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At least 145 records · Page 8Linked to original sources
PubMed1993

Evaluation of a quality assessment manual: effectiveness in a quality assurance program.

1. An occupational health quality assessment manual was evaluated to judge its effectiveness as part of an overall quality assurance program. 2. The first step in the evaluation process examined standards; the second step determined measurable process criteria. 3. A quality assessment evaluation should promote accountability among care providers and clarify standards and criteria.

Evaluation Studies as Topic↗
PubMed1992

The second Chicago televised smoking cessation program: a 24-month follow-up.

OBJECTIVES: As smoking decreases in the population, the remaining smoking population will change, and cessation initiatives will have to incorporate strategies designed for these smokers. METHODS: To study patterns of response to a cessation intervention composed of 20 televised segments and the American Lung Association Freedom from Smoking in 20 Days manual, this study compared cessation rates over 24 months in a cohort of smokers who registered for a cessation program with those in a cohort selected from the smoking population at large. RESULTS: At post intervention, multiple point prevalence of cessation among participants, adjusted for baseline smoking, was 14% among registrants and 6% in the population; at 24 months the adjusted rates were 6% and 2%, respectively. Heavy smokers benefited more than light smokers, and there was a consistent dose-response relationship between extent of exposure to the intervention and cessation. CONCLUSION: The effects of the intervention were strongest for those who read the manual and watched the programs daily. Manual use was important, and those who did not read it did not appear to benefit. Compared to the population and given full participation, heavy smokers benefited more than lighter smokers.

Adult↗
PubMed1997

Outcome of delirium: Part 1. Outcome of delirium diagnosed by DSM-III-R, ICD-10 and CAMDEX and derivation of the Reversible Cognitive Dysfunction Scale among acute geriatric inpatients.

OBJECTIVE: To study performance of DSM-III-R, ICD-10 and CAMDEX diagnoses of delirium as predictors of improvement in mental state in survivors, and to develop a brief rating scale which will predict reversibility of cognitive dysfunction. DESIGN: Prospective cohort study. SETTING: Acute geriatric inpatient units. PATIENTS: A random sample of consecutive acute admissions of patients over the age of 65 (N = 80). MAIN MEASUREMENTS: Serial assessments of mental state and cognitive function and observational data. Establishment of DSM-III-R, ICD-10, CAMDEX diagnoses. OUTCOME MEASURE: Patients with more than five points of 20% improvement in Mini Mental State Examination following the most severely impaired assessment operationally designated 'reversible cognitive dysfunction'. MAIN RESULTS: Diagnoses of delirium by DSM-III-R and ICD-10 do not predict improvement in cognitive function well; CAMDEX does rather better. Discriminant function analysis yielded the Reversible Cognitive Dysfunction Scale (RCDS), a simple clinical scale which accurately predicted improvement. This comprised reduced conscious level, poor attention, poor contact with the patient, incoherent speech, reduced psychomotor activity, lack of awareness of surroundings and poor orientation and memory. CONCLUSIONS: The concept of and diagnostic criteria for delirium should be reconsidered. The RCDS merits further evaluation.

Acute Disease↗
PubMed1997

The DSM-IV Outline for Cultural Formulation: a critical demonstration with American Indian children.

OBJECTIVE: The publication of DSM-IV is notable for the improved coverage of cultural issues in the diagnosis of mental disorders. In particular, Appendix I of DSM-IV includes an "Outline for Cultural Formulation" (Outline) which assists the clinician in evaluating the impact of an individual's cultural context on diagnosis and treatment. However, the capacity of the Outline to facilitate the development of comprehensive cultural formulations for children and adolescents has not been established. In this article the use of the Outline with American Indian children is reviewed critically. METHOD: Based on the Outline, cultural case formulations for four American Indian children were developed and their comprehensiveness was assessed. RESULTS: Applied to the case material, the Outline provided a clear template for the development of cultural formulations. Nonetheless, several gaps in the material required by the Outline were identified, particularly in the areas concerning cultural identity and cultural elements of the therapeutic relationship. CONCLUSIONS: Clinicians working with children should recognize the strengths as well as the limitations of the Outline and expand their cultural descriptions accordingly. Several additions to the text of the Outline that will facilitate the development of comprehensive cultural formulations specific to children and adolescents are proposed.

