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Biomedical subjects

I B Pless

Publications and source records attributed to I B Pless.

At least 163 records · Page 9Linked to original sources
PubMedDate not supplied

Using the measure of processes of care with parents of children hospitalized for head injury.

Despite recommendations that rehabilitation programs adopt family/patient satisfaction as an outcome measure, few studies have addressed satisfaction with services for children with head injury. This report describes our use of the Measure of Processes of Care (MPOC) to document the perceptions of care of parents whose children were hospitalized with a head injury and to compare parental perceptions of care with those of the service providers (n = 16). The MPOC is a self-administered questionnaire consisting of 56 items, each of which is included in one of five care-giving scales: (1) enabling and partnership; (2) providing general information; (3) providing specific information about the child; (4) coordinated and comprehensive care; (5) respectful and supportive care. The MPOC was mailed to parents of children with a head injury who were consecutively admitted to a pediatric trauma center during a 5-mo period. The results, based on the responses of 73 parents (response rate, 59.3%), revealed that the needs of these parents are being met to varying degrees. Mean scores for the five scales ranged from 4.6 to 6.4 and from 5.9 to 6.6 for parents and providers, respectively. Significant differences between the groups were found for two scales: providing general and specific information. Because of the low percentage of valid responses for three of the five scales, the MPOC appears to be an inappropriate tool for use with parents of children with mild head injury (89%) in the acute care setting. The MPOC, however, is applicable for parents of children who are more severely injured (e.g., average hospital stay, 9 days) and is informative for rehabilitation service providers.

Adolescent↗
PubMedDate not supplied

Effectiveness of a head injury program for children: a preliminary investigation.

OBJECTIVE: The purpose of this study was to investigate whether a more coordinated, comprehensive head injury rehabilitation program provided at a children's trauma center yielded better outcomes than a less coordinated, less comprehensive program. DESIGN: Using a quasi-experimental design, 64 children with head injury admitted to the center and who received rehabilitation services in either 1995 or 1993 were evaluated by using the Functional Independence Measure for children (WeeFIM)/The Functional Independence Measure (FIM) (e.g., primary outcome measure). Secondary outcomes included "psychosocial adjustment," "return to regular school," and "current problems related to the head injury." RESULTS: No statistically significant differences were found between the groups with respect to mean WeeFIM/FIM scores after controlling for age and injury severity. The 1993 group had poorer scores on the withdrawal subscale of the psychosocial measure (P = 0.02), yet a smaller proportion of these children were enrolled in a special education class (P = 0.02). CONCLUSIONS: This study serves as a model for a larger, definitive study of the effectiveness of rehabilitation for children with head injury. The trends suggest that more comprehensive care may lead to better outcomes.

Activities of Daily Living↗
PubMedDate not supplied

Division, duplication and neglect: patterns of care for children with chronic disorders.

The care of forty-four children with chronic arthropathies (usually juvenile rheumatoid arthritis) was studied by parental interview. The goal was to determine parents' perceptions of how management responsibilities are shared between primary physicians and specialists. Responses to questions about each of nine specific areas of care, ranging from diagnosis and treatment of the chronic disorder to the care of minor, acute illnesses, enabled the investigators to determine which physician had assumed major responsibility for each area. The results suggest a pattern whereby basic care is either divided or duplicated, but with many of the supportive aspects of care neglected in a high proportion of families. A comparison of these results with those of a similar study of children with meningomyelocele provides support for the view that such patterns are typical of the care of most children with chronic disorders.

Acute Disease↗
PubMedDate not supplied

Family counselors in a pediatric specialty clinic setting.

Numerous studies point up the psychosocial needs of chronically ill children, as well as the fragmentation or lack of services to meet these needs. Following an earlier study demonstrating the effectiveness of nonprofessional family counselors in improving the self-concept of children with chronic illness, this project placed five counselors in the pediatric specialty clinics of a teaching hospital. They were well accepted by all professional staff, and they provided a variety of services for families, improved communication among and coordination of care givers, and felt satisfaction in this role. This program provided an important expansion of social work services at low cost.

Adult↗
PubMedDate not supplied

Social class and the occurrence of traffic injuries and deaths in urban children.

This paper examines motor vehicle traffic accident deaths and injuries to pedestrians and bicyclists (ICD-9 codes E813-E814) aged 0-14 years, by income quintile of area of residence. It is based on 92 deaths in urban Canada in 1981, 69 deaths in Montreal during the period 1979-1983, and 1,133 injuries which resulted in hospital care or police reports in Montreal in 1981. For injuries in Montreal, the pattern of socio-economic inequality in the annual incidence rates by quintile was very pronounced, completely regular and highly significant. The rate of injury to children living in the poorest neighbourhoods was four times that of children living in the least poor neighbourhoods. For both sexes, inequalities were much more pronounced for pedestrians compared to bicyclists. For deaths in Montreal and all of urban Canada, the inequality in the rates did not follow such a consistent pattern across the income quintiles, nor were the differences statistically significant in most cases, but the rates for each sex were consistently highest in the poorest income quintile. Socio-economic inequalities in the rates of death and injury were greater in girls than in boys. The results are discussed in the context of theories of etiology and strategies for prevention.

Accidents, Traffic↗
PubMedDate not supplied

Bicycle accidents among children in the urban environment.

We studied all bicycling accidents requiring hospital visits among children 15 years of age and less, occurring on the Island of Montreal over an 18-month period. Data collected from 11 major Montreal hospitals and police accident reports were examined using various statistical methods: visual representation (a comparative accident index), spatial (quadrat analysis), and a comparative environmental analysis (differentiation of means). The results suggest that these accidents are not distributed randomly but correspond to a particular spatial pattern. High-risk areas are characterized by high population density, fast and dense vehicular traffic, and the absence of parks. Accidents usually take place on two-way streets, on straight stretches far from traffic lights, on dry pavement, and during clear weather when the visibility is good. More boys than girls are involved in these accidents and, more often than not, failure to obey traffic regulations is involved. The socio-economic status of the injured child tends to be low.

Accidents, Traffic↗