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Biomedical subjects

S R Edwardson

Publications and source records attributed to S R Edwardson.

At least 19 recordsLinked to original sources

Symptom consultation in lay networks in an elderly population.

Although lay referrals are known to be important as factors affecting the use of professional services, less is known about how individuals use lay consultation in evaluating symptoms. The amount and type of advice given by persons in the social network is especially important with respect to self care of symptoms that never reach the attention of professional caregivers. This article provides information on how often and from whom elderly citizens seek and receive consultation, such as family and friends, when they experience common symptoms. Findings suggest that female relatives are important sources of advice but that neither gender nor living arrangements are closely related to the tendency to seek lay advice for common symptoms. Subjects who consulted lay advisers about arthritic symptoms also were more likely to seek professional consultation.

Age Factors

Costs and benefits of clinical nurse specialists.

The emphasis on cost containment during the 1980s has given way to a renewed interest in the quality of health care services that can be delivered at a reasonable cost. In this climate, clinical nurse specialists (CNSs) have an excellent opportunity to demonstrate the cost-effectiveness of their work. In order to do so, costs and benefits of CNS services must be measured and compared.

Cost-Benefit Analysis

Resource use in home care agencies.

Increasing use of home care services in the past decade has led to concern about the nature and number of services provided to clients. Because third party payers have used case mix measures to develop reimbursement systems for acute and long-term care facilities, it seems likely that similar measures will be developed for home care. Three types of home care agencies were studied to test the usefulness of routinely gathered clinical and financial data for predicting resources provided. The findings suggest that current data sources may be inadequate for predicting the actual delivery of services.

Activities of Daily Living

The dependency at discharge instrument as a measure of resource use in home care.

The dependency at discharge instrument, developed to evaluate the needs for care of hospitalized patients on the day of discharge, was tested for its usefulness in measuring resource consumption in home health care. The instrument evaluates dependency in relation to bathing/hygiene, activity, technical procedures, and monitoring signs and symptoms. The sample used in this study consisted of 150 subjects admitted to one of three types of home health care agencies. Interrater reliability and internal consistency of the instrument were high. Factor analysis produced results similar to those of the developers for three of the four scale items. The item concerning need for assistance with procedures had a much lower loading, indicating that it had little in common with the other items. Criterion-based validity was measured by testing the instrument's ability to predict the number of registered nurse and home health aide visits, and length of enrollment. Findings indicated that the instrument had a modest level of criterion-based validity in predicting the use of registered nurse and home health aide services for the hospital-affiliated agency, but was relatively ineffective for public health and for-profit agencies.

Activities of Daily Living

Outcomes of coronary care in the acute care setting.

A prospective descriptive study of 151 myocardial infarction patients in five hospitals, shortly after the implementation of prospective payment, showed them to be in stable physical condition and generally free of physical and emotional symptoms at the time of discharge. They did, however, have major deficits in their knowledge of continued self-care and treatment prescriptions. Multivariate analysis showed age to be more closely associated with outcome at discharge than were severity of illness, comorbidity, complications or the intensity of medical treatment. The findings suggest that strategies for preparing patients (especially older patients) for continued self-care may need to be adjusted to the current short lengths of stay in the acute care hospital.

Adult

Nursing care costs for stroke patients in a rehabilitation setting.

Many nursing departments have developed methods for identifying the cost of acute nursing care services. Assuming that rehabilitation services will soon be reimbursed on a prospective basis as well, the nursing costs of those services will also need to be ascertained. In a study of one rehabilitation service, it was found that nursing care costs accounted for a greater proportion of hospital charges in rehabilitation than is true in acute care and that length of stay was the best predictor of the cost of care.

Aged

Physician acceptance of home care for terminally ill children.

The study reported here explored the factors associated with the implementation of Martinson's model of home care and treatment for children in the terminal stages of illness with cancer. The model is described as an example of a health care strategy that was dramatically different from the prevalent model of care and may have conflicted with existing values. Data for the study were gathered from the hospital records of the children and from a survey of their oncologists. The findings suggest that physicians viewed the model of care as desirable and made their referral decisions on the basis of their judgment about whether the family in question was technically and emotionally capable of providing the care.

Adolescent