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Biomedical subjects

B J Chandler

Publications and source records attributed to B J Chandler.

4 recordsLinked to original sources
PubMed2000

An epidemiological survey of the health needs of disabled people in a rural community.

OBJECTIVE: To describe service use and unmet needs of disabled people in a rural environment, given well-recognized difficulties in providing equitable services to a widely-spread population, availability of transport and the presence of discrepancies in wealth. PARTICIPANTS: Disabled people registered with a single rural general practice, identified by postal questionnaire. METHOD: All 3462 households were screened using the Office of Population, Censuses and Surveys (OPCS) disability screening questionnaire. An 86% response rate was achieved. Seventy-four people aged 16-65 and 69 people aged 66-75 were interviewed by a rehabilitation physician. Fifty-five people aged 76+ were interviewed. Disability was assessed using the OPCS scales of disability, Barthel Index, and Hospital Anxiety and Depression Scale. RESULTS: Thirty per cent (43) of those aged 16-75 received assistance for their personal activities of daily living (ADLs), and 98% (140) required assistance for extended ADLs (taken from the OPCS surveys criteria). There was no difference in either disability or dependency by age group. Fifty-three per cent of this group had domestic adaptations, 75% had disability aids. Those aged 16-75 had significantly fewer aids and adaptations, less home care, care management, respite, district nursing and chiropody services than people over 75. Equipment was provided by statutory services less frequently and fewer carers were salaried. The rehabilitation physician assessed them as needing more occupational therapy, physiotherapy and chiropody. Thirty per cent saw their GP monthly and 45% attended hospital. CONCLUSION: Unmet need was assessed as greater in the younger group. Elderly people are possibly more visible to service providers with better recognition of need. There is no evidence of a relationship between medical surveillance and identification of rehabilitation needs. Those with greater degrees of disability require more interlinked and organized services.

Activities of Daily Living↗
PubMed1999

A study of the health and social needs of carers of traumatically brain injured individuals served by one community rehabilitation team.

PRIMARY OBJECTIVE: To examine how carers perceive and rate the importance of their needs and to make recommendations regarding service improvements. RESEARCH DESIGN: A descriptive survey of a randomly selected group of carers taken from the client list of the Northumberland Head Injury Service. Quantitative and qualitative approaches were employed. RESULTS: There was a poorer quality of life and higher level of psychiatric morbidity amongst carers than is recognized in the general population. Carers with high levels of unmet need had significantly higher levels of psychiatric morbidity and a perceived lower quality of life. Experiences of caring were individualized. CONCLUSION: There was a great variability of experience and needs amongst carers. Assessment of needs and planned interventions should be made on an individual basis. The hypothesis that providing an increased level of emotional and instrumental support could reduce psychiatric morbidity and improve quality of life should now be explored.

Adult↗
PubMed1998

Sex and relationship dysfunction in neurological disability.

OBJECTIVES: (1) to ascertain how many people with neurological disability experience sexual or relationship problems; (2) to examine the interplay of neurological disability and sexual function within the context of the dyadic relationship; (3) to consider the implications of the results for service provision. METHODS: A survey of outpatients attending Hunters Moor Regional Rehabilitation Centre, Newcastle upon Tyne over a 6 month period. Standardised measures of sexual function and concern, relationship satisfaction, disability, and mental health were used. RESULTS: Seventy people were interviewed (18% of the potential study population). Prevalence figures therefore refer to this self selected sample. Fifty one per cent had experienced a change in sexual function and 27% were concerned about this change. Of those in cohabiting relationships 25% were experiencing difficulties. Gender was significantly associated with concern about sexual function, men being more concerned. A high score on the marital adjustment scale indicating relationship dissatisfaction was the best predictor of change in and concern about sexual function. Change in sexual function and duration of illness were the most powerful predictors of relationship dissatisfaction. CONCLUSION: If concern is taken as an indication of a desire for help more than one in four of this sample required help for sexual dysfunction. Sexual and relationship functioning were very closely associated and dysfunction in either of these areas was the best predictor of dysfunction in the other area. The dyadic relationship is an important institution in the management of disability. Sexual dysfunction can be predictive of difficulties within a relationship. Any service designed to address sexual health should also address relationship issues.

Brain Diseases↗