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Biomedical subjects

P Goering

Publications and source records attributed to P Goering.

17 recordsLinked to original sources
PubMed1992

Social networks of residents in supportive housing.

One goal of supportive housing is to enlarge and improve the functioning of the social support networks of residents. The networks of a convenience sample of 42 residents were assessed using scales developed by Barrera. The size of the networks (11.5) was no larger than that reported for similar clients living in other types of community settings but the composition differed. Staff and co-residents appear to partially replace rather than add to family and friends. This is of concern because friends are uniquely important determinants of satisfaction. An association between perceived need for support and network size was also found. These findings suggest some positive influences but also raise questions about unintended negative consequences of living in artificially constructed social environments.

Adult↗
PubMed1992

Clinical issues in social network therapy for clients with schizophrenia.

Social networks are viable foci for therapeutic interventions. A social network therapy program for clients with schizophrenia was developed by a community-based mental health agency. This paper presents four of the most common clinical issues encountered and illustrates each with a case example.

Adult↗
PubMed1992

Gender differences in the manifestations of problem drinking in a community sample.

A probability sample of 6,250 respondents in Ontario and Quebec was surveyed by telephone to determine the prevalence of problem drinking and its relationship to other psychiatric symptoms. The survey instrument included a psychiatric symptom inventory and questions relating to problem drinking that were adapted from the Diagnostic Interview Schedule. This survey found a rate of 7.1% for problem drinking which parallels other recent community surveys. Rates for men are approximately six times greater than for women. A significant proportion (18.5%) of problem drinkers have concurrent psychiatric impairment. The extent and nature of concurrent psychiatric impairment and disability differs significantly for men and women.

Adolescent↗
PubMed1992

Gender differences among clients of a case management program for the homeless.

Differences between 24 female and 35 male clients were assessed at entry into an intensive case management program serving homeless shelter residents and again nine months later. Both men and women were socially isolated, with small social networks and severe deficits in social functioning. Histories of homelessness were similar for both genders, and there were no gender differences in psychopathology at baseline or follow-up. At entry into the program women had higher levels of social skills, larger and more supportive networks, and better housing conditions than men, but these differences disappeared after the subjects spent nine months in the program. Inadequate living conditions may have contributed to the more negative initial picture for men. Although there were more similarities than differences between the men and women in this sample, more research on gender differences is needed to design and evaluate programs for homeless mentally ill persons.

Adult↗
PubMed1992

Supportive housing: a consumer evaluation study.

The current debate about how to provide housing for persons with persistent psychiatric disabilities should be informed by empirical information from a variety of sources. Data from a study of 17 residents discharged from Regeneration House Inc., illustrates the value of consumer perceptions in the evaluation of supportive housing. Extensive exploration of the positive and negative aspects of living in a group home from the perspective of experienced residents provides useful input for programme planning. The implications of the findings for the individual programme and the wider field are discussed.

Activities of Daily Living↗
PubMed1992

Planning mental health services: I. Background and key issues.

Planning mental health services is a complex task requiring an understanding of background developments and key issues related to mental health services. In Canada, the deinstitutionalization of patients attempted to shift the locus of care from provincial psychiatric hospitals to general hospital psychiatric units. This resulted in the isolation of provincial psychiatric hospitals, general hospital psychiatric units and community mental health programs, with little overall accountability for the services provided--three solitudes. To move toward the creation of responsible, integrated systems a number of issues must be addressed: target population(s); the roles of provincial psychiatric and general hospitals; community support services; continuity of care; co-morbidity; consumerism; and methods of integration. In the development of a comprehensive mental health plan, each issue should be recognized and decisions made which are in keeping with current knowledge. A companion report will survey Canadian initiatives in mental health planning and discuss approaches to many of the issues identified.

Activities of Daily Living↗
PubMed1992

Planning mental health services: II. Current Canadian initiatives.

A brief overview of recent policy developments across Canada and a discussion of the common themes and challenges they address demonstrates the scope of activity in this field. The federal level of mental health planning and a summary of recent of policy developments in each province are described. Significant progress has been made in Canada in the development of mental health services since deinstitutionalization. Major challenges remain, however, which are being addressed to varying degrees across the country. The challenges related to the key issues of major mental illness, integration and consumerism are illustrated.

