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At least 19 recordsLinked to original sources

Psychiatric liaison with private facilities caring for discharged patients.

Motivated by concern about the fate of psychiatric hospital patients after discharge to the community, a community mental health center decided to send a psychiatrist into the community to establish liaison with private-care facilities and to determine the needs of such discharged patients. As a result of the psychiatrist's efforts, owners of the area's private-care facilities acquired a better understanding of the needs of their residents and learned where they could turn for help in caring for discharge psychiatric patients. A study of one board-and-care facility revealed a marked decrease in the use of the center's emergency service and in the number of hospital admissions after one year of this extended service.

Aftercare

Community aftercare of patients discharged from Utah state hospital: a follow-up study.

To find out whether patients discharged from mental hospitals to the community are following recommended courses of aftercare treatment, the authors, with the assistance of five medical students, studied a sample of patients discharged from Utah State Hospital during 1973 and 1974. The discharge plans of 143 patients admitted from Salt Lake County indicated that 125 of them should have received aftercare services from a community mental health center. A review of CMHC records and interviews with the patients indicated that only 100 actually had contact with a center. Only 43 of the patients were still receiving aftercare services in the summer of 1975.

Adult

Health needs of geriatric patients discharged from hospital.

In a survey of the health needs of White and Coloured geriatric patients discharged from hospital it was found that community services were not effectively utilized to meet existing needs. While the White elderly suffered less financial hardship and had better access to medical care, they complained of more symptoms, more loneliness and more depression than their Coloured counterparts.

Black or African American

Who gets aftercare? A study of patients discharged from state hospitals in Kentucky.

A cohort of 579 patients discharged from state mental hospitals in Kentucky during a one-year period was studied to determine the amount and nature of after-care services provided to them. A total of 319 received some form of attercare from community mental health centers during the two to three years after discharge. The majority received at least one service that could be classified as individual therapy or chemotherapy, about one-third received evaluation or rehabilitation services, and only a few had family interviews or group therapy. The majority of those receiving services had contact with psychiatrists, nurses, or other mental health professionals; less than half had contact with social workers or psychologists. In general the aftercare services tended to be medically oriented, brief, and limited in number. They were provided to a majority of the patients within their first month in the community.

Adult

A comparative study of long-stay psychiatric patients discharged to boarding houses and satellite houses.

A comparative psychosocial study of two groups of long-stay psychiatric patients discharged from Callan Park Hospital to boarding houses and satellite houses in the Callan Park Hospital region is reported. It was concluded that the social and vocational functioning of both groups was at a low level but that satellite house residents had more spare money and described a less institutionalized and a more homely environment in satellite houses.

Attitude to Health

Effect of a digitally augmented general health promotion intervention on abstinence from health-risk behaviors among emergency department discharge patients: A randomized controlled trial.

