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PubMed2004

The PedsQL Family Impact Module: preliminary reliability and validity.

BACKGROUND: The PedsQL Measurement Model was designed to measure health-related quality of life (HRQOL) in children and adolescents. The PedsQL 4.0 Generic Core Scales were developed to be integrated with the PedsQL Disease-Specific Modules. The newly developed PedsQL Family Impact Module was designed to measure the impact of pediatric chronic health conditions on parents and the family. The PedsQL Family Impact Module measures parent self-reported physical, emotional, social, and cognitive functioning, communication, and worry. The Module also measures parent-reported family daily activities and family relationships. METHODS: The 36-item PedsQL Family Impact Module was administered to 23 families of medically fragile children with complex chronic health conditions who either resided in a long-term care convalescent hospital or resided at home with their families. RESULTS: Internal consistency reliability was demonstrated for the PedsQL Family Impact Module Total Scale Score (alpha = 0.97), Parent HRQOL Summary Score (alpha = 0.96), Family Functioning Summary Score (alpha = 0.90), and Module Scales (average alpha = 0.90, range = 0.82 - 0.97). The PedsQL Family Impact Module distinguished between families with children in a long-term care facility and families whose children resided at home. CONCLUSIONS: The results demonstrate the preliminary reliability and validity of the PedsQL Family Impact Module in families with children with complex chronic health conditions. The PedsQL Family Impact Module will be further field tested to determine the measurement properties of this new instrument with other pediatric chronic health conditions.

Activities of Daily Living↗
PubMed1975

Depression and senility.

The literature suggests a closer relationship between reversible depression and irreversible senile organicity than generally has been accepted. Accordingly, Zung's Self-Rating Depression Scale was given to 120 men and women, aged 60 or older, of whom 30 of each sex were classified as nonsenile and 30 of each sex were classified as moderately senile by the personnel of senior citizen centers, convalescent hospitals, and nursing homes. The results indicated that moderately senile Ss scored significantly higher on the SRDS than did the nonsenile Ss, that sex differences were not significant, that there were no significant differences between institutionalized and noninstutionalized Ss of either sex in either the nonsenile or the moderately senile groups, and that further refinement of the SRDS and a longitudinal study of personality, experience, and depression would be extremely useful.

Aged↗
PubMed1982

Training for independent living unit: its function in a rehabilitation convalescent setting.

This article describes a Geriatric Self-Care Unit in a 92 bed Rehabilitation Convalescent Hospital. Ten beds are set aside for this unit. The overall goal of the Self Care Unit (S.C.U.) is to facilitate the patients' discharge into the community. This pilot project has been in effect for six months with 47 patients having completed the program. Results of the program, its problem areas and progress are outlined.

Activities of Daily Living↗
PubMed1995

Convalescence and hospital stay after colonic surgery with balanced analgesia, early oral feeding, and enforced mobilisation.

OBJECTIVE: To evaluate the combined effects of pain relief by continuous epidural analgesia, early oral feeding and enforced mobilisation on convalescence and hospital stay after colonic resection. DESIGN: Uncontrolled pilot investigation. SETTING: University hospital, Denmark. SUBJECTS: 17 unselected patients (median age 69 years) undergoing colonic resection. INTERVENTIONS: Patients received combined epidural and general anaesthesia during operations and after operation were given continuous epidural bupivacaine 0.25%, 4 ml hour and morphine 0.2 mg hour, for 96 hours and oral paracetamol 4 g/daily. No patient had a nasogastric tube, and oral feeding with normal food and protein enriched solutions (1000 Kcal (4180 KJ/day) was instituted 24 hours postoperatively together with intensive mobilisation. RESULTS: Median visual analogue pain scores were zero at rest and minimal during coughing and mobilisation, which allowed early mobilisation for up to 11 hours on the third postoperative day. Gastrointestinal function with defaecation had returned to normal in 12 patients within the first two postoperative days. Median hospital stay was five days with minimal increase in fatigue and without postoperative weight loss. CONCLUSION: These results suggest that a combined approach of optimal pain relief with balanced analgesia, enforced early mobilisation, and oral feeding, may reduce the length of convalescence and hospital stay after colonic operations.

