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Results for “Institutionalization”

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PubMedDate not supplied

Developing positive self-concepts in institutionalized children with severe behavior disorders.

This study investigated the capacity of one intervention--a modified creative dramatics program--for development of positive self-concept and creative expression in children. Using a sample of both institutionalized (n = 44) and noninstitutionalized (n = 38) children, the study indicated that the intervention group significantly improved on both self-concept and creative expression measures. The most improvement, moreover, was noted in subjects who were both institutionalized and behavior-disordered.

Child↗

PubMed1979

Language differences between institutionalized and noninstitutionalized retarded children.

The linguistic performances of 15 noninstitutionalized and 15 institutionalized retarded children were compared on usage of grammatical categories and structure of spoken language (Length--Complexity Index) and for underlying subskills (Illinois Test of Psycholinguistic Abilities). Differences were not found between the groups for usage of grammatical categories or structures but were found for subskills of Auditory Reception. Auditory Sequential Memory, Verbal Expression, and Auditory Closure. Further analysis by multiple stepwise regression indicated that noninstitutionalized and institutionalized retarded children may be differentiated by examining a number of linguistic variables. The grammatical structure of language appeared less affected by environment than were the semantic and auditory elements.

Adolescent↗

PubMed1984

Motivating institutionalized adolescents for psychotherapy.

In the study of psychotherapy, one surely must come to appreciate the importance of client motivation. Intuitively, its value in obtaining a successful outcome would seem unquestioned. Nonetheless, motivation for treatment has not received the attention in the literature that its importance might warrant. This paper deals exclusively with the adolescent and in particular, the institutionalized adolescent. Often members of this population become known as "untreatable cases" and attempts at treatment result in frustration from emotional and economic drain. This paper reviews the literature regarding client motivation, client preferences, and token economies, and offers recommendations for designing a program to increase motivation for psychotherapy in institutionalized adolescents.

Adolescent↗

PubMed1984

Survey of bruxism in an institutionalized mentally retarded population.

Bruxism was assessed in a population of 358 institutionalized mentally retarded individuals using two independent indexes: toothwear and staff reports. Bruxism based upon toothwear was found in 58%. Bruxism identified by staff reports was found in 41% of the population. No sex differences were observed. Three bruxer subgroups were identified: daytime only (17%), night only (8%), and day and night (16%). Older residents were more likely to grind their teeth than were younger residents. These results, when compared with other reports, suggest that bruxism is more likely to occur in the institutionalized mentally retarded population than in the nonretarded population.

Adolescent↗

PubMed1983

Factors related to the self-concept of institutionalized, white, male, adolescent drug abusers.

The main purpose of this research was to examine the relationship between selected drug-related, familial, and demographic variables and the self-concepts of institutionalized, white, male, adolescent drug abusers in a large midwestern city. In addition, the self-concepts of the subjects in the study were compared with the self-concepts of Pulliam et al.'s (1971) non-drug using adolescent sample. The TSCS, a family questionnaire, an index of socioeconomic status, and an interview were used to collect data from 140 subjects. The mean self-concept score of this sample was significantly lower than the mean self-concept score of Pulliam et al.'s sample. Results of a stepwise multiple regression yielded four statistically significant predictors of the subjects' self-concepts: both mother/adolescent relationship and father/adolescent relationship when the adolescent was between age thirteen and his present age; the number of the subject's prior status offenses and the subject's preference for non-depressant drugs. These variables were positively correlated with the subjects' self-concepts. This study demonstrated the importance of differentiating among institutionalized adolescents' self-concepts based on type of drug abused, prior criminal record, and parent/adolescent relationships.

Adolescent↗

PubMed1982

Life-span development of institutionalized and community-based mentally retarded residents.

Life-span development of mentally retarded residents in institution and community settings was examined. Results showed that significant growth in adaptive behavior occurred for all groups of residents regardless of their level of retardation. Furthermore, the shapes of these growth curves were parallel across the different levels of retardation over the age range studies (5 to 50 years). Measures of the quality of the environment were available for institutionalized residents and were found to be unrelated to adaptive behavior growth; however, environmental quality was associated with initial levels of adaptive behavior, suggesting that for institutionalized residents, adaptive behavior competence may determine the type of environment provided.

