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At least 595 records · Page 33Linked to original sources
PubMed2006

Transition experience of parents caring of children with epilepsy: a phenomenological study.

BACKGROUND: Families who have a child with epilepsy show a significant impact on both the dynamics of the child's development and family systems in a social context. Knowledge of a family's lived experience in dealing with the early stages of their child's illness will provide a deeper understanding of their life and coping process. Most studies have focused on the child's developmental issues, parental attitudes, coping strategies and the child's adjustment. In order to assist families to cope with the early stage of having a child with epilepsy, nurses need to understand the nature of a family's lived experience. OBJECTIVE: The purpose of this study was to investigate the essence of the family health-illness transition experience from the parental perspective when a child is afflicted with epilepsy. DESIGN: Colaizzi's phenomenological approach was used. In-depth interviews were conducted with ten couples with regard to the first one and a half years after the diagnosis of epilepsy. SETTINGS AND PARTICIPANTS: Ten couples from two medical centers in Taiwan participated in the study. The age range of the children at diagnosis was 0.2-4.3 years. METHODS: Open attitude and imaginative variation techniques were used to investigate the meanings of the experience. This study used Colaizzi's method with both destructured and restructured analysis. Lincoln and Guba's trustworthiness criteria were employed to evaluate methodological rigor. RESULTS: Three concepts emerged: parents' psychological reactions, parental coping patterns and family resources. The parents' psychological reaction was that of being emotionally traumatized and physically exhausted. Parental coping patterns were vigilant parenting and aimed at reframing roles, facing the social challenge and assisting the child's social re-integration. The nature of family resources was family resiliency. The findings provide a scientific knowledge base for nurses when assisting parents and children during the health to illness transitional phase following a diagnosis of epilepsy.

Adaptation, Psychological↗
PubMed1994

Facilitating problem drinking clients' transition from inpatient to outpatient care.

Engaging and retaining problem drinkers in the helping process are among the most difficult tasks encountered by professionals working with alcoholic clients. The engagement process is particularly difficult for individuals who are referred for outpatient treatment following inpatient care. This article reports on the use of transition groups to improve the linkages between inpatient and outpatient alcoholism treatment. Findings revealed that clients who had access to a transition group had more favorable outcomes than did individuals who had no access to the group. The group was especially useful for inpatients who had encounters with the outpatient clinic before their hospitalizations. This investigation illustrates the positive impact of simple service adjustments on the delivery of care.

Adult↗
PubMed2002

Transition: a future promise for children and adolescents with special health care needs and disabilities.

Transitions are a part of everyone's life experience. Most young people with special health care needs and disabilities (SHCN/D) become independent partners in adult society, but some need deliberate guidance and support. This latter group is growing in number. Through a new consensus statement from the American Academy of Pediatrics and the U.S. Federal Government (Healthy People 2010), society is recognizing the need to assist young people with SHCN/D in attaining their potential in adulthood. This article discusses the growing number of young people with SHCN/D, their desires for their transition, the definition and areas of transition that should be addressed, and the key elements of successful transition programs. The article ends with a suggested list of actions a health care professional can undertake to foster a successful transition and a selected list of helpful resources for health professionals, families, and young people with SHCN/D.

Activities of Daily Living↗
PubMed1979

Brief hospitalization: two-year follow-up.

This article presents the long-term follow-up effects of brief vs standard hospitalization on families. One hundred seventy-five newly admitted inpatients who lived with their families were randomly assigned to standard inpatient care, brief hospitalization followed by the availability of transitional day care, and brief hospitalization. All patients were offered follow-up outpatient treatment. Initial length of stay was 11 days for both brief hospitalization groups and 60 days for the standard group. The long-term results generally indicate little differential effect between treatments. When differences occurred, they generally favored the brief groups. For example, at one year the standard group families were judged to have a higher overall level of burden than the brief-day families. The findings suggest that patients are more likely to be rehospitalized because of their psychopathology than because of family burden.

Adult↗
PubMed1990

Conditions for the transition to home health care.

A number of changes in health care thinking have been taking place during the past years; these changes are in the financial system, in professional thinking and in political views. As one of the consequences, general hospitals in the Netherlands are thinking of entering home health care for professional and financial reasons. Most probably this may be done now if the management dares to take some risks. However, many conditions still need to be adapted to that situation. Most importantly, it is absolutely necessary to achieve a functional co-operation between professional groups in home health care. Hospital pharmacists should do their home work to make clear what extra value they can bring into home health care. Undoubtedly there are possibilities for the hospital pharmacy in home health care as part of the whole hospital policy in that direction.

Government↗
PubMed1996

Payer-hospital collaboration to improve patient satisfaction with hospital discharge.

