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PubMed1976

The development and evaluation of a community mental health education program for seminarians.

Because the clergy stands in an ideal position to serve the mental health needs of the community, seminaries have, for some time, included courses in pastoral counseling and related skills. While valuable, these courses tend to focus on the traditional clinical relationship excluding the broader role of community interventionist. Viewing this need, a course was developed to train seminarians in principles and practices of community mental health. The 28 students were compared to 24 controls at the beginning and end of the term. Evaluative instruments were the Community Mental Health Ideology Scale, two scales adapted from the Theological School Inventory, a self-evaluative competence scale, and a role evaluation scale. Data within a 2 X 2 X 2 design were subjected to an analysis of variance. Experimentals were found to exceed controls on the Community Mental Health Ideology Scale (p less than or equal to .001), the competence scale (p less than or equal to .01), and role evaluation scale (p less than or equal to .01).

Adult↗
PubMed1983

Self-management of disruptive verbal ruminations by a mentally retarded adult.

Chronic and high-rate disruptive verbal ruminations of a mentally retarded adult in a vocational training setting were successfully reduced following introduction of a multi-component, self-management intervention program. Self-management skills of self-monitoring, self-evaluation, self-consequation, and self-instruction were trained and then practiced in vivo. In addition to influencing the specific dependent disruptive rumination behaviors targeted for intervention, three collateral behaviors not specifically treated showed positive effects. A combined treatment withdrawal and modified changing criterion design was used to assess changes throughout phases of the study. Follow-up data obtained 6 months and again 12 months after termination of the program revealed durability of intervention effects. The practical, conceptual, and philosophic significance of these findings are noted.

Adult↗
PubMed1994

Acquisition of Eye-hand Coordination Skills for Videoendoscopic Surgery

Evaluation of eye-hand coordination skills in relation to experiential human factors may lead to improved instruction for videoendoscopic surgical skills acquisition. Twenty-nine subjects (medical students or residents in surgical specialties) volunteered to perform three exercises of increasing complexity in an "inanimate" trainer system that simulated the eye-hand coordination tasks inherent in a laboratory videoendoscopic surgical environment. Fourteen subjects participated in a biweekly practice program of 4 weeks duration using an inanimate trainer. Fifteen subjects had no practice on the laparoscopic trainer during the 4 weeks. Both groups were tested after demonstration on three exercises at the beginning and end of a 4 week period and all performed the procedures in solitude. Both groups of subjects increased performance levels (time and accuracy) over the four weeks, but improvement was significantly greater for the practicing subjects. After eight sessions, convergence of performance levels was observed, but plateauing of performance levels was not evident, even with the simple paradigms evaluated. To investigate what factors contribute to learning, subjects were assessed with respect to their surgical experiences, personality, and self-evaluated motor skills. Subjects with prior endoscopic surgical experience, interest in mechanical activities (as measured by the Strong Interest Inventory), or regular engagement in video game play tended to be more skillful initially, but demonstrated less improvement in performance levels after practice than subjects who had lower levels of experience, interest, or video game play. Manual dexterity (as measured by the Purdue Pegboard Manual Dexterity Test) was positively related to the degree of observed improvement. We conclude that "inanimate" videoendoscopic paradigms offer relatively inexpensive and useful training exercises for acquiring basic eye-hand coordination skills. Relevance for animate laboratory skills requirements are probable but can only be inferred. Subjects with manual dexterity skills used in video games may perform better initially in the inanimate videoendoscopic situation but this advantage is shortlived.

Journal Article↗
PubMed1995

HIV agencies: can they evaluate their own services?

This paper describes the development and implementation of self-evaluation methods and guidelines in non-statutory HIV agencies that have been funded by Lothian Health. Two researchers developed this work under the aegis of the Lothian Health Centre for HIV/AIDS and Drug Studies (CHADS). It was implemented in eight agencies providing a diverse range of services. The methodology used included seminars, interviews, and self-evaluation report booklets, which the agencies completed. This process was not designed to be a full evaluation on its own, but rather used in conjunction with independent health board evaluation and monitoring systems. It proved to be an effective system and is currently being used with drug services who have already received an independent evaluation.

Community Health Services↗
PubMed1992

Continuous improvement of nursing practice: experience in Québec.

