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Rehabilitation and the client with epilepsy: a survey of the client's view of the rehabilitation process and its results.

A survey of epileptic clients of the Maryland State Department of Vocational Rehabilitation was conducted to evaluate the success of the rehabilitation process from the client's point of view. Less than half had become employed, 70% had continuing seizures, most had psychosocial problems. Recommendations are made as to how the rehabilitation process could better serve persons with epilepsy.

Adolescent↗

[Prevalence of HIV in clients of an outpatient clinic for sexually transmissible diseases and in a group of prostitutes and their clients].

In order to gain insight into the heterosexual spread of HIV infections in Amsterdam, a study was carried out in 1991 among persons attending an outpatient clinic for sexually transmitted diseases (STD) and among a group of prostitutes and prostitutes' clients. Out of 2362 persons attending the STD clinic, 2138 (90.5%) could ultimately be examined for presence of HIV antibodies. The HIV seroprevalence was 4.2% (90/2138); among homosexual males it was 22% (70/324), among heterosexual male intravenous drug users 12% (2/17) and among heterosexual males who never had used i.v. drugs 0.5% (5/997). The HIV seroprevalence among female intravenous drug users was 41% (12/29) and that among females who never had used i.v. drugs it was 0.1% (1/771). Among the heterosexually active subjects (active in the preceding six months, including the groups of bisexual males and intravenous drug users), the seroprevalence amounted to 1.5% (28/1884). HIV antibodies could be demonstrated in 1.5% (3/199) of the prostitutes and in 0.5% (1/213) of prostitutes' clients. However, the one positive male had had homosexual contacts in the past. Out of the total of nine heterosexually infected persons, two originated from the Netherlands, two from Ghana, two from Turkey, one from Nigeria, one from Pakistan and one from the Dominican Republic; six of them had commercial contacts. The heterosexual spread of HIV among the heterosexual population of Amsterdam can for the moment be classified as slight. However, further heterosexual transmission of HIV cannot be excluded, considering the frequency of unprotected sex.

Cohort Studies↗

Client outcomes II: Longitudinal client data from the Colorado treatment outcome study.

The outcomes of a reform of the Denver mental health system, cosponsored by the state and the RWJF, are contrasted with changes in a comparison area of the state. The study examines the structural characteristics of the mental health system, staff attitudes and satisfaction, and client-reported services and outcome. Results indicate that, in Denver, structural changes, the introduction of new services, and an intervening financial crisis increased worker dissatisfaction. Client reports documented parallel changes in the following variables: continuity of care, unmet need for case management services, frequency of symptoms, and satisfaction with services. The reform had no impact, however, on most quality-of-life indicators. The possibly adverse consequences of centralizing the system and the indirect influences of system integration on quality of life are discussed.

Adult↗

Person drawings by transsexual clients, psychiatric clients, and nonclients compared: indicators of sex-typing and pathology.

The drawings by 31 transsexual clients, 61 psychiatric inpatients, and 62 nonclient college students were compared to derive information about whether they differed with regard to sex-typing and psychopathology. Transsexuals did not differ from nonclients or psychiatric patients as far as their conceptualization of masculinity is concerned, nor are they more or less sex-role stereotyped. However, their conceptualization of femininity of women differs significantly from that of the other groups in that transsexuals view women as more feminine than either of the other groups. Finally, transsexuals differed from both nonclients and psychiatric patients in inconsistent patterns across other variables, indicating that they are neither similar to nonpathological controls, nor to psychiatric inpatients. This uniqueness of the transsexual group is discussed in the context of multiple possible interpretations.

Adult↗

Clients' perceptions of client-nurse relationships in local authority psychiatric services: a qualitative study.

The Mental Health Care reform in Sweden aimed, among other things, to improve the possibilities for persons with mental illnesses to experience companionship and participation in society. The aim of the study was to describe how persons suffering from mental illness perceive their relationships with nursing staff in local authority psychiatric services. Data were collected through semi-structured recorded interviews with 17 strategically chosen clients. A qualitative approach inspired by phenomenography was used to analyse the data. The analysis resulted in four main categories and 13 subcategories. The main categories were: security, companionship, confirmation and development.

Adult↗

When the client is armed or dangerous: management of violent and difficult clients in primary care.

Health care settings and providers are not immune to violent or disruptive behavior by clients or by strangers off the street. Verbal abuse and threats of violence can escalate to physical attacks directed against health care practitioners. This article discusses the management of violent or dangerous patients in the primary care setting. Characteristics of potentially violent patients are reviewed, along with assessment clues useful in predicting violent behavior. Specific interventions to counteract or diffuse a potentially violent situation are proposed.

Adult↗

Visit to suit the client not the system. Obtaining clients' views on district nurse visiting times.

1. Research, as well as personal experience, shows that clients and carers frequently find the visiting times of district nurses and other professionals inappropriate. 2. The study aimed to discover when clients/carers would prefer to schedule a district nurse's visit. 3. A questionnaire may not be a satisfactory method of critically appraising a district nursing service.

Community Health Nursing↗

Advocating for clients: successful case management when clients retain an attorney.

Have you ever been driving comfortably along a highway and suddenly noticed, looming in the mirror, a very large truck coming up the road? The sight can be startling. Although you do not need to panic or pull off at the next exit, a bit of increased alertness, a review of defensive driving basics, and preparation for possible turbulence is more than appropriate.

Case Management↗