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Biomedical subjects

L Grant

Publications and source records attributed to L Grant.

At least 37 records · Page 2Linked to original sources
PubMed1996

Preventing skin breakdown: nursing practices, costs, and outcomes.

The aims of this study were to identify patients at risk for skin breakdown, to describe nursing interventions associated with the prevention of skin breakdown, and to analyze the cost of supplies used to prevent skin breakdown. An evaluation of nursing interventions used at three hospitals revealed that nurses used a variety of strategies for preventing skin breakdown. However, greater expenditures on prevention strategies did not improve outcomes and overuse of some items increased the incidence of skin breakdown. Protocol-based preventive nursing interventions are necessary to provide a cost-effective approach to the maintenance of skin integrity.

Adult↗
PubMed1994

Screening for mental health using adolescent-reported parenting.

BACKGROUND AND OBJECTIVES: Little is known in primary care practices about the relationship between parenting and adolescent mental health. In addition, current parenting measures have a narrow focus or do not lend themselves to clinical intervention. This study examined the clinical utility of a new instrument measuring adolescent-reported parenting, the Parenting Assessment Scale (PAS), to predict adolescent mental health. METHODS: A total of 147 adolescents regularly attending an inner-city clinic were asked to complete the Youth Self Report (YSR), a standard scale measuring mental health, and a PAS for each biological parent. Global scores on the PAS and YSR summarized the reported parenting quality and the adolescents' mental health status. RESULTS: Receiver Operating Characteristics and discrimination analyses showed that the global parenting index was highly predictive of mental health using a z score of .73 (sensitivity = 92.3%, specificity = 88.9%). CONCLUSIONS: The PAS may be useful as a screening tool in older, black adolescent females, although further research is needed to clarify its role in the clinical setting.

Adolescent↗
PubMed1993

Trends in Medicaid nursing home reimbursement: 1978-89.

Medicaid nursing home reimbursement is of concern because of implications for nursing home expenditures. This article presents data on State Medicaid nursing home reimbursement methods, ratesetting methods, and average per diem rates, refining earlier data and updating through 1989. A trend in the early 1980s toward adopting prospective systems played out by the end of the decade. There were trends, however, toward casemix methods, which may increase access for high-need patients, and toward cost-center limits on nursing, which may provide incentives to lower quality care. Analysis supports previous findings that prospective systems allow greater control over increases in rates.

Data Collection↗
PubMed1992

Psychotropic drug use in long-term care facilities: a review of the literature.

We reviewed 19 studies of psychotropic drug use for residents of long-term care facilities, located through a MEDLINE search of the literature published between 1978 and 1990. The review compares each study in terms of its sample, research design, and findings. The studies reviewed found that a substantial proportion of nursing home residents are taking psychotropic drugs on a regular, long-term basis and this usage is accompanied by prescribing and monitoring problems and many potential adverse risks.

Aged↗
PubMed1991

Sources and magnitude of job stress among physicians.

Research has suggested that physicians' jobs are more stressful than many other types of work, but sources of job stress for physicians have rarely been measured systematically. Interview data from 204 young physicians (57 women, 147 men) were used to construct four scales of sources of job stress: patient relationships, business/financial issues, time pressures, and competence concerns. The latter is a stronger source of stress for doctors in early practice. Sources and intensity of job stressors do not vary significantly by gender, but medical practice problems are more stressful in nonprofit than in for-profit practices. Early-career doctors appeared to experience only moderate levels of stress, and stressors were not related to impaired mental health.

Adaptation, Psychological↗
PubMed1991

Acute back pain: a psychological analysis.

A cross-sectional evaluation of 117 people who sustained acute back injuries was undertaken within 15 days of the first report of the pain. The subjects showed no discal or neural signs and had not experienced previous episodes of back or neck pain. All subjects were given a structured interview and filled in a series of psychological evaluation instruments. Results show acute pain reactions to be comparable to those seen in chronic pain groups. The predominant emotion is one of frustration rather than anxiety or depression and considerable behavioural disruption is evident from this early point. The extent to which these data undermine the model of gradual evolution of chronic back pain problems is discussed.

Acute Disease↗
PubMed1991

The evolution of chronic back pain problems: a longitudinal study.

A longitudinal evaluation of the recovery from an acute back pain episode was undertaken on 117 sufferers, with assessments at the onset, 3 and 6 months. The number of individuals still reporting pain at 6 months, and therefore qualifying for 'chronic pain', was considerably higher than expected (40%). At 6 months, the persisting pain problems were found to be moderate to severe in intensity in approx. 20% of cases. Despite the pain, the chronic sufferers showed gradual continuing adjustments to it, re-establishing activities despite pain. Most of the change in the pain components (cognitive, subjective, behavioral, depression, anxiety) occur in the first 3 months, after which considerable stability is evident in the residual problem. In contrast, the impact of the pain and the consequent disability decline more markedly and continue to do so right up to the 6 month point. There was no evidence of chronic pain evolving and growing, but rather of a persistence of the acute presentation.

Adult↗
PubMed1991

The prevention of chronic pain and disability: a preliminary investigation.

A preliminary investigation was undertaken on 117 acute back pain cases, to assess the utility of counseling at the acute stage upon the course of recovery over the subsequent 6 months. In addition, the extent to which psychological reactions to acute injury would allow the 'tagging' of individuals at risk for chronic pain problems, was studied. The minimal rehabilitation counseling proved inadequate to effect the course of recovery, but remarkably accurate predictions were possible at the sub-chronic point (3 months) as to who would make complete recoveries.

Adult↗