Health care professionals must be accountable for the quality of their practice and self-regulating professional organizations have the responsibility to ensure that the public receives the best possible care to which it is entitled. Québec's legislation mandates professional corporations to supervise the practice of their members. The nursing profession comes under that legislation and, at l'Ordre des infirmières et infirmiers du Québec, a program of professional inspection has existed since 1976. The philosophy of this program is based on individual and collective responsibility of nurses towards the continuous improvement of their practice and the enhancement of the quality of care they provide. Standards and criteria of competence were elaborated with the participation of groups of nurses, validated by large samples of the population and distributed to all nurses. Evaluation tools were devised and have progressed over the years. The concepts of self-evaluation (Bandura, Am Psychol 33: 344, 1978; Bandura, Prentice Hall, 1986; Knox and MacKay, Nurs Papers/Perspect Nurs 4: 17, 1982) and of self-managed collective development (Payette, Rev québécoise Psychol 5: 104, 1984) have inspired the program, allowing nurses to identify their needs, set priorities and determine their plan of action. A study to evaluate the impact of the program is now in progress. This article will describe the conceptual framework, the method of evaluation, its application, the reactions of nurses as well as some of the results observed concerning the improvement of practice and of quality of care.

Canada↗
PubMed1997

Prevalence and implications of attention-deficit hyperactivity disorder among adolescents in treatment for substance abuse.

OBJECTIVE: Attention-deficit hyperactivity disorder (ADHD) is overrepresented among adults and adolescents in treatment for substance abuse. This study was designed to assess the prevalence of ADHD and to elucidate differences among adolescent substance abusers relative to ADHD symptomatology. METHOD: The Wender Utah Rating Scale and the Self-Evaluation (Teenager's) Self-Report were used to evaluate childhood history of ADHD and current symptoms, respectively, and the Child Attention Problems Scale was completed by treatment program clinicians. A quantitative substance use history and a subjective substance use interview were also administered. RESULTS: A total of 50% of 14 females and 16 males, ranging in age from 14 to 19, met study criteria for ADHD. ADHD subjects began drug use at an earlier age, had more severe substance abuse, and had a more negative self-image prior to drug use and improved self-image with drug use. They experienced more negative affective responses related to substance use and more drug craving and attentional difficulties in treatment than control subjects. CONCLUSIONS: The results support a substantial comorbidity of ADHD among adolescent substance abusers, with indications of drug use for self-medication. Counseling for ADHD and medication may be indicated to improve treatment outcome and future functioning.

Adolescent↗
PubMed1997

Prediction of success from a multidisciplinary treatment program for chronic low back pain.

STUDY DESIGN: The study included 90 disabled patients with chronic low back pain recruited from a pain clinic who were admitted to an 8-week program of functional restoration and behavioral support. Initial evaluations included a medical examination, rating of the physical impairment, a personal interview, a visual analogue scale to record pain intensity, an assessment of limitations for daily activities, a pain disability index, a depression and psychovegetative scale, and a scale to evaluate general living standards. The physical assessment included different flexibility measurements, measurement of power and endurance through standardized exercises, and measurements of isokinetic trunk and lifting strength and general endurance. The measurements were repeated at the end of the 8-week program and thereafter an intervals of 6 and 12 months. Final analyses were carried out on 82 patients. OBJECTIVES: To determine whether objective or subjective signs most influence the outcome of rehabilitation. SUMMARY OF BACKGROUND DATA: In recent years, several studies have shown that active and intensive multimodal treatment of chronic low back pain is successful. Until now there has been lack of information about which patients will respond to the therapy and what is the most effective part of treatment. METHODS: Prognostic factors (return to work, pain intensity, self-assessment of treatment success by patients) were tested by studying variance and regression analyses for their ability to predict treatment outcome. RESULTS: Certain factors were identified that had a significant impact on determining the probability of a patient's return to work and the reduction of pain intensity. These factors included self-evaluation for predicting a return to work, the length of absence from work, application for pension, and a decrease is disability after treatment. Overall satisfaction with treatment was best determined by the number of medical consultations before treatment, the extent of disability, previous measures taken for coping with the disease, and reduction of disability during treatment. Medical background, medical diagnosis, and physical impairment had no predictive value. Physical variables (i.e., mobility, strength, endurance, and physical performance) also demonstrated only limited predictive value. CONCLUSION: This study has demonstrated that the most important variable in determining a successful treatment of chronic low back pain is the reduction of subjective feelings of disability in patients.

Adult↗
PubMed1986

Evaluation of family therapy trainees: acquisition of cognitive and therapeutic behavior skills.

