PubMed Health⌕ Search

Biomedical subjects

M R O'Leary

Publications and source records attributed to M R O'Leary.

At least 19 recordsLinked to original sources
PubMed1992

From quality assurance to quality improvement. The Joint Commission on Accreditation of Healthcare Organizations and Emergency Care.

The transition from quality assurance to quality improvement is at an early stage, but it clearly has begun. The progressive anticipated changes in the tone and content of JCAHO standards will place the JCAHO in a different posture in relation to accredited hospitals. Standards are of course a set of requirements that must be met as a condition of accreditation. But the JCAHO's bottom line expectation will be a meaningful and demonstrated improvement in hospital performance. How hospitals reach this objective is their business. This shifts the onus of responsibility to where it belongs and suggests a more facilitative role for the JCAHO. Although the JCAHO is introducing standards requirements that are minimally essential to the achievement of improved performance, full-fledged adoption of CQI concepts will not be mandated. Management structures and styles in health care organizations vary considerably, and CQI is but one means to the desired end of improved performance. We believe, however, that it is the best means and that most organizations will discover this for themselves. Notwithstanding the magnitude of needed internal behavioral change, excellence in performance is what most health care organizations want for themselves and their patients. CQI offers them the opportunity to reach this lofty goal.

Emergency Service, Hospital↗
PubMed1979

Application of discriminant analysis to level of performance of alcoholics and nonalcoholics on Wechsler-Bellevue and Halstead-Reitan subtests.

Investigated the utility of subtests from the Wechsler-Bellevue Intelligence Scale and the Halstead-Reitan Neuropsychological Test Battery to differentiate between alcoholics and nonalcoholics (N = 76). Analyses of variance indicated that the alcoholics were more impaired than nonalcoholics. It was found that the Wechsler-Bellevue Performance subtests were more discriminative than were Verbal subtests, with performance on the Halstead-Reitan variables being intermediate. The nine measures that differentiated most significantly between groups were subjected to a stepwise multivariate discriminant analysis. The resulting function correctly classified Ss with an overall accuracy of 74.7%. It was found that the Block Design subtest was the best single discriminator. The findings were discussed in relationship to previous findings and with respect to general issues of clinical neuropsychological assessment.

Alcoholism↗
PubMed1979

Implicit preadmission screening criteria in an alcoholism treatment program.

The fact that alcoholism programs are biased in terms of the kind of patients admitted to treatment is well recognized. The authors examined the possible bias of preadmission screening procedures in an alcoholism treatment program and investigated some of the criteria used by staff clinicians in determining an applicant's acceptability for treatment. They found that accepted and rejected applicants had highly similar characteristics, differing only in age (accepted applicants were slightly younger than those rejected) and source of referral. The overall findings suggest that clinicians implicitly evaluate problem drinkers along dimensions related to their perceived "treatability" in a given therapeutic setting.

Adult↗
PubMed1979

Validation of a subjective helplessness measure.

Investigated the potential utility and validity of a measure of subjective helplessness, the H25. Helplessness is defined as the degree to which the individual perceives him/herself to be unable to influence or control the initiation and outcome of a variety of potentially reinforcing activities. Alcoholic subjects were classified into three levels of self-reported helplessness. An initial multivariate analysis of variance indicated that the groups differed with respect to severity level across a number of dimensions of depressive symptomatology, with the High Helplessness group appearing significantly more depressed on each of the measures than Low Helplessness subjects. Subsequent analyses supported the construct validity of the H25. Those measures found to be most descriminating between groups and most predictive of the level of helplessness reflected a dimension of behavioral retardation consistent with the motivational dificits noted in the learned helplessness model. Recommendations for the future validation of individual difference measures of helplessness are discussed.

Adult↗
PubMed1979

Influence of cognitive style on an incidental memory task.

The present study investigated the interaction between cognitive style, imagery, and memory. The Tactual Performance Test Location Score from the Halstead-Reitan battery was used as a measure of incidental tactual memory and mental imagery. The Group Embedded Figures Test was used to assess cognitive style. Results for 38 Caucasian males of mean age 49.9 yr. suggest that cognitive style is related to an individual's ability to perform a non-verbal, non-visual memory task. Further, cognitive style may be an important mediating variable influencing intrapersonal behaviors such as non-verbal memory and mental imagery.

Field Dependence-Independence↗
PubMed1979

Control orientation among alcoholics: a cognitive social learning perspective.