Adaptation, Psychological↗

PubMed1982

Adaptive behavior scale differences in scores of mentally retarded individuals referred for institutionalization and those never referred.

Adaptive Behavior Scale profiles of 68 mentally retarded individuals referred for institutionalization were compared with a matched sample of retarded individuals who were never referred for institutionalization. A discriminant analysis identified the following six domains that, in combination, accounted for the significant differences between groups: Violent and Destructive Behavior, Sexual Aberrations, Hyperactivity, Antisocial Behavior, Physical Development, and Socialization. Implications for the effectiveness of an abbreviated ABS measure for diagnostic purposes and program planning in community and institutional settings were discussed.

Adaptation, Psychological↗

PubMed1995

High prevalence of Helicobacter pylori antibodies in an institutionalized population: evidence for person-to-person transmission.

OBJECTIVE: To evaluate the prevalence of H. pylori antibodies in mentally and physically handicapped adults living together in a long-term care facility. METHODS: One hundred twenty-two institutionalized subjects from six living areas were compared to a normal representative Caucasian population obtained by random sampling from the urban population area of Melbourne. Serum samples from 1977 and 1989 from 122 subjects were tested for H. pylori antibody by an ELISA technique. The data were analyzed by Student's t test, chi 2 test and logistic regression. RESULTS: Ninety-two of the 122 subjects (75%) from whom sera was collected in 1989 were seropositive for H. pylori, compared with only 23% in age- and sex-matched control subjects (p < 0.0001). The prevalence of H. pylori antibodies in 1977 was 34% (42/122). Of the remaining 80 seronegative subjects, 51 (61.4%) converted to became positive in the 12-yr interval. The annual seroconversion rate was 7.4%, with an average of 4.25 newly positive subjects each year. The prevalence of H. pylori in 1989 was significantly higher than in 1977 after adjustment for age (odds ratio 2.39, 95% CI 1.1-5.3, p = 0.03). CONCLUSIONS: H. pylori antibodies are significantly more prevalent in institutionalized adults compared with controls from the general population. These data support the hypothesis that H. pylori is acquired by either fecal-oral or oral-oral transmission.

Adult↗

PubMed1996

[Longitudinal study of fractures in institutionalized elderly].

AIM: Evaluation of fracture incidence in the institutionalized elderly and analysis of associated risk factors. EXPERIMENTAL DESIGN: Longitudinal and prospective study with 3-year follow-up. SETTING: Old people's home in Turin for patients who are no longer self-sufficient. PARTICIPANTS: 197 subjects (47 males and 150 females) aged between 61-98 years old, dependent in at least two basic daily activities. PARAMETERS: At the time of enrollment, the following parameters were evaluated: age, weight, height, degree of walking autonomy, bone mineral density at proximal and distal radius. The number of falls and fractures were recorded during follow-up. RESULTS: A total of 46 fractures (22 femoral and 24 in other sites) were recorded with an annual incidence of 7.8%. Femoral fractures only occurred in females. The following risk factors were associated with femoral fractures: very old age (relative risk = 2.6; 95% confidence interval = 1.1-6.4), low body mass index levels (RR = 3.3; 95% CI = 1.3-8.7), low bone mineral density levels at the proximal radius (RR = 2.6; 95% CI = 1.1-6.3), autonomous walking capacity (RR = 3.7; 95% CI = 1.1-12.0) and recurrent falls (RR = 2.7; 95% CI = 1.2-6.2). The following risk factors were associated with non-femoral fractures: autonomous deambulation (RR = 5.7; 95% CI = 1.4-23.7) and recurrent falls (RR = 6.4; CI = 2.3-18.3). CONCLUSIONS: Institutionalized elderly patients present numerous risk factors for femoral fractures. Fractures in other sites are only associated with risk factors that express a tendency to fall.

Aged↗

PubMed1997

Attitude to work and health problems among home care workers in settings with different degrees of institutionalization.

