Biomedical subjects

J H Flaskerud

Publications and source records attributed to J H Flaskerud.

At least 19 recordsLinked to original sources

PubMed1992

Relationship of ethnicity to psychiatric diagnosis.

The purpose of this study was to determine the relationship of ethnic identity to psychiatric diagnosis in white, black, Latino, and Asian clients of the Los Angeles County mental health system. The sample (N = 26,400) consisted of adult inpatient and outpatient clients seen in county mental health facilities between January 1983 and August 1988. Logistic regression analysis was used to determine the relationship of ethnicity to diagnosis in both outpatient and inpatient samples. The covariates included in the analysis were age, gender, socioeconomic status, and primary language. Ethnicity had a significant and consistent relationship to diagnosis in both outpatient and inpatient samples, with black and Asian clients having a greater proportion of psychotic diagnoses than whites, and Latinos a lesser proportion than whites. None of the covariates included in the analysis had a consistent relationship to diagnosis. Whites and Asians received more diagnoses of major affective disorders than blacks or Latinos; blacks and Asians received more diagnoses of schizophrenia and other psychoses than whites, and Latinos received fewer of these diagnoses than whites. Substance abuse was lower for Asians than for the other three groups. Based on the findings, it was concluded that there continues to be a difference in psychiatric diagnosis that is related to ethnicity. Clinical practice issues and recommendations for further research are considered in relationship to these findings.

Adult↗

PubMed1992

Racial/ethnic identity and amount and type of psychiatric treatment.

OBJECTIVE: The purpose of this study was to examine the relationship of racial/ethnic identity to the amount and type of psychiatric treatment received by white, black, Latino, and Asian patients in the Los Angeles County mental health system. METHOD: The patients studied (N = 19,400) consisted of all adult inpatients and outpatients seen in all county mental health facilities between January 1983 and August 1988. Multiple regression analysis was used to test the relationship between race/ethnicity and four measures of treatment received: number of treatment sessions, treatment modality, treatment setting, and therapist's discipline. The covariates included in the analyses were age, sex, socioeconomic status, primary language, diagnosis, and measures of treatment when these were logical predictors and were not acting as dependent variables. RESULTS: Race/ethnicity did not have a consistent significant relationship to the treatment variables studied. However, diagnosis had a consistent and highly significant relationship to all four measures of treatment. A psychotic diagnosis was related to receiving more treatment sessions, greater use of medication, greater use of inpatient treatment, and less treatment by a professional therapist. Socioeconomic status and primary language also had consistent and significant relationships to three of the treatment variables. CONCLUSIONS: In considering modifications to the service delivery system, clinicians must evaluate whether the type of treatment provided to psychotic patients is the treatment of choice in terms of effectiveness and efficiency or whether it involves bias in service delivery. Similarly, the issue of bias in treatment of lower socioeconomic patients must be addressed.

Adolescent↗

PubMed1992

HIV disease and levels of prevention.

It appears that several cofactors are involved in determining the pathogenesis of HIV disease. Exposure cofactors affect acquisition of HIV infection. Trigger cofactors determine a person's likelihood of being infected after exposure to HIV, or contribute to HIV disease progression in those who have been infected. Identification of the most common exposure and trigger cofactors should become a major focus of community health nursing practice at all levels of prevention. Changes in behaviors, early intervention activities, and rehabilitative measures related to known cofactors may improve the health of persons at all stages of HIV disease.

Community Health Nursing↗

PubMed1992

Psychosocial and neuropsychiatric care.

Psychosocial problems of persons with HIV disease require knowledge and skill in psychosocial assessment, suicide risk assessment, crisis intervention and various other therapeutic modalities, provision of social and community resources, and spiritual care. Neuropsychiatric problems require knowledge and skill in neurologic, cognitive, and behavioral assessment and supportive care. Families and partners have needs commensurate with those of the person with HIV disease.

AIDS Dementia Complex↗

PubMed1991

Beliefs about AIDS, health, and illness among low-income Latina women.

