A note on rigidity and length of institutionalization.
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Examined the performance of 64 children on the Minnesota Percepto-Diagnostic test (MPD) who were diagnosed as either Brain-Damaged (BD) or emotionally impaired Non-Brain-Damaged (NBD). There were 31 children in the NBD group and 33 in the BD group. The MPD T-score and Actuarial Table significantly differentiated between the two groups. Seventy-four percent of the combined BD-NBD groups were identified correctly. Additional discriminant analysis on this sample yielded combined BD-NBD groups classification rates that ranged from 77% with the MPD variables Separation of Circle-Diamond (SPCD), Distortion of Circle-Diamond (DCD) and Distortion of Dots (DD) to 83% with the WISC-R three IQ scores plus the MPD T-score, SPCD and DD. The MPD T-score and Actuarial Table (MPD Two-Step Diagnosis) appeared to generalize to other populations more readily than discriminant analysis formulae, which tend to be sensitive to the samples from which they are derived.
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To identify causative factors we screened 1,715 deaf individuals from 16 schools for the deaf in Colombia. We found evidence of environmental causation in 579 (33.8%) cases, genetic in 608 (35.4%), and in 528 (30.8%) we were unable to identify the etiology. The degree of hearing loss was severe to profound in 1,238 (72.2%), although in 987 (57.5%) of the deaf population studied the hearing impairment was not noticed until 2 to 5 years of age. The frequent association of deafness with other anomalies underscores the importance of a careful clinical and ophthalmologic evaluation in individuals with hearing loss. Our observations also emphasize the need for programs directed towards the prevention of hearing loss, including primary prevention as well as early diagnosis, investigation of possible genetic causes, and rehabilitation of deaf individuals.
OBJECTIVE: This study examined the effects of reminiscence on depressive symptoms and mood status of elderly people residing in long-term care facilities. METHODS: A longitudinal quasi-experimental design was conducted, using two equivalent groups for pre-post test and purposive sampling. Each subject was administered pre- and post- tests at a 4 month interval, but subjects in the experimental group underwent weekly individual reminiscence therapy. Geriatric Depression Scale short form (GDS-SF) and Apparent Emotion Rating Scale (AER) were used as study instruments. RESULTS: Forty-eight subjects completed the study, with 25 in the experimental group and 23 in the control group. The experimental findings indicated that the experimental group demonstrated fewer depressive symptoms (p < 0.05) and better mood status (p = 0.05) on the post-test comparing to the control group. CONCLUSION: These warranted that reminiscence therapy is a recommended therapy for older people who reside in care facilities. It can provide a basis for planning geriatric care in community to promote the well being and quality of life of older people.
OBJECTIVE: To investigate why elderly persons moved to a nursing home and detect any change in their psychopathological and cognitive profile, dependency and perceived QOL. METHOD: We considered 100 elderly consecutively admitted to a nursing home, within 1 week of admission and 6 months later. Data were collected from medical and nursing records (medical and psychiatric history, ADL), interviews (MMSE, reasons for admission) and self-report instruments (GDS, BSI, WHOQOL-brief). RESULTS: At admission, 68 subjects were able to participate in the survey and agreed to take part. Only 5.9% (n = 4) had moved to the nursing home by their own choice, 26.5% (n = 18) because they were lonely and 36.7% (n = 25) because they had no caregiver available. The reasons for admission reported by the interviewed residents only partly corresponded with the ones noted in their records. Twenty-six subjects had an MMSE score >or= 18 and agreed to undertake complete assessment. The scores of 20 of the 26 subjects exceeded the cut-off on the GDS and five of the nine BSI subscales. During the follow-up period, 19 of the 68 originally assessed residents died (33 of the entire sample of 100) and one refused to continue to take part in the survey. The mean MMSE and ADL scores of the 48 survivors decreased from 16.87 (SD +/- 7.32) to 14.27 (SD +/- 7.24; t = 4.89, p < 0.000) and from 8.22 (SD +/- 3.55) to 6.39 (SD +/- 3.56; t = 5.34, p < 0.000), respectively. The scores achieved on GDI and BSI subscales worsened in 20 survivors with MMSE >or= 18. The score achieved on the QOL physical health domain also worsened. Comparison of the subjects who died and survived during the follow-up period showed a significant difference in terms of ADL (6.60 SD +/- 4.221 vs 3.64 SD +/- 3.773 F = 11.639; p < 0.001). CONCLUSION: The 68 original participants expressed feelings of loneliness and marginalization, but these experiences were not noted in their personal records. Most subjects presented psychiatric symptoms and cognitive decline. After 6 months, the clinical condition of the sample, particularly the females, had worsened, with a 33% mortality rate. This suggests that moving to a nursing home did not bring about improvement or stabilization; rather, psychiatric symptoms worsened and quality of life was perceived more poorly.
OBJECTIVE: The relationship of cognitive impairment to functional status in older adults with schizophrenia was investigated. PATIENTS: Ninety-three psychiatric inpatients with schizophrenia between the ages of 65 and 88 years. Two subsets of this sample, consisting of 48 and 24 patients, were studied with a greater number of assessment instruments. MEASURES: The Mini-Mental State Examination (MMSE) was used for brief assessment of overall cognitive functioning, and the Psychogeriatric Dependency Rating Scale (PGDRS) was administered to assess functional status. The cognitive test battery from the Consortium to Establish a Registry for Alzheimer's Disease (CERAD) and/or an expanded neuropsychological battery, was given to a subset of the patients. RESULTS: In the overall sample, patients with greater global cognitive impairment had higher levels of rated impairment on the individual items that comprised the Orientation and Physical, but not Behavior, subscales of the PGDRS. Furthermore, in the two subsamples, specific neuropsychological measures of problem-solving, word list learning, naming and constructional praxis were related to overall measures of outcome. CONCLUSIONS: Neuropsychological deficit and psychosocial outcome are multi-dimensional entities that relate to one another in complex ways.
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The climate for autonomy in four urban proprietary nursing homes was investigated as part of a larger study of the relationship between perceived control and morale. Data from 113 residents, 137 caregivers, and 10 administrative personnel revealed that caregivers see themselves as the predominant decision makers. Although they prefer a slightly higher level of self-determination for residents, only in one-to-one and solitary activities do they prefer giving residents the primary decision making role, possibly because they see most residents as not capable of making decisions. Residents saw themselves as having more control than did staff. Grooming and eating were identified by both groups as areas where residents had the least control. A substantial proportion of caregivers and administrative staff did not emphasize the availability of options to residents.
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A survey of adult male immates of the major institutions for mental patients in Belgium was undertaken in 1965. Out of 10417 males examined 61 had positive sex chromatin (5.8%); 201 had bilateral small testis (1.9%), 4 hypogonad patients carried a D/D translocation. Out of 857 karyotyped children, 2.9% carried an autosomal or sex-chromosomal anomaly other than trisomy G. This prevalence of chromosomal anomalies in children with low I.Q. (less than 50) emphasizes the need for further studies.
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