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Biomedical subjects

H M Waxman

Publications and source records attributed to H M Waxman.

15 recordsLinked to original sources
PubMed1994

An inexpensive hospital-based program for outcome evaluation.

A relatively low-cost outcome evaluation program was developed for a 147-bed psychiatric hospital with a variety of inpatient programs and extensive outpatient and partial hospital facilities. The evaluation staff consists of the research director, a senior research assistant, and a secretary. Much of the program's data comes from documents completed by clinical staff, which are then scanned by an optical mark-reading scanner. The data are automatically entered into a data base and analyzed using PC-based software, SPSS for Windows. Data are used to produce in-house reports that are distributed to clinical programs and the hospital's quality assurance committee. This in-house system can be tailored to an individual hospital's needs and is a less expensive alternative to evaluation by an external contractor.

Adolescent↗
PubMed1991

Wish to transfer to other jobs among long-term care workers.

This study is based on questionnaires that were sent to the homes of health care personnel working in geriatric care (N = 583) and acute care (N = 328). The purpose was to investigate differences between these groups of personnel regarding job assignment, intention to transfer to another job, attitudes towards demented patients, and the experience of burnout. The results showed that more persons working in acute care were self-assigned to their jobs than those working in geriatric care. More persons in geriatric care stated a wish to transfer to another job in the health care field than those in acute care. The personnel who constantly work with demented patients showed the most positive attitudes towards this group of patients. A larger proportion of personnel with high burnout scores wanted to transfer to another job, compared to those with low burnout scores.

Aged↗
PubMed1988

Conflicting attitudes toward euthanasia for severely demented patients of health care professionals in Sweden.

This survey study of 1,798 Swedish health care workers in 31 acute and chronic institutional settings found considerable disagreement between staff concerning euthanasia. For example, attitudes of aides and LPNs, were significantly (chi 2 = 42.0, P less than .0001) more favorable toward active euthanasia (38.9% of aides and 28.8% of LPNs were neutral or approved) than were RNs and physicians (20% and 14.9%). This disagreement was most apparent among those staff in institutions with many demented patients. Favorable attitudes were also more frequent among aides experiencing job dissatisfaction and "burnout," younger staff, and those without a relative in long-term care. Possible reasons for favorable attitudes toward active euthanasia and staff attitude polarization are discussed along with implications for patient care.

Adolescent↗
PubMed1985

Rapid tranquilization: the efficacy of oral concentrate.

The efficacy of oral concentrate in the rapid tranquilization of 159 acutely disturbed patients in a psychiatric emergency service was evaluated. Patients were randomly assigned to 1 of 10 treatment groups: 7 oral groups and 3 comparison intramuscular groups. Although intramuscular medication produced a faster response, concentrate also proved to be effective for rapid tranquilization. Side effects were benign and minimal. Age, sex, race, and diagnosis had no effect on outcome. The use of concentrate as a paradigm for treating acutely psychotic patients is discussed.

Acute Disease↗
PubMed1984

Geriatric psychiatry in the emergency department, II: Evaluation and treatment of geriatric and nongeriatric admissions.

The records of a hospital psychiatric emergency department were reviewed for elderly and middle-aged patients who were diagnosed with organic brain syndrome (OBS) or psychiatric disorder. These records were then compared with those of elderly patients from the medical emergency department. While elderly medical patients received routine physical evaluations and laboratory testing, elderly psychiatric patients with behavioral symptoms were often referred to psychiatry before they received tests necessary to differentiate physical disorders from functional psychiatric disorders. When tests were administered to psychiatric patients, many abnormal results were apparent, indicating the possible presence of physical disease. It is recommended that all elderly patients with psychiatric symptoms undergo adequate medical evaluations to screen for physical causes of the psychiatric symptoms.

Aged↗
PubMed1983

Depressive symptoms and health service utilization among the community elderly.

The relationship between depression and complaints of physical disease in the elderly is often discussed but has received little documentation. The authors administered questionnaires to 88 elderly volunteers to assess two common psychologic diagnoses, affective disorders and organic brain syndrome, and three common cardiovascular symptoms, pain or numbness in the jaw or arm, pressure in the chest, and difficulty in breathing. Data on utilization of health care professionals and demographic information were also obtained. A significant correlation between reports of depression and complaints of cardiovascular symptoms was seen. While the volunteers with depressive symptoms also visited their physicians more often than did the other volunteers, they did not seek the help of mental health professionals. This raises the larger issue that elderly persons who have mild to moderate depression present to our health care system.

Aged↗
PubMed1982

Geriatric psychiatry in the emergency department: characteristics of geriatric and non-geriatric admissions.

A study was made of the Emergency Department records of 49 elderly (65 years old or older) and 49 middle-aged (40-64 years old) patients seen in an urban hospital's psychiatric emergency service. The data were compared for demographic and admission information, psychiatric treatment history, presenting complaints, symptoms, diagnoses, and final disposition status. For the elderly patients, the referral was more likely to be their first contact with psychiatric treatment, and they were more likely to be referred (accompanied) by family or friends than to be self-referred. Among the middle-aged patients, "substance abuse" (e.g., drugs, alcohol) disorders and schizophrenic disorders were more common. The elderly, however, were much more likely to be regarded as having an organic brain syndrome of unspecified cause (34.7 per cent vs 0). Access to treatment was fairly consistent for both groups as measured by the hospital's priority code, total time spent in the emergency department, and final disposition. These results raise important issues concerning the unique psychosocial characteristics and psychiatric treatment needs of elderly patients. This applies particularly to the emergency-department medical clearance of elderly patients with symptoms of organic brain syndrome.

Adult↗
PubMedDate not supplied

Community mental health care for the elderly--a look at the obstacles.

Despite the recent attention given to mental disorders in the aged and their higher risk for organic mental disorders, older people rarely receive specialized mental health treatment. This paper reviews recent research on some of the major obstacles to the use of treatment by the elderly. These include claims of "ageism" by health care professionals, the negative attitudes and behaviors of older persons toward mental disorders and their treatment, and the failure of general practice physicians to recognize or treat symptoms of mental disorders in their elderly patients or to refer these patients to geriatric mental health specialists. It is suggested that increased public education in geriatric mental health is urgently needed for potential patients, their families, and their general physicians.

Adult↗