Search PubMed⌕ Search

Biomedical subjects

R M Kent

Publications and source records attributed to R M Kent.

6 recordsLinked to original sources
PubMed2005

The needs of young people with disabilities in transition from paediatric to adult services.

Transition to adulthood requires consolidation of identity, achievement of independence establishment of adult relationships and finding vocation. Those with disabilities and health problems experience difficulty in this through lack of social opportunity. There are 340,000 affected UK individuals of 16-29 years. Most, having survived childhood disability, may experience later deterioration in functional level. Most will require long term monitoring. Health needs include treatment for the complications and progression of their condition, appropriate treatment for everyday, and unrelated diseases, and health maintenance knowledge. Leaving a cohesive paediatric service and entering the uncoordinated adult health services has been described as hurtling into a void''. Therefore, number of health service models have been proposed, including the person-focussed model, a disease-focussed model, a hospital-based model, a team-based outside the health service, a named person, a voluntary organisation and a primary care model. For those with complex disabilities an interdisciplinary team comprising a consultant in Rehabilitation Medicine, (who will facilitate referral to other medical consultants) occupational therapy, speech therapy, psychology and social work input with support from physiotherapy and nursing addresses all these needs. Young Adult Teams can both teach skills, and facilitate health and other service usage. This whole area of work is under-researched. The outcomes for disabling childhood conditions must be investigated, and planning for adulthood must influence the pattern of care in childhood. The most urgent need is to set up effective services for young adults, which will help to ensure that their 50 years of adulthood have quality of life.

Adolescent↗
PubMed2003

Spasticity in multiple sclerosis.

The objective of this article is to establish the prevalence of spasticity in a random selection of people with multiple sclerosis (MS) in the city of Newcastle upon Tyne in the Northeast of England. A secondary aim was to assess the adequacy of current pharmacological intervention for spasticity and assess the relationship between spasticity and overall disability. The study design was a simple comparison that examined differences in functional independence in 2 random groups of people with MS subdivided by the presence of clinically significant spasticity. A total of 68 adults with a diagnosis of clinically definite MS were included in the study. Their level of functional independence was assessed using the Newcastle Independence Assessment Form (NIAF), the Functional Independence Measure (FIM), and the Kurtzke Extended Disability Status Scale (EDSS). Spasticity was assessed using the Modified Ashworth Scale. A subjective analysis was made of the appropriateness of oral antispastic medication by a rehabilitation physician. Thirty-two people (47%) had clinically significant spasticity (Modified Ashworth Score of 2, 3, or 4). Seventy-eight percent of the population were receiving some oral antispastic medication, but 50% were deemed to require some drug adjustment or additional treatment. Individuals with spasticity were found to have significantly higher levels of disability than those who had no spasticity or clinically insignificant spasticity. This study has confirmed that spasticity is highly prevalent in the MS population and is significantly associated with a reduced level of functional independence. Treatment of spasticity is suboptimal in a large proportion of the population, and the need for further information and education to health professionals and to people with MS is highlighted.

Adult↗
PubMed2000

An epidemiological survey of the health needs of disabled people in a rural community.

OBJECTIVE: To describe service use and unmet needs of disabled people in a rural environment, given well-recognized difficulties in providing equitable services to a widely-spread population, availability of transport and the presence of discrepancies in wealth. PARTICIPANTS: Disabled people registered with a single rural general practice, identified by postal questionnaire. METHOD: All 3462 households were screened using the Office of Population, Censuses and Surveys (OPCS) disability screening questionnaire. An 86% response rate was achieved. Seventy-four people aged 16-65 and 69 people aged 66-75 were interviewed by a rehabilitation physician. Fifty-five people aged 76+ were interviewed. Disability was assessed using the OPCS scales of disability, Barthel Index, and Hospital Anxiety and Depression Scale. RESULTS: Thirty per cent (43) of those aged 16-75 received assistance for their personal activities of daily living (ADLs), and 98% (140) required assistance for extended ADLs (taken from the OPCS surveys criteria). There was no difference in either disability or dependency by age group. Fifty-three per cent of this group had domestic adaptations, 75% had disability aids. Those aged 16-75 had significantly fewer aids and adaptations, less home care, care management, respite, district nursing and chiropody services than people over 75. Equipment was provided by statutory services less frequently and fewer carers were salaried. The rehabilitation physician assessed them as needing more occupational therapy, physiotherapy and chiropody. Thirty per cent saw their GP monthly and 45% attended hospital. CONCLUSION: Unmet need was assessed as greater in the younger group. Elderly people are possibly more visible to service providers with better recognition of need. There is no evidence of a relationship between medical surveillance and identification of rehabilitation needs. Those with greater degrees of disability require more interlinked and organized services.

Activities of Daily Living↗