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Individualized Assessment (individualized + assessment)
Selected AbstractsIndividualized assessment and treatment program for alcohol dependence: results of an initial study to train coping skillsADDICTION, Issue 11 2009Mark D. Litt ABSTRACT Aims Cognitive,behavioral treatments (CBT) are among the most popular interventions offered for alcohol and other substance use disorders, but it is not clear how they achieve their effects. CBT is purported to exert its beneficial effects by altering coping skills, but data supporting coping changes as the mechanism of action are mixed. The purpose of this pilot study was to test a treatment in which coping skills were trained in a highly individualized way, allowing us to determine if such training would result in an effective treatment. Design Participants were assigned randomly to a comprehensive packaged CBT program (PCBT), or to an individualized assessment and treatment program (IATP). The IATP program employed experience sampling via cellphone to assess coping skills prior to treatment, and provided therapists with a detailed understanding of patients' coping strengths and deficits. Setting Out-patient treatment. Participants A total of 110 alcohol-dependent men and women. Measurements Participants in both conditions completed experience sampling of situations, drinking and coping efforts prior to, and following, 12 weeks of treatment. Time-line follow-back procedures were also used to record drinking at baseline and post-treatment. Findings IATP yielded higher proportion of days abstinent (PDA) at post-treatment (P < 0.05) than did PCBT, and equivalent heavy drinking days. IATP also elicited more momentary coping responses and less drinking in high-risk situations, as recorded by experience sampling at post-treatment. Post-treatment coping response rates were associated with decreases in drinking. Conclusions The IATP approach was more successful than PCBT at training adaptive coping responses for use in situations presenting a high risk for drinking. The highly individualized IATP approach may prove to be an effective treatment strategy for alcohol-dependent patients. [source] The Implications of ADA Litigation for Employers: A Review of Federal Appellate Court DecisionsHUMAN RESOURCE MANAGEMENT, Issue 1 2001Barbara A. Lee Analysis of litigation outcomes indicates that most plaintiffs who sue under the Americans with Disabilities Act are unsuccessful. Equal Employment Opportunity Commission enforcement data and six years of federal appellate court decisions were reviewed, as well as recent rulings of the United States Supreme Court. The courts are interpreting the ADA very narrowly, and very few plaintiffs prevail. The results of this research suggest that if employers engage in an individualized assessment of whether an individual is protected by the law and whether the requested accommodation is reasonable, legal liability will be minimized. © 2001 John Wiley & Sons, Inc. [source] Incontinence: prevalence, management, staff knowledge and professional practice environment in rehabilitation unitsINTERNATIONAL JOURNAL OF OLDER PEOPLE NURSING, Issue 1 2009Geraldine McCarthy MSc Background., Bladder and bowel incontinence is a major health care problem, which adversely affects the lives of many individuals living at home or in health service facilities. Current approaches to continence care emphasize comfort, safety and reduction of risk, rather than detailed individualized assessment and management. The literature illustrates a gap between evidence and actual practice and emphasizes the context of care as being a key element for successful implementation of evidence based practice. Aims., To identify prevalence of bowel and bladder incontinence and its management, investigate continence knowledge and describe the professional practice environment within a rehabilitation unit for older people. Method., An integrated evaluation of continence prevalence, staff knowledge and the work environment was adopted. Results., Findings revealed a high incidence of incontinence (60% urinary, 3% faecal, 37% mixed) a lack of specific continence assessment and specific rationale for treatment decisions or continuation of care. The focus was on continence containment rather than on proactive management. Staff demonstrated a reasonable knowledge of incontinence causation and treatment as measured by the staff knowledge audit. The evaluation of the work environment indicated a low to moderate perception of control over practice (2.39), autonomy in practice (2.87), nurse doctor relationship (2.67) and organizational support (2.67). [source] The Importance of Screening, Assessing, and Managing Urinary Incontinence in Primary CareJOURNAL OF THE AMERICAN ACADEMY OF NURSE PRACTITIONERS, Issue 3 2003FAANArticle first published online: 24 MAY 200, Mikel Gray PhD Purpose To present evidence that routine screening for urinary incontinence is justified because it is a clinically relevant and prevalent disorder that responds to treatment, resulting in improved outcomes for many patients managed by the nurse practitioner (NP). Data Source Selected scientific literature. Conclusions The prevalence of urinary incontinence and success of treatment options justify routine screening, individualized assessment, and treatment. Implications for Practice Routine screening for urinary incontinence by NPs is uncommon. Based on the relative risk, the potential success of treatment and improved quality-of-life outcomes after treat-ment, NPs should regularly screen and assess for incontinence. [source] Description of an advanced practice nursing consultative model to reduce restrictive siderail use in nursing homes,,RESEARCH IN NURSING & HEALTH, Issue 2 2007Laura M. Wagner Abstract Researchers have demonstrated that the use of physical restraints in nursing homes can be reduced, particularly where advanced practice nurses (APNs) are utilized. We examined the link between APN practice, siderail reduction, and the costs of siderail alternatives in 273 residents in four Philadelphia nursing homes. The majority of participants were cognitively and physically impaired with multiple co-morbidities. APNs recommended a total of 1,275 siderail-alternative interventions aimed at reducing fall risk. The median cost of siderail alternatives to prevent falls per resident was $135. Residents with a fall history experienced a significantly higher cost of recommendation compared to non-fallers. Findings suggest that an APN consultation model can effectively be implemented through comprehensive, individualized assessment without incurring substantial costs to the nursing home. © 2007 Wiley Periodicals, Inc. Res Nurs Health 30: 131,140, 2007 [source] | ||||||||||