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Biomedical subjects

D J Jessop

Publications and source records attributed to D J Jessop.

26 records · Page 2Linked to original sources
PubMed1984

Relationship between health status and psychological adjustment among children with chronic conditions.

The extent to which children's psychological adjustment is affected by the presence of chronic physical illness is a subject of controversy. Data obtained at entry to a study of children with chronic illness show that among the 81 children greater than or equal to 5 years of age there is little relationship between psychological adjustment and traditional morbidity measures such as days hospitalized and days in bed. There is, however, a moderate but significant relationship between psychological adjustment and both the number of days absent from school and the child's functional status: children who have more absences and those with poor functional status have poorer psychological adjustment. The data also suggest that these relationships may differ in size within demographic subgroups of the population, something that may explain current controversies over the relationship between the child's chronic condition and psychological adjustment.

Absenteeism↗
PubMed1984

Does pediatric home care make a difference for children with chronic illness? Findings from the Pediatric Ambulatory Care Treatment Study.

The ongoing care needed by children with chronic physical illness is a topic of national concern. The Pediatric Ambulatory Care Treatment Study ( PACTS ) is a classic pretest-posttest randomized experiment designed to evaluate a Pediatric Home Care (PHC) program in which an interdisciplinary team provides comprehensive primary health care, support, coordination, patient advocacy, and education to chronically ill children and their families. Home interviews were conducted by an independent research team with the 219 families at enrollment, 6 months, and 1 year; 80% completed all three interviews. Analyses indicate that pediatric home care is effective in improving the satisfaction of the family with care, in improving the child's psychological adjustment, and in lessening the psychiatric symptoms of the mother. The functional status of the children was equally well maintained in both groups, and there was no significant difference in the impact of the illness on the family between the two groups. There are indications that there may be a dose-related effect with respect to the child's psychological adjustment with those in the program for the longest period of time showing the greatest benefit. Such a home care program can be an effective intervention for minimizing the social and psychological consequences of chronic illness.

Adaptation, Psychological↗
PubMed1983

Health care services received by children with chronic illness.

The mothers of 209 children with chronic illness who were being treated at a university-affiliated municipal hospital were interviewed in their homes to assess the extent to which their children received health services. Most families received traditional biomedical types of care, but few families had received psychosocial services. Children with the most severe conditions tended to receive more services than others, and receipt of nonbiomedical services was associated with identification of a specific provider. Mothers indicated that, in addition to traditional services, they wanted advice on how to manage the child's condition at home. These results confirm previous findings and suggest that gaps in service provision may be generalizable to children with chronic illness regardless of the setting and diagnosis.

Catchment Area, Health↗
PubMed1983

An ethics committee to aid in implementing a randomized clinical trial.

Individuals who care for children are sometimes reluctant to participate in experimental research because of concern about withholding a potentially helpful intervention from some of their patients and their impressions about the effects of the treatment being studied. These concerns may conflict with investigators' interests in obtaining subjects for protocols. This report describes the use of an external review committee to assess the appropriateness of enrolling patients in a randomized clinical trial. The committee served as a mechanism for assessing the validity of physicians' concerns about randomization of a given patient and for reconciling clinicians' differences about enrollment. It appears to have helped implement randomization by affording a procedure to ensure patients' rights and quality of care. It is offered as a technique for resolving the practical dilemmas of those conducting clinical research while at the same time respecting the rights of patients.

Child↗
PubMed1983

A service delivery program and its evaluation. A case study in the sociology of applied research.

Descriptions are rare of instances in which true experimental designs have been implemented in evaluating ongoing programs. This article is a case study of a health service delivery program and the classical pretest-posttest randomized experiment that evaluated it. The main theses are (1) that the research developed was based on the values and interests of the persons and institutions involved, and concordance in interests and values among the several parties was responsible for success in implementing the rigorous experimental design; and (2) that the program being evaluated and the research evaluation affect each other in significant ways, some intended and others unanticipated.

Ambulatory Care↗
PubMedDate not supplied

[The testing and validation of the German version of the impact on family scale in families with children with disabilities].

Despite increased interest in the wellbeing of families with children with chronic conditions and disabilities, instruments to assess family impact of health conditions are still lacking in German speaking countries. The Impact on Family Scale has been developed in the Anglo-american literature as a self report instrument to assess the consequences of chronic conditions and disability in childhood and adolescence for the family. The present paper describes the translation and psychometric testing of a German version of the Impact on Family scale (Familien-Belastungs[FaBel]-Questionnaire). The questionnaire contains 33 Likert-scaled items to assess the general negative impact of parents, the description of social relationships, the concern for siblings, the financial impact and problems in coping as well as a total score. The FaBel questionnaire was used and tested for psychometric criteria of reliability and validity in a cross-sectional study of 273 families with children with chronic conditions and disabilities. The results of this psychometric testing of the FaBel-Questionnaire show acceptance by responders, acceptable construct validity, good internal consistency and discriminant validity. The psychometric structure of the questionnaire corresponds with psychometric results with another German population of children with chronic conditions. The results suggest the applicability of the instrument to assess family impact of chronic disease and disability in children and adolescents.

Adolescent↗
PubMedDate not supplied

Measuring health variables among Hispanic and non-Hispanic children with chronic conditions.

This paper addresses two concerns related to differences in the health status of Hispanic and non-Hispanic children: methodological issues in the measurement of health status across population subgroups and the substantive differences in the health of these subgroups. Interview data from a study of chronically ill children in a northeastern inner city were collected using carefully translated measures of health and health-related behaviors. The psychometric properties of the scales were assessed across the subgroups to determine if common interpretation of the scales was possible. After determining that this was the case, group means in health and health-related variables were compared. Despite sociodemographic group differences in variables, there were remarkably few differences among the groups on traditional morbidity measures. However, significant differences were found on four of five scaled health-related measures (the impact of the child's illness on the family, the child's functional status, and the mental health of both mother and child). These findings did not all favor the same group, suggesting that certain areas of function may present more problems for some subgroups. These differences virtually all disappear when multivariate techniques are used to control for variation in important socioeconomic characteristics among the three subgroups. Statements that the health status of one subgroup is better than that of another are too simplistic if they do not indicate the particular aspect of health status being discussed and control for differences among the groups in maternal education, family structure, maternal welfare status, and similar background characteristics.

Adult↗