Showing papers on "Health care published in 1982"
Journal Article•
1,334 citations
TL;DR: The present attempt to define the concept patient satisfaction and to hypothesize some of its determinants can be regarded as first steps in building a theory of patient satisfaction.
782 citations
TL;DR: In this article, the authors devised a brief selfadministered questionnaire which, when used among a group of 789 students and hospital employees, disclosed that 94.2% had stool frequencies between three per day and three per week, and that 17.1% had bowel dysfunction.
719 citations
TL;DR: Estimates of the costs of illness and disease are produced and used in cost-benefit and cost-effectiveness analyses and in other modes to set priorities and make government policy decisions, to prepare and deliver congressional testimony, and to support agency budgets.
Abstract: illness and disease have been on a dramatic upward trend that is projected to continue. The most recent estimates of national health expenditures indicate a 400 percent increase since 1965 (Freeland and Schendler, 1981). As a proportion of the Gross National Product (GNP), the costs associated with illness and disease are projected to reach nearly 11 percent by the year 1990 (Freeland and Schendler, 1981) compared to 9.4 percent in 1980 and 6 percent in 1965 (Gibson and Waldo, 1981). It should not be surprising that the analytic literature on these costs has also grown rapidly. Medical journals, in particular, contributed to this growth as the medical profession has become increasingly involved with economists, sociologists, public health specialists, and others in scrutinizing the cost of modern health care (Warner and Hutton, 1980). Estimates of the costs of illness and disease are produced and used in cost-benefit and cost-effectiveness analyses and in other modes to set priorities and make government policy decisions, to prepare and deliver congressional testimony, and to support agency budgets. The application of the techniques of cost-benefit and cost-effectiveness analysis to health care, in particular, has been the subject of several
672 citations
TL;DR: A unit of health status, the "Well-Year," is described, which expresses the output of health programs in terms of the number of years and the health-related "quality of life" produced by a treatment or program.
Abstract: The present article describes a unit of health status, the "Well-Year," which expresses the output of health programs in terms of the number of years and the health-related "quality of life" produced by a treatment or program. Dividing the cost of the program by the number of Well-Years that it produces gives the cost-utility of the program. This cost-utility ratio can be used in a general health policy model to compare the efficiency of different programs or to assess the relative contribution of different programs and providers in the health care system. A comprehensive standardized measure of health status has many advantages for health planning, decision analysis, and program evaluation. An example demonstrates how the relative production of WellYears by psychologists might be compared to the contribution of other health care services.
648 citations
TL;DR: The appropriate and rational use of drugs by the elderly is a matter of growing medical and social concern.
Abstract: THE appropriate and rational use of drugs by the elderly is a matter of growing medical and social concern. Life expectancy in the Western world currently stands at 69 years for men and 77 years for women and is increasing.1 , 2 In 1980 an estimated 11 per cent of the total population was over 65 years old; the proportion is expected to exceed 15 per cent by the year 2040. As compared with the young, elderly persons on the average spend more money and a greater fraction of their income on health care. Old people have more illnesses and hospitalizations than . . .
570 citations
TL;DR: The results suggest that although considerable differences in potential accessibility exist between rural areas near and far from urban centres, the smaller catchment populations of most rural general practitioners may partly compensate for isolation from major, urban concentrations of physicians.
330 citations
TL;DR: As social policy moves away from principles of universal provision and towards greater selectivity, there will be an onus on epidemiology to help identify those who are vulnerable--economically, chemically, and environmentally, as well as biologically.
Abstract: Any national strategy of preventing disease and promoting health cannot ignore the implications of social deprivation. As social policy moves away from principles of universal provision and towards greater selectivity, there will be an onus on epidemiology to help identify those who are vulnerable--economically, chemically, and environmentally, as well as biologically. The uncertainty of current knowledge about lifestyles calls for new experiments, not merely observation and disputation.
324 citations
256 citations
TL;DR: It appears that more emphasis should be placed on minimizing deterrents (especially detrimental effects on skin and peer pressure) rather than on emphasizing the importance of HW.
229 citations
Journal Article•
TL;DR: Since depression is common after stroke, is associated with failure to return to previous activities, and cannot be predicted by commonly used patient characteristics, the health care team must carefully identify, monitor, and manage depression in the patient recovering from stroke.
