Caregivers Of Inpatients Research Articles

Relationship of psychological resilience, acceptance and positive feelings of the caregivers of cancer patients

Objective To investigate the relationship of psychological resilience, acceptance and positive feelings of the caregivers of cancer patients, to improve the positive feelings and reduce caregiver burden of caregivers. Methods Totally 201 caregivers of cancer inpatients from a Beijing top three hospital were investigated with Connor-Davidson Resilience Scale (CD-RISC) , Acceptance and Action Questionnaire-2nd Edition (AAQ-II) , Positive Aspects of Caregiving (PAC) . Results The score of 201 caregivers on the CD-RISC was (71.18±14.79) , the score of AAQ-II was (16.14±8.57) , the score of PAC was (37.46±6.64) ; the relationship between the CD-RISC score and the AAQ-II score was negatively correlated (r=-0.381, P<0.01) , and the relationship between the AAQ-II score and the PAC score was negatively correlated (r=-0.175, P<0.05) , the CD-RISC score was closely related to the PAC score (r=0.367, P<0.01) . Conclusions Nurses should increase the psychological resilience and acceptance of caregivers, thus improve their positive feelings. Key words: Resilience, psychological; Cancer patients; Caregivers; Experiential avoidance; Positive feeling

The Practices and Meanings of Care for Nurses Working on a Pediatric Bone Marrow Transplant Unit.

Bone marrow transplant (BMT) units are stressful work environments with high staff burnout, anxiety, and turnover. A qualitative study was undertaken to better understand care for nurses within the context of their clinical practice on a pediatric BMT unit. Understanding care practices for BMT nurses will allow us to design interventions and provide appropriate support for this subspecialty of nurses. Focus groups were held with 24 nurses as key participants, and 2 focus groups with general participants: unit management (N = 2) and caregivers of inpatients (N = 7). Data were analyzed using a thematic analysis. Data were transcribed verbatim and coded to consensus by members of the research team. Five themes emerged from the data: ( a) experiencing stressful situations that impede care, ( b) growing and developing personally and professionally, ( c) providing trustworthy and respectful care, ( d) acquiring meaningful coping skills, and ( e) sharing with others versus isolation. Stress management, professional development, and interdisciplinary communication were areas that emerged for potential intervention.

Social support, self-efficacy and gender as predictors of reported stress among inpatient caregivers

The study examined the predictive role of social support, self-efficacy and gender on self-reported stress among inpatients’ caregivers. One hundred and sixty eight (36 males and 132 females) inpatients’ caregivers were sampled from University of Nigeria Teaching Hospital (97) and Niger Foundation Hospital (71) all in Enugu, Nigeria. Three instruments were used for the data collection, namely, Multidimensional Scale of Perceived Social Support (MSPSS), New General Self Efficacy Scale (NGSES), and the Perceived Stress Scale (PSS). The study adopted a cross sectional design and Multiple Regression was used for data analysis. Results showed that social support negatively predicted inpatient caregivers’ reported stress (β=−.28, p<.001). Gender significantly predicted stress among the inpatients’ caregivers (β=.35, p<.001). Findings were discussed and implications of the study highlighted.

Psychological distress and loneliness in caregiver of advanced oncological inpatients

The objective of this study is to compare and examine the relationships between levels of loneliness, anxiety, depression, and other variables on primary caregivers and cancer inpatients. The study involved 100 Turkish primary caregivers of inpatients with advanced or terminal stages of cancer. Loneliness and anxiety scores were significantly higher for the primary caregivers of inpatients with terminal stage of cancer than primary caregivers of inpatients with advanced stage of cancer. Excluding the cancer stage, loneliness and anxiety were primarily associated with the socio-demographic factors of primary caregivers rather than the characteristics of patients.

Nonviolent Resistance: Helping Caregivers Reduce Problematic Behaviors in Children and Adolescents.

In this review, the principles of nonviolent resistance (NVR) and studies examining its acceptability and efficacy are reviewed. Originating in the sociopolitical field, NVR has been adapted for numerous settings including parents of youth with externalizing and other problems, foster parents, teachers and school personnel, and caregivers of psychiatric inpatients. NVR has also been applied to reduce accommodation of highly dependent adult children and to improve novice driving habits. The principles of NVR include refraining from violence, reducing escalation, utilizing outside support, and maintaining respect for the other.