BACKGROUND: Brigham and Women's Hospital, in Boston, and its major health maintenance organization (HMO), Harvard Community Health Plan, collected data in spring 1994 which revealed that patients were less satisfied with hospital discharge planning than with other elements of care. PROBLEM IDENTIFICATION PROCESS: An interdisciplinary team, formed in November 1994 and composed of eight members from the hospital and HMO, used data from the hospital's Patient Satisfaction Survey, flowcharting, and phone interviews with patients to identify discharge planning-related problems. For example, follow-up contact with patients after discharge was erratic and no clear signal of the successful "hand off" of care from the hospital team to the community team existed. IMPROVEMENT CYCLE 1: Eighty-three percent of the payer's patients that received the improvement strategy developed by the interdisciplinary team-a concierge service-rated discharge planning as excellent or very good, compared to 63% of control patients. IMPROVEMENT CYCLE 2: PLAN SOLUTIONS/STRATEGIES FOR IMPROVING HOSPITAL DISCHARGE PLANNING: The results of the team's Cycle 1 improvement provided information for the team to use in designing a second cycle of incremental improvement activity. For example, to address the lack of clarity about who was responsible for making decisions about discharge and follow-up care, the attending physician was designated the transition-of-care coordinator. Once all the improvements were implemented, Cycle 2 patients who received the intervention rated satisfaction with discharge higher (83% versus 73%) than the control group. CONCLUSIONS: Implications of hospitalwide implementation of discharge planning-related services attempted on one unit are being considered.

Ancillary Services, Hospital↗
PubMed2005

[Migration specific transitions and family care-giving].

This qualitative study focuses on care-giving among Russo-German re-settlers. Since the early '90s, Russo-Germans have been increasingly allowed to return to Germany. Up to now, the phenomenon of care-giving in this group was little known. The meaning of family care-giving within this particular group of immigrants can only be understood by investigating the foundations of care, the kind of care given, and the ways of providing care. Using the Grounded Theory method, four data sets of 81 interviews have been conducted and analysed in Russia and Germany. Care-giving among Russo-German re-settlers is part of a system of comprehensive family care and support stemming from a collectivistically oriented family concept. Family care is taken for granted and experienced as a must. On account of their biographic experiences and the experiences of immigration, the caring behaviour of Russo-German re-settlers is not necessarily congruent with the caring behaviour practised in Germany, let alone the caring behaviour of professional carers. This has an impact on the utilization of professional support. In order to provide helpful and meaningful support professional carers have to take into account the whole system of family carers and to avoid the separation of the family.

Caregivers↗
PubMed1997

Transitions across various continuing care settings.

PURPOSE: to compare cross-nationally the sources and rates of admission and discharge in nursing homes. METHODS: data on admission were used from the Minimum Data Set of the Resident Assessment Instrument as collected in a multi-nation database at the University of Michigan. Additional data containing longitudinal episodes were used from databases in the Netherlands, Switzerland and the USA. RESULTS: the sources and rates of admission and discharge in nursing homes vary widely between countries. In Japan 47.5% of the sample was admitted from another long-term care setting, in Italy and the USA 36% and 42% respectively were admitted directly from hospital, while in Denmark and Iceland more than 60% came from home. The longitudinal data show that in the Netherlands, residents' return to home was much more likely than in Geneva or the USA (27% vs 5% vs 10%) and that in the USA a relatively large number of nursing home residents (>45%) was discharged (intermittently) to a hospital within 180 days after first admission as compared to the Netherlands (10%). CONCLUSIONS: there are large differences between countries in admission and discharge to and from nursing homes. Various policies, payment schemes, care patterns and routine referrals influence this and can be studied with cross-national data now available.

Aged↗
PubMed1997

A randomized control trial of an opportunistic health screening tool in primary care for people with intellectual disability.

People with intellectual disability have an increased variety of health care problems compared with the general population. The transition of care for such people from institutions into the community places them in a primary care system already facing increasing demands for their services. There is a consensus that health screening is at its most useful in identifying functional disabilities. Therefore, an intervention which helps the general practitioner (GP) towards opportunistically checking those areas of health most often deficient in people with intellectual disability would appear of considerable benefit (especially if information directing the GP towards appropriate secondary care services is also provided). The present study was designed to evaluate the impact of such an intervention.

Adolescent↗
PubMed2002

Facilitating large-scale transitions to quality of care: an idea whose time has come.

In the field of reproductive health, investigation of the transfer of knowledge gained from demonstration and pilot projects to large public-sector programs typically has not been considered a relevant domain for research or other investigation. This article draws on a range of research in the social sciences and presents two frameworks for understanding the critical attributes of successful expansion of small-scale innovations. Seven key lessons are developed using examples from family planning where scaling up was an explicit objective, including the early Taichung Study of Taiwan, the Chinese Experiment in Quality of Care, the Bangladesh MCH-FP Extension Project, the Navrongo Project in Ghana, and the Reprolatina Project in Brazil. Unless small, innovative projects concern themselves from the outset with determining how their innovations can be put to use on a larger scale, they risk remaining irrelevant for policy and program development.

Diffusion of Innovation↗