In this study, which describes the evaluation of a structural family therapy training program, we developed an evaluation procedure that can be used with other similar training programs. Trainees were evaluated before and after training as to their improvement in cognitive, case-planning and in-therapy intervention skills. Results suggest a progression of skill learning, beginning with cognitive understanding, followed by case planning, and then intervention skills. Though trainees made significant progress in cognitive and planning skills, this was not the case with intervention skills. Trainees' self-evaluations were similar to their results on other measures.

Curriculum↗
PubMed1986

Longitudinal evaluation of a self-inspection plaque index in periodontal recall patients.

This paper presents a controlled clinical trial to compare the effects of 2 programs for maintenance of oral hygiene after periodontal treatment. Oral hygiene instruction using a self-inspection plaque index was compared to traditional instruction using professional monitoring of disclosed plaque. 31 periodontal recall patients were randomly assigned to 2 groups. 15 patients in the self-inspection group were provided a manual that taught scoring of disclosed plaque on 6 teeth, a lighted dental mirror, and disclosing wafers. 16 patients in the traditional group were shown disclosed plaque in their own mouths, and were given feedback regarding oral hygiene skills. Instruction was given initially, at 2 weeks, at 1.5 months and at 3 months. The teeth were scaled at the start and at 3 months. Disclosed dentogingival plaque (before and after brushing), gingival bleeding on probing, and oral hygiene skills were assessed at 0, 1.5, 3 and 6 months. Initial mean plaque scores for only the self-inspection group decreased significantly at 1.5 months and were maintained throughout the study; however differences between groups were not observed at any time except at baseline. Gingival bleeding scores were low throughout the study for both groups. Results provide some evidence for the effectiveness of self-evaluation of disclosed plaque as a means for improving oral hygiene behavior in already-motivated patients.

Adult↗
PubMedDate not supplied

The role of the Health Belief Model in amputees' self-evaluation of adherence to diabetes self-care behaviors.

This study involving 76 amputated patients with non-insulin-dependent diabetes mellitus examined the relationship between their beliefs regarding diabetes and its treatment and their self-evaluation of adherence to diabetes self-care behaviors. Descriptive results showed a high level of adherence to medication, foot care, and blood glucose testing, and a low level of adherence to diet and exercise. The correlative analysis revealed significant relationships between perceived social support and adherence to diet, and between perceived social support, barriers, and adherence to the practice of exercise. The regression analysis showed a significant influence of perceived social support on adherence to diet. The same relationship was observed for the influence of perceived social support and barriers on adherence to exercise. Findings support the importance of giving more attention to patients' needs regarding adherence to diet and exercise, improving social support, and removing barriers to patients' treatment. After an amputation it is important to provide patients with an appropriate diabetes teaching and follow-up program.

Adult↗
PubMed1991

A simple guide for design, use, and evaluation of educational materials.

Few health workers in Latin America are trained in how to produce effective and appropriate health education materials. In order to provide an instrument and a strategy to help overcome this problem, the Pan American Health Organization developed an effective methodology to orient the design, use, and evaluation of health education materials. This article describes the development of this methodology and summarizes the basic operating principles and criteria for evaluation. These operating principles include developing educational materials from the community perspective, ensuring that they are an integral part of a health education program, relating them to health services delivery, pretesting the materials, and distributing instructions for use along with these materials. An evaluation scale helps health personnel assess materials that have been designed elsewhere and decide if they would be appropriate for their own target audiences. The scale also promotes self-evaluation by the community in the development of its own materials. This simple and straightforward methodology has been successfully applied in courses and seminars as well as in the design, use, and evaluation of health education materials throughout Latin America.

Evaluation Studies as Topic↗
PubMed1991

Home visiting outcomes and quality of life measures.

Public Health agencies are faced with the task of self-evaluation. For years, they have evaluated themselves solely through utilization as demonstrated by the numbers of patients that they have served. A new thrust is to change the methods of evaluation by devising and implementing a quality assurance (QA) system. Traditional QA systems focus on acutely ill patients and are based on the medical model. In contrast, public health focuses on well or chronically ill patients with services that involve mostly palliative treatment, disease prevention, and/or health promotion. The criteria used by hospitals do not apply. Thus, public health agencies are forced to review their standards and develop criteria applicable to public health. This re-examination of public health can stimulate new ways of viewing old programs and therefore, elicit information that has never been gathered before.

Baltimore↗
PubMed1979

Self-control training in the classroom: a review and critique.

