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Biomedical subjects

R G Sands

Publications and source records attributed to R G Sands.

14 recordsLinked to original sources
PubMed1999

Service components of case management which reduce inpatient care use for persons with serious mental illness.

This is a study of two types of case management: case management (CM) which provided the service coordination functions, and Intensive Case Management (ICM) which consisted of both the coordination function and the provision of direct support to the client. Using secondary data on public clients, characteristics of mental health service use were analyzed for 80 ICM and 84 CM clients. The ICM clients had significantly fewer episodes per patient and less inpatient days per year than the CM clients. These findings suggest that direct support services make a significant difference in reducing annual hospital care.

Adolescent↗
PubMed1998

The impact of employment and serious illness on grandmothers who are raising their grandchildren.

Increasing numbers of children are living in families consisting of grandparents and grandchildren. This paper presents findings of a study in which 123 caregiving grandmothers were interviewed. Fifty-eight percent of these grandmothers were "career caregivers," whose homes were always filled with a child or grandchild. Most of them were in good to excellent physical health and their mental health was at least as good as that of a national sample. Regression analyses found that having a life-threatening physical condition, being younger and white explained psychological anxiety; and having a life-threatening physical condition and not being employed explained psychophysiological mental health symptoms. These findings suggest that some grandmothers are at risk for mental health symptoms and raise questions about the implications of caregiving of grandchildren for women.

Aged↗
PubMed1994

Two modes of case management: assessing their impact.

This is a study of two strategies of case management-Community Treatment Teams (CTTs) and Intensive Case Management Teams (ICMTs). A random sample of 30 cases from the CTT group were matched with 30 cases from the ICMT group using 4 criteria. Data were collected from case records and verified with case managers. The analysis revealed that although the CTTs engaged in more case management activities, there were few significant differences in the outcomes of the two approaches. The results are discussed in relation to a possible "ceiling effect" of case management, cost effectiveness, and limitations in the sample.

Activities of Daily Living↗
PubMed1993

The missing voice in interdisciplinary communication.

The research problem investigated in this article emerged from a year-long ethnographic study of the interdisciplinary process of teams evaluating children for mental retardation/developmental disabilities. The researchers noticed that when a discipline was not present at team meetings, others attempted to speak for it. This article examines the team process and case consequences of such a "missing voice." Data collected through participant observation and videotaping were triangulated with transcripts, written and audiovisual records, and an interview with the missing team member. This process revealed a trail of ambiguous findings and uncertainty on the part of team members of disciplines related to that of the missing member. The "missing" member identified the knowledge, assessment skills, and theoretical perspective she could have contributed if consulted. The findings demonstrate that (a) team members bring differing knowledge and observational perspectives and (b) team deliberations appear to be a function of who is present and what is negotiated.

Child↗
PubMed1990

'I beg to differ': conflict in the interdisciplinary team.

Three cases in which interdisciplinary teams experienced conflict were examined in depth. Disagreement within the team was expressed covertly and overtly. In the face of conflicting perceptions, team members attempted to influence others to agree with them, changed their own recommendations, or tried to find an area of compromise. Team members did not fully address differences across disciplines. Interactions during these cases suggest that team members see themselves primarily as representatives of their own discipline rather than as members of a team. Different values and theoretical perspectives seem to influence divergence of opinion. A need for a common value base, language, and conceptual framework was evident.

Adolescent↗
PubMed1990

Ethnographic research: a qualitative research approach to study of the interdisciplinary team.

Ethnography, one of many kinds of qualitative research, employs cultural theory, which emphasizes part-whole relationships, context, and multiple perspectives. Theory and method are intrinsically related. In ethnographic research, the primary instrument is human. Multiple observations, researchers, and sources of data contribute to the soundness of the study. This paper describes ethnographic research utilizing the study of interdisciplinary team-work as an exemplar.

Data Collection↗
PubMed1989

The social worker joins the team: a look at the socialization process.

