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K Wallston

Publications and source records attributed to K Wallston.

3 recordsLinked to original sources
PubMed2001

Effects of home environment, socioeconomic status, and health status on cognitive functioning in children with HIV-1 infection.

OBJECTIVE: To investigate the effects of the home environment, socioeconomic status (SES), and health status on cognitive functioning in a sample of children with HIV-1 infection in a cross-sectional study. METHODS: Forty-three caregivers and their children (2.5 to 12 years) participated. Caregivers completed two self-report measures of the home environment that included questions regarding the organization of the environment, play materials, parental involvement, variety of stimulation, and parental attitudes toward the provision of a cognitively stimulating environment. Cognitive functioning was assessed using a standardized intelligence (IQ) test. Children's medical charts were reviewed for HIV-1 classification status (CDC, 1994), CD4 cell counts, and current medication. RESULTS: This study revealed two primary findings. First, measures of the home environment mediated the association between SES and child IQ. Second, measures of the home environment had a stronger association with child IQ during the advanced stages of disease than earlier stages of disease. CONCLUSIONS: The home environment is associated with cognitive functioning among children with HIV-1 infection. Moreover, interventions aimed at enhancing the quality of the home environment may have a positive impact on these children's cognitive development.

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PubMed1991

Assessment and quality control of incontinence care in long-term nursing facilities.

A statistical quality-control process was used to assess how well incontinence management procedures were being implemented by indigenous nursing staff in four nursing homes. Eighty-one incontinent patients were treated with the prompted-voiding toileting procedure. Thirty-six of these patients proved responsive to the toileting procedures, and nursing home staff was instructed to maintain the toileting program for these responsive patients. The first part of the quality-control model involved setting job standards specifying how dry the patients should be if toileted on a 2-hour schedule. Second, a job-monitoring control chart was used to continuously assess how well the job standards were being met. The remaining forty-five patients, who were unresponsive to the toileting protocol, were managed with a 2-hour changing schedule. Job standards specifying how wet (volume) the patient would be if changed on a two-hour basis were set. Control-chart monitoring of these patients urine output assessed how well the changing procedures were being implemented. Incontinence care in nursing homes is difficult to supervise because of problems in measuring how consistently nursing aides change or toilet patients. This paper describes a management system for effective incontinence care.

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