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Biomedical subjects

S Quine

Publications and source records attributed to S Quine.

54 records · Page 3Linked to original sources
PubMed1987

Implementing an innovative rehabilitation programme in an acute care hospital.

There have been various proponents of the advantages of early intensive rehabilitation programmes for improved patient outcome. This suggests that rehabilitation should commence whilst patients are in standard wards of acute care hospitals, rather than the usual practice of waiting until they are transferred to a rehabilitation unit or rehabilitation hospital. For effective implementation of such programmes it is important to consider the organization of personnel required and the implications for efficient delivery of services. This paper reports the experiences of implementing such a programme.

Arousal↗
PubMed1986

The contents of the Labour Ward Register. A research note.

Information recorded in the Labour Ward Register was identified for all maternity hospitals and hospitals with maternity sections in the N.S.W. Sydney Metropolitan area. This survey established that certain demographic and clinical information is consistently recorded and therefore can be relied on for planning and research purposes. Furthermore this information is conveniently located and avoids recourse to accessing patients' medical records.

Australia↗
PubMedDate not supplied

External hip protectors: likely non-compliance among high risk elderly people living in the community.

The factors that may influence compliance with wearing of external hip protectors by potential users living in the community were investigated. Elderly women (median age 83 years) who were hospitalised after fracture, joint replacement or falls and were expected to return to community living participated. Five focus groups were conducted. Most participants said they would not use the hip protector demonstrated. The main objections were a perceived lack of comfort in wearing the appliance, particularly in bed, coupled with the belief that they were not at high risk. Other lesser issues were the extra effort needed to wear the device, appearance, accuracy of fit, cost and unfamiliarity with the protectors. These findings suggest that, in general, high risk elderly women living in the community will be unlikely to use external hip protectors unless there is considerable encouragement from family members and/or health professionals. Educational programmes could reduce some misconceptions about hip fracture, and reinforce the benefits of wearing a protective appliance. They may also increase awareness of personal risk. An introductory period of supervised wearing of the hip protectors, while in hospital or respite care, may enhance compliance.

Journal Article↗
PubMedDate not supplied

Relatives as lay-therapists for the severely head-injured.

Although the need for an integrated approach to the management of the head-injured patient has been recognized, and the concept of incorporating the family in the rehabilitation treatment programme suggested, there is minimal documentation of how the services of family members can be utilized to optimal effect. At a large university teaching hospital in Sydney, Australia, an early intensive rehabilitation programme was pretested on 37 patients during 1984-85. The pretest was to identify the extent to which relatives could contribute input as lay-therapists to such a programme. The findings indicate that relatives can make a major time commitment to providing therapy, but that to avoid harm to both patients and relatives certain safeguards need to be enforced. These experiences and resultant recommendations may have a bearing on the organization of rehabilitation programmes for other categories of patient.

Adolescent↗
PubMedDate not supplied

The effectiveness of coma arousal intervention.

Thirty-one patients who were in coma or persistent vegetative state two weeks after sustaining a severe head injury were entered into a coma arousal programme. The coma arousal protocol called for a sequence of vigorous multisensory stimulations to be applied to the patient by a relative for up to eight hours a day for seven days a week. An independent study team monitored two patient outcomes, the time taken to obey a simple command on two consecutive occasions 24 hours apart and patients' score on the Glasgow Outcome Scale 10-12 months post-injury. Outcomes were compared with an historical reference group chosen from the literature, consisting of 135 similarly classified patients. Differences between the pilot study and the reference group patients on initial characteristics suggested that the pilot study patients might have the more favourable outcomes, independent of treatment effect. The sample size was sufficient to detect a 40% improvement in recovery rate. No significant improvements were noted in either the time to obey a simple command (p greater than 0.2) or in the Glasgow Outcome Scale (p greater than 0.25), although the observed difference in the latter group was 11% in favour of the pilot study patients. This study was unable to find any evidence that coma arousal, for all its arduous patient contact, had a markedly better outcome compared with conventional treatment.

Adolescent↗
PubMedDate not supplied

Outcome following physical trauma: a comparative approach.

This study aimed to examine physical and psychosocial changes after injury in a range of trauma patients. Three groups were selected for comparison purposes: severely head-injured patients, patients with major trauma, and those with minor trauma (n = 102). Outcomes were assessed by questionnaires and inventories administered to a family member or friend of the trauma survivor, approximately 1 year post-injury. Severely head-injured patients were reported to have the greatest degree of difficulty in self-care and mobility, and in community living skills, followed by other major trauma patients and then minor trauma patients. Severely head-injured patients also had relatively more frequent reports of behavioural changes than the other two groups. None the less, more than half of the major trauma group were reported to act differently after the accident. The relative frequency of adverse outcomes in the major trauma group was greater than expected and should be the focus of further research.

Activities of Daily Living↗
PubMedDate not supplied

Accelerated rehabilitation after proximal femoral fracture: a randomized controlled trial.

This randomized controlled trial compared accelerated rehabilitation after surgical treatment of proximal femoral fracture with conventional care and was conducted in a general hospital in an outer urban area. Participating were 261 sequentially admitted patients over the age of 50 years who met predetermined inclusion criteria and all were followed up until death or 4 months after fracture. Patients who were treated with the accelerated rehabilitation programme had a 20% reduction in length of hospital stay. Improved physical independence (as measured by Barthel Index) was observed after fracture in accelerated rehabilitation programme patients with limited pre-existing disability. Non-nursing-home patients receiving accelerated rehabilitation were also less likely to be discharged to nursing-home care or die in hospital. Accelerated rehabilitation led to a substantial reduction in length of hospital stay with a modest short-term improvement in level of physical independence and accommodation status after discharge.

Activities of Daily Living↗
PubMedDate not supplied

Carer burden after proximal femoral fracture.

This carer study forms part of a wider study which compares accelerated rehabilitation after proximal femoral fracture with conventional care. Two measures of burden on family caregivers were used; social worker's assessment of overall burden and an index of disruption to carers' lives. Participants were carers of 200 patients interviewed at five periods up to 12 months after fracture. Carer burden prior to the fracture was the strongest predictor of subsequent burden, with carers of patients in nursing homes and patients with a cognitive or physical disability being more burdened. Carer burden may increase or decrease after the patient's injury, irrespective of randomization group. There is no simple relationship between burden and randomized group. Accelerated rehabilitation does not impact greatly on carer burden, but already severely burdened carers may benefit from additional counselling/information. Specific ways in which carers; lives were disrupted are reported.

Aged↗
PubMedDate not supplied

The impact of work related trauma on the psychological health of nursing staff: a cross sectional study.

This study aims to investigate the effects of work-related trauma exposure on the health of nursing staff in hospitals. The survey was conducted using a randomised sample of 314 nurses. Half (52.2%, n = 189) of staff surveyed had multiple exposures to different kinds of trauma. Results on the General Health Questionnaire (GHQ) and Beck's Depression Inventory--Revised (BDI-R) suggested that nearly 40% of staff experienced poor health, while nearly 10% experienced moderate to severe depression. Results of the logistic analyses, after adjusting for confounders, suggested that high and long term trauma exposure is detrimental to the mental health of nurses. These findings indicate that hospital nursing staff, in particular those who have high exposure to trauma, are in urgent need of support services such as debriefing and counselling.

Accidents, Occupational↗