老年住院患者照护者伦理认知的现状调查

Objective: Through the survey of ethical cognitive situation of caregivers for the elderly inpatients, and the analysis of their ethical cognitive characteristics, this paper provides guidance to strengthen and improve the ethical management in hospital, in order to establish a good doctor-patient relationship. Methods: In this paper we design and adopt 10 questions to conduct an investigation of caregivers for elderly inpatients in Beijing Geriatric Hospital. Results: Through the analysis of survey results we come to the conclusion that the age of caregivers is generally elder, mainly among the 40-59 age group; and the education level is relatively lower – 17 of the informants (29.31%) are illiterate; 89.70% of caregivers are very clear of the importance of ethical censorships; most of the family members (51.80%) and caregivers (89.7%) think that doctors should not receive a red envelope (illegal cash from patients) and regard this behavior as a contrary to the medical ethics. Conclusion: Strengthening the team building of caregivers of elderly inpatients and the medical ethical management in hospital, improving the ethical training of medical workers, and establishing a good doctor-patient relationship are the things that we should do.

Psychiatric social work intervention program for “high expressed emotion” among the caregivers of persons with schizophrenia in India – a feasibility study

Introduction Schizophrenia is a severe mental illness that creates various psychosocial problems among family members. In addition, the family also contributes to psychosocial issues such as, expressed emotion. Expressed emotion (EE) has been found to predict relapse. Literature indicated that psychosocial interventions along with medicines would helps in mainstreaming the persons with illness. However, there is paucity of culturally sensitive interventions for EE in India. Methodology The objective of the study is to test the feasibility of cultural sensitive psychiatric social work intervention package to reduce expressed emotion among the caregivers of persons with schizophrenia in India. Ten caregivers of inpatients with schizophrenia from National Institute of Mental Health and Neurosciences, India, participated in the study. MINI 6.0 was used as screening tool. Socio-demographic profile collected. The Family Emotional Involvement and Criticism Scale was used to elicit the expressed emotion. A standardized 10 session spread over 10 days psychiatric social work package was given to the caregivers. Intervention package included methods of Social work and various techniques. Results and conclusion Mean score of family income (M=3200, SD=1.98), onset of illness (M=26.0, SD=6.56), illness duration (M=3.10, SD=1.41), duration of care giving (M=2.3, SD=1.56). Overall ill individual's perception of expressed emotion on their caregivers was found to be decreased in post-assessment (M=29.60, SD=2.9) when compared to the pre-assessment (M=50.0, SD=1.9). It was found to be statistically significant (0.000*= P

Informal Caregivers' Knowledge and Practice of Caring for Neutropenic Patients.

Cooperation of informal caregivers on neutropenic patient care is very important. This descriptive study includes interviews with 100 informal caregivers of inpatients who became neutropenic at least two days previously. Data were collected through face-to-face interviews on informal caregivers' knowledge and practice of caring for patients with neutropenia. The authors found that some rules, such as washing hands and attention to personal cleaning, were known and practiced; other rules, such as having a bath every other day, were less well known. At a Glance • Caregivers should be provided with regular training and standard education programs. • Informal caregivers should be observed when engaged in their routines to assess whether their practice is appropriate in neutropenic patient caring, and nurses should check whether or not their recommendations are being applied and ensure any deficiencies are addressed. • The verbal instruction provided by nurses for caregivers does not include enough information about care for neutropenic patients.

Brief Chinese version of the Family Experience Interview Schedule to assess caregiver burden of family members of individuals with mental disorders.

BackgroundCaregiver burden is an important issue that needs to be addressed when developing management programs for persons with chronic mental illnesses, but there is, as yet, no reliable way for assessing this in China.AimAssess the validity and reliability of a brief adapted Chinese version of the Family Experience Interview Schedule (FEIS) among caregivers of inpatients with mental disorders in China. MethodsWe first translated and back-translated the original 114-item FEIS and administered it to 606 primary caregivers of psychiatric inpatients. After excluding 9 items about sociodemographic variables and 9 items that over 15% of respondents were unable to answer, we conducted an exploratory factor analysis using a random half of the sample on the remaining 96 items and, based on the results of the factor analysis, selected the items to be included in the final shortened scale. Correlation analysis, confirmatory factor analysis, and internal consistency measures were used to assess the reliability and validity of the final scale using data from the second half of the sample.ResultsThe final scale included 28 items that loaded on five dimensions: (a) patients’ violent behavior; (b) patients’ suicidal tendency; (c) caregivers’ depression and anxiety; (d) disruption of caregivers’ daily routines; and (e) caregivers’ satisfaction with health services. These five dimensions explained 50.5% of the total variance. Confirmatory factor analysis found reasonable fit of this 5-factor model (χ2 /df=2.94, p<0.001, goodness-of-fit index [GFI]=0.85, comparative fit index [CFI]=0.85, root-mean-square error of approximation [RMSEA]=0.08). The correlation coefficients between each item and the corresponding factor were all above 0.5. The Cronbach α coefficient of the entire scale was 0.76 and that for the five dimensions varied between 0.71 and 0.84.ConclusionThe five dimensions of family burden assessed by the 28-item brief Chinese version of FEIS have good internal consistency and, thus, appear to assess valid dimensions of family burden in Chinese caregivers of persons with serious mental illnesses. Further work is needed to assess the test-retest reliability of this scale and its sensitivity to change over time.

