Year of degree and psychologists' attitudes toward peer review.

Examined survey data on the American Psychological Association/Civilian Health and Medical Program of the Uniformed Services reviewers' and psychological providers' attitudes toward peer review to uncover differences as a function of respondents' degree date. 262 and 270 each of 2 questionnaires were returned by reviewers, and 551 questionnaires were returned by psychologists. Compared to the later-degreed providers, the earlier-degreed providers were less supportive of involving the patient in the treatment plan and having the patient rate his/her progress on the treatment report. Compared to the later-degreed respondents, the earlier-degreed providers and reviewers were less critical of the exclusion of benefits for such services as biofeedback and sex therapy. (8 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Neuronal signals are required for estrogen-mediated induction of progesterone receptor in cultured rat Schwann cells

This paper presents a methodology for estimating costs of delivering specific substance abuse treatment services. Data collected from 13 programs indicate that the mean cost of residential treatment is $2,773 per patient per month, and outpatient treatment costs average $636 per patient per month. Data are presented on the cost patient per month for individual treatment and nontreatment services, average number of services, cost per unit of service, and intensity of services. In addition to their application to insurance benefit cost estimation, these data illustrate the costing of best-practice adolescent treatment consistent with a Center of Substance Abuse Treatment (CSAT) Treatment Improvement Protocol. In the emerging policy environment, detailed cost estimates like these will aid the design of cost-effective treatment programs, and serve the development of the substance abuse benefit in a health care reform insurance package.     

The provision of orthodontic services by general dental practitioners. 1. Methods and descriptive results

Information regarding orthodontic service provision by general dental practitioners in Australia is limited. The aim of this survey was to determine the amount and variety of orthodontic services provided by general dental practitioners in the Melbourne Statistical Division, Victoria, Australia. A random sample of 307 dentists drawn from the Victorian Dentists Register was surveyed by mailed questionnaire: 218 (71%) replied. Data were collected using a fortnight log. During this time 59 per cent of the dentists saw at least one orthodontic patient; one dentist saw 66 orthodontic patients. Removable orthodontic appliances were used by 35 per cent of the dentists and fixed orthodontic appliances by 18 per cent. Twenty-six per cent provided comprehensive orthodontic treatment, 22 per cent aligned incisors, and 21 per cent corrected anterior crossbites. The general dental practitioners surveyed provided a wide range of preventive and interceptive orthodontic services to generally a small percentage of their patients.     

The perceived influence of clinical pharmacy services on physician prescribing behavior: a matched-pair comparison of pharmacists and physicians

In contrast with cross-sectional designs used in previous studies, this exploratory study compared survey data from 127 matched pairs of clinical pharmacists and physicians working together. Physicians' perceptions of the importance of clinical pharmacy activities for patient care and the competence of pharmacists performing the activities were examined for their influence on prescribing behavior in an institutional setting. Data from a national survey showed that physicians rated pharmacists higher regarding recommendations based on drug use evaluations (p = 0.004) and competency to provide all clinical pharmacy services. Scores for pharmacokinetics ratings were similar between pharmacists and physicians (p = 0.168). Pharmacists rated the importance of recommendations based on cost-effectiveness higher than physicians (p = 0.012). Overall, physicians' perceptions of activity importance for patient care and pharmacist competency appear to dictate pharmacists' influence on physician prescribing behavior (R = 0.723).     

Social factors influencing female swimming performance

A National Tuberculosis Treatment Survey was instituted in the Republic of Singapore in 1969 with the aim of evaluating the Tuberculosis Treatment Services in Singapore. This five-year follow-up study of the 1969 survey was based on the assessment of the first 1000 consecutive patients who were registered for treatment during the year. Two hundred and forty-six cases were excluded for various reasons, leaving 754 cases for analysis. At the end of 5 years, only 2 (0.3%) were culture positive, 677 (89.8%) were culture negative, 48 cases (6.4%) had died from tuberculosis and 27 cases (3.6%) were lost. The most notable factor which influenced bacteriological positivity was lack of co-operation leading to interruption of chemotherapy. It is concluded that with an efficient organisation highly satisfactory results can be achieved by routine treatment services and prolonged observation of adequately treated patient is not necessary.     

Stroke services in general practice--are they satisfactory?

