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Biomedical subjects

I L Abraham

Publications and source records attributed to I L Abraham.

At least 55 records · Page 3Linked to original sources

Outpatient psychogeriatric nursing services: an integrative model.

The complex needs of psychogeriatric patients and their families require specialized outpatient psychogeriatric services. The interaction of physical and mental health and the need for coordinated care places important responsibilities on nursing because it contributes to integrated, multidisciplinary care delivery to these patients and their families. This article presents a model of outpatient psychogeriatric nursing services focused on the community integration of patients and families. Experiences in the development of the Geriatric Neuropsychiatry Clinic at the University of Virginia, Charlottesville, are used as the point of departure from which to describe a model of outpatient psychogeriatric nursing care delivery that is multidisciplinary, clinically innovative, and epidemiologically justified.

Aged↗

The Geriatric Depression Scale and Hopelessness Index: longitudinal psychometric data on frail nursing home residents.

We administered the Geriatric Depression Scale and the Hopelessness Index 18 times over a 39-wk. period to an initial sample of 76 old, frail, multiply impaired, and depressed nursing home residents participating in a longitudinal quasi-experimental study on the effects of cognitive group interventions on cognition, depression , hopelessness, and life satisfaction. As no changes over time were observed on the outcome variables of geriatric depression and hopelessness, the stability of the instruments' internal consistency was examined longitudinally. For the Geriatric Depression Scale, Kuder-Richardson KR-20 coefficients ranged from .69 to .88, with a mean of .82 (SD = .05). Coefficients for the Hopelessness Index were between .72 and .86, with a mean of .80 (SD = .04). We conclude that both instruments give reliable measurements of geriatric depression and hopelessness in old, frail, and depressed nursing home residents.

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Depression. Nursing implications of a clinical and social problem.

Depression is a phenomenon with concurrent personal, social, and clinical dimensions. Each person is affected by depression differently and expresses depressive symptomatology in a unique manner. Socially, the incidence of depressive illness in the general population is three times that of schizophrenia. The cost of depression in terms of lost days at work and treatment is estimated to be $29 billion in 1991. Diagnosing and treating depressive illnesses depend on the clinical manifestations of the illness and the assessment skills of the practitioner. Different treatment modalities such as psychotherapy, psychopharmacology, and electroconvulsive treatments can be effective singularly or in combination to assist the patient in regaining his or her functionality in daily life.

Depression↗

Therapeutic group work with depressed elderly.

This article presents several approaches to therapeutic group work with the elderly, drawing from experience in designing and implementing several group interventions for frail nursing home residents. What is important to recognize is that the common preconception that the elderly, in general, and the frail, in particular, cannot participate in therapy and groups is a misconception at least, if not a prejudice.

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A psychogeriatric nursing assessment protocol for use in multidisciplinary practice.

The assessment of geriatric patients with psychiatric or neurobehavioral problems demands a multidisciplinary approach linking nursing, psychiatry, neurology, geriatrics, and internal medicine. While the medical disciplines have relatively well-established approaches to assessing psychogeriatric patients, nursing lacks a comprehensive assessment strategy that supports both nursing and multidisciplinary practice. This article describes the Psychogeriatric Nursing Assessment Protocol (Abraham, 1989) developed for use in a multidisciplinary geriatric neuropsychiatric outpatient clinic. The relationship of the protocol to psychiatric, neurological, geriatric, and medical assessments is discussed in an attempt to clarify the linkages of knowledge and care required for successful service delivery to geriatric patients with psychiatric or neurobehavioral problems, as well as to their families and formal and informal caregivers.

Activities of Daily Living↗

Changes in resident mix in nursing homes: cognitive and sensory data from a (redesigned) sampling plan.

In planning and implementing a study, we unintentionally and serendipitously obtained data about changes in resident mix over a 2.8-yr. period. We screened residents of a 184-bed nursing home for cognition and sensorium in October 1984 to assess sampling feasibility for a grant proposal in preparation. At that time, 65.2% of the residents met the sampling criteria. However, in July/August 1987, after award of funding, only 5.4% of residents of the same nursing home met the cognitive and sensory criteria. We were forced to recruit from an additional six nursing homes, in which only 9.3% of residents met the sampling criteria.

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Unemployment and health. Health promotion for the jobless male.

This article reviews the effects of joblessness on health, with a special emphasis on men. This serves as the basis of a model for health promotion for the unemployed male, bringing together personal, family, and community resources. Health care policy is also considered.

Family↗

Diagnostic discrepancy and clinical inference: a social-cognitive analysis.

This review posits that clinical inference be studied as an instance of human inference. Normative rules for clinical inference may be derived from those for human inference in general, but clinicians choose not to adhere to them, relying instead on possibly biasing and suboptimal methods. A seven-phase model of clinical inference, with each phase containing particular tasks, is presented. Performance on these tasks depends on the effect of cognitive and environmental influences and the application of cognitive strategies, with erroneous performance leading to impaired clinical inference.

Diagnosis, Differential↗

A proposed expert system for nursing practice. A springboard to nursing science.

The knowledge on which nursing practice is based comes largely from traditional sources, expert nurses passing on the wisdom of their experience to novices. Nursing research, although increasing, is usually parallel to nursing practice, and its findings, at best, are implemented only after long delays. Consequently, the most effective nursing responses to a particular client problem may be undiscovered or unknown. Nursing information systems reflect the nature and usage of nursing knowledge. They offer standard care plans, but the knowledge and decision structures for individualizing care remain exclusively in the mind of the nurse. Nurses may have great freedom to enter information into the information system, but the information is rarely retrievable in a form suitable for evaluation or research. Nursing practice, and the knowledge on which it is based, could be enhanced through the use of a novel expert system. This paper describes how such a system could be developed, with examples from the authors' prototype programs. Taxonomies of data, diagnoses, objectives, and interventions would make it possible to compare patients and to determine the relative effectiveness of nursing interventions. A built-in evaluation component would provide feedback and correction. Everyday nursing practice would become a field for research, and the knowledge gained from research would immediately be fed back into practice. In its development and in its implementation, this kind of system would help to build nursing science.

Computers↗

Critique: external comparison of conceptual nursing models.

Research by Jacobson on development of a semantic differential for external comparison of conceptual nursing models was reported in 1984. The present article critiques the philosophical stance and the research methods presented in the Jacobson report. Methods of analysis and evaluation of conceptual nursing models are reviewed, and the influences of conceptual nursing models on the structure of the discipline are examined in light of the purposes of the Jacobson study. Issues related to the investigation and use of models in the development of nursing knowledge are discussed.

Humans↗