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Biomedical subjects

W Paras

Publications and source records attributed to W Paras.

3 recordsLinked to original sources

Decrease of depression during stroke and amputation rehabilitation.

Clinical observation had suggested that mild depression occurs after admission for acute medical treatment and then decreases during further hospitalization for rehabilitation treatment. The Geriatric Depression Scale (GDS) was given on admission and discharge to 14 stroke and 17 amputee rehabilitation patients. Each of the two groups showed decreasing GDS scores from beginning to end of the rehabilitation admission. Suggested reasons included: (1) the gradually diminishing effects of stroke and amputation as life crises during the 1-2 month admission, (2) effects of physical improvement on mood and affect, (3) milieu effects of the medical ward, and (4) tendencies for all psychopathology scale scores to decrease on retest.

Activities of Daily Living↗

Increase of medical hospital length of stay by depression in stroke and amputation patients: a pilot study.

Past studies have found that medical patients with the diagnosis of depression (comorbidity) have longer hospital lengths of stay (LOS) than those without the diagnosis of depression. This suggested that scores on a depression scale would be positively correlated with LOS. On a rehabilitation ward, 14 stroke and 17 amputee patients were given the Geriatric Depression Scale (GDS) and lengths of stay were recorded. Correlations between GDS scores and LOS were +0.575 for stroke and +0.266 for amputee patients, both in the hypothesized direction. Explanations considered included: (1) depression and medical illness each produce morbidity which summate to require increased LOS; (2) depression delays medical recovery as well as the appearance of medical recovery, and (3) discharge planning is complicated by depression. When depression is associated with inpatient medical illness, DRGs may need to be reevaluated.

Activities of Daily Living↗

Falls in the rehabilitation setting: incidence and characteristics.

A prospective six-month study was conducted to determine a high-risk index for medical rehabilitation patients who fall. Variables studied for all patients included demographics, medical conditions, associated symptoms, orthostatic blood pressure measurements, physical function, posture control, proprioception, use of physical restraints, and medications, A detailed examination of the fall events was also conducted. Of the 143 patients studied, 46 (32%) fell at least once, making a total of 84 falls. Impaired ability to follow directions, impaired judgment, impaired proprioception, presence of physical restraints, use of major tranquilizers, use of sedatives, and presence of psychiatric diagnosis were all individually associated with patients who fell. Males fell more than females. Logistic regression identified altered proprioception as the only major predictor of falling. Of those who fell, only 26% called for assistance prior to the fall. Sixty-eight percent of the falls were from wheelchairs. Importantly, no patients had serious injury or morbidity from the falls.

Accidental Falls↗