Health management demands of primary caregivers of psychiatric inpatients after discharge

Objective To investigate the demand of health management of psychiatric patients primary caregivers after discharge, and to provide references for the health management of patients after discharge. Methods A self-designed questionnaire was used. One hundred and eighty two primary caregivers of patients to be discharged in psychiatric department were enrolled. Results 96.15% of caregivers had demands of health management for patients after discharge. In the content of management, the highest score was relapse prevention related knowledge (4.75±0.23), the lowest score was the vocational skills training (2.74±0.47). The highest demand of health management mode of patients after discharge from hospital was telephone follow-up, totally 158 caregivers (86.81%), followed by medical personnel on-site guidance, totally 139 caregivers (76.37%). In the management of frequency, most of the caregivers selected telephone and SMS follow-up once per half a month, or medical personnel on-site guidance once per two months; or designated medical expert consultants once per month. In the management period, 3 to 6 months after discharge was the mainly choice. Conclusions The main caregivers of patients after discharge from hospital has strong demand of health management. The hospital should establish reasonable health management service system according to the needs and wishes of patients, and carry out targeted content rich, diverse forms, a specific number of health management services, to improve the patient’s family function, promote the recovery of social function of patients, to reduce the relapse rate and disabled rate. Key words: Mentally ill persons; Discharge; Primary caregivers; Health management; Demand

The development and implementation of the structured training programme for caregivers of inpatients after stroke (TRACS) intervention: The London Stroke Carers Training Course

Objective: To describe the content and delivery of the adapted London Stroke Carers Training Course intervention evaluated in the Training Caregivers after Stroke (TRACS) trial. Setting: The London Stroke Carers Training Course is a structured training programme for caregivers of inpatients who are likely to return home after their stroke. The course was delivered by members of the multidisciplinary team while the patient was in the stroke unit with one recommended ‘follow through’ session after discharge home. Intervention: The intervention consists of 14 training components (six mandatory) that were identified as important knowledge/skills that caregivers would need to be able to care for the stroke patient after discharge home. Following national training days, the London Stroke Carers Training Course was disseminated to intervention sites by the cascade method of implementation. Results: The intervention was adapted for implementation across a range of stroke units. Training days were well attended (median 2.5 and 2.0 attendees per centre for the first and second days, respectively) and the feedback positive, demonstrating ‘face validity’ for the intervention. However cascading of this training to other members of the multidisciplinary team was not consistent, with 7/18 centres recording no cascade training. Conclusion: The adapted London Stroke Carers Training Course provided a training programme that could be delivered in a standardised, structured way in a variety of stroke unit settings throughout the UK. The intervention was well received by stroke unit staff, however, the cascade method of implementation was not as effective as we would have wished.

Extent of the Burden of Caregiving on Family Members of Neurosurgical Inpatients in a Tertiary Care Hospital in North India

Taking care of admitted patients has usually been as much a responsibility of family members as that of hospital staff in India, but caregiver burden in caregivers of admitted patients has seldom been explored. The current study attempts to understand the prevailing situation in terms of burden of caregiving, among caregivers of neurosurgical inpatients of a tertiary care hospital, through identification and quantification of the same. All dimensions of the expected impact were recognized and explored among family caregivers. This study followed a cross-sectional design and included adult caregivers of 100 neurosurgery inpatients from the neurosurgery ward of Post Graduate Institute of Medical Education and Research, Chandigarh. Both qualitative and quantitative data were collected and analyzed accordingly. Univariate analysis showed most caregivers to be male young adults. More than 70% were immediate family members of the patients. Severe disturbance in the lives of caregivers was observed through thematic analysis of qualitative data, although less than 20% accepted caregiving to be a burden on them. Ninety percent of respondents mentioned disturbed sleep patterns, and average Caregiver Strain Index scores came out to be 11.65, depicting the overall strain levels to be moderate. Burden of caregiving in caregivers of neurosurgery patients is a real problem, with deep-rooted causes and far-reaching potential consequences. Efforts need to be made to take stock of this issue, for the benefit of both neurosurgery patients and their caregivers.

