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PubMed1976

A survey of the dental needs of hospital inpatients in Scotland.

Eight hundred and ninety-four inpatients in four hospitals in Edinburgh were assta were used to estimate future inpatients' dental requirements and the hospital dental services which would be necessary to meet these needs. Seventeen percent of the sample was found to be suffering from pain or discomfort of dental origin and over 30% were considered to require some form of dental treatment before their expected date of inpatient discharge.

Adolescent↗

PubMed2026

Feasibility and effectiveness of the Bergen 4-Day Treatment for obsessive-compulsive disorder in Australia: A pilot comparison with 3-week inpatient obsessive-compulsive disorder treatment.

OBJECTIVES: Obsessive-compulsive disorder is a debilitating and chronic condition that, when untreated or unresponsive to treatment, imposes a significant health and economic burden on individuals and families. This prospective non-randomised inpatient study compared the acceptability and clinical outcomes of the Bergen 4-Day Treatment programme with those of a standard 3-week specialised treatment programme for obsessive-compulsive disorder in Australia. METHOD: Twenty-five participants diagnosed with obsessive-compulsive disorder were non-randomly assigned to Bergen 4-Day Treatment (n = 12) or a 3-week standard (n = 13) inpatient programme. Independent assessments were completed at pre-treatment, 10 days post treatment and at 3-month follow-up. The Yale-Brown Obsessive-Compulsive Scale was rated to assess obsessive-compulsive disorder severity, while secondary measures of depression, anxiety, obsessive beliefs and wellbeing were self-rated by participants. RESULTS: Baseline characteristics of both groups were comparable, with obsessive-compulsive disorder symptom severity within the moderate to severe range. After treatment, obsessive-compulsive disorder symptoms as well as secondary depression and anxiety symptoms were reduced in both treatment groups. Participants receiving Bergen 4-Day Treatment had significantly lower Yale-Brown Obsessive-Compulsive Scale scores at 10 days (M = 13.46) and 3 months (M = 11.84), compared to standard treatment (M = 19.04 and M = 19.15, respectively). Response (91.9%) and remission (45.8%) rates for the Bergen 4-Day Treatment group were significantly higher at both post-treatment timepoints, compared to the standard treatment group. No dropouts occurred in the Bergen 4-Day Treatment group, and participant satisfaction was high. CONCLUSION: The findings of this pilot open-label study suggest that Bergen 4-Day Treatment shows promise as an acceptable, efficient and effective treatment for obsessive-compulsive disorder, warranting further investigation as a scalable alternative for improving access to specialised obsessive-compulsive disorder treatment in Australia.

Humans↗

PubMed1975

Labeling effects in psychiatric hospitalization. A study of diverging patterns of inpatient self-labeling processes.

This report explores two theoretical positions regarding psychiatric inpatient self-labeling processes over time. One position suggests that acceptance of the deviant label "mentally ill" is benign; the other suggests that such label acceptance may be harmful to patients. Employing empirical, longitudinal data from a sample of 43 inpatients, three complex, but discernible, patterns of "acceptance," "rejection," or "denial" of the "deviant" label of mental patient emerged over time within a short-term hospital setting. The three patient groups varied on Minnesota Multiphasic Personality Inventory scales, staff behavioral ratings over time, involvement in approved ward activities, and length of hospitalization. Results were discussed in terms of patient-staff interaction and its possible relation to patient self-labeling.

Adult↗

PubMed1977

Family intervention with severely disturbed inpatients.

Although there is considerable evidence that family variables and interaction patterns affect the duration of hospitalization and frequency of readmission of psychiatric patients, it is rare to find inpatient facilities having psychotherapeutic programs that systematically stress family interventions. This article discusses the difficulties encountered by both families and staff as they cope with the issues of hospitalization, suggests a structured, patient-oriented family approach, and recommends some specific techniques for short-term work with families of severely disturbed inpatients.

Acute Disease↗

PubMed1978

Breast biopsy. A comparison of outpatient and inpatient experience.

Nine hundred ninety-seven breast biopsies that were performed at one hospital over the five-year period from 1971 through 1975 were reviewed because of a changing pattern in the use of breast biopsies on outpatients who were under local anesthesia. In 1971, 17% of all breast biopsies were performed as outpatient procedures; by 1975, the figure was 60%. In 1971, 5% of all malignant neoplasms were diagnosed by the use of biopsies as outpatient procedures and 30% in 1975. Hospital charges for biopsy on an inpatient basis of benign breast disease were 7.2 times higher than for biopsy on an outpatient basis. Interviews of 102 patients clearly suggested that most patients were satisfied with the outpatient breast biopsy experience. Outpatient breast biopsy under local anesthesia is a safe procedure that is more economical in terms of medical cost, surgeons' time, and patients' time away from home and/or job. Preliminary biopsy of malignant lesions using local anesthesia permits more efficient use of diagnostic procedures to stage the extent of disease prior to treatment. Patient acceptance of breast biopsy as an outpatient procedure under local anesthesia was similar to their acceptance of biopsy on an inpatient basis under general anesthesia.

