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Author: Publisher: ISBN: Category : Languages : en Pages : 107
Book Description
Prior research has examined the eating disorders in terms of etiology, predictive factors, treatment modalities, clinical course, and outcome with variable results and minimal consensus. No research was found linking collected assessment data to discharge needs, nor was research addressing the impact of discharge planning on successful treatment outcome identified. The purpose of this study was to determine if data collected for individuals during the initial assessment phase of an eating disorders program could predict the nature of discharge needs at the time of treatment completion. Using a data collection tool developed by the researcher, a one time retrospective chart review of 29 female subjects treated in an outpatient eating disorders program between 1994 and 1996 was accomplished. Using the Statistical Package for the Social Sciences, descriptive statistics were used to assess the characteristics of the sample population, analysis of variance was employed to examine differences between diagnostic groups for particular variables and a Chi-square test was applied to test for associations. Probability levels were set at .05 for statistical significance and .10 to indicate a trend. Although limited by available data, several significant findings were noted. Women diagnosed with Bulimia Nervosa (BN) had significantly higher admission Global Assessment of Functioning versus women with Anorexia Nervosa (AN); those with AN were positively linked to a family history of mood disorders; a significant relationship existed between BN and a family history of eating disorders and to brothers having a psychiatric history; a link between treatment involvement and a) discharge type and b) clinical outcome; and a positive relationship between those with AN and the lack of follow through with discharge plans.
Author: Publisher: ISBN: Category : Languages : en Pages : 107
Book Description
Prior research has examined the eating disorders in terms of etiology, predictive factors, treatment modalities, clinical course, and outcome with variable results and minimal consensus. No research was found linking collected assessment data to discharge needs, nor was research addressing the impact of discharge planning on successful treatment outcome identified. The purpose of this study was to determine if data collected for individuals during the initial assessment phase of an eating disorders program could predict the nature of discharge needs at the time of treatment completion. Using a data collection tool developed by the researcher, a one time retrospective chart review of 29 female subjects treated in an outpatient eating disorders program between 1994 and 1996 was accomplished. Using the Statistical Package for the Social Sciences, descriptive statistics were used to assess the characteristics of the sample population, analysis of variance was employed to examine differences between diagnostic groups for particular variables and a Chi-square test was applied to test for associations. Probability levels were set at .05 for statistical significance and .10 to indicate a trend. Although limited by available data, several significant findings were noted. Women diagnosed with Bulimia Nervosa (BN) had significantly higher admission Global Assessment of Functioning versus women with Anorexia Nervosa (AN); those with AN were positively linked to a family history of mood disorders; a significant relationship existed between BN and a family history of eating disorders and to brothers having a psychiatric history; a link between treatment involvement and a) discharge type and b) clinical outcome; and a positive relationship between those with AN and the lack of follow through with discharge plans.
Author: Hallie Marie Espel-Huynh Publisher: ISBN: Category : Clinical psychology Languages : en Pages : 135
Book Description
Eating disorders (EDs) are severe psychiatric illnesses which can lead to substantial psychological impairment and significant medical comorbidity. Relative to those with other psychiatric illnesses, individuals with EDs are particularly prone to treatment nonresponse (e.g., reliable deterioration or inadequate improvement during treatment). Further, very little is known about treatment response patterns in intensive treatment settings such as residential care. Evidence from general outpatient psychotherapy research suggests that risk for treatment nonresponse can be significantly reduced with use of Progress Monitoring and clinician Feedback (PM-FB) systems. PM-FB systems use empirically-derived benchmarking and prediction algorithms to determine a patient's expected course of treatment. When integrated into clinical practice, PM-FB systems significantly improve treatment outcomes and reduce risk of treatment nonresponse; effects are particularly pronounced for patients at risk for deterioration. Given the high rates of treatment nonresponse among patients with EDs, PM-FB may be a particularly effective tool for improving ED treatment outcomes. To date, PM-FB systems have been developed and tested primarily for use in general outpatient therapy settings. Their utility in ED treatment settings is largely unknown, particularly in intensive residential treatment. Development of an ED- and treatment-specific PM-FB system could facilitate increased treatment effectiveness. The present study sought to: (1) develop and validate an ED-specific PM measure for residential treatment (the Progress Monitoring tool for EDs, PMED); (2) identify an expected treatment response curve characterizing typical patterns of weekly symptom change; and (3) develop an algorithm to predict patient treatment outcome using only early treatment data. Thirty-seven PMED items were generated by a team of content experts, clinicians, and administrative staff from the target treatment setting. Items were administered to 531 residential patients with EDs as part of routine intake assessments and subsequently submitted to factor analysis. Results yielded a 5-factor, 26-item structure with adequate psychometric properties. To generate expected treatment response curves, the refined PMED was then administered to 371 patients at admission, discharge, and weekly throughout treatment. Latent growth mixture modeling was applied to characterize the number and nature of possible response patterns in residential care. A three-class trajectory model was the best fit for the data. Patients were classified into one of the three groups based on posterior predicted probabilities associated with their individual treatment response trajectories from admission to discharge. Using only data from the first two assessments, support vector machine learning was applied to predict patients' ultimate response class from early treatment data. Analyses yielded 84% overall prediction accuracy, which was significantly better than chance prediction. Findings suggest that residential ED treatment response is best characterized by three distinct patterns of symptom change. Treatment response patterns in residential ED treatment are heterogeneous in nature and are best represented by three distinct patterns of response. Results from machine learning analyses support the feasibility and accuracy of machine learning methods in predicting ED these response patterns early on in treatment. In the future, data from a patient's active treatment could be entered into this algorithm; information on the likely response pattern would inform therapeutic treatment planning and alert providers of risk for nonresponse.