A cluster randomised controlled trial and economic evaluation of a structured training programme for caregivers of inpatients after stroke: the TRACS trial

The majority of stroke patients are discharged home dependent on informal caregivers, usually family members, to provide assistance with activities of daily living (ADL), including bathing, dressing and toileting. Many caregivers feel unprepared for this role and this may have a detrimental effect on both the patient and caregiver. To evaluate whether or not a structured, competency-based training programme for caregivers [the London Stroke Carer Training Course (LSCTC)] improved physical and psychological outcomes for patients and their caregivers after disabling stroke, and to determine if such a training programme is cost-effective. A pragmatic, multicentre, cluster randomised controlled trial. Stratified randomisation of 36 stroke rehabilitation units (SRUs) to the intervention or control group by geographical region and quality of care. A total of 930 stroke patient and caregiver dyads were recruited. Patients were eligible if they had a confirmed diagnosis of stroke, were medically stable, were likely to return home with residual disability at the time of discharge and had a caregiver available, willing and able to provide support after discharge. The caregiver was defined as the main person--other than health, social or voluntary care provider--helping with ADL and/or advocating on behalf of the patient. The intervention (the LSCTC) comprised a number of caregiver training sessions and competency assessment delivered by SRU staff while the patient was in the SRU and one recommended follow-up session after discharge. The control group continued to provide usual care according to national guidelines. Recruitment was completed by independent researchers and participants were unaware of the SRUs' allocation. The primary outcomes were self-reported extended ADL for the patient and caregiver burden measured at 6 months after recruitment. Secondary outcomes included quality of life, mood and cost-effectiveness, with final follow-up at 12 months. No differences in primary outcomes were found between the groups at 6 months. Adjusted mean differences were -0.2 points [95% confidence interval (CI) -3.0 to 2.5 points; p = 0.866; intracluster correlation coefficient (ICC) = 0.027] for the patient Nottingham Extended Activities of Daily Living score and 0.5 points (95% CI -1.7 to 2.7 points; p = 0.660; ICC = 0.013) for the Caregiver Burden Scale. Furthermore, no differences were detected in any of the secondary outcomes. Intervention compliance varied across the units. Half of the participating centres had a compliance rating of > 60%. Analysis showed no evidence of higher levels of patient independence or lower levels of caregiver burden in the SRUs with better levels of intervention compliance. The economic evaluation suggests that from a patient and caregiver perspective, health and social care costs, societal costs and outcomes are similar for the intervention and control groups at 6 months, 12 months and over 1 year. We have conducted a robust multicentre, cluster randomised trial, demonstrating for the first time that this methodology is feasible in stroke rehabilitation research. There was no difference between the LSCTC and usual care with respect to improving stroke patients' recovery, reducing caregivers' burden, or improving other physical and psychological outcomes, nor was it cost-effective compared with usual care. Compliance with the intervention varied, but analysis indicated that a dose effect was unlikely. It is possible that the immediate post-stroke period may not be the ideal time for the delivery of structured training. The intervention approach might be more relevant if delivered after discharge by community-based teams. Current Controlled Trials ISRCTN49208824. This project was funded by the MRC and is managed by the NIHR (project number 09/800/10) on behalf of the MRC-NIHR partnership, and will be published in full in Health Technology Assessment; Vol. 17, No. 46. See the NIHR Journals Library website for further project information.

A structured training programme for caregivers of inpatients after stroke (TRACS): a cluster randomised controlled trial and cost-effectiveness analysis