The relationship between different degrees of institutionalization in the care of the elderly (service house, home care, and a combination of both) and work-load, as well as staff feelings regarding psychosocial variables and health complaints, was investigated. Seventy-one staff members similar in background factors answered questionnaires semi-annually during a period of 3 years. The results revealed consistent and stable differences between the different settings. The staff in service houses had the highest documented and subjective work-load and were doubly at risk for neck pain, fatigue and nervousness, and with a five-fold risk of shoulder pain, in comparison with the staff in home care, with the mixed group in an intermediary position. The results indicate that work involving mixed tasks might lower the strain of dealing with highly dependent clients in a highly institutionalized environment. Generalizations are limited, because of small sample sizes and descriptive design, but the results were consistent and persisted over a 3-year period.

Adult↗

PubMed2005

Institutionalizing policy-level health impact assessment in Europe: is coupling health impact assessment with strategic environmental assessment the next step forward?

European Union (EU) Member States are interested in using health impact assessment (HIA) as a means of safeguarding their obligations to protect human health under the 1997 Treaty of Amsterdam. However, several have encountered difficulties institutionalizing HIA with the policy-making process. As a consequence, the World Health Organization (WHO) Regional Office for Europe has suggested coupling HIA with strategic environmental assessment (SEA). Traditionally, the incorporation of HIA into other forms of impact assessment has been resisted, for fear of losing its focus on health issues to environmental concerns, and compromising its social model of health with the introduction of biophysical indicators. But can these fears be substantiated? In this paper, we investigate the grounds for such concerns by reviewing the relevant policy documents and departmental guidelines of four non-European countries that have considered the use of integrated assessment. We found that the case for associating HIA with SEA in Europe is strong, and offers potential solutions to problems of screening, theoretical framework, causal pathways and ready entry to the policy process. Coupling HIA with SEA may thus be the next step forward in a longer journey towards institutionalizing HIA as an independent policy-linked device.

Australia↗

PubMedDate not supplied

Slow release theophylline disposition and effect in elderly patients with chronic obstructive lung disease: influence of dose formulation and institutionalization.

We studied the steady-state disposition of slow release theophylline tablets and granules in 12 institutionalized (I) and 12 community-dwelling (C) elderly patients with fixed chronic obstructive lung disease. Design was open label with random order crossover; each formulation was given 5 min before food every 12 h for 7 days. Age (median 70 y, range 55-88), sex, smoking status, and baseline lung function off drug were similar. Though plasma concentration (Cp) was higher with the tablets as was the area under the Cp vs time curve: 134 (74-252) vs 121 (75-197) mg h l-1; p = 0.028. The standard deviation of Cp over one dose interval was lower with the granules. FEV 1.0 was slightly improved over baseline. Dose required to reach target Cp was higher in the institutionalized group (12.6 vs 8.6 mg kg-1 day-1; p = 0.003) as was apparent clearance; I:94 (43-148) ml hr-1 kg-1 vs C:68 (34-163); p = 0.003. Although bioavailability was slightly reduced for the granules, fluctuations of Cp was less, and we failed to find a food effect that was clinically important in geriatric subjects.

Aged↗

PubMed2005

Effect of timed bright light treatment for rest-activity disruption in institutionalized patients with Alzheimer's disease.

BACKGROUND: Disturbances in rest-activity rhythm are prominent and disabling symptoms in Alzheimer's disease (AD). Nighttime sleep is severely fragmented and daytime activity is disrupted by multiple napping episodes. In most institutional environments, light levels are very low and may not be sufficient to entrain the circadian clock to the 24-hour day. METHOD: The purpose of this randomized clinical trial was to test the effectiveness of timed bright light therapy in reducing rest-activity (circadian) disruption in institutionalized patients with AD. The experimental groups received either morning (9.30-10.30 am) or afternoon (3.30-4.30 pm) bright light exposure ( > or = 2500 lux in gaze direction) Monday through Friday for 10 weeks. The control group received usual indoor light (150-200 lux). Nighttime sleep, daytime wake, and rest-activity parameters were determined by actigraphy. Repeated measures analysis of variance was employed to test the primary study hypotheses. RESULTS: Seventy institutionalized subjects with AD (mean age 84) completed the study. No significant differences in actigraphy-based measures of nighttime sleep or daytime wake were found between groups. Subjects in either experimental light condition evidenced a significantly (p < 0.01) more stable rest-activity rhythm acrophase over the 10-week treatment period compared to the control subjects whose rhythm phase delayed by over two hours. CONCLUSIONS: One hour of bright light, administered to subjects with AD either in the morning or afternoon, did not improve nighttime sleep or daytime wake compared to a control group of similar subjects. However, exposure to one-hour of bright light in either the morning or afternoon may provide sufficient additional input to the circadian pacemaker to facilitate entrainment to the 24-hour day.