Acetaminophen↗
PubMed1999

[Hospitalization and convalescence after hysterectomy. Open or laparoscopic surgery?].

Approximately 6,000 hysterectomies are performed per year in Denmark. The major part of these are performed by laparotomy, although the use of laparoscopically assisted techniques is increasing. Laparoscopic surgery seems to lead to a reduction in the need for postoperative hospitalization and convalescence, which is confirmed in the few available randomised and to our knowledge all retrospective studies. The length of stay seems to be reduced from four to two days if the patient is hysterectomised by the laparoscopically assisted or vaginal techniques. The introduction of endoscopic techniques has caused a change in routines and recommendations, but not for women operated by the classical open procedures. In this article we question the relevance of comparing different types of operations given the fact that the routines and recommendations are different.

Convalescence↗
PubMed1993

Continuing evolution of regionalized perinatal care: community hospital neonatal convalescent care.

We describe the convalescent care of 169 back-transported (to community hospitals) and 285 eligible but not back-transported very low birth weight (VLBW) infants. Eligible infants who were not back transported to a level I or II community hospital were transferred to a level II nursery within the Medical University of South Carolina (MUSC) for convalescent care. Study infants were admitted to the neonatal intensive care unit (NICU) at MUSC from July 1985 through June 1989. They were admitted after maternal transport to MUSC for imminent delivery (N = 159), out-born community delivery (N = 55), or in-born MUSC delivery (N = 240). The mean +/- SD birth weight and gestational age and the NICU admission diagnoses for the back-transported and non-back-transported neonates were similar. The mean +/- SD weight of neonates at the time they were back transported was significantly greater than the weight of neonates at the time of intrahospital transfer. In contrast, the discharge weight to home and total days hospitalized were significantly less in the back-transported infants. Five back-transported neonates (3%) and 12 non-back-transported neonates (4%) were readmitted to the NICU. The back-transported infants used more than 3,800 bed days at community hospitals that would otherwise have been spent in the regional center, thus facilitating increased parental and primary physician involvement in their care.

Hospitals, Community↗
PubMed1975

Current and emerging models of residential psychiatric treatment, with special reference to the California situation.

The author reviews the steps that have led to the progressive deemphasis of psychiatric hospitalization in California and surveys the empirical basis for rejecting the usefulness of hospitalization. He discusses the four alternative residential models that have emerged in California as substitutes for state mental hospitals--general hospital psychiatric units, board and care homes, private psychiatric facilities available through vendor contracts, and convalescent hospitals. The author also touches briefly upon some important problems, including the possible fate of public general hospital psychiatric units, community mental health services, and the commitment law in California.

California↗
PubMed1983

Tetanus and diphtheria immunity in an elderly population in Los Angeles County.

Fifty-four per cent of 246 subjects attending senior citizen centers (mean age 69), and 29 per cent of 111 convalescent hospital subjects (mean age 82) had protective levels of tetanus antitoxin (greater than or equal to 0.01 units/ml). Age-specific immunity levels were lower for females than males, and generally decreased with age. Forty-eight and one-half per cent of the senior citizen center subjects and 55.9 per cent of the convalescent hospital subjects had protective levels of diphtheria antitoxin (greater than or equal to 0.01 units/ml).

Age Factors↗
PubMed1978

Economic aspects of day care after operations for hernia or varicose veins.

In a trial of 360 patients with hernia or varicose veins, day care surgery provided an economic alternative to the provision of surgical aftercare either in the surgical wards of a district hospital or in a convalescent hospital. There was only slightly more work for general practitioners. Most of the additional work for the community services was carried out by district nurses, with an average contact time in the postoperative period of 325 minutes for day care patients, compared with 186 minutes and 204 minutes respectively for patients admitted for 48 hours to the surgical or convalescent wards. Day care produced estimated savings of 30 pounds compared with the costs of a 48-hour stay in the surgical wards, and savings of 22 pounds compared with a 48-hour stay in the convalescent wards.

Aftercare↗