Most patients who have had a stroke are dependent on informal caregivers for activities of daily living. The TRACS trial investigated a training programme for caregivers (the London Stroke Carers Training Course, LSCTC) on physical and psychological outcomes, including cost-effectiveness, for patients and caregivers after a disabling stroke. We undertook a pragmatic, multicentre, cluster randomised controlled trial with a parallel cost-effectiveness analysis. Stroke units were eligible if four of five criteria used to define a stroke unit were met, a substantial number of patients on the unit had a diagnosis of stroke, staff were able to deliver the LSCTC, and most patients were discharged to a permanent place of residence. Stroke units were randomly assigned to either LSCTC or usual care (control group), stratified by geographical region and quality of care, and using blocks of size 2. Patients with a diagnosis of stroke, likely to return home with residual disability and with a caregiver providing support were eligible. The primary outcome for patients was self-reported extended activities of daily living at 6 months, measured with the Nottingham Extended Activities of Daily Living (NEADL) scale. The primary outcome for caregivers was self-reported burden at 6 months, measured with the caregivers burden scale (CBS). We combined patient and caregiver costs with primary outcomes and quality-adjusted life-years (QALYs) to assess cost-effectiveness. This trial is registered with controlled-trials.com, number ISRCTN 49208824. We assessed 49 stroke units for eligibility, of which 36 were randomly assigned to either the intervention group or the control group. Between Feb 27, 2008, and Feb 9, 2010, 928 patient and caregiver dyads were registered, of which 450 were in the intervention group, and 478 in the control group. Patients' self-reported extended activities of daily living did not differ between groups at 6 months (adjusted mean NEADL score 27·4 in the intervention group versus 27·6 in the control group, difference -0·2 points [95% CI -3·0 to 2·5], p value=0·866, ICC=0·027). The caregiver burden scale did not differ between groups either (adjusted mean CBS 45·5 in the intervention group versus 45·0 in the control group, difference 0·5 points [95% CI -1·7 to 2·7], p value=0·660, ICC=0·013). Patient and caregiver costs were similar in both groups (length of the initial stroke admission and associated costs were £13,127 for the intervention group and £12,471 for the control group; adjusted mean difference £1243 [95% CI -1533 to 4019]; p value=0·380). Probabilities of cost-effectiveness based on QALYs were low. In a large scale, robust evaluation, results from this study have shown no differences between the LSCTC and usual care on any of the assessed outcomes. The immediate period after stroke might not be the ideal time to deliver structured caregiver training. Medical Research Council.

The status and influencing factors of sub-health in inpatient caregivers

Objective To explore the status and influencing factors of sub-health in inpatient caregivers. Methods A total of 432 caregivers met the inclusion criteria were enrolled.Suboptimal health status questionnaire (SHSQ-25) was used to evaluate the status of sub-health.Sub-health was defined as SHSQ-25 score ≥ 35.100 people undertaking routine physical examinations were enrolled as control group.The incidence and influencing factors of sub-health in caregivers were analyzed. Results (1) The caregivers group valued higher in SHSQ-25 score significantly (36.9±8.6 vs.27.5±13.0, P<0.05). The incidence of sub-health was obviously higher in caregiver group than that in control group (69.9% vs.39.0%, P<0.05). (2) A significant difference in the SHSQ-25 scores between female caregivers and male caregivers was observed (37.9±9.0 vs.34.6±7.1, P<0.05). The SHSQ-25 score was positively related with age (r=0.578, P<0.05) and accompanying time(r=0.507, P<0.05). Parents, children, or spouses of patients got higher scores than other types of caregivers(38.1±8.1 vs.31.1±8.8, P<0.05). (3) Among the sub-health caregivers, only 10.9% of them were aware of their sub-health status. Conclusion The incidence of sub-health may be higher in inpatient caregivers than the general population.Gender, age, accompanying time, and the relationship between patients and caregivers may be influencing factors for sub-health.Effective action should be taken to improve the health status of caregivers. Key words: Caregivers; Sub-health; Influencing factors

Effect of yoga therapy on anxiety and depressive symptoms and quality-of-life among caregivers of in-patients with neurological disorders at a tertiary care center in India: A randomized controlled trial

Context:The concerns of caregivers of patients with neurological disorders have been a felt need for a long time, with many of them experiencing significant psychiatric morbidity.Aims:This study aimed to find the effect of yoga in reducing anxiety and depression, as well as improving quality-of-life in caregivers of patients with neurological disorders.Settings and Design:The study was conducted using a randomized controlled design, with yoga intervention and waitlisted controls.Methodology:Sixty consenting caregivers of inpatients in neurology wards were randomized into two groups: Yoga and control. Demographic variables except years of education and length of caretaking were comparable in the two groups, as also baseline scores of anxiety, depression and quality-of-life. A specific yoga module comprising yogāsanas, prāṇāyāma, and chanting was taught to the participants in the yoga group by the researcher. At follow-up 43 patients (yoga n=20 and control group n=23) were available. Two-way repeated measures analysis of variance was used to test the change from pre-test to post-test scores within and between groups. Analysis of covariance was performed to compare the post-test scores between the groups adjusting for education and length of caretaking.Results:Following one month intervention of yoga therapy, there was a significant (P<0.001) decrease in anxiety and depression scores, as well as improved quality-of-life among the participants in the yoga group as compared with the control group.Conclusion:This study highlights the usefulness of a yoga intervention for caregivers of inpatients with neurological problems. The small sample size and lack of blinding were some of the limitations of this study.