Author: Dawn O. Witherspoon Publisher: ISBN: Category : Eating disorders Languages : en Pages : 150
Book Description
Eating disorders are common psychiatric disorders, especially in adolescent and adult females. Given the significant impairment these disorders cause, patients often require intensive inpatient treatment; however the majority of outcome studies are related to outpatient treatment. The purpose of this study was to create and test a theoretical model that predict inpatient treatment outcomes for patients with eating disorders using structural equation modeling. The goal of the current study was to examine predictors of treatment outcomes in an inpatient and partial hospitalization eating disorder program. The sample consisted of a total of 140 subjects with bulimia nervosa, anorexia nervosa and eating disorders NOS. Empirically supported risk factors for the development and maintenance of eating disorders, including demographic factors, biological factors and psychological factors were included in the model. Structural equation modeling was used because it allows for the production and testing of theoretical models that can then be used in predicting and studying treatment outcomes in this population. To refine the proposed model separate linear regression analyses were conducted on both the psychological and eating disorder severity risk factors and the treatment outcome variable. Overall, psychological severity risk factors model was statistically significant. The results from this multivariate regression using eating disorder severity factors were statistically significant as well. The revised model was tested by an EFA including the variables in the model. The items converged into two factors; however they did not align according to the predicted model of Psychological Severity and Eating Disorder Severity Factors. Instead they formed the first factor termed: Mental Health Factors in ED and the second factor called Self Destructive/Impulsive Behavior. The final model showed a superior fit to the data. One important clinical implication is the effect of financial restraints and health care insurance systems on clinical treatments, as evident by the relatively large number of patients who had to leave treatment early due to financial restraints. Other findings support the need for early treatment intervention to reduce morbidity and mortality.
Author: Anna Mae Jorgensen Publisher: ISBN: Category : Electronic dissertations Languages : en Pages : 74
Book Description
The present investigation examined characteristic, symptomatic, and familial predictors of long-term symptom severity of eating disorders. The purpose of the study was to determine if, after accounting for a number of known predictors of outcome, familial variables explained a significant amount of additional variance in disordered eating and general well-being scores measured at post-treatment follow-up. The sample included 398 women, ages 13 to 56, who had completed eating disorder treatment at an inpatient facility. Hierarchal multiple regression analysis demonstrated that familial predictors at admission to treatment did significantly predict long-term outcomes, while changes from admission to treatment in symptoms and perceptions of parents did not predict recovery. Patients' relationships with their fathers significantly contributed to the regression model. Recommendations for future investigations are discussed.
Author: Ronda Hughes Publisher: Department of Health and Human Services ISBN: Category : Medical Languages : en Pages : 592
Book Description
"Nurses play a vital role in improving the safety and quality of patient car -- not only in the hospital or ambulatory treatment facility, but also of community-based care and the care performed by family members. Nurses need know what proven techniques and interventions they can use to enhance patient outcomes. To address this need, the Agency for Healthcare Research and Quality (AHRQ), with additional funding from the Robert Wood Johnson Foundation, has prepared this comprehensive, 1,400-page, handbook for nurses on patient safety and quality -- Patient Safety and Quality: An Evidence-Based Handbook for Nurses. (AHRQ Publication No. 08-0043)." - online AHRQ blurb, http://www.ahrq.gov/qual/nurseshdbk/
Author: John R. Burton Publisher: Springer ISBN: 3319318314 Category : Medical Languages : en Pages : 352
Book Description
This book focuses on the circumstances that lead to the marked increased vulnerability of seniors and are most challenging to clinicians including the presence of multiple chronic medical conditions, variable losses of physiological function, and heterogeneity among individuals. Written by the experts who lead the initiative to deliver high quality surgical and medical care to the elderly, Geriatrics for Specialists is the first book of its kind to provide the comprehensive knowledge specialists and associated generalists need to deliver quality health care to seniors. With topics on important cross cutting issues like frailty, delirium and polypharmacy and specialty chapters on emergency medicine, anesthesia, many surgical and medical disciplines and rehabilitation, this book provides clinicians the knowledge and tools needed to evaluate, treat and manage the unique needs of seniors. Geriatrics for Specialists was created as a resource for specialist, generalists and allied health professionals and their students and trainees who care for elderly patients.
