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D L Patrick

Publications and source records attributed to D L Patrick.

167 records · Page 10Linked to original sources

Screening for depression in well older adults: evaluation of a short form of the CES-D (Center for Epidemiologic Studies Depression Scale).

We derived and tested a short form of the Center for Epidemiologic Studies Depression Scale (CES-D) for reliability and validity among a sample of well older adults in a large Health Maintenance Organization. The 10-item screening questionnaire, the CESD-10, showed good predictive accuracy when compared to the full-length 20-item version of the CES-D (kappa = .97, P < .001). Cutoff scores for depressive symptoms were > or = 16 for the full-length questionnaire and > or = 10 for the 10-item version. We discuss other potential cutoff values. The CESD-10 showed an expected positive correlation with poorer health status scores (r = .37) and a strong negative correlation with positive affect (r = -.63). Retest correlations for the CESD-10 were comparable to those in other studies (r = .71). We administered the CESD-10 again after 12 months, and scores were stable with strong correlation of r = .59.

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Improvement in quality of life after lung transplantation: a preliminary study. The University of Washington Medical Center Lung Transplant Study Group.

BACKGROUND: Lung transplantation is an expensive therapeutic option for a number of endstage conditions. Improving health-related quality of life is an important objective of transplantation. METHODS: We report quality of life measurements in 21 waiting list patients and 23 patients after transplantation with seven different pulmonary conditions using two standardized instruments: the Sickness Impact Profile and the standard gamble. RESULTS AND CONCLUSIONS: This cross-sectional study indicates the following: (1) overall quality of life improves significantly after transplantation; (2) although most dimensions of functional disability improve after transplantation, some aspects may suffer; (3) quality of life gains after transplantation may not be equal for all pretransplantation conditions.

Activities of Daily Living↗

The mental health patient profile: does it change primary care physicians' practice patterns?

BACKGROUND: We conducted a prospective trial randomizing 75 physicians to either a control or intervention arm to evaluate the impact of providing patient-reported information on anxiety and other mental health symptoms and disorders to primary care physicians. METHODS: Five hundred seventy-three patients of the study physicians who met entry criteria were randomized to either usual care or usual care supplemented with feedback of patient-reported mental health information to physicians. This mental health information was derived from initial patient-reported questionnaires completed in waiting rooms of physicians contracted to a mixed-model health maintenance organization in Colorado. Main outcome measures included impact of intervention on rates of (1) chart notation of anxiety, depression, or other mental health diagnoses or symptoms; (2) referral to mental health specialists; (3) prescription of psychotropic medications; (4) hospitalization; and (5) office visits during a 5-month observation period. RESULTS: Physicians receiving feedback on previously unrecognized and untreated anxiety patients were more likely to make chart notations (adjusted odds ratio [AOR] = 2.51, 95 percent confidence interval [CI] = 1.62-3.87), to make referrals to mental health specialists (AOR = 3.86, 95 percent CI = 1.63-9.16), and to see patients for more frequent outpatient visits (AOR = 1.73, 95 percent CI = 1.11-2.70). Use of psychotropic medications and rate of hospitalizations did not differ significantly. CONCLUSIONS: Providing patient-reported mental health information to primary care physicians resulted in increased recognition and referral rates for previously unrecognized and untreated anxiety patients, plus an increase in primary care visits, without concomitant increases in the use of psychotropic medications or rate of hospitalizations.

Adult↗

Physical activity and health promotion for older adults in public housing.

INTRODUCTION: Designing health promotion and disease prevention (HPDP) programs for older residents of public housing is hampered by a lack of information about residents' needs and interests. This study addressed whether residents have greater needs for lifestyle modification or for preventive care and assessed interest in programs emphasizing physical activity. METHODS: Older residents (n = 199) of public housing facilities in Seattle were surveyed to assess HPDP needs. A comparison of residents with older HMO enrollees (n = 2,289) identified which needs were relatively greater in residents of public housing. Residents' interest in physical activity programs was assessed by interviewing residents and by observing their interest in an exercise class. RESULTS: The majority of residents could benefit from physical activity programs (75% of residents reported less than 60 minutes per week of exercise); fewer residents could benefit from smoking cessation programs (21%) and alcohol counseling (4%). The largest difference between residents and HMO enrollees was the greater need of residents for physical activity promotion. Residents and HMO enrollees reported similar use of preventive care services. Though residents seldom identified physical inactivity as a major concern, residents demonstrated interest in physical activity programs. Eighteen (41%) of 44 residents participated regularly or irregularly in an exercise class offered at their facility. When the class was scheduled to be discontinued, residents successfully lobbied city government to sustain the class. CONCLUSIONS: The results suggest promoting physical activity should be a major goal of HPDP programs for older residents of public housing.

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