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Continuing Care (continuing + care)

Distribution by Scientific Domains

Medical Sciences	100%

Terms modified by Continuing Care

continuing care retirement community

Selected Abstracts

Three-Year Chemical Dependency and Mental Health Treatment Outcomes Among Adolescents: The Role of Continuing Care

ALCOHOLISM, Issue 8 2009
Stacy Sterling
Background:, Few studies have examined the effects of treatment factors, including the types of services [chemical dependency (CD), psychiatric, or both], on long-term outcomes among adolescents following CD treatment, and whether receiving continuing care may contribute to better outcomes. This study examines the effect of the index CD and ongoing CD and psychiatric treatment episodes, 12-step participation, and individual characteristics such as CD and mental health (MH) severity and gender, age, and ethnicity, on 3-year CD and MH outcomes. Methods:, Participants were 296 adolescents aged 13 to 18 seeking treatment at 4 CD programs of a nonprofit, managed care, integrated health system. We surveyed participants at intake, 1 year, and 3 years, and examined survey and administrative data, and CD and psychiatric utilization. Results:, At 3 years, 29.7% of the sample reported total abstinence from both alcohol and drugs (excluding tobacco). Compared with girls, boys had only half the odds of being abstinent (OR = 0.46, p = 0.0204). Gender also predicted Externalizing severity at 3 years (coefficients 18.42 vs. 14.77, p < 0.01). CD treatment readmission in the second and third follow-up years was related to abstinence at 3 years (OR = 0.24, p = 0.0066 and OR = 3.33, p = 0.0207, respectively). Abstinence at 1 year predicted abstinence at 3 years (OR = 4.11, p < 0.0001). Those who were abstinent at 1 year also had better MH outcomes (both lower Internalizing and Externalizing scores) than those who were not (11.75 vs. 15.55, p = 0.0012 and 15.13 vs. 18.06, p = 0.0179, respectively). Conclusions:, A CD treatment episode resulting in good 1-year CD outcomes may contribute significantly to both CD and MH outcomes 3 years later. The findings also point to the value of providing a continuing care model of treatment for adolescents. [source]

Continuing care after cancer treatment

JOURNAL OF ADVANCED NURSING, Issue 2 2003
Brian Pateman MA MPhil RN DNT
Background. Despite nearly three decades of debate and policy guidance there is evidence that, in the United Kingdom, patient hospital discharge remains problematic. District nurses, who deliver skilled home nursing care, receive referrals from hospitals for continuing nursing care needs. However, district nurses' expectations of appropriate patient referral from hospitals are not always achieved. In an attempt to improve services after hospital discharge, government policy has emphasized partnership between care providers, highlighting the need for smooth transition between care settings. Aim. To explore hospital discharge and referral procedures for patients with cancer, with particular emphasis on referrals made by hospital nurses to district nurses. Method. In-depth interviews were carried out with nurses actively involved in the discharge process as both referrers and recipients of referrals. Twenty nurses from a regional cancer centre and 20 district nurses from three adjacent primary care trusts were interviewed. Interviews were transcribed and analysed thematically, and themes compared between the two care settings. Conclusions. We conclude that competing sets of expectations, not only between hospital and community nursing settings, but amongst district nurses themselves, are a major factor impeding agreement on referral criteria and satisfaction with the referral process. [source]

Nursing Time Devoted to Medication Administration in Long-Term Care: Clinical, Safety, and Resource Implications

JOURNAL OF AMERICAN GERIATRICS SOCIETY, Issue 2 2009
Mary S. Thomson PhD
OBJECTIVES: To quantify the time required for nurses to complete the medication administration process in long-term care (LTC). DESIGN: Time-motion methods were used to time all steps in the medication administration process. SETTING: LTC units that differed according to case mix (physical support, behavioral care, dementia care, and continuing care) in a single facility in Ontario, Canada. PARTICIPANTS: Regular and temporary nurses who agreed to be observed. MEASUREMENTS: Seven predefined steps, interruptions, and total time required for the medication administration process were timed using a personal digital assistant. RESULTS: One hundred forty-one medication rounds were observed. Total time estimates were standardized to 20 beds to facilitate comparisons. For a single medication administration process, the average total time was 62.0±4.9 minutes per 20 residents on physical support units, 84.0±4.5 minutes per 20 residents on behavioral care units, and 70.0±4.9 minutes per 20 residents on dementia care units. Regular nurses took an average of 68.0±4.9 minutes per 20 residents to complete the medication administration process, and temporary nurses took an average of 90.0±5.4 minutes per 20 residents. On continuing care units, which are organized differently because of the greater severity of residents' needs, the medication administration process took 9.6±3.2 minutes per resident. Interruptions occurred in 79% of observations and accounted for 11.5% of the medication administration process. CONCLUSION: Time requirements for the medication administration process are substantial in LTC and are compounded when nurses are unfamiliar with residents. Interruptions are a major problem, potentially affecting the efficiency, quality, and safety of this process. [source]

Participation in arranging continuing health care packages: experiences and aspirations of service users

JOURNAL OF NURSING MANAGEMENT, Issue 2 2001
S. Abbott ba(hons), ma(econ)
Aims, This paper examines patients' and carers' experiences of receiving community health services, and considers the degree of patients' participation in the management of their continuing care. Background, Care management, advocated for many years as a way of ensuring appropriate and coordinated care, emphasizes the involvement of patients and carers in care planning. Evidence suggests that such involvement is unusual. Methods, Semi-structured interviews were carried out with 99 continuing health care patients and/or their carers. Findings, A few informants had willingly chosen to be active in arranging and coordinating their care, and a few others, who did not take an active role, were very satisfied with the services which they received. The majority, however, were not satisfied, feeling unclear about how their needs had been assessed and how services had been arranged. They were mostly disappointed by the absence of information and by the lack of regular contact with NHS and/or Social Services personnel. Some had felt compelled to become proactive in order to ensure that the care provided was adequate. Conclusions, Community nurses are valued by patients, and are well placed to be care managers. However, less qualified staff are also able to offer the regular support and information which patients want and value. [source]

Three-Year Chemical Dependency and Mental Health Treatment Outcomes Among Adolescents: The Role of Continuing Care

Attitudes towards the doctor,patient relationship: a prospective study in an Asian medical school

MEDICAL EDUCATION, Issue 11 2008
Kheng Hock Lee
Context, Patient-centredness is an accepted guiding principle for health system reform, patient care and medical education. Although these attitudes are strongly linked with cultural values, few studies have examined attitudes towards patient-centredness in a cross-cultural setting. Objectives, This prospective study evaluated attitudes towards patient-centredness in a cohort of Asian medical students and examined changes in these attitudes in the same students on completion of their junior clinical clerkships. Methods, The study was conducted in a cohort of 228 medical students entering Year 3 in medical school. The Patient,Practitioner Orientation Scale (PPOS), a validated instrument which scores an individual's level of patient-centredness, was used. Results, Being female and having personal experience of continuing care were significantly associated with higher scores. Students in the USA were previously reported to have similar ,caring' but higher ,sharing' scores on the same scale. At the end of the junior clinical clerkship, there were improvements in the ,caring' subscale, but no change or a reduction in ,sharing'. Students who did not have previous personal experience with continuing care experienced a greater increase in overall PPOS score. Conclusions, When compared with students in the USA, the students in our study appear to have a lower propensity to view the doctor,patient relationship as a partnership. This may be a reflection of differences in cultural norms and expectations of doctor,patient interaction in different societies. Our finding that attitudes towards patient-centredness did not decline over the course of the year, which contrasts with findings of other studies, may be attributed to various factors and warrants further study. [source]