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Occupational therapy program development for medical-psychiatry units: a cognitive model.

Occupational therapy programs form an essential component of the overall treatment program on medical psychiatry units for patients with depression, physical debilitation, and cognitive dysfunction. This article outlines theoretical and practical aspects of developing an occupational therapy program for medical-psychiatric inpatients. Emphasis is placed on accurate assessment of cognitive and physical functioning to facilitate stratification of patients into appropriate therapeutic activities that are commensurate with their level of functioning. The theoretical basis and orientation of occupational therapy is also discussed vis-à-vis its relevance to the treatment of patients with concurrent medical and psychiatric illness.

Adolescent

Liver transplantation at UCLA. Program development, organization, initiation, and early results.

The development of a liver transplantation program requires a multidisciplinary approach which can only be provided in a large tertiary referral medical center. Preparation for the clinical program involves training of all team members, both in the animal laboratory and at an established liver transplant center. A special commitment from the medical center to the program is essential and involves medical, nursing, and administrative divisions, blood bank, social service, and operating room personnel, and intensive care unit facilities. With careful planning, a successful liver transplant program can be realized from the onset. In the first 2 years of UCLA's liver transplant program, 62 transplants in 50 patients were performed. The overall survival rate was 72 percent with no operative deaths. Thirty-four of 36 surviving patients have returned to useful, productive lives after orthotopic liver transplantation.

Actuarial Analysis

Identifying nursing research priorities: a first step in program development.

This study determined nursing research priorities and focused on the development of a nursing research program within a single institution. Of the 715 nurses within the Department of Nursing, 286 (40%) responded to the first round of a two-round Delphi technique, and 137 (48%) responded to the second. The following clinical priorities were determined: prevention and treatment of pressure sores, pain management, treatment of nosocomial infections, and patient education. Nonclinical priorities included staffing and its effects on turnover and patient care, job satisfaction, and factors influencing the quality of nursing care. Serendipitous findings underscored the relevance of the Department of Nursing's conceptual framework to nursing practice and research, revealed the need for dissemination of current research results, and suggested that nurses want to participate in research without assuming responsibility beyond their expertise.

Delphi Technique

Geriatric training in family medicine: the natural history of a developing program.

During the past three years, the Duke-Watts Family Medicine Program and the Duke University Center for the Study of Aging and Human Development have developed training in geriatric medicine as an integral part of the family medicine residency program. This paper traces the following steps in the development of this program: a survey of resident and faculty interest, institution of a conference series, identification of potential training sites, development of elective rotations, and use of consultants. Principles found helpful in establishing training in geriatrics for family medicine residents include the following: involve residents in planning, start with modest goals, make the program relevant and practical, build on local strengths, include other health care professional trainees, and use ambulatory, acute hospital, and long-term care sites in the training rpogram.

Curriculum

Educating blue collar workers: the challenge of program development.

1. Blue collar workers are less likely than other workers to participate in worksite health programs. 2. Effective health intervention methods require an understanding of factors that influence a worker's decision regarding participation. 3. Negative factors can be transformed into opportunities to encourage healthy behavior. 4. Meaningful education can develop within workers a sense of empowerment that they possess the capacity to modify health practices.

Educational Status

Resident, faculty, and residency program development. An integrated approach through annual retreats.

Retreats during residency training have evolved as an escape from the daily routine. Recognizing that the retreat format could also be used as a foundation for program design and personal development, we have designed annual retreats for each of the 3 years of pediatric residency training. The sessions vary in length and agenda, but serve as the basis for an ongoing effort fostering growth and maturation of the department and its component participants. The effectiveness of the program (and the morale of the residents) is greatly influenced by this program.

Chicago

Launching a multidisciplinary staff development program for liver transplantation.

This article describes a collaborative effort between specialty areas at a large urban medical center to develop a comprehensive liver transplant educational program. The historical overview, needs assessment, and program planning are discussed. The implementation, planning, and evaluation phases are examined. The process presented here can serve as a framework for clinical educators confronted with major new initiatives.

Curriculum

Accreditation of occupational health programs: development and validation of criteria.

Defined standards and a mechanism for evaluation of performance can help promote new and improve existing occupational health programs. Criteria must be based on sound principles, be comprehensive, discriminating and attainable. They should apply to small and large establishments with varying hazards. A successful program requires a multi-disciplinary effort involving physicians, nurses, industrial hygienists, health physicists, safety professionals, managers, technicians and labor. Assessment by on-site peer review is necessary. The criteria and process for their use must be accepted by the professions, labor and management. The Occupational Health/Safety Programs Accreditation Commission plans to use the document entitled Standards, Interpretations and Audit Criteria for Performance of Occupational Health Programs in its accreditation activities. The development and validation of this document and its use are described.

Accreditation

Improving a community preceptorship through a clinical faculty development program.

A department of family and community medicine has successfully used annual conferences to develop the teaching skills of clinical faculty. The conferences focus on specific topics each year, faculty are required to attend, and experienced preceptors are used as facilitators. These conferences have effectively improved the preceptors' abilities as teachers of medical students. This is dramatically illustrated by the increase in measurable objectives on the negotiated learning contracts.

