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Biomedical subjects

S A Freedman

Publications and source records attributed to S A Freedman.

10 recordsLinked to original sources
PubMed1999

Predictors of chronic post-traumatic stress disorder. A prospective study.

BACKGROUND: Most individuals who, shortly after trauma, express symptoms of post-traumatic stress disorder (PTSD) recover within one year of their traumatic experiences. In contrast, those who remain ill for one year rarely recover completely. The early identification of the latter is, therefore, very important. AIMS: To prospectively evaluate predictors of PTSD at four months and one year. METHOD: We followed 236 trauma survivors recruited from admissions to a general hospital's emergency room for four months, at which point 41 (17.4%) met diagnostic criteria for PTSD. Twenty-three of these individuals, and 39 individuals without PTSD at four months, were assessed again at one year. RESULTS: Depressive symptoms were the best predictors of PTSD at both time points. Intrusive symptoms and peri-traumatic dissociation were better at predicting four-month PTSD than one-year PTSD. CONCLUSIONS: The occurrence of depression during the months that follow a traumatic event is an important mediator of chronicity in PTSD.

Adult↗
PubMed1987

Model program. REACH: a family-centered community-based case management model for children with special health care needs.

The Rural Efforts to Assist Children at Home (REACH) model of decentralized case management has been found to be an efficient and effective method for (a) coordinating and structuring the health, social service, and educational needs of complex chronically ill children and their families and (b) providing to families the training and support they need to effectively assume the role of primary case manager. The REACH administrative, training, care planning, and staff monitoring systems are presented as a model for family-centered community-based case management.

Child↗
PubMed1983

The REACH Project: an innovative health delivery model for medically dependent children.

Rural Efforts to Assist Children at Home (REACH) is a service/demonstration and training project designed to provide specialized health care and case management services to medically dependent children in a 16-county area in central FLorida. REACH nurses, acting as Health Care Coordinators, provide instruction, consultation, coordination, and supervision of health care services in collaboration with tertiary care physicians and services at the University of Florida Health Center. Patients include infants, children, and adolescents with a wide variety of chronic illnesses including leukemia, muscular dystrophy, pulmonary disorders, failure to thrive, and seizure disorders. In addition to extensive work with families in the home, the REACH program incorporates a feedback system for its nurses, a progress-oriented record system, carefully designed agreements between tertiary care centers and community agencies, and an innovative training program for its nurses. REACH intends to serve about 1000 children during its 3-year demonstration phase. Success will be based on careful monitoring of costs, family functioning, and school attendance. If successful, the project will provide a model for the structured utilization of health and social services for families with medically dependent children.

Child↗