Author: National Academies of Sciences, Engineering, and Medicine Publisher: National Academies Press ISBN: 0309477042 Category : Social Science Languages : en Pages : 227
Book Description
Chronic homelessness is a highly complex social problem of national importance. The problem has elicited a variety of societal and public policy responses over the years, concomitant with fluctuations in the economy and changes in the demographics of and attitudes toward poor and disenfranchised citizens. In recent decades, federal agencies, nonprofit organizations, and the philanthropic community have worked hard to develop and implement programs to solve the challenges of homelessness, and progress has been made. However, much more remains to be done. Importantly, the results of various efforts, and especially the efforts to reduce homelessness among veterans in recent years, have shown that the problem of homelessness can be successfully addressed. Although a number of programs have been developed to meet the needs of persons experiencing homelessness, this report focuses on one particular type of intervention: permanent supportive housing (PSH). Permanent Supportive Housing focuses on the impact of PSH on health care outcomes and its cost-effectiveness. The report also addresses policy and program barriers that affect the ability to bring the PSH and other housing models to scale to address housing and health care needs.
Author: Max Kuhn Publisher: Springer Science & Business Media ISBN: 1461468493 Category : Medical Languages : en Pages : 595
Book Description
Applied Predictive Modeling covers the overall predictive modeling process, beginning with the crucial steps of data preprocessing, data splitting and foundations of model tuning. The text then provides intuitive explanations of numerous common and modern regression and classification techniques, always with an emphasis on illustrating and solving real data problems. The text illustrates all parts of the modeling process through many hands-on, real-life examples, and every chapter contains extensive R code for each step of the process. This multi-purpose text can be used as an introduction to predictive models and the overall modeling process, a practitioner’s reference handbook, or as a text for advanced undergraduate or graduate level predictive modeling courses. To that end, each chapter contains problem sets to help solidify the covered concepts and uses data available in the book’s R package. This text is intended for a broad audience as both an introduction to predictive models as well as a guide to applying them. Non-mathematical readers will appreciate the intuitive explanations of the techniques while an emphasis on problem-solving with real data across a wide variety of applications will aid practitioners who wish to extend their expertise. Readers should have knowledge of basic statistical ideas, such as correlation and linear regression analysis. While the text is biased against complex equations, a mathematical background is needed for advanced topics.
Author: Stephen Touyz Publisher: Routledge ISBN: 1317678109 Category : Psychology Languages : en Pages : 366
Book Description
Based on the only evidence-based randomized controlled trial yet undertaken in patients with severe and enduing anorexia nervosa, Managing Severe and Enduring Anorexia Nervosa uses the results of that trial to present a new paradigm for treatment. Moreover, this informative new text assembles the leading scientists across three continents to provide a comprehensive overview and new paradigm for treatment and stimulate interest in the development of new psychosocial approaches. Students, clinicians, and researchers in the field of eating disorders will find this edited volume a valuable reference handbook in the clinical management of patients with anorexia nervosa.
Author: Institute of Medicine Publisher: National Academies Press ISBN: 0309038324 Category : Medical Languages : en Pages : 257
Book Description
There have always been homeless people in the United States, but their plight has only recently stirred widespread public reaction and concern. Part of this new recognition stems from the problem's prevalence: the number of homeless individuals, while hard to pin down exactly, is rising. In light of this, Congress asked the Institute of Medicine to find out whether existing health care programs were ignoring the homeless or delivering care to them inefficiently. This book is the report prepared by a committee of experts who examined these problems through visits to city slums and impoverished rural areas, and through an analysis of papers written by leading scholars in the field.
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Author: Hallie Marie Espel-Huynh
Author: Dawn O. Witherspoon
Author: Anna Mae Jorgensen
Author: Ronda Hughes
Author: John R. Burton
Author: National Academies of Sciences, Engineering, and Medicine
Author: Max Kuhn
Author: Stephen Touyz
Author: Institute of Medicine