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Biomedical subjects

C W Given

Publications and source records attributed to C W Given.

At least 55 records · Page 3Linked to original sources
PubMed1991

Assessment of the attitudes of family caregivers toward community services.

Previous research has not taken into account the influence of attitudinal variables on the use of community services by dementia caregivers. The Community Service Attitude Inventory (CSAI) was developed to provide a measurement tool to further understanding of community service use by family caregivers. Testing of the CSAI revealed five distinct components of family attitudes toward use of community services.

Alzheimer Disease↗
PubMed1990

Responses of elderly spouse caregivers.

In this paper three categories of variables were identified to predict spouses' reactions to caregiving roles: patient characteristics, the caregiving environment, and characteristics of the caregiver. Measures of these variables were administered to 159 spouse caregivers. Four domains of caregivers' responses were identified: negative emotional reactions, feelings of responsibility for the patient, feelings of abandonment by family, and impact of caregiving on daily schedules. These domains were influenced most by patient negative behaviors, physical health, and age, and by caregiver age, employment, and emotional status. Amount of assistance, affective support, and hours of care also were predictive of spouse responses.

Activities of Daily Living↗
PubMed1989

Methods of analyzing physician practice patterns in hypertension.

A principal method of studying physician practice patterns has been to examine physicians' responses to brief written cases. We have compared this method with practice patterns of the same physicians derived from chart audit. Subjects were 98 family practice residents for whom data were available in actual patient encounters for the workup of asymptomatic hypertension. Short, carefully structured case reports using four cues were designed and a checklist similar to the one used for test ordering in practice was employed. Chart reviews and billing encounter forms were used for comparison. Results indicated residents ordered fewer tests in clinical practice, due, in part, to practice constraints not represented in the written cases. Physicians tend to make the diagnosis of hypertension incrementally in practice, with no one visit adequately representing the point of diagnosis. Studies based on data bases using a patient encounter as the unit of analysis in chronic disease such as hypertension may spuriously underestimate the actual number of tests ordered for the workup. Judgment cases may better reflect the patterns of use of information in a well-defined problem. Prediction of number of tests ordered in the clinical setting has not been established in this case.

Adult↗
PubMed1989

Cancer nursing for the elderly. A target for research.

Using the stages in the cancer illness trajectory as an organizing framework, this article describes information available about the elderly individual with cancer. Areas lacking research and suggestions for proposed nursing research are identified.

Aged↗
PubMed1988

Sources of stress among families caring for relatives with Alzheimer's disease.

We have described the different sources of stress and burden that are imposed by caring for a family member with AD. We have provided an approach to assessing each of these possible sources of stress and burden and have indicated how such assessments must take a family-based approach and consider the broader social roles and family dynamics that may color the way in which family members view and carry out their caregiving roles.

Aged↗
PubMed1985

Evaluation and application of continuity measures in primary care settings.

Continuity of contact between patients and physicians has become an important criterion of quality primary care. Using three measures of continuity that have appeared in the literature, this article examines, through the use of simulated data and through application to data from five primary care settings, the differences and utility of these approaches for measuring continuity. Further, these measures are applied to four selected diagnoses from each of the five sites, and the observed continuity scores afforded patients with these diagnoses are compared with those expected based on the population. Finally, the scores are correlated with the number of return visits prescribed and kept and with the rate at which laboratory studies are ordered. The findings indicate that site-specific differences in continuity prevail even after adjustments in the number of visits. Continuity based on selected diagnoses is greater, for the most part, than continuity afforded the patient population. Finally, continuity is related to the number of return visits prescribed but not to the number kept or the rate at which laboratory studies are ordered. The implications of continuity for other aspects of quality patient care are discussed.

Anxiety↗
PubMed1985

Defining the information content of health data systems.

Uses of health information systems depend heavily on the background and experiences of those who evaluate the data. Effective collaboration between physicians and system managers can enhance significantly the decision-making and information obtained from these systems. This article describes some methods of collaboration and the current uses of one system developed through collaborative efforts of physicians and system managers.

Ambulatory Care↗
PubMed1984

Measuring the social psychological health states of ambulatory chronically ill patients: hypertension and diabetes as tracer conditions.

Measures of social psychological health states were developed and tested for dimensionality, internal consistency, and generalizability on samples of ambulatory hypertensive and diabetic patients. Despite the existence of several measures of health status, none had been tested solely on ambulatory chronically ill patients. Therefore, to insure that sensitive, reliable measures were available to measure patients' responses to nursing interventions designed to increase ambulatory chronically ill patients' participation in their care of themselves, these measures were developed. The two scales were found to be reliable, generalizable, and valid, in that they were correlated with existing measures of symptom severity, psychological, and functional health status. The question of whether disease specific measures of health status are preferable to more general measures is discussed.

Adult↗
PubMed1984

The effects of patient characteristics and beliefs on responses to behavioral interventions for control of chronic diseases.

Tests of behavioral interventions seldom examine changes in health beliefs and behaviors thought to be prerequisites of improved outcome health states and they do not attempt to specify how patient characteristics or pretest measures influence responses to the intervention. In this study an experimental nursing intervention, its impact on hypertensive patients' beliefs about their disease, efficacy of medications and diet, as well as blood pressure and weight are described. Among patients from the experimental group, the ability of selected pretest variables to predict clinical outcomes and changes in clinical health states was evaluated. The intervention was successful in lowering diastolic blood pressure and altering certain beliefs held by the patients. The pretest characteristics were not successful in explaining hypertensive patients' responses to the intervention. Explanations for this are pursued through remarks from the content analysis of the intervention protocol. From these observations, the original health belief model was revised. The discussion concludes with a set of research questions that may prove promising for future research.

Attitude to Health↗
PubMed1983

Screening the ambulatory care performance of family practice residents using a health information system.

This paper describes uses of data from a health information system for evaluating family practice residents' performance and progress through their residency programs. Because this system captures limited data from patient encounters, emphasis was placed on working closely with clinical faculty to develop information displays that they could interpret and integrate into residency program evaluations. The data displays are designed to help faculty screen residents' performances and to identify patient care problems that can be pursued further through audits on the medical records. The uses of these displays require that faculty incorporate clinical judgments into the screening process.

Ambulatory Care↗
PubMed1981

Evaluating primary ambulatory care with a health information system.

This paper describes one method by which data from a computer based health information system are used to screen the ambulatory care experiences of family practice residents. The steps in the evaluation process are discussed. Data collection techniques and definition of the reference population against which comparisons among the residents are made are also explained. The evaluation process is based on initial observations to answer progressively more specific questions about the resident-patient encounters. This approach is acceptable to faculty for several reasons: (1) data are timely and require minimal extra effort for collection, (2) resident discrepancies are easily identified, (3) data summaries are concise and easy to interpret, (4) cost effectiveness of resident performance can be evaluated, and (5) data are organized around a patient and the encounters he or she has had with all residents providing care.

Adolescent↗