Prädiktoren für die Belastung von Angehörigen Schizophreniekranker

Relatives of persons with schizophrenia have an essential role in informal caregiving. This may result in a high level of burden. Aim of the study was to investigate, if the frequency of unmet needs among relatives caring for schizophrenia patients increases the risk for burden among these relatives. 135 relatives of patients with schizophrenia or schizoaffective disorder were investigated by means of the "Involvement Evaluation Questionnaire" (IEQ) and the "Carer's Needs Assessment for Schizophrenia" (CNA-S). Multiple linear regression analyses showed positive associations between the frequency of caregivers' unmet needs and the IEQ-subscores "tension" and "worrying". Further, the IEQ-subscore "worrying" was significantly lower among caregivers of outpatients than among caregivers of inpatients or day hospital patients. The IEQ-subscore "urging" was significantly associated with patient's negative symptoms. Unmet needs among caring relatives have negative effects on their burden. Further, the patients' type of treatment setting (inpatient, outpatient, day hospital) seems to predict caregivers' burden.

Development and feasibility of need-based yoga program for family caregivers of in-patients with schizophrenia in India

Context and Aim:Yoga has been found to be effective in the management of stress. This paper describes the development of a yoga program aimed to reduce burden and improve coping of family caregivers of inpatients with schizophrenia in India.Materials and Methods:Based on the assessment of caregiver needs, literature review, and expert opinion, a ten-day group yoga program was initially developed using the qualitative inductive method of inquiry. Each day's program included warm-up exercises, yogic asanas, pranayama, and satsang. A structured questionnaire eliciting comments on each day's contents was given independently to ten experienced yoga professionals working in the field of health for validation. The final version of the program was pilot-tested on a group of six caregivers of in-patients with schizophrenia admitted at NIMHANS, Bangalore.Results:On the question of whether the program would help reduce the burden of caregivers, six of the ten experts (60%) gave a rank of four of five (very much useful). Based on comments of the experts, several changes were made to the program. In the pilot-testing stage, more than 60% of the caregivers assigned a score of four and above (on a five-point Likert scale, five being extremely useful) for the overall program, handouts distributed, and performance of the trainer. Qualitative feedback of the caregivers further endorsed the feasibility and usefulness of the program.Conclusion:The developed yoga program was found to be acceptable to caregivers of in-patients with schizophrenia.

Psychometric Evaluation of the Turkish Version of the Zarit Burden Interview in Family Caregivers of Inpatients in Medical and Surgical Clinics

The aim of this study was to adapt the Zarit Burden Interview (ZBI) to family caregivers of inpatients in medical and surgical clinics to assess the validity and reliability of the Turkish version. The study design was descriptive and methodological. A total of 223 family caregivers providing care to patients for at least 1 week in clinics were selected through convenience sampling. Data were collected using the Turkish translation of the ZBI. The psychometric testing of the adapted instrument was carried out to establish internal consistency, interitem correlation, and construct validity. The content validity procedure resulted in a final scale comprising 18 items. Cronbach's alpha was .82. Factor analysis yielded one factor. The Turkish version of the ZBI adapted to the clinics can be used as a one-factor tool.

A pilot study of the “Continuation of Care” model in “revolving-door” patients

PurposeThe efficiency of continuation of care (COC) treatment by inpatient caregivers as compared to treatment administered by outpatient services for “revolving door” psychiatric patients was tested in this study. Number and days of hospitalization were examined. MethodAll patients who were hospitalized three times or more during the past 12months were offered continuing follow-up in the ward, by the same staff, instead of being referred to the outpatient department. Information on number and length of hospitalizations before and after initiation of this care model was retrieved from the hospital computerized database. ResultsOf the 36 patients meeting the criteria, 35 patients agreed to participate. The number of hospitalizations in the 18months following the index hospitalization was 1.79±3.51 as compared to 4.67±1.79 before the index hospitalization (p=0.0002), and the number of days of hospitalization 18months after was 24±41.65 as compared to 119.71±69.31 before (p<0.0001). ConclusionCOC via inpatient follow-up significantly reduces the number and length of hospitalizations in “revolving door” psychiatric patients as compared to the traditional system of follow-up in an outpatient clinic.