Community Medicine

Institutional child protection: issues in program development and implementation.

As part of a comprehensive inventory of state institutional child protection programs, state protective services offices were surveyed by telephone, self-administered questionnaire, and site interviews regarding the policies, procedures, and protocols of each for handling complaints of abuse and neglect in children's institutions.

Child

[A self-development program for obese female students].

The purpose of this study is to construct and evaluate a self-development programme for obese female students. The important role of psychological factors in the etiology of obesity, affects self-development in the client through methods of growth stimulation, and will promote ego strength to assist in the demands of mass control. A self-development programme is constructed and applied to a group of obese female students. The experimental design comprised a pre, post and post-post evaluation with physical and psychological measuring instruments on an experimental and a control group. No significant changes in body mass occurred. Psychologically the programme promoted self-actualisation in terms of (intrapersonally) increased spontaneity, self-regard, confidence, worthiness and decreased nervousness, and (interpersonally) increased general social adaptation and the capacity for intimate, personal contact. It is recommended that the stimulation of psychological growth be stressed even more in mass control programmes. Also, the contents of this type of programme should be investigated to promote behaviour change over a longer period of time.

Adolescent

Teaching material. Ways to enhance visual aids in staff development programs.

Most nurse educators incorporate some kind of media into their teaching strategies. The widespread availability of professionally developed media resources, however, does not guarantee effectiveness. The ASSURE model was presented as one method of selecting these materials on the basis of their suitability for the subject, the adult learner, and the instructor in achieving the desired educational outcomes. Furthermore, it offers guidelines for modifying or designing materials to be used in settings where media resources may be limited. The ASSURE model can help staff development educators provide effective instruction by making the best use of available media through the use of systematic instructional design principles.

Audiovisual Aids

An intrathoracic left ventricular assist system: utilization of results from a development program.

An intrathoracic, electrohydraulically actuated, left ventricular assist system (LVAS) was subjected to formal device readiness testing. Endurance testing was initiated on eight systems before testing was halted due to failure of four of the systems. Three failed due to environmental leakage. Solutions were straightforward, involving gasket changes and o-ring resizing. The fourth failure involved a magnetic coupling piston swelling and seizing. The failure was attributed, after long investigation, to hydrogen adsorption by the samarium-cobalt magnets. An unknown number of coupling magnets were affected in this fashion, necessitating complete replacement of magnets to resolve the problem. However, this was beyond the scope of the program, and no further endurance testing was accomplished. The test experience of the Nimbus/CCF LVAS has demonstrated all functional aspects of the complete LVAS, both in vitro and in vivo, and the endurance and reliability potential is indicated as well. Although the LVAS program is currently inactive, its legacy of technical innovations continue to drive the development of other medical devices.

Animals

United States National Cancer Institute Radiotherapy Development Program.

The United States National Cancer Institute (NCI) has long supported research in radiotherapy since its establishment by an act of Congress in 1937. One of the first grants for research awarded in 1938 was to support work in developing a cyclotron for conducting clinical research on therapeutic uses of neutrons and radioactive isotopes. Support for training cancer specialists was given high priority in the early days of NCI. In 1961, the Cancer Centers Program was instituted which included a radiation research program that became the primary source of grant support for radiotherapy clinical research centers in the US. There is a need for radiotherapy research because approximately 50-60% of people with newly diagnosed cancers will receive radiotherapy at some time during their disease. In 1979, the Radiotherapy Development Branch (RDP) assumed responsibility for all radiation program grants including radiation physics, radiobiology, and radiotherapy. The RDB manages a portfolio of grants and contracts with an annual budget of over $45 million. In fiscal year (FY) 1984, research support for individual investigator grants, program project grants, and contracts amounted to $22, 15, and 6 million, respectively. The accomplishments of NCI research grantees and contractors in radiotherapy-related areas have been considerable over the past 45 years. It is essential that NCI continue its commitment to radiotherapy research and development.

National Institutes of Health (U.S.)

The Commission on Ophthalmic standards--the American Optometric Association's standards development program.

The American Optometric Association has been concerned with ophthalmic standards for over fifty years. This paper describes this involvement and how it has led to the creation of the Commission on Ophthalmic Standards. The commission's scope and function and the responsibilities of the Director of Standards Development are given. The progress of the commission's program has been temporarily delayed due to a proposed FTC rule on voluntary standards setting organizations.

Eyeglasses

Toward program development.

An era of disciplined thinking may result not only in acknowledging but also in addressing those questions that may lead to a consistent examination of existing programs within a profession. This paper is one attemp at encouraging the professional membership to continue to address: 1. the nature and focus of the content and practice environments of the field of Occupational Therapy; 2. two approaches to investigating the distinctive character of the field of Occupational Therapy-the Separate Domain Approach and the Retroductive Approach; 3. and the basic documents developed and/or sponsored by the professional organization-in this case-The Ohio State Study (1), the NIH Study (2), and the Curriculum Guide (3).

Clinical Competence