[Causes of hospitalization in a recently opened university hospital psychiatric department (apropos of 750 hospitalizations)].
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It has become increasingly important, as an administrative aid in assessing the functioning of hospital social work departments and improving their services, to determine and evaluate their activities. This article reports on a study conducted by the social work department in a Canadian university psychiatric hospital to determine the work load of social workers, aspects of the process of referring persons for social work services, and differences between hospitalized persons who do or do not receive social work services.
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Psychiatric evaluation of the elderly is especially difficult for several reasons, e.g., the presence of organic impairment, the effects of multiple drug therapy, and the tendency to confuse the normal concomitants of aging with neurotic symptoms. The authors have developed and evaluated a brief series of self-report assessment tests (GRDB) designed to assist the psychiatrist in the process of diagnosis. Coefficients of the internal consistency of the seven scales are presented. A comparison was make between 28 psychiatric patients attending a geriatric clinic and 48 well-functioning elderly persons matched for age and sex, and living in the same community. Results showed that the geriatric outpatients functioned at a lower level of adaptation than did the control group, on all seven scales - depression, daily living skills, social interaction, cognitive skills, number of illnesses, number of life problems, and the use of drugs and alcohol. These findings provide a measure of discriminant validity. The advantages of this brief assessment instrument are discussed.
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To examine the effects of three modes of nursing attire on the behaviors, e.g., aggressive behavior, leaving the unit against medical advice, of psychiatric inpatients, nurses were clad in white uniforms for 6 wk., then in street clothes for 6 wk., optional dress for 6 wk., street clothes for 3 wk., white uniforms for 3 wk., and optional dress for 3 wk. Data from each mode were combined, yielding three experimental conditions. Results showed the greatest rates of maladaptive behaviors occurred during the white uniforms condition followed by the optional and street clothes conditions, respectively. An explanation of this outcome based upon patient's expectations was presented.
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The present investigation analyses the psychiatric service available to and utilized by a population in a geogrphically delimited area, namely the Randers area with a population of 108.928. During the period 1970-74, the average yearly rate of patients admitted to the three psychiatric institutions covering this area was per 1,000: 7.9 males and 9.1 females. During 1970-71, 1.2 males and 1.8 females per 1,000 were treated as outpatients in a psychiatric clinic affiliated to a psychiatric hospital, and a psychiatric outpatient clinic in a general hospital discharged 4.1 males and 7.7 females per 1,000. It seems probable that despite outpatient treatment the number of admissions increases slightly rather than decreases, and consequently, outpatient treatment cannot replace psychiatric admission.
The author's discuss their experience using nurses as therapists on a small unit at St. Joseph's Hospital, a general hospital in Hamilton, Ontario. They describe the training of the first nurse-therapists and the three-level training system established to make the program self-sustaining. The nurse-therapist system is now used on several psychiatric units in the hospital. Problems in role relationships and schedules occurred, but the authors, noting the patient-care, economic, and staff benefits, believe that the system would be especially useful in small inpatient units.