Although much has been written about interdisciplinary teams, little is known about how social workers who begin employment in interdisciplinary settings learn how to be team players. This article, based on a year-long ethnographic sociolinguistic research study in one such setting, describes and analyzes the interactive experiences of a social worker who, during the course of the study, changed roles from newcomer to instructor of social work students. Through an analysis of the social worker's interactions, several observations were made. (1) Three team rules prescribed how team members were to participate (use trigger words, develop behaviorally specific descriptors, use action verbs). (2) The "coaching" of the new social worker and her coaching of students were visible in the two teams that were observed. (3) Certain language was preferred by the teams and disciplines. (4) Over time the social worker became more assertive and pro-active.

Communication↗
PubMed1985

Bipolar disorder and social work practice.

With the introduction of lithium and increasing evidence that bipolar disorder is a biogenetic condition, changes have occurred in the diagnosis and treatment of bipolar disorder. Cross-cultural studies indicate that in the United States there is a tendency to overuse the diagnosis of schizophrenia when bipolar may be indicated. Both disorders have psychotic symptoms, rendering diagnostic confusion possible. This paper describes the characteristics of bipolar disorder, explanatory theories and treatment. A medical model of treatment is preferred. Issues of concern to social workers are addressed.

Adult↗
PubMed1984

Correlates of success and lack of success in deinstitutionalization.

This is a case study of ninety-two patients served by an outpatient service of a state psychiatric hospital in a rural area in west central New York State. The purpose was to identify variables associated with success (tenure in the community) and lack of success (number of readmissions within last year and five years and one subsequent year). Using a stepwise multiple regression analysis, age and living with others were positively correlated with success and negatively correlated with rehospitalizations within one year. Over a five-year period, affective disorders, inconsistency in taking medication, and having a hobby were correlated with multiple hospitalizations. In the year following data collection, readmissions were related only to inconsistency in taking medication. Mental health practitioners are advised to carefully follow up persons at highest risk of returning to the hospital.

Adult↗
PubMed1984

Social work with victims of Huntington's disease.

Huntington's Disease (HD) is a progressive, hereditary neurological disease that affects cognitive, behavioral, and physical functioning. It has a severe impact on the family, the members of which are affected by the patient as well as the vulnerability of children at risk. Social workers can provide support and anticipatory guidance to patients and their families. Adult children can benefit from genetic counseling regarding their own at risk status. Community involvement in voluntary organizations is also beneficial.

Child↗
PubMed1983

Crisis intervention and social work practice in hospitals.

Crisis intervention, with its emphasis on focused treatment in a limited time frame, is adaptable to social work practice in hospitals. The author discusses the crisis intervention model in relation to the hospitalized patient and his or her family and examines three kinds of crises: those caused by illness or injuries, by hospitalization itself, and by treatment procedures.

Adult↗
PubMedDate not supplied

Reported vague symptoms and at-risk status: the case of polyvinyl chloride workers in Louisville.

This study concerns the frequency of visits to the dispensary by workers with vague symptoms of physical illness at a polyvinyl chloride plant in Louisville, KY, where an outbreak of hepatic angiosarcoma occurred. The illness behavior of three cohorts of workers at three levels of risk--workers removed from the chemical plant to a pallet plant (PP) because their screening results indicated liver abnormalities; workers who had some positive test results (TP); and workers whose test results were negative (TN)--was studied before (time 1) and after (time 2) the angiosarcoma crisis. It was predicted that, during time 2, the groups' visits to the dispensary would increase in relation to their levels of risk (PP greater than TP greater than TN). Although there was an overall increase in the percentage of visits because of vague symptoms during time 2, the only cohort with different behavior was the group of TP workers: they reduced their use of the dispensary. These results are similar to those in a previous study in which all symptoms of illness were included. It is speculated that social and individual factors, as well as the labeling phenomenon, explain the results. Health care providers are encouraged to follow up with workers at risk who seem to avoid monitoring their health.

Chemical Industry↗