Biomedical subjects

W Lancee

Publications and source records attributed to W Lancee.

17 recordsLinked to original sources

PubMed1996

Long-term consistency in speech/language profiles: I. Developmental and academic outcomes.

OBJECTIVE: This study examined the 7-year developmental and academic outcome of speech/language-impaired and control children selected from a community sample. METHOD: Speech/language and psychiatric measures were administered to the children at ages 5 and 12.5 years. Using children's age 5 speech/language test results, a cluster analysis was performed to ascertain whether specific linguistic subgroups would emerge. The long-term consistency of these subgroups was explored. The association between time 1 speech/language clusters and linguistic, cognitive and academic measures at time 2 were examined. RESULTS: Four groups were identified in the cluster analysis: high overall, poor articulation, poor comprehension, and low overall. Children with pervasive language problems continued to perform poorly on linguistic, cognitive, and academic measures, while those with comprehension problems fared slightly better but still had more difficulties than those with normal language. The poor articulation cluster had few articulation errors at follow-up. CONCLUSIONS: Empirically supported speech/language classifications identified as early as age 5 continued to be relevant into late childhood. Pervasive speech/language impairment in early childhood was associated with increased risk of poor linguistic and academic outcome at follow-up, while isolated articulatory problems improved over time. These findings reveal the urgent need for early intervention among children with pervasive speech/language impairment.

Child↗

PubMed1996

Long-term consistency in speech/language profiles: II. Behavioral, emotional, and social outcomes.

OBJECTIVE: This study examined the 7-year behavioral, emotional, and social outcome of speech/language-impaired and control children selected from a community sample. METHOD: Speech/language and psychosocial measures were administered to the children at ages 5 and 12.5 years. Using children's age 5 speech/language test results, a cluster analysis was performed to ascertain whether specific linguistic subgroups would emerge. The association between speech/language cluster at age 5 and psychosocial functioning at age 12.5 was examined. RESULTS: Children with receptive and pervasive speech/language problems at age 5 demonstrated greater behavioral disturbance than children without such impairment. Controlling for initial behavioral status, early childhood language profile was still associated with behavioral and social competence ratings, 7 years later. Children without receptive language problems showed superior social adjustment. CONCLUSIONS: Empirically supported speech/language classifications identified as early as age 5 were associated with behavioral disturbance in late childhood. Receptive and pervasive speech/language impairment in early childhood was associated with the greatest risk at follow-up. Early auditory comprehension problems may be a specific risk factor for later aggressive and hyperactive symptoms. These findings identify the need for effective intervention with speech/language-impaired children.

Affective Symptoms↗

PubMed1996

Seven-year follow-up of speech/language impaired and control children: psychiatric outcome.

This study examined the 7-year psychiatric outcome of 202 speech/language (S/L) impaired and control children selected from a community sample at age 5 years. Children with S/L at age 5 years were more likely to be psychiatric cases at age 12.5 years than were normal controls, even if their S/L improved. Controlling for concurrent psychiatric disorder, S/L impairment at age 5 years was still associated with an increased rate of psychiatric disorder at 12.5 years. Psychiatric disorder at age 12.5 years was more likely to co-occur with language disorder than with speech disorder.

Articulation Disorders↗

PubMed1995

The impact of childhood sexual abuse on the psychological well-being and practice of nurses.

This study compares the psychological well-being of nurses who were sexually abused as children with those who were not abused and considers the impact of this abuse on aspects of their clinical practice. On the psychological measures, abused nurses differed from the nonabused nurses by having significantly higher distress scores and lower self-esteem scores. For some nurses, the abuse influenced their private and professional relationships including personal sexual relationships and working with other health professionals. These results highlight the need for the educational and health care systems to consider the needs of health care professionals who may have been abused.

Adaptation, Psychological↗

PubMed1995

Inquiring about childhood sexual abuse as part of the nursing history: opinions of abused and nonabused nurses.

