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Alistair Burns

Publications and source records attributed to Alistair Burns.

6 recordsLinked to original sources
PubMed2002

Expressed emotion and attributions in the carers of patients with Alzheimer's disease: the effect on carer burden.

Burden of care, expressed emotion (EE), causal attributions, and salivary cortisol were assessed in 100 carers of patients with Alzheimer's disease. Forty-one carers were rated high EE, which was associated with higher scores of carer distress and strain, and greater reports of noncognitive features in the patient, but not with cortisol levels. High EE carers made more attributions personal to, and controllable by, the patient for negative events. Critical carers made more attributions of the patient's behavior that was idiosyncratic. Warmth toward the patient was associated with the opposite of this pattern. Overinvolved carers made attributions of the patient's behavior to causes external to the patient and internal to themselves. Cortisol levels were associated with self-reports of strain and distress.

Adaptation, Psychological↗
PubMed2002

Rating scales in old age psychiatry.

BACKGROUND: There is a vast array of scales available to assess all aspects of mental and physical health in older people which may be of relevance to the work of old age psychiatrists. AIMS: To summarise some of the scales that may be commonly used in clinical and research practice and to give the reader guidelines as to where further information can be obtained. METHOD: The scales were selected on the basis of the authors' own clinical and research knowledge and information was gathered from a comprehensive text on assessment scales in old age psychiatry. Results The selected scales are described in brief and a table outlines the purposes for which they are most suitable. CONCLUSIONS: Although many scales are available, the choice of the individual scale relies specifically on the question that is to be asked. The ideal scale does not exist.

Aged↗
PubMed2000

Economic impact of a specialist outreach team in residential and nursing home settings.

BACKGROUND: The results of a randomized controlled trial have indicated that a training and educational programme for staff in nursing or residential homes may result in reductions in levels of depression and levels of cognitive impairment for residents presenting with an active management problem. The training and educational intervention consisted of members of a hospital outreach team who presented a series of 1 hour seminars on topics which staff had indicated would improve their knowledge and skills. AIMS OF THE STUDY: The aim of this study was to present an exploratory analysis of the impact on costs associated with providing an old age psychiatry outreach team giving training and education for staff in nursing and residential homes. METHOD: For the economic study, a societal perspective was employed. Measures of resource use and costs to the health service, social and community services and the nursing and residential homes were analysed for 120 residents from 12 nursing or residential homes, as part of a randomized controlled trial to assess a training package provided in residential and nursing homes. Cost estimates were based on estimates from generalized estimated equations. To allow for clustering effects within homes, the unit of randomization was the home as opposed to the individual. To ensure models were correctly specified, several tests including the Ramsey RESET test were employed. RESULTS: There were no significant differences in the total cost per person in the homes that received the intervention and the control homes. This study has shown that the additional cost of providing the specialist outreach team was likely to be covered by reductions in the use of other resources such as GP visits to nursing and residential homes. Therefore, though the study had limitations, it appeared that improved care could be provided at little or no extra cost. IMPLICATIONS FOR HEALTH CARE PROVISION AND USE: The evidence presented suggests that the specialist outreach team was unlikely to add to the total cost of caring for residents in nursing and residential homes. This finding combined with the benefits in terms of lower levels of depression and cognitive impairment suggested that the intervention was good value for money. The intervention should be considered for use in other nursing and residential homes.

Journal Article↗
PubMed2000

The burden of Alzheimer's disease.

Alzheimer's disease (AD) imposes a severe burden upon patients and their carers. In particular, family carers of AD patients face extreme hardship and distress that represents a major but often hidden burden on healthcare systems. Carers often experience clinically significant alterations in physical and mental health, particularly depression. A number of individual features of the dementia syndrome that are known to be particularly burdensome to carers include the degree of cognitive impairment, amount of help required with activities of daily living, personality changes and the presence of psychiatric symptoms and behavioural disturbances. The neuropsychiatric features of AD patients can adversely impact the relationship between the patient and caregiver generating feelings of strain, burden and social isolation. Individual characteristics of the caregiver including personality, gender, degree of formal and informal support and physical and mental health, as well as attributional style ('coping style') and expressed emotion (critical or hostile attitudes), also dictate carer burden. As informal caregivers play such a crucial role in the care of AD patients, appropriate management strategies that incorporate interventions which address the specific burdens of the individual caregiver are essential. Reducing the burden of care can be achieved by the combination of a number of individual and general measures, including education, respite and emotion-focused interventions. These measures, accompanied by non-pharmacological strategies, are extremely important in the total care of the AD patient, with the emphasis on maintaining people in the community as long as possible.

Journal Article↗
PubMed2000

Introduction.

Alzheimer's disease (AD) is the commonest form of dementia in developed countries, accounting for approx. 50-60% of the overall cases of dementia among persons over 65 years of age. Furthermore, because of the world's ageing population, and without an effective prevention or treatment, a sharp rise in the prevalence of dementia with age is predicted. AD itself is a progressive and irreversible neurodegenerative disorder associated with three main clinical features in the domains of declines in cognitive function (neuropsychologic) and activities of daily living, together with neuropsychiatric symptoms (including behavioural disturbances). These expressions of the pathology of AD impact tremendously not only in terms of the patient, but also the carer and society in general. Considering the high frequency of AD in the aged population, the rapid growth of the elderly population, and the heavy impact in terms of disability, AD has become a major problem for healthcare systems, public health planning and society as a whole. The scale of this problem presents a huge economic burden, in terms of both direct (healthcare system resources) and indirect (unpaid carer services) costs. Thus, the last two decades have witnessed an enormous research effort directed towards discovering the cause of AD with the ultimate hope of developing safe and effective pharmacological treatments.

Journal Article↗