BACKGROUND: The contribution of general practice and primary care teams to stroke care has received surprisingly little attention despite research evidence on the importance of coordinated care. AIM: To determine general practitioners' (GPs') and their patients' satisfaction with hospital and community services for stroke patients in Grampian Region, Scotland. METHOD: A questionnaire survey of 138 stroke patients and their GPs was carried out six weeks after each patient was discharged home between June 1995 and January 1996. Outcomes measured were GP and patient satisfaction with services, Barthel Index, Hospital Anxiety and Depression scores, London Handicap Score, and Homsat and Hospsat scores (satisfaction with stroke services). RESULTS: Response rates of 95% (131) for GPs and 91% (125) for patients were obtained. GPs and patients were generally satisfied with services. Stroke patients were more likely to have had contact with their GP than with any other service. Adverse comments from GPs focused on problems with hospital discharge letters. At six weeks, patients received an average of 2.5 community services and 1.5 hospital services, but there was wide variation across disability groups. CONCLUSIONS: Levels of satisfaction were high, but the wide range and variation in services used by patients emphasized the complexity of the primary care of stroke patients; the need for coordination, review and effective links with hospital; and the key role of the GP.     

Socioeconomic status and traditional treatment approaches reconsidered.

Notes that while mental health services and research with traditional therapies are scarce, innovative treatment approaches are employed increasingly with low-income patients. It is suggested that pertinent data must be carefully considered lest the present trend produce separate and unequal services for various social groups. While socioeconomic status appears to be a significant correlate of acceptance for, and duration of, individual psychotherapy, it does not relate to treatment outcome. Clarification of this discrepancy requires a more precise identification of the social groups comprising the "lower-classes," a clearer understanding of the environmental demands faced by such patients, and an objective assessment of specific socioeconomic status factors that may exclude a given patient from a given treatment. It is concluded that resolution of such issues is necessary for a realistic allocation of available mental health services. (75 ref.) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

A clinical sample of Maori being treated for alcohol and drug problems in New Zealand

AIMS: To document key clinical characteristics of a group of Maori being treated for alcohol and drug problems; compare the characteristics of Maori accessing dedicated Maori alcohol and drug treatment services with Maori accessing non-dedicated services; and investigate these clinical characteristics in relation to patient satisfaction. METHODS: A sample of 105 Maori with alcohol and drug problems, accessing the range of treatment services in the Canterbury area, undertook a semi-structured interview. RESULTS: Overall this sample of Maori were socially disadvantaged. Their main drug of use was alcohol, followed by cannabis, opioids and sedatives/hypnotics. There were no significant differences between the subjects who attended Maori dedicated services and those who attended non-dedicated Maori services in terms of demographic variables, alcohol and drug use history, current level of dependence, or anxiety/depression state. Subjects in dedicated Maori services were more likely to have had greater than 21 days of treatment compared to those in non-dedicated Maori services and were more likely to have been to their home marae than those in non-dedicated services. In multivariate analysis, Maori in dedicated Maori services were significantly more likely to be satisfied with treatment than those in non-dedicated services (odds ratio = 5.5, 95% confidence interval = 1.81-16.78). CONCLUSION: Further research is required to investigate the relationship between high patient satisfaction by Maori with alcohol and drug problems attending dedicated Maori treatment services, treatment effectiveness and the components of dedicated Maori services that may contribute to higher retention rates, greater patient satisfaction and increased positive treatment outcome.     

A longitudinal study of schoolchildren's experience in the North Carolina Dental Medicaid Program, 1984 through 1992

OBJECTIVES: This evaluation of a state Medicaid dental program describes dental treatment received, relates treatment needed to treatment received, and describes enrollment and use over an 8-year period. METHODS: Three databases were linked: (1) clinical records from a 1986/87 statewide epidemiological survey, providing data on treatment need; (2) Medicaid dental claims from 1984 through 1992, providing data on treatment received; and (3) Medicaid enrollment files from 1984 through 1992. RESULTS: Half of Medicaid-enrolled children never used dental services. Among users of dental services, 45% and 25% of children needed restorations in primary and permanent teeth, respectively. In this group, 29% had all needs met, 28% had needs partially met, and 43% had no needs met. Forty-six percent of children sought care for only 1 year. CONCLUSIONS: Federal guidelines for dental care are not met in this typical Medicaid population of short-term enrollees who use services sporadically. Programs should aim to increase use and ensure that all needed services, especially preventive procedures such as sealants, can be completed within the short period of time a child attends for care.     