This article explores the opinions of nurses who were sexually abused as children and those who were not, concerning routine inquiry about a history of sexual abuse. Approximately 60% of the participants indicated that routine inquiry should be conducted in pediatric and psychiatric settings. Reasons put forward for not inquiring included concerns about being intrusive, feeling unqualified to deal with content if abuse had occurred, and fear of increasing the distress of clients. Participants believed nurses needed education in this area if they were to be effective. Reasons why this topic involving sexuality and violence may be difficult for nurses are considered.

Adaptation, Psychological↗

PubMed1993

Residents' and nurses' perceptions of difficult-to-treat short-stay patients.

OBJECTIVE: Characteristics attributed by nurses and by psychiatric residents to difficult-to-treat inpatients in a short-stay setting were compared to determine whether discipline-specific perceptions of such patients existed. METHODS: A total of 117 patients consecutively admitted to a short-stay inpatient unit were assessed by both psychiatric residents and nurses during the third week of hospitalization using subscales of the Hospital Treatment Rating Scales. The degree of management difficulty presented by each patient in 28 areas was rated, and an overall rating was calculated. Two separate regression analyses were used to examine characteristics of patients rated difficult. RESULTS: Self-harm behaviors, violence toward others, and behaviors that sabotage treatment were identified by both nurses and residents as characteristics of difficult patients, although these characteristics contributed less to residents' perceptions of patient difficulty than to nurses'. For nurses, the most important additional characteristics contributing to treatment difficulty were related to patients' inability to form a therapeutic alliance. For residents, by far the most significant contributor to overall treatment difficulty was lack of response to medication. CONCLUSIONS: The discipline-specific differences in perceptions of difficult-to-treat patients were associated with differences in professional roles. Communication problems between physicians and nurses may be due in part to their different perceptions of treatment and management difficulty.

Adult↗

PubMed1993

The hostel outreach program: assertive case management for homeless mentally ill persons.

OBJECTIVE: This study measured the impact of an assertive case management program for psychiatrically disabled homeless persons in metropolitan Toronto. It was hypothesized that the program would improve residential stability, reduce psychiatric symptoms, improve social functioning, improve social networks, and increase use of appropriate services. METHOD: For 59 clients admitted to the program, assessments for the nine-month period before program entry were completed and were repeated nine months later. The Brief Psychiatric Rating Scale and a version of the Scale for Level of Functioning were the main measures of outcome. RESULTS: At follow-up significant improvements in residential stability and reductions in psychopathology were demonstrated. Improvements in social functioning and increases in social network size were significant. Although no baseline data about service use were collected, clients used basic support services during their first nine months in the program. CONCLUSIONS: The success of the program demonstrates that a difficult-to-treat patient population can be helped in a humane fashion if trained personnel are available.

Activities of Daily Living↗

PubMed1993

Measuring self-perceived role competence among first nations and non native children.

The objective of this research is to develop and test measures of self-perceived academic and social competence among First Nations and non native children. The method used is the analysis of psychometric properties of scales derived from questionnaires administered to First Nations children four culture areas of North America, as well as comparison samples of non native children. The results consist of the reliability coefficients, which fall into a satisfactory range; an internal consistency which increases with age; an agreement between self- and teacher-rated competence which is higher for non native than for native children. In the second grade, the competence scores of the native and non native children were equal. Thereafter, the scores of the native children either declined or remained static, while the non native scores tended to increase. In conclusion, the Flower of Two Soils scales are suitable for children from elementary schools, from First Nations and the majority culture. As children mature, the assessments of competence become an increasingly stable part of their repertoire of self-percepts; asynchronous socialization may adversely affect self-perceived competence.

Adolescent↗

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↗

PubMed1991

Nurses and AIDS.

Explore the source record for details and available documents.

Acquired Immunodeficiency Syndrome↗

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↗

PubMed1984

From hospital to community. Six-month and two-year outcomes for 505 patients.