Case Management↗
PubMedDate not supplied

Computer-aided learning--a solution for the training needs of users & maintainers of medical equipment.

It can be argued that the strategic role of training and assessment in the use and maintenance of medical equipment for the delivery of safe and efficient healthcare is underestimated. While there has been frequent comment on this issue, the resources provided for this activity are most often insufficient. New methods are required to deliver regular, cost-effective training within the working environment, at the time and place of need. Similarly, the administrative workload has to be automated--and thus reduced--if training is to improve in both frequency and content. Computer-aided learning has had increasing and diverse application in education and training over the past few decades. The sophistication of software tools and the reduced cost of the necessary hardware makes this a viable and appropriate method for application in the field of Clinical Engineering. However, this technology has not yet been fully exploited to provide instruction in the use and maintenance of equipment. In this paper, it is proposed that computer-based training packages should not only be a source of interactive instruction and assessment, but also act as rapidly accessible reference materials or simulators of the actual device for the purpose of fault finding or troubleshooting. Brief details of a sample package are given for training in the use and maintenance of the Siemens Elema Servo Ventilator 900C.

Biomedical Engineering↗
PubMed2000

Certification of an emergency department according to UNI EN ISO 9002 criteria.

Over the past decade, the philosophy of total quality has appeared in all fields of industry in Japan and the USA. This philosophy is now present all over Europe as well, Italy included. In 1993 the Arcispedale Santa Maria Nuova of Reggio Emilia, a town in Northern Italy, began to apply the total quality management philosophy, thus embarking on a course of continuous quality improvement. The present article describes the main steps which led to an external accredited team granting the emergency department of this hospital a quality system certificate in 1997 according to the international quality system requirements UNI EN ISO 9002. The importance of this work lies in the fact than an industrial quality standardization system, whose requirements have little in common with a traditional view of medical practice, can nevertheless be applied to a public health care department.

Accreditation↗
PubMed1990

A risk-reduction nutrition course for adults.

This article details the development, delivery, and evaluation of a six-session nutrition course entitled "Eating Today for a Healthier Tomorrow." The course addressed nutrition practices associated with the reduction of risk for coronary heart disease, cancer, osteoporosis, and obesity. Teaching teams, consisting of an extension agent and a registered dietitian, were used in course delivery. A wide variety of printed and audiovisual teaching aids helped participants learn through discussion, goal setting, games, and food tasting. Evaluation components of the course included demographic and pre- and post-course food frequency information as well as an overall evaluation by each participant. Post-course evaluation data were collected at a reunion session held 2 months after course completion. One hundred forty-two of 195 participants (73%) completed the course and the evaluation. Three-fourths of the participants had a family history of at least one of the life-style diseases addressed by the course. The food frequency results indicated that participants made some significant changes in their food practices. They decreased the number of times they selected high-fat cheese, regular red meats, foods from the saturated fatty acid group, desserts, sodium-rich products, and tea/coffee (p less than .05), and they increased selection of low-fat dairy products (p less than .05). Further study is recommended to determine whether individuals maintain the dietary changes and how those changes affect others in the person's immediate environment.

Adult↗
PubMed1989

Caring for people at home.

This new series presents advice and interesting tips on caring for sick, elderly and disabled people in their homes. Although it is written mainly for people who care for others at home the advice is useful knowledge for the attending medical practitioner. The topics are reproduced from the Australian Red Cross Society 'Caring For People At Home' manual. The Red Cross programme has three components--the manual, a practical course, and an advisory or information service. The manual can be purchased from the Red Cross at a reduced price of $12.95.

Australia↗
PubMed1989

Caring for people at home.

This series presents advice and interesting tips on caring for sick, elderly and disabled people in their homes. Although it is written mainly for people who care for others at home the advice is useful knowledge for the attending medical practitioner. The topics are reproduced from the Australian Red Cross Society 'Caring For People At Home' manual. The Red Cross programme has three components--the manual, a practical course, and an advisory or information service.