The purposes of this study were to describe (a) the health beliefs of Latina women about acquired immunodeficiency syndrome (AIDS); and (b) the relationship of these beliefs to the subjects' traditional beliefs about illness and its treatment. The sample consisted of 59 low-income Latina women attending nutrition programs in Los Angeles. A qualitative approach was used to gather the data in semi-structured focus group interviews. Content analysis was used to classify data according to causes of AIDS and prevention and treatment of AIDS. Causes of AIDS included all of the current biomedical and public health explanations of transmission, current popular beliefs and misconceptions about transmission, and long-standing traditional beliefs about the causes of illness. Prevention and treatment of AIDS reflected these same three perspectives. The women's beliefs consisted of accurate, inaccurate, and incomplete information about AIDS. Implications were drawn from the findings for AIDS education and prevention programs which are congruent with the participants' cultural beliefs, values, attitudes, and expectations.

Acquired Immunodeficiency Syndrome↗

PubMed1991

Effects of an Asian client-therapist language, ethnicity and gender match on utilization and outcome of therapy.

The purpose of this study was to examine the relationship of Asian client-therapist ethnicity, language and gender match on two measures of utilization: number of sessions with primary therapist and dropout from therapy; and one measure of client outcome: admission-discharge difference in Global Assessment Scale (GAS) scores. The sample consisted of 1746 Asian client episodes in Los Angeles County mental health facilities between January 1983 and August 1988. Various types of multiple regression analyses were used to investigate the relationship of language, ethnicity, and gender match to the three dependent variables and to eight socio-demographic variables. Either client-therapist language match or ethnic match significantly increased the number of client sessions with the primary therapist. However, only ethnicity match had a significant effect on dropout rate. Gain in GAS admission-discharge score was not affected by either a client-therapist ethnicity or language match. Gender match had no consistent effect on the dependent variables. Of the covariates examined, only therapist discipline (social worker) had a consistent effect on the dependent variables. It was concluded that both client-therapist language and ethnicity match are important variables affecting the utilization of treatment. Further research will be needed to separate the effects of language and ethnicity on therapy utilization.

Adolescent↗

PubMed1991

Review of literature on culture and pain of adults with focus on Mexican-Americans.

The purposes of this paper are to review the literature on culture and pain in adults, and specifically on Mexican-American beliefs about pain, and nurses' responses to patients' pain. Nurses and other health caregivers in the United States often characterize various ethnocultural groups according to their reaction to pain and their ability to tolerate pain. Cross-cultural studies have demonstrated that White Americans of Northern European origin react to pain stoically and as calmly as possible, choosing to withdraw if pain becomes intense. This response to pain has become the cultural model or norm in the United States. It is the behavior expected and valued by health caregivers. Mexican-Americans are often described as complainers who want immediate relief for their pain. Yet studies of Mexican-American culture and cross-cultural studies of the pain experience and responses of Mexican-Americans do not support this characterization. Nurses and patients assess pain differently regardless of cultural background. Both nurses and physicians tend to underestimate and undertreat the pain of their patients when compared to patients' assessment of pain. However, the ethnicity and culture of the patient influence the extent of difference between the patient's and nurse's assessment. The culture of the nurse also influences the inference of patients' physical pain and psychological distress. Based on the studies reviewed, implications are drawn for transcultural nursing practice and recommendations are made for future nursing research.

Cross-Cultural Comparison↗

PubMed1990

Effects of an AIDS education program on the knowledge, attitudes and practices of low income black and Latina women.

The purpose of this study was to test the effects of an AIDS education program on the knowledge, attitudes and practices of low income black and Latina women. A pretest-posttest nonequivalent control group design was used with a 2-3 month retest of the experimental group. The sample consisted of 506 experimental and 206 control group women who were clients of the Public Health Foundation's Nutrition Program for Women, Infants and Children in Los Angeles County. The program included a slide-tape presentation, and educational and resource brochures in English and Spanish. Knowledge, attitudes, and sexual and drug use practices were measured using a structured questionnaire that was developed in English and Spanish. Content validity and reliability of the questionnaire were established. A 2-way repeated measures ANOVA examined differences in pretest-posttest knowledge, attitudes, and practices for experimental and control groups and for both racial/ethnic groups. The experimental group made significant gains over the control group on pretest-posttest measures of knowledge and attitudes. Both experimental and control groups made significant changes in practice. Changes in knowledge were retained on retest; changes in practices came close to significance on retest. Blacks and Latinas differed on pretest knowledge and attitudes but not practices. Blacks had more knowledge and positive attitudes on pretest. However, posttest improvements for both knowledge and attitudes were greater in Latinas than in blacks. A multiple regression analysis revealed that the best predictors of knowledge, attitudes and practices were racial/ethnic group, education, and religion. It is concluded that a didactic audio visual program can positively affect the knowledge and possibly the practices of participants and that these are retained over time but that changes in attitudes will take further efforts.

