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An effectiveness analysis of the com...

Chalifoux, Zona Louise.

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An effectiveness analysis of the comparative impact of home-based versus clinic-based supervision in rural elders experiencing depressive symptomatology.

紀錄類型:	書目-語言資料,印刷品 : Monograph/item
正題名/作者:	An effectiveness analysis of the comparative impact of home-based versus clinic-based supervision in rural elders experiencing depressive symptomatology./
作者:	Chalifoux, Zona Louise.
面頁冊數:	249 p.
附註:	Adviser: Elizabeth Merwin.
Contained By:	Dissertation Abstracts International62-01B.
標題:	Health Sciences, Health Care Management. -
電子資源:	http://pqdd.sinica.edu.tw/twdaoapp/servlet/advanced?query=3000161
ISBN:	0493089284

An effectiveness analysis of the comparative impact of home-based versus clinic-based supervision in rural elders experiencing depressive symptomatology.
Chalifoux, Zona Louise.

An effectiveness analysis of the comparative impact of home-based versus clinic-based supervision in rural elders experiencing depressive symptomatology. - 249 p.

Adviser: Elizabeth Merwin.

Thesis (Ph.D.)--University of Virginia, 2001.

The value of the nurse case manager's role as a health educator, supportive advocate and coordinator of continuity in health care is widely accepted. Yet, the effectiveness of using this intensive form of client-professional relationship to achieve complex objectives, such as improving health status, and medication adherence while reducing health care utilization, has not been comprehensively explored and/or revealed in the literature. This project examined the comparative effectiveness, of (1) an in-home based comprehensive case management services provided by psychiatric nurse case managers versus (2) a clinic-based, medically managed program on rural elders' functional competence, adherence to prescribed medication regimes, responses to the impact/severity of health care problems (cognitive, affective and psychomotor) and utilization of health care services. More specifically, this study tested whether or not nurse case managers implementing direct services, in addition to the traditional case management services, in the home setting could positively influence health-related outcomes when compared with those receiving customary services provided by a community-based health clinic.

ISBN: 0493089284Subjects--Topical Terms:

1017922
Health Sciences, Health Care Management.

An effectiveness analysis of the comparative impact of home-based versus clinic-based supervision in rural elders experiencing depressive symptomatology.
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245 1 0 $a An effectiveness analysis of the comparative impact of home-based versus clinic-based supervision in rural elders experiencing depressive symptomatology.
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500 $a Source: Dissertation Abstracts International, Volume: 62-01, Section: B, page: 0158.
502 $a Thesis (Ph.D.)--University of Virginia, 2001.
520 $a The value of the nurse case manager's role as a health educator, supportive advocate and coordinator of continuity in health care is widely accepted. Yet, the effectiveness of using this intensive form of client-professional relationship to achieve complex objectives, such as improving health status, and medication adherence while reducing health care utilization, has not been comprehensively explored and/or revealed in the literature. This project examined the comparative effectiveness, of (1) an in-home based comprehensive case management services provided by psychiatric nurse case managers versus (2) a clinic-based, medically managed program on rural elders' functional competence, adherence to prescribed medication regimes, responses to the impact/severity of health care problems (cognitive, affective and psychomotor) and utilization of health care services. More specifically, this study tested whether or not nurse case managers implementing direct services, in addition to the traditional case management services, in the home setting could positively influence health-related outcomes when compared with those receiving customary services provided by a community-based health clinic.
520 $a This study focused on a high risk, relatively unstudied group, consisting of community dwelling rural elders who were greater than 60 years of age and experiencing depressive symptomatology. The sample consisted of twenty-one pairs of subjects matched on the criteria of age grouping, gender, race, living situation, and percentage of financial responsibility for self-payment of medications. A quasi-experimental, pretest/post test design was used. Each group was exposed to one type of health care service (in-home or clinic-based programs). The difference between the two groups was tested using the statistical procedures of Mann Whitney U, t-test, and analysis of covariance.
520 $a The in-home case management intervention significantly improved subjects adherence to all prescribed medications; while, also reducing depressive symptomatology. Although improvements in group mean scores for other health-related outcomes were noted in the case managed subjects, these were not significant at the p = .05 level.
520 $a The study was conducted in two health care agencies in the Piedmont region of central Virginia. The Jefferson Area Rural Elder Health Outreach Program, a W. K. Kellogg Foundation funded demonstration project, which provided case management services to five counties in central Virginia, contributed subjects and data for the in-home group. The second site, the clinic setting, was a federally supported community health center (CHC) staffed by physicians. It provided Medicare and Medicaid mandated health care services to one Central Virginia county immediately adjacent to the counties covered by in-home program.
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