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Biomedical subjects

L Gurel

Publications and source records attributed to L Gurel.

At least 19 recordsLinked to original sources
PubMed1998

Scheduled intermittent hospitalization for psychiatric patients.

OBJECTIVE: The effect of scheduled intermittent hospitalization on the hospital utilization, community adjustment, and self-esteem of persons with serious and persistent mental illness was examined in an experimental study. METHODS: Fifty-seven male veterans, aged 65 or younger, with a primary axis I psychiatric diagnosis who were frequent utilizers of inpatient care over the previous two years were randomly assigned to two groups. Patients in the experimental group were prescheduled for four hospital admissions, each lasting nine to 11 days, per year for two years. Patients in the control group had traditional access to hospital care. Psychiatric bed days, community adjustment, and self-esteem were assessed during and after the intervention. RESULTS: No differences between the groups on demographic or clinical variables were detected at study entry. The experimental group showed improvement in self-esteem, affect, and complaints of physical symptoms at one year. No statistically significant differences between groups were found in hospital utilization, financial management, substance abuse, or psychological well-being at one year. CONCLUSIONS: Scheduled intermittent hospitalization may be an appropriate and promising alternative to traditional care for revolving-door patients. This intervention could maintain patients at a higher level of wellness than traditional care and reduce the recurrence of the crises that precipitate hospitalization.

Adult↗
PubMed1987

Knowledge of AIDS among hospital workers: behavioral correlates and consequences.

Incidents of suboptimal care being rendered to AIDS patients have been documented. Using a voluntary anonymous questionnaire, we surveyed the employees of a large urban hospital in order to evaluate the knowledge, attitudes and professional behavior of the staff regarding AIDS. Responses were obtained from 1194 (60%) of the staff. Poor knowledge of the transmission of AIDS was documented, with 50% of workers stating that AIDS can be spread through ordinary non-sexual contact and 23% through the air by a cough or a sneeze. One-third of employees believed that they should be able to refuse to care for patients with AIDS. Extreme anxiety in dealing with AIDS patients was noted by 25% of employees, and only 16% of the employees would volunteer to work on an AIDS ward. Knowledge regarding AIDS was demonstrated to be a predictor of positive attitudes, appropriate professional behavior and lower anxiety in dealing with AIDS patients. The goal of hospital education programs on AIDS must be to ensure the incorporation of accurate information into the belief system of workers.

Acquired Immunodeficiency Syndrome↗
PubMed1985

Nursing home care as an alternative to psychiatric hospitalization. A Veterans Administration cooperative study.

Nursing homes have played a major role in deinstitutionalization, and their increased use for the mentally ill has been questioned. We performed a controlled study of nursing homes as an alternative to continued psychiatric hospitalization. Men (N = 403) referred for nursing home placement from eight Veterans Administration medical centers were randomly assigned to community nursing homes (CNHs), Veterans Administration nursing care units, continued care on the same ward, or transfer to another psychiatric ward. Patients met defined criteria for schizophrenia or organic brain disease. Data were collected before random assignment and six and 12 months later, covering physical and mental function, psychopathology, mood, social adjustment, satisfaction with care, as well as drug use, characteristics of settings, and movement in and out of settings. Significant differences between settings were found in self-care, behavioral deterioration, mental confusion, depression, and satisfaction with care. Results were strikingly consistent, showing the group transferred to another ward doing better and the CNH group doing worse. Drug use did not differ from six months before entering the study or later between the settings. Cost showed a marked advantage for the CNH group. Thus, the less costly community nursing home alternative must be viewed in the context of the nonmonetary costs of less favorable patient outcome.

Aged↗
PubMed1977

Patterns of association voting behavior: I. Demographic correlates of voting/nonvoting and preference for candidates/issues.

A total of 58% of the eligible members voted in the 1974 APA balloting involving 6 officers, 13 amendments to the By-Laws, and a membership-initiated referendum. Analysis revealed that there was no significant relationship between member characteristics and voting/nonvoting behavior and that relatively few members followed specific voting patterns. The data support the view that most members voted carefully and relatively independently of organized influence.

Adult↗
PubMed1977

Patient outcome as a measure of quality of nursing home care.

One thousand males transferred from a general medical hospital into 40 community nursing homes were classified by their physicians as to expectations of outcome within six months and measured on physical functioning at the time of their transfer. They were followed up six months later and retested on functional status. Subjects were classified on follow-up as improved, the same deteriorated, or dead. They were also classified as discharged from the nursing home, still in the home, or readmitted to the hospital. Nursing homes were measured every six months on structural variables. Outcomes of the patients were related to the nursing home characteristics by multivariate analysis of variance, controlling for expected outcome, age, and diagnoses of cancer and chronic brain disease. Homes with more RN hours per patient were associated with patients being alive, improved, and discharged from the home. Better ratings on meal services were related to being alive and improved. A higher professional staff-to-patient ratio, better medical records, and more services were related to being discharged from the nursing home.

Aged↗
PubMed1975

Some characteristics of psychiatric residency training programs.

The author summarizes responses to a major questionnaire survey of psychiatric residency training programs. In addition to providing objective data on residents, training staff, and on the training institution and its related facilities, the author presents information drawn from the narrative responses to questions on major issues facing psychiatry. These include training for dealing with critical social problems, recruitment of minority group trainees and faculty, and training in interdisciplinary collaboration and preparation for work with paraprofessionals. It is hoped that these data will facilitate answers to questions about the training psychiatrists should receive in the future by providing information about training programs in the immediate past.

Child Psychiatry↗
PubMed1975

Project Anchor: a study of an unsuccessful volunteer program to help former patients.

The authors conducted a controlled research investigation into the effectiveness of a volunteer program at three Veterans Administration hospitals. In the program, called Project Anchor, volunteers helped mental patients being released from the hospital become reintegrated into their home communities. A total of 78 volunteers and 89 patients participated in the program; another 82 patients served as a control group. The researchers compared the two patient groups using data obtained through questionnaires, interviews, and hospital records. Analysis of the data indicated that the program had little therapeutic effect for the patients involved. The authors believe that the results are a forceful argument against an uncritical investment of treatment funds and personnel in outpatient volunteer programs, and that they raise serious questions about the proper role of the volunteer.

Adaptation, Psychological↗