Canada↗
PubMed1991

The expanded role of nurse case managers.

1. Effective nursing practice is responsive to the changing needs of clients. The community, rather than the hospital, has become the primary treatment setting in which the long-term mentally ill manage their daily activities. 2. The professional role of rehabilitative nurse case management can provide an opportunity for nurses to expand their roles and develop new career directions. 3. The primary nursing model provides an excellent foundation for acquiring the attitudes and skills necessary in the delivery of a comprehensive rehabilitative model of case management.

Hospital Departments↗
PubMed1990

Housing homeless women: a consumer preference study.

Consumer preference surveys can provide valuable information on which to base the planning and development of housing for groups with special needs. The authors describe a survey that explored the housing histories, problems, needs, and preferences of a sample of 38 chronically homeless women contacted in metropolitan Toronto hostels and drop-in centers. Despite having multiple mental and physical health problems, the women showed a strong preference for a normal, independent living situation. However, they acknowledged the need for a range of supportive services to maintain themselves in such a situation. The women strongly opposed being housed in settings with mentally ill persons, with alcohol or drug abusers, and with those involved in criminal activities.

Adolescent↗
PubMed1989

Training volunteers to work with the chronic mentally ill in the community.

The psychiatric literature gives evidence supporting the use of volunteers in caring for chronic psychiatric patients in the community. Thorough training of volunteers can be expected to enhance the quality of care they provide and help them to maintain interest in their role. The ten-week training program described in this paper was designed to increase volunteers' knowledge of mental illness, improve the quality of care they provided, and stimulate interest in the volunteer role. Pre- and posttraining scores on a questionnaire indicated that volunteers' knowledge had increased. The volunteers rated most aspects of the training very highly and felt that the orientation had helped them meet their goals. Several volunteers indicated increased tolerance for the mentally ill. Many questions remain unanswered. For example, in the long run, what difference does such training make for the patients with whom the volunteers work? Will reluctant professionals be more willing to refer patients to volunteer-staffed programs if those volunteers have had intensive training? Is the training cost-effective? We feel that the potential benefits of volunteers working with the chronic mentally ill in the community make this an important area for future research.

Chronic Disease↗
PubMed1988

Aggressive combined modality treatment of progressive sinonasal fungal infections in immunocompromised patients.

PURPOSE: Invasive fungal infections of the paranasal sinuses in immunocompromised hosts are often fatal despite therapeutic interventions. In an effort to achieve a better outcome in patients with these infections, aggressive management was combined with medical/surgical intervention. PATIENTS AND METHODS: A series of 18 immunocompromised patients with invasive sinonasal fungal infections was retrospectively analyzed. Management consisted of a combined modality clinical approach, including aggressively sought early diagnosis; early amphotericin use; extensive surgical debridement; and liberal use of granulocyte transfusion support. RESULTS: Eight of 13 patients with eventual neutrophil recovery survived with control of all local and systemic signs of fungal infection. All patients with persisting neutropenia died of progressive infection. CONCLUSION: We conclude that meticulous surveillance of patients in high-risk groups for fungal infection should be maintained due to the apparent value of rapid intervention with a combination of surgical resection and medical management (antifungal chemotherapy and white blood cell transfusions). Infection control and survival are ultimately dependent on recovery of marrow function and circulating neutrophils.

Adolescent↗
PubMed1985

Psychiatric aftercare in a metropolitan setting.

In the face of the trend toward brief hospitalization, rising re-admission rates and other indices of poor community adjustment, concern has developed about the adequacy of psychiatric aftercare services. The authors report on a comprehensive study of psychiatric aftercare in a large metropolitan area (population 2.5 million). The study followed prospectively a group of 747 patients, representative of a significant proportion of patients in the care system. The findings document inadequacies in hospital-based discharge planning, unbalanced use of aftercare services and poor patient outcomes six months and two years post-discharge. The study found heavy reliance on medical/therapeutic aftercare services with a relative neglect of housing, vocational/educational, financial and social/recreational services. Despite the large volume of medical/therapeutic service use, the patient group had a high readmission rate, high levels of symptomatology and poor social adjustment on follow-up. The authors suggest that community-based practitioners with specialized training in psychiatric rehabilitation would improve the system of aftercare.

Adult↗