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Biomedical subjects

J Townsend

Publications and source records attributed to J Townsend.

152 records · Page 9Linked to original sources
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Reduction in hospital readmission stay of elderly patients by a community based hospital discharge scheme: a randomised controlled trial.

STUDY OBJECTIVE: To compare a community support scheme using care attendants with standard aftercare for their effects on independence and morale of elderly patients discharged from hospital and on their use of health and social services. DESIGN: Randomised controlled study of cohort of patients over 75 discharged to their own homes. SETTING: District general hospital and community. PATIENTS: Total of 903 patients (mean age 82, 25% over 85). INTERVENTIONS: Total of 464 patients received support from care attendants on first day at home and for up to 12 hours a week for two weeks. Support comprised practical care, help with rehabilitation, and organising social help. The remaining 439 patients received standard aftercare. END POINT: Difference between two groups of 7% in hospital readmission rates or one point on activities of daily living scale (power 80%, significance level 5%). MEASUREMENTS AND MAIN RESULTS: Three months after the initial discharge 763 patients were interviewed (84%). There were no significant differences between the two groups in physical independence (activities of daily living scale), in measures of morale (Philadelphia scale), or in death rates. Hospital readmission rates within 18 months of discharge, however, were significantly higher in the control group and they spent more days in hospital (mean; control group 30.6 days, support group 17.1 days; p = 0.014). Of the patients living alone who were followed up for 18 months 21 (15%) receiving standard aftercare were readmitted more than twice compared with 6 (5%) supported by care attendants (p less than 0.01). CONCLUSIONS: If the findings are confirmed, and the policy extended to all patients over the age of 75 living alone, an average health district might expect either to save about 23 hospital beds at a net annual saving of about pounds 220,000 in the short term or to increase available beds by this number.

Activities of Daily Living↗
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Taxing assessments.

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Education, Nursing↗
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A comparison of the effects of lumpectomy versus mastectomy on sexual behaviors.

The purpose of this study was to investigate the effects of lumpectomy and mastectomy on female sexual behaviors. It is assumed frequently that lumpectomy causes fewer sexual sequelae for the patient. Although review of the literature indicated consensus regarding the advantage of lumpectomy in preserving body image, no such consensus exists regarding preservation of female sexuality. The literature also was unclear regarding treatment and demographic factors that may be useful in identifying patients at risk for sexual difficulties. A convenience sample of 165 women participated in the study. Data were collected using the Sexual Behaviors Questionnaire and the Watts' Sexual Functioning Questionnaire. Findings indicate that no significant difference existed in sexuality between women treated by lumpectomy and those treated by mastectomy. Other factors with a significant positive effect on sexuality included a history of minimal alcohol use, absence of chemotherapy treatment, and tamoxifen use. Counseling women and their partners about the sexual side effects of cancer treatments is an important part of the health professional's role.

Adult↗