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Biomedical subjects

Coletta Hobbs

Publications and source records attributed to Coletta Hobbs.

3 recordsLinked to original sources

Implementation of a SNAP intervention in two divisions of general practice: a feasibility study.

"SNAP" is a model for the general practice management of four common behavioural risk factors: smoking, nutrition, alcohol and physical activity. The SNAP program was developed for the Australian Government in 2002. In 2003 and 2004, a feasibility study was conducted in one urban and one rural division of general practice (DGP) in NSW, in partnership with their local area health services. Information technology support and referral directories were developed, based on an initial needs assessment, SNAP guidelines, a clinical summary chart, patient education materials, and general practitioner and staff training. GPs reported that the SNAP approach fitted general practice consultations well. After its implementation, they were more confident in using motivational interviewing and SNAP interventions and referred more frequently. The impact and sustainability of the SNAP program were limited by a lack of effective practice teamwork, poor linkages with referral services, and the lack of a business model to support SNAP in the practices. DGPs could play an important role in providing practice visits and resources to improve communication, education and collaboration to support SNAP programs.

Alcoholism↗

Deinstitutionalization for long-term mental illness: a 6-year evaluation.

OBJECTIVE: Forty-seven patients with long-term mental illness were transferred to the community following the closure of a psychiatric hospital in Sydney. This 6-year evaluation is an extension of a detailed clinical, ethnographic and economic study of the initial 2-years of community transition. METHOD: Quantitative evaluation was conducted using the Brief Psychiatric Rating Scale, Life Skills Profile, Social Behaviour Scale, Montgomery Asberg Depression Rating Scale and Quality Of Life measures. Assessments were completed prior to discharge and at two- and 6-year intervals following community transfer. Repeated measures analysis was utilized to determine changes in outcome variables over time. The residents' perception of 6-years of community living was explored in qualitative semistructured interviews. Details of accommodation, level of care, readmissions, incidents and medication were also documented. RESULTS: During the 6 years following community relocation a total of seven residents returned to hospital for long-term care, three residents died from medical causes and one resident required detention in a corrective services facility. The 36 residents who remained in the community at the 6-year follow-up no longer required intensive 24-h supervision. Living semi-independently, 23 residents resided in two to three person accommodation with either daily or weekly case manager visits. Clinically, community residents remained stable over the 6 years without significant changes in psychiatric symptoms, depression, living skills or social behaviour problems. Clinical stability was achieved with significant reduction in medication levels over the 6 years. Community-based residents continued to experience improved quality of life and reported their marked preference for living in the community. CONCLUSION: The residents maintained community tenure with significant improvement in quality of life and a reduction in medication, supported by a mental health system with adequate community resources. Issues regarding continuing rehabilitation and social integration need to be addressed. Further deinstitutionalization will require 24-h supervision for most initially and for some on a continuing basis. An ageing population will require specific age related medical and psychiatric services.

Activities of Daily Living↗

Reasons for cannabis use in psychosis.

OBJECTIVE: To examine the reasons for cannabis use among individuals with psychotic disorders. METHOD: Forty-nine people with psychotic disorders in treatment with community health centres in Northern Sydney were interviewed to collect information about their experience of antipsychotic side-effects and their influence on cannabis use. Other information collected on cannabis use included: amount and frequency, effects of use and other general reasons given for use. RESULTS: It was found that boredom, social motives, improving sleep, anxiety and agitation and symptoms associated with negative psychotic symptoms or depression were the most important motivators of cannabis use. Positive symptoms of psychosis and antipsychotic side-effects that were not associated with anxiety, were not important motivators of cannabis use. CONCLUSIONS: As cannabis use may precipitate relapse in this population, it is important to reduce these motivators of use. Clinician's must assess and treat these problems, thus reducing the need for patients to self-medicate with cannabis, and therefore reducing the risk of relapse.

Adolescent↗