Nurses and various areas of philosophy.
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Biomedical subjects
Publications and source records attributed to B Geach.
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When a key person resigns or is fired, his or her job may be filled by an acting employee. Usually this works well, but there may be hidden costs for both employee and organization. Questions the prospective acting person might ask and tips for superiors are among the findings from in-depth interviews with 19 subjects in a variety of positions.
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In a study to determine the therapeutic value of ward policies of restriction and coercion, as in a step system of privileges, investigators compared the adjustments of patients in three ward settings: one with a formal step system, one in which the formal system had been abolished but a significant degree of restriction-coercion maintained, and one in which almost all activities and medications were optional. Patients' behaviors in seven areas were rated at admission, at discharge, and at one and six months after discharge. The patients on the ward with the formal step system showed better adjustment on 23 out of 35 ratings, although only one of the ratings was statistically significant. The slight therapeutic value of restriction-coercion suggested by these data contrasts with the results of an earlier, retrospective study. Cost-benefits involving economic, political, and therapeutic issues are raised.
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The hypothesis that coercive-restrictive features of the contemporary hospital milieux are necessary to the therapeutic and safety task of the hospital was tested by comparing three ward situations in varying degrees of coercion-restrictiveness. The situations were equivalent in other important respects. Review of patients' records indicated that the therapeutic, satisfaction, and safety outcomes of these three situations were similar. We conclude that a relatively high degree of coercion-restrictiveness may not be justifiable on therapeutic or safety grounds.
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