Ambulatory Care↗

PubMed1976

Personality characteristics related to treatment decisions among inpatient alcoholics: a non-relationship.

A battery of standard personality and experimental research scales was administered to 110 male alcoholic inpatients. No differences were found on the 30 scale scores derived from the tests among three groups with differential treatment dispositions: (1) those who discontinued treatment after a 2-week evaluation period; (2) those who chose to remain for a 60-day treatment program, but discontinued prior to completion; and (3) those who chose and did complete the 60-day program. It was suggested that attrition from an inpatient alcoholism program might be predicted better by a multivariate approach that used demographic, life history, psychosocial and personality variables as predictors.

Alcoholism↗

PubMed1978

The relation between trait anxiety and the Harris MMPI PD subscales among psychiatric inpatients.

Investigated the relationship between trait anxiety and MMPI PD scores among psychiatric inpatients from a multidimensional standpoint by means of the Harris PD subscales. The trait anxiety scale of the State-Trait Anxiety Inventory and the Harris PD subscales were administered to 24 female and 21 male psychiatric inpatients. Trait anxiety was correlated positively with the basic PD scale in accord with previous findings. However, the Self-Alienation and Social Alienation PD subscales were the only Harris subscales that were correlated significantly with anxiety in the positive direction. The Social Imperturbability PD subscale was related inversely to trait anxiety. The findings were discussed primarily in terms of the potential benefit of employing the Harris subscales in studies of psychopathy and in clinical settings.

Adolescent↗

PubMed1979

A study of mental status and anamnestic factors related to the decision for inpatient or outpatient treatment.

Reviewed previous studies of the determinants of disposition decision-making. Experimental flaws in these studies are indicated. A study of the intake decision process and its relationship to mental status and anamnestic variables obtained during the intake examination is presented (N = 523). Results suggest that diagnoses of psychosis and personality disorder are rleated to inpatient care, while the diagnosis of neurosis is related to outpatient care. In addition, depressed/suicidal symptomatology is found to be related to inpatient treatment, while a previous history of either sexual maladjustment or stubbornness/retardation is found to be related to outpatient care. Results are discussed in terms of universal and local criteria that are involved in intake decision-making.

Adult↗

PubMed1978

The effectiveness of planning for community mental health center inpatient units.

The number of beds identified among 308 community mental health centers in operation in 1972 bore little relation to inpatient case load or to the proportion of center patients likely to require hospitalization. Analysis of occupancy data indicated that there was a surplus of beds in many centers. These findings suggest a lack of effective planning for community mental health center impact on the nature of psychiatric treatment provided. This is suggested by the close relationship between inpatient capacity and average duration of stay.

Adolescent↗

PubMedDate not supplied

Inpatient bed needs for psychiatric care.

Along with other types of hospital inpatient care, acute psychiatric units are subject to state certificate-of-need review under Public Law 93-641. A study of 15 hospitals in Virginia suggests that prevailing techniques for determining inpatient bed needs are not appropriate for psychiatric beds, if indeed they are for other types of care. An alternative technique is offered, not as a substitute for judgment in such matters, but as assistance to it.

Beds↗

PubMed1979

The interaction of family therapy and psychodynamic individual therapy in an inpatient setting.

Although individual psychotherapy is an established treatment modality in psychoanalytically oriented hospitals, family therapy is a relative newcomer. When family therapy is introduced into such an inpatient setting, it raises issues which have not yet been widely discussed. On the one hand there is the question of how inpatient family therapy differs from outpatient family therapy, and what its special characteristics are. This question has only begun to be discussed. On the other hand there is the question of how family therapy relates to individual therapy that is being conducted simultaneously with a member of the same family. In general the individual psychotherapy literature tends to speak as if family therapy did not exist, and the family therapy literature speaks as if individual therapy should be abolished and supplanted by family therapy. Some authors have begun to try to build bridges between the two fields on the level of theory, but almost none have reported on the interaction between the two treatment modalities on a pragmatic level when they are conducted simultaneously (Kugel, 1974).

Adult↗

PubMed1976

Inpatient care or outplacement: which is better for the psychiatric medically infirm patient?

