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Biomedical subjects

Mary Lou Kelley

Publications and source records attributed to Mary Lou Kelley.

9 recordsLinked to original sources

Effects of community violence exposure and parental mental health on the internalizing problems of urban adolescents.

Previous research has documented an association between adolescent community violence exposure (CVE) and poor psychological functioning. The purpose of this study is to delineate the relations of CVE, parental mental health, and adolescent PTSD and depression. Participants consisted of 121 pairs of junior high and high school students and their parents. Adolescents completed measures to assess their history of violence exposure and current psychological functioning. Parents completed a demographic questionnaire and measures assessing their psychological functioning. Hierarchical regression analyses were conducted, and results indicated that, after controlling for demographic variables and family violence exposure, parental mental health emerged as a moderating variable in the relation between CVE and adolescent-rated PTSD, but not in the association between adolescent CVE and depression. Clinical implications of this study and directions for future research are discussed.

Adaptation, Psychological↗

Screening ADHD problems in the sports behavior checklist: factor structure, convergent and divergent validity, and group differences.

The Sports Behavior Checklist (SBC) is subjected to a principal components analysis, and subscales are correlated with subscales of the Conners' Revised Parent Form and the Social Skills Rating System. Both of these analyses are conducted to determine the construct validity of the instrument. A subsample of lower socioeconomic status individuals is used to compare ADHD and control group differences on the subscales of the SBC. The authors find that a six-factor solution, as proposed by the original authors, accounted for 71.5% of the variance. As hypothesized, subscales on the SBC are low to moderately related to subscales on the anchor measures. Significant group differences are found on the Aggression, Emotional Reactivity, and Injury subscales. Implications and limitations are discussed.

Attention Deficit Disorder with Hyperactivity↗

Effects of violence exposure and daily stressors on psychological outcomes in urban adolescents.

Relations between adolescent violence exposure, daily stress, and psychological outcome were examined. Parent/adolescent dyads (N = 80) completed questionnaires, which included parent ratings of adolescent externalizing and internalizing problems and adolescent self-ratings of emotional adjustment. Severity of daily stress moderated the relation between levels of violence exposure and extent of adolescent externalizing and internalizing problems. The relation was significant at higher levels of daily stress, but nonsignificant at lower levels of stress. In contrast, daily stress did not emerge as a moderator in the relation between violence exposure and adolescent emotional adjustment. Results suggest that adolescents experiencing high levels of violence exposure and daily stress should be considered at great risk for poor psychological outcome.

Adolescent↗

Quality end-of-life care in long-term care facilities: service providers' perspective.

The goal of this project was to provide guidance on what constitutes quality end-of-life care in long-term care (LTC) facilities. Seventy-nine direct care providers from six LTC facilities participated in 12 focus groups. The focus group discussions examined what made the difference between a "good" death and a "bad" death, and what changes in LTC would improve the care of dying residents. Analyses of the focus group data revealed six themes that contribute to quality end-of-life care in LTC facilities: responding to resident needs, creating a homelike environment, supports for families, providing quality care processes, recognizing death as a significant event, and having sufficient institutional resources. These findings challenge policy makers and providers to consider how to normalize life and death in LTC facilities.

Aged↗

Building capacity to provide palliative care in rural and remote communities: does education make a difference?

One strategy for improving access to palliative care services in rural and remote communities is to educate community-based health professionals in the knowledge and skills required to provide end-of-life care. It is, therefore, important to evaluate palliative care educational initiatives. This article provides an evaluation of the interdisciplinary education program at Lakehead University which aims to: improve the knowledge and skills of individual providers; contribute to the development of palliative care programs in rural communities; and develop palliative care trainers to educate their co-workers in the workplace. A survey of 353 providers who participated in the education program was completed after eight years of providing education. Results confirm that the goals of the education program were met, and that rural and remote communities reported a greater capacity to deliver palliative care. Nevertheless, respondents identified a lack of resources, especially home care visits, as an obstacle to improving care.

Analysis of Variance↗

Rural nonphysician providers' perspectives on palliative care services in northwestern Ontario, Canada.

Most palliative care in rural remote areas is provided by nonphysicians. This paper reports a survey of interdisciplinary rural health service providers (not including physicians) to identify the strengths and weaknesses in palliative care service delivery in a rural and remote region in northwestern Ontario, Canada. Questionnaires were sent to 156 nurses, homemakers, social workers, and pastoral care workers who care for terminally ill persons and their families, and 122 were completed and returned (response rate 78%). Consistent with practice in most rural areas, 90% of respondents were generalists. Respondents identified several problems with palliative care services, including inadequate training for caregivers, inadequate support services for family and professional caregivers, inadequate human resources, and lack of organized volunteer programs. Suggestions for improvements included better education for service providers; better availability of palliative care services; more counseling and support services for patients, family members, and professionals; and greater availability of respite beds. Overall, respondents rated clients' needs as being better met than their own. The most frequently reported problems for care providers were related to the lack of supports for care provision.

Adult↗

Social problem solving in suicidal adolescents.

Whether adolescent suicide attempters would have deficits in interpersonal problem solving and the relation between social problem solving, suicide intent, and medical lethality were evaluated. Compared with psychiatric and normal controls, adolescents who attempted suicide exhibited poorer social problem-solving abilities, particularly in terms of problem orientation. Specifically, suicide attempters brought more maladaptive cognitive-emotional-behavioral response sets to problematic situations than did psychiatric and normal controls. Both suicide attempters and psychiatric controls had similar deficits in problem-solving skills (e.g., generation of alternatives, decision making, and solution implementation) compared with nonhospitalized peers. Social problem solving was not found to be correlated with suicide lethality or intent.

Adaptation, Psychological↗

Clinical case study: pediatric residents' discussions of and interventions for children's behavioral and emotional problems.

OBJECTIVE: To examine the effects of a screening instrument and parent handouts on pediatric residents' discussions of and interventions for children's behavioral and emotional problems. METHOD: Four pediatric residents and 52 parent-child dyads attending an ambulatory pediatric primary care clinic participated in the study. We used a multiple baseline design across residents. We assessed the effect of the interventions by measuring nine target behaviors of the pediatric residents. RESULTS: After being trained to use the screening instrument, residents increased the number and variety of questions they asked regarding behavioral and emotional issues. Residents' attempts at intervention showed small but consistent increases when handouts on behavior management procedures were made available for distribution to parents. CONCLUSIONS: The use of a screening instrument in pediatric primary care shows promise for increasing discussions between residents and parents about children's behavioral and emotional issues. Further research should examine strategies to improve pediatric residents' attempts at intervention for behavioral and emotional problems in children.

Adolescent↗