TL;DR: In this article, the authors conducted two-hour semistructured interviews with a heterogeneous group of psychotherapists (N = 60) in order to investigate their experiences of therapeutic practice and found that therapists expect their work to be difficult and even stressful, they also expect their efforts to "pay off."
Abstract: The present study focuses on the phenomenon of therapist burnout—a problem of rapidly increasing public and professional concern. Two-hour semistructured interviews were conducted with a heterogeneous group of psychotherapists (N = 60) in order to investigate their experiences of therapeutic practice. According to therapists, professional satisfaction derives from the ability to promote a helpful therapeutic relationship; dissatisfaction stems primarily from lack of therapeutic success; and burnout is primarily a consequence of the nonreciprocated attentiveness, giving, and responsibility demanded by the therapeutic relationship. The data suggest that although therapists expect their work to be difficult and even stressful, they also expect their efforts to "pay off." Burnout is not only psychologically debilitating to therapists, it also critically impairs the delivery of mental health services. As part of a comprehensive project to investigate the effects of psychotherapy on psychotherapists, the present study was designed to focus on the phenomenon of therapist burnout. Freudenberger (1974) originally coined the term burnout to describe the emotional and physical exhaustion of staff members of alternative health care institutions. In recent years a small but growing number of investigators have studied the burnout phenomenon (Cherniss, 1980; Cherniss, Egnatios, & Wacker, 1976; Edelwich & Brodsky, 1980; Freudenberger, 1974, 1977; Freudenberger & Richelson, 1980; Kahn, 1978; Maslach, 1976, 1978; Maslach & Pines, 1977; Mattingly, 1977; Pines & Aronson, 1980; Pines & Kafry, 1978). Maslach (1976), for example, in studying a broad range of health and social service professionals, found that burned-out professionals "lose all concern, all emotional feelings for the persons they work with and come to treat them in detached or even de-humanized ways" (p. 16). Burned-out professionals may become cynical toward their clients, blaming them for creating their own difficulties or labeling them in derogatory terms. To maintain a safe emotional distance from an unsettling client, professionals may increasingly resort to technical jargon and refer to clients in diagnostic terms. Furthermore, the emotional frustrations attendant to this phenomenon may lead to psychosomatic symptoms (e.g., exhaustion, insomnia, ulcers, headaches) as well as to increased family conflicts. Burnout has become a problem of increasing public and professional concern. Indeed, it may well become a "catch-phrase" of the 1980s (Kennedy, 1979). There is, however, a notable paucity of research on stress and burnout in psychotherapists. This gap exists despite the fact that over 40 years ago Freud (1937/1964) wrote of the "dangers of analysis" for analysts, despite the fact that the inner experience of the therapist has come to be acknowledged as an important variable in the psychotherapeutic process (Burton, 1972), and despite, too, the fact that the manpower shortage in the mental health field (Albee, 1959,1968; Hobbs, 1964) critically increases the need to maximize the job satisfaction and efficiency of available personnel. The literature bearing on the issue of therapist stress and burnout consists primarily of (a) studies that have investigated the general nature of burnout in the human services field (e.g., Cherniss, 1980, Edelwich & Brodsky, 1980; Freudenberger & Richelson, 1980; Pines & Aronson, 1980); (b) clinical accounts of the difficulties of therapeutic
TL;DR: Because of the scarcity of trained personnel in neurology in developing countries, a protocol utilizing, in large part, non-doctor primary health care personnel for collecting data in a number of developing countries is designed.
Abstract: Because of the scarcity of trained personnel in neurology in developing countries, we designed a protocol utilizing, in large part, non-doctor primary health care personnel for collecting data in a do
TL;DR: Univariate ANOVAs indicated that the courtesy manipulation influenced the perception of courtesy and general medical satisfaction, while the competence manipulation influenced not only perceived competence but perceived courtesy, generalmedical satisfaction, and compliance as well.
Book•
14 Oct 1982
TL;DR: This review concludes that future discussions of paternalism in health care will have to come to terms with the contentions of this book, which must be reckoned the best existing treatment of its subject.