The authors have completed a large descriptive study of the system of psychiatric aftercare in Metropolitan Toronto. This article describes the relevant 6-month and 2-year postdischarge outcome in each of five aftercare components for 505 subjects in a traditional system of service delivery. Provincial hospital, research institute, and general hospital subgroups are compared. For the total group, recidivism and employment rates are similar to those found in previous studies. Symptoms and distress levels are high. Considerable numbers of subjects live in inadequate and unsatisfactory housing. Social isolation, inadequate income, and difficulties with instrumental role functioning are persistent problems with little improvement between 6 months and 2 years postdischarge. Differences among the subgroups vary according to type of outcome and, for the most part, can be explained by differences in the characteristics of the patients served by the three types of inpatient treatment settings. These findings provide additional information about serious deficiencies in discharge planning and aftercare service delivery that is focused primarily upon the treatment of illness. The authors conclude that a more balanced system of aftercare requires a shift in resources to rehabilitation programs in the community.

Academies and Institutes↗

PubMed1983

Social support and post hospital outcome for depressed women.

In a larger follow-up study of discharged patients, a subgroup of 87 women with non-psychotic disorders had an unexpectedly poor outcome at six months with regard to readmissions, symptoms and social adjustment. The only factor which distinguished those who had been readmitted was lack of social support. Lack of social support was also related to poor symptom and social adjustment outcomes. There were considerable difficulties with social functioning independent of high symptoms. The adequacy of aftercare services is questioned in the light of these findings.

Adolescent↗

PubMed1982

Help for families of suicide: survivors support program.

The Survivors Support Program attempts preventive intervention with a high risk population. As with most preventive efforts in psychiatry, it is difficult to predict who will be most at risk, what services will best meet their needs, and what positive effects are due to the services. To answer these questions through properly controlled and designed experimental programs conforming to scientific methodology would require the investment of much time, personnel and money. To postpone attempts at intervention until answers are provided by such experimental programs would be to ignore the evidence of common sense and clinical experience. The Survivors Support Program demonstrates that a volunteer self-referral service, organized through professional liaison with a community organization and committed to providing service and gathering information, can suggest interim answers to the questions while providing support and counselling to a needy population.

Adaptation, Psychological↗

PubMed1981

Psychiatric aftercare: identified needs versus referral patterns.

Although psychiatric aftercare has received increased attention, little is known about patients' needs for community resources or about predischarge referral patterns. The authors interviewed hospital staff about needs and referrals for each of 747 patients about to be discharged. Nearly all patients had needs in the medical/therapeutic area and most received referrals. In three other nonmedical aftercare areas needs were identified for a much lower percentage of patients, and identified need was two to three times greater than referrals made. The authors discuss the implications of these findings for the provision of aftercare services.

Adult↗

PubMedDate not supplied

Seven-year follow-up of speech/language-impaired and control children: speech/language stability and outcome.

OBJECTIVE: This study examined the 7-year outcome of speech/language (S/L) impaired and control children selected from a community sample at age 5 years. METHOD: Two hundred fifteen children completed a variety of speech and language tests at age 12 years. Children with S/L impairment were further classified as "speech only," "language only," or "speech and language impaired." RESULTS: More than 72% of children who had S/L impairment at age 5 remained impaired at age 12. Children with both speech and language problems were most likely to remain S/L impaired; 81% had some kind of S/L impairment at follow-up. Similarly, children with both expressive and receptive language impairment were more likely to show expressive or receptive impairment at follow-up than children with expressive impairment alone. One third of time 1 controls had S/L problems at follow-up, and of these 82% had speech impairment only. CONCLUSIONS: S/L impairment identified at age 5 has long-lasting effects. More pervasive problems were associated with poorer outcomes. Screening at age 5 may be useful, as most serious S/L problems that emerged by middle childhood could be identified at age 5. The effects of S/L treatment require further study.

Adolescent↗