Psychological services provided within Veterans Administration nursing homes.

[Correction Notice: An erratum for this article was reported in Vol 17(5) of Professional Psychology: Research and Practice (see record 2008-10955-001). In this article, the copyright information was incorrect. The correct copyright information is included in the erratum.] Surveyed the nature and scope of psychological services provided within 67 Veterans Administration nursing facilities to examine the emerging professional domain of the nursing home psychologist. Data regarding service delivery models, use of time, assessment and treatment services, multidisciplinary team activities, staff and student training, and research are provided. The profile of the ideal nursing-home psychologist that emerges from this survey is that of a well-rounded psychologist capable of rendering a full range of assessment, treatment, and consultative services while also functioning as a treatment team member, a teacher, a program developer, and a researcher. (40 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Patient satisfaction. The survey says...

Health care organizations and providers compete in a marketplace where loyal consumers are essential to a successful business. Contemporary consumers have health care knowledge and power. As employers negotiate benefits with providers, most will consider input from employees receiving care. Negative feedback from dissatisfied recipients of care can affect employers' selection of facilities and providers. This is significant leverage that health care organizations should consider when providing services to customers. Information obtained through patient satisfaction programs has proven to be a valuable source for quality improvement marketing, risk management, strategic planning, and finance initiatives. In this article, the authors describe variables associated with a patient satisfaction survey, identify key elements of a patient satisfaction survey program, and offer workable solutions to maximize patient satisfaction programs.     

Interpreter use in an inner city accident and emergency department

OBJECTIVE: To determine the extent of communication problems that arose from patients whose primary language was non-English presenting to an inner city accident and emergency (A&E) department. METHODS: A prospective survey over seven consecutive days during September 1995. All adult patients other than those directly referred by their general practitioner to an inpatient team had a questionnaire completed by the A&E doctor first seeing the patient. The doctor recorded language ability and form of interpreter used, and estimated any prolongation of the consultation and ability to improve communication by the use of additional services. RESULTS: 103 patients (17%) did not speak English as their primary language; 55 patients (9.1% of the study population) had an English language ability rated as other than good, and 16 (29%) of these consultations could have been improved by the use of additional interpreter services; 28 patients overall (4.6% of the study population) required the use of an interpreter, who was usually a relative. CONCLUSIONS: A significant number of patients presenting to A&E have difficulty in communicating in English. These consultations could often have been improved by the use of additional interpreter services. Telephone interpreter services may provide the answer for use in A&E departments because of their instant and 24 hour availability.     

Goal definition by staff consensus: A contribution to the planning, delivery, and evaluation of mental health services.

To provide a basis for the evaluation of VA mental health services, a survey was conducted of staff opinion regarding the importance of several specific goals for these services. Nine goals were formulated and submitted to 6,435 central office and field facility staff to obtain their ratings of each goal's importance, with an "of no importance" rating being possible. The goals dealing with (a) the development of patient skills necessary for being self-supporting, (b) the elimination of psychological disorders, and (c) the protection of patients and others from violence received the highest average ratings. The remaining goals were considered as having some importance although there were substantial differences among the sample about the degree. Interoccupational group differences in importance ratings were statistically significant but small. Although the goals formulated and ratified by staff were general, they were more specific than previous goal statements. It is suggested that because of this relative specificity, they provide useful guidance for planning, managing, delivering, and evaluating mental health services. (14 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Similarity of outcome predictors across opiate, cocaine, and alcohol treatments: Role of treatment services.

This study examined the patient and treatment factors associated with 6-month outcome in 649 opiate-, alcohol-, and cocaine-dependent (male and female) adults, treated in inpatient and outpatient settings, in 22 publicly and privately funded programs. Outcomes were predicted by similar factors, regardless of the drug problem of the patient or the type of treatment setting or funding. Greater substance use at follow-up was predicted only by greater severity of alcohol and drug use at treatment admission, not by the number of services received during treatment. Better social adjustment at follow-up was negatively predicted by more severe psychiatric, employment, and family problems at admission and positively predicted by more psychiatric, family, employment, and medical services provided during treatment. (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

"Psychological services provided within Veterans Administration nursing homes": Correction to Kupke.