Abstract: "A very good book indeed: there is scarcely an issue anyone has thought to raise about the topic which Childress fails to treat with sensitivity and good judgement....Future discussions of paternalism in health care will have to come to terms with the contentions of this book, which must be reckoned the best existing treatment of its subject."--Ethics. "A clear, scholarly and balanced analysis....This is a book I can recommend to physicians, ethicists, students of both fields, and to those most affected--the patients themselves."--Edmund D. Pellegrino, John Carroll Professor of Medicine and Medical Humanities, Georgetown University Medical Center.
TL;DR: This change process model provides a basis for orienting continuing medical education activities to the achievement of behavioral outcomes.
Abstract: The changes all physicians make in their treatment of patients constitute a neglected but key issue in the operation of the health care system. Identification of a model of this crucial change process was the purpose of this study. Interviews with a random sample of 66 physicians representing five specialties produced data on 182 changes. The fundamental stages in the change process were priming (coming to feel dissatisfaction with some aspect of practice behavior), focusing (learning of alternative practice behavior), and follow-up (obtaining further information or advice regarding the possible change). Any of a variety of information sources may focus a change, but follow-up is overridingly dependent on colleague communication (representing local professional opinion) and journals (representing an authoritative professional perspective). This change process model provides a basis for orienting continuing medical education activities to the achievement of behavioral outcomes.
Book•
01 Aug 1982
TL;DR: Problems of defining equity and equality of access are not trivial; there are fundamental disagreements about the nature of health care as a social good and about other principles of distributive justice.
Abstract: Problems of defining equity and equality of access are not trivial; there are fundamental disagreements about the nature of health care as a social good and about other principles of distributive justice. Presuppositions about equity underlying several current proposals for reform of health care "markets" are considered. Issues of equity--and theories of justice--arise also in contexts other than disputes about access.
Book•
01 Jan 1982
TL;DR: In this article, the authors present a catalogues of book to open to show the benefits of reading a book to improve mental health care, which is one of the most popular reading material in this world.
Abstract: Now, we come to offer you the right catalogues of book to open. not on our street community attitudes to mental health care is one of the literary work in this world in suitable to be reading material. That's not only this book gives reference, but also it will show you the amazing benefits of reading a book. Developing your countless minds is needed; moreover you are kind of people with great curiosity. So, the book is very appropriate for you.
Book•
01 Jan 1982
TL;DR: When you read more every page of this interpersonal issues in health care, what you will obtain is something great.
Abstract: Read more and get great! That's what the book enPDFd interpersonal issues in health care will give for every reader to read this book. This is an on-line book provided in this website. Even this book becomes a choice of someone to read, many in the world also loves it so much. As what we talk, when you read more every page of this interpersonal issues in health care, what you will obtain is something great.
TL;DR: The foster home care system is the most commonly used alternative for the care of dependent children in the United States, but it often fails to achieve its objective of returning the child to his home or providing a permanent substitute family.
Abstract: The foster home care system is the most commonly used alternative for the care of dependent children in the United States. However, it often fails to achieve its objective of returning the child to his home or providing a permanent substitute family. Children entering foster care have frequently suffered social, emotional, and medical neglect, and physical abuse. They have a high rate of chronic medical problems, educational handicaps, and severe emotional impairment. In many cases the health care that foster children receive fails to recognize and/or adequately address their disabilities. In order for the pediatric practitioner to work successfully with a foster child, he must not only provide comprehensive health care, but also must be familiar with the social welfare system within which the child lives.
TL;DR: Interactive television was used to provide consultation with university-based critical care physicians for patients in the ICU of a 100-bed hospital and had greater clinical and educational impact than consultation using the telephone.
Abstract: We introduced telemedicine, i.e., telecommunications for delivery of health services, to alleviate scarcity and maldistribution of critical care services. For 18 months, we used interactive television to provide consultation with university-based critical care physicians for patients in the ICU of a 100-bed hospital. Telemedicine "visits" (1548) were made to 395 patients. Television consultation had greater clinical and educational impact than consultation using the telephone. Equipment was expensive but proved to be reliable and easy to use. Interactive television extended the availability of specialist expertise, but full exploitation of this technology for delivery of critical care services was not achieved. Extensive background research, currently underway at the University of Pittsburgh, is necessary before the next telemedicine demonstration.
Book•
01 Jan 1982
TL;DR: This is a comprehensive text that aims to cover both theory and practice within a systems framework and should be useful to BSN students on undergraduate and postgraduate programmes.