Self-control training in classroom settings is becoming widespread. Establishing effective self- rather than externally controlled behavior modification programs in schools would enable children to control their own academic and social behavior, while enabling teachers to devote more time to teaching. The following components of self-control are reviewed in the present article: self-recording, self-evaluation, self-determination of contingencies, and self-instruction. Self-control strategies designed for the maintenance of appropriate classroom behavior, and issues associated with self-control training, such as the reliability of self-observation, response maintenance, generalization, and the role of external control, are examined. Finally, suggestions for maximizing the potential effectiveness of self-control training in the classroom (e.g., teaching self-observational procedures, teaching students to provide themselves with instructions and praise), as well as future areas for experimental investigation (e.g., social changes that may be associated with self-control procedures), are presented.

Adolescent↗
PubMed1983

A participative management approach for improving direct-care staff performance in an institutional setting.

The present study evaluated a participative management approach for increasing the frequency of interactions between institutional staff and severely/profoundly retarded residents. The participative management approach involved teaching staff how to use self-monitoring, standard setting, self-evaluation, and self-reinforcement procedures. These procedures were then used by staff with minimal involvement of supervisory personnel. Although supervisors provided feedback and praise to staff for using these self-management behaviors, feedback and praise were never dispensed contingent on staff interactions with residents. Results indicated that during the participative management program there was an increase in staff interactions that were contingent on appropriate resident behavior. The increase in this type of staff interaction was accompanied by an increase in appropriate resident behavior. Follow-up data on both staff and resident behaviors, although showing moderating trends, suggested generally good maintenance of the initial behavior changes. Acceptability data suggested that staff were quite receptive to the program. The advantages of participative management procedures for improving staff performance in residential settings are discussed.

Adolescent↗
PubMed1988

A simple system for auditing the quality of primary care screening in school-age children.

A system for auditing quality of care and increasing effectiveness was applied to a health screening program for school-age children and the results were analyzed during 2 subsequent years. A problem-oriented record to be filled in whenever the screening was positive represented the basic tool for the evaluation. The record was sent to the specialist who was requested to make a diagnostic assessment and a treatment plan. The same record returned back to the first-level staff thus providing feedback information about diagnostic accuracy and effectiveness of the screening. Periodic self-evaluation meetings and a tutorial system for diagnostic procedures were instituted leading to a general improvement in quality indexes.

Adolescent↗
PubMed1986

Techniques for managing the self-study.

Accreditation is a status frequently sought by institutions and programs. It is also a process that includes a self-study, an on-site visit, and a survey report. The need for self-evaluation as part of the accreditation process is well documented. Many institutions have difficulty initiating the activity of developing the self-study. This article attempts to provide assistance in preparing the self-study. It outlines the basic steps of accreditation and provides a checklist for accreditation activities. Finally, it offers suggestions for carrying out this essential component of the accreditation process.

Accreditation↗
PubMed1978

Performance documentation: how to confirm a resident's progress.

Family medicine faculty members are accountable for the quality of training and the level of proficiency that residents attain. Determination of board certification and hospital privileges is dependent on technical and affective skills as well as cognitive testing. Self-evaluation and self-education behaviors will result from placing the responsibility for documentation of satisfactory performance with the resident. "Performance documentation" is defined as those parts of an evaluation system combining a cumulative record of patient care experiences with proficiency ratings indicating performance at or above the criteria specified in a program's behavioral objectives.

Education, Medical, Continuing↗
PubMed1994

[A vocal treatment plan for voice disorders after phonosurgery--a preliminary study].

In this study, twenty-five subjects have received phonosurgery of benign vocal pathology but persistent voice disorders postoperatively, characterized by a hoarse, low-pitched, soft voice or efforted phonation. Each subject had filled out a self-evaluation questionnaire of vocal behaviors before surgery and his vocal cords examined by ENT doctor with indirect laryngoscope or direct fiberscope. Voice evaluations was done based on perceptual and acoustic parameters preoperatively and postoperatively. Twenty-five subjects were grouped into three post-operative vocal rehabilitation programs: voice rest group, vocal hygiene group, and direct voice therapy group. The criteria in grouping were according to the subjects' amount of vocal use, environmental pressures, vocal abuse or misuse behaviors and time flexibility. The therapy strategies included reducing amount of vocal use, changing life style, analyzing environmental pressures and treating voice problems with established facilitating techniques. The post-surgical vocal rehabilitation program lasted three to six months. Each subject's voice parameters were reevaluated six months after surgery. The results of three vocal rehabilitation groups were compared with those before rehabilitation. The implication of this study is to provide a holistic voice treatment plan and obtain better surgical intervention results.

Adult↗