Reports an error in "Psychological services provided within Veterans Administration nursing homes" by Thomas Kupke (Professional Psychology: Research and Practice, 1986[Jun], Vol 17[3], 185-190). In this article, the copyright information was incorrect. The correct copyright information is included in the erratum. (The following abstract of the original article appeared in record 1986-28163-001.) Surveyed the nature and scope of psychological services provided within 67 Veterans Administration nursing facilities to examine the emerging professional domain of the nursing home psychologist. Data regarding service delivery models, use of time, assessment and treatment services, multidisciplinary team activities, staff and student training, and research are provided. The profile of the ideal nursing-home psychologist that emerges from this survey is that of a well-rounded psychologist capable of rendering a full range of assessment, treatment, and consultative services while also functioning as a treatment team member, a teacher, a program developer, and a researcher. (40 ref) (PsycINFO Database Record (c) 2010 APA, all rights reserved)     

Use of health services for anxiety disorders: a multisite study in Quebec

OBJECTIVE: We investigated patient characteristics and use of services for anxiety disorders among patients seeking care from participating clinicians at 7 anxiety clinics in Quebec: 3 general hospital clinics, 3 psychologist-run clinics, and one psychiatric hospital clinic. METHODS: Persons eligible for the study were those who were visiting the clinics for the first time, had a current diagnosis of an anxiety disorder, and could communicate in French or English. Subjects recruited through advertisements were excluded. Data, collected by a self-administered questionnaire, included demographics, treatment history, use of services for anxiety, and the Beck Anxiety Inventory (BAI). RESULTS: The sample comprised 235 subjects: 146 seen at 3 general hospital clinics, 54 at 3 psychologist-run clinics, and 35 at a psychiatric hospital clinic. There were statistically significant differences by clinic type in the prevalence of specific anxiety diagnoses, BAI score, referral source, antidepressant use, and use of services. High-intensity use (10 or more consultations during the previous year) was reported by 23.4% of the sample for medical services and 19.6% for mental health services. Multiple logistic regression identified variables associated with high-intensity use of medical services (higher BAI score, 1 to 4 years since first sought treatment, and less than 12 years of education) and high-intensity use of mental health services (clinic type, obsessive-compulsive disorder [OCD], and 5 or more years since first sought treatment). CONCLUSIONS: The patient populations seen at different types of anxiety clinics differ in several respects, including referral source, previous treatment, and severity of symptoms. Regardless of type of clinic, patients with a longer time since they first sought treatment use more services, particularly mental health services. Those with less education use more medical services than those with greater education.     

A telephone survey of day-surgery eye patients

The objective of this research study was to evaluate the nursing care processes and patient satisfaction with the new day-surgery services. Forty-five adult day-surgery eye patients were selected at random to take part in a telephone survey. The response rate was 84.4% (38). Patients were contacted 48 hours post-surgery to obtain their view of the entire surgical experience. The research result found that the majority of the patients were satisfied with the day-surgery services. The main problems experienced by patients were long waiting times to see the doctor during pre-operation assessment, unsatisfactory journeys to and from theatre, and difficulty in remembering verbal advice. Twenty-eight (73.6%) of the day-surgery patients would prefer day-surgery again for a similar operation, but 10 (26.3%) would prefer a longer stay in hospital. The main implications for practice are that realistic assessment time should be allocated to reduce waiting time, verbal advice should be accompanied by written leaflets or audio-tape, and patients should be encouraged to make an informed choice about day or in-patient surgery. A regular survey of day-surgery eye patients should be part of a general audit.     

Sexual abuse treatment for persons with developmental disabilities.

Recent research by the Sexual Abuse and Disability Project at the University of Alberta included a survey of 119 sexual abuse (SA) victims with developmental disabilities (DDs). Their responses indicated that SA treatment services for people with DDs are typically inaccessible, unavailable, and inappropriate. Inadequate treatment services appear to be due to the paucity of qualified professionals in the area of SA and DDs coupled with the slow development of appropriate SA treatment approaches. The application of adapted therapy approaches for people with DDs and examples of adapted SA treatment for children and women abused as children are presented. SA treatment issues for the developmentally disabled are discussed for practitioners' considerations. (PsycINFO Database Record (c) 2010 APA, all rights reserved)