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PubMed1994

Therapeutic use of humor to improve social support in an institutionalized schizophrenic inpatient community.

We attempted to use passive communal laughter to improve social support within a chronic schizophrenic inpatient population. Two identical wards were compared on classical measures of social support (emotional and functional), social network (size and dispersion), satisfaction, and the nature of the social relationships (source). The experimental group was exposed to video projection of humorous movies four times daily for 3 months, and the control group to video projections of other, assorted movies at the same rate. In the experimental ward a significant improvement was manifest in the category of "distinct individuals supporting each patient." The difference may have been due to an improvement in the relationship with the staff. No improvement was found on any of the other measures. We concluded that the positive atmosphere that humor creates affects the therapeutic alliance between staff and patients but does not affect other social networks because of the regressed nature of the schizophrenics' social relationships.

Adult↗
PubMed1992

Care with an indwelling urinary catheter. Tips for avoiding problems in independent and institutionalized patients.

Ideally, no patient would have an indwelling urethral catheter. However, certain circumstances require long-term catheterization. In these patients, bacterial colonization is to be expected. Morbidity and mortality related to long-term catheterization can be minimized by attention to the details of catheter care, prompt treatment of often minimally symptomatic catheter-related infections, and attentiveness to changes in patient condition or alternative treatments that may permit catheter removal.

Clinical Protocols↗
PubMed1998

Seizures in the de-institutionalized patients with early brain injuries.

The number of individuals with early brain injury and multiple disabilities discharged from institutions had increased steadily over the past 10 years. The most frequently encountered problems by patients with early brain injury and epilepsy placed in the community were reviewed. Unavailability of specialized services, inadequate reimbursement, high turnover and lack of knowledge by caregivers, lack of understanding/acceptance of the concepts of seizure intractability and pseudoseizures, unrealistic expectations by overseeing agencies and/or family, and side effects of antiepileptic medications were the most common seizure-related problems afflicting these patients. Everything else being equal, good exchange of information between the various caregivers and continued education of caregivers, both time consuming endeavors, are the crucial factors for the successful management of seizures in this population.

Brain Injuries↗