Referral

About: Referral is a research topic. Over the lifetime, 27614 publications have been published within this topic receiving 479918 citations.

Manual handling activities and injuries among nurses: an Australian hospital study.

Abstract: The aims of this study were to identify patterns of manual handling activities and their associated injuries and consequences among nurses working at a large teaching and referral medical centre in Melbourne, Australia. A self-report 140-item questionnaire was distributed to 523 registered nurses working full time at the medical centre. Of the 269 (51.4%) nurses who completed the questionnaire, 108 (40.1%) retrospectively reported an injury associated with manual handling activity, of which 75.9% (82) comprised back injuries. When all full-time nurses working at the medical centre are considered, the prevalence of all manual handling injuries was 20.6% (n=108) and 15.7% (n=87) for back injuries. About two-thirds (67.6%) of all manual handling injuries were associated with direct patient care activities and another third (32.4%) with non-direct patient care activities. Approximately one-third (34.3%) of all injuries were associated with lifting patients and this activity comprised one half of all causes associated with injuries arising from direct patient care activities. The consequences of injuries were significant. Recommendations for reducing manual handling activities and injuries are made and future research directions are discussed.

Patterns of Referral to a Gender Identity Service for Children and Adolescents (1976–2011): Age, Sex Ratio, and Sexual Orientation

Abstract: In a previous Letter to the Editor (Zucker, Bradley, Owen-Anderson, Kibblewhite, & Cantor, 2008), we provided data on the number of referred children and adolescents to a specialized gender identit...

Pathways for psychosocial care of cancer survivors

Abstract: Today, the growing number of survivors from many sites of cancer necessitates that thought be given to ways that ensure follow-up psychosocial care and its integration into ongoing medical surveillance. The establishment of standards of care together with evidence- and consensus-based clinical practice guidelines have provided a highly effective method of enhancing quality care for treatment of cancer. There remain, however, major problems in dissemination and application of these guidelines on the clinical level. The National Comprehensive Cancer Network (NCCN) formed a Panel on Distress Management that developed the first set of consensus-based standards for psychosocial care and clinical practice guidelines specific to cancer illnesses. This article proposes the extension of their concepts to cancer survivors. A model is presented that can assist oncologists and multidisciplinary teams in busy ambulatory settings to more readily identify those survivors who are distressed, whose quality of life is impaired, and who may benefit from further psychological evaluation and treatment. Three groups of cancer survivors are identified for whom pathways for psychosocial care should be defined and developed: 1) survivors with physical sequelae, often resulting in significant neuropsychologic and physical consequences; 2) survivors with psychological sequelae or psychiatric disorders that interfere with functioning and quality of life; and 3) survivors with subsyndromal symptoms who have no identified physical or psychiatric sequelae, but who may nonetheless need help integrating the cancer experience into their lives to increase a sense of purpose, direction, and well being. A rapid screening tool for distress could be used at the time of follow-up visits to oncologists or physicians to identify patients with psychological, social, or spiritual concerns and could serve as a pathway for evaluation and referral for psychosocial counseling. Treating distress in these areas is to be viewed as an integral part of surveillance for survivors, and pathways to ensure integration are important.

Left in limbo: patients' views on care across the primary/secondary interface.

Abstract: OBJECTIVES: To discover the views of patients about their experiences across the interface between primary and secondary health care, including referral from general practitioners, outpatient and inpatient care, discharge, and aftercare. DESIGN: A qualitative study involving individual and focus group interviews of patients and interviews of carers. SUBJECTS: 33 patients who had attended at least one outpatient appointment or had been an inpatient between two and four months previously, and eight carers of patients with chronic conditions. SETTING: Three acute hospitals and one community health service in Leicestershire. MAIN OUTCOME MEASURES: Common themes in the views of patients and carers towards their experiences of care. RESULTS: Five themes emerged. The first four were: "getting in" (access to appropriate care), "fitting in" (orientation of care to the patient's requirements), "knowing what's going on" (provision of information), and "continuity" (continuity of staff and coordination and communication among professionals). The fifth theme was "limbo" (difficulty in making progress through the system), which was influenced by failures in care in relation to the other four themes. CONCLUSIONS: The concept of progress is central to patients' views of care. It involves both progress through the healthcare system and progress towards recovery or adjustment to an altered health state. Patients' views on how well they progress through the healthcare system may be an appropriate indicator for monitoring health service performance.

Referral for cancer genetics consultation: a review and compilation of risk assessment criteria

Abstract: Methods: The criteria were based on a comprehensive review of publications describing diagnostic criteria for hereditary cancer syndromes and risk to first degree relatives of cancer patients. Priority was given to diagnostic criteria from consensus statements (for example, those from the National Comprehensive Cancer Network). Expert opinion from study personnel was then used to adopt a single set of criteria from other publications whenever guidelines differed. Results: Based on family history, a set of criteria was developed to identify patients at risk for a hereditary cancer susceptibility syndrome, patients with moderate risk who might benefit from increased cancer surveillance, and patients who are at average risk. The criteria were applied to 4360 individuals who provided their cancer family history between July 1999 and April 2002, using a touch screen computer system in the lobby of a comprehensive cancer centre. They categorised an acceptable number of users into each risk level: 14.9% high risk, 13.7% moderate risk, and 59.6% average risk; 11.8% provided insufficient information for risk assessment. Conclusions: These criteria should improve ease of referral and promote consistency across centres when evaluating patients for referral to cancer genetics specialists.