Hospital-to-community transitions. A bridge program for adolescent mental health patients

Making the transition from the hospital to a community setting can be extremely challenging for patients with acute mental health conditions. Transitional services have been created to help patients overcome difficulties associated with this transition. Nurses frequently play an integral role in the success of these services. By providing patients with individualized support during such transitions, nurses act as clinical liaisons and directly contribute to an increase in positive patient and system-level outcomes. This article describes a transitional service called the Bridge Program, designed to help adolescents make a successful transition from the hospital to the community. An overview of the Bridge Program is provided, and the results of an evaluation of this program are presented. Results suggest that the Bridge Program contributes to a decrease in the length of hospital stays and improves continuity of care for patients and their families.     

The Transitional Discharge Model: comparing implementation in Canada and Scotland

Effective discharge planning is needed to facilitate clients' transition from psychiatric hospital wards to community care. Previous studies have shown that client outcomes can be improved by using a Transitional Discharge Model (TDM) that includes peer support and an extension of inpatient-practitioner relationships that are introduced prior to discharge. However, countries vary in many ways that may affect implementation of the model. This article describes some of the similarities and differences related to introducing transitional discharge in two countries: Canada and Scotland. It is important to elucidate facilitators and challenges in implementing the TDM to identify and disseminate strategies to aid implementation. Implications for future implementation of the model are also discussed.     

Quality of life among lifetime victimized men

Quality of life was compared for lifetime victimized (n = 353) and nonvictimized men (n = 167) for demographic and quality of life variables by a cross-sectional design. The univariate analyses showed that victims compared to nonvictims had a lower quality of life, were younger, more often had upper secondary school education, and were more often blue-collar/low white-collar workers, on student allowances, on unemployment, financially strained, and smokers. The regressions revealed that unemployment, financial strain, smoking, depression, and home/public abuse were associated with reduced quality of life among victimized men. Being a blue-collar/low/intermediate white-collar worker and social support were related to increased quality of life. This study may have provided new insights into the experiences of quality of life of victimized men.     

Personality and psychopathological profiles in individuals exposed to mobbing

Increasingly, mental health and medical professionals have been asked to assess claims of psychological harm arising from harassment at the workplace, or "mobbing." This study assessed the personality and psychopathological profiles of 146 individuals exposed to mobbing using validity, clinical, and content scales of the Minnesota Multiphasic Personality Inventory 2. Profiles and factor analyses were obtained. Two major dimensions emerged among those exposed to mobbing: (a) depressed mood, difficulty in making decisions, change-related anguish, and passive-aggressive traits (b) somatic symptoms, and need for attention and affection. This cross-sectional pilot study provides evidence that personality profiles of mobbing victims and psychological damage resulting from mobbing may be evaluated using standardized assessments, though a longitudinal study is needed to delineate cause-and-effect relationships.     

Client satisfaction with live-in and live-out home care workers in Israel

In an era of globalization where the migration of longterm care workers is common, foreign live-in home care workers can compensate for the unavailability of family members and, perhaps, even substitute for institutional care in the provision of long-term care services to disabled older persons. This study examines differences in home care satisfaction between disabled older persons in Israel with "live-in" home care workers and those with "live-out" workers, and explores some differences in sociodemographic and personal characteristics between these two groups. Face-to-face interviews were held with a random sample of 93 older persons in Beer-Sheva. Older persons with live-in home care workers were more satisfied with their home care service than those with live-out workers. Those with live-in workers were more severely disabled, tended not to have any children living in close proximity, although an adult child was available as an informal caregiver. Communication difficulties between the elderly persons and their home care workers were found not to affect negatively the satisfaction with the service.     

Environmental changes to increase physical activity: perceptions of older urban ethnic-minority women

Despite the numerous benefits of physical activity, older adults continue to be more sedentary than their younger counterparts, and sedentary behavior is more prevalent among older racial and ethnic minorities than among Whites. This study used the nominal group technique (NGT) to examine participants' perceptions of what neighborhood environmental changes would encourage greater physical activity for older African American and Hispanic women. Participants age 50-75 years were recruited from 2 urban community health clinics. Nine NGT sessions (45 participants) were conducted. The women were asked what changes in their neighborhood environment would encourage them to become more physically active. Responses to the research question were tabulated, and qualitative analysis was used to identify themes and categories. Major categories were physical environment changes, safety, and activities/social support. Although the physical environment received the greatest number of points, concerns for personal safety cut across categories. Participants indicated the need for more facilities in which to be active.     

Development and evaluation of the physical activity questionnaire for elderly Japanese: the Nakanojo study

The Physical Activity Questionnaire for Elderly Japanese (PAQ-EJ) is a self-administered physical activity questionnaire for elderly Japanese; the authors report here on its repeatability and direct and indirect validity. Reliability was assessed by repeat administration after 1 month. Direct validation was based on accelerometer data collected every 4 s for 1 month in 147 individuals age 65-85 years. Indirect validation against a 10-item Barthel index (activities of daily living [ADL]) was completed in 3,084 individuals age 65-99 years. The test-retest coefficient was high (r = .64-.71). Total and subtotal scores for lower (transportation, housework, and labor) and higher intensity activities (exercise/sports) were significantly correlated with step counts and durations of physical activity <3 and >or=3 METs (r = .41, .28, .53), respectively. Controlling for age and ADL, scores for transportation, exercise/sports, and labor were greater in men, but women performed more housework. Sex- and ADL- or age-adjusted PAQ-EJ scores were significantly lower in older and dependent people. PAQ-EJ repeatability and validity seem comparable to those of instruments used in Western epidemiological studies.     

Death by survey: Estimating adult mortality without selection bias from sibling survival data

The widely used methods for estimating adult mortality rates from sample survey responses about the survival of siblings, parents, spouses, and others depend crucially on an assumption that, as we demonstrate, does not hold in real data. We show that when this assumption is violated so that the mortality rate varies with sibship size, mortality estimates can be massively biased. By using insights from work on the statistical analysis of selection bias, survey weighting, and extrapolation problems, we propose a new and relatively simple method of recovering the mortality rate with both greatly reduced potential for bias and increased clarity about the source of necessary assumptions.