ABSTRACT
In the primary care setting, 20% to 25% of patients experience alcohol-related problems; however, clinicians often treat the symptoms of alcoholism and fail to identify the disease itself. Unlike men, women commonly seek help for alcoholism from primary care clinicians. Further, the development and progression of alcoholism is different in women than in men. Women with alcohol problems have higher rates of dual diagnoses, childhood sexual abuse, panic and phobia disorders, eating disorders, posttraumatic stress disorder, and victimization. Early diagnosis, brief interventions, and referral are critical to the treatment of alcoholism in women.
Subject(s)
Alcoholism/diagnosis , Alcoholism/therapy , Nurse Practitioners , Primary Health Care/methods , Women's Health , Alcoholism/complications , Alcoholism/psychology , Child , Child Abuse, Sexual/psychology , Diagnosis, Dual (Psychiatry) , Feeding and Eating Disorders/complications , Female , Humans , Male , Mass Screening/methods , Medical History Taking/methods , Nursing Assessment/methods , Patient Acceptance of Health Care/psychology , Phobic Disorders/complications , Physical Examination/methods , Referral and Consultation , Risk Factors , Spouse Abuse , Stress Disorders, Post-Traumatic/complications , Surveys and QuestionnairesSubject(s)
Critical Pathways , Health Services for the Aged/organization & administration , Heart Failure/nursing , Home Care Services/organization & administration , Patient Care Planning , Aged , Aged, 80 and over , Female , Hospitalization/statistics & numerical data , Humans , Male , Retrospective Studies , Total Quality Management , Treatment OutcomeABSTRACT
This study has shown improved outcomes with the use of a clinical pathway. However, under PPS additional ways for coordination among healthcare providers and patients need to be developed to ensure improved care beyond those focusing on the use of the pathway. One recommendation is the use of telehealth.
Subject(s)
Critical Pathways , Heart Failure/nursing , Home Care Services , Aged , Female , Hospitalization/statistics & numerical data , Humans , Male , Outcome Assessment, Health Care , Patient Education as TopicSubject(s)
AIDS-Related Opportunistic Infections/diagnosis , Candidiasis, Vulvovaginal/diagnosis , AIDS-Related Opportunistic Infections/drug therapy , AIDS-Related Opportunistic Infections/nursing , Adult , Candidiasis, Vulvovaginal/drug therapy , Candidiasis, Vulvovaginal/nursing , Counseling , Female , Humans , Nurse Practitioners , Patient Education as Topic , Primary Health Care , Recurrence , Safe SexABSTRACT
In the United States, 45% of all women use alcohol, and nearly 26% smoke cigarettes. Approximately 13% use illicit substances, prescribed medications, or both in recreational ways. Although women use these substances less often than men, the health consequences of their use for women, particularly the use of alcohol, are either equivalent or greater. Women's social relationships play key roles in the onset of substance use disorders, treatment, and continued recovery. Major psychoactive substances include nicotine, alcohol, illicit drugs, and recreational use of nonprescribed medications. Biopsychosocial aspects unique to women are reviewed, followed by treatment approaches, concluding with implications for primary care providers.
Subject(s)
Substance-Related Disorders/epidemiology , Substance-Related Disorders/psychology , Women's Health Services , Women's Health , Female , Humans , Substance-Related Disorders/therapyABSTRACT
This study compared elderly patients with congestive heart failure discharged from home healthcare to the home vs. those rehospitalized. The rate of rehospitalization in this sample of 117 was 27%. Significant predictors of rehospitalization included number of home healthcare days, number of previous hospitalizations, and the services of a home health aide. Implications include the timing and nature of home health visits.
