PubMed Health⌕ Search

Biomedical subjects

J S Lyons

Publications and source records attributed to J S Lyons.

At least 55 records · Page 3Linked to original sources
PubMed1993

Nursing care hours of patients receiving varying amounts and types of consultation/liaison services.

Psychiatric comorbidities in the general hospital population have been found to increase the cost of health care. This descriptive study provides an in-depth analysis (including nursing hours), of general hospital patients receiving low, medium, and high intensity consultation/liaison (C/L) services from C/L psychiatrists and C/L nurses using computerized databases and the medical record. The results show that there are significant differences among the subgroups receiving varying amounts of C/L services. This study has particular significance for C/L nursing as many C/L nursing interventions are focused on both the patient and the delivery of nursing care by the staff nurse.

Cost-Benefit Analysis↗
PubMed1993

Prayer and health during pregnancy: findings from the Galveston Low Birthweight Survey.

In this study we examined the relationship between praying for one's baby during pregnancy and self-ratings of health. Data were collected from a biethnic (black and Hispanic) sample of postpartum mothers in Galveston, Tex, from 1986 to 1987. This sample is representative of the annual biethnic population of live births in Galveston. Subjective health was assessed for the periods both before and during pregnancy with self-ratings of global or overall health, worry over health, and functional health or lack of disability. Analyses controlled for the effects of the mother's age, marital status, gravidity, education, and self-rated religiosity. Findings revealed that all three prepregnancy health measures were associated with prayer. Subjectively unhealthier mothers prayed more for their baby during pregnancy regardless of their perceived health during pregnancy, and subjectively healthier mothers prayed less for their baby regardless of their self-reported religiosity. Additional analyses revealed that the effect of poor health on the frequency of prayer was not simply an outcome of the mother's worry over her own health.

Adult↗
PubMed1993

A brief agitation rating scale (BARS) for nursing home elderly.

OBJECTIVE: To determine the effectiveness of a brief agitation rating scale (BARS) derived from the Cohen-Mansfield Agitation Inventory (CMAI). DESIGN: Test of reliability and validity of a new test. SETTING: The Lieberman Geriatric Health Centre, a skilled nursing facility. PARTICIPANTS: Forty members of the Lieberman Geriatric Health Centre nursing staff, 232 residents, and a sample of 40 randomly selected residents. MEASUREMENTS: Observational agitation ratings by registered nurses and certified nurses' assistants; item to total correlations for the CMAI on each of the three shifts; Pearson correlations between the 10-item BARS and the BEHAVE-AD and the BSSAD scales. RESULTS: Internal consistency reliability for the BARS was .74 (for the day shift), .82 (evening shift), and .80 (night shift), compared with .86, .91, and .87 for the full CMAI. Each of the 232 residents' scores on the BARS was correlated with a total score from the CMAI separately on each shift. Correlations were of .95, .94, and .95. Thus, across all shifts, the BARS accounted for approximately 90 percent of the variance of the total score of the CMAI. Concurrent validity of the BARS was supported by significant correlation with BEHAVE-AD and BSSD. CONCLUSIONS: The BARS represents a brief and effective mechanism to assess the presence and severity of physically aggressive, physically non-aggressive, and verbally agitated behaviors in elderly nursing home residents.

Aged↗
PubMed1993

Religious content in the DSM-III-R glossary of technical terms.

The authors reviewed Appendix C of DSM-III-R, Glossary of Technical Terms, for its references to religion. Religion was referred to more frequently in this glossary than it is in psychiatric research. The authors conclude that although the Glossary uses religion in constructive or cautionary reminders, the high rate of illustrative case examples of psychopathology that involve religion in the Glossary indicates cultural insensitivity in interpreting religion.

Humans↗
PubMed1992

Evaluating psychiatric consultations in the general hospital. Multivariate prediction of concordance.

A study of 316 consultation cases was undertaken to examine the concordance between the psychiatric consultants' recommendations and the consultees' follow-through. Using a model of case concordance (defined as the proportion of all recommendations followed on each case), it was demonstrated that process variables, including who (the referring doctor p < or = 0.07) recommended what (psychosocial ward management p < 0.01, psychosocial diagnostic action p < 0.01, biological diagnostic action p < 0.01, aftercare p < or = 0.02, and number of recommendations p < or = 0.03), and when (timing of consultation p < or = 0.02), were the significant predictors of case concordance rather than clinical or demographic variables.

Comorbidity↗
PubMed1992

Family functioning as a predictor of progress in substance abuse treatment.

This study tested the hypothesis that the level of family functioning is related to changes in the patient's progress while in treatment. We studied the relation of family functioning, as measured by the Family Adaptability and Cohesion Scales' (FACES II) dimensions of cohesion and adaptability, to 7 dimensions of the severity of patient drug use, as measured by the Addiction Severity index (ASI). The results indicated that family functioning, the cohesion dimension in particular, predicts severity of patient's dysfunction resulting from drug use and family and psychological problems. In particular, 28% of the variability in the ASI Drug Problems, 52% of the variability in the ASI Family Problems, and 29% of the variability in the ASI Psychological Problems were accounted for by the FACES II cohesion score. Although the study has several limitations, it supports the relevance of family factors in the treatment of drug-addicted patients.

Adaptation, Psychological↗
PubMed1992

Associations between dimensions of religious commitment and mental health reported in the American Journal of Psychiatry and Archives of General Psychiatry: 1978-1989.

