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Biomedical subjects

L MacDonald

Publications and source records attributed to L MacDonald.

At least 37 records · Page 2Linked to original sources
PubMed1988

Measuring patient satisfaction with life in a long-stay psychiatric hospital.

A survey of patient satisfaction with physical and social conditions was carried out in the long-stay wards of a large inner city psychiatric hospital in London, Britain. Patient satisfaction was assessed by means of an administered questionnaire which was developed specifically for this purpose. Factor analysis identified eight components of patient satisfaction. Of 143 eligible patients, 104 (73%) successfully completed the interview. Responses showed that patients were generally satisfied with life in the hospital, although levels of satisfaction varied significantly among wards. The factors causing greatest dissatisfaction related to failure to be treated as individuals and to feelings of isolation and apathy. Our findings showed that patients can express views about their conditions which should be useful in planning improvements in care. The questionnaire proved a simple and effective method of measuring satisfaction and may be useful to others concerned with improving the quality of the environment of patients.

Adult↗
PubMed1988

Improving the reliability of a Maladaptive Behavior Scale.

A methodology was described for operationalizing the terms occasionally and frequently on the Maladaptive Behavior Scale (MacDonald & Barton, 1986), previously developed by modifying Part II of the AAMD Adaptive Behavior Scale. The modal ratings obtained from staff members of 28 rehabilitation agencies were used to define numerically these terms on a revised scale; interrater reliability and item-by-item agreement were slightly greater for the revised scale. On the basis of these findings and raters' comments, it is suggested that a similar methodology might increase the reliability and usefulness of the ABS, Part II.

Humans↗
PubMed1987

Sensitivity to change and the effect of mode of administration on health status measurement.

A measure of global health status, the McMaster Health Index Questionnaire (MHIQ), was assessed to determine two important measurement properties related to its reliability and validity--sensitivity to change and the effect of mode of administration. Ninety-six patients in a physiotherapy clinic were randomly assigned to three mode-of-administration study groups, administered the MHIQ at four points in time including at admission and discharge from the clinic, and assessed for change by their physiotherapist. MHIQ physical function, social function, and emotional function retest scores obtained by self-completion within a 1-week interval were most stable. Physical function scores by any of self-completion, telephone interview, or personal interview were sensitive to change, that is, they improved dramatically by the time of discharge from the clinic. Mode of administration did not affect the size of the change scores. Changes reflected by the physical function scores correlated with changes in physical function reported by a patient's physiotherapist. No systematic changes occurred with social and emotional function scores; this is not surprising in a group of patients with predominantly physical function problems.

Activities of Daily Living↗
PubMed1986

Bowels: beliefs and behaviour.

A postal questionnaire about knowledge, beliefs, and experiences of bowel function was returned by 171 patients aged 55 years and over from a group general practice in London. Of the respondents, 10% reported no predictable frequency of movement, a higher proportion being women than men; 79% believed that a daily movement is important and 90% that 'regularity' is necessary for good health; 14% were dissatisfied with their bowel habits and 16% regularly self-treated; 95% gave reasonable definitions of 'regular' and 'diarrhoea'; a tenth were unsure about the definition of 'constipation'. Although 76% believed there were bowel symptoms which require immediate medical attention, 98% would in the first instance treat themselves for constipation, 90% for diarrhoea, and 25% for rectal bleeding. To reduce delay in the diagnosis of colorectal cancer, it is suggested that consultations for disturbance of bowel function be encouraged among the middle-aged and the elderly. Doctors should examine such patients with the diagnosis of malignancy in mind.

Aged↗
PubMed1986

Measuring severity of behavior: a revision of Part II of the Adaptive Behavior Scale.

This study was designed to: (a) assess the degree to which rehabilitation staff rate the severity of maladaptive behaviors on Part II of the AAMD Adaptive Behavior Scale (ABS) and, on the basis of the obtained rating, (b) develop a socially validated revision of the scoring system to allow more accurate classification of mentally retarded individuals as having mild, moderate, or severe behavior problems. On the basis of the modal ratings obtained from various service agencies for "occasionally" and "frequently" on Part II of the ABS, we constructed a revised scoring system. Preliminary use of the scoring system suggests satisfactory agreement between "severity profile" scores and subjective ratings of individuals classified by service agencies as demonstrating mild, moderate, or severe behavior problems.

Adolescent↗
PubMed1985

Children's multiple vitamins: overuse leads to overdose.

A suburban Ontario community hospital encountered 21 +/- 1 overdoses of children's multiple vitamins yearly between 1978 and 1981. Of these, 35% involved one particular cartoon character preparation. Parents were surveyed to determine whether this particular preparation resulted in a disproportionate number of accidental overdoses. However, the use of vitamins with a cartoon character format did not lead to a greater risk of overdose than did conventional preparations. Of the 1051 families who had given multiple vitamins to their children 34 (3%) had experienced an overdose. The number of vitamin preparations used by each family was the most powerful determinant of overdose (p less than 0.001). The risk of accidental overdose increased from 1.5% with one multiple-vitamin preparation to 8% with four or more preparations. Among all the variables examined, exposure was the most important element in the risk of multiple-vitamin overdose.

Adolescent↗
PubMed1977

Behavioral therapy: its application to reduce disruptive behaviors of the elderly in nursing homes.

Nurses who care for the elderly in nursing homes and auxiliary hospitals have many goals. They provide for the health, recreational, social and emotional needs of their patients. They also strive to increase their patients' levels of self-care and self-respect. Unfortunately, because many patients exhibit disruptive behaviors--striking staff or other patients, throwing temper tantrums, lying on the floor in corridors, refusing to take medication and so on, these desirable goals cannot always be met. What nurses need, in addition to their specialized, medically oriented training, is training in a consistent strategy for handling these problems. Behavioral therapy provides this strategy.

Aged↗
PubMedDate not supplied

Fine needle aspiration biopsy of Hashimoto's thyroiditis. Sources of diagnostic error.

OBJECTIVE: To determine the accuracy of cytologic interpretation in the diagnosis of Hashimoto's thyroiditis (HT). STUDY DESIGN: At Ottawa Hospital from 1987 to 1994, 1,638 fine needle aspiration biopsies (FNABs) from thyroid were performed. HT was suggested in 184 FNAB samples taken from 157 patients. Of the 184 aspirates diagnosed with HT, 39 had corresponding surgical specimens taken from 31 patients. A retrospective review of these FNABs and surgical pathology slides formed the basis of this study. RESULTS: In 27 (69%) aspirates, HT was diagnosed on both the FNAB and surgical specimens. In 10 of 27 FNABs an associated lesion was not sampled by FNAB. In four of these 10 aspirates some of the cellular features of HT were misinterpreted, and the possibility of an associated neoplasm could not be ruled out. This resulted in four false positive diagnoses. In 12 (31%) FNABs from nine patients, the cytologic diagnosis of HT was not confirmed histologically. These cases included five Hürthle cell adenomas and one case each of follicular adenoma, nodular goiter, macrofollicular adenoma and malignant lymphoma. This resulted in five false negative diagnoses. CONCLUSION: These results support the value of FNAB in the diagnosis of HT. The presence of hyperplastic follicular cells on FNAB samples from HT may mimic a follicular neoplasm and result in a false positive interpretation. Adequate sampling of the thyroid is important, particularly when there is an associated lesion. The diagnosis of lymphocytic thyroiditis should not be made when only a few lymphocytes are present. Finally, pleomorphic Hürthle cells may be present in aspirates from Hürthle cell neoplasms and underdiagnosed as HT, especially when they are associated with a few lymphocytes.

Adult↗