Abstract: Material new to this edition includes: nursing research, motivation, overview of the US health care system, managed care, and risk management. This is a comprehensive text and aims to cover both theory and practice within a systems framework. It should be useful to BSN students on undergraduate and postgraduate programmes.
TL;DR: The refugee population should not be considered a homogeneous group of Indochinese, particularly by those responsible for their health care.
Abstract: More than 0.5 million refugees from Southeast Asia have immigrated to the United States. We undertook a prospective evaluation of 709 refugees within two months of their resettlement in San Diego. The sample included 164 Vietnamese, 356 Cambodians, 139 Laotians, and 50 Hmong. The prevalence of abnormalities was high: intestinal parasites, 61%; positive tuberculin test (PPD) results, 55%; anemia, 37%; hepatitis B antigenemia, 14%; and abnormal VDRL test results, 12%. Except for hepatitis, significant differences were noted among the Vietnamese, Cambodian, Laotian, and Hmong subjects on each of these health status indicators. The refugee population should not be considered a homogeneous group of Indochinese, particularly by those responsible for their health care. ( JAMA 1982;247:1303-1308)
TL;DR: Utilizing a prospective diary method with a random sample of 96 female users of a neighborhood health center, bivariate analysis indicate that the presence of stress on a given day is associated with an approximate doubling of the probability of a health care contact on that day.
Abstract: services. Utilizing a prospective diary method with a random sample of 96 female users of a neighborhood health center, bivariate analysis indicate that the presence of stress on a given day is associated with an approximate doubling of the probability of a health care contact on that day. When controls are introduced into these analyses for a variety of background characteristics of these families, the daily stresslutilization relationship persists, independently of reported symptoms. In addition, a measure of stressful life events reported prior to the diary period also predicts utilization independently of both the daily stresses and reported symptoms; the stressful life-events variable in fact is one of the best single predictors of utilization. The diary data are also aggregated to approximate a retrospective research design, and substantial
TL;DR: The concept of accountability is analyzed and selected definitions of the concept by directors of nursing are provided to provide insights into the presence or absence of true accountability in nursing organizations and presents issues for further study.
Abstract: How can a nursing service convincingly argue for autonomy and accountability without an understanding of the precise meanings of these terms? In this second of two articles exploring the meanings and implications of autonomy and accountability in nursing service, Lewis and Batey arrive at this and other provocative questions. They analyze the concept of accountability and provide selected definitions of the concept by directors of nursing. Their discussion provides insights into the presence or absence of true accountability in nursing organizations and presents issues for further study.
TL;DR: The past and present contributions of advances in cardiovascular research to this decline are reviewed and continued emphasis must be placed on research in the areas of etiology and pathogenesis, on validating potentially beneficial research hypotheses, and on the translation and dissemination of research results to the health care practitioner and the public.
Abstract: Mortality due to cardiovascular diseases has decreased more than 30 percent in the last 30 years, and this decline has accelerated so much that over 60 percent of it has occurred between 1970 and 1980. The past and present contributions of advances in cardiovascular research to this decline are reviewed. Although three have been significant research accomplishments, too many people still die of heart and blood vessel diseases. Continued emphasis must be placed on research in the areas of etiology and pathogenesis, on validating potentially beneficial research hypotheses, and on the translation and dissemination of research results to the health care practitioner and the public. Only then can our long-term goal, the prevention of cardiovascular disease, be fully realized.
TL;DR: The division of responsibility between general medical staff and mental specialists for care of persons with medical record diagnoses of mental disorders is documented in four organized health care settings and mental disorder diagnoses were associated with greater patient use of general medical departments.
Abstract: • The division of responsibility between general medical staff and mental health specialists for care of persons with medical record diagnoses of mental disorders is documented in four organized health care settings. Rates of mental disorders identified in all departments ranged from 35.6 to 122.8 per 1,000 population. Specialty mental health departments treated most severe psychotic and personality disorders, plus transient situational disturbances, whereas neurotic, childhood behavior, and psychophysiological disorders received as much or greater attention in general medical departments. Mental disorder diagnoses were associated with greater patient use of general medical departments. However, joint specialty mental health/ general medical treatment of these patients was associated with lower general medical department visit rates in all settings. Such joint care was facilitated by the low average visit frequency use of mental health departments (2.2 to 8.9 visits per patient per year).