BACKGROUND: Noncommunicable diseases (NCDs) are the leading global cause of death and are driven by modifiable behaviors, such as tobacco use, harmful alcohol consumption, unhealthy diet, and physical inactivity. Recognizing that emergency department (ED) visits represent a unique opportunity to promote behavior change, this trial evaluated a digitally augmented, theory based general health promotion approach, combining a brief telephone-based intervention with mobile instant messaging support, to help discharged ED patients abstain from health risk behaviors. METHODS AND FINDINGS: This assessor-blinded randomized controlled trial was conducted in a major public hospital ED in Hong Kong. Adults (18-65 years) triaged as semi-urgent or non-urgent and with &#x2265;1 health-risk behavior and smartphone access were randomized to receive a digitally augmented, theory&#x2011;based general health&#x2011;promotion intervention consisting of a brief telephone&#x2011;based AWARD&#x2011;model intervention (Ask, Warn, Advise, Refer, and Do-it-again) followed by weekly WhatsApp or WeChat messages for 6 months, or to a control group receiving brief telephone advice only. The primary outcome was self-report abstinence from &#x2265;1 health-risk behavior at 6 months; secondary outcomes included the proportion of participants who achieved self-reported abstinence from &#x2265;1 health-risk behavior at 12 months and reduction in the number of behaviors at 6 and 12 months. Of the 2,134 screened patients, 572 were enrolled (286 per group). At 6 months, 30.1% of the intervention participants versus 19.9% of the controls achieved self-reported abstinence (RR&#x2009;=&#x2009;1.51; 95% CI, 1.13-2.02; P&#x2009;=&#x2009;0.006). The intervention also significantly increased the likelihood of fewer risky behaviors at 6 (RR&#x2009;=&#x2009;1.54; P&#x2009;=&#x2009;0.01) and 12 (RR&#x2009;=&#x2009;1.48; P&#x2009;=&#x2009;0.02) months. Physical inactivity showed the greatest improvement at 6 months (31.7% versus 16.2%; P&#x2009;<&#x2009;0.001). The effects attenuated after cessation of booster messaging. Limitations include reliance on self-reported outcomes, the single-center study design, and loss to follow-up, which may have affected the generalizability of the results. CONCLUSIONS: A digitally augmented, theory-based general health promotion strategy delivered at ED discharge through brief telephone intervention and mobile instant messaging support demonstrated short-term benefits in promoting self-reported abstinence and reducing health-risk behaviors at 6 months. However, the absence of a sustained effect at 12 months suggests that extended support or maintenance strategies may be required to maintain these improvements over time. Multicenter trials with longer follow-up are warranted to evaluate long-term effectiveness. CLINICAL TRIAL REGISTRATION: ClinicalTrials.gov (Registration No: NCT06077565).

Humans

Impact of subthreshold troponin levels and temporal trends on short term adverse cardiovascular outcomes in patients discharged from the emergency department: a RACE-IT trial substudy.

BACKGROUND: High-sensitivity cardiac troponin I assays enable early exclusion of myocardial infarction in the emergency department. However, the clinical implications of detectable troponin values below the 99th percentile upper reference limit (4-18 ng/L) remain unclear. OBJECTIVE: To assess the association between subthreshold troponin levels and 30-day outcomes in patients from the RACE-IT trial, using exact troponin values when available. METHODS: This post-hoc analysis of the RACE-IT stepped-wedge randomized controlled trial included patients with troponin&#x2009;&#x2264;&#x2009;18 ng/L across nine EDs. Patients were stratified by initial troponin, peak value, absolute change, and percent change. The primary outcome was a 30-day composite of all-cause death, acute MI, percutaneous coronary intervention, and coronary artery bypass grafting. Logistic regression analysis after adjusting for age, sex, race, and coronary artery disease was performed. RESULTS: Among 19,194 patients with troponin&#x2009;&#x2264;&#x2009;18 ng/L, 117 (0.6%) experienced the composite outcome. Higher troponin levels were associated with increased event rates in unadjusted analyses. Adjusted analyses showed no independent associations overall, though patients whose highest troponin values fell within the&#x2009;&#x2265;&#x2009;11-&#x2009;&#x2264;&#x2009;18 ng/L range continued to demonstrate significantly worse outcomes than those with lower peak levels. Elevated troponin values correlated with older age, male sex, and greater comorbidity burden. CONCLUSION: In this post-hoc analysis of patients with troponin values below the 99th percentile URL, absolute levels and temporal changes were not independently associated with 30-day adverse outcomes. These findings support the use of subthreshold troponin values in rapid rule-out protocols, emphasizing the need to consider clinical context and comorbidities in risk assessment.

Humans

Predictors of community tenure of discharged state hospital patients.

Community treatment of formerly hospitalized patients is in need of evaluation. The authors evaluated an aftercare program by examining its effect on the amount of time spent in the community by patients discharged from a state mental hospital. They assessed the impact of specific intervention in the areas of housing, employment, finances, psychiatric treatment, medication, and leisure. They conclude that assistance during the transition from the hospital to the community prolonged community tenure, that intervention in the areas of housing, finances, and medication was especially important, and that treatment in the community increased the amount of time spent in the community during the first 6 months after discharge.

Adult