Australia↗
PubMed1989

Caring for people at home.

This series presents advice and interesting tips on caring for sick, elderly and disabled people in their homes. Although it is written mainly for people who care for others at home the advice is useful knowledge for the attending medical practitioner: The topics are reproduced from the Australian Red Cross Society "Caring For People At Home" manual. The Red Cross programme has three components--the manual, a practical course, and an advisory or information service. The manual can be purchased from the Red Cross at a reduced price of $12.95.

Australia↗
PubMed1984

Problems with diagnostic criteria for depression.

Limitations of the three major psychiatric diagnostic systems are discussed, with particular reference to depression and its subtypes. The lack of demonstrated reliability and validity for standard diagnoses, and the use of these diagnoses as independent variables in clinical research, is criticized. Possible approaches to improving current classification methods include increased specificity and sensitivity of symptoms, differential weighting, and objective recording. Scientific validation procedures should be applied to the classification of depressions, including studies of natural history and course, specific antidepressant drug responses, and the use of laboratory markers such as the dexamethasone suppression test and sleep EEG parameters.

Antidepressive Agents↗
PubMed1985

International experience with DSM-III.

The authors investigated various aspects of the international use of and experience with DSM-III through a consultation by mail sponsored by the World Psychiatric Association. The respondents were 175 expert diagnosticians nominated as such by the national psychiatric associations of 52 countries spanning all continents. The United States diagnostic system was used by 72% of the participants, only slightly less than the internationally official International Classification of Diseases, Injuries, and Causes of Death, ninth revision (ICD-9) (77%). Furthermore, DSM-III was perceived to be considerably more useful than the current international classification manual. The leading difficulties encountered with DSM-III involved problematic boundaries or definitions of diagnostic categories and the lack of suitable categories in some cases. The most frequent recommendations offered for the advancement of diagnostic systems included the improvement of patient evaluation procedures, the greater use and refinement of multiaxial diagnosis, and the empirical validation of diagnostic systems.

Cross-Cultural Comparison↗
PubMed2004

Cognitive behavioral treatment for older adults with generalized anxiety disorder. A therapist manual for primary care settings.

At least four academic clinical trials have demonstrated the utility of cognitive behavior therapy (CBT) for older adults with generalized anxiety disorder (GAD). These data may not generalize, however, to more heterogeneous and functionally impaired patients and the medical settings in which they typically receive care. A recent pilot project suggested the potential benefits of a new version of CBT for GAD among older patients in primary care. The manual developed and tested in this pilot project is presented here. Treatment components include motivation and education, relaxation skills, cognitive therapy, problem-solving-skills training, exposure exercises, and sleep-management-skills training. Procedures are designed to be administered flexibly to maximize attention to individual patient needs. Examples of session summaries, patient handouts, and homework forms are provided.

Aged↗
PubMedDate not supplied

Intervention fidelity.

BACKGROUND: Although an assumption of consistency in intervention delivery is key to the conclusion that the findings are valid, attention to both interventionist adherence and competence has not become a standard in nursing intervention research. OBJECTIVES: The purpose of this article is to describe the technology model of intervention fidelity as it applies to psychosocial interventions, and to propose its application in nursing intervention research as a way to support accurate conclusions about validity. METHODS: The features and methods of the Technology Model of intervention fidelity were reviewed. The review included development of a manual, training and supervision of interventionists, measurement of intervention fidelity, and inclusion of intervention fidelity as an independent variable in the analysis. RESULTS: The Technology Model and the associated methodologies that have been used to monitor psychosocial intervention fidelity in psychiatry can be adapted and applied by nursing. Monitoring costs can be managed through use of a general system that can be applied across programmatic or related studies. CONCLUSIONS: Application of the Technology Model of intervention fidelity could advance the maturation of nursing intervention research and evidence-based clinical practice.

Analysis of Variance↗
PubMed1995

Setting standards.

A method of involving users and providers in residential care for older people was used to develop standards of care and outcome indicators. The standards were prioritized using the paired comparison technique. Describes the method and the outcomes of the processes. These include 28 standards relating to the quality of care developed by providers and service users.

Aged↗