RESUMO
Transitional care programs are one method of providing care to elderly high-risk patients. The aims of this study were to determine if patient characteristics (including number of comorbidities, functional status, and length of stay during initial hospitalization) and social factors (including presence of a caregiver in the home and place of discharge disposition) were associated with increased hospital readmission and mortality for patients discharged from specialized transitional care.
Assuntos
Continuidade da Assistência ao Paciente/organização & administração , Serviços de Saúde para Idosos/organização & administração , Enfermeiros Clínicos/organização & administração , Alta do Paciente/normas , Atividades Cotidianas , Assistência ao Convalescente/organização & administração , Idoso , Idoso de 80 Anos ou mais , Assistência Integral à Saúde/organização & administração , Avaliação Geriátrica , Transição Epidemiológica , Hospitais de Veteranos , Humanos , Tempo de Internação/estatística & dados numéricos , Pessoa de Meia-Idade , Profissionais de Enfermagem/organização & administração , Auditoria de Enfermagem , Pesquisa em Avaliação de Enfermagem , Avaliação de Resultados em Cuidados de Saúde , Avaliação de Programas e Projetos de Saúde , Estudos RetrospectivosRESUMO
OBJECTIVE: Atypical neuroleptics, including risperidone, are used to treat children with autism, despite limited efficacy and safety data. Many clinicians believe that risperidone will not induce dyskinesias in children. The authors investigated open risperidone treatment in children with autism and included findings on dyskinesias. METHOD: The sample included 22 outpatients (mean age = 7.1 years) diagnosed with autism (DSM-IV). Treatment consisted of a 1-month short-term phase followed by a 6-month long-term phase. At the end of the long-term phase, drug was discontinued, and the need for further drug treatment and the occurrence of withdrawal dyskinesias were assessed. Measures included the Clinical Global Impressions (CGI), Children's Psychiatric Rating Scale (CPRS), and the Abnormal Involuntary Movement Scale. RESULTS: The mean risperidone dosage was 1.2 mg/day. Overall, the children had significant clinical improvement as assessed by the CPRS and CGI. Untoward effects included sedation, increased appetite, and weight gain. Two of 13 (15.4%) children treated long-term developed mild, reversible withdrawal dyskinesias when risperidone was discontinued. No child developed dyskinesias on risperidone. CONCLUSIONS: Risperidone shows promise as a treatment in autism. However, withdrawal dyskinesias were noted. Further assessment of the risk of risperidone-related dyskinesias is indicated.
