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Outcome Literature (outcome + literature)

Distribution by Scientific Domains

Psychology	50%

Selected Abstracts

International Experts' Perspectives on the State of the Nurse Staffing and Patient Outcomes Literature

JOURNAL OF NURSING SCHOLARSHIP, Issue 4 2007
Koen Van den Heede
Purpose: To assess the key variables used in research on nurse staffing and patient outcomes from the perspective of an international panel. Design: A Delphi survey (November 2005-February 2006) of a purposively-selected expert panel from 10 countries consisting of 24 researchers specializing in nurse staffing and quality of health care and 8 nurse administrators. Methods: Each participant was sent by e-mail an up-to-date review of all evidence related to 39 patient-outcome, 14 nurse-staffing and 31 background variables and asked to rate the importance/usefulness of each variable for research on nurse staffing and patient outcomes. In two subsequent rounds the group median, mode, frequencies, and earlier responses were sent to each respondent. Findings: Twenty-nine participants responded to the first round (90.6%), of whom 28 (87.5%) responded to the second round. The Delphi panel generated 7 patient-outcome, 2 nurse-staffing and 12 background variables in the first round, not well-investigated in previous research, to be added to the list. At the end of the second round the predefined level of consensus (85%) was reached for 32 patient outcomes, 10 nurse staffing measures and 29 background variables. The highest consensus levels regarding measure sensitivity to nurse staffing were found for nurse perceived quality of care, patient satisfaction and pain, and the lowest for renal failure, cardiac failure, and central nervous system complications. Nursing Hours per Patient Day received the highest consensus score as a valid measure of the number of nursing staff. As a skill mix variable the proportion of RNs to total nursing staff achieved the highest consensus level. Both age and comorbidities were rated as important background variables by all the respondents. Conclusions: These results provide a snapshot of the state of the science on nurse-staffing and patient-outcomes research as of 2005. The results portray an area of nursing science in evolution and an understanding of the connections between human resource issues and healthcare quality based on both empirical findings and opinion. [source]

Do patients drop out prematurely from exposure therapy for PTSD?

JOURNAL OF TRAUMATIC STRESS, Issue 6 2003
Elizabeth A. Hembree
Abstract Many studies have demonstrated the efficacy of exposure therapy in the treatment of chronic posttraumatic stress disorder (PTSD). Despite the convincing outcome literature, a concern that this treatment may exacerbate symptoms and lead to premature dropout has been voiced on the basis of a few reports. In this paper, we examined the hypothesis that treatments that include exposure will be associated with a higher dropout rate than treatments that do not include exposure. A literature search identified 25 controlled studies of cognitive,behavioral treatment for PTSD that included data on dropout. The results indicated no difference in dropout rates among exposure therapy, cognitive therapy, stress inoculation training, and EMDR. These findings are consistent with previous research about the tolerability of exposure therapy. [source]

School-based prevention and intervention programs for children with emotional disturbance: A review of treatment components and methodology

PSYCHOLOGY IN THE SCHOOLS, Issue 2 2009
Linda A. Reddy
School practitioners and educators are frequently challenged by the diverse and pervasive academic, social, and behavioral needs of children at risk for and with emotional disturbance. The present article examines the outcome literature on school-based prevention and intervention programs by systematically reviewing the key treatment interventions and methodology used. A total of 29 investigations including 1,405 children and adolescents were reviewed and coded on 41 variables across three dimensions (i.e., sample characteristics, treatment components, and methodology). Single subject and group design studies were included. Behavioral and/or cognitive behavioral treatment approaches were primary used. Deficit-based assessment and treatment approaches (i.e., problem behaviors) were predominately used in the outcome literature with few investigations incorporating strength-based outcome approaches. Findings are discussed in relation to previous research. © 2008 Wiley Periodicals, Inc. [source]

Mechanisms of action in youth psychotherapy

THE JOURNAL OF CHILD PSYCHOLOGY AND PSYCHIATRY AND ALLIED DISCIPLINES, Issue 1 2002
V. Robin Weersing
Background: In this review, we address a basic, but unanswered, question about psychosocial interventions for youth: How does psychotherapy work? Methods: We propose a framework for using mediation analysis to answer this question, and we review the youth therapy outcome literature for evidence on mediating mechanisms. We focus our review on clinical trials of empirically supported treatments for youth anxiety, depression, and disruptive behavior (N= 67). Results: Contrary to previous reports indicating that potential mediators are rarely assessed, 63% of the studies included measures of potential mediating mechanisms in their designs. Across treatment domains, percentages ranged from 22% of the studies of learning-based interventions for anxiety (i.e., systematic desensitization, modeling, and reinforced practice) to 91% of parent training investigations. Despite the rather extensive assessment of potential mediators, only six studies included any attempt to use the measures in a formal mediation test. Thus, despite the positive effects of treatments and surprisingly ample assessment of mediators, we still know remarkably little about how youth psychotherapies work. Conclusions: We note common problems that hampered mediation testing (e.g., the design of many trials made it difficult to determine the temporal order of change in the mechanism and outcome), and we offer recommendations for improving study design to better assess mechanisms of therapeutic action. We also note the need to test mediation among referred youth treated in representative practice settings to complement the laboratory-based evidence on therapy mechanisms that prevails to date. [source]