Social adjustment as a criterion of treatment success: just what are we measuring?
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Female↗
Biomedical subjects
S Platt
Publications and source records attributed to S Platt.
The effects of brief hospitalization upon the psychiatric patient's household.
This paper describes the social results of a randomized controlled trial of brief versus standard hospitalization for acute psychiatric inpatients. All the data reported were obtained through the use of a new semi-structured standardized interview schedule, The Patient Behaviour Assessment Schedule (PBAS). Overall, there were no significant differences between groups in the extent of Objective Burden and Subjective Distress experienced by the informant's household. The groups were differentiated, however, on a number of individual items. At the 2-week evaluation Brief Care informants expressed more distress than Standard Care informants arising out of the patient's slowness, but were less distressed by the effect of the patient's behaviour on their work performance. At the follow-up interview Standard Care informants were more affected in their social life and pursuit of leisure activities, while expressing less distress as a result of the patient's overdependence. The sensitivity of the PBAS Distress Scales is demonstrated by comparing the informant's differential emotional response to role and nonrole aspects of the patient's behaviour at different points in time.
Clinical Trials as Topic↗
Memory strategies in absolute identification of "circular" pitch.
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Adolescent↗
On establishing the validity of 'objective' data: can we rely on cross-interview agreement?
It has been proposed that a high level of agreement between informants' reports about events and happenings ('objective' data) is a sound basis for establishing (a) the validity of the measure which is based on the reports, and (b) the nature of objective reality. In this paper it is argued that such agreement may not be an adequate basis for validation since the accounts may not be independent. Likewise, low across-interview agreement may not signify the inaccuracy of either report because of the phenomenon of 'object-variation'. It is concluded that, although this method of validation can be significantly improved, it should be supplemented, wherever possible, by other approaches.
Data Collection↗
Shortening hospital stay for psychiatric care: effect on patients and their families.
A one-year cohort of patients from a defined catchment area with acute functional disorders were allocated at random to brief care (experimental group) or standard care (control group) in hospital to examine the effect of shortening hospital stay on the clinical and social functioning of patients and the distress abnormal functioning caused to others. A total of 127 patients were interviewed on entry to the study, and 106 were followed up. The brief care group had significantly shorter mean and median lengths of stay than the control group, but there was no difference between the groups in the number of days spent in hospital during subsequent admissions. The groups were well matched for clinical and social variables. Rates of improvement over 13 weeks were essentially the same by all measures of outcome, including the Present State Examination and Patient's Behaviour Assessment Scale, which was developed for the study to measure deterioration in behaviour and social functioning and adverse effects and distress on others. There was no difference between the two groups in burden to the community supporting services, social security requirements, or GP attendances. Improvement rates were nearly identical on all measures within and across diagnostic subgroups. Brief care resulted in a 33% reduction in average length of stay compared with the year before but was associated with a corresponding increase in day hospital use. The short-stay policy continued the year after the study finished.The findings confirm the value of shortening hospital stay and improving day care facilities for most localities.
Attitude↗
Service utilisation, social support and psychiatric status in a cohort of patients with schizophrenic psychoses. A 7 year follow-up study.
All persons (n = 60) who contacted the South-Verona Psychiatric Case Register in 1979 and received an ICD-9 diagnosis of 'schizophrenia or other functional non-affective psychosis' were traced in 1986. 41 patients (17 males, 24 females) living in the community were assessed on a number of measures of psychopathology, social functioning, social support and service use. There were two major types of contact during the follow-up period: long-term but not high use (n = 9); and neither long-term nor high use (n = 16). In addition, ten patients were out of contact and six were outside the catchment area. Social support was highly variable, but overall negative and positive factors were evenly balanced. Symptomatology and social functioning were largely unrelated to service use, but significantly and negatively correlated with social support (i.e., the greater the level of social support, the higher the level of functioning). Social support was unrelated to patterns of contact, but was negatively correlated with measures of service utilization (i.e., the greater the level of social support, the lower the dependency on hospital inpatient care). These findings point to the need for developing community-based mental health services which maintain and enhance the protective effect of the patient's social support network.
Adult↗