A cognitive social learning model of the maintenance of problem drinking is presented. Basic constructs involving social skills acquisition, experienced cognitive control and self-efficacy expectations as they relate to alcoholism are discussed. It is concluded that the model provides a useful theoretical framework in which to conceptualize the development, maintenance and treatment of drinking problems. A number of specific suggestions are made for further research which test various hypotheses generated by this model.

Adaptation, Psychological↗
PubMed1979

The use of multivariate personality strategies in predicting attrition from alcoholism treatment.

This study attempted to replicate previous work which used discriminant analysis to predict attrition from an outpatient alcoholism treatment program. The MMPI-168 and Rotter's locus of control scale were administered to a sample of inpatient male alcoholics who later entered outpatient treatment. The MMPI-168 was scored using 5 factor-analytically derived measures, Depression, Somatization, Low Morale, Psychotic Distortion and Acting Out. Both studies found Depression to be the strongest predictor of attrition after controlling for Somatization. Internal locus of control was also related to attrition. The utility of discriminant analysis in predicting outcome from personality data and the ramifications for treatment is discussed.

Adult↗
PubMed1979

Interpersonal attractiveness and clinical decision in alcoholism treatment.

The authors investigated the interactive contribution of patient characteristics and staff perceptions of the patient to decisions concerning the provision of continued alcoholism treatment following an initial 2-week evaluation period. Staff perceptions contributed significantly more to an individual's acceptance or rejection than did patient characteristics. A high interpersonal attractiveness rating also led to a significantly more positive evaluation of the patients' level of intelligence, knowledge of current events, morality, and adjustment. The present results and research findings with general psychiatric populations are compared.

Adult↗
PubMed1979

Correlates of clinicians' perceptions of patients in alcoholism treatment.

Previous research has shown that clinicians' perceptions of alcoholic patients' interpersonal attractiveness exert an influence on clinical decision processes. The present study investigated the relationship between clinicians' perceptions of alcoholic patients, as measured by Byrne's Interpersonal Judgment Scale, and patients' personality, cognitive, and demographic characteristics. The results suggest that the male alcoholic patient is more likely to be perceived favorably if he is young and exhibits behaviors that correspond to clinicians' treatment expectations. Overall, the measured personality characteristics of patients accounted for only small proportions of the variance in clinician's ratings of patients attractiveness. Alternative interpretations of these data are discussed with reference to subsequent research efforts.

Age Factors↗
PubMed1979

Cognitive impairment and treatment outcome with alcoholics: preliminary findings.

The relationship of cognitive impairment to treatment outcome in a sample of male alcoholics (N = 30) was explored. The Brain-Age Quotient (BAQ), an index of problem solving and adaptive abilities based on a battery of neuropsychological tests, was used as the summary measure of cognitive impairment. High BAQ scores were found to be more highly related to clinical ratings of patients' level of functioning on the treatment ward, to the successful completion of inpatient treatment, and to fewer relapses, longer abstinence periods, and lower rates of alcohol consumption at a 1 year follow-up than were lower BAQ scores. The implications of these findings with regard to appropriate treatment planning are discussed.

Alcoholism↗
PubMed1978

The use of the Goldberg Indices with alcoholics: a cautionary note.

Applied Goldberg's (1972) regression equation for the classification of MMPI profiles to the MMPI profiles of 173 alcoholic male veterans. All Ss also completed a detailed alcoholic life history questionnaire. It was hypothesized that there would be differences between the life history responses of those Ss classified as sociopathic and those classified as normal neurotic, or psychotic. However, analysis revealed no significant differences between the groups. This finding is discussed in terms of the relationship of life events to diagnosis and the validity of the use of Goldberg Indices with alcoholic patients.

Alcoholism↗
PubMed1978

Locus of control research on alcoholic populations: a review. I. Development, scales, and treatment.

Research literature dealing with the relationships of locus of control to alcoholism and the treatment of alcoholism is reviewed. The review includes a discussion of some of the scales used in this research, the relative locus of control of alcoholics compared with controls, the change in locus of control during treatment of alcoholics, and the relationship of locus of control to treatment success. Much of the research is inconclusive. Research on the control orientation of alcoholics compared to controls has had equivocal results, but the better designed studies tend to find no difference or externality in alcoholics. Most studies find that alcoholics become more internal over treatment, but the relationship of locus of control to treatment success is unclear. Methodological difficulties have included problems with sampling, selecting appropriate controls, assuming homogeneity of alcoholics as a group, and assuming linearity and unidimensionality of the scales. A number of needed studies which would clarify some of the questions are suggested.

Alcoholism↗