Aged↗

PubMed1995

Institutionalizing fertility management/human sexuality training in Colombian nursing schools.

While there is no universally applied definition of the terms, 'institutionalization', 'capacity', 'capability' and 'commitment' have been suggested as subindicators of a self-sustained program. This paper describes efforts to measure these terms in the context of a fertility management/human sexuality (FM/HS) education program for student nurses in Colombia. Interviews with 19 school deans formed the basis of measuring progress towards institutionalization. All the deans supported the idea of having FM/HS instruction, although resource commitment to effectively carry out the instruction varied. Focus groups with professors from participating schools provided insights into the effect of the project on both the students and course teachers. Professors found that students who had taken the course were more effective FM/HS counselors in later practical courses. Responses from interviews with a random sample of students who had or had not attended the course were compared to assess the effect of the course on the nursing students. Although attitudes between the two groups did not differ significantly, knowledge levels about FM/HS were significantly higher among nursing students who had attended the course. In general, the results indicate that the participatory educational approach used in teaching the FM/HS topics was effective in sensitizing both students and teachers to this subject area.

Colombia↗

PubMed1992

Meeting the oral health needs of institutionalized elderly.

Numerous impairments cause suffering to the institutionalized elderly person. The medically compromised or severely demented patient, especially one with swallowing difficulties, presents a challenge to the dental practitioner. This paper summarizes typical geriatric dental problems that caregivers in a long-term care (LTC) facility should find recognizable. It also describes palliative and preventive treatment modalities that help improve the quality of life for such institutionalized patients.

Aged↗

PubMedDate not supplied

Institutionalized patients with hip fractures: characteristics associated with returning to community dwelling.

The authors sought to identify patient- and nursing home-specific characteristics associated with a return to community living among patients with hip fractures discharged initially to nursing homes. One hundred eighty-nine free-living elderly patients were admitted for hip fractures to a 1,120-bed community hospital during 1984-1986. At hospital discharge, 114 (60%) of these patients were institutionalized. One year later, 49/114 (43%) had returned to the community. Three factors independently correlated with patients' return to community living: being discharged to a nursing home with a large ratio of annual admissions to number of beds (RR = 2.51, 95% CI 1.65, 3.94), achieving any in-hospital ambulation (RR = 4.24, 95% CI 1.77, 8.14), and receiving conventional Medicare insurance (RR = 0.37, 95% CI 0.05, 0.53). These data suggest the existence of patient and nursing home features that identify those institutionalized patients with hip fractures who are more likely to return to community dwelling.

Age Factors↗

PubMedDate not supplied

The effects of a rehabilitation program with mnemotechniques on the institutionalized elderly subject.

After having screened the cognitive functions in 103 institutionalized elderly subjects in Terni, a sample affected by mnemic deficit was obtained so as to verify the use of mnemotechniques on the same. Generally the findings show an improvement in cognitive performance in those treated which leads to suppose that our patients were affected by apparent cognitive deficits rather than real ones, supporting in any case the use of neuropsychological rehabilitative treatment in institutionalized subjects.

Journal Article↗

PubMed1992

Dental state and needs for episodic care of institutionalized elderly in an Asian community.

This study examined the dental state of institutionalized elderly and their need for care. An oral examination was carried out on 479 elderly persons living in long-term care facilities with a mean age of 74.9 years. Results showed an overall DMF score of 27.0 and the average number of teeth in dentate subjects was 7.5. A large proportion of teeth (76.6%) was lost through dental caries and the loss increased significantly with age. Consequently, 56.1% of subjects were edentulous, of whom 78.8% were without dentures. Among the conditions that required urgent dental care, majority of subjects needed extractions of residual roots and loose teeth. A lesser proportion required treatment for gross caries (4.8%), periodontal disease (5.0%), suspected tumor (0.2%), as well as alleviation of pain and infection arising from mucosal lesions (4.8%), abscesses (3.3%) and TMJ problems (2.8%). The treatment needs for dentures and episodic care are high among institutionalized elderly and need to be addressed.

Aged↗