The authors assessed all measures of religious commitment (N = 139) reported in research studies published in the American Journal of Psychiatry and Archives of General Psychiatry in 1978 through 1989 (N less than 35). For nearly two-thirds of the measures, the studies either made no hypotheses or reported no results concerning the relationship of religious commitment to mental health status. For the great majority of the measures assessed, the studies reported a positive relationship between religious commitment and mental health.

Humans↗
PubMed1992

An estimation of the impact of OBRA-87 on nursing home care in the United States.

The Omnibus Budget Reconciliation Act of 1987 (OBRA-87) established criteria for Medicare- or Medicaid-certified nursing homes to use in admitting or retaining mentally ill patients. In effect, the law created five dispositional categories for residents or potential residents of nursing homes. Using data from the 1985 National Nursing Home Survey conducted by the National Center for Health Statistics, the authors estimate what proportion of nursing home residents would fall into each of the categories. They suggest that the initial impact of the law will be to shift costs from federal programs to the states. Nursing homes will be expected to provide more mental health services. In the absence of other services, the regulations have a high potential for creating homelessness and continuing a pattern of failure to adequately serve patients with serious mental illness.

Activities of Daily Living↗
PubMed1992

Clinical and economic evaluation of benzodiazepines: a value analysis.

Benzodiazepines are one of the most frequently prescribed classes of medications in the world. Thought to relieve the symptoms of anxiety, insomnia, epilepsy, and some less common conditions, these medications are supported by a body of clinical trials demonstrating efficacy. However, there is also literature that suggests problems of abuse and dependence, along with some serious adverse effects. The present article utilises a value-analysis strategy to outline the clinical efficacy and economic efficiency of benzodiazepines from a variety of perspectives including those of the patient, physician and manufacturer. Results of this analysis suggest that these medications are effective when used appropriately, but that implementation of appropriate use is difficult. Remedies to this situation are discussed.

Benzodiazepines↗
PubMed1991

A biopsychosocial treatment approach to the management of diabetes mellitus.

The relationship among recent life stress, social support, a patient's locus of control, and the control of blood glucose is evaluated in persons with diabetes mellitus, using objective measures of these psychosocial variables. Short-term [fasting blood sugar (FBS)] and long-term [glycosylated hemoglobin (Hgb A-1C)] control measures are taken at two points in time in order to evaluate the effects of the psychosocial variables on change in diabetes control. For life events, a significant positive association was found between the number of recent life events and blood glucose control. Decrease in social support predicted a worsening of longer-term (Hgb A-1C) control over time. An external locus of control within the patient was associated both with poor short-term control at time one and prediction of poorer long-term control over time. The implications of these findings are discussed in support of a biopsychosocial approach to the management of diabetes mellitus.

Blood Glucose↗
PubMed1991

Psychiatric consultations for psychoactive substance disorders in the general hospital.

A series of 511 consultations to a psychiatric consultation-liaison service was studied. Patients diagnosed with substance abuse disorders were found more likely to be younger, male, and nonwhite. Payer status was not significantly different. Psychiatric consultants' recommendations for substance abuse patients more often consisted of aftercare referral, with less utilization of nonmedical consultations, environmental manipulations, social support, and psychological testing. Further, nonsubstance abusers received more and longer follow-up visits. Overall length of stay was shorter for substance-abuse cases, and for nonabusing cases earlier consultation was associated with briefer hospital stay. The authors discuss factors that may explain these findings, and urge psychiatric consultants to rethink their approach to these patients. A thorough, thoughtful diagnostic evaluation and consideration of a variety of interventions is always indicated.

Adult↗
PubMed1991

Health service delivery and research outcomes of a common departmental structure for psychiatric consultation-liaison and social work services at a university hospital.

Convincing evidence exists that psychosocial factors have a major impact on both outcome and costs in the medical/surgical services in general hospitals. This paper describes the Human Services Department's impact on social work and consultation-liaison psychiatry, using a data-based management system across five specialties: 1) social work; 2) consultation-liaison psychiatry; 3) supportive care (hospice); 4) home care (home health discharge planning); and 5) pastoral care, which offers opportunities for research and quality assurance monitoring. Time spent in service delivery was used to estimate the cost per hour: 1) pastoral care $96; 2) social work $36; 3) consultation-liaison psychiatry $59; 4) home care $49. Referral to social work was preferred for a range of family and discharge planning services. Consultation-liaison services were preferred for depression, paranoid behavior, and management problems. Referral overlap was noted for "coping with diagnosis" for social work and consultation-liaison psychiatry. Using a computerized data base format for documenting the referral process, work accomplished, and time spent among those services providing mental health care in the general hospital permits the observation of redundancy of services delivered and their costs.

Chicago↗
PubMed1991

Mandatory parental involvement prior to adolescent abortion.

The issue of parental involvement in an adolescent's decision to abort a pregnancy is complex and controversial. Consequently, the impact of legislation to mandate parental involvement is reviewed. Although the costs of such legislation are high, there are at least three important clinical benefits. First, a legal mandate will require many adolescents who would not otherwise involve their parents in this decision process to seek their counsel and emotional support. Second, parent's responsibility for the actions of their adolescent children is acknowledged within the legal system. Third, family unity may be promoted by allowing parents and adolescents an opportunity to deal more openly with the causes and implications of the pregnancy.

Abortion, Legal↗