Eighty-four geriatirc ward patients were randomly assigned to groups targeted for outplacement planning or inpatient care. During the following year, half of the former were placed in community settings while nearly all of the latter remained in the hospital. Neither the physical health, level of self-care, or psychiatric condition ratings of the two groups changed differentially over that time. However, the mean Morale Inventory score of the outplacement sample improved while that of the in-patient group remained static. Additional analyses were run between three groups - outplacement planning subjects who were released, those who were not released, and inpatient planning men who were not released. These results confirmed those of the first analyses; the only significant difference appeared on the Morale Inventory, the patients who left showing more improvement than the other two groups. The results argue for an increased emphasis on outplacement programs among geriatric patients.

Activities of Daily Living↗

PubMed1975

The impact of staff suicide on a psychiatric inpatient unit.

A staff nurse on a psychiatric inpatient unit committed suicide. A retrospective study of patients and staff reactions was conducted. It showed that the inpatients dealt openly and effectively with grieving. Staff had a great deal of difficulty with the situation. One of the nurse's outpatients required rehospitalization. Recommendations for more attention to the staff mourning process were made.

Attitude of Health Personnel↗

PubMed1977

Learning child psychiatry skills on the adult inpatient service.

Integration of child psychiatry training into general psychiatric residency programs is often unsuccessful. The authors describe an innovative model of training in child psychiatry that involves the children of adult inpatients. This model offers several advantages: splitting of child-adult psychiatric training is avoided, child diagnostic and evaluative skills tend to be learned rapidly, preventive orientations develop, and family process is both learned and used. Preliminary experience with this model on two inpatient services suggests that it is both didactically effective and economical in child psychiatry staff hours.

Adolescent↗

PubMed1975

Short-term follow-up after brief inpatient treatment.

A total of 110 patients admitted to the inpatient unit of a community mental health center in Philadelphia were followed up between 90 and 120 days after discharge to determine their level of functioning after an average hospital stay of 21 days. All but five of the patients were referred for aftercare, and 80 received outpatient or day hospital care after their release. Sixteen patients were readmitted to inpatient care within 90 days after discharge. The author describes the patients' social and community adjustment at follow-up, based on information obtained from aftercare therapists.

Adolescent↗

PubMed1978

Developing a psychiatric inpatient service in a rural area.

An inpatient psychiatric service was developed in a community hospital in Appalachia by building on the hospital's existing mental health components, a comprehensive alcoholism program and an inservice training program for general-duty nurses. In its first phase, the program offered a consultation service to help physicians deal with emotional problems of medical-surgical patients and a daytime therapy program for selected patients referred by the consultation service. In the second phase, psychiatric patients were admitted directly from the community and placed in wards throughout the hospital. Eventually a separate 23-bed psychiatric unit was opened. Between 1973 and 1976 more than 2200 patients were treated by the therapy service or as psychiatric inpatients. The author discusses problems that occurred during each phase of development, including a continuing shortage of nursing staff.

Hospital Bed Capacity, 300 to 499↗

PubMed1979

A validity scale sign calling for caution in the interpretation of MMPIs among psychiatric inpatients.

Three expert MMPI judges classified 100 psychiatric inpatients as psychotic or non-psychotic on the basis of their MMPIs. Validity scale data, as well as clinical scale scores, were included for 50 of the profiles, while the validity scale scores were withheld from the judges for the remaining 50 profiles. Within each of the above two groups, half had a "positive" validity scale sign (a defensive validity scale configuration defined as L or K greater than or equal to 70, or both greater than or equal to 60) and half had a negative validity scale sign, indicating a lack of defensiveness. Using actual diagnosis as the external criterion, results indicated that the majority of defensive psychotic patients produced clinical scale configurations which appeared nonpsychotic to the judges. Conversely, the majority of nondefensive nonpsychotics produced psychotic-appearing clinical scale configurations. These two types of test misses suggest that K corrections on MMPI scales relating to psychosis are not optimal for psychiatric inpatients. Guidelines were developed for interpreting defensive profiles.

Defense Mechanisms↗

PubMed1979

Substitution of outpatient care for inpatient care:problems and experience.

This paper provides a logical framework for considering possible alternatives to inpatient care. First it presents the concept of a substitute-complement relationship among factors of production (or goods and services in consumption) and examines several problems often encountered when applying this concept. Second, it presents four general sources of substitution: (1) technological innovation; (2) changes in organization; (3) capital accumulation; and (4) the dissemination of knowledge. Third, it examines nine activities which are frequently mentioned as providing alternatives to inpatient care. Fourth, it examines some problems and consequences of governmental efforts to plan substitution. The general thrust of the paper is that the substitution process is complex and often depends upon amorphous variables whose influences are subtle, generally nonquantifiable, and often of overriding importance. These variables introduce a downward bias in estimates of program costs and an upward bias in the estimates of program accomplishments. The result is that government attempts to plan substitution are not well conceived and will generally fall short of announced goals and/or cost significantly more than original estimates.

Ambulatory Care↗