Types Of Medical Conditions Research Articles

ELDERLY ADULTS' PREFERENCES FOR LIFE-SUSTAINING TREATMENTS: THE ROLE OF IMPAIRMENT, PROGNOSIS, AND PAIN

Elderly adults' preferences for life-sustaining treatment are known to vary by type of medical condition and treatment. Less is known about how treatment preferences vary based on underlying health dimensions, such as the nature of the impairment, prognostic information, and the experience of pain. Fifty elderly adults stated preferences for 4 life-sustaining treatments in response to 4 pairs of health state scenarios. Overall, life-sustaining treatments were preferred less in response to (a)cognitive versus physical impairment, (b) when the prognosis described no chance versus a very slight chance of recovery/improvement, and (c) if pain was present. These findings have implications for the way in which preferences for life-sustaining treatments are recorded in advance directives. Historically, advance directives have been limited by overly broad or overly specific statements about treatment preferences. Recording underlying health dimensions that guide treatment decisions may allow decision makers to generalize and apply patient preferences to novel health conditions.

Spinal cord injury hospitalisation in a rehabilitation hospital in Japan

The Kanagawa Rehabilitation Hospital was established by Kanagawa Prefecture 20 years ago. The hospital has a 40 bed SCI unit and has been providing comprehensive medical and rehabilitation services for SCI patients of this prefecture. A letter of enquiry to 404 major surgical units within this prefecture revealed that 630 SCI patients had been under care in this prefecture during a period of 3 years. Of these, the Frankel grade A, B and C patients, were assumed to be rehabilitation candidates, totalling about 130 in this prefecture per year. The inpatient medical record revealed that we treated 770 SCI patients from 1986 to 1991. From this data, we estimated that the hospital accepted an average of 54.5 SCI patients per year for rehabilitation purposes. Other inpatients were rehospitalised for various complications. According to the study of 125 patients who were hospitalised for comprehensive rehabilitation, they waited an average of 139 days and stayed in the hospital for 288 days. The increasing number of chronic patients who required treatment of complications appeared to be delaying the early admission of rehabilitation patients. The medical treatment cost for those with spinal cord injuries was less than that for the average patient with other types of medical conditions.

Medical Conditions, Level of Care Needs, and Health-Related Outcomes of Persons with Mental Retardation: A Review

A literature review was conducted to analyze existing data on health needs of people with mental retardation and possible barriers to integration in the community. Information was obtained on medical conditions, level of care needed, and health-related outcomes. The type and range of medical care, resources, and support services needed to maintain individuals with medical problems were identified, as were barriers to and recommendations for the provision of community-based medical care. Although there are barriers to the provision of services to people with mental retardation and allied medical conditions, there are people who currently live in the community who have the same type of medical conditions and who require the same level of care needed as those who live in institutions. Medical services are typically, but not always, available to persons with mental retardation who reside in the community. Availability and access to services are addressed. Recommendations for future research and policy implications are presented.