behavior and time-out from positive reinforcement) and the most commonly used treatment at this time, pharmacotherapy. Nurses were asked to read a clinical case vignette and three treatment descriptions, rating the treatments with Kazdin's Treatment Evaluation Inventory. Results show that both behavioral treatments, including a mildly aversive treatment (time-out) were rated more positively than pharmacotherapy. Nurses modified their ratings in response to described differences in the patient's cognitive functioning and place of residence. Most interesting, acceptability ratings were influenced by characteristics of nurse raters, including the nurses' educational background and the amount of contact with geriatric patients.
Subject(s)
Behavior Therapy , Geriatric Nursing , Haloperidol/therapeutic use , Reinforcement, Psychology , Social Behavior Disorders/therapy , Adult , Aged , Attitude of Health Personnel , Female , Humans , Nursing Evaluation Research/methods , Social Behavior Disorders/drug therapyABSTRACT
The management of geriatric behavioral disturbances presents a challenge for both caregivers and care receivers. Previously, we have investigated caregivers' and health care professionals' perceptions of the acceptability of behavioral treatments and pharmacotherapy. However, the perceptions of the potential or actual recipients of these interventions are equally important. In this study, vignette methodology assessed elderly individuals' acceptance of two behavioral treatments and one pharmacologic intervention using Kazdin's Treatment Evaluation Inventory. Respondents assigned the highest treatment acceptability ratings to behavioral treatments and the lowest to drug therapy. The place of patient residence described in the vignettes (community or nursing home) mediated treatment acceptability ratings.
Subject(s)
Behavior Therapy , Mental Disorders/therapy , Patient Acceptance of Health Care , Aged , Analysis of Variance , Evaluation Studies as Topic , Female , Geriatrics , Humans , Linear Models , Male , Mental Disorders/drug therapyABSTRACT
The concept of advanced nursing practice varies widely in interpretation and regulation. The economic, societal, and political forces affecting change in the U.S. health care delivery system have heightened the public's interest in alternative approaches to health care. Traditional acts of medicine increasingly overlap with those of other providers, such as nurse practitioners, nurse midwives, nurse anesthetists, and clinical nurse specialists. Crucial challenges face state Boards of Nursing as they balance their public protection responsibilities with their support of the evolution of nursing practice. This article provides information regarding the national approach to the regulation of advanced practice nursing, followed by an overview of one state's approach to this issue.
Subject(s)
Certification , Facility Regulation and Control , Nurse Practitioners/standards , Humans , Licensure, Nursing , Nurse Practitioners/education , Nurse Practitioners/legislation & jurisprudence , Professional Staff Committees , South Dakota , State GovernmentABSTRACT
In response to growing interest in employing behavioral treatments and environmental modification for behavioral disturbances in older adults, we employed vignette methodology to examine physicians' acceptance of two behavioral treatments and haloperidol using Kazdin's Treatment Evaluation Inventory. Physicians assigned the highest acceptability ratings to the behavioral treatments and the lowest ratings to haloperidol. The patient's cognitive capacity, living situation (nursing home vs. community), and the type of behavior problem mediated treatment acceptability ratings.