Acquired Immunodeficiency Syndrome↗

PubMed1990

Psychiatric nurses' needs for AIDS information.

The purpose of this study was to identify 1) the needs of psychiatric nurses for information on AIDS; 2) the groups to whom they provide AIDS education, counseling, and referrals; and 3) their preferred resources for AIDS information. A national survey of 233 psychiatric nurses was conducted. The most important areas of need for AIDS information were psychosocial aspects of the care of AIDS patients, families, and healthcare workers; the assessment of AIDS symptoms; and management of psychiatric complications. The nurses provided education and counseling to a wide variety of transmission groups, community groups, and healthcare workers. They preferred continuing education conferences, journals, and popular print and visual media as resources for AIDS information.

Acquired Immunodeficiency Syndrome↗

PubMed1990

Influence of therapist ethnicity and language on therapy outcomes of Southeast Asian clients.

The purpose of this study was to examine the relationship of Southeast Asian client-therapist ethnicity and language match on three therapy outcomes: number of sessions with primary therapist, dropout from therapy and admission-discharge difference in Global Assessment Scale (GAS) scores. The sample consisted of 543 Southeast Asian client episodes in Los Angeles County mental health facilities between January 1983 and August 1988. Various types of multiple regression analyses were used to investigate the relationship of language and ethnicity match to the three outcome variables and to eight sociodemographic variables. Either therapist-client language or ethnicity match significantly increased the number of client sessions with the primary therapist. Dropout from therapy was significantly affected by a language match in the Cambodian sample only but the effect was to increase dropout. Neither ethnicity nor language match was significantly related to GAS score gain. Several possible explanations for these findings and their clinical significance were explored.

Adult↗

PubMed1990

Matching client and therapist ethnicity, language, and gender: a review of research.

The purpose of this article is to examine whether therapy process and outcome are influenced by a client-therapist ethnicity, language, or gender match. A review of research in this area does not demonstrate support for a client-therapist match on any of these variables. The methodological problems and unresolved conceptual issues involved in this research may limit the findings. The ethical and political context of the research and the implications for mental health nursing are explored.

Cultural Characteristics↗

PubMed1989

Black and Latina womens' AIDS related knowledge, attitudes, and practices.

As part of a larger study designed to provide an AIDS education and prevention program for low-income black and Latina women in Los Angeles County, a pilot study of black (n = 51) and Latina (n = 56) womens' AIDS related knowledge, attitudes and practices was conducted to gather baseline data and to test an instrument that would measure these variables. The factors underlying the instrument were identified and reliability coefficients were determined. The need for changes in the format and administration of the instrument was identified due to nonresponse to some items. There were sociodemographic differences between the two groups of women as well as differences in knowledge and attitudes. In general, black women had more knowledge of AIDS than Latina women and more positive attitudes. Practices did not differ. Both groups denied drug use and multiple sexual partners.

Acquired Immunodeficiency Syndrome↗

PubMed1989

Effectiveness of an AIDS education program on knowledge, attitudes, and practices of state employees.

While the number of companies employing HIV infected workers has more than tripled since 1985, only 10% of American corporations have policies for dealing with persons infected with HIV. The occupational health nurse is in a unique position to influence the attitudes, knowledge, and behaviors of workers in promoting a safe and productive work environment and reducing high risk activities. While the number of all individuals with AIDS has increased 4,000% in the last 6 years, there has been no reported increase in the percentage of HIV infected health care workers as compared with other occupations. An evaluation of an AIDS educational program revealed that while knowledge base was fairly high, statistically significant improvements were noted from pretest to retest in specific knowledge, attitude, and practice items.

Acquired Immunodeficiency Syndrome↗

PubMed1988