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Biomedical subjects

M C Grob

Publications and source records attributed to M C Grob.

At least 19 recordsLinked to original sources
PubMed1994

Reliability and validity of a brief patient-report instrument for psychiatric outcome evaluation.

OBJECTIVE: The authors describe the Behavior and Symptom Identification Scale (BASIS-32), a brief patient-report measure for psychiatric outcome assessment, and present the measure's factor structure and reliability and validity data. METHODS: Using the BASIS-32, interviews were conducted with a total of 387 patients shortly after their admission to the adult inpatient services of a private not-for-profit psychiatric hospital. Six months after admission, they received a follow-up questionnaire version of the instrument. RESULTS: Factor analysis of the instrument yielded five factors, on which subscales were based: relation to self and others, daily living and role functioning, depression and anxiety, impulsive and addictive behavior, and psychosis. Internal consistency of the subscales ranged from .63 to .80. Internal consistency of the full 32-item scale was .89. Test-retest reliability ranged from .65 to .81 for the five subscales. Concurrent and discriminant validity analyses indicated that the BASIS-32 ratings successfully discriminated patients hospitalized six months after admission from those living in the community, patients working at follow-up from those not working, and patients with particular diagnoses. Follow-up ratings indicated that the BASIS-32 is sensitive to changes in symptomatology and functioning. CONCLUSIONS: The BASIS-32 provides a brief, standardized assessment of symptoms and problems from the patient's perspective. The instrument can be used for outcome assessment with most psychiatric inpatients.

Activities of Daily Living↗
PubMed1992

Case-based reimbursement for psychiatric hospital care.

A fixed-prepayment system (case-based reimbursement) for patients initially requiring hospital-level care was evaluated for one year through an arrangement between a private nonprofit psychiatric hospital and a self-insured company desiring to provide psychiatric services to its employees. This clinical and financial experiment offered a means of containing costs while monitoring quality of care. A two-group, case-control study was undertaken of treatment outcomes at discharge, patient satisfaction with hospital care, and service use and costs during the program's first year. Compared with costs for patients in the control group, costs for those in the program were lower per patient and per admission; cumulative costs for patients requiring rehospitalization were also lower. However, costs for outpatient services for patients in the program were not calculated. Treatment outcomes and patients' satisfaction with hospital care were comparable for the two groups.

Adolescent↗
PubMed1992

Patient outcome after transfer within a psychiatric hospital.

Patients' satisfaction with the process and outcome of transfer between units of a private psychiatric hospital and the immediate impact of the transfer were examined through chart reviews (59 patients) and interviews (29 of the 59 patients). Results suggested that most patients were satisfied with the transfer and were not adversely affected by it. Satisfaction was positively correlated with briefer hospitalization, feeling better (less anxious or depressed) after transfer, and being informed ahead of time about the program on the new unit. The adversely affected patients had fewer previous hospitalizations at the current facility, were transferred sooner after admission, and had briefer current stays. No relationship was found between adverse effects and dissatisfaction. Patients suggested that better communication, more information about the new unit, and more advance notice would be helpful.

Adaptation, Psychological↗
PubMed1989

Most likely to succeed: correlates of good versus poor hospital outcome in young adult inpatients.

This paper presents the findings of a study comparing disparate hospital outcomes of a young adult population. Clinical ratings of much improved and unimproved status at the time of discharge were our outcome variables. Major differences in patient characteristics associated with improvement status related to age of onset of disorder and premorbid functioning. Hospital variables yielding significant differences between the cohorts included treatment alliance on the part of patients and families, reduction in symptomatology, and diagnostic classifications. A discriminant function analysis was carried out to identify the combination of variables contributing the most to the variance. Directions for further study are explored.

Adult↗
PubMed1986

BASIS: the development of a self-report measure for psychiatric inpatient evaluation.

Reliable and valid instruments are vital to assess the course and outcome of psychiatric disorders. This paper describes the development of BASIS (Behaviour and Symptom Identification Scale), a self-report assessment instrument for assessing functioning of psychiatric inpatients, and provides validating data for its use in a psychiatric hospital. The instrument was administered to 677 newly admitted patients. For approximately half of the sample, patients' nearest relatives provided parallel ratings of the patient. Interviews were repeated three to six weeks after admission and again six months after discharge. Test-retest reliability was found to be comparable to that for a standardized symptom checklist (SCL-90). Analyses of validity pointed to the instrument's capability in discriminating diagnostic groups, item correlations with similar symptom dimensions on other assessment measures, and correlations with relative's assessments of patients on the same measure. In conclusion, BASIS appears to be a promising tool for psychiatric inpatient evaluation studies.

Data Collection↗
PubMed1984

Outcome evaluation findings: a decade of experience.

Using the experience and findings of the McLean Hospital Evaluative Service Unit as a framework, this report presents an overview of outcome evaluation during the last decade and outlines some directions for future work in the field. Evaluation techniques and criteria are discussed, with particular emphasis on the effectiveness of the problem-focused approach, using patient and family perceptions of treatment and outcome. Various factors relating to successful post-hospital adjustment are enumerated, with adherence to aftercare and the presence of a strong social support system emerging as significant. In our own work, patient characteristics found to be correlated with good outcome are being older, married, or diagnosed with an affective disorder. Of the problems and symptoms explored, improvement in depression emerges as the best indicator of good mental health at follow-up.

Evaluation Studies as Topic↗
PubMed1983

Health agencies and a school of social work: practice and research in partnership.

Growing out of their joint recognition of the need for evaluation, accountability, and definition of social work's interdisciplinary contributions, a school of social work and Boston-area health agencies formed a research partnership. Fifty-five studies involving graduate students' research resulted in reportings, publications, and utilizations of findings.

Boston↗
PubMed1982

Medical care in a geriatric psychiatry unit: impact on psychiatric outcome.

The medical care of 49 randomly selected patients admitted to a geriatric psychiatry evaluation unit was assessed to determine the impact on psychiatric care and outcome. Medical factors were identified as directly causing psychiatric symptoms in 12 of the 49 cases, whereas psychiatric decompensation was precipitated by medical illness in 25. Previously undiagnosed significant medical problems were found in ten patients. In 25 cases concomitant medical illness had a major effect on psychiatric treatment, and in 23 the course of the medical illness affected psychiatric outcome. Seventy-nine per cent of the patients had at least moderately improved at the time of discharge, and most were able to return to their homes. Improvement in medical condition was correlated significantly with psychiatric improvement. Implications for the care of geriatric psychiatry patients are discussed.

Adult↗
PubMed1982

Clinical social work with young adult inpatients: perspective of patients, parents, and clinicians.

This article describes an empirical study designed to identify the unique role of the clinical social worker as a member of the hospital team in the treatment of young adult psychiatric inpatients. Fifty-five patients, their parents and social workers were interviewed at admission and 60 days later to ascertain: (1) initial attitudes and expectations regarding social work services, (2) specific services desired by clients, (3) actual services provided, and (4) helpfulness of the services. Results indicated that the services most frequently desired were those most often provided. These included providing information to families about patients' progress, helping families deal with hospital procedures and helping with aftercare planning. Most services provided were viewed as helpful. Social workers were seen as more helpful to families than to patients and more so by parents than by patients. Clients who felt the social worker understood their needs and was available when needed, felt he/she was more helpful to them. The implications of these findings for definition of the social worker's role are discussed.

Adolescent↗
PubMed1979

Assessing consumer satisfaction from letters to the hospital.

A private psychiatric hospital's evaluation research unit assessed consumer satisfaction with service by analyzing the content of letters written in response to an invitation to comment on the hospital experience. Respondents included relatives and referring agents of those who had received treatment. They expressed greatest satisfication with the helpfulness of the hospital, general patient care, and the quality of the clinical staff. They expressed much dissatisfaction with communication, such as adequacy of information about patients' treatment and progress, and with management rules and procedures. The analysis showed that the older the patient and the fewer the number of previous hospitalizations, the greater was the satisfaction expressed.

Adult↗
PubMed1975

Short-term versus long-term hospitalization in a private psychiatric facility: a follow-up study.

A follow-up study was made of 43 short-term and 42 long-term ex-patients 18 months after their discharge from a private psychiatric hospital. The short-term sample was different from the long-term sample on many preadmission and hospitalization variables, but it was much less different on the follow-up variables. Although most ex-patients in both samples were functioning well at follow-up, the long-term sample was doing somewhat better in all areas, according to both the former patients and their nearest relatives. Differences between the improvement of those in the short- and long-term sample increased when tested by diagnosis; long-term schizophrenic patients improved the most.

Adult↗