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Biomedical subjects

W B Dalziel

Publications and source records attributed to W B Dalziel.

11 recordsLinked to original sources
PubMed2004

An examination of the health profile, service use and care needs of older adults in residential care facilities.

Private, unregulated residential care facilities have become an increasingly important component of the continuum of housing and care for frail older adults in Canada. To date, this growing segment of the older population has received very little research attention. This study involved an in-depth examination of the functional/health profile, patterns of service use, and medical/care needs of a representative sample of 178 older adults in residential care facilities in the City of Ottawa. The results indicate great diversity in resident and facility profiles in this setting and confirm earlier impressions that special care units in the residential care sector have become increasingly close to being unlicensed pseudo-nursing homes. Despite the heavy burden of care, the evidence suggests that the care needs of the majority of residents are adequately met in the residential care environment. The results can inform future research, case finding, educational, and policy planning initiatives in this setting.

Aged↗
PubMed2001

Seniors' decision making about pain management.

BACKGROUND: Musculoskeletal pain is a problem with which many seniors must contend, many on a daily basis. Little is known, however, of the self-care decisions that seniors make regarding the management and control of this pain. These decisions can influence in a significant manner the delivery of health care to seniors and their overall health and well-being. Purpose. The purpose of our exploratory-descriptive study was to investigate seniors' decision making regarding the management and control of musculoskeletal pain by gathering data about the context of decision making, the types of decisions seniors made, their decisional conflict and the resources they used in decision making. METHODS: Focus groups and a mail-back questionnaire were used. Data were gathered in 1997 from a convenience sample of 50 seniors in Canada who experienced musculoskeletal pain of a noteworthy nature. RESULTS: Findings revealed that participants made decisions within a context of ageing and the health and social consequences of advancing age. The types of decisions they made included to ignore their pain and to use distraction. They also used exercise, the application of heat and cold, and medications to manage pain. Decisional conflict was minimal and consultation with family and friends superseded that with professionals. CONCLUSIONS: This study contributed to knowledge of decision making in later life about health matters generally, and the management and control of pain specifically. Findings point to the resourcefulness of seniors with respect to self-care and decision making. Seniors want to make informed decisions. However, they need information about the risks and benefits of decisions.

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PubMed2001

Family caregiving in long-term care facilities.

Family caregiving within institutional settings is a neglected area of research In an era of cost containment, more and more is being asked of families of institutionalized persons. This article presents the results of a study designed to investigate family caregiving following the admission of an elderly relative to a long-term care facility. Beginning with a brief summary of findings from previous research, the article reports on visiting and task performance by families within the long-term care facility. Continuing with descriptions of families' satisfaction with institutional care and their care-related learning needs, the article concludes with recommendations for policy and practice.

Caregivers↗
PubMed1999

Assessing the quality of newspaper medical advice columns for elderly readers.

BACKGROUND: Medical advice columns in newspapers can provide a valuable service by educating the general public about important health-related issues. However, these columns may be harmful if the advice or information given in them is incomplete, inappropriate or misleading. The objective of this study was to assess the safety and appropriateness of advice given to elderly readers of newspapers in medical advice columns. METHODS: Medical advice columns published in Canadian newspapers in 1995 were identified from a CD-ROM database. The articles that were selected were published in English and contained medical advice pertinent to elderly people about topics that could be found in a textbook of geriatric medicine. Fifty articles, randomly selected from the 109 articles that met these criteria, were independently assessed by 5 geriatricians. A scoring system was used to rate the ability to determine to which population the article applied, how well fact was distinguished from opinion, the degree to which critical issues were addressed, the safety and the appropriateness of the advice. When the kappa statistic for inter-rater agreement was 0.74 or less, a 2-stage Delphi process was used in an attempt to reach consensus. RESULTS: Agreement (kappa > 0.74) was eventually achieved for 232 (92.8%) of the 250 ratings. In 4 (8%) of the articles there was a high probability that the advice given could be applied to the wrong patient population; in 7 (14%) there was a high probability that opinion might be interpreted as fact; and in 11 (22%) the major critical issues were not identified. Of greatest concern, however, the advice in 25 (50%) of the articles was judged to be inappropriate, and in 14 (28%) advice may have been dangerous and potentially life-threatening. INTERPRETATION: Although medical advice columns have the potential to improve the health of elderly readers, a significant percentage of these articles contain inappropriate or even potentially dangerous advice.

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PubMed1997

The pharmacoeconomics of dementia therapies. Bringing the clinical, research and economic perspectives together.

Dementia has reached epidemic proportions. The large numbers of people affected and the major impact that this disease has on healthcare costs are still not fully appreciated by the general public, governments or healthcare providers. Prevalence rates are expected to continue to escalate because of the dramatic aging of the population in many nations. This could create serious economic problems for already strained healthcare systems around the world. Fortunately, medications suitable for widespread use appear to be on the horizon. As therapies are developed, it will be necessary to assess their impact on individuals, healthcare systems and societies. The latter two refer to pharmacoeconomic research, an area in which a careful examination of issues central to the design and interpretation of such analyses must now be undertaken. This article outlines the critical components in the application of pharmacoeconomic methodology to the field of dementia research. Specifically, the accuracy of a pharmacoeconomic study is affected by the prevalence data and the economic methodology used. The outcome measures used in efficacy, effectiveness and pharmacoeconomic studies must be carefully chosen to ensure that they are valid, reliable and sensitive to change. These measures must also be meaningful to patients, families and clinicians. In the future, dementia therapies may prevent, delay, cure or slow the progression of the disease, and may also help control symptoms. It is important to study the impact of these effects from the perspectives of the patient, family and society. Dementias are important in terms of the number of people affected and the degree of suffering experienced, as well as the considerable financial burdens placed on families and society. Pharmacoeconomic analyses will have a significant influence on healthcare decisions affecting people with dementia. To ensure that these future decisions are in the best interests of patients, families and society, clinical knowledge of dementias must be incorporated into the design of pharmacoeconomic studies. Collaboration between clinicians, researchers and economists is essential in assessing future pharmacotherapies for dementing illnesses.

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PubMed1997

Referral to specialized geriatric services. Which elderly people living in the community are likely to benefit?

PROBLEM BEING ADDRESSED: As the Canadian population ages, family physicians encounter increasing numbers of elderly people with medical, functional, psychological, and social difficulties. In the past two decades, most regions of Canada have developed systems of specialized geriatric services, available on a consultative basis, to assist family physicians evaluating and managing elderly patients with these difficulties. For many family physicians, however, it is often unclear which of their elderly patients are likely to benefit from referral to these geriatric services. OBJECTIVE OF PROGRAM: Using an interdisciplinary approach, specialized geriatric services seek to optimize health, maximize function, promote independence, and prevent or delay institutionalization of elderly people. Yet not all elderly people benefit from referral to specialized geriatric services. This article offers a clear and clinically practical framework to help family physicians identify elderly patients in their practices who are likely to benefit from referral to specialized geriatric services. MAIN COMPONENTS OF PROGRAM: By synthesizing previous work on the concept of frail elderly persons into a 2 x 2 matrix, the level and intensity of geriatric intervention most appropriate for different segments of the elderly population is clarified. CONCLUSIONS: Using the simple approach described in this article, family physicians should be able to use available geriatric resources easily and efficiently to optimize the health and function of their elderly patients.

Activities of Daily Living↗
PubMed1996

Demographics, aging and health care: is there a crisis?

Will the aging of Canada's population bankrupt the health care system? In this issue (see pages 1555 to 1560) Dr. Marie Demers reports that the increase in physician service costs for elderly people in Quebec from 1982 to 1992 resulted primarily from increased utilization and only secondarily from the growth of the elderly population. In this editorial the author argues that the common perception that masses of elderly people will soon swamp the system deflects attention from the crucial issue of utilization. Although a wide range of interventions for elderly people have demonstrable benefits, more research is needed to ensure that intensified services, especially for elderly people in good health, are effective and well targeted. It is not the aging of our population that threatens to precipitate a financial crisis in health care, but a failure to examine and make appropriate changes to our health care system, especially patterns of utilization.

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PubMedDate not supplied

Continuing education for staff in long-term care facilities: corporate philosophies and approaches.

The purpose of this study was to determine corporate philosophies of continuing education and approaches to meeting the learning needs of staff who strive to provide for the increasingly challenging care requirements of seniors who reside in long-term care facilities. In-depth interviews lasting approximately 1 hour were conducted with key informants at the administrative level from nine long-term care facilities. Content analysis revealed a commitment to continuing education for staff. While recognizing the importance of organizational responsibility for continuing education, administrators placed emphasis on the individual responsibility of staff. Learning needs were identified as affective, managerial, and physical in nature. Challenges to providing continuing education programs were derived from a general lack of fiscal and human resources. A variety of measures was suggested as important to supporting the continuing learning of staff. Implications of this study point to the need for long-term care facilities to incorporate into their strategic plans measures of ensuring continuing education as a basis for the ongoing competence and development of staff. In addition, there is a need for collaboration between long-term care facilities and other institutions of a long-term care, acute care, and educational nature in the development of strategies to operationalize a philosophy of continuing learning as a basis for the provision of optimal care to residents.

Attitude of Health Personnel↗