Home About us Contact
|
Home About us Contact | ||
|
|
||
Treatment Quality (treatment + quality)
Selected AbstractsThe quality of treatment of eating disorders: A comparison of the therapists' and the patients' perspectiveINTERNATIONAL JOURNAL OF EATING DISORDERS, Issue 4 2008Simone de la Rie MA Abstract Objective: The aims of this study were to investigate the quality of treatment of eating disorders (EDs) from the therapists' and patients' perspective and to compare their views. Method: The Questionnaire for Eating Problems and Treatment (QEPT) was administered to 73 therapists working with patients with ED, to 156 current ED and 148 former ED patients. The QEPT addresses the quality of treatment of EDs. ED diagnosis was assessed by the Eating Disorder Examination Questionnaire. Answers were analyzed quantitatively and qualitatively. Results: Both therapists and patients most often mentioned focus of treatment, therapeutic alliance, and communicational skills as important aspects of the quality of treatment. However, they valued similar topics differently. Therapists valued the focus on ED symptoms and behavioral change more highly, whereas patients underscored the importance of the therapeutic relationship and addressing underlying problems. Most therapists work from a cognitive behavioral orientation, but protocol-based treatment was not found important. Conclusion: There is an avid need for dissemination of evidence-based treatment. Therapists' and patients' views supplement current evidence-based knowledge on treatment quality of EDs. Optimal treatment of EDs will be facilitated when these three bodies of knowledge,the available evidence and the therapists' and patients' views,are integrated. © 2007 by Wiley Periodicals, Inc. Int J Eat Disord, 2008 [source] GPs' perceptions of multiple-medicine use in older patientsJOURNAL OF EVALUATION IN CLINICAL PRACTICE, Issue 1 2010Janne Moen PhD Abstract Rationale, aim and objective, Multiple-medicine use (polypharmacy) is a growing problem for older patients, prescribers and health policy makers. The general practitioner (GP) is most often the main professional care provider; hence, improvements of treatment can only be carried out in concordance with GPs. The aim of this study was, therefore, to explore GPs' perspectives of treating older users of multiple medicines, using a qualitative approach. Method, Six focus groups, with four private GPs and 27 county-employed GPs, were analysed by using the framework method. Results, In contrast to definitions in most epidemiologic studies, the GPs gave a spontaneous definition of polypharmacy as ,the administration of more medicines than are clinically indicated'. They had problems stating both a cut-off number and which medicines should be included. Clinical practice guidelines were thought of as ,medicine generators', having an ambiguous effect on the GPs, who both trust them and find them difficult to apply. There was a perceived lack of communication between GPs and hospital specialists concerning their patients' medicines, which was further perceived to reduce treatment quality. The influence of patient pressure was acknowledged by the GPs as a factor contributing to the development of multiple-medicine use. Conclusions, The GPs felt insecure although surrounded by clinical practice guidelines. There is a need for policy makers to appreciate this paradox, as the problem is likely to grow in size and proportion. GPs must be empowered to handle the increasing proportion of older users of multiple medicines with individual agendas, receiving care from multiple specialists. [source] The RWJF Reclaiming Futures Initiative: Improving Substance Abuse Interventions for Justice-Involved YouthsJUVENILE AND FAMILY COURT JOURNAL, Issue 4 2006LAURA BURNEY NISSEN ABSTRACT Juvenile justice systems in the United States do not always respond effectively to substance abuse problems among young offenders. In 2002, the Robert Wood Johnson Foundation launched a 10-community demonstration project to address this problem. Reclaiming Futures (RF) relies on community partnerships to improve treatment quality, strengthen local leadership, expand inter-organizational collaboration, and create systems of shared performance management. The initial findings of a cross-site evaluation suggest that Reclaiming Futures is yielding important and positive change. Bi-annual surveys of key informants measure the quality and integration of juvenile justice and substance abuse treatment systems in each community. Of 13 indices measured by the surveys, 11 showed significant improvements between 2003 and 2005. [source] Prehospital management of diabetic emergencies , a population-based intervention studyACTA ANAESTHESIOLOGICA SCANDINAVICA, Issue 5 2003A. Holstein Background: Diabetes-related emergencies are frequent and potentially life-threatening. A study was performed to obtain reliable data about the prevalence of diabetic emergencies and to improve the quality of prehospital care of patients with diabetes-related emergencies. Methods: A prospective population-based study in a German emergency medical service district in the period from 1997 to 2000 was conducted. After initial diabetes training for the entire emergency team, a standardized protocol was introduced for prehospital emergency therapy of severe hypoglycaemia (SH) and severe hyperglycaemic disorders. A rapid blood glucose test was performed on all emergency patients with the exception of resuscitations and deaths. Indicators of treatment quality before and after these interventions were compared. Results: A rapid blood glucose test was performed in 6631 (85%) of the 7804 emergencies that occurred during the period investigated. The prevalence of acute diabetic complications was 3.1%, and 213 cases of SH and 29 severe hyperglycaemic disorders were recorded. Education of the emergency team led to a significant improvement in the quality of treatment. Larger volumes of iv 40% glucose solution (50 ± 20 ml (1997,2000) vs. 25 ± 17 ml (1993,96); P < 0.0001) were administered to patients with SH. Insulin-treated patients who were well educated about their diabetes were more often treated only at the emergency scene, after SH (25% vs. 8%; P = 0.007), and without complications. In 50 patients who experienced sulfonylurea-induced SH, the mandatory additional glucose infusions and hospitalization for further observation reduced mortality from 4.9% to 0% (P = 0.2). Conclusion: Training of the emergency team is an effective and efficient intervention to improve quality of treatment and prognosis outcome for patients with diabetic emergencies. Treatment of SH at the emergency scene only was demonstrated to be safe in type 1 diabetic patients who had previously received structured patient education. [source] Critical Failures in a Regional Network of Residential Treatment FacilitiesAMERICAN JOURNAL OF ORTHOPSYCHIATRY, Issue 2 2010Thomas W. Pavkov The present descriptive case study reports on the state of treatment services and environmental settings in adolescent residential treatment facilities (RTFs) conducted as part of the Residential Treatment Center Evaluation Project. The project frequently uncovered poor quality of care exposing youth to deleterious conditions. Observations related to harsh treatment practices, psychiatric practice and medication management, educational and aftercare planning, and general treatment planning were closely examined. The analysis indicated that accreditation and licensing are insufficient to assure the quality of the service process in RTFs. Future research should address the relationship between treatment quality and treatment outcome. Efforts should also be made to develop strategies for organizational change to